immunology Flashcards
1
Q
site of B cell localization and proliferation
A
Lymph node follicle
2
Q
active follicles
A
secondary
3
Q
contain reticular cells and macrophages
A
lymph node medulla
4
Q
houses T cells
A
lymph node paracortex
5
Q
not well developed in Di George
A
lymph node paracortex
6
Q
lymph drainage of upper limb and lateral breast
A
axillary
7
Q
lymph drainage of stomach
A
celiac
8
Q
lymph drainage of duodenum, jejunum
A
superior mesenteric
9
Q
lymph drainage of sigmoid colon
A
colic –> inferior mesentaric
10
Q
lymph drainage of rectum
A
internal iliac
11
Q
lymph drainage of anus
A
superficial inguinal
12
Q
lymph drainage of testes
A
superficial and deep plexuses –> paraaortic
13
Q
lymph drainage of scrotum
A
superficial inginal
14
Q
lymph drainage of thigh (superficial)
A
superficial inguinal
15
Q
drained by right lymphatic duct
A
right upper quadrant - including right side of head
16
Q
T cells found in ___ of spleen
A
periarterial lymphatic sheath
17
Q
B cells found in ____ of spleen
A
follicles in the white pulp of spleen
18
Q
macrophages in spleen remove
A
encapsulated bacteria
19
Q
immune issues in splenic dysfunction
A
low IgM–> lower complement activation –> low C3b opsonization
20
Q
encapsulated bugs a problem in spenic dysfunction
A
strep p HiB neissera meningitis salmonella Klebsiella Group B Strep
21
Q
function of thymus
A
positive selection of T cells (cortex) negative selection (medulla)
22
Q
neutrophils, macrophages, NK cells, and complement mediate
A
innate immunity
23
Q
T cells, B cells and circulating antibody mediate
A
adaptive immunity
24
Q
MHC I and II
A
encoded by HLA genes and present antigen fragments to T cells. Bind TCR
25
encoded by HLA A,B,C
MHC I
26
binds CD8
MHC I
27
mediates viral immunity
MHC I
28
antigen is loaded in RER
MHC I
29
encoded by HLA DR,DP, DQ
MHC II
30
binds CD4
MHC II
31
expressed only on antigen-presenting cells
MHC II
32
HLA-A3 disease
hemochromatosis
33
HLA-B27
Psorisis, ankylosing spondy, inflammatory bowel disease, reiter's
34
HLA-DQ2/8
celiac
35
HLA-DR3
DM1, graves disease
36
HLA-DR4
RA, DM1
37
HLA-DR5
pernicous anemia, hashimoto's thyroitis
38
enhance NK activity
IL-2/12 IFN-B/a
39
NK cell MOA
use perfornin and granzymes to induce apoptosis
40
NK cells attack
viral infected cells and tumor cells
41
induces NK cells to kill
exposure to nonspecific activation signal on target cell or to absence of class I target cell surface
42
good B cell function
```
make antibody
opsonize bacteria
neutalize viruses (IgG)
activate complement (IgM, IgG)
sensitive mast cells (IgE)
```
43
bad B cell functions
```
allergy (type 1 hypersensitivity)
cytotoxic (type II hypersensitivity)
immune complex (type III hypersensitivity)
hyperacute and humorally mediated acute and chronic organ rejection
```
44
good T cell functions
CD4: help B cells make antibody and produce cytokines to ackivate other immune cells
CD8: kill virus-infected cells directly
45
bad T cell functions
delayed cell-mediated hypersensitivity (IV)
| acture and chronuc cellular organ rejection
46
positive selection makes ____ cells survive
TCRs capable of binding surface self MHC
47
negative selection makes ___ cells DIE
TCRs with high affinity for self antigens
48
activates T cells
dendritic cells
macrophages
B cells
49
only APC that can activate naive T cell
dendritic
50
costimulatory signal activating naive T cells
B7 (on dendritic) and CD28 (on T cell)
51
receptor on B cell that binds to Th cell
CD40
52
secretes cytokines to determine class switching of B cells
T helper cell (CD4)
53
Th1 cell secretes
IFN-gamma
54
activates macrophages
Th1
55
inhibits Th1 cells
IL-4 and IL-10
56
secretes IL-4/IL-10
Th2
57
express CD4
Th1
58
Th2 cells secrete
IL-4/5/10/13
59
recruits eosinophils
Th2
60
inhibited by IFN-g
Th2
61
kills virus inducedm neoplastic and donor graft cells
cytotoxic T cells
62
MOA of
perforin and granzyme
63
cytotoxic cells express
CD8
64
express MHC 1
virus infected cell
65
express MHC II
B cells
66
supress CD4 and CD8 cells
regulatory T cells
67
express CD3/4/25
regulatory T cells
68
priduce IL-10 and TGF-B
regulatory T cells
69
function of IL-10 and TGF-B
antiinflamatory
70
"arms" of the antibody
Fab segment
71
"Tail" of the antibody
Fc segment
72
antigen binding fragment
Fab (VH/L)
73
determins indiotype
Fab
74
binds complement
Fc (CH2)
75
determins isotype
Fc
76
antibody promotes phagocytosis
opsinization
77
antibody promotes bacterial adherance
neutralization
78
enhaces lysis
membrane attack complex
79
generates antibody diversity
random recombination of VJ (light chain) and VDJ (heavy chain) genes
80
antibody toes that bind complement
IgG and IgM
81
IgG functions
fixes complement
crosses placenta
opsonizes bacteria
neutralizes bacterial toxins and viruses
82
main antibidy in delayed response to antigen
IgG
83
IgA function
prevents attachment of bacteria dn viruses to mucous membranes
found in secretions and colostrum
84
IgM function
produced in immediate response to atigen
fixes complement
antigen receptor on surace of B cells
shape of pentamer
85
IgE function
binds mast cells and basophils
cross-links when exposed to allergen
mediates type 1 hypersensitivity through relese of histamine
mediates immunity to worms by activating eosinophils
86
mediates classic complement pathway
IgG/IgM
87
mediates alternative complement pathway
microbe surface molecules
88
mediates anaphylaxis
C3a, C5a
89
activates neutrophil chemotaxis
C5a
90
activates MAC
C5b-9
91
mediates opsonins
C3b and IgG
92
inhibits complment from actiaving on self cells
Deleay accelrating factor (DAF)
| C1
93
C1 esterase deficiency leads to
heriditary angioedema (contraindicates ACE inhibitor)
94
C3 deficiency leads tro
severe, recurrent pyogenic sinus and respiratory tract infections. higher susceptibility to type III hypersensitivty reactions
95
C5-C9 deficicncy leads to
recurrent neisseria bacteramia
96
DAF defiecny leads to
complement medated RBC lysis and paroxysmal nocturnal hemoglobinria
97
IL-1 function
FEVER, actute inflamation, a
98
IL-2 function
stimulates T cells
99
IL-3 dunction
stimulates bone marrow
100
IL-4 function
stmulates IgE function
101
IL-5 dunction
stimulates IgA function
102
Il-6 function
fever and production of acute-phase proteins
103
IL-8 function
major chemotactic factor for neutrophils (clean-up on aILse 8)
104
Il-12 function
differentates T cells into Th1 cells, activates NK cells, (also secreted by B cells)
105
TNF-alpha function
mediates septic shock, activates endothelim, vascular leack
106
secreted by macrophages
IL 1/6/8/12 tnf-alpha
107
secreted by all T cells
IL-2/3
108
secreted by Th1 cells
interferon gamma
109
function of interferon gamma
activates macrophages and Th1 cells, supreses Th2 cells, has antiviral/antitumor properties
110
secreted by Th2 cells
IL-4/5/10
111
function of IL-10
modulates inflammatory cells, regulator function
112
inhibit viral protein synthesis
interferon A and B
113
increase MHC I/II espxression and antigen presentation in all cells
interferon gamma
114
all cells (except RBC) express
MHC 1
115
T cells express
TCR, CD3, CD28
116
helper T cells express
CD4, CD40 ligand
117
cytotoxic T clls express
CD8
118
B cells express
Ig, Cd19, CD20, CD21, CD40, MHCII, B7
119
macrophages expressC
CD14, Cd40, MHCII, B7, Fc and C3b receptors
120
NK cells express
CD16, CD56
121
unique marker for NK
CD56
122
binds Fc of IgG
CD16
123
anergy
self-reactive T cells become nonreative without constimulatory molecule
124
effect of superantigens
cross-like the B region of the T cell receptor to the MHC II class II on APC. Can activate any T cells - leads to cytokine stomr
125
release superantigens
staph A, S pyogenes
126
undergo antigen variation
salmonella, borrelia (relapsing fever), neisseria gonorrhoea, flu virus, trupanosomes
127
Passive immunity comes from
recieving preformed antibodies
128
speed of passive immunity
rapid
129
how passive immunity can be induced
IgA in breast milk, antitoxin, humanized monoclonal antibody
130
examples of passive immunity medical therapy
botox, tetanus, rabies, or HBV post exposure vaccination of preformed antibodies
131
active immunity comes from
exposure to forigen antigens
132
speed of active immunity
slow
133
how active immunity can be induced
natural infection, vaccienes, toxoid
134
live vaxes
MMR, sabin polio, varicella, yellow fever
135
innactivated or killed vaxes
cholera, hep A, Salk polio, rabies
136
live vax induces a
cellular response
137
killed vax induces
humoral immunity
138
anyphlaxis is what of hypersensitivity
type 1
139
immune complexes are what of hypersensitivity
type III
140
serum sickness and arthus reaction is what of hypersensitivity
type III
141
antibody and complement is what of hypersensitivity
type II
142
delayed sensitivity is is what of hypersensitivity
type IV
143
cell mediated is is what of hypersensitivity
type IV
144
mostly local autoimmmunity diseases are what of hypersensitivity
type II
145
most systemic autoimmunity is what of hypersensitivity
type III
146
MS, GB and GVHD are what of hypersensitivity
type IV
147
anticentromere antibody gives
scleroderma (CREST)
148
anti-basement membrane antibody gives
goodpastures
149
anti-desmolgein antibody gives
pemphigus vulgaris
150
antithyroglobulin antibody gives
hashimoto's
151
asnti-SSA/SSB antibody gives
sjogren's
152
anti-glutamate decarboxylase antibody gives
DM 1
153
c-ANCA antibody gives
Wengerner's granulomatosis
154
p-ANCA antibody gves
microscopic polyangiitis, churg-strauss syndrome
155
if you don't have T cells you'll get
sepsis, CMV, EBV, ZVZ, chronic viral RTI, candida and PCP (think AIDS)
156
if you don't have B cells you'll get
encapulated bacteria infections (SHiN SKiS)
entoviral encephilitis, polio
GI giardiasis
157
if you don't have granulocytes you'll get
staph, serratia, nocardia, candida, aspergilus
158
if you don't have complement you'll get
neiserria (because of no MAC)
159
X linked (burton's aggammglobulinemia) defect/presentation
defect in BTK - no B cells
recurrent bacteria after 6 months
160
selective IgA deficeicy defect/presentation
unknown (but most common)
majority asymptomatic, but can see autoimmune and anaphylaxis to IgA products
161
common variable immunodeficnecy defect/presentation
defect in B cell maturations due to multiple causes. results in normal B cells, but low # of plasma cells and immunoglobulin
aquired in 20-30s, high risk of autoimmune, lymphoma, sinopulmonary infection
162
DiGeorge defect/presentation
22q11 deletion. failure to develop 3/4 pharyngeal pouches
tetany, recurrent viral/fungal infections. Congenital heart defects
163
Hyper-IgE (Job's syndrome) defect/presentation
Th1 cells fail to produce IFN-g (inability of neutrophils to respond to chemotaxis)
coarse facies, abcesses, retained primary teeth, eczema
164
SCID defect/presentation
commonly X linked, defective IL-2 receptor , adenosine deanimase deficnecy
failure to thrive, chronic diarrhea, thrush and lots of varied infections. No thymic shadow/germinal centers/B cells
165
treatment for SCID
bone marrow transplant (no allograft rejection)
166
ataxia-telengiectasia defect/presentation
defect in ATM gene, coding for DNA repair enzymes
ataxia, spider angiomas, IgA deficiency
167
Hyper IgM syndrome defect/presentation
CD40L on helper T cells defective - can't class switch. almost no antibodies other than IgM
severe early life pyrogenic infections
168
wiskott-aldrich syndrome defect/presentation
X lnked. defective in WAS gene on X chromosome (high IgE/A, low IgM)
Thrombocytopenic purpua, infections and eczema
169
leukocyte adhesion deficncey defect/presentation
defect in LFA-1 integrin (CD18) on phagocytes - neutophilia
recurnednt bacterial infections, absent pus, delayed seperation of ummbilical cord)
170
chediak higashi syndrome defect/presentation
AR - defect in lysosomal trafficking regulator gene - microtubule dysfunction in phagosome-lysosome fusion
recurrent staph/stprep infection. partial albinism, peripheral neuropathy
171
chronic granulomatous disease defect/presentation
lack of NADPH oxidase --> sbsent respiratory burst in neutrophils
lots of catalase + infections (Staph, E colo, aspergillis)
172
allograft is from
self
173
syngenic graft from
twin or clone
174
allograft from
nonidentical individual of same species
175
xenograft from
different species
