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IPCS > Immunology Exam 2 Review > Flashcards

Immunology Exam 2 Review Flashcards

1
Q

_______________ the first phase of Humoral Immunity where Naive B-cells are stimulated by antigen-binding to cell surface proteins and the cross-linking of several B-cell receptors

A

Antigen recognition

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2
Q

What are 2 examples of ig involved in antigen recognition

A

IgM
IgD

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3
Q

In antigen recognition receptor associated proteins will transmit the signal to the:

A

cytoplasm

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4
Q

______________ can also be stimulated by antigens to differentiate and initiate Ig production

A

Memory B cells

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5
Q

What receptors on B-cells can co-stimulate and strengthen responses?

A

complement receptors

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6
Q

multivalent antigens that are NOT dependent on T-cell presence to create a maximal humoral immune response

A

T independent antigens

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7
Q

What is the most common TCI-Ags response produced?

A

IgM response

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8
Q

True/False: TCI-Ags have high affinity maturation or memory response.

A

False

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9
Q

T-Cells can provide assistance in activating _________ by increasing antibody production.

A

B cells

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10
Q

What two things can B cells present

A

antigen and costimulators

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11
Q

T-cells express CD40L and secrete _______

A

cytokines

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12
Q

ONLY ________ (T-cells/B-cells) recognize the same antigenic complex T-cells and B-cells will bind _________ (different/same) epitopes on the
_______ (different/same) antigen.

A

T cells
different
same

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13
Q

a molecule that is recognized by an antibody, but does NOT induce a T-cell response (antibody production) when alone

A

Hapten
( haptens cannot cross-link surface Ig on B-cells; haptens require a carrier protein in order for antibody production to occur)

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14
Q

When haptens are attached to a carrier-protein, a ______ will recognize the“foreign” peptides that are presented to the B-cell to the T-cell

A

T cells

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15
Q

The normal B-cell is isotype is IgM and the principal effector function of IgM is _________________

A

complement activation

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16
Q

True/False: affinity maturation is non-specific and occurs with both B-cells and T-
cells

A

False (B cell only)

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17
Q

The VDJ site is usually ______ (variable/fixed) even though random point mutations can occur in dividing B-cells

A

fixed

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18
Q

describes when B-cells die off because there is less antigen stimulation occurring

A

Humoral response decline

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19
Q

The humoral response decline is regulated by high-levels of which ig

A

IgG

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20
Q

Which immunoglobulin replaces IgM and IgD on the B-cell surface?

A

IgG

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21
Q

bind to free microbes and interfere with host-cell binding to prevent infection

A

Neutralizing

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22
Q

Immunoglobulins will stimulate opsonization and phagocytosis: What are the 5 steps

A

Step1-IgG opsonizes a microbe
Step 2 - Opsonized microbe binds to phagocyte Fc
Step3- Phagocyte is activated by Fc receptors
Step 4 -Microbe is phagocytosed
Step 5- The ingested microbe is killed

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23
Q

Mucosal Immunity–aids in protection; a transport molecule moves ____(IgG/IgA) across the mucosal epithelium to prevent and block microbe colonization entry to the body

A

IgA

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24
Q

The IgA antibody is mainly produced by B-cells in ______ tissues and requires high levels of TGFβ

A

mucosal

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25
Q

the ability for microbes to evade antibody recognition by altering their surface antigens/molecules

A

antigen variation

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26
Q

shift or drift: When a pathogen endures a mutation to a gene-component that causes many changes to Ag-epitopes. Rarely occurs, but when it does it can be very significant/detrimental

A

antigenic shift

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27
Q

shift or drift: When a pathogen endures one or several mutations that resultingly change a few Ag-epitopes. Occurs on an annual basis

A

antigenic drift

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28
Q

_______ – a substance, that is typically added to vaccines, that triggers an innate immune response to enhance adaptive immunity

A

Adjuvant

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29
Q

________________ composed of killed viruses and/or protein fragments of the pathogen that cannot replicate in the host

A

killed/subunit vaccines

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30
Q

True/False: The antibody response is CD8+ cell-mediated in killed/subunit vaccines

A

False

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31
Q

Dead(Non infectious) virus alone → stimulates Class ___ to _____ cells, B-cells, & TLR-
ligands

A

class 2 CD4+

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32
Q

Dead(Non-infectious) viral protein alone → stimulates Class II to CD4+ cells, B-cells
■ Will only stimulate TLR-ligands if an _______ is present to stimulate innate cells

A

adjuvant

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33
Q

most effective and provide long-term protection BUT can cause the disease in an immunocompromised host

A

Live/attenuated vaccines

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34
Q

Vaccines produce mucosal immunity, CD8+ cell-mediated protection, and antibody
production as the virus/pathogen replicates in the host over a short period of time

A

Live attenuated vaccine

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35
Q

Live (Infectious) virus alone → stimulates Class ___ to ____ cells

A

Class 1 CD8

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36
Q

Live (Infectious) virus PLUS _____________________ → stimulates Class II to CD4+ cells, B-cells, and TLR-ligands

A

dead virus/infected cells

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37
Q

occurs when an immune response is too robust and causes tissue damage

A

hypersensitivity reaction

38
Q

What is Type 1 hypersensitivity also called

A

anaphylaxis

39
Q

What is Type 2 hypersensitivity also called

A

cytotoxic

40
Q

What is Type 3 hypersensitivity also called

A

immune complex

41
Q

What is Type 4 hypersensitivity also called

A

delayed-type

42
Q

Type 1: IgE bound to Mast Cells to produce what

A

an allergic reaction, stimulated by TH2 (eosinophils)

43
Q

Type 2: Damage is done where the antibody binds to the tissue antigen. Antibody binds directly to antigens → antigens activate ____ cells

A

TH1

44
Q

Type 3: Damage is done where the immune complex is deposited (not necessarily where
antigen is expressed). Antigen activate ___ cells

A

Th1

45
Q

Type 4: T-cell-mediated usually the first contact with T-cells produces memory. Second contact with T-cells causes what

A

damage

46
Q

IgE Production → dependent on _____ CD4+ stimulating B-cells

A

TH2

47
Q

TH2 Cell activation is promoted by what 3 things

A

IL-4, IL-5, IL-13

48
Q

IgE Production Inhibition → dependent on ____ CD4+ cell production

A

TH1

49
Q

TH1 cell activation is promoted by what

A

IL-12, IL-2, IFN gamma

50
Q

Tissue Damage occurs in Type II and Type III Hypersensitivity: Injury is caused by anti tissue antibody → ____ Cells produce more complement-fixing isotypes which recruit and activate anti-inflammatory cells

A

TH1

51
Q

immunologically mediated via IgE; typically anaphylaxis results

A

Allergic

52
Q

resembles an allergic reaction, but is not immunologically mediated (i.e., histamine is released but there is NO cross-linking of IgE)

A

pseudoallergic

53
Q

Process of Type I Hypersensitivity Reaction: The antigen will bind to IgE on the surface of mast cells which causes cross-linking of IgE on mast cell. An increased influx of _____ into the mast cell

A

Ca2+

54
Q

_______ procedure that is used when there is no other treatment option and the patient has a Type I HS reaction to the medication that is needed

A

Desensitization

55
Q

Immunology of desensitization protocol: Two immunoglobulins dependent on IL-4→

A

IgE and IgG4

56
Q

True/False: IgG4 only elicits tolerance to the allergen

A

True

57
Q

_____ is key to the production of IgG4 versus IgE

A

IL-10

58
Q

_______ tolerance self-reactive B-cells and T-cells are deleted in either the bone marrow or thymus

A

Central

59
Q

_______ tolerance self-reactive cells that escape are usually controlled by regulatory T cells (tregs)

A

peripheral

60
Q

Self-antigens without innate danger signals or co-stimulators that are unresponsive

A

anergic antigens

61
Q

Treg Effector functions

A

inhibit APCs
secrete IL-10 and TGF beta
Use IL-2
Adenosine

62
Q

a microbial peptide or protein may be recognized by a self-antigen reactive T-cell or B-cell

A

molecular mimicry

63
Q

antibodies that arise from defects in clearance of dead/dying cells and Ag-Ab complexes

A

antinuclear antibodies (ANA)

64
Q

A common condition that is triggered by exposure to cold or stress that leads to vasospasm in the extremities, extremities can blue:

A

raynauds

65
Q

What are some drugs that can induce or worsen Raynaud’s syndrome?

A

beta blockers
bleomycin
cisplatin
amphetamine, pseudoephedrine

66
Q

What drug could we use to treat Raynaud’s syndrome?

A

CCB (nifedipine)

67
Q
  1. What is the non-pharmacologic therapy used to treat Psoriasis?
A

UV light

68
Q

When should we use topical therapy VS system therapy to treat Psoriasis?

A

> 10% of body use systemic therapy
topical: tazarotene + halobetasol
systemic: apremilast

69
Q

a systemic autoimmune disease that can affect any organ system in the body

A

SLE

70
Q

Common ss/sx of SLE:

A

fatigue
malar rash
depression

71
Q

What the first line medication for SLE that everyone should be on?

A

hydroxychloroquine

72
Q

What baseline labs that we need to account for in hydroxychloroquine?

A

vision evaluation

73
Q

What are some side effects of this medication in hydroxychloroquine?

A

N/V/D
rash
CNS
headaches

74
Q

When to add steroids to therapy in SLE?

A

flares

75
Q

List drugs that can cause SLE:

A

hydralazine
anti-TNF
methyldopa

76
Q

Hydroxychloroquine agent and when to use in lupus

A

Primary Non-Biologic DMARD
maintenance

77
Q

NASIDS when to use in lupus

A

flares

78
Q

Glucocorticoids when to use in lupus

A

flares

79
Q

Non-Biologic DMARDs

A

MXT, MMF

80
Q

Biologic DMARDS

A

Rituximab, Belimumab

81
Q

List conventical DMARDS for RA treatment, which one is first line?

A

methotrexate***
sulfasalazine
lefluonmide
hydroxycholoquine

82
Q

What is the dose typically use for methotrexate

A

7.5-15 mg weekly
(use with folic acid)

83
Q

What ADRs would we monitor in methotrexate

A

GI, hepatic, liver, Scr, CBC

84
Q

joint inflammation that occurs due to decreased synthesis of chondrocytes associated with cartilage degradation–bone-on-bone; referred to as “wear and tear arthritis”

A

osteoarthritis

85
Q

Common immunosuppressive drugs and their targets: FκBP Receptor on calcineurin

A

Tacrolimus

86
Q

Common immunosuppressive drugs and their targets: FκBP Receptor on mTOR

A

Sirolimus

87
Q

Common immunosuppressive drugs and their targets: 6-MP substrate of purine synthesis

A

Azathioprine

88
Q

Common immunosuppressive drugs and their targets: IL-2Rɑ

A

Basiliximab

89
Q

Common immunosuppressive drugs and their targets: IMPDH to inhibit purine synthesis

A

Mycophenolate

90
Q

Common immunosuppressive drugs and their targets: Calcineurin

A

Cyclosporine

91
Q

List Induction therapy medications:

A

basiliximab
alemtuzumab
high dose steroids

92
Q

List maintenance therapy medications:

A

tacolimus
sirolimus
mycophnolate mofetil

IPCS (5 decks)

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