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Dermatology > Immunology > Flashcards

Immunology Flashcards

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Dermatology Board Prep flashcards
1
Q

What factors of the skin contribute to it as an immunological system?

A

Structure
Eg. keratin layer (stratum corneum), stratification

Immune system cells and keratinocytes

Cytokines, chemokines, eicosanoids, antimicrobial peptides

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2
Q

How can the innate immune system be described?

A

No memory

Non-specific

First line

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3
Q

How can the adaptive immune system be described?

A

Memory
Highly specific (Eg. antibodies)
Tolerance
Self-limiting

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4
Q

What is an antigen?

A

protein/peptide or polysaccharide that elicits an immune response

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5
Q

What are the jobs of keratinocytes in terms of the immune response?

A

Sense pathogens on cell surface receptors and mediate an immune response.

Produce antimicrobial peptides (AMPs) that can directly kill pathogens.

Produce cytokines and chemokines.

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6
Q

What type of immune cell are Langerhans cells?

A

Antigen presenting dendritic cell

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7
Q

What type of T cell is found in the epidermis?

A

CD8+ T cells

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8
Q

What type of T cell is found in the dermis?

A

CD4 + and CD8+ T

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9
Q

What subtype of CD4+ T cells give rise to the inflammation in Psoriasis?

A

TH1 (psoriasis)

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10
Q

What subtype of CD4+ T cells give rise to the inflammation in atopic dermatitis?

A

TH2 (atopic dermatitis)

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11
Q

What subtype of CD4+ T cells give rise to both psoriasis and atopic dermatitis?

A

TH17 (psoriasis and atopic dermatitis).

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12
Q

Describe the difference between CD8+T cells and CD4+T cells

A 
CD4 = helper T cells
CD8 = cytotoxic T cells
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13
Q

What types of dendritic cells are found in the dermis?

A

Dermal DC: involved in Ag presenting and secreting cyto/chemokines

Plasmacytoid DC (pDC): produce IFNα. Found in diseased skin

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14
Q

Name the preformed mediators often released from mast cells upon activation

A

Tryptase
chymase
TNF
histamine

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15
Q

What type of inflammatory mediators do mast cells have?

A 
Preformed
Newly synthesised (lots of these!)
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16
Q

What antibody triggers a mast cell response?

A

IgE

17
Q

What does MHC stand for?

A

Major Histocompatibility Complex

18
Q

Where is the DNA which codes MHC found?

A

Chromosome 6

19
Q

What is the difference between Class I and II MHC?

A

Class I:
Found on almost all cells
Present Ag to cytotoxic T cells
Present endogenous Ag

Class II:
Found on APC (B cells, macrophages)
Present to TH cells
Present exogenous Ag

20
Q

What are interleukins now being used for?

A

Targets of drug treatments

21
Q

Why will a skin biopsy of a psoriasis patch grow no bacteria when incubated?

A

The red patches are loaded with antibiotics (peptides we make ourselves)

22
Q

Why do people on antibiotics often experience fungal infection?

A

The antibiotics wipe out our own biofilm, therefore leaving a breading ground for other microbes to grow - eg. the fungus that causes thrush

23
Q

Where does psoriasis usually occur on the body?

A 
in areas of low grade trauma 
i.e. 
scalp - due to hair growing
extensor surfaces of elbows
lower back and buttocks - due to body weight resting on these
24
Q

Describe the immunopathogenesis of psoriasis

A

KC under stress

Chemical signals activate DC
these drain to lymph node to activate T cells

T cells are attracted to the dermis by chemokines and secrete IL-17A/17F/22

CD8+ cells also contribute to pathogenesis.

Dermal fibroblasts become involved, which release KC and epidermal growth factors.

25
Q

In what age group is atopic eczema most common?

A

Children

26
Q

What is the immunopathogenesis of atopic eczema?

A

Mutations in fillagrin gene associated with severe/early onset disease.

Fillagrin helps retain moisture => without it skin = DRY

↓AMP in skin

Immune response is then mounted to microbes from the biofilm

27
Q

What type of T cell links eczema to asthma and other allergic conditions?

A

TH2 cells

28
Q

Give 3 examples of autoimmune skin conditions

A

Psoriasis
Vitiligo
Systemic lupus erythematosus

29
Q

Give examples of things which could cause a Type 1 Hypersensitivity Reaction

A

Pollen (birch, oilseed rape)
Drugs (penicillin)
Food (nuts, eggs, seafood)
Insects/animals (bee sting, cat hair)

30
Q

What antibodies mediate type II and III hypersensitivity reactions?

A

IgG and IgM

31
Q

What can inflict a Type II or III hypersensitivity reaction?

A

Haemolytic disease of the newborn

Blood transfusion recipients

32
Q

What cell mediates a Type IV hypersensitivity reaction?

A

Tuberculin reaction
Contact allergy
Metals (nickel, chromate), drugs.

33
Q

When does a type IV hypersensitivity reaction peak?

A

Peaks at 24-48h after contact with Ag

34
Q

What factors affect the skins immune response?

A

Organ transplant (Immunosuppression)
Sunlight/UV (Immunosuppression / Structure)
Ageing

Dermatology (18 decks)

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