IMMUNOLOGY and BASIC PATHOLOGY1 Flashcards

1
Q

Where will you find B cells in a lymph node? Where will you find plasma cells?

A

B cells = cortex; plasma cells = medullary cords

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1
Q

Which cytokine turns a helper T cell into Th1, into Th2?

A

IL-12 turns a helper T cell into Th1; IL-4 turns a helper T cell into Th2

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1
Q

Anti-Jo-1 ab

A

dermatomyositis, polymositis

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2
Q

Name 4 cytokines secreted by Th2

A

IL-4, IL-5, IL-10, IL-13 (NOTE: IL-4 and IL-10 inhibit Th1)

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3
Q

What is CD25?

A

alpha chain of the IL-2 receptor, expressed on Treg cells along with CD3 and CD4

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3
Q

Neoplasm associated with autoimmune dz

A

lymphoma

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4
Q

Which molecule increases both MHC 1 and 2 on all cells to enhance antigen presentation?

A

IFN gamma

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6
Q

What are 3 blood findings on blood smear post-splenectomy?

A

Howell-Jolly bodies, Target cells, thrombocytosis

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7
Q

What is a graft from an identical twin called?

A

Syngeneic graft

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8
Q

Neoplasm associated with acanthosis nigricans

A

(visceral malignancy (stomach, lung, uterus)

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9
Q

What is a xenograft?

A

Graft from another species

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9
Q

What neoplasms are associated with trisomy 21

A

ALL and AML

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9
Q

Neoplasm associated with Plummer vinson

A

SCC of esophagus

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9
Q

Tumor and gene product of bcl-2 (oncogene or TS)

A

Follicular lymphoma, anti-apoptotic, oncogene

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10
Q

Anti-SSB (La)

A

Sjogrens

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11
Q

Which cell contains CD28? B7?

A

CD28 = T cell; B7 = B cell

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11
Q

3 autoantibodies in dermatomyositis and polymositis

A

Anti-Jo-1, Anti-SRP, and Anti-Mi-2

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12
Q

ANA antibodies

A

SLE (nonspecific)

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13
Q

What is recombining in VJ recombination? V(D)J?

A

VJ = light chain; V(D)J = heavy chain; both contribute to Fab (variable) part that recognizes single antigen—this is actual DNA that is recombined. There are nucleotides added by a terminal deoxynucleotidyl transferase

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13
Q

T/F: CD4 T cells express MHC1

A

TRUE; however, their main fxn is to use MHC II to bind to CD4 T cells

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13
Q

IgA anti-tissue transglutaminase

A

Celiac

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14
Q

What aspect of the immune system is induced in live attenuated vaccines vs. inactivated and killed vaccines?

A

CMI; humoral

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15
Q

Name 3 bacteria that do antigenic variation

A

Salmonella (2 flagellar variants), B. recurrentis (relapsing fever), and N. gonorrhea

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16
Q

Which cells do not have MHC I?

A

RBC’s (only on nucleated cells)

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16
Q

What CD markers are expressed in cells undergoing positive selection in the thymic cortex?

A

BOTH 4 and 8, eventually then becomes 4 or 8 and goes to medulla for negative selection

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17
Q

Antimitochondrial ab

A

PBC (granulomatous!)

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17
Q

Autoantibody in mixed connective tissue disease

A

Anti-U1-RNP

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18
Q

What is the function of IL-12?

A

Induces differentiation of T cells into Th1 cells and activates NK cells

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18
Q

How do interferons alpha and beta work?

A

They inhibit viral protein synthesis by inducing cells to make a ribonuclease to cleave viral mRNA but not host mRNA!

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18
Q

How do NK cells bind IgG in ADCC?

A

They bind to Fc of IgG with CD16

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19
Q

Neoplasm associated with radiation (4)

A

Leukemia, Papillary thryoid CA, sarcoma, Breast CA

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20
Q

Tumor and gene product for L-myc (oncogene or TS)

A

Lung CA, transcription factor (oncogene)

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21
Q

What is the main isotype offering passive immunity in infants AFTER birth?

A

They have IgG for awhile, but IgA is in the breast milk

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22
Q

Which type of vaccines require boosters?

A

killed and toxoid etc. (anything that isnt live attenuated)

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23
Q

Which part of the lymph node contains high endothelial venules? What is their function?

A

Paracortex; allows B and T cells to enter from blood

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24
Q

Disease associated with HLA DR2 (4)

A

MS, Hay fever, Goodpasture’s, and SLE

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24
Q

Tumor and gene product of ras (oncogene or TS)

A

Colon carcinoma, GTPase, oncogene

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25
Q

What is the usual cause of “serum sickness” now?

A

Drugs that act as haptens, not actual serum

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26
Q

Which neurologic disorders are type IV hypersens (2)?

A

Multiple sclerosis, Guillian Barre

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27
Q

Neoplasm associated with Barrets

A

Adenocarcinoma of esophagus

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29
Q

What disease involves a deficiency of DAF?

A

Decay Accelerating factor = Paroxysmal Nocturnal Hemoglobinuria (since DAF is attached by GPI anchor, acquired mutation involves loss of GPI anchor)

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29
Q

Anti-U1 RNP

A

Mixed connective tissue disease

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30
Q

IgM ab against Fc of IgG

A

Rheumatoid factor; Rheumatoid arthritis (anti-CCP is better)

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30
Q

Anti-thyroglobulin ab

A

Hashimoto Thyroiditis (DR5 HLA assoc)

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31
Q

Which cell can activate na?ve T cells?

A

Dendritic cells ONLY

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33
Q

What complement component helps to clear immune complexes?

A

C3b

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34
Q

What 2 cells contain CD40? Which contains CD14?

A

B cells and MO; MO

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34
Q

Anti-SSA (Ro)

A

Sjogrens

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34
Q

c-ANCA

A

(PR3-ANCA) Wegeners

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35
Q

Neoplasm associated with chronic atrophic gastritis

A

Gastric adenocarcinoma

36
Q

2 neoplasms associated with Paget’s of bone

A

Fibrosarcoma, osteosarcoma

37
Q

Which parasites have antigenic variation?

A

Trypanosomes (T. cruzi; T. brucei)

39
Q

What part of the antibody recognizes antigens?

A

Variable part of light and heavy chains

41
Q

Disease associated with HLA DQ2 and DQ8

A

Celiac sprue

42
Q

Neoplasm associated with dysplastic nevus

A

malignant melanoma

43
Q

Disease associated with HLA DR4 (2)

A

RA and DM I

44
Q

Which molecule has actions the most similar to IL-10?

A

TGF-B because it is anti-inflammatory

46
Q

5 cytokines from MO

A

IL-1, TNF alpha, IL-6 (the pyrogens), and IL-12 and IL-8

47
Q

Neoplasm associated with pernicious anemia

A

Gastric adenocarcinoma

49
Q

Regarding the timing of an immune response, why is IgM a pentamer while IgG is a monomer?

A

As the humoral response (specific) is developing, IgM can trap more antigen even though it does so less specifically

50
Q

What is the endotoxin receptor?? What is the implication?

A

CD14 on macrophages!!!! It binds to LPS which leads to direct stimulation and shock! MO release IL-1, IL-6 and most importantly TNF-alpha (all the pyrogens!!!!)

51
Q

Neoplasm associated with gastric remnants from surgery

A

Gastric adenocarcinoma

53
Q

Where will you find lymph follicles?

A

Outer cortex of lymph node

55
Q

Disease associated with HLA DR5

A

Pernicious anemia and Hashimoto

56
Q

Disease associated with HLA B27 (4)

A

Psoriatic arthritis, Ankylosing spondylitis, Inflammatory bowel disease, Reiter’s

56
Q

Neoplasms associated with Xeroderma pigmentosum and albinism

A

Basal cell CA, Melanoma, and SCC

57
Q

Tumors and gene product of ret (oncogene or TS)

A

MEN 2A and 2B, tyrosine kinase, oncogene

58
Q

Anti-dsDNA, Anti-smith

A

SLE (specific)

58
Q

Neoplasm arising from actinic keratosis

A

SCC

58
Q

Tumor and gene product for N-myc (oncogene or TS)

A

Neuroblastoma, transcription factor, oncogene

60
Q

HLA associated with Hashimoto? With Graves?

A

Hashimoto is DR5; Graves is DR3

61
Q

Anti-GBM

A

Goodpasture’s (linear deposits, rapidly progressive (crescentic) glomerulonephritis)

62
Q

Anticentromere

A

CREST form of scleroderma

63
Q

Name 2 type II hypersensitivity rxns that are blistering dermatoses

A

Bullous pemphigoid (hemidesmosomes); pemphigus vulgaris (desmosomes)

64
Q

Neoplasm associated with UC

A

Colonic adenocarcinoma

66
Q

What are the 2 primary opsonins?

A

C3b and IgG

67
Q

What cytokines to activated Treg cells produce (2)? Why?

A

TGF-B and IL-10, shut down immune response? They “regulate” CD4 and CD8

69
Q

What kind of hypersensitivity is an acute hemolytic transfusion rxn?

A

Type II cytotoxic

70
Q

Anti-Mi-2

A

dermatomyositis, polymositis

71
Q

IL-3 functions the most like what other molecule?

A

GM-CSF

73
Q

Which cell contains the CD40 ligand?

A

CD4 T cells (binds to CD40 on B cell to allow class switching)

73
Q

Vaccine type for cholera?

A

Killed

75
Q

What is the alternative pathway for complement activation?

A

Microbe surface molecules (but not mannose as that is the lectin pathway)

76
Q

What is swelling and inflammation following a tetanus vaccine? What is induration following a PPD?

A

Type III hypersens (i.e. arthus reaction); Type IV hypersens

76
Q

Anti-desmoglein ab

A

Pemphigus vulgaris

78
Q

Where do vasoactive amines act?

A

mostly postcapillary venules

79
Q

Cancers associated with 1) c-myc 2) N-myc 3) L-myc

A

1) Burkitt’s lymphoma 2) neuroblastoma 3) lung cancer

80
Q

Neoplasm (3) associated with tuberous sclerosis

A

Giant cell astrocytoma, Renal angiomyolipoma, and cardiac rhabdomyoma

81
Q

HLA associated with DM I (2)

A

HLA DR 3 and DR 4

83
Q

What are 4 signals that can enhance the activity of NK cells? What part of the immune system are they apart of?

A

IL-2, IL-12, IFN B, IFN alpha; NK cells are the only lymphocyte member of the innate immune system

85
Q

What drugs are contraindicated in C1 esterase deficiency? Which is indicated?

A

ACE I; Danazol (Hereditary angioedema)

86
Q

Antihistone Ab

A

Drug induced lupus (phenytoin, hydralazine, procainamide, isoniazid)

87
Q

2 cells that secrete IL-10

A

Th2, Treg

88
Q

What do CD16 and CD56 indicate?

A

CD56 is unique to NK cells; CD16 allows the NK cell to bind Fc of IgG (i.e. ADCC)

89
Q

Which cells (2) get presensitized in type I hypersens?

A

mast cells and basophils

90
Q

Anti-scl-70

A

Diffuse form of scleroderma

92
Q

Why is the thymic medulla paler than the cortex?

A

Because positive selection occurs in the thymic cortex and most lymphocytes die during this process, thus, the medulla is paler because fewer cells have made it there for negative selection

93
Q

4 situations in which you are given passive immunity (i.e. to treat something)

A

Tetanus, Botulism, HBV exposure, and Rabies

94
Q

Disease associated with HLA A3

A

Hemochromatosis

96
Q

What is an arthus reaction?

A

A localized type III hypersens

97
Q

Anti-smooth muscle

A

Autoimmune hepatitis

98
Q

Which hypersensitivity does not involve antibodies?

A

Type IV (cannot transfer from serum)

100
Q

Which 2 molecules are inhibitors of complement activation?

A

C1 esterase inhibitor; DAF (Decay Accelerating Factor, doesnt work in paroxysmal nocturnal hemoglobinuria)

101
Q

Tumor and gene product of abl (oncogene or TS)

A

CML, oncogene for tyrosine kinase

103
Q

IgA anti-endomysial

A

Celiac

104
Q

Tumor and gene product of HER2/neu (oncogene or TS)

A

Breast, ovarian, gastric CA? Tyrosine kinase (oncogene)

105
Q

Tumor and gene product of c-myc (oncogene or TS)

A

Burkitt’s lymphoma, transcription factor (oncogene)

107
Q

Anti-CCP

A

Rheumatoid arthritis, best test

109
Q

What are the 6 bugs vaccinated for with live attenuated vaccines?

A

Measles, Mumps, Rubella (MMR), Polio (sabin) Varicella, Yellow fever

110
Q

Name tumor and gene product for c-kit (oncogene or TS)

A

GIST (interstitial cell of Cajal), cytokine receptor, oncogene

111
Q

Anti-SRP

A

dermatomyositis, polymositis

112
Q

Where does the lymphatics of the stomach drain?

A

Celiac nodes

113
Q

What 2 cytokines come from ALL T cells?

A

IL-2 and IL-3

114
Q

What cells are inhibited by IFN gamma?

A

Th2? This is secreted by Th1, activates macrophages

115
Q

Anti-microsomal ab

A

Hashimoto Thyroiditis (DR5 HLA assoc)

116
Q

Which immunoglobulin has the lowest concentration in serum?

A

IgE

117
Q

Autoantibody in DM 1

A

Anti-glutamate decarboxylase

118
Q

What is MHC I bound to and why? What is MHC II bound to and why?

A

I = B2 microglobulin to aid in transport to the cell surface; II = invariant chain which leaves the antigen binding site when endosome is acidified

119
Q

What kind of enzyme is granzyme?

A

A serine protease that activates apoptosis

120
Q

Anti-glutamate decarboxylase

A

DM I

121
Q

Disease associated with HLA-DR3 (2)

A

DM I, and Graves

122
Q

p-ANCA

A

(MPO-ANCA) = microscopic polyangiitis, Churg-Strauss (also in PSC and therefore UC)

123
Q

How is IgA present in the blood? In secretions?

A

As a monomer; As a dimer, it crosses the secreting epithelium via transcytosis and picks up a secretory component along the way