Immunology Exam 2 Flashcards

1
Q

Lymphocyte that is part of humoral immunity

A

B lymphocyte

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2
Q

Lymphocyte that is part of cell mediated immunity

A

T lymphocyte

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3
Q

These cells can recognize antigens without specific antigen receptors

A

Natural killer cells

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4
Q

Three common types of processes for B and T lymphocyte maturation

A
  • Proliferation
  • Expression
  • Selection
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5
Q

Where antigen-independent lymphopoiesis occurs

A

Bone marrow

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6
Q

Site of maturation for B lymphocytes

A

Bone marrow

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7
Q

This CD marker signals to regulate B cell development and activation

A

CD19

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8
Q

This CD marker is thought to be involved in B cell activation

A

CD20

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9
Q

Important B cell CD Markers:

Receptor for complement breakdown component

A

CD21

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10
Q

Important B cell CD Markers:

Found on activated T and B cells; receptor for interleukin-2 (IL-2); it is a growth factor made by T cells

A

CD25

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11
Q

Important antigen that is found on all nucleated cells

A

MCH I

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12
Q

Important antigen that interacts with Th cells; is present on all stages of B lymphocytes except plasma cells

A

MHC II

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13
Q

CD marker that is found on all hematopoietic cells and is involved in activation

A

CD45R

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14
Q

Basic unit construction of an antibody contains what type and how many chains?

A

2 Heavy chains and 2 Light chains

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15
Q

Maturation sequence of a B lymphocyte

A
  1. Lymphoid stem cell
  2. Pro-B cell
  3. Pre-B cell
  4. Immature B cell
  5. Mature B cell
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16
Q

Also known as Pro-B Cell

A

Progenitor B Cell

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17
Q

This maturation stage of a B lymphocyte is committed to the formation of mu; the IgM heavy chain

A

Pro-B cell
AKA
Progenitor B Cell

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18
Q

During this stage of maturation of B lymphocytes the bone marrow stroll cell stimulates the lymphoid stem cell to become a B cell. This is the first recognizable cell in the B-cell line.

A

Pro-B cell

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19
Q

The formation of the mu heavy chains signal the beginning of this stage of maturation for B lymphocytes

A

Pre-B cell

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20
Q

Also known as Pre-B Cell

A

Preliminary B-Cell

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21
Q

During this stage of maturation for B lymphocytes, the cell is committed to the formation of light chains

A

Preliminary B-Cell
AKA
Pre-B Cell

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22
Q

What forms the Pre-B receptor to stimulate proliferation and further maturation?

A

mu heavy chains and surrogate light chains

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23
Q

B cell maturation:

This stage sees the completion of IgM molecule on the cells surface.

A

Immature B cell

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24
Q

B cell maturation:

In this stage of maturation, mu is no longer in the cytoplasm.

A

Immature B cell

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25
Q

B cell maturation:

In the immature B cell stage, what is the cell committed to the formation of?

A

IgD

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26
Q

about what percentage of B cells are eliminated due to self-reacting?

A

About 90%

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27
Q

If the B cells are not eliminated via apoptosis due to self-reacting, where do they go to continue maturation?

A

Spleen

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28
Q

Definition:

Cell self-destruction

A

Apoptosis

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29
Q

The B cell receptor is the co-expression of ____ and ____

A

IgD and IgM

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30
Q

TRUE OR FALSE:

IgM and IgD have the same antigen specificity

A

TRUE

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31
Q

The BCR is seen during which stage of B cell maturation?

A

Mature B cell

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32
Q

Where are plasma cells found?

A

Bone marrow and secondary follicles

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33
Q

Function of plasma cells

A

Production of antibodies

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34
Q

What is required in order for B cells to form memory cells?

A

Protein antigen

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35
Q

Produces antibodies

A

Plasma cell

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36
Q

Expression of IgM and IgD

A

Mature B cell

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37
Q

Starts forming mu chain

A

Pro-B cell

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38
Q

Antigen-dependent lymphopoiesis

A

Activated B cell

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39
Q

Expression of IgM only

A

Immature B cell

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40
Q

1st recognizable B cell

A

Pro-B cell

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41
Q

Has a long life span; found in secondary follicles

A

Memory B cells

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42
Q

Formation of IgD

A

Immature B cell

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43
Q

Starts forming lights chains

A

Pre-B cell

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44
Q

This cell produces cytokines

A

T helper lymphocyte

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45
Q

This cell kills altered cells

A

T cytotoxic lymphocyte

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46
Q

Percentage of peripheral blood lymphocytes that are B cells

A

10-15%

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47
Q

Where T cells mature

A

Thymus

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48
Q

Lymphocyte precursor for T cells

A

Thymocytes

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49
Q

Percentage of peripheral blood lymphocytes that are T cells

A

60-80%

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50
Q

What drives T cell maturation?

A

Chemokines

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51
Q

T cell marker involved in T cell acitvation

A

CD2

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52
Q

Complex of proteins that delivers the signal to T cell interior upon TCR-AGN recognition, alpha and beta chains

A

CD3

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53
Q

CD marker known as T-cell maker

A

CD5

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54
Q

This marker on T cells creates rosettes when mixed with sheep RBCs and is used to detect and identify T cells.

A

CD2

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55
Q

TRUE or FALSE:

Thymocytes lack both CD4 and CD8

A

TRUE

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56
Q

Name of the first cell in T cell maturation

A

Double-Negative T cells (thymocytes)

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57
Q

In this stage of T cell maturation, both CD4 and CD8 are expressed

A

Double-Positive T cells

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58
Q

What is completed during the Double-Positive T cells maturation phase?

A

CD3:TCR complex

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59
Q

What happens if T cells show a weak recognition of MHC 1 and peptide?

A

A mature CD8+ T cell forms

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60
Q

What happens if T cells show a weak recognition of MCH II and peptide?

A

A mature CD4+ T cell forms

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61
Q

What happens if there is no recognition by the T cell of MHC and peptide?

A

Apoptosis

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62
Q

The negative selection process for T cells determines tolerance to _____

A

Self

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63
Q

Estimated amount of T cells that are CD4

A

~2/3

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64
Q

Estimated amount of T cells that are CD8

A

~1/3

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65
Q

What activates T cells?

A

Antigens

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66
Q

Type of memory cells produced by CD4 T cells

A

T helper memory cells

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67
Q

Type of memory cells produced by CD8 T cells

A

T cytotoxic memory cells

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68
Q

Estimated percentage of CD4 cells that become T regs

A

5-10%

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69
Q

What CD markers do T regulatory cells possess?

A

CD4 and CD25

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70
Q

Purpose of T regulatory cells

A

Maintain self-tolerance and exert active immune suppression

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71
Q

Location of T cells in the lymph nodes

A

Paracortex

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72
Q

Location of T cells in the spleen

A

Central PALS

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73
Q

Location of B cells in the lymph nodes

A

Cortex

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74
Q

Location of B cells in the spleen

A

Marginal PALS

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75
Q

These cells are found mainly in the spleen and peripheral blood

A

Natural Killer cells

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76
Q

Percentage of peripheral blood lymphocytes that are natural killer cells

A

10-15%

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77
Q

TRUE or FALSE:

Natural Killer cells contain either T or B cell markers

A

FALSE - they generally do not have T or B cell markers

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78
Q

What are natural killer cells believed to be derived from?

A

Double Negative Thymocytes with gamma and delta chains

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79
Q

This cell is considered a transitional cell bridging the natural and acquired immune responses.

A

Natural Killer cell

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80
Q

This CD marker is the receptor for the Fc portion of IgG on Natural Killer cells

A

CD16

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81
Q

This CD marker is the main Natural Killer marker

A

CD56

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82
Q

This cytokine activates NK cells in to lymphokine-activated killer cells (LAK)

A

Interleukin-2 (IL2)

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83
Q

This cell kills diseased/infected and cancerous cells

A

Natural Killer cells

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84
Q

TRUE or FALSE:

Natural killer cells kill cells with reduced MCH I expression

A

TRUE

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85
Q

The ability for natural killer cells to lyse cells with reduced MHC I expression is known as

A

Antibody-Independent Cytotoxicity

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86
Q

What CD marker is used on natural killer cells for antibody-coated cells to bind to?

A

CD16

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87
Q

CD16 on natural killer cells is a receptor for which antibody class?

A

IgG

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88
Q

What other cell types can perform Antibody-dependent cytotoxicity like natural killer cells? (3)

A

Monocytes
Macrophages
Neutrophils

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89
Q

Antibody-independent cytotoxicity

A

Natural Killer cells

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90
Q

Step with CD4 and CD8

A

Double Positive Stage

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91
Q

Step with either CD4 or CD8

A

Mature stage

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92
Q

Produce cytokines when activated

A

T helper cell

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93
Q

Step with neither CD4 nor CD8

A

Double Negative Stage

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94
Q

Has CD4 and CD25 markers

A

T Regulatory cell

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95
Q

Kills diseased/infected cells when activated

A

Cytotoxic T cell

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96
Q

How often does the spleen filter our blood?

A

4-5 times a day

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97
Q

These are the backbone of T cell activation

A

Antigen Presenting Cells

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98
Q

Viral antigens that present to both CD8 and CD4 cells are known to be __________

A

“Cross-presenting”

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99
Q

All nucleated cells have what MHC class?

A

MHC I

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100
Q

These lymphocytes act against changed self-antigens (viruses, intracellular microbes, tumors)

A
Cytotoxic T lymphocytes
AKA 
CTLs
AKA
Tc lymphocytes
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101
Q

TRUE or FALSE:

The initial binding of Tc cells with APCs is non-specific

A

TRUE

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102
Q

What complex and marker bind with the MHC 1?

A

TCR-CD3 and CD8

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103
Q

What toxins are released from CTLs?

A

Perforin and Granzymes

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104
Q

Purpose of perforin

A

Destroys cell wall

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105
Q

Purpose of granzymes

A

Apoptosis

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106
Q

How are activated T helper lymphs important in humoral immunity?

A

They help B cells produce antibodies

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107
Q

How are activated T helper lymphs important in cell-mediated immunity?

A

They help T cytotoxic cells activate

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108
Q

T-dependent antigens are made of ______

A

Protein

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109
Q

T-independent antigens are ____-______

A

Non-Protein (typically carbohydrates)

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110
Q

TRUE or FALSE

Non-protein antigens produce a weaker response due to no production of memory cells

A

TRUE

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111
Q

These molecules stabilize binding and allows time for the TCR to “scan” the peptide antigen

A

Adhesion molecules

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112
Q

What are the Th cell subsets?

A

Th1
Th2
T-Reg

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113
Q

This Th cell subset occurs in response to intracellular microbes (cell-mediated immunity)

A

Th1

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114
Q

This Th cell subset occurs in response to helminths and allergens (humoral immunity)

A

Th2

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115
Q

This Th cell subset exerts active immune suppression to reduce immune response to avoid chronic inflammation

A

T-Reg

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116
Q

What are the different types of T-Reg cells?

A

tTreg and pTreg

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117
Q

This T-Reg cell is thymus derived

A

tTreg

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118
Q

This T-Reg cell is peripheral derived

A

pTreg

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119
Q

T cell that deals with cell-mediated immunity

A

T helper 1

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120
Q

T cell that deals with humoral immunity

A

T helper 2

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121
Q

T cell that deals with suppressing the immune system in order to avoid overactive immune response

A

T reg

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122
Q

Cells that T regs inhibit

A

Th1, Th2, and APCs

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123
Q

This T cell enhances the activity of Tc cell, NK cells, and antigen presentation

A

T helper 1

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124
Q

This T cell enhances the activity of antibody formation, allergic response, anti-parasitic response, and antigen presentation

A

T helper 2

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125
Q

This subset of T helper cells is driven by IL-9 and is a major player in the development of allergic pathologies, especially asthma

A

T helper 9

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126
Q

This interleukin stimulates cell proliferation and is proven to prevent apoptosis

A

IL-9

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127
Q

This T helper subset is a pro-inflammatory cell

A

T helper 17

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128
Q

This T helper subset is influenced by IL-21 and IL-6 and participates in the development of antigen-specific B-cell immunity. Located in the follicular areas of lymphoid tissue

A

T follicular helper cell

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129
Q

This interleukin causes proliferation and differentiation of B cells

A

Interleukin-2

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130
Q

B cells proliferate in to:

A

Plasma cells and memory cells

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131
Q

What type of Th subset develops in response to intracellular microbes?

A

T helper 1

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132
Q

What type of Th subset develops for helminths and allergens?

A

T helper 2

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133
Q

What type of antigen is referred to as T-dependent antigen?

A

Protein

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134
Q

What type of antigen is referred to as T-independent antigen?

A

Carbohydrate

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135
Q

What is the main antibody produced during the primary immune response?

A

IgM

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136
Q

What is the secondary immune response is also known as?

A

Anamnestic

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137
Q

What is the primary antibody produced in the anamnestic immune response?

A

IgG

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138
Q

Immunogen stimulates cells expressing specific BCR or TCR

A

Monoclonal activators

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139
Q

Also known as Superantigens. Typically derived from bacteria. Bind without being processed; outside of the peptide-bind groove.

A

Oligoclonal activators

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140
Q

Superantigens can activate up to ____% of Th cells

A

20%

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141
Q

Capable of inducing cell division in high percentages of T or B cells regardless of their antigen specificities

A

Mitogens

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142
Q

What are mitogens?

A

Polyclonal activators

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143
Q

This lymphocyte activator is typically plant proteins

A

Polyclonal activator

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144
Q

Polyclonal activator of B cells

A

Lipopolysaccharide

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145
Q

Most common polyclonal activator of both T and B cells

A

Pokeweed mitogen

146
Q

Polyclonal activators of T cells

A

Concanavalin A and Phytohemagglutinin

147
Q

How is the super antigen able to activate T helper cells?

A

Binds TCR and MHC II without being processed

148
Q

What are the 5 classes of immunoglobulins?

A

IgG, IgM, IgA, IgD, and IgE

149
Q

Most abundant immunoglobulin in serum

A

IgG

150
Q

Where most antibodies are found in serum protein electrophoresis

A

Gamma band = “gamma globulins”

151
Q

Basic unit of an antibody

A

Monomer

152
Q

Number of polypeptides in basic structure of antibody

A

Four

153
Q

Types of polypeptides in basic structure of antibodies

A

Heavy chains (2) and Light chains (2)

154
Q

Fragments immunoglobulin in to 3 different pieces

A

Papain

155
Q

Proteolytic enzyme from papaya

A

Papain

156
Q

Important effector functions of antibodies

A

Opsonization and Complement fixation

157
Q

What is included in the Fc portion of an immunoglobulin?

A

2 pieces of heavy chain which crystallized at 4C

158
Q

What is included in the Fab portion of an immunoglobulin?

A

1 heavy chain and 1 light chain linked by a disulfide bond

159
Q

Purpose of Fab portion of immunoglobulin

A

Antigen binding

160
Q

Fragments immunoglobulins in to 2 pieces

A

Pepsin

161
Q

Digestive enzyme found in the stomach that breaks down proteins to amino acids

A

Pepsin

162
Q

Antigen binding fragment produced by pepsin

A

F(ab’)2

163
Q

2 units produced from an immunoglobulin when cleaved by pepsin

A

F(ab’)2 and Fc’

164
Q

TRUE or FALSE:
The Fc portion produced when pepsin cleaves an immunoglobulin is bigger than the Fc portion produced when Papain cleaves an immunoglobulin

A

FALSE- the Fc portion produced from papain cleavage is bigger.

165
Q

Found in urine of multiple myeloma patients

A

Bence Jones proteins

166
Q

Types of Light Chains

A

Kappa and Lambda

167
Q

Ratio of kappa to lambda

A

2:1

168
Q

Which classes of heavy chains have subclasses?

A

IgG and IgA

169
Q

How many subclasses are there for IgG?

A

Four

170
Q

How many subclasses does IgA have?

A

Two

171
Q

Antibody types:

More commonly refers to the constant region of heavy chain

A

Isotype

172
Q

Antibody types:

Variants between individuals within a species

A

Allotype

173
Q

Antibody types:

Source of immense diversity. Variations in variable regions.

A

Idiotype

174
Q

Where is the hinge region located on immunoglobulins?

A

Heavy chain - between Ch1 and Ch2

175
Q

What is located on the Ch2 domain (in most cases) that helps the Fc receptors on phagocytes recognize the Fc unit?

A

Carbohydrate

176
Q

Complement binding site for immunoglobulins

A

Ch2

177
Q

Activation of complement results in:

A

Lysis of microbes and host cells

178
Q

Percentage of IgG in serum

A

70 - 80%

179
Q

Molecular weight of IgG

A

150,000

180
Q

What determines the IgG subclass?

A

The number and position of the disulfide bridges

181
Q

Immunoglobulin that provides immunity for newborn by crossing the placenta

A

IgG

182
Q

Least efficient IgG subclass to provide immunity to newborn by crossing the placenta

A

IgG2

183
Q

Immunoglobulin that fixes complement

A

IgG

184
Q

Most efficient IgG subclass at fixing complement

A

IgG3 - due to a larger hinge region

185
Q

IgG subclass that is a poor mediator of complement fixation

A

IgG4

186
Q

Immunoglobulin that opsonizes antigen for enhanced phagocytosis

A

IgG

187
Q

Immunoglobulin that neutralizes toxins and viruses by diffusing into extravascular spaces (tissues)

A

IgG

188
Q

Immunoglobulin that is utilized in agglutination and precipitation reactions in the lab

A

IgG

189
Q

Why is IgM better for agglutination reactions?

A

It is larger

190
Q

Why is IgG better for precipitation reactions?

A

It moves through the gel easier

191
Q

Molecular weight of IgM

A

900,000

192
Q

Percentage of Immunoglobulins in serum that are IgM

A

~10%

193
Q

Half-life of IgM

A

10 Days

194
Q

Half-life of IgG

A

23-25 Days

195
Q

Immunoglobulin that is a pentamer

A

IgM

196
Q

Where is the monomer form of IgM found?

A

Surface of B cells

197
Q

What links the 5 IgM monomers to form the pentamer?

A

J chain (joining chain)

198
Q

Number of binding sites on IgM pentamer

A

10

199
Q

Where is IgM found?

A

Intravascular pool

200
Q

Immunoglobulin that cannot cross the placenta

A

IgM

201
Q

Best immunoglobulin for triggering the classical complement pathway

A

IgM

202
Q

Why is IgM the most efficient immunoglobulin for agglutination?

A

It has multiple sites and is a large molecule

203
Q

4 Mechanisms used by antibodies to combat infections

A

Neutralization, Opsonization/phagocytosis, Antibody Dependent Cell Cytotoxicity (ADCC), Complement (C’)

204
Q

Name the different light chains

A

Kappa and Lambda

205
Q

What is a monomer?

A

The basic structure of immunoglobulins - 2 light chains and 2 heavy chains

206
Q

Which antibody is a great opsonin?

A

IgG

207
Q

Which antibody is great at activating complement and agglutination?

A

IgM

208
Q

Site of production for IgA

A

Mainly in MALT

209
Q

Where are IgA secreting plasma cells found?

A

Sub-epithelial tissues

210
Q

Subclasses of IgA

A

IgA1 and IgA2

211
Q

Where is IgA1 found?

A

Serum

212
Q

Location of IgA2

A

Mucosal surfaces (GI, urogenital, and respiratory tracts) and body secretions

213
Q

TRUE or FALSE:

IgA is a pentamer

A

FALSE- IgA is a dimer (IgM is a pentamer)

214
Q

The structure of IgA2 includes:

A

2 IgA monomers, a J chain, and a secretory component

215
Q

Purpose of the secretory component on IgA2

A
  • Facilitates the transport of IgA to mucosal surfaces

- Makes the dimer more resistant to enzymatic digestion

216
Q

Where is the secretory component precursor found?

A

On epithelial cell

217
Q

Purpose of secretory component precursor?

A

Binds dimer and transports it across the epithelial barrier to mucosal surfaces (known as transcytosis)

218
Q

Immunoglobulin that protects mucosal surfaces by neutralization, opsonization (weak), and complement activation (poor)

A

IgA

219
Q

What removes IgA and antigen?

A

Ciliated epithelial cells

220
Q

Percentage of IgA in serum

A

10-15%

221
Q

Predominant immunoglobulin in external secretions

A

IgA

222
Q

Oral vaccine used against polio vaccines

A

Sabin vaccine

223
Q

Immunoglobulins that have a very low concentration in serum

A

IgD and IgE

224
Q

Concentration of IgD in serum

A

<0.001%

225
Q

Half-life of IgD

A

1 - 3 Days

226
Q

Function of IgD

A

Naive B cell antigen receptor (part of B cell maturation)

227
Q

Where is IgD found?

A

On the surface of naive B cells

228
Q

Least abundant immunoglobulin in serum

A

IgE

229
Q

Immunoglobulin that has no complement fixation, no agglutination, no opsonization, and does NOT cross the placenta

A

IgE

230
Q

Which immunoglobulin is important in host defense against parasitic infections?

A

IgE

231
Q

Immunoglobulin responsible for allergic reactions

A

IgE

232
Q

The Fc portion of IgE will attach to high affinity Fc receptors on which cells only?

A

Basophils and Mast cells

233
Q

Antigen binds to how many IgE molecules before causing a cascade of events?

A

2 Adjacent IgE molecules

234
Q

TRUE or FALSE:

IgD recruits PMNs and eosinophils to the area of an acute inflammatory response that it triggers

A

FALSE- IgE triggers an acute inflammatory response and recruits PMNs and eosinophils to the area

235
Q

Most abundant Ig in serum

A

IgG

236
Q

Building blocks for immunoglobulins are found on which chromosomes? (3)

A

14, 2, and 22

237
Q

Chromosome 14 contains the building blocks for which part of immunoglobulins?

A

Heavy chains

238
Q

Chromosome 2 contains the building blocks for which part of immunoglobulins?

A

Kappa light chains

239
Q

Chromosome 22 contains the building blocks for which part of immunoglobulins?

A

Lambda light chains

240
Q

Heavy chain gene groups

A

Constant, Variable, Diversity, and Joining

241
Q

Purpose of constant gene

A

Codes for Mu, Gamma, Delta, Epsilon, or Alpha

242
Q

How many different variable genes are there for heavy chains?

A

At least 51 genes

243
Q

How many different diversity genes are there for heavy chains?

A

At least 27 genes

244
Q

How many different joining genes are there for heavy chains?

A

6

245
Q

Light chain gene groups

A

Constant, Variable, and Joining

246
Q

Number of different light chain variable genes

A

32

247
Q

Number of different light chain joining genes

A

5

248
Q

Difference between light chains and heavy chains regarding their genes

A

Light chains do not have a diversity gene

249
Q

Light chain rearrangement always starts with ______

A

Kappa

250
Q

What starts lambda light chain transcription?

A

A nonfunctional kappa chain

251
Q

Term for only 1 kind of light chain made at a time

A

Allelic exclusion

252
Q

What will stimulate B cells to class switch?

A

A protein antigen

253
Q

Antibodies as Reagents:

What are antibodies used to detect?

A
  • Microorganisms

- Cell antigens and antibodies

254
Q

Antibodies as Reagents:

Type of antibody that is heterogeneous

A

Polyclonal

255
Q

Source of polyclonal antibodies

A

Animal or human

256
Q

Problems associated with polyclonal antibodies

A

Cross-reaction and reagent variability (not specific to any particular antigen)

257
Q

Antibodies as Reagents:

Type of antibody that is homogeneous

A

Monoclonal

258
Q

Antibodies as Reagents:

All the antibodies came from the same B cell clone making is specific

A

Monoclonal antibody

259
Q

Advantages of monoclonal antibodies

A
  • Permanent
  • Reproducibility
  • Defined specificity
260
Q

Disadvantages of monoclonal antibodies

A
  • Cost

- Narrow reactivity range

261
Q

Therapeutic agent used to treat 20-30% of breast cancer patients

A

Herceptin

262
Q

Therapeutic agent used to treat Rheumatoid Arthritis and Crohn’s disease

A

Inflixmab and adalimumab

263
Q

Therapeutic agent used to treat Non-Hodgkin lymphoma

A

Rituzimab

264
Q

Therapeutic agent used to treat Colorectal cancer and head and neck cancers

A

Cetuximab

265
Q

Therapeutic agent used to treat B lymphoma and Non-Hodgkin lymphoma

A

Ibritumomab tiuxetan and tositumomab (antibody + radioactive substances)

266
Q

Ig most associated with mucosal membranes

A

IgA

267
Q

Ig involved in allergic reactions

A

IgE

268
Q

Ig that is important in parasitic infections

A

IgE

269
Q

Location of most proteins production

A

Liver

270
Q

3 different complement pathways

A
  • Classical
  • Alternative
  • Lectin
271
Q

How is the Classical complement pathway activated?

A

Antigen-antibody combination

272
Q

How is the alternative complement pathway activated?

A

On microbial surfaces

273
Q

How is the lectin complement pathway activated?

A

Microbial polysaccharides

274
Q

___ plays an essential role in all three complement pathways

A

C3

275
Q

Ways the Classical complement pathway is activated

A
  • Immune complexes (aby/agn complexes)
  • CRP
  • Few microorganisms
276
Q

Which immunoglobulins activate the classical complement pathway?

A

IgG1, IgG2, IgG3, and IgM

277
Q

Order of components in classical complement pathway

A

C1, C4, C2, C3, C4, C5, C6, C7, C8, C9

278
Q

Three main stages in classical complement pathway

A
  • Recognition unit
  • Activation unit
  • Membrane attack complex
279
Q

Recognition unit in classical complement pathway

A

C1

280
Q

What does C1 recognize on IgG?

A

CH2

281
Q

What does C1 recognize on IgM?

A

CH3

282
Q

Classical Complement Pathway:

C1 cleaves C4, which part of this cleave attaches to the cell membrane?

A

C4b

283
Q

Classical Complement Pathway:

C4b attaching to the membrane after C1 cleaves C4 is known as:

A

1st amplification step

284
Q

Classical Complement Pathway:

What binds to C4b and is cleaved by C1?

A

C2

285
Q

Classical Complement Pathway:

What part of the C2 cleave is bound to C4b?

A

C2a

286
Q

Classical Complement Pathway:

C4bC2a is the first enzymatic complex. What is it known as?

A

C3 convertase

287
Q

Classical Complement Pathway:

What is included in the 2nd amplification step on the classical complement pathway

A

C3 convertase cleaves C3 into ‘a’ and ‘b’ fragments

288
Q

Classical Complement Pathway:

Powerful opsonin

A

C3b

289
Q

Classical Complement Pathway:

What is formed when C3b bonds with C3 convertase?

A

C5 convertase = C4b2a3b

290
Q

Classical Complement Pathway:

C3 convertase

A

C4b2a

291
Q

Classical Complement Pathway:

C5 convertase

A

C4b2a3b

292
Q

Classical Complement Pathway:

Cleaves C5

A

C5 convertase = C4b2a3b

293
Q

Classical Complement Pathway:

Membrane Attack Complex components

A

C5b6789

294
Q

Classical Complement Pathway:

Purpose of the membrane attack complex

A

Punches holes in the cell membrane

295
Q

How many C9s are included in the MAC?

A

10-17

296
Q

What part of complement can lyse only RBCs?

A

C5b678

297
Q

What part of complement can lyse any cell?

A

C5b6789

298
Q

Importance of C3a

A
  • Anaphylatoxin-
  • Releases histamine
  • Dilates blood vessels
  • Contracts smooth muscles
  • Allows vascular fluid leaks
299
Q

Importance of C3b

A

-Strong opsonin

300
Q

C4a activity

A

Anaphylatoxin (weaker than C3a and C5a

301
Q

C5a activity

A

Major attractant and strong anaphylatoxin (100x stronger than C3a)

302
Q

Activation of this complement pathway does not require antibody

A

Alternate Pathway

303
Q

Complement pathway that is a component of the natural defense

A

Alternate Pathway

304
Q

What is the Alternate Complement Pathway also known as?

A

Properdin system

305
Q

What is properdin?

A

A serum protein

306
Q

What parts of the classical complement pathway are not included in the alternate complement pathway?

A

C1, C2, and C4

307
Q

What starts the alternative complement pathway?

A

C3 spontaneously hydrolyzes to “tickover” formed C3b

308
Q

What protects host cells from “accidental” activation by the alternative complement pathway?

A

High levels of sialic acid

309
Q

Alternative complement pathway:

What makes up C3 convertase?

A

C3bBb

310
Q

Alternative complement pathway:

What cleaves Factor B to form Bb?

A

Factor D

311
Q

Alternative complement pathway:

What binds with C3 convertase to stabilize it?

A

Properdin

312
Q

Alternative complement pathway:

What makes up C5 convertase

A

C3bBbP3B

313
Q

TRUE or FALSE:

After the alternative complement pathway completes cleaving C5, the pathway is identical to the classical pathway.

A

TRUE

314
Q

What is “tickover”?

A

Spontaneous hydrolysis of C3 to C3a and C3b

315
Q

What activates the alternative complement pathway?

A

Microorganisms

316
Q

What 4 serum proteins are involved in the activation of the alternative complement pathway?

A

C3, Factor B, Properdin, and Factor D

317
Q

What activates the lectin complement pathway?

A

Polysaccharides that bind to lectin

318
Q

What are lectins?

A

Proteins that bind to carbohydrates

319
Q

What complement pathway is a link between innate and acquired immune response?

A

Lectin Pathway

320
Q

Lectin Complement Pathway:

What is structurally similar to C1qrs?

A

MBL (Mannose-binding lectin)

321
Q

Lectin Complement Pathway:

What 3 enzymes make up MBL?

A

MASP-1, MASP-2, and MASP-3

322
Q

Lectin Complement Pathway:

Which MBL enzyme takes the active role of cleaving C4 and C2?

A

MASP-2

323
Q

Lectin Complement Pathway:

Where does the lectin pathway intersect the classical pathway?

A

C3 convertase

324
Q

Complement:

What are most control proteins aimed at halting?

A

C3b

325
Q

Regulators of Complement:

Soluble inhibitors

A
  • C1INH
  • Factor H
  • Factor I
  • S protein
326
Q

Regulators of Complement:

Surface inhibitors

A
  • DAF (CD55)

- MAC-inhibitory protein (CD59)

327
Q

Regulators of Complement:

Role of C1 inhibitor

A

Blocks initiation of pathways

328
Q

Regulators of Complement:

How does C1 inhibitor (C1INH) block the initiation of the classical pathway?

A

Binds to C1q causing C1r and C1s to dissociate

329
Q

Regulators of Complement:

How does C1INH block the initiation of the lectin pathway?

A

Inhibits MBL-MASP-2 from binding with C4 and C2

330
Q

Regulators of Complement:

What will result from having a deficiency in C1INH?

A

Hereditary angioedema

331
Q

Regulators of Complement:

A deficiency in this inhibitor leads to excessive cleavage of C4 and C2

A

C1 Inhibitor

332
Q

Regulators of Complement:

Purpose of Factor H in the classical pathway

A

Binds C3b making it vulnerable to inactivation by Factor I

333
Q

Regulators of Complement:

Purpose of Factor H in the alternative pathway

A

Binds C3b preventing binding to Factor B

334
Q

Regulators of Complement:

This inhibitor inactivates C3b when bound by Factor H

A

Factor I

335
Q

Regulators of Complement:

This inhibitor inactivates C4b with help from C4-binding protein (C4BP)

A

Factor I

336
Q

Regulators of Complement:

Another name for S protein

A

Vitronectin

337
Q

Regulators of Complement:

Purpose of S protein

A

Interacts with C5b67 to prevent it from binding to cell membranes

338
Q

Regulators of Complement:

Inhibitor also known as CD55

A

Decay-Accelerating Factor (DAF)

339
Q

Regulators of Complement:

This inhibitor is present on peripheral blood cells, endothelial cells, and fibroblasts

A

DAF
aka
CD55

340
Q

Regulators of Complement:

Purpose of CD55

A

Dissociates components of C3 convertase

341
Q

Regulators of Complement:

When C3b or C4b are bound to DAF, they are vulnerable to inactivation by which inhibitor?

A

Factor I

342
Q

Regulators of Complement:

This inhibitor protects cells from bystander lysis.

A

DAF

343
Q

Regulators of Complement:

What results from a deficiency of Decay-Accelerating Factor?

A

Paroxysmal nocturnal hemoglobinuria

344
Q

Regulators of Complement:
Immune deficiency found in RBCs that are deficient in CD55 and CD59 causing RBCs to be vulnerable to bystander lysis. Patients with this deficiency have a chronic hemolytic anemia

A

Paroxysmal nocturnal hemoglobinuria

345
Q

Regulators of Complement:

Binds to C8 and prevents insertion of C9

A

CD59
AKA
MAC-inhibitory protein

346
Q

Regulators of Complement:

This inhibitor is found on host cells and inhibits the formation of the MAC

A

MAC-inhibitory protein
AKA
CD59

347
Q

Complement Receptors:
This receptor is present on a number of cells - mainly peripheral blood cells; binds to C3b, iC3b, and C4b; and works with Factor I to degrade C3b

A

CR-1

AKA CD35

348
Q

Complement Receptors:

  • Receptor for C3b degradation products
  • Found on B cells and dendritic cells
  • Involved in B cell stimulation
  • Also a receptor for Epstein-Barr virus
A

CR-2

AKA CD21

349
Q

Complement Receptors:

Patients without these receptors are prone to recurrent infections

A

CR-3 and CR-4

350
Q

Complement Receptors:

Mediates transport of immune complexes to the liver/spleen

A

CR-1

351
Q

How are complement components measured?

A
  • Nephelometry

- ELISA

352
Q

Laboratory tests measure the _______, not the _________ of components.

A

Laboratory tests measure the presence, not the function of components.

353
Q

What measures total complement activity?

A

Total hemolytic complement (CH50)

354
Q

Which components of complement are acute phase reactants?

A

C3 and C4

355
Q

Autoimmune disorders that occur due to elevated complement levels

A
  • Early SLE

- Rheumatoid arthritis

356
Q

Infections that occur due to elevated complement levels

A
  • Viral hepatitis

- Acute rheumatic fever

357
Q

What percentage of patients without C4 develop systemic lupus erythematosus (SLE)?

A

90%

358
Q

Deficiences in what 3 complement components leads to reduced clearing of immune complexes; causing tissue damage?

A

C1, C2, and C4

359
Q

RBCs are deficient in DAF and CD59 resulting in chronic hemolytic anemia

A

Paroxysmal nocturnal hemoglobinuria

360
Q

A deficiency in C1INH causes and increase in vascular permeability (edema)

A

Hereditary angioedema

361
Q

Deficiencies in C1qr, C4, and C2 causing lupus-like disease

A

Early complement deficiencies

362
Q

Deficiencies in C5, C6, C7, and C8 will have recurrent infections from what bacteria?

A

Neisseria