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Immunology Flashcards

1
Q

What is the bodies first line of defence?

A

Physical barriers - skin, mucous, commensal bacteria

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2
Q

What are cytokines?

A

Small proteins that can modify cellular behaviour (co-ordinate the immune system)

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3
Q

What is TNF-alpha?

A

A pro-inflammatory cytokine

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4
Q

What are antibodies and what produces them?

A

Produced by antigen activated B cells - are immunoglobulin proteins that are made specifically in response to an antigen

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5
Q

What are the roles of B and T cells?

A

B cells: secretion of antigens against extracellular pathogens
T cells:
Helper T cells (immune system regulators)
or
Cytotoxic T cells (kill virally infected body cells)

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6
Q

Which form of T cells are CD4 or CD8?

A 
CD4+T = Helper T cells
CD8+T = Cytotixic T cells
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7
Q

What is the purpose of natural killer cells (NK)?

A

To detect and kill tumour cells or virally infected cells

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8
Q

Which cells can undergo phagocytosis?

A

Monocytes, macrophages and neutrophils

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9
Q

What is the difference between monocytes and macrophages?

A

Monocytes - live in the blood

Macrophages - liver in tissues

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10
Q

Name the 3 granular cells and state their location/job

A 
Basophils + Eosinphils (circulate in the blood - recruited to sites of infection)
Mast cells (reside in tissues - degranulate to release histamine)
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11
Q

Name the primary and secondary lymphoid tissues

A

Primary: thymus + haemapoietic bone marrow
Secondary: spleen, lymph nodes, small/large intestine (peters patches in ileum of SI)

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12
Q

What are secondary lymphoid tissues?

A

Sites where T/B cells become activated by an antigen

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13
Q

Which of the following are part of the innate immune system and which are part of the adaptive?
Macrophages, neutrophils, complement proteins, acute inflammation, mast cells, NK cells, B cells (antibodies), T cells

A

Innate: macrophages, neutrophils, complement proteins, acute inflammation, mast cells, NK cells
Adaptive: B cells (antibodies), T cells

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14
Q

What is the response time for the innate and adaptive immune system?

A

Innate: mins-hours
Adaptive: days

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15
Q

What kind of cells communicate between the innate and adaptive immune system?

A

Dendritic cells

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16
Q

What are the 2 methods of communication in the immune system?

A 
Direct contact (receptor + ligand)
Cytokines
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17
Q

What kind of cells produce interferons?

A

Virally infected cells (interferon alpha/beta)

Interferon gamma: induced by stimulation of lymphocytes (increases activity of macrophages)

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18
Q

What is the difference between MHC class I and II?

A

Class I: on the surface of all cells - prevents self-attack (presents intracellular proteins)
Class II: on surface of antigen presenting cells (such as dendritic cells)

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19
Q

How does the innate immune system recognise pathogens?

A

PAMPS/PRR:
PAMP (pathogen associated molecular patterns) are expressed on the surface of pathogens
PRR (pattern recognition receptors) are expressed on the surface of dendritic cells and macrophages

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20
Q

What are inflammatory mediators?

A

Serotonin/histamine

Case vasodilation and increases vascular permeability

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21
Q

What is CRP used for?

A

Marker of inflammation

Activates complement system

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22
Q

What effect do reactive oxygen species have upon cells?

A

Are toxic - produced by neutrophils to kill cells

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23
Q

Where are complement proteins produced?

A

Liver

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24
Q

What is the key complement protein in activation of the complement cascade?

A

Cleaving of C3 to C3a and C3b

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25
What is opsonisation?
The coating of pathogens with opsonins to facilitate pathogensis (C3b, CRP, IgG/M)
26
How does the adaptive immune system recognise pathogens?
Antigens + antigen receptors
27
What are the 2 chains of an antibody?
Heavy and light chain (contain a variable region and a constant domain)
28
Where do adaptive immune responses occur?
Secondary lymphoid tissues
29
Where are dendritic cells activated and where do they mature to?
Immature in peripheral tissues, Phagocytes antigens, Mature + migrate to secondary lymphoid tissues to present antigens
30
How many signals do B and T cells need for activation and what are these?
2 T cells: MHC class II + another dendritic cell complex B cells: antigen/BCR + PAMP/PRR
31
What kind of cells can becomes memory cells?
B and T cells
32
What are plasma cells?
A fully differentiated B cell that produces a specific antibody
33
What are the 5 classes of immunoglobulins?
IgA, IgG, IgD, IgE, IgM
34
What is the first Ig type produced during an immune response?
IgM
35
Which Ig type is present as a pentamer?
IgM
36
Which is the most and second most abundant Ig classes?
Most abundant: IgG | Second most abundant: IgA
37
Which Ig class provides foetal immune protection and which provides neonatal defence?
Foetal immune protection: IgG - actively transported across placenta Neonatal defence: IgA
38
Which Ig classes act as B cell activators when membrane bound?
IgM (most common), IgD, IgA
39
What is the function of IgD?
Not fully understood - extremely low levels in blood
40
Which Ig class exists as a dimer?
IgA - dimer in all secretions except blood (monomer)
41
Which Ig type is present in mucosa?
IgA
42
What does IgE do?
Triggers allergic responses
43
What do T helper cells do?
Help stimulate other immune cells, | Increase the activity of other immune cells,
44
What is the function of cytotoxic T cells (CD8+T cells)?
To kill virally infected cells
45
What are the signs of immunodeficiency?
``` SPUR S- serious infections P-persistent infections U-unusual infections R- recurrent infections ```
46
What are the two types of immunodeficiency and which is more common?
Primary and secondary | Secondary = more common (acquired - can be caused by drugs etc)
47
What is Kostmann syndrome?
Blocked neutrophil development (primary immunodeficiency)
48
What is the definitive treatment for most primary immunodeficiencies?
Stem cell transplantation, gene therapy
49
Which MHC class do CD4 and CD8 cells recognise and respond to?
``` CD8 = MHC class I (don't kill these cells) CD4 = MHC class II (activate immune system to respond to presented pathogen) ```
50
What is SCID?
Severe combined immunodeficiency - failure in differentiation of the adaptive immune system after production of immune cells
51
What is DiGeorge syndrome?
Deletion on chromosome 22 (cleft palate etc) - have absent T cells (failure in thymus development)
52
What is hypersensitivity?
Overreaction of the immune system to a normal stimulus
53
What are the 4 types of hypersensitivity reactions?
Type I: immediate hypersensitivity (Allergic reactions) Type II: Direct cell killing Type III: Immune complex mediated Type IV: Delayed type hypersensitivity ``` 1 = Allergic reaction 2 = antiBody 3 = immune Complexes 4 = Delayed ```
54
What is allergic rhinitis more commonly known as?
Hayfever
55
Which antibody mediates allergic reactions?
IgE
56
What happens in the first and second exposure to an allergen?
First: B cells produce allergen-specific IgE antibodies which bind to mast cells Second: IgE antibodies remain in the bodies circulation bound to mast cells, causes degranulation of mast cells (histamine = vasodilation/vascular permeability) - increased immediate reaction to allergen
57
Which form of asthma is in response to an allergen?
Extrinsic asthma
58
Levels of what substance can be measured to identify recent anaphylaxis?
Tryptase (histamine peaks and falls too quickly to be measured)
59
What is an anti-mast cell agent and how is ti applied?
Sodium cromoglycate - topical spray
60
What receptor do anti-histamines act upon?
H1 receptor antagonists
61
Name and describe the action of a leukotriene receptor antagonist
Monteleukast: blocks the effects of leukotrienes which are produced by mast cells after activation
62
How do corticosteroids work?
Mimic the bodies natural steroids | Inhibits formation of different inflammatory mediators (cytokines etc)
63
How does adrenaline in anaphylaxis work?
Acts upon B2 receptors - constricts arterial smooth muscle (limits vascular leakage)
64
How does immunotherapy work?
Small amounts of exposure over time which build up to train the body not to react to an allergen
65
How does type II hypersensitivity reactions work?
Direct cell killing by binding of antigens to antibodies
66
What are immune complexes?
Antigen + antibody complexes
67
How is type II hypersensitivity treated?
Immunosuppression
68
Which antibody is associated with type II hypersensitivity?
IgG
69
What type of reaction is acute hypersensitivity pneumonitis?
Type III (immune complex mediated)
70
How does type III hypersensitivity work?
Antibody binds to soluble antigen precipitating it out of solution and causing it to become trapped in the vasculature
71
How is type III hypersensitivity treated?
Avoidance, Steroids (decrease inflammation) Immunosuppressant (decrease antibody production)
72
How does type IV hypersensitivity work?
Initial exposure to an antigen produces no response - however produces CD4 and memory T cells If exposed again, CD4 triggers immune system to activate macrophages => controlled by macrophages
73
What is autoimmunity?
The presence of immune responses against self-tissues
74
What do HLA genes code for?
MHC class I and II
75
In which population group and autoimmune diseases more common?
Women
76
What 3 factors contribute to auto-immunity?
Genes, Environment, Immune regulation
77
What is Goodpastures syndrome?
Autoimmune disease where antibodies attack the basement membranes in the kidneys and lungs
78
What are the clinical signs of lupus (Systemic lupus erythematosus)
Butterfly rash across nose Poor circulation in fingers and toes Loss of appetite Arthritis
79
Which autoimmune diseases are type IV hypersensitivity reactions?
Type 1 diabetes, Coeliac disease Rheumatoid arthritis
80
Describe the 4 types of hypersensitivity reaction?
Type I: (minutes) vasoactive molecules are released by mast cells and macrophages on exposure to antigen Type II: Antibody binds to host cell + kills it Type III: Antibody + soluble antigen form complex which gets stuck in vasculature and causes local inflammation Type IV: CD4 cells activated upon initial exposure, on further exposure CD4 cells activate macrophages
81
What kind of disease is coeliac?
Autoimmune
82
What is the gold standard for diagnosis of coeliac disease?
Biopsy
83
What is the principle behind vaccination?
Allows formation of memory to antigen response (by a small non-disease causing exposure to antigen)
84
What is the difference histologically between the different types of white blood cell?
Neutrophils - multi lobed nucleus Eosinophils - granules + bilobed nucleus Basophils - nucleus obscured by granules Macrophages - horseshoe shaped nucleus Lymphocytes - large nucleus covering most of the cell

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