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tsomkapQ > Immunology COPY > Flashcards

Immunology COPY Flashcards

1
Q

Which cytokine is released when a macrophage is activated?

A

IL-1

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2
Q

Which cytokines do T-helper cells stimulate?

A

All IL’s except IL-1

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3
Q

Which enlarged lymph nodes are most likely malignant?

A

Supraclavicular, Epitrochlear (above the elbow), inguinal

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4
Q

What is CD8?

A

T-killer or T-suppressor cell

Responds to MHC-1 complex (self)

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5
Q

Which of your cells express MHC-1?

A

All nucleated cells except the immune-privileged cells/tissues, RBC’s and Platelets

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6
Q

What are the classifications of MHC-1?

A

HLA-A, HLA-B and HLA-C

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7
Q

What are the Immuno-privileged sites?

A

Areas of the body that have no lymphatic flow, no antigens, and these areas can be transplanted without fear of rejection (brain, cornea, thymus, and testes) they do not express MHC-1

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8
Q

Which cells express MHC-2?

A

Antigen presenting cells

macrophages, dendritic cells, and neutrophils

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9
Q

What are the classifications of MHC-2?

A

HLA-DP, HLA-DQ, HLA-DR

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10
Q

What are CD4 cells?

A

T-helper cell - Responds to MHC-2 (foreign attack)

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11
Q

What type of immunity does TH1 provide?

A

Enhances cell mediated immunity

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12
Q

What type of immunity does TH2 provide?

A

Enhances humoral immunity

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13
Q

What do B cell deficiency patients die of?

A

Bacterial infection?

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14
Q

What is Common Variable Immuno. Def?

A

Young adults with B cells that do not work

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15
Q

What is the BTK Killer?

A

Bruton’s Agammaglobulinemia
Boys
B cells absents
Bacterial+enteroviral infections after 6 mmonths

Tyrosine
K Kinase deficiencyids ( < 1 y/o because decreased maternal IgG) with defective tyrosine kinase; they have no antibodies and have x-linked transmission
pg116FA

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16
Q

Job’s Syndrome

A 
FATED: 
coarse FACIES 
Abscesses
retained primary TEETH
increased IgE amd Eosinophils
Dermatologic problems

Seen in red headed females
they are stuck in the IgE stage

deficiency of Th17 cells due to STAT3 mutation
Cant recruit neutrophils to site of infection

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17
Q

What is Multiple Myeloma?

A

Multiple osteolytic lesions
Increased IgG and kappa light chains
Rouleaux formation seen on slide
FA pg 419

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18
Q

What is Heavy Chain Disease?

A

IgA and Multiple Myeloma of the GI tract

The disease is centered in the Middle East, and affected individuals are usually between the ages of 10 and 30. They present with abdominal mass and malabsorption.

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19
Q

What is selective IgG2 Deficiency?

A

Seen in patients with recurrent encapsulated infections

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20
Q

What is Selective IgA Deficiency?

A 
MC primary immunodeficiency, cause unknown
Asymptomatic (mostly)
Airway and GI infections
Autoimmune disease 
Atopy
Anaphylaxis to IgA contained products

Decreases IgA, normal IgG, increased IgM

Seen in transfusion, anaphylaxis, and mucus membrane infections (and immunodeficiency)

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21
Q

What is Hairy Cell Leukemia?

A

Cells have a fried egg/ Sunburst appearance and TRAP +

FA420
Adult males,
Mature B-cell tumor, causes marrow fibrosis (dry tap on aspiration)
Patient usually present with massive splenomegaly/pancytopenia
treatment: cladribine, pentostatin

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22
Q

What is Ataxia Telangiectasia?

A

Patients have low IgA and neurological problems, difficulty ambulating and spider like blood vessels

the A's: 
ATM gene defect (unable to repair double strand DNA breaks)
Angiomas
Ataxia
AFP increased! 
IgA deficiency
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23
Q

What is Hyper IgM Syndrome?

A 
High IgM and all other Ig's are low
"defective CD40L" on Th cells (class switching defect)

FA117
*Severe pyogenic infections early in life; opportunistic infection with Pneumocystis, Cryptosporidium, and CMV.
Failure to make germinal center (mature B cells proliferate, differentiate, and mutate their antibody genes)

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24
Q

What do T cell deficiency patients die of?

A

Viral infections, fungal, etc

except bacterial

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25
What is DiGeorge Syndrome?
No Thymus, inferior Parathyroid and low calcium ``` FA116 22q11 deletion; failure to develop 3rd and 4th pharyngeal pouches-> absent thymus/parathyroid No function of MHC 1 and 2, recurrent viral/fungal infections (t-cells deficiency) Conotruncal abnormalities (tetralogy of Fallot, truncus arteriosus) ```
26
What is Chronic Mucocutaneous Candidiasis?
T-cell defect against Candida Albicans and chronic fatigue
27
What is SCID?
``` "Severe Combined Immunodeficiency" No Thymus (no T-cells) frayed long bones (no B-cells) baby dies by 18 months ```
28
What is Wiskott-Aldrich?
``` Low IgM/IgG, Low Platelets High IgA, IgE Eczema Petechiae (a small red or purple spot caused by bleeding into the skin) X-linked recessive ```
29
What does the viral load tell you?
Progression of HIV
30
What organs have the most CD4 receptors?
``` Blood vessels brain testicles cervix rectum ```
31
What are the 3 tests used to screen for HIV?
ELISA: Detects IgG Ab to p24 Ag Western Blot: Proteins PCR: Detects Virus (used in babies)
32
What is the definition of AIDS?
CD4 count less than 200 or defining illness
33
What are the LIVE Vaccines?
``` "Bring Your Own Very Small Virus and MMR" B - BCG Y - Yellow Fever O - OPV (Sabin) = oral polio V - Varicella (chicken-pox/shingles) S - Smallpox (poxvirus) V - Rotavirus M - Measles = Rubeola M - Mumps R - Rubella = German 3 day measles ```
34
What is a Neutrophil?
The Phagocyte (it has Antimicrobials, most abundant)
35
What is an Eosinophil?
The parasite destroyer(helminths) and allergy inducer (major basic protein=helminthotoxin) FA396
36
What is a Basophil?
The allergy helper (IgE receptor - histamine release)
37
What is a Monocyte?
The destroyer - macrophage (has hydrolytic enzymes and a coffee bean nucleus) FA397
38
What is a Lymphocyte?
The warrior - T, B, and NK cells
39
What is a Platelet?
The clotter (has no nuclei and smallest cells) + fibrinogen to from platelet plug. Directly derived from Megakaryocytes Lifespan 8-10 days
40
What is a Blast?
Baby hematopoietic cell "An immature cell that can develop into all types of blood cells, including white blood cells, red blood cells, and platelets. Hematopoietic stem cells are found in the peripheral blood and the bone marrow."
41
What is a Band?
Baby Neutrophil
42
What is Chronic Granulomatous Disease?
NADPH Oxidase deficiency - they have recurrent Staph / Aspergillus infections (Nitro-blue Tetrazolium Stain Negative= stays yellow color) or Dihydrorhodamine flow and Cytometry test FA117 Decrease reactive oxygen species (superoxide) and decrease respiratory burst in neutrophils X-linked Can also be related to penthose phosphate pathway (G6PD disease- G6PD is absent)
43
What does MPO (Myeloperoxidase) deficiency cause?
Catalase positive infections Catalase degrades H2O2 into H20 and bubbles of O2 before it can be converted to microbicidal products by the enzyme myeloperoxidase. FA128 EXAMPLES: Cats(cat-alase) Need PLACESS to Belch their Hairballs. (Nocardia, Pseudomonas, Listeria, Aspergillus, Candida, E. Coli, Staphylococci, Serratia, B. cepacia, H. pylori)
44
What is Chediak Higashi syndrome?
Lazy Leukocyte Syndrome (Lysosomal trafficking regulator gene-LYST) (Lysosomes are slow to fuse around bacteria) FA117 Giant granules; PLAIN: Progressive neurodegeneration, lymphohistiocystosis, albinism (partial), recurrent pyogenic Infections by staphylococci and streptococci, peripheral Neuropathy
45
What is the most common transplant?
Blood transfusion
46
What is an Autograft? What is an isograft?
transfer of tissue from one part of the same body to another part of that body. isograft is transfer of tissue from genetically identical twins (twin to twin (spare parts))
47
What is an Allograft?
Human to human transplant
48
What is a Xenograft?
1 species to another species (pig heart into humans)
49
What is a Hyperacute Rejection?
Autoimmune response within 12 hours, preformed antibodies responded This is a Type 2 hypersensitivity reaction widespread thrombosis --> ischemia/necrosis
50
What is an Acute Rejection?
Occurs 4 days to months later. T-cell and macrophage response vasculitis of graph with dense lymphocytic infiltrate
51
What is Chronic Rejection?
Occurs months to years later and fibroblasts are present clinical picture dominated by arteriosclerosis. has several features- bronchiolitis obliterans, nephropathy, vanishing bile duct syndrome, accelerated atherosclerosis in coronary a.
52
What is Graft vs. Host Disease?
When the graft attacks the body (T-Killer cells and macrophages responded)
53
What Diseases have a low LAP (Leukocyte Alkaline Phosphatase)?
CML (chronic myeloid leukemia) & | PNH (paroxysmal nocturnal hemoglobinemia)
54
What has high LAP (Leukocyte Alkaline Phosphatase)?
Leukemoid reaction
55
What is the difference between Acute and Chronic Leukemia's?
Acute: started out in the bone marrow, squeezes RBC out of the marrow Chronic: started in the periphery, not constrained and will expand
56
What is the difference between Myeloid and Lymphoid Leukemia's?
Myeloid: increased RBC, WBC, platelets, macrophages (decreased Lymphoid cells) and bone marrow biopsy Lymphoid: increased NK, T, B cells (decreased Myeloid cells) and do lymph node biopsy
57
What defines Acute Lymphoblastic Leukemia/lymphoma (ALL)?
0-15 year old males, bone pain, + PAS stain and +TdT(marker for pre-T and pre-B cells). CALLA antigen positive T (12;21) good prognosis FA420 Associated with Down Syndrome May spread to CNS and testes
58
What defines Acute Myeologenous Leukemia (AML)?
``` 15-30 y/o males Sudan Stain Auer Rods, (CD30) APL: t(15;17) (formerly D M3 AML subtype) treat with ATRA ``` FA420 Myeloperoxidase positive Risk factor: Down syndrome, chemotherapy, radiation, myeloproliferative disorders Responds to all-trans Retinoic acid (vitamin A) DIC is a common presentation (Disseminated intravascular coagulation)
59
What defines Chronic Myelogenous Leukemia (CML)?
30-50 y/o females Philadelphia Chromosome t(9;22) BCR-ABL FA420 presents with dysregulated production of granulocytes (neutrophils, basophils, myelocytes, metamyelocytes) May accelerate and transform to AML or ALL (Blast crisis) Treatment: Imatinib, Dasatinib (bcr-abl tyrosine kinase inhibitors)
60
What defines Chronic Lymphocytic Leukemia (CLL)?
50+ y/o males with lymphadenopathy soccer ball nuclei Present with autoimmune Hemolytic anemia ``` FA420 Smudge cells (Crushed Little Lymphocytes) Can turn into aggressive lymphoma (Diffuse Large B-cell Lymphoma) ```
61
What defines Hodgkin's Lymphoma?
EBV and may have Reed-Sternberg cells
62
What are the B cell Non-Hodgkin's Lymphomas?
Follicular: t(14;18) and bcl-2 Burkitt: t(8;14), c-myc, Starry sky, Macrophages in american kids: abdominal mass in african kids: jaw mass
63
What are the T-cell Non-Hodgkin Lymphomas?
Mycosis Fungoides: total body rash | Sezary Syndrome: Cerebreform cells in the blood
64
What is Myelofibrosis?
Megakaryocytes, fibrotic bone marrow, teardrop cells (RBC's) and extramedullary Hematopoiesis
65
What are Plasma Neoplasms?
They produce many antibodies
66
What is Waldenstrom Macroglobulinemia?
IgM and Hyperviscosity of the blood
67
What is Monoclonal Gammopathy of undetermined significance (MGUS)?
Old Person with Gamma Spike (from years of building up) | Build up of abnormal protein in blood- Monoclonal protein
68
What is Multiple Myeloma?
``` Male >40 with lower back pain Serum M protein (IgG) Bence-Jones Proteins in the urine Rouleaux formation Punched out lesions on x-ray ```
69
What is Heavy Chain Disease?
Increased IgA
70
Monocyte -> Macrophage Name? 1. Brain 2. Lungs 3. Liver 4. Kidneys 5. Spleen 6. Lymph nodes 7. Skin 8. Bone 9. Bone marrow and blood 10. Peyers patches 11. Connective Tissue
1. Brain= Microglia 2. Lungs= airway-clara (alveoli- dust cells) 3. Liver= kupffer cells 4. Kidneys= mesangial cells 5. Spleen= red pulp macrophages 6. Lymph nodes= dendritic cells 7. Skin= langerhans cells (dendritic cells) 8. Bone= osteoclasts 9. Bone marrow and blood= *monocytes* 10. Peyers patches= M-cells (aggregate lymph nodules located in GI tract- distal jejunum/ileum; usually affected by prion disease) 11. Connective Tissue= Giant cells, histiocytes, epithelioid cells (scar formation)

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