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Medicine Dermatology > Immunology > Flashcards

Immunology Flashcards

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Dermatology Board Prep flashcards
1
Q

Skin provides a barrier and front line defence between us and what?

A

Pathogens, chemical insults and physical trauma

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2
Q

Factors that contribute to the skin as an immunological system

A

Structure
Cell types
Cytokines, chemokines, eicosanoids and antimicrobial peptides
Genetics

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3
Q

How does the structure of the skin contribute to the skin as an immunological system?

A

Has a keratin layer and stratification

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4
Q

Function of cytokines

A

Proteins which encourage migration between cells

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5
Q

Function of chemokines

A

Attract migration of cells

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6
Q

What happens to an infection in a normal immune response?

A

It is controlled

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7
Q

Hypersensitivity

A

Overreaction to antigen

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8
Q

Immunodeficiency - is the infection controlled?

A

Infection not controlled and tumours may arise

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9
Q

Autoimmunity

A

Reaction to host tissue causing chronic inflammation

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10
Q

Stratum corneum

A

Keratin layer - formed by terminal differentiation of keratinocytes to corneocytes

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11
Q

Important structural proteins in the stratum corneum

A

Fillagrin, involucrin, keratin

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12
Q

Functions of keratin in the epidermis

A

Sense pathogens via cell surface receptors and help mediate an immune response
Produce antimicrobial peptides that directly kill pathogens
Produce cytokines and chemokines

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13
Q

How can keratinocytes be activated?

A

UV light and sensitizers

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14
Q

Main skin resident immune cell

A

Langerhans cells

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15
Q

Birbeck granule

A

Tennis racket shaped characterisation of the antigen presenting cells Langerhans cells

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16
Q

Function of Langerhans cells

A

Process lipid antigen and microbial fragments and present them to effector T cells
Help activate T cells

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17
Q

What type of T cells are mainly found in the epidermis?

A

CD8+ T cells

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18
Q

What type of T cells are mainly found in the dermis?

A

CD4+ T cells and CD8+ T cells

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19
Q

CD4+ T cells associated with inflammation

A

TH1 (psoriasis), TH2 (atopic dermatitis) and TH17 (psoriasis and atopic dermatitis)

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20
Q

Where are T cells produced and sensitised?

A

Produced in bone marrow, sensitised in the thymus

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21
Q

What does antigen recognition and T cell activation involve interaction between?

A

T cell receptor and major histocompatibility complex, enhanced by co-receptors

22
Q

2 co-receptors in interaction between T cell receptor and major histocompatibility complex

A

CD4+ helper T cells and CD8+ cytotoxic T cells

23
Q

Function of TH1

A

Activate macrophages to destroy microorganisms

24
Q

Function of TH2

A

Help B cells to make antibodies

25
Q

Function of CD8+ cytotoxic T cells

A

Kill infected cells directly

26
Q

Dendritic cells found in the dermis

A

Dermis dendritic cell and plasmacytoid dendritic cell

27
Q

What is produced by plasmacytoid dendritic cell?

A

IFN-alpha

28
Q

True or false: plasmacytoid dendritic cells are found in healthy skin

A

False - they are found in diseased skin

29
Q

What transmits information from dendritic cells to T and B cells?

A

Antigen presenting cells

30
Q

True or false: macrophages, neutrophils and mast cells are found in the dermis

A

True

31
Q

Where is the major histocompatibility complex found?

A

Chromosome 6

32
Q

Class I histocompatibility complex:

  • Which cells is it present on?
  • Which T cells does it present the antigen to?
  • What type of antigen does it present?
  • What can it detect?
A

Present on almost all cells
Presents antigen to cytotoxic T cells
Presents androgynous antigen
Can detect intracellular antigens

33
Q

Class II histocompatibility complex:

  • Which cells is it present on?
  • Which T cells does it present the antigen to?
  • What type of antigen does it present?
A

Present on antigen presenting cells
Presents antigen to helper T cells
Presents exogenous antigens

34
Q

True or false: the major histocompatibility complex is involved in immunological recognition and transplant rejection

A

True

35
Q

Examples of skin conditions associated with inappropriate immune responses/inflammation

A 
Psoriasis
Atopic dermatitis
Bullous pemphigoid
Contact dermatitis
Morphea/systemic sclerosis
Urticaria
SLE
Skin infections
Skin tumours
36
Q

Which CD4 cells make IL-17?

A

TH1 and TH17

37
Q

What things can lead to autoimmunity?

A 
Lymphocyte abnormalities
Intercell communication
Genetic predisposition
Anatomic alterations
Hormonal influence
Infections
38
Q

Examples of skin conditions that are autoimmune

A

Psoriasis, vitiligo and systemic lupus erythematosus

39
Q

Primary immunodeficiency is __ and secondary immunodeficiency is __
(acquired and genetic)

A

Primary immunodeficiency is genetic

Secondary immunodeficiency is acquired

40
Q

Causes of secondary immunodeficiency

A 
AIDS
Malignancy
Ageing
Diabetes
Renal malfunction
Burns
Alcoholic cirrhosis
Malnutrition
41
Q

Type I hypersensitivity is __ mediated

A

Antibody - IgE

42
Q

Describe type I hypersensitivity - early exposure and later exposure

A

Early exposure to antigen causes IgE production, which binds to FcεR1 receptor on mast cells.
Later exposure causes rapid cross-linking of the receptors, signal transduction and degranulation of the mast cell

43
Q

Type II and type III hypersensitivity reactions are __ mediated

A

Antibody - IgG and IgM

44
Q

When are type II hypersensitivity mechanisms important?

A

Autoimmunity and transplantation e.g. haemolytic disease of the newborn and blood transfusion recipients

45
Q

Skin testing in type III hypersensitivity reaction leads to what?

A

An Arthus reaction

46
Q

Type IV hypersensitivity is __ mediated

A

T cell

47
Q

Describe type IV hypersensitivity reactions

A

Delayed type hypersensitivity is based on T-cell mediated response, which then recruits other cells to the site and peaks 24-48 hours after contact with antigen

48
Q

Factors that can affect skin immune response

A

Organ transplant, UV, ageing

49
Q

How does organ transplant affect the skin immune response?

A

Immunosuppression

50
Q

How does UV affect the skin immune response?

A

Immunosuppression

Affects the structure of the skin

51
Q

How does ageing affect the skin immune response?

A

Changes in skin structure
Decreased ability to detect malignant cells
Decreased ability to detect antigen infection risk
Decreased ability to distinguish self from non-self - autoimmunity

Medicine Dermatology (19 decks)

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