immunology Flashcards

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1
Q

site of B cell localization and proliferation

A

Lymph node follicle

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2
Q

active follicles

A

secondary

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3
Q

contain reticular cells and macrophages

A

lymph node medulla

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4
Q

houses T cells

A

lymph node paracortex

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5
Q

not well developed in Di George

A

lymph node paracortex

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6
Q

lymph drainage of upper limb and lateral breast

A

axillary

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7
Q

lymph drainage of stomach

A

celiac

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8
Q

lymph drainage of duodenum, jejunum

A

superior mesenteric

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9
Q

lymph drainage of sigmoid colon

A

colic –> inferior mesentaric

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10
Q

lymph drainage of rectum

A

internal iliac

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11
Q

lymph drainage of anus

A

superficial inguinal

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12
Q

lymph drainage of testes

A

superficial and deep plexuses –> paraaortic

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13
Q

lymph drainage of scrotum

A

superficial inginal

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14
Q

lymph drainage of thigh (superficial)

A

superficial inguinal

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15
Q

drained by right lymphatic duct

A

right upper quadrant - including right side of head

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16
Q

T cells found in ___ of spleen

A

periarterial lymphatic sheath

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17
Q

B cells found in ____ of spleen

A

follicles in the white pulp of spleen

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18
Q

macrophages in spleen remove

A

encapsulated bacteria

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19
Q

immune issues in splenic dysfunction

A

low IgM–> lower complement activation –> low C3b opsonization

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20
Q

encapsulated bugs a problem in spenic dysfunction

A
strep p
HiB
neissera meningitis
salmonella
Klebsiella
Group B Strep
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21
Q

function of thymus

A
positive selection of T cells (cortex)
negative selection (medulla)
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22
Q

neutrophils, macrophages, NK cells, and complement mediate

A

innate immunity

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23
Q

T cells, B cells and circulating antibody mediate

A

adaptive immunity

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24
Q

MHC I and II

A

encoded by HLA genes and present antigen fragments to T cells. Bind TCR

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25
Q

encoded by HLA A,B,C

A

MHC I

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26
Q

binds CD8

A

MHC I

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27
Q

mediates viral immunity

A

MHC I

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28
Q

antigen is loaded in RER

A

MHC I

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29
Q

encoded by HLA DR,DP, DQ

A

MHC II

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30
Q

binds CD4

A

MHC II

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31
Q

expressed only on antigen-presenting cells

A

MHC II

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32
Q

HLA-A3 disease

A

hemochromatosis

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33
Q

HLA-B27

A

Psorisis, ankylosing spondy, inflammatory bowel disease, reiter’s

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34
Q

HLA-DQ2/8

A

celiac

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35
Q

HLA-DR3

A

DM1, graves disease

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36
Q

HLA-DR4

A

RA, DM1

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37
Q

HLA-DR5

A

pernicous anemia, hashimoto’s thyroitis

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38
Q

enhance NK activity

A

IL-2/12 IFN-B/a

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39
Q

NK cell MOA

A

use perfornin and granzymes to induce apoptosis

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40
Q

NK cells attack

A

viral infected cells and tumor cells

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41
Q

induces NK cells to kill

A

exposure to nonspecific activation signal on target cell or to absence of class I target cell surface

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42
Q

good B cell function

A
make antibody
opsonize bacteria
neutalize viruses (IgG)
activate complement (IgM, IgG)
sensitive mast cells (IgE)
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43
Q

bad B cell functions

A
allergy (type 1 hypersensitivity)
cytotoxic (type II hypersensitivity)
immune complex (type III hypersensitivity)
hyperacute and humorally mediated acute and chronic organ rejection
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44
Q

good T cell functions

A

CD4: help B cells make antibody and produce cytokines to ackivate other immune cells

CD8: kill virus-infected cells directly

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45
Q

bad T cell functions

A

delayed cell-mediated hypersensitivity (IV)

acture and chronuc cellular organ rejection

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46
Q

positive selection makes ____ cells survive

A

TCRs capable of binding surface self MHC

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47
Q

negative selection makes ___ cells DIE

A

TCRs with high affinity for self antigens

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48
Q

activates T cells

A

dendritic cells
macrophages
B cells

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49
Q

only APC that can activate naive T cell

A

dendritic

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50
Q

costimulatory signal activating naive T cells

A

B7 (on dendritic) and CD28 (on T cell)

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51
Q

receptor on B cell that binds to Th cell

A

CD40

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52
Q

secretes cytokines to determine class switching of B cells

A

T helper cell (CD4)

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53
Q

Th1 cell secretes

A

IFN-gamma

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54
Q

activates macrophages

A

Th1

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55
Q

inhibits Th1 cells

A

IL-4 and IL-10

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56
Q

secretes IL-4/IL-10

A

Th2

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57
Q

express CD4

A

Th1

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58
Q

Th2 cells secrete

A

IL-4/5/10/13

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59
Q

recruits eosinophils

A

Th2

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60
Q

inhibited by IFN-g

A

Th2

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61
Q

kills virus inducedm neoplastic and donor graft cells

A

cytotoxic T cells

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62
Q

MOA of

A

perforin and granzyme

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63
Q

cytotoxic cells express

A

CD8

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64
Q

express MHC 1

A

virus infected cell

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65
Q

express MHC II

A

B cells

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66
Q

supress CD4 and CD8 cells

A

regulatory T cells

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67
Q

express CD3/4/25

A

regulatory T cells

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68
Q

priduce IL-10 and TGF-B

A

regulatory T cells

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69
Q

function of IL-10 and TGF-B

A

antiinflamatory

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70
Q

“arms” of the antibody

A

Fab segment

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71
Q

“Tail” of the antibody

A

Fc segment

72
Q

antigen binding fragment

A

Fab (VH/L)

73
Q

determins indiotype

A

Fab

74
Q

binds complement

A

Fc (CH2)

75
Q

determins isotype

A

Fc

76
Q

antibody promotes phagocytosis

A

opsinization

77
Q

antibody promotes bacterial adherance

A

neutralization

78
Q

enhaces lysis

A

membrane attack complex

79
Q

generates antibody diversity

A

random recombination of VJ (light chain) and VDJ (heavy chain) genes

80
Q

antibody toes that bind complement

A

IgG and IgM

81
Q

IgG functions

A

fixes complement
crosses placenta
opsonizes bacteria
neutralizes bacterial toxins and viruses

82
Q

main antibidy in delayed response to antigen

A

IgG

83
Q

IgA function

A

prevents attachment of bacteria dn viruses to mucous membranes
found in secretions and colostrum

84
Q

IgM function

A

produced in immediate response to atigen
fixes complement
antigen receptor on surace of B cells
shape of pentamer

85
Q

IgE function

A

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
Q

mediates classic complement pathway

A

IgG/IgM

87
Q

mediates alternative complement pathway

A

microbe surface molecules

88
Q

mediates anaphylaxis

A

C3a, C5a

89
Q

activates neutrophil chemotaxis

A

C5a

90
Q

activates MAC

A

C5b-9

91
Q

mediates opsonins

A

C3b and IgG

92
Q

inhibits complment from actiaving on self cells

A

Deleay accelrating factor (DAF)

C1

93
Q

C1 esterase deficiency leads to

A

heriditary angioedema (contraindicates ACE inhibitor)

94
Q

C3 deficiency leads tro

A

severe, recurrent pyogenic sinus and respiratory tract infections. higher susceptibility to type III hypersensitivty reactions

95
Q

C5-C9 deficicncy leads to

A

recurrent neisseria bacteramia

96
Q

DAF defiecny leads to

A

complement medated RBC lysis and paroxysmal nocturnal hemoglobinria

97
Q

IL-1 function

A

FEVER, actute inflamation, a

98
Q

IL-2 function

A

stimulates T cells

99
Q

IL-3 dunction

A

stimulates bone marrow

100
Q

IL-4 function

A

stmulates IgE function

101
Q

IL-5 dunction

A

stimulates IgA function

102
Q

Il-6 function

A

fever and production of acute-phase proteins

103
Q

IL-8 function

A

major chemotactic factor for neutrophils (clean-up on aILse 8)

104
Q

Il-12 function

A

differentates T cells into Th1 cells, activates NK cells, (also secreted by B cells)

105
Q

TNF-alpha function

A

mediates septic shock, activates endothelim, vascular leack

106
Q

secreted by macrophages

A

IL 1/6/8/12 tnf-alpha

107
Q

secreted by all T cells

A

IL-2/3

108
Q

secreted by Th1 cells

A

interferon gamma

109
Q

function of interferon gamma

A

activates macrophages and Th1 cells, supreses Th2 cells, has antiviral/antitumor properties

110
Q

secreted by Th2 cells

A

IL-4/5/10

111
Q

function of IL-10

A

modulates inflammatory cells, regulator function

112
Q

inhibit viral protein synthesis

A

interferon A and B

113
Q

increase MHC I/II espxression and antigen presentation in all cells

A

interferon gamma

114
Q

all cells (except RBC) express

A

MHC 1

115
Q

T cells express

A

TCR, CD3, CD28

116
Q

helper T cells express

A

CD4, CD40 ligand

117
Q

cytotoxic T clls express

A

CD8

118
Q

B cells express

A

Ig, Cd19, CD20, CD21, CD40, MHCII, B7

119
Q

macrophages expressC

A

CD14, Cd40, MHCII, B7, Fc and C3b receptors

120
Q

NK cells express

A

CD16, CD56

121
Q

unique marker for NK

A

CD56

122
Q

binds Fc of IgG

A

CD16

123
Q

anergy

A

self-reactive T cells become nonreative without constimulatory molecule

124
Q

effect of superantigens

A

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
Q

release superantigens

A

staph A, S pyogenes

126
Q

undergo antigen variation

A

salmonella, borrelia (relapsing fever), neisseria gonorrhoea, flu virus, trupanosomes

127
Q

Passive immunity comes from

A

recieving preformed antibodies

128
Q

speed of passive immunity

A

rapid

129
Q

how passive immunity can be induced

A

IgA in breast milk, antitoxin, humanized monoclonal antibody

130
Q

examples of passive immunity medical therapy

A

botox, tetanus, rabies, or HBV post exposure vaccination of preformed antibodies

131
Q

active immunity comes from

A

exposure to forigen antigens

132
Q

speed of active immunity

A

slow

133
Q

how active immunity can be induced

A

natural infection, vaccienes, toxoid

134
Q

live vaxes

A

MMR, sabin polio, varicella, yellow fever

135
Q

innactivated or killed vaxes

A

cholera, hep A, Salk polio, rabies

136
Q

live vax induces a

A

cellular response

137
Q

killed vax induces

A

humoral immunity

138
Q

anyphlaxis is what of hypersensitivity

A

type 1

139
Q

immune complexes are what of hypersensitivity

A

type III

140
Q

serum sickness and arthus reaction is what of hypersensitivity

A

type III

141
Q

antibody and complement is what of hypersensitivity

A

type II

142
Q

delayed sensitivity is is what of hypersensitivity

A

type IV

143
Q

cell mediated is is what of hypersensitivity

A

type IV

144
Q

mostly local autoimmmunity diseases are what of hypersensitivity

A

type II

145
Q

most systemic autoimmunity is what of hypersensitivity

A

type III

146
Q

MS, GB and GVHD are what of hypersensitivity

A

type IV

147
Q

anticentromere antibody gives

A

scleroderma (CREST)

148
Q

anti-basement membrane antibody gives

A

goodpastures

149
Q

anti-desmolgein antibody gives

A

pemphigus vulgaris

150
Q

antithyroglobulin antibody gives

A

hashimoto’s

151
Q

asnti-SSA/SSB antibody gives

A

sjogren’s

152
Q

anti-glutamate decarboxylase antibody gives

A

DM 1

153
Q

c-ANCA antibody gives

A

Wengerner’s granulomatosis

154
Q

p-ANCA antibody gves

A

microscopic polyangiitis, churg-strauss syndrome

155
Q

if you don’t have T cells you’ll get

A

sepsis, CMV, EBV, ZVZ, chronic viral RTI, candida and PCP (think AIDS)

156
Q

if you don’t have B cells you’ll get

A

encapulated bacteria infections (SHiN SKiS)
entoviral encephilitis, polio
GI giardiasis

157
Q

if you don’t have granulocytes you’ll get

A

staph, serratia, nocardia, candida, aspergilus

158
Q

if you don’t have complement you’ll get

A

neiserria (because of no MAC)

159
Q

X linked (burton’s aggammglobulinemia) defect/presentation

A

defect in BTK - no B cells

recurrent bacteria after 6 months

160
Q

selective IgA deficeicy defect/presentation

A

unknown (but most common)

majority asymptomatic, but can see autoimmune and anaphylaxis to IgA products

161
Q

common variable immunodeficnecy defect/presentation

A

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
Q

DiGeorge defect/presentation

A

22q11 deletion. failure to develop 3/4 pharyngeal pouches

tetany, recurrent viral/fungal infections. Congenital heart defects

163
Q

Hyper-IgE (Job’s syndrome) defect/presentation

A

Th1 cells fail to produce IFN-g (inability of neutrophils to respond to chemotaxis)

coarse facies, abcesses, retained primary teeth, eczema

164
Q

SCID defect/presentation

A

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
Q

treatment for SCID

A

bone marrow transplant (no allograft rejection)

166
Q

ataxia-telengiectasia defect/presentation

A

defect in ATM gene, coding for DNA repair enzymes

ataxia, spider angiomas, IgA deficiency

167
Q

Hyper IgM syndrome defect/presentation

A

CD40L on helper T cells defective - can’t class switch. almost no antibodies other than IgM

severe early life pyrogenic infections

168
Q

wiskott-aldrich syndrome defect/presentation

A

X lnked. defective in WAS gene on X chromosome (high IgE/A, low IgM)

Thrombocytopenic purpua, infections and eczema

169
Q

leukocyte adhesion deficncey defect/presentation

A

defect in LFA-1 integrin (CD18) on phagocytes - neutophilia

recurnednt bacterial infections, absent pus, delayed seperation of ummbilical cord)

170
Q

chediak higashi syndrome defect/presentation

A

AR - defect in lysosomal trafficking regulator gene - microtubule dysfunction in phagosome-lysosome fusion

recurrent staph/stprep infection. partial albinism, peripheral neuropathy

171
Q

chronic granulomatous disease defect/presentation

A

lack of NADPH oxidase –> sbsent respiratory burst in neutrophils

lots of catalase + infections (Staph, E colo, aspergillis)

172
Q

allograft is from

A

self

173
Q

syngenic graft from

A

twin or clone

174
Q

allograft from

A

nonidentical individual of same species

175
Q

xenograft from

A

different species