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Step Review > Immunology > Flashcards

Immunology Flashcards

1
Q

CD14

A

It is a TLR present on macrophages that recognizes LPS

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2
Q

Activation of TLRs leads to what

A

Upregulation of NF-kappa B

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3
Q

Actions of prostaglandins

A

Vasodilation of arteriole
Increased vascular permeability
Fever and pain (PGE2)

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4
Q

Leukotrienes

A

Attract and activate neutrophils

Also mediate vasoconstriction, bronchospasm, and increase vascular permeability

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5
Q

What process allows for increased vascular permeability?

A

Contraction of endothelial pericytes

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6
Q

Activation of classic complement pathway

A

Binds an IgG or IgM that are bound to an antigen

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7
Q

Activation of the alternative complement pathway

A

Complement directly to microorganisms

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8
Q

Activation of lectin complement pathway

A

MBL binds mannose on microorganisms

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9
Q

C3a and C5a

A

Trigger mast cell degranulation

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10
Q

C5a

A

Chemotactic for neutrophils

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11
Q

C3b

A

Opsonin for phagocytosis

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12
Q

MAC (C5b-C9)

A

Lyses microbes by creating holes in cell membrane

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13
Q

Bradykinin actions

A

Pain, vasodilation, and increased vascular permeability

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14
Q

What leads to fever during acute inflammation?

A

Pyrogens –> macrophages to release IL1 and TNF –> increase COX activity in hypothalamus –> increased PGE2

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15
Q

Steps of neutrophil entry into tissue

A

Margination: vasodilation slows blood so neutrophils flow to the periphery
Rolling: SLX on neutrophils bind selectins which slow neutrophil movement
Adhesion: Integrins (CD18) on neutrophils bind ICAM 1 on endothelial cells
Transmigration (PECAM-1)
Chemotaxis (bacteria, leukotrienes, C5a, IL-8)

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16
Q

Leukocyte Adhesion Deficiency

A

Deficiency in CD18 (integrin)

Delayed separation of the umbilical cord, increased circulating neutrophils, recurrent bacterial infections

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17
Q

Chediak-Higashi Syndrome

A

Protein trafficking defect characterized by impaired phagolysosome formation

Increased pyogenic infections, neutropenia, giant granules in leukocytes, albinism, peripheral neuropathy

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18
Q

Chronic granulomatous disease

A

Defective NADPH oxidase –> poor O2 dependent killing

Granulomas are caused by catalase-positive organisms

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19
Q

Anti-inflammatory mediators

A

IL-10 and TGF-beta (secreted by macrophages)

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20
Q

IL-8

A

Released by macrophages to call more neutrophils to the site of inflammation

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21
Q

Di George Syndrome

A

Developmental failure of 3rd and 4th pharyngeal pouches due to 22q11 deletion

No thymus (T cell deficiency), hypocalcemia, abnormal heart/great vessels/face

22
Q

SCID causes

A 
Cytokine receptor defects
adenosine deaminase deficiency 
MHC class II deficiency
23
Q

X-linked agammaglobulinemia

A

Complete lack of immunoglobulin due to disordered B-cell maturation (BTK mut)

Susceptible to: bacterial, enterovirus, and giardia infections after 6 months of life

24
Q

Hyper IgM Disease

A

Due to mut in CD40 which means that class switching cannot occur

25
Q

Wiskott-Aldrich syndrome

A

Due to X-linked mut in WASP gene

Thrombocytopenia, Eczema, Recurrent infections

26
Q

Describe look of….
Neutrophils
Lymphocytes
Plasma Cells

A

Multi-lobular nucleus
One center nucleus
Nucleus off to side

27
Q

T cell receptor complex

A

MHC recetor + CD3

28
Q

T cell activation

A

Binding of MHC/antigen complex AND
B7 (APC) binds CD28 for CD4 T cells
IL-2 for CD8 T cells

29
Q

TH1 Cells

A

Secrete IL-2 –> activated CD8 cells

Secretes IFN-gamma –> activates macrophages

30
Q

TH2 Cells

A 
Secrete IL-4 --> class switching to IgG and IgE
IL-5 --> class switching to IgA, eosinophil chemotaxis, and maturation of B cells 
IL-10 --> inhibits TH1 cells
31
Q

Cytotoxic killing by CD8 T cells

A

Express FasL and binds Fas on target cells

Secrete perforins and granzymes –> apoptosis

32
Q

What is expressed on naive B cell surface

A

IgM and IgD

33
Q

B cell activation

A

Antigens can directly bind IgM or IgD on surface or

CD40 receptor on B cell binds CD40L on TH cells

34
Q

Causes of non-caseating granulomatous inflammation

A 
Reaction to foreign material 
Sarcoidosis
Beryllium exposure 
Crohn disease 
Cat scratch disease
35
Q

Causes of caseating granulomatous inflammation

A

TB

Fungal infections

36
Q

Granuloma formation

A

Macrophages present antigens to CD4 T cells

Macrophages –> IL-12 –> TH1 –> IFN-gamma –> converts macrophages to epithioid histiocytes and giant cells

37
Q

SLE

A

Autoimmune that can be Type II or Type III HSR
Malar rash, arthritis, heart issues, diffuse proliferative glomerulonephritis, anemia

ANA and anti-dsDNA

38
Q

Drug induced lupus

A

Hydralazine, procainamide, isoniazid

Antihistone antibody

39
Q

Anti-ribonucleoprotein antibodies

A

Anti-SS-A or Anti-SS-B

Sjogrens syndrome

40
Q

Anti-DNA topoisomerase I (Scl-70)

A

Generalized Scleroderma

41
Q

CREST syndrome antibody

A

Anti-centromere

Calcinosis, Raynaud, esophageal dysmotility, sclerodactyly, telangiectasias

42
Q

U1 ribonucleoprotein antibody

A

Mixed connective tissue disorders

43
Q

Macrophages release

A 
IL-1 --> endogenous pyrogen 
TNF-alpha --> vascular leak/septic shock 
IL-6 --> actute phase reactants
IL-8 -->  attracts neurtrophils
IL-12 --> promotes TH1
44
Q

Natural killer cells

A

CD16 –> binds Fc on IgG –> antibody dependent cellulary cytotoxicity
CD56 (NCAM)

45
Q

CD25

A

Regulatory T cells

46
Q

Graft vs Host Disease

A

Mostly with bone marrow transplant

Donated CD8 T cells react with recipient cells

47
Q

Joints affected in RA

A

MCP and PIP

They also get subcutaneous nodules when RF positive

48
Q

Large vessel vasculitis

A

Temporal arteritis (giant cell)
Jaw claudication, headache, –> blindness
High ESR and granulomas

Takayasu
Weak pulses in one arm a d high ESR
Granulomas in aortic arch and branches

49
Q

Medium vessel vasculitis

A

Kawasaki
Diffuse red rash, strawberry tongue, –> coronary aneurysms

Beurgers
Male smokers with gangrene

Polyarteritis Nodosa
Immune complex mediated w/ Hep B
Nodules, palpable purpura, and renal failure
Beads on a string, fibrinoid necrosis of vessels

50
Q

Small vessel vasculitis

A

Henoch-Schonlein purpura
Follows a URI in children (IgA + C3 deposition)
Palpable purpura, GI issues, nephritis

Churg-strauss
p-ANCA, asthma, sinusitis, neuropathy
Granulomatous necrotizing vasculitis

Microscopic polyangiitis
p-ANCA, hemoptysis, kidney failure, purpura

Wegerners
c-ANCA, sinusitis, otitis media, hemoptysis, renal
Granulomas

Step Review (17 decks)

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