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Immunology Flashcards

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1
Q

Described the electomagnetic spectrum from shortest wavelength to longest wavelength.

A

Radiowaves> microwaves > infared >visible> UV > xrays > gamma rays

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2
Q

IL1 is secreted by ___ and has ___ effects.

A

IL1 secreted by macrophages, b cells and keratinocytes.
Target(s): Endothelium
Effects: Fever (endogenous pyrogen), Inflammation, Increased Vascular Permeability by activating endothelium to express adhesion molecules; induces chemokine secretion to recruit leukocytes.

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3
Q

IL2 is secreted by ___ and has ___ effects.

A

IL2 secreted by T cells, causes T cell differentiation

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4
Q

IL3 is secreted by ___ and has ___ effects.

A

IL3 secreted by T cells, causes maturation of multple immature hematopoietic cell lineages

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5
Q

IL4 is secreted by ___ and has ___ effects.

A

IL4 secreted by Th2 cells, causes isotype switching to IgE

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6
Q

IL5 is secreted by ___ and has ___ effects.

A

IL5 secreted by Th2 cells, causes eosinophil activator, Increases IgA secretion

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7
Q

IL6 is secreted by ___ and has ___ effects.

A

IL6 secreted by T and B cells
Target(s): T-Cell, B-Cell
Effects: Endogenous pyrogen. Causes fever and stimulates production of acute phase proteins.

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8
Q

IL8 is secreted by ___ and has ___ effects.

A

IL8 secreted by macrophages.
Target(s): Neutrophil
Effects: Major chemotactic factor (“Clean up on aisle 8.” Neutrophils are recruited by IL-8 to clear infections)

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9
Q

IL10 is secreted by ___ and has ___ effects.

A

Secreted by Treg and macrophages.
Target(s): TH1
Effects: Down-regulates the expression of TH1 cytokines, MHC class II antigens, and costimulatory molecules.

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10
Q

IL12 is secreted by ___ and has ___ effects.

A

Secreted by Macrophages, dendritic cellls
Target(s): TH1, NK Cell
Effects: Induces T cell differentiation into TH1 cells. Increases IFN-gamma, TNF-alpha production.

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11
Q

TNF alpha secreted by ____ and has ____effects.

A

Secreted by macrophages. Targets endothelium and mediated septic shock.

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12
Q

IL 22 and 23 does what?

A

Promotes proliferation and differentiation of Th17 cells.

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13
Q

IFN-gamma secreted by ___ and has ___ effect.

A

IFN-gamma secreted by T-cells and NK cells. Causes macrophages activation, differentiation of Th1 cells and downregulation of Th2 pathway.

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14
Q

TLR2 is triggered by ___.

A

TLR2 is triggered by Lipopeptides from gram positive bacteria (p acnes). Bacterial lipopolysaccharides binding is dependent on TLR2.

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15
Q

TLR 3 is triggered by ___.

A

Viral ds RNA

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16
Q

TLR 5 is triggered by ___.

A

Bacterial flagellin

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17
Q

TLR 7 is triggered by ___.

A

Viral ssRNA and the synthetic ligand imiquimod

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18
Q

Classical complement pathway activated by ___. How does it work?

A

Ab-antigen complexes. It works by. C1q binds to Fc portion of the IgM and IgG (not IgG4). Activates C1r/c1s. C1s cleaves C4 and C2 forming C4b/C2a (C3 convertase). C3 convertase cleaves C3 into C3a and C3b. C3b joins wiht C4b2b to form C5 convertase

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19
Q

Alternative complement pathway activated by ___. How does it work?

A

Activated by LPS. Causes low level of C3 cleavage. C3b binds to bacterial cell surface structures and binds factor B. Factor B cleaved by factor d into Ba and Bb. Bb and C3b forms C3 convertase, which is stablized by properidin.

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20
Q

Lectin complement pathway activated by ___. How does it work?

A

Activated by mannose-binding lectin protein, a plasma protein that binds to cell’s surface polysaccharides. Causes cleavage of C4 and C2.

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21
Q

Anaphylactoxins

A

C3a and C5a

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22
Q

MAC subunits

A

C5b, C6, C7, C8, C9

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23
Q

B cell markers/receptors include:

A

CD19, CD20 and CD79a

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24
Q

What co-stimulatory molecules do T cells need on their APC?

A

CD28 binds to B7-1/B7-2 on APCs.
CD2 (LFA2) binds to LFA-3 (CD58) on APCs.
LFA1 bind to ICAM-1 on APCs.

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25
Q

LFA1 on what cell?

A

On T cell. Lymphocyte function-associated antigen 1 (LFA-1) is an integrin found on lymphocytes and other leukocytes.[1] LFA-1 plays a key role in emigration, which is the process by which leukocytes leave the bloodstream to enter the tissues. LFA-1 also mediates firm arrest of leukocytes.[2] Additionally, LFA-1 is involved in the process of cytotoxic T cell mediated killing as well as antibody mediated killing by granulocytes and monocytes

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26
Q

What is a leukocyte?

A

Neutrophils, eosinophils (acidophiles), basophils, lymphocytes, and monocytes

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27
Q

What inhibitory cell signaling occurs between T cells and APCs?

A

CTLA binds to B7-1 and B7-2 on APCs–> inhibition. Ipilimumab blocks CTLA4 allowing greater T cell activation.

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28
Q

T cells markers include:

A

CD2, CD3, CD4, CD8

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29
Q

What Ig activate complement?

A

IgM and IgG (except IgG4)

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30
Q

What is the only antibody that crosses the placenta?

A

IgG

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31
Q

Cell-mediated immunity is what TH response?

A

TH1. Delayed-type hypersensitivity reactions

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32
Q

Th1 differentiation requires stimulation by….

A

IL-12 and IFN gamma which activate the transcription factors T-bet, STAT1, STAT4

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33
Q

TH1 cells produce…

A

IFN-gamma (downregulated Th2), IL2, IL12, TNFalpha. Stimulate IgG2, IgG3

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34
Q

Humoral immunity is what TH response?

A

TH2

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35
Q

TH2 cells produce…

A

Produce IL4, IL5, IL6, IL10 (suppresses Th1) , IL13. Stimulate IgG4 and IgE class-switching

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36
Q

Th17 cells recruit what cells?

A

Recruit neutrophils that can destroy extracellular pathogens

37
Q

Th17 produce what interleukins?

A

IL6, IL17, IL22, IL23, IL36, TNFalpha

38
Q

Treg cells express what?

A

CD25 and transcription factor FOXP3

39
Q

How do CD8 cells kill?

A

Perforin enables granyme ot enter the cytoplasm of the target cell
Fas ligand on CD8 T cells binds Fas on target cell

40
Q

Diseases associated with TH1

A

MS, psoriasis, DM1, tuberculoid leprosy, cutaneous leishmaniasis, sarcoid, delayed-type hypersensitivity reactions and CTCL

41
Q

Diseases associated with TH2

A

Atopic dermatitis, helminthic infections, lepromatous leprosy, disseminated leishmaniasis, Sezary syndrome, scleroderma, systemic lupus

42
Q

Diseases associated with Th17

A

asthma, multiple sclerosis, psoriasis, RA, transplant rejection, and allergic contact dermatitis

43
Q

NK cell markers

A

CD2, CD56, CD16

44
Q

What do NK cells secrete?

A

IFNgamma which have the phagocytic capability of macrophages

45
Q

NK cells are activated by?

A

IL12, IL15, type 1 interferons

46
Q

Monocytes have what cell markers?

A

CD 11, CD6, Fc receptor for IgG, MHC2

47
Q

Eosinophilic granules contain what?

A

Major basic protein.

48
Q

Mast cells express?

A

C-kit receptor (CD 117), Stem cell factor (ligand), CD34, CD 13

49
Q

Preformed mast cell granules?

A

Histamine, Tryptase, heparin, chymase, cathepsin G, Carboxypeptidase

50
Q

Synthesized mast cell granules?

A

Prostaglandin D2, Leukotrienes C, D, E4, and Platelet-activating factor

51
Q

What cases mas cell degranulation?

A

Cross linking of FcRI-bound IgE, anti-FcRI antibodies, stem cell factor, neuropeptides (substance P), drugs (opiates, aspirin, vancomycin, curare, and polymyxin B), and radiocontrast media

52
Q

What do the primary granules in neutrophils contain?

A

defensins, myeloperoxidase, lysozyme, proteinase-3, cathelicidin, catheprsin B/D

53
Q

What do the secondary granules in neutrophils contain?

A

lactoferrin, lysozyme, alk phos, collagenase, phospholipase A

54
Q

What are langerhan cell markers?

A

CD1a, S100, Langerin (birbeck granules), vimentin.

55
Q

How do langerhan cells adhere to keratinocytes?

A

E-cadherins

56
Q

What chromosome is the MHC locus on?

A

Chromosome 6

57
Q

What cells express MHC1? What type of antigens?

A

All nucleated cells. Intracellular proteins (small proteins)

58
Q

What cells express MHC2? What type of antigens?

A

APCs. Extracellular antigens (large proteins)

59
Q

MHC associated with lupus?

A

HLA DR3

60
Q

MHC associated with psoriasis?

A

HLA CW6

61
Q

MHC associated with guttate psoriasis ?

A

HLA B17, B13

62
Q

MHC associated with psoriatic arthritis?

A

HLA B27

63
Q

MHC associated with behcets?

A

HLA B51

64
Q

MHC associated with Chronic idiopathic urticaria?

A

HLA DR4, DRB4, DQ8

65
Q

MHC associated with Pemphigoid gestationis?

A

HLA DR3, DR4

66
Q

MHC associated with Pemphigus vulgaris?

A

HLA DR4, DRw6

67
Q

MHC associated with DH?

A

HLA A1, B8,

DR3, DQ2

68
Q

MHC associated with Lichen planus?

A

HLA B57, B8,

DR1, and DR10

69
Q

MHC associated with Vitiligo?

A

HLA A33, B13

HLA B44, DRB1, DR4

70
Q

Thumb and 2,3rd fingers

A

Tuliposide,Lillies, garlic

71
Q

Dyhidrosis of hands

A

Systemic contact dermatitis to nickel

72
Q

Gloves

A

Thiuram

73
Q

Axillary vault

A

Lyral, fragrance

74
Q

Periaxillary skin

A

Formaldehyde disperse blue

75
Q

Seaquiterpene lactose

A

Chrysanthemums, rageeed,daisy, artichoke, sunflower, chamomile

76
Q

Balsam of Peru

A

Tupentine, colophony, vanilla, Cloves, cinnamon

77
Q

Cutaneous signs of group a strep

A

Perinatal, vulvovaginosis

78
Q

Griseofulvin reaction in kids

A

Facial rash. Use steroids. Continue to treat.

79
Q

Terbinafine interactiins

A

Doxepin, betablocker, tca

80
Q

Mino induced SLE

A

Anca

81
Q

What do you use imatinib?

A

Myeloproliferative hypereosinophilic syndrome

Fusion gene translocation. TK ACTIVATION

Eos>1.5 for >6months

DFSP

82
Q

25

A

Credit for EM WITH PROCEDURE

83
Q

24

A

Separate EM WITHIN GLOBAL PERIOD of procedure

84
Q

59

A

For cheaper of the procedures

85
Q

79

A

Separate procedure during surgery global period

86
Q

When does global period start?

A

Post op day 1

87
Q

Global periods 10day

A

Destruction, excision, simple to complex repairs

88
Q

Global period 90 days

A

Adjacent tissue transfer, graft

Basic Science (5 decks)

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