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phase 2 > Immunology > Flashcards

Immunology Flashcards

1
Q

What is a lysozyme

A

An anti microbial enzyme in some secretions, part of the innate immune system

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2
Q

Which stem cell progenitor is used for the innate immune system

A

Myeloid

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3
Q

Which stem cell progenitor is used for the adaptive immune system

A

Lymphoid

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4
Q

Neutrophil primary lysosomes

A

Combine with phagosomes to digest their contents, they contain myeloperoxidase, muramidase, acid hydrolases and defensins

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5
Q

Neutrophil secondary granules

A

Are secreted, they contain complement activators and enzymes eg lactoferrin and lysozyme

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6
Q

Which enzymes are needed for the respiratory bursts used for energy for phagocytosis in neutrophils

A

MPO and NADPH oxidase

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7
Q

What is used by macrophages for phagocytosis

A

Perioxidase lysosomes

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8
Q

What receptors do macrophages have

A

Fc, PRR toll-like and mannose receptors so can bind to all microbes

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9
Q

Macrophage in bone marrow/ blood

A

Monocyte

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10
Q

Macrophage in liver

A

Kupffer cell

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11
Q

Macrophage in lymph nodes

A

Sinus histiocytes

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12
Q

Macrophage in lungs

A

Alveolar macrophages

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13
Q

Macrophage in connective tissue

A

Tissue macrophages (histiocytes) leading to giant cells

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14
Q

Macrophage in skin and mucosa

A

Langerhans cells

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15
Q

Macrophage in CNS

A

Microglia

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16
Q

Macrophages in bone

A

Osteoclasts

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17
Q

Macrophages in granulomas

A

Epithelioid cells

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18
Q

Placenta macrophages

A

Hofbauer cells

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19
Q

Macrophages in kidney

A

Intraglomerular mesangial cells

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20
Q

Peyers patches macrophages

A

LysoMac 💪🏻

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21
Q

What type of leukocyte is a monocyte

A

Mononuclear

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22
Q

What type of leukocyte are basophils and eosinophils

A

Polymorphonuclear

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23
Q

Name a high affinity IgE receptor

A

FCER1 present on mast cells and basophils

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24
Q

What type of leukocyte and lymphocytes

A

Mononuclear

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25
Q

What is CD3

A

T cell receptor complex which activated t lymphocytes

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26
Q

What’s he difference between T helper 1 and T helper 2 cells

A

Th 1 helps immune response against intracellular pathogens. Th2 helps to produce antibodies against extra cellular pathogens

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27
Q

What surface markers are displayed by T regulatory cells

A

FoxP3 and CD4

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28
Q

Which surface marker is expressed by natural killer cells

A

CD56

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29
Q

What is complement

A

20 serum proteins, must be activated, involved in opsonisation and lysis of pathogens

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30
Q

Classical pathway of C3 convertase formation

A

Antibody-antigen complex, antibody binds antigen. This is adaptive

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31
Q

Alternative pathway of C3 convertase formation

A

Microorganism route, complement binds microbe

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32
Q

Lectin pathway of C3 convertase formation

A

Microorganism route, mannose binding lectin binds to microbe

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33
Q

What are C3a, C4a and C5a

A

Pro inflammatory mediators causing amplification, inflammation and cell recruitment

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34
Q

What does C5b activation lead to

A

Opsonisation and removal of immune complexes

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35
Q

What does C5b-9 activation do

A

Forms membrane attack complexes which insert into microorganisms causing cell lysis

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36
Q

Antibody definition

A

Protein produced in response to an antigen, it can only bind with the antigen which induced its formation (specificity)

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37
Q

Antigen

A

Molecule that reacts with preformed antibodies and specific receptors in T and B cells

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38
Q

Epitope

A

The part of the antigen that binds to the antibody/ receptor binding site

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39
Q

Affinity

A

Measure of the binding strength between an epitope and an antibody binding site

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40
Q

What does IgG1 do

A

Cleaves protein

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41
Q

What does IgG2 do

A

Cleaves carbohydrate

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42
Q

What does IgG3 do

A

Cleaves protein

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43
Q

What does IgG4 do

A

Associated with allergens. Only IgG not to activate complement.

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44
Q

3 main IgG functions

A

Activated complement, cleaves antigens and neutralises pathogens

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45
Q

What does IgM monomer do

A

Binds to B cell receptors

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46
Q

Describe IgM structure

A

Large pentamer held together by a J chain

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47
Q

What does IgD do

A

It is a transmembrane monomeric receptor on mature B lymphocytes

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48
Q

Cytokines

A

Proteins release by cells activated by antigens, invoked in cell to cell communications

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49
Q

Interleukins

A

Act between cells of the immune system

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50
Q

Chemokines

A

Induce chemotaxis of leukocytes

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51
Q

Interferons

A

Induce antiviral resistance in uninflected cells and therefore limit the spread of viral infection

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52
Q

Chemokine definition

A

Chemostatic cytokines which create a gradient to direct leukocytes and other cells from the blood to the site of infection

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53
Q

Extravasation

A

Leukocyte transendothelial migration

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54
Q

Inflammation definition

A

Series of reactions which bring cells and molecules of the immune system to sites or infection or damage

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55
Q

Acute inflammation

A

Complete elimination of a pathogen followed by resolution of damage, disappearance of leukocytes and full regeneration of tissue

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56
Q

Chronic inflammation

A

Persistent unresolved inflammation

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57
Q

What are the hallmarks of inflammation

A

Increased blood supply, increased vascular permeability and extravasation

58
Q

What senses microbes in the blood

A

Monocytes and neutrophils

59
Q

What senses microbes in the tissues

A

Macrophages and dendritic cells

60
Q

Which PAMP do scavenger PRR bind to

A

Lipid on foreign bacteria

61
Q

Which PAMP do toll like receptor (PRR) bind to

A

Foreign shapes e.g RNA

62
Q

Which PAMP do lectin PRR bind to

A

Sugars on foreign bacteria

63
Q

Why is opsonisation

A

Chemicals are modified to have stronger interactions with cell surface receptors, increasing attraction.

64
Q

What’s the sequence of extravasation

A

TNf release causes adhesion molecules to be released so endothelium becomes sticky. Neutrophils adhere then move up chemokine gradient into the cell.

65
Q

Name 3 acute phase proteins

A

C reactive protein, mannose binding lectin and surfactant protein A

66
Q

Name primary lymphoid tissues

A

Bone marrow and thymus

67
Q

Name secondary lymphoid tissues

A

Spleen, lymph nodes, mucosal associated lymphoid tissue (MALT)

68
Q

What codes for major histocompatability complex

A

Human leukocyte antigen genes

69
Q

What is neutropaenic sepsis

A

Where all neutrophils are removed, leading to sepsis. This can be a consequence of chemotherapy.

70
Q

Which structural similarities can be identified by PRRs

A

Gram stain, double stranded RNA, CpG motifs

71
Q

What are defensins

A

Eg Cathelicidin. They’re antimicrobial peptides secreted in lining fluids

72
Q

What are lectins and collectins

A

Eg. MBL and surfactant protein A and D. Carbohydrates containing proteins which bind to carbohydrates or lipid in cell walls to activate complement and improve phagocytosis

73
Q

What are petroxins

A

Eg. CRP they have antimicrobial actions

74
Q

What does TLR 2 look for

A

Bacterial gram positive cell walls

75
Q

What does TLR3 look for

A

Viruses

76
Q

What does TLR3 look for

A

Bacterial endotoxin

77
Q

What does TLR 7 look for

A

Viral RNA

78
Q

What does TLR 8 look for

A

Viral RNA

79
Q

What does TLR 9 look for

A

Bacterial DNA

80
Q

What do mannose receptors on macrophages identify

A

Fungi

81
Q

What do dectin-1 receptors on phagocytes identify

A

Beta glucans in fungal cell walls

82
Q

What do scavenger receptors in macrophages identify

A

Lipid on foreign bacteria

83
Q

What do nod like receptors identify

A

Peptidoglycans and break down products

84
Q

What do RLRs identify

A

Double stranded Viral RNA and DNA

85
Q

What did polly matzinger discover

A

Tissue damage products are hydrophobic and detected by TLRs

86
Q

Extracellular damage molecules

A

Fribrinogen, hyaluronic acid, tenascin C

87
Q

Intracellular damage products

A

MRNA, uric acud and heat shock proteins

88
Q

Which two public health interventions have had the greatest impact

A

Vaccines and clean water

89
Q

What is passive immunity

A

The transfer of preformed antibodies from one person to another

90
Q

Natural passive immunity provides protection against

A

Diphtheria. Tetanus. Poliovirus. Mumps. Rubella

91
Q

Artificial passive immunisation is used when

A

No time for immunisation, B cell defects, antivenoms and antitoxins, acute danger of infection and in vulnerable patients

92
Q

What do passive immunity antitoxins act against

A

Botulism, tetanus, diphtheria

93
Q

Which antivenins are given by passive immunity

A

Snake bites, insects, jelly fish

94
Q

Passive immunisation is used prophylactically against which infections

A

Hepatitis, measles, rabies

95
Q

What is somatic hypermutation

A

B cell receptors are diversified to recognise antigens and allows immune system to adapt its response to new threats

96
Q

Active immunisation definition

A

Manipulating the immune system to generate a persistent protective response against pathogens by safely mimicking natural infection

97
Q

Which diseases are treated with live attenuated pathogens

A

TB typhoid MMR

98
Q

Which diseases are treated with whole inactivated pathogen

A

Cholera, pertussis, plague, Hep A, influenza

99
Q

Subunit vaccines

A

Purified molecular components used as immunogenicity agents

100
Q

How do aluminium salts act as adjuvants

A

Form precipitates and potentiate opsonised phagocytosis

101
Q

How do chemicals act as adjuvants

A

Cause inflammation and irritation

102
Q

How do toxoids and killed organisms act as adjuvants

A

They trigger the immune system and send out danger signals

103
Q

What do NLRs do

A

The detect intercellular pathogens

104
Q

Which antibodies are involved in allergy

A

IgE, IgG4 and IgA

105
Q

Define allergy

A

abnormal response to harmless foreign material

106
Q

Define atopy

A

A tendency to develop allergies

107
Q

Define atopic individual

A

Someone who has an allergic response

108
Q

Does IgE fix complement or lead to a proinflammatory repsonse

A

No

109
Q

What is IgE half life

A

2.5 days

110
Q

What is IgG half life

A

23 days

111
Q

What is IgE serum concentration

A

0.3-100 microgram/ml

112
Q

What is IgG serum concentration

A

1000 microgram/ml

113
Q

Why is it hard to influence IgE binding pharmakinetically

A

As IgE binds to FCERI with a very high affinity

114
Q

What is CD23

A

FCER11, receptor which regulates IgE. Is a leukaemia marker

115
Q

What is a distinguishable feature of mast cells structure

A

ckit surface protein which is a receptor for stem cell factor. Needed for mast cell development in bone marrow

116
Q

What causes mast cell granule release

A

IgE crosslinking

117
Q

Which protein levels will be raised during anaphylaxis

A

Tryptase (protease from mast cells) and histamine

118
Q

What is anaphylaxis

A

An immediate response to allergic stimuli, it occurs within minutes unless it is contained within GI

119
Q

Which cytokines are involved in Th1

A

IL 2,10,12,18 and TNF-a

120
Q

Which cytokines are involved in Th2

A

IL 3,4,5,6,10 and GM-CSF

121
Q

What do the interleukins released from mast cells cause

A

Amplification

122
Q

What does GM-CSF release from mast cells cause

A

Macrophage and eosinophil activation

123
Q

What does Xolair/ omalizumab do

A

Blocks IgE binding via FCERI

124
Q

Define hypersensitivity

A

Excessive or innapropriate reaction to an environmental agent, often immunologically mediated

125
Q

Define autoimmunity

A

Abnormal state where the body’s immune system reacts against its own tissues or constituents

126
Q

What is anergy

A

Absence of a normal immune response, can be because there arent two signals to activate CD4 T cells. Like in immunological tolerance to self antigens.

127
Q

What is primary immunodeficiency

A

Caused by an inherent flaw in the immune system which increases the susceptibility of infections

128
Q

What is secondary immunodeficiency

A

Caused by an environmental factor which compromises the immune system

129
Q

What is a sentinal lymph node

A

The first lymph node draining a cancer, will be the hottest on PET scan

130
Q

Which cancers commonly spread to bone

A

Breast, prostate, lung, thyroid and kidney

131
Q

How big are slices of CT scan

A

1cm

132
Q

Define adjuvant therapy

A

extra treatment given after surgical excision

133
Q

What is the action of the vinblastine chemotherapy

A

Binds to mitotic spindles of dividing cells and stops them contracting, preventing replication - antimicrotubule agent

134
Q

What is the action of etoposide chemotherapy

A

Binds to topoisomerase II and prevents DNA replication

135
Q

What is the action of ifosamide chemotherapy

A

Cross links DNA and therefore inhibits DNA synthesis

136
Q

What is the action of cisplatin chemotherapy

A

Cross links DNA and therefore inhibits DNA synthesis

137
Q

What is myelosuppression

A

Where bone marrow activity is decreased

138
Q

Name some fast dividing tumours

A

germ cell tumours of the testes, leukaemias, lymphomas, embryonal paediatric tumours, choriocarcinomas (placenta cancer)

139
Q

How is her-2 identified

A

fluorescent in situ hybridisation and immunohistochemistry

140
Q

What are the disadvantages of monoclonal antibodies

A

They are expensive and have to be given by IV infusion and dont cross BBB so dont treat brain mets

phase 2 (17 decks)

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