Immunology Flashcards
1
Q
Where is the site of B-cell localization and maturation?
A
Follicle of lymph node
2
Q
Which part of the lymph node contains contain Reticular cells and Macrophages
A
Medulla
3
Q
The region of the cortex between follicles and medulla is called
A
Paracortex
4
Q
Where is T cells housed in the lymph node
A
Paracortex
5
Q
Lymphatic drainage for the head and neck
A
Cervical Lymph node
6
Q
Lymphatic drainage for the LUNGS
A
Hilar Lymph node
7
Q
Lymphatic drainage for the Trachea and esophagus
A
Mediastinal Lymph Node
8
Q
Lymphatic drainage for the Upper limb, breast, skin above umbilicus
A
Axillary Lymph node
9
Q
Lymphatic drainage for the Liver, stomach, spleen, pancreas, upper duodenum
A
Celiac Lymph node
10
Q
Lymphatic drainage for Lower duodenum, jejunum, ileum, colon to splenic flexure
A
Superior Mesenteric Lymph node
11
Q
Lymphatic drainage for Colon from splenic flexure to upper rectum
A
Inferior Mesenteric Lymph Node
12
Q
Lymphatic drainage for Lower rectum to anal canal (above pectinate line), bladder, vagina (middle third) cervix, prostate
A
Internal Iliac Lymph Node
13
Q
Lymphatic drainage for Testes, Ovaries, Kidneys, Uterus
A
Para-aortic Lymph Node
14
Q
Lymphatic drainage for Anal canal (below pectinate line), skin below umbilicus (except popliteal area), scrotum, vulva
A
Superficial Inguinal Lymph Node
15
Q
T and B-cell activation is through
A
APC (antigen presenting cells)
16
Q
What are the antigen presenting cells
A
B-cells, Dendritic cells, Langerhans cells, Macrophages
17
Q
Which cells require Two signals before they can be activated
A
T-cells, B-cells and Class switching
18
Q
Which SPECIALIZED APC cells sample antigens, processes antigens and migrates them to the draining lymph node
A
Dendritic Cells
19
Q
What is the 1st signal in T-cell activation?
A
- Antigen is presented on MHC II and recognized by
TCR on Th (CD4+) cells— ( exogenous synthesized) - Endogenous or cross-presented antigen is presented
on MHC I to Tc (CD8+) cell
20
Q
What is the 2nd signal in T-cell activation?
A
- Co-stimulatory signal via interaction of B7 protein on
dendritic cells (CD80/86) and CD28 on naive T cell.
** The cells activate and produce cytokines.
** Tc cells activate and is able to recognize and kill
virus-infected cells
21
Q
What is B-cell receptor-mediated endocytosis
A
Foreign antigen is presented on MHC II and recognized by TCR on Th cell
22
Q
Which receptor binds the CD40L on Th cell during B-cell receptor mediated endocytosis
A
CD40 receptor
23
Q
What happens in B-cell receptor endocytosis after the binding of CD40 and CD40L
A
Th cell secretes cytokines that determine Ig class switching of B-cell
24
Q
What determines the unique antigen-binding pocket
A
Fab region
25
What determines the Isotype (eg. IgM, IgD etc)
Fc region
26
Which cytokine when secreted causes 1. Fever, 2. acute inflammation, 3. activates endothelium to express adhesion molecules and 4. Induce chemokine secretion to recruit WBC's
Interleukin -1
27
Interleukin-6 causes
Fever and stimulate production of acute phase proteins
28
Cytokine for Major Chemotactic factor for neutrophils
Interleukin-8
29
Interleukin-12
1. Induces differentiation of T cells into Th1 cells and
| 2. Activates NK cells
30
What does Tumor necrosis factor-alpha do
1. Activates endothelium 2. Causes WBC recruitment
| 3. Vascular leak
31
Which cytokines are secreted by T-cell
1. Interleukin-2 and 2. Interleukin-3
32
Cytokine for Stimulating GROWTH of 1. Helper,
| 2. Cytotoxic and 3. Regulatory T cells and 4. NK cells
Interleukin-2
33
Interleukin-3 secretion is for
Supporting growth and differentiation of bone marrow stem cells. Function like GM-CSF
34
What are the components of innate immunity?
1. Neutrophils
2. Macrophages
3. Dendritic Cells
4. Natural Killer Cells (NK) - lymphoid origin
5. Complement
35
How does innate immunity respond to pathogens?
1. Nonspecific
2. Rapid response (Minutes --> Hours)
3. No memory response
36
What are the secreted proteins associated with innate immunity?
1. Lysozyme
2. Complement
3. C-reactive protein (CRP)
4. Defensins
37
What are the components of adaptive immunity?
1. T cells
2. B cells
3. Circulating antibodies
38
How does adaptive immunity respond to pathogens?
1. Highly specific
2. Refined over time
3. Develops over long periods
4. Memory response that is faster and more robust
39
What are the secreted proteins associated with the adaptive immune response?
Immunoglobulins (Ig)
40
What cytokine is secreted by NK cells and T cells in response to antigen or IL-2 from macrohages
Interferon-gamma
41
Which cytokine stimulates macrophages to kill phagocytosed pathogens and inhibit differentiation of Th2 cells
Interferon-gamma
42
Cytokine that 1. Activates NK cells to kill virus-infected cells and 2. Increases MHC expression and antigen presentation by all cells
Interferon-gamma
43
Which cytokines is produced from Th2 cells
Interleukin-4, Interleukin-5 and Interleukin-10
44
Function of interleukin-4
1. Induces differentiation of T cells into Th2 cells
2. Promote growth of B cells
3. Enhances class switching to IgE and IgG
45
Function of Interleukin-5
1. Promote growth and differentiation of B cells
2. Enhance class switching to IgA
3. Stimulate growth and differentiation of Eosinophils
46
Function of Interleukin-10
1. Attenuates inflammatory response
2. Decreases expression of MHC class II and Th1
cytokines
3. Inhibits activated macrophages and dendritic cells
47
Which cytokines ATTENUATE immune response
TGF-beta and Interleukin-10
48
Which enzyme place a role in the creation and neutralization of reactive oxygen species
NADPH oxidase
49
NADPH oxidase deficiency
Chronic granulomatous disease
50
Which enzyme has the blue green heme containing pigment that gives sputum its color
Myeloperoxidase
51
Which enzyme converts O2- to H2O2
Superoxide dismutase
52
What condition are patients with Chronic granulomatous disease at risk of
Increased risk of infection with
| (catalase +) species. { staph aureus, Aspergillus)
53
Why are patients with chronic granulomatous disease at an increased risk with catalase + species
They are capable of neutralizing their own H2O2
54
What does Pseudomonas aeruginosa use to generate reactive oxygen species (ROS) to kill competing microbes
Pyocyanin
55
What are the major functions of T cells?
1. Cell mediated immunity
2. CD8+ T cells directly kills virus infected cells
3. CD4+ T cells help B cells help B cells make Ab and produce cytokines
4. Assoc with delayed cell mediated hypersensitivity (IV)
5. Assoc with chronic cellular organ rejection
56
Which interferons are synthesized by virus-infected cells that act locally on UNinfected cells to prime them for viral defens by helping degrade viral nucleic acid and protein
Interferon alpha and interferon-beta
57
Where are T cells located in the spleen?
Periarteriolar lymphatic sheath (PALS) in the white pulp
58
Where B cells found in the spleen?
Follicles within the white pulp
59
What is positive selection?
Ability for TCR of T cells to survive the binding to self MHC on cortical epithelial cells
60
What is negative selection?
T cells expressing TCR with high affinity for self Ag undergo apoptosis
61
What should pts undergoing splenectomy or are asplenic or SS pts be vaccinated against?
encapsulated organisms:
1. HiB
2 Pneumococcus
3. Menningococcus
62
Where do antigen presenting cells (APC) capture blood-borne antigens for recognition by lymphocytes
Marginal zone
63
Where are B cells found
Follicles within white pulp
64
Where are T cells found
Periarteriolar lymphatic sheath (PALS)
65
What happens in splenic dysfunction (eg. sickle cell disease, post-splenectomy)
decrease IgM---> decrease complement activation---> decrease C3b opsonization---> increase susceptibility to encapsulated organisms
66
What infection should a patient be vaccinated against before undergoing splenectomy
pneumococcal, Hib, meningococcal)
67
Which pharyngeal pouch is the thymus derived from
Third pouch
68
The thymus is hypoplastic in which condition
DiGeorge and SCID
69
The thymus is derived from which pharygeal pouch?
3rd pharyngeal pouch
70
What does the cortex of the thymus contain?
Immature T cells
71
What does the medulla of the thymus contain?
```
Mature T cells
Hassal corpuscles (contain epithelial reticular cells)
```
72
What is a thymoma?
Benign neoplasm of the thymus
73
What dz is associated with thymoma?
1. Myasthenia Gravis
| 2. Superior Vena Cava syndrome
74
What is superior vena cava syndrome?
Obstruction of the superior vena cava ---> impaired blood drainage from the head, inc. ICP
75
What dz are associated with hypoplastic thymus?
1. SCID
| 2. DiGeorge syndrome
76
What cytokines enhances the activity of Natural Killer cells?
IL-2, IL-12, IFN-alpha, IFN-beta
77
What is the MOA of Natural Killer cells?
Use perforin and granzyme to induce apoptosis of virally infected cells and tumor cells
78
What are the major functions of B cells?
1. Humoral immunity
2. Recognize Ag
3. Produce Ab
4. Maintain immunological memory
79
What are the major functions of T cells?
1. Cell mediated immunity
| 2.
80
What is the general function of cytokines?
Recruit phagocytes and produce cytokines
81
Where does positive selection of T cell occur?
Cortex of thymus
82
Where does negative selection of T cell occur?
Medulla of thymus
83
Why is tissue specific Ag expressed in the thymus?
d/t action of (AIRE) autoimmune regulator
84
What is the cause of autoimmune polyendocrine syndrome-1
Deficiency in AIRE
85
What does T helper cell differentiate into?
Th1, Th2, Th17 and T-reg
86
What Ig are expressed on the surface of mature, naive B cells prior to their activation?
IgM and IgD
87
Where do B cells differentiate?
In germinal center of the lymph node
88
What do B cells class switch to?
Plasma cells that secrete IgA, IgE or IgG
89
What the functions of IgE?
1. Bind mast cells and basophils
2. Mediate type I hypersensitivity
3. Release inflammatory mediators eg: histamine
4. Activate eosinophils (immune response to worms)
90
Where is IgD found?
In serum and on the surface of B cells
91
What is the function of MHC
Present antigen fragments to T cells and bind T cell receptor and are coded by HLA genes
92
What is the Loci of MHC I
HLA-A, HLA-B, HLA-C
93
MHC I binds to which components
TCR and CD8
94
MHC II binds to which components
TCR and CD4
95
Where are MHC I expressed
All Nucleated cells, APCs, Platelets but Not RBC
96
Where are MHC II expressed
APCs
97
What is the structure of MHC I
1 long chain and 1 short chain
98
The structure of MHC II
2 equal length chain
99
What are the loci of MHC II
HLA-DP, HLA-DQ, HLA-DR
100
Which MHC class present ENDOGENOUSLY synthesized ANTIGENS (eg. viral or cytosolic proteins) to CD8+ cytotoxic T cells
MHC I
101
EXOGENOUSLY synthesized ANTIGENS (eg. bacterial proteins) are presented to CD4+ helper T cell by
MHC II
102
Which protein is associated to MHC I
Beta2-microglobulin
103
Invariant Chain is associated to which class of MHC
MHC II
104
Hemochromatosis is associated to which subtype of HLA
HLA-A3
105
HLA - B8 is associated to which conditions
Add Mye Graves Bi8/ B8 is GAMe
1. Addison disease------ Add
2. Myasthenia Gravis--- Mye
3. Graves disease------- Graves
106
HLA - B27 is associated to which conditions
PAIR of B27 bombers/ Seronegative PAIR
1. Psoriatic arthritis
2. Ankylosing spondylitis
3. IBD-associated arthritis
4. Reactive arthritis
107
Which HLA subtype is associated with Celiac disease
```
I ate (8) too (2) much gluten at DQ
HLA-DQ2/ HLA-DQ8
```
108
HLA-DR2 is associated to which disease
2 GLAM to give a damn!/ Hey MSG
1. Multiple sclerosis
2. Hay fever (Allergic Rhinitis)
3. SLE (Lupus)
4. Goodpasture syndrome
109
Which two HLA subtypes are associated to SLE
HLA-DR2 and HLA-DR3
110
Diabetes mellitus type -1, Graves disease, Hashimoto thyroiditis, Addison disease and SLE are associated to which HLA subtype
HLA-DR3
111
HLA-DR4 is associated with which diseases
There are 4 walls in a Rheum (room)
1. Rheumatoid arthritis
2. Diabetes mellitus type 1
3. Addison disease
112
Hashimoto thyroiditis, Pernicious anemia-----> vitamin B12 deficiency is associated to which HLA subtype
HLA-DR5
| Hush Puppies
