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Immunology > Immunology Exam 5 (Vaccines, Immunoproliferative, Immundeficiency diseases) > Flashcards

Immunology Exam 5 (Vaccines, Immunoproliferative, Immundeficiency diseases) Flashcards

1
Q

What is Active Immunity? Give a few examples of active immunity.

A

Stimulation of a person’s own immune system to mount an adaptive immune response to an antigen.

Examples:
- Natural exposure to an infection (natural active)
- Administration of vaccine (artificial active)

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2
Q

What is Passive Immunity? Give a few examples of passive immunity.

A

Transfer of preformed antibodies from immunized hosts to a non-immune individual.

Examples:
- Transfer of antibodies through placenta/breast milk (natural passive)
- Passive immunotherapy (RhoGam, monoclonal Ab) (artificial passive)

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3
Q

What antibody mediates placental vs breast milk antibody transfer?

A

Placental - IgG
Breast Milk - IgA

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4
Q

Benefits of passive immunity

A
  • Provides immediate immunity
  • Can be used as immunosuppressive therapy in selected situations
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5
Q

Limitations of passive immunity

A
  • Short lived immunity
  • Can induce Type I or Type III hypersensitivities
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6
Q

What is HISG (Human Immune Serum Globulin)?

A

“Gamma globulin” - pooled serum from donors with a wide range of antibodies against numerous antigens; good for immunodeficient patients that need broad spec antibodies

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7
Q

What are Antigen-Specific Immune Globulins?

A

“Hyperimmune globulins” - made from pooled serum of donors with immunity to a particular pathogen; good to treat unimmunized individuals who have potentially been exposed to a pathogen
Ex. Rabies, Tetanus, HepA/HepB

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8
Q

What are animal globulins?

A

Usually prepared from horse serum
- Anti-toxins (tetanus, diphtheria, botulism)
- Anti-venom

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9
Q

Monoclonal antibodies

A

Made by a single clone of B cells, directed against a particular epitope of an antigen

Used for cancer, autoimmune diseases

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10
Q

Adoptive immunity

A

Transfer of cells (usually lymphs) of the immune system used to increase cell-mediated immunity

Ex. CAR-T cell therapy, HSC transplants, cancer treatment with TILs

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11
Q

Advantages and disadvantages of active immunity

A

Adv: Induces long term protection (memory cells created)
Disadv: Takes time to develop

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12
Q

Advantages and disadvantages of passive immunity

A

Adv: Immediate protection
Disadv: Short term (memory not produced)

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13
Q

Advantages and disadvantages of adoptive immunity

A

Adv: Can transfer cell-mediated immunity
Disadv: immune cells must be depleted, possible rejection (GvHD)

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14
Q

What vaccine provides immunity for Chickenpox? How is this disease spread? What are the disease complications?

A

Varicella
Air/direct contact
Blisters, bleeding disorders, encephalitis, pneumonia

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15
Q

What vaccine provides immunity for Diphtheria? How is this disease spread? What are the disease complications?

A

DTaP
Air/direct contact
Swelling of heart muscle, heart failure, coma, paralysis, death

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16
Q

What vaccine provides immunity for Hib? How is this disease spread? What are the disease complications?

A

Hib vaccine
Air/direct contact
Meningitis, epiglottis

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17
Q

What vaccine provides immunity for Hepatitis A? How is this disease spread? What are the disease complications?

A

HepA vaccine
Direct contact, contaminated food/water
Liver failure, arthralgia, kidney/pancreatic disorders

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18
Q

What vaccine provides immunity for Hepatitis B? How is this disease spread? What are the disease complications?

A

HepB vaccine
Contact w/ blood or body fluids
Liver failure, liver cancer

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19
Q

What vaccine provides immunity for Influenza? How is this disease spread? What are the disease complications?

A

Flu vaccine
Air/direct contact
Pneumonia

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20
Q

What vaccine provides immunity for Measles? How is this disease spread? What are the disease complications?

A

MMR vaccine
Air/direct contact
Encephalitis, pneumonia

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21
Q

What vaccine provides immunity for Mumps? How is this disease spread? What are the disease complications?

A

MMR vaccine
Air/direct contact
Meningitis, inflammation of testicles/ovaries

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22
Q

What vaccine provides immunity for Pertussis? How is this disease spread? What are the disease complications?

A

DTaP vaccine
Air/direct contact
Pneumonia

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23
Q

What vaccine provides immunity for Polio? How is this disease spread? What are the disease complications?

A

IPV vaccine
Air/direct contact/through mouth
Paralysis and death

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24
Q

What vaccine provides immunity for Pneumococcal? How is this disease spread? What are the disease complications?

A

PCV13 vaccine
Air/direct contact
Bacteremia, meningitis

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25
What vaccine provides immunity for Rotavirus? How is this disease spread? What are the disease complications?
RV vaccine Through the mouth Severe diarrhea and dehydration
26
What vaccine provides immunity for Rubella? How is this disease spread? What are the disease complications?
MMR vaccine Air/direct contact Very serious in pregnant women, can lead to miscarriage/stillbirth/premature delivery
27
What vaccine provides immunity for Tetanus? How is this disease spread? What are the disease complications?
DTaP vaccine Exposure through cuts in skin Broken bones, breathing difficulty, death
28
What are attenuated vaccines?
Contain live, but weakened viruses or bacteria Organisms grown under abnormal conditions so that they are no longer pathogenic but are still capable of stimulating the immune response - Chick embryo passaging
29
Examples of live, attenuated vaccines for bacterial diseases
BCG - for M. tuberculosis/M. bovis Typhoid fever - for Salmonella typhi
30
Examples of live, attenuated vaccines for viral infections
Polio (Sabin) --> orally Influenza (nasal mist) MMR Varicella Zoster
31
Rubeola vs Rubella
Rubeola = measles (M in MMR) Rubella = German measles (R in MMR)
32
What are some advantages and disadvantages of live, attenuated vaccines?
Adv: Stimulates humoral AND cell-mediated immunity Disadv: Cannot be given to immunocompromised, potential interference by maternal antibodies, may revert to pathogenic form
33
What are inactivated (whole killed) vaccines
Intact viruses/bacteria that have been killed by chemicals or heat
34
Examples of inactivated (whole killed) vaccines
Polio (Salk) - intramuscular Influenza - intramuscular or intradermal Hepatitis A
35
Polio Salk vs Polio Sabin
Polio Salk = intramuscular vaccine for polio that is whole killed Polio Sabin = oral vaccine for polio that is live, attenuated
36
Advantages and disadvantages of inactivated (whole killed) vaccines
Adv: Can be given safely to immunocompromised Disadv: No stimulation of cell-mediated immunity, may require boosters
37
What are the different types of subunit vaccines?
Toxoids Polysaccharides Purified proteins Recombinant proteins
38
Advantages and disadvantages of subunit vaccines
Adv: Induce immune response to the pathogenic components of microorganism and safe since organism isn't in tact Disadv: Require boosters, adjuvants, and must be multivalent
39
What is a Toxoid vaccine? What are some examples?
Type of subunit vaccine that has chemically inactivated bacterial toxins that are not pathogenic Ex: Diphtheria, Tetanus
40
What is a Polysaccharide vaccine? What are some examples?
Type of subunit vaccine that has biochemically purified polysaccharide from bacterial capsules Ex: Strep pneumonia, Hib vaccine, Neisseria meningitidis Requires conjugation to a carrier protein
41
What is Hib vaccine?
Haemophilus influenza type b
42
What is a glycoconjugate?
A carrier protein that helps to induce IgG production and long-term immunity, associated with subunit vaccines
43
What is a purified protein vaccine? What are some examples?
Type of subunit vaccine that contains biochemically purified components of a microorganism Ex. Bordetella pertussis
44
What is a recombinant protein vaccine? What are some examples?
Proteins produced by genetically modified nonpathogenic bacteria/yeast/other cells Ex. Hepatitis B, HPV
45
What are some factors influencing immunogenicity?
- Age - Immune status of patient - Vaccine composition (live vaccines are most immunogenic, subunit are least)
46
What are adjuvants? What is the goal of adjuvants?
Substances that enhance the immune response when administered together with a vaccine's antigen Goal is to: - Increase antibody titers - Increase cell-mediated immunity - Reduce the dose of antigen and # boosters needed
47
What are the main mechanisms of actions for adjuvants?
1. Modify antigen delivery systems (enhance uptake of antigens by APCs) 2. Modify immunopotentiators (activate dendritic cells to present antigens to T cells)
48
Examples of adjuvants
- Aluminum salts - Oil in water emulsions - Virosomes - CpG - Ethyl-mercury
49
Benefits of vaccines
- Decreased morbidity and mortality - Herd immunity
50
What is herd immunity?
If enough people get vaccinated, protection will be extended to nearby persons who have not been immunized.
51
Adverse affects of some vaccines
- Localized reactions (swelling, tenderness) - Generalized reactions (fever/malaise) - Allergic reactions (Type I or Type III hypersens.) - Development of disease (if live vaccine is given to immunocompromised)
52
What are immunoproliferative diseases involving lymphoid cells?
Leukemia, lymphoma, plasma cell dyscrasia
53
Malignant cells originate in bone marrow and travel to peripheral blood
Leukemia
54
Solid tumors that arise in lymph nodes and other lymphoid tissues
Lymphoma
55
Malignant or premalignant conditions of the plasma cells, also known as monoclonal gammopathies
Plasma cell dyscrasia
56
WHO classification of hematological malignancies are based on:
- Cell lineage/morphology - Immunological markers/flow cytometry - Genetic features/molecular - Cytochemical staining
57
What is the most common type of ALL in children?
Pre-B-cell ALL
58
Hyperdiploidy is associated with a _______ prognosis
Good
59
What is the most common leukemia in adults?
CLL
60
What disease is associated with smudge cells?
CLL
61
What is a highly specific marker for Hairy Cell Leukemia?
CD103 TRAP stain positive
62
What immunoproliferative disease is associated with Reed-Sternberg Cells?
Hodgkin Lymphomas
63
What are the types of Non-Hodgkin Lymphomas of B cell origin?
Diffuse Large B-cell lymphoma Follicular lymphoma Mantle cell lymphoma Burkitt lymphoma **B-cell origin = more common
64
What are the types of Non-Hodgkin Lymphomas of T-cell or NK-cell origin?
Mycosis fungoides Sezary syndrome Adult T cell leukemia **T cells have a flower-like nucleus or cerebriform nucleus
65
What are the types of Plasma Cell Dyscrasias?
MGUS Smoldering Multiple Myeloma Multiple Myeloma Waldenstrom's macroglobulinemia
66
Describe MGUS
Pre-malignant condition - Production of a monoclonal Ig (low serum concentration, less than 3.0 g/dL) - Less than 10% bone marrow are plasma cells
67
Describe Smoldering Multiple Myeloma (SMM)
Pre-malignant condition - Production of a monoclonal IgG or IgA greater than or equal to 3.0 g/dL - Plasma cell count is 10-60% of bone marrow cells
68
Describe Multiple Myeloma
Malignancy of plasma cells - CD38+, CD56+, CD138+ - Plasma cells make up 10% or more of the bone marrow - Increased IgG - CRAB features - Bence Jones proteinuria
69
What are CRAB features?
C - calcium increased R - renal dysfunction A - anemia B - bone disease and atrophy
70
What is Waldenstrom macroglobulinemia?
Malignant proliferation of IgM-producing B cells or plasma cells CD19+, CD20+, CD22+, CD79a+ NO lytic bone lesions like MM Monoclonal IgM
71
What area on serum protein electrophoresis would be abnormal in someone with a monoclonal gammopathy?
Gamma region increased
72
What is IFE?
Immunofixation electrophoresis, shows the amount of each IgG and kappa/lamba present to indicate where the monoclonal gammopathy is coming from
73
What is immunosubtraction?
Use of capillary electrophoresis to identify monoclonal Ig heavy and light chain determinants - Monoclonal peaks will DISAPPEAR in the electrophoresis wells that contain the causative Ig, as opposed to IFE where the appearance of bands indicate the causative Ig
74
What is Serum Free Light Chain Analysis?
Automated, latex-enhanced immunoassays for bence jones protein detection, measure free Kappa and Lambda light chain concentrations in serum
75
What is the normal K:L ratio?
0.26-1.65
76
Primary vs secondary immunodeficiencies
Primary: inherited (PIDs) Secondary: acquired
77
What is Bruton X linked Agammaglobulinemia?
PID, decreased to absent antibodies with a mutation to Bruton's tyrosine kinase on the X chromosome - Usually seen in 0-3 year old boys - Hypersusceptibility to infections from pyogenic organisms - Normal T cell function, Absent B cells
78
What is Transient hypogammaglobulinemia of infancy?
Delayed development of IgG production, normal number of B cells but delayed Th maturation
79
What is Selective IgA deficiency
Low IgA levels, most common PID that results in anti-IgA antibodies that may result in anaphylaxis if given FFP or acellular blood products
80
What is CD154 deficiency?
Decreased levels of IgG, IgA, and IgE as a result of defect in B cell switching
81
Immunodeficiencies affecting cellular and humoral immunity
Caused by genetic mutations that alter development of T and B cells such as SCID and PNP deficiency
82
Pathogenicity of SCID (How is it inherited)
X linked recessive form caused by IL2RG gene mutation
83
What are the combined deficiencies with associated syndromic features?
Wiskott-Aldrich syndrome 22q11.2 deletion (DiGeorge) Ataxia telangiectasia
84
What is Wiskott-Aldrich Syndrome?
Defective WASp gene Characterized by problems with cellular cytoskeleton, adhesion, and migration Defect in CD43 Eczema, Thrombocytopenia
85
What is DiGeorge Syndrome?
T cell defect from faulty embryogenic development of thymus and parathyroid - Results in aplasia to these glands, facial and vascular anomalies, associated with Zinc deficiency, hypocalcemia, heart defects, increased susceptibility to infections 22q11.2 deletion
86
What is ataxia telangiectasia?
Affects DNA repair and VDJ gene rearrangement in T and B cells Patient presents with ataxia, telangiectasia, and dysplastic thymus Patient has decreased IgA and likely to develop anti-IgA
87
What is Chronic Granulomatous Disease?
Neutrophils unable to generate oxidative burst leading to decreased killing of catalase + organisms
88
Chediak-Higashi Syndrome
Normal number of T and B cells, but reduced control over functions - Decreased NK cells and neutrophils, enlarged lysosomal granules, hypopigmentation
89
What are the different types of tumor antigens?
- Mutation-derived tumor antigens - Antigens from oncogenic viruses - Cancer/testis antigens - Differentiation antigens - Overexpressed antigens
90
AFP tumor marker is associated with which type of cancer. What is it used for?
Liver/testicular Screening Diagnosis Prognosis Monitoring
91
CA 125 tumor marker is associated with which type of cancer? What is it used for?
Ovarian Screening Diagnosis Prognosis Monitoring
92
CA 19-9 tumor marker is associated with which type of cancer? What is it used for?
Pancreatic Diagnosis Prognosis Monitoring
93
CEA tumor marker is associated with which type of cancer? What is it used for?
Colorectal, breast, lung Prognosis Monitoring
94
hCG tumor marker is associated with which type of cancer? What is it used for?
Testicular, trophoblastic Diagnosis Prognosis Monitoring
95
PSA tumor marker is associated with which type of cancer? What is it used for?
Prostate Screening Diagnosis Prognosis Monitoring
96
Direct allorecognition
T cells from recipient bind to foreign HLA antigens on cells of the allograft
97
Indirect allorecognition
Host APCs present foreign MHC antigens on graft cells to recipient Th cells
98
What disease is B27 antigen on HLA associated with?
Ankylosing spondylitis
99
What disease is B51 antigen on HLA associated with?
Behcet's syndrome
100
What disease is DR3 antigen on HLA associated with?
Gluten-sensitivity enteropathy
101
What disease is DR5 antigen on HLA associated with?
Hashimoto's thyroiditis
102
Hyperacute GvHD (time/onset, mechanism of injury, cause)
Time: minutes Mechanism: humoral Cause: preformed cytotoxic antibodies to donor HLA
103
Accelerated GvHD (time/onset, mechanism of injury, cause)
Time: 2-5 days Mechanism: cell-mediated Cause: previous sensitization to donor antigens
104
Acute GvHD (time/onset, mechanism of injury, cause)
Time: 7-21 days Mechanism: cell mediated and cytotoxic antibody Cause: allogeneic recognition of donor antigens by HLA class I
105
Chronic GvHD (time/onset, mechanism of injury, cause)
Time: >3 months Mechanism: cell mediated or antibody Cause: Host vs Graft disturbances or tissue trauma
106
Function of corticosteroids
Anti-inflammatory
107
Function of antimetabolites
Interfere with lymphocyte maturation and division
108
Function of calcineurin inhibitors
Block cytokine synthesis in T cells
109
Function of monoclonal antibodies
Interfere with T cell or B cell function by binding to lymphocyte surface molecules
110
Function of polyclonal antibodies
Animal-derived antibodies against human cells that deplete thymocytes or lymphocytes

Immunology (6 decks)

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