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Immunology/Microbiology > Immunology Exam I > Flashcards

Immunology Exam I Flashcards

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1
Q

when either of the three pathways of complement are activated what results…

A

inflammation
lyse certain infectious agents
opsonize infectious agents
clears immune complexes

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2
Q

what activates the lectin pathway

A

mannan binding lectin binds CHO on bacteria

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3
Q

what activates the alternative pathway

A

spontaneous lysis of C3 if binds to bacteria, initiates the pathway

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4
Q

the classical pathway requires what Ig to bind

A

pentameric IgM or 2 molecules of IgG

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5
Q

what is the molecule that binds to the microbial surface in the complement pathway

A

C3b

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6
Q

what is opsonization

A

the coating of molecules with opsonins that help deliver bacteria to the phagocyte for destruction

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7
Q

what molecules aid in opsinization

A

antibody IgG and complement C4b

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8
Q

what are immune complexes

A

they are insoluble lattices that trigger inflammation and type III hypersensitivity reactions

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9
Q

What disrupts immune complexes

A

C3b

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10
Q

anaphylatoxins

A

cause degranulation of mast cells and basophils WITHOUT IgE

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11
Q

_____________is a major chemotactic protein for inflammation

A

C5a

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12
Q

What does MAC do ?

A

forms pores in molecules and lyses the cell

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13
Q

MAC is critical for protection against

A

Neisseria infections

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14
Q

MAC is not effective against

A

gram negative because of LPS

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15
Q

deficiencies in the classical pathway c1q, c1r, c1s, c42 and c2 results in

A

increased immune complex diseases

increased infectious with pyogenic bacteria

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16
Q

Deficiency in the alternative pathway factor B and properdin results in

A

nessierial infections

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17
Q

deficiency in C3 results in

A

recurrent bacterial infections, immune complex disease

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18
Q

deficiency in MAC

A

recurrent meningoccocal and gonococcal infections

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19
Q

Deficiency in C1-INH results in

A

over missue use of C1,4,2 and presents with edema of mucosal surfaces

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20
Q

what is a cytokine

A

a chemical messenger of the immune system; a low mw protein secreted by white blood cells in response to a stimulus

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21
Q

autocrine action of cytokine

A

acts on the cell that secreted it

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22
Q

paracrine action of cytokine

A

acts on a nearby cell

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23
Q

endocrine

A

goes through the blood to act on a distant cell

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24
Q

What are the four effects of cytokine signaling

A

pleiotropy, redundancy, syngergy, and antagnosim

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25
Q

pleiotropy

A

multiple functions

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26
Q

synnergy

A

better when together

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27
Q

anatognism

A

work against eachother

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28
Q

redudndancy

A

multiple cytokines with similar functions

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29
Q

what is the significant of gamma chian of IL2-R

A

IL2 and IL4 share the gamma chain of IL2

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30
Q

_______-causes T and B cell proliferation

A

IL2

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31
Q

_________causes B cells to make different antibodies (class switching)

A

IL-4

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32
Q

mutations in the gamma chian of IL-2R leads to

A

SCID

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33
Q

____________is used to treat HBV, HCV, and HHV-8

A

IFN-alpha

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34
Q

___________is used to treat MS

A

IFN-beta

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35
Q

_____________are both antiviral

A

IFN-alpha and beta

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36
Q

____________activates macrophages to stimulate intracellular killing and inhibits the TH2 Response

A

IFN-gamma

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37
Q

____________-is used to treat chronic granulamatous disease

A

IFN-gamma

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38
Q

Three actions of IFN-alpha and beta

A

resistance to viral replication, increase MHC class I expression, activates NK cells to kill virus infected cells

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39
Q

What are the three fever inducing cytokines

A

IL-1, IL-6 and TNF-alpha

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40
Q

Actions of the pyrogenic cytokines

A

activation of complement/ opsinization
phagocytosis
decreased viral and bacterial replication, increased ag processing, initiation of adaptive immune response

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41
Q

TNF-alpha is made by

A

macrophages, T cells and fibroblasts

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42
Q

TNF-beta is made by

A

actiated T and B cells

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43
Q

______________-can kill tumor cells

A

TNF-alpha

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44
Q

____________can inhibit TNF-alpha

A

monoclonal antibodies

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45
Q

____________-is used to treat chronic inflammatory diseases such as RA, chrons, and psoriasis

A

TNF-alpha inhibitors

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46
Q

what is the side effect of anti-TNF-alpha

A

increased susceptibility to diease

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47
Q

____________- and __________-are proinflammatory and induce the liver to make acute phase proteins and induce febrile response

A

IL1-6

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48
Q

______________stimulates hematopoiesis, acts on plasma cells to drive Ab production

A

IL6

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49
Q

IL-2 is made by

A

T cells

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50
Q

what type of regulation is IL-2 under

A

autocrine regulation

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51
Q

_____________stimulates growth and differentiation of T cells , B cells and NK cells

A

IL-2

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52
Q

_________________ and __________ are directed toward the alpha chain of IL-2R which blocks IL2

A

basilizimab and daclizumab

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53
Q

___________ has been found to have success of organ transplants and experimental treatment of leukemia and melanomas

A

IL2 treatment

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54
Q

____________-promotes class swithcing from IGM to IgE and IgG

A

IL-4

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55
Q

what inhibits IFN-gamma production

A

IL4

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56
Q

_______promotes class switching to IgA

A

IL-5

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57
Q

both IL4 and IL5 are made by

A

Th2 cells

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58
Q

____________induces eosinophil development and differentiation

A

IL-5

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59
Q

monoclonal antibodies against IL-4 are used to treat

A

serious allergies

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60
Q

______________is made by macrophages

A

IL10

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61
Q

__________downregulates pro-inflammatory cytokine production

A

IL-10

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62
Q

_________activates B cells promoting the TH2 response

A

IL-10

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63
Q

how is IL-12 made

A

primarily by macrophages

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64
Q

_______________induces differentiation of Th cells into Th1 cells

A

IL-12

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65
Q

IL-18 with IL-12

A

induce IFN-gamma from Th1 cells

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66
Q

_________is the first cytokine responsible for stimulating immune response

A

IL-12

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67
Q

______________-attact leukocytes to the site of inflammation

A

chemokines

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68
Q

IL8 is a chemokine that attracts

A

neutrophils

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69
Q

RANTEs atttracts

A

T cells and monocytes

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70
Q

Eotaxin attracts

A

eosinophils

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71
Q

____________are growth factors

A

IL3 and Il7

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72
Q

IL3

A

growth factor for WBC

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73
Q

IL7

A

growth factor for lymphocytes (B and T cells)

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74
Q

G-CSF

A

essential for neutrophils

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75
Q

___________ is used to boost immunity during chemotherapy

A

GM-CSF

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76
Q

________________is used to boot immunity prior to bone marrow transplant

A

G-CSF

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77
Q

___________–is used to treat anemia

A

EPO

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78
Q

What cytokines are secreted by TH1 cells

A

IL-2,and IFN-gamma

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79
Q

What cytokines are secreted by macrophages

A

IL-8, 10, 12, TNF-alpha, GCSF, GM-CSF

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80
Q

what cytokines are secreted by Th2

A

IL4,5,6

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81
Q

what cell funxtions in both adaptive and innate immunity

A

NK cell

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82
Q

what are three ways why adaptive immunity shows up

A

physical bariers failed
innate immunity is unable to clear the infection
preventative step

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83
Q

what is the time frame for adaptive immunity

A

days versus hours for innate immune system

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84
Q

how is specificy generated ?

A

clonal selection

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85
Q

what is the main antibody for the primary response

A

IGM and later IgG

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86
Q

what is the main antibody for the secondary response

A

IgG

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87
Q

passive artifical immunity

A

transfer of antibodies to a patient

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88
Q

what cells are responsible for the adaptive immune response

A

small lymphocytes, B lymphocytes, T lymphocytes

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89
Q

CD3 is associated with what cells

A

T cells and T cell receptor

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90
Q

B cells are responsible for attacking invaders ______-the cells

A

outside

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91
Q

T cells are responsible for attacking invaders_______inside the cell

A

inside

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92
Q

what cells are responsible for secreting antibodies

A

plasma cells

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93
Q

Th1 activates what types of cells

A

Tc and macrophages

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94
Q

Th2 activates what types of cells

A

B cells

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95
Q

where does lymph end up going

A

left subclavian vein

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96
Q

does lymph have valves

A

yes (one way valves)

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97
Q

is lymph have a pumping system

A

moves via movement of muscles

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98
Q

What are the two primary lymphoid organs

A

bone marrow and thymus

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99
Q

what are the secondary lymphoid organs

A

MALT CALT, spleen and lymph nodes

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100
Q

__________________ is where lymphocyte development and maturation occurs

A

primary lymphoid organs

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101
Q

______________________is where the lymphocyte interacts with the antigen

A

secondary lymphoid organ

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102
Q

What occurs in the thymus

A

T cell development and selection

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103
Q

What is DiGeorge’s syndrome

A

congenital birth defect, failure of the thymus to develop, absence of circulating T cells, increased # of infections

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104
Q

When is the thymus the largest ?

A

puberty

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105
Q

____________is the major site of hematopoiesis

A

bone marrow

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106
Q

where do B cells develop and mature

A

in the bone marrow

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107
Q

what structure is the first lymph tissue to encounter antigen ?

A

lymph nodes

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108
Q

What cells are responsible for trapping antigen traveling through the lymph node

A

phagocytic and dendritic cells

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109
Q

What are the two major parts of the spleen ?

A

red pulp and white pulp

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110
Q

______________is responsible for trapping blood borne antigens

A

spleen

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111
Q

____________________is the formation and development of red and white blood cells from stem cells

A

hematopoeisis

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112
Q

Where does hematopoeisis begin ?

A

it begins in the yolk sac and then migrates to the fetal liver and spleen

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113
Q

where is the major site of hematopoesis after birth until death

A

bone marrow

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114
Q

all lymphoid cells are derived from___________

A

pluripotent hematopoietic stem cells

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115
Q

_____________-cells are resistant to radiation

A

PHSC

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116
Q

What is important to know before a BM transplant can occur

A

MHC compatability to prevent graft rejection

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117
Q

Stem cells can be used to treat what two diseases

A

SCID and ADA deficieny

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118
Q

_________are recognized by monoclonal antiodies

A

Clutster of differentiations

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119
Q

what is the marker for Th

A

CD4

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120
Q

what is the marker for TC

A

CD8

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121
Q

whta is the marker for all T cells

A

CD3

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122
Q

whatis the marker for macrophages

A

CD14

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123
Q

What is the markers for NK cells

A

CD16, CD56

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124
Q

what are the markers for all B cells

A

CD19, 20, 21

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125
Q

what are the markers for stem cells

A

Cd34

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126
Q

What are the lymphoid cells /

A

B T and NK

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127
Q

what are the granulocyte cells

A

neutrophils, eosinophils, basophils, and mast cells

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128
Q

mononuclear cells inlcude

A

macrophages
granulocutes
dendritic cells

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129
Q

What cell makes up the majority of adult blood counts ?

A

neutrophils

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130
Q

what is the term associated a B or T cells have not yet come in contact with antigen

A

Naive Cells

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131
Q

Th1 cells activate

A

Tc and Macrophages

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132
Q

Th2 cells activate

A

B cells

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133
Q

NK cells have receptors for

A

Ab-ADCC

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134
Q

Chediak-Higashi

A

no NK cells and have increased incidence of lymphomas

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135
Q

macrophages in the lung are called

A

alveolar macrophages

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136
Q

macrophages in CT are

A

histiocytes

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137
Q

macrophages in the liver are called

A

kupfer cells

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138
Q

macrophages in the kidney are called

A

mesangial cells

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139
Q

macrophages in the brain are called

A

microglial cells

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140
Q

activated macrophages have….

A

increased phagocytic abilities, increased ability to activate Th and high levels of class II MHC on the surface

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141
Q

what cell is first at the site if inflammation

A

neutrophil

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142
Q

cells that have phagocytic capabilites, play a major role in parsites and secrete granules that damage the parasite membrane

A

eosinphils

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143
Q

________are non phagocytic and release pharmacoligcally active substances contained within granules and are involved in the allergic response

A

basophils

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144
Q

______–are precursors formed in the bM during hepatopoeisis and play a role in allergies

A

mast cells

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145
Q

_______________express high levels of class II MHC and B7

A

dendritic cells

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146
Q

langerhan cells are found in

A

epidermis and mucous membranes

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147
Q

interstitial dendritic cells are found in

A

most organs

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148
Q

interdigitating cells are found in

A

T cell zones of secondary lymph tissue and thymic medulla

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149
Q

__________-are found in the blood

A

circulating dendritic cells

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150
Q

_____________are found exclusively in the follicles of the lymph nodes

A

follicular dendritic cells

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151
Q

characteristics of follicular dendritic cells

A

don’t express class II MHC, don’t function as APC for Th cell activation, have many receptors and bind Ag-Ab complexes and play a role in the formation of memory b cells

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152
Q

cells of the innate immune system include

A

phagocytes

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153
Q

cells of the adaptive immune system include

A

lymphocytes

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154
Q

what cells are concidered phagocytes ?

A

neutrophils, macrophages, eosinophils, and basophils

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155
Q

what are the receptors on macrophages

A

CR3, CR4, (complment) and CD14 (LPS receptor), and toll receptors

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156
Q

what are the receptors on neutrophils

A

toll receptors, CR3,4 (compplement), CD14 and Fmet peptide receptors

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157
Q

phagocytes have receptors for what two things that greatly enhance their phagocytic capability

A

IgG and C3b

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158
Q

What does NADPH oxidase make

A

toxic oxygen radicals

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159
Q

what does myeloperoxidase make

A

hypochlorite (bleach)

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160
Q

Il1-beta

A

activates endothelium lymphocytes and local tisue destruction and increases access to affector cells, produces systemicaly fever and production of IL-6

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161
Q

Function of IL-6

A

lymphocyte activation and increased antibody production

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162
Q

cytokines secreted by macrophages

A

IL-1 Beta, TNF-alpha, IL-6, CXCL8,IL-12

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163
Q

rolling of wbc’s is done by

A

selectins

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164
Q

tight binding of wbcs in inflammation is done by

A

integrins

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165
Q

vasciular endothelium receptors for rolling adhesion

A

p and e selectin

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166
Q

neutrophil receptors for rolling adhesion

A

sialyl lewis carbohydrates on wbc

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167
Q

vascular endothelium for tight binding

A

ICAM-1

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168
Q

Neutrophils receptors for tight binding

A

LFA-1 and CR3

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169
Q

IL-8 and IL-1 are

A

proinflammatories

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170
Q

_____________ and__________directly inhibit viral replication

A

IFN-alpha and IFN-beta

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171
Q

________is produced by fibroblasts

A

IFN-beta

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172
Q

_________is produced by leukocytes

A

IFN-alpha

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173
Q

Functions of IFN-alpha and IFN-beta

A

induce resistance to viral replication
increase MHC class I expression
activate NK cells to kill viruses

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174
Q

CD expressed on NK cells

A

16 and 56

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175
Q

activation of NK cells leads to

A

degranulation via perforin

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176
Q

NK cells kill what type of cells

A

have decreaed MHC class I expression on them

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177
Q

the major line of defense against bacteria or extracellular pathogens is

A

antibodies

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178
Q

three main functions of antibodies

A

opsonization
neutralization
antibody dependent cellular cytotoxicity (ADCC)

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179
Q

basic structure of the antibody includes how many light chains and how many heavy chains

A

2 heavy and 2 light

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180
Q

what are the two domains of the light chains

A

1C and 1V

181
Q

what are the domains of the heavy chains

A

1V and 3-4 C

182
Q

What is the region of the antibody that binds the Ag

A

variable region (Fab)

183
Q

how many antigen can the variable region bind

A

2

184
Q

What does the constant region of the antibody function in

A

complement activation

opsonization, and crossing the placenta

185
Q

what region of the antibody determines its function

A

Fc or constant region

186
Q

What type s of bonds hold the antibody chains together

A

disulfide bonds

187
Q

heavy chains have how many classes

A

5

188
Q

light chains have how many classes

A

2

189
Q

what joints to form the heavy chain

A

V,D, and J

190
Q

what joints to form the light chains

A

V and J

191
Q

which chain rearranges first (heavy or light chain)

A

heavy chain THEN light chain

192
Q

what are the genes called that are responsible for DNA rerangement ?

A

RAG 1 and RAG 2

193
Q

what is the first antibody that is made

A

IgM

194
Q

what are some functions of IgG

A

opsonization

ADCC, activation of classical complement and can cross the placenta

195
Q

which antibody can cross the placenta

A

IgG

196
Q

what antibody is predonimnant antibody in the serum

A

IgG

197
Q

What antibody predominates in the secondary immune response

A

IgG

198
Q

what is the predominant antibody during the primary immune response

A

IgM

199
Q

first antibody made in neonates

A

IgM

200
Q

activates classical complement pathway

A

IgM

201
Q

pentameric in serum

A

IgM

202
Q

high avidity but low affinity

A

IgM

203
Q

the predominant antibody in secretion s

A

IgA

204
Q

secretion present as a dimer

A

IgA

205
Q

protected in secrety by a secreotry piece

A

IgA

206
Q

found in low levels in the plasma cells and binds mast cells and basophils

A

IgE

207
Q

functions in type I hypersensitivity reactions

A

Ige

208
Q

antigen receptor is on B cells

A

IgD

209
Q

which two antibodies have the naive B cell Ag receptor

A

IgM and IgD

210
Q

which antibody opsonizses

A

IgG

211
Q

which antibody functions in ADCC

A

IgG

212
Q

which antibody is transported across the placenta

A

IgG

213
Q

which antibodys have memory B cell Ag receptot

A

IgG, IgA and IgE

214
Q

which antibody triggers mast cell granule release

A

IgE

215
Q

if cells in the bone marrow express rag, tdt, MHC II, and CD19, 20,21 and 40 which types of B cells are they

A

ProB and PreB

216
Q

Which cells express Tdt

A

Prob B and Preb B

217
Q

Cd19, CD20, CD21, and CD40 are expressed on

A

all developing B cells

218
Q

memory B cells express ___________ __________ and _____________on their cell surfaces

A

IgG, IgA, and IgE

219
Q

what are the 3 important things that happen in the germinal centers ?

A 
class switching, plasma or memory cell formation
and somatic hypermutation
220
Q

_____________interaction is essential for class switching

A

CD40/CD40L

221
Q

the second signal in B cell activation includes

A

helper Th2 cell via the cd40 ligand and cytokines

222
Q

IL4 is responsible for class swithcing of

A

IgG and IGE

223
Q

IL5 is responsible for class swithcing to

A

IGA

224
Q

_______is a coreceptor that functions in B cell activation

A

CD19

225
Q

Antigen dependent B cell development involves 3 important events

A

class switching
plasma/memory cell formation
affinity maturation

226
Q

somatic hypermutations

A

point mutations, deletions, or insertions into the V,D, or J region of rearranged Ig genes

227
Q

class I letters

A

ABC

228
Q

class II leters

A

DP, DQ, AND DR

229
Q

function of HLA

A

bind antigenic peptides and present them to T cells

230
Q

HLA class II

A

extracellular bacteira, exogenous Ag

231
Q

HLA class I

A

endogenous antigens (viral)

232
Q

____________is expressed on all nucleated cells

A

class I HLA

233
Q

composition of HLA

A

3 alpha chian and Beta 2 microglobulin

234
Q

length of amino acids taht can bind class I HLA

A

8-10 amino acids in length

235
Q

_________is required for proper folding of the molecule

A

B2 microglobulin

236
Q

what combines to form the antigen binding cleft of HLA 1

A

alpha 1 and alpha 2

237
Q

class II HLA expressed on

A

APCS

238
Q

APCs consist of

A

macrophages, dendritic cells and B cells

239
Q

composition of HLA class II

A

composed of an alpha and beta chian

240
Q

size of amino acids in length that bind HLA Class II

A

12-15 aa

241
Q

what combines to form the peptide binding cleft

A

alpha 1 and beta 1

242
Q

what is responsible for making the viral peptides shorter

A

proteosomes

243
Q

what transports the HLA molecules into the cytoplasm

A

TAP 1 and TAP 2

244
Q

how do we prevent endogenous peptides from binding into the peptide binding groove of class II

A

the invariant chain

245
Q

the majority of diseases associatied with HLA problems are found to be assocaited with

A

Class II

246
Q

what viruses can decrease MHC expression

A

CMV, HBV, and adenovirus

247
Q

what are the two significant things that distinguishes TCR from BCR

A

TCR is never secreted and TCR must recognize antigen and MHC and NOT FREE antigen

248
Q

what does the TCR resemble

A

FAB fragment

249
Q

__________is the signaling molecule for T cells

A

CD3

250
Q

the cortex of the thymus includes

A

immature lymphocytes and nurse cells (specilized epithelial cells)

251
Q

the meduall of the thymus includes

A

mature thymocytes and cells that survived selection

252
Q

selection occurs where in the thymus

A

cortex

253
Q

in the subcapsular region you find

A

immature double negative thymocytes

254
Q

in the cortex you find

A

immature double positive thymocytes

255
Q

in the medulla you find

A

mature thymocytes

256
Q

positive selection

A

ensures that the alpha and beta TCR’s expressed in a given individual will bind the self MHC

257
Q

negative selection

A

ensures that thymocytes bearing high affinity for self MHC or self ag+ self MHC are removed from the repertoire

258
Q

what cells constitutiely express B7

A

dendritic cells

259
Q

macrophages can expres B7 if

A

activated by IFN-gamma

260
Q

B7 on the APC interacts with

A

CD28 on the helper T cell

261
Q

what is the function of CTLA-4

A

it downregulates B7-CD28

262
Q

macrophages secrete

A

IL1-6 and tNF-alpha

263
Q

Th cells express____that alters gene expression

A

IL2 receptor

264
Q

super antigens

A

viral or bacterial proteins that bind particular Vbeta regions of TCR and alpha regions of MHC OUTSIDE of the peptide binding cleft

265
Q

__________inhibits the Th2 response

A

IFN-gamma

266
Q

__________inhibits the TH1 response

A

IL-4 and IL-10

267
Q

what cells are often the targets for infection with intracellular pathogens

A

macrophages

268
Q

interaction between Fas and Fas L causes

A

apoptosis

269
Q

CD markers for CTL

A

TCR, Cd2,3,and 8

270
Q

effector molecules of CTL

A

perforin, granzymes, TNF-beta, and IFN-gamma

271
Q

primary lymphoid organs are ?

A

bone marrow and the thymus

272
Q

cell name that is the only cell capable of activating the naive T cells

A

interdigitating dendritic cells

273
Q

do FDC’s express MHC class II

A

NO!

274
Q

what is the function of FDC’s

A

retain immune complexes and help in the formation of immune complexes

275
Q

can FDC’s present and process Ag

A

NO!

276
Q

What are the two receptors on FDC’s

A

complement and Antibody receptors

277
Q

if Ag enters the GI or respiratory tract the Ag will be cleared by

A

MALT

278
Q

if Ag enters the blood the Ag will be cleared by

A

spleen

279
Q

if Ag enters the tissue the Ag will be cleared by

A

lymph nodes

280
Q

the T cells are found in what compartment of the lymph node

A

paracortex

281
Q

the B cells are found in what compartment of the lymph node

A

cortex

282
Q

composition of germinal centers

A

FDC’s and dividing B cells

283
Q

where are plasma cells and memory cells generated

A

germinal centers

284
Q

what is the name of the artery that carries Ag to spleen

A

splenic artery

285
Q

Where are B cells found in the spleen

A

marginal zone arranged in follicles

286
Q

Where are T cells found in the spleen

A

surround the artery in the periarteriolar lymphoid sheath (PALS)

287
Q

the flow of B and T cells through the secondary lymphoid tissues is directed by cell adhesion molecules (CAMS’s and

A

specialized endothelial cells called High endothelial venules (HEV’s)

288
Q

___________use HEV to recirculate through the secondary lymphoid tissues

A

Naive lymphocytes

289
Q

what is the cell marker that the lymphocyte binds to on the vascular endothelium /

A

CD34

290
Q

When lymphocyte binds Cd34 what does it activate

A

Beta 2 integrins which change the conformation, bind ICAM

291
Q

what happens when your missing CD18

A

you get LAD

292
Q

LAD is characterisized by

A

recurrent bacterial infections and impaired wound healing

293
Q

primary immunodeficiencies are

A

inherited

294
Q

__________is the primary means for removal of extracellullar bacteria from the body

A

phagocytosis

295
Q

what is the happmakr of phagocyticic deficiencies

A

recurrent bacterial or fungal infections (s. aureus, pneumoniae, ecoli, pseudomonas, candida, aspergillus)

296
Q

________is a mutation in NADPH oxidase

A

chronic granulmatous diseaes

297
Q

hallmarks of CGD

A

severe and recurrent infections with Catalase positive organisms

298
Q

infections if unresolved in CGD result in

A

granulomas

299
Q

CGD is treated with

A

antibiotics and IFN-gamma

300
Q

what is NTR test

A

tests for active NADPH oxidase (negative in CGD)

301
Q

______is results in the absence of CD18

A

leukocyte adhesion deficiency

302
Q

hallmarks of LAD

A

chronic bacterial infections no abscess and no pus formation, severe gum inflammation

303
Q

treatment for LAD

A

bone marrow transplant, antibiotics, and IFN-gamma

304
Q

_______________ affects the synthesis and maintenance of storage granules in many cell types including neutrophils, melanocytes, monocytes and NK cells

A

chediak higashi

305
Q

what is the result of chediak higashi syndrome

A

phagocytosed material is NOT delivered to the lysosomes because of fusion defect

306
Q

Halkmarks of CH syndrome

A

recurrent bacteirial
no NK activity
albinism because of melanocytes

307
Q

treatment for CH

A

BMT and high dose of gamma globulins IgG’s

308
Q

Job Syndrome

A

TH1 cells can’t make IFN-gamma, PMN’s don’t respond to chemotactic stimuli; course facies, cold abscess, retain primary teeth, increaed IgE

309
Q

C3 deficiency

A

defects in opsonization, chemotaxis, clearance of immune complexes and lysis, increased susceptiblity and severity to pyogenic bacteria

310
Q

C1inh deficiency that leads to uncontrolled activation of the classical pathway, overproduction of C2 (vasoactive)-edema

A

hereditary angioedema

311
Q

B cells deficiencies are characterized by

A

recurrent bacterial infections with normal immunity to virus and fungal parasites

312
Q

results in NO B cells and is a mutation in a tyrosine kinase

A

X linked Agammaglobulinemia

313
Q

patients with X linkged agammaglobulinemia have difficulty qith

A

encapsulated bacteria like the flu

314
Q

———-results when there is a mutation in CD40L on T cells

A

Hyper IgM syndrome (HIM)

315
Q

what Immunoglobulins are missing in HIM

A

IgA, G and E

316
Q

presents in late teens and early 20’s, can’t differentiate into plasma cells, patients presentwith recurrent bacteiral infections

A

common arialbe immunodeficieincy

317
Q

_______________is delyaed onset of normal IgG synthesis usually seen in the 5th or 6th month of life, pts have recurrent respiraotry infections

A

transient hypogammaglobulinemia of infancy

318
Q

what is the most common immunodeficiency

A

selective IgA deficiency

319
Q

what is the deficiency in bruton X linked hypo-gamma globulinemia

A

deficiency of a tyrosine kinase blocks B cell maturation

320
Q

deficiency of X linked hyper IgM syndrome

A

deficiency of Cd40 L

321
Q

in _______________there is absence of thymus, cardiovascular abnormlaities, and characteristic facial features recurrent infections with intracellular pathogens

A

DiGeorge’s syndrome

322
Q

_______is an autosomal recessive mutation that prohibits the expressionof class II MHC therefore TH cells can’t develop

A

Bare lymphocyte syndrome

323
Q

what is MHC class I deficiency

A

failure of TAP1 molecules to transport peptides to the ER

324
Q

__________is a defect in the common gamma of IL-2 receptor or Adenosine deaminase that results in chronic diarrhea, skin mouth and throat lesions, opportunistic infections and cells unresponsie to mitoens

A

SCID

325
Q

one does deficiency in Rag 1 or Rag 2 result in

A

SCID

326
Q

__________is a mutation in leukosialin (CD43) responsible for actin filament assembly and cytoskeletal rearrangemnt necessary for T cell signaling resulting in THROMBOCYTOPENIA, ECZEMA, AND IMMUNODEFICIENCY

A

wISCOTT alDRISH SYNDROME

327
Q

____________________ is a mutation in a cell cycle kinase resulting in broken capillaries of the eye and difficulting maintaining balance

A

ataxia telangiesctasia

328
Q

people with ataxia telangiestsa have deficiencies in

A

IgA and IgE

329
Q

vaccination

A

to induce a protective immune response against an infectious agent without causing harm to the patient

330
Q

________-is to induce Ab and activated T cells to protect the those from FUTURE infection

A

memory

331
Q

what is used for killed and inactivated vaccines

A

formalin or heat

332
Q

advantages of killed and inactivated vaccines

A

safe

333
Q

disadvatnages of killed/inactivated vaccines

A

needs large amounts, not as strong of an immune response and will probably need boosters

334
Q

what is a live attentuated vaccine

A

genetic mutations are induced, grown in non-human animal hosts

335
Q

advantages of live attenutaetd vaccine

A

capable of replication, reach the anatomical site, strongly immunogenic

336
Q

disadvatnage of live attenuated vaccine

A

revert back to virulent form, contraindicated for immunodeficient population

337
Q

what type of vaccine requires boosters

A

killed or inactivated

338
Q

which vaccine can revert

A

attenuated

339
Q

type of immunity that is induced for attenuated

A

humoral and cell mediated

340
Q

type of immunity that is induced for killed

A

humoral

341
Q

________________utilizes an antigenic portion of the organism

A

subunit

342
Q

______-are inactivated toxins

A

toxoids

343
Q

__________outer surface protein vaccine such as for Hep B

A

surface antigen

344
Q

what is a subunit capsule vaccine

A

polysaccharide conjugated to a protein

345
Q

____________is a substance that is found to Ag to illicit a stronger immuune response

A

adjuvant

346
Q

what is the adjuant commonly used for humans

A

alum

347
Q

what are the four routes for vaccine delivery

A

oral, intranasal, subcutaneous, and intramuscular

348
Q

adenovirus affects _________ and the type of vaccine given is __________ and commonly given to

A

respiratory infection
oral live attenuated
military personel

349
Q

hepatits A and B is a ________ and the type of vaccine is a __________

A

hepatitis

subunit surface antigen

350
Q

HPV type of vaccine is

A

subunit outer coat protein

351
Q

influenza type of vaccine is

A

Nasal- live attenuated or Intramuscular- killed

352
Q

japanense encephalitis type of accine

A

killed, given to travelers

353
Q

measels, mumps and rubella type of vaccine and important notes

A

live attenuated and contraindicated in pregnany women, and AIDS patients

354
Q

Polio vaccine

A

OPV-live attenuated

SALK IPV-killed *US

355
Q

rabies vaccine

A

killed vacine; only given to at risk individuals

356
Q

rotavirus results in _________ and is a ______type of vaccine

A

diarrhea

oral live attenuated

357
Q

shingles

A

live attenuated , adults greater than 60 years old

358
Q

small pox

A

live attenuated

359
Q

varicella

A

live attenuated contraindicated in pregnant women and AIDS patients

360
Q

yellow fever

A

live attenuated given to travelres

361
Q

what is herd immunity

A

when the majority of the population has immunity and thus protects the minority of the population that is NOT immune

362
Q

what is a definition of hypersensitivity

A

failure of the immune system that are unwarranted and harmful to the host

363
Q

What is the effector cell in type I hypersensitivty

A

IgE

364
Q

wwhat is the effector cells in type II and type III hypersentiivty

A

IgM and IgG

365
Q

what are the effector cells in type IV hypersensitivity

A

T cells (48 hours) delyaed type hypersensitivyt

366
Q

what distinguishes a type 1 HS reaction from a NORMAL IR

A

the secretion of IgE from plasma cells

367
Q

when does degranulation occur in a type I hypersensitivity reaction /

A

after cross linking but that only occurs after a 2nd exposure

368
Q

what is the significant of IGE bound to FcR

A

it can remain stable for weeks to months as opposed to 2-3 days when not bound

369
Q

where are mast cells found

A

mucosa and epithelial surfaces lining body surfaces

370
Q

what is the response when APCc present allergen to Th cells

A

Th2 response and eleated IgE

371
Q

what two cytokines are responsible for stimulating the B cell to produce IgE

A

Il-4 and Il-13

372
Q

What does the granules consist of in mast cells

A

HISTAMINE, heparin, TNF-alpha, proteases, degradative enzymes and ECF and NCF (recruits the eosinophils and neutrophils)

373
Q

what is the action of histamine

A

induces vascular permeability and evenutally causes inflammation and causes smooth muscle contraction (constricts airways and increases secretions of mucus)

374
Q

what are some secondary meidators of type I

A 
platelt activating factor
IL4
prostaglandins
leuotrienes
effects of these are more potent and longer lasting
375
Q

what is the function of PAF

A

chemotactic for leukocytes and activates neutrophils, eosinphils, and platelets

376
Q

what is heparin

A

anticoagulant

377
Q

action of porstaglandin

A

increased smooth muscle contraction and vascular permeability

378
Q

leukotriene

A

increased smooth muscle contraction and permeability

379
Q

leukotriene

A

chemotactic for neutrophils

380
Q

systemic anaphylaxis

A

occurs when allergens enter the blood

381
Q

organ specific anaphylazis

A

occursn when allergens affect target organs

382
Q

What happens when you have systemic anaphylaxis

A 
wide spread MAST cell activation
increased VP
constriction of SM
drop in BP
organ systems damaged
mortality usually from airway constriction and epiglottal swelling
383
Q

what is the most common allergen associated with systemic anaphylazis

A

peniciliin (although insect stings peanuts and brazil nuts are also common)

384
Q

What does epinephrine do

A 
stimulates reformation of tight junctions
reduces permeability
prevents fluid loss in blood
decreases swellin
increass BP
385
Q

difference between type II and type III hypersensitivities

A

type II antivodies binding to cells or tissues

type III immune complex mediated destruction of tissues

386
Q

which hypersensitivty is associated with a ribbon like or linear deposition of antibodies

A

type II

387
Q

which hypersensitivity is associated with a granular or lumpy bumpy kidney

A

type III

388
Q

type II hypersensitivity causes

A

local complement activation
influx of leukocytes
tissue destruction via ADCC and degrantion and oxygen radicals

389
Q

examples of type II HS

A

drugs, transfusion reactions, erythroblastosis fetalis graft rejection, grave’s disease and myasthenia gravis

390
Q

what is graves diseases

A

IgG autoantibodies are formed against the TSH receptor, uregulated production of thyroid hormones

391
Q

__________is caused by high levels of circulating immune complexes

A

type III hypersensitivity

392
Q

the common subunit associated with Gm-CSF is

A

beta subunit

393
Q

the common subunit associated with IL-6 is

A

gp130 subunit

394
Q

common subunit of IL-2 is

A

common gamma subunit

395
Q

mutations in the gamma chain if IL-2 results in

A

SCID

396
Q

What is the common factor in IL-2 and IL-4

A

the share the gamma chain of IL-2R

397
Q

the pyogenic cytokines have what effect on the liver

A

induces the liver to produce acute phase proteins which help in activation of complement and opsonization

398
Q

the pyogenic cytokines have what effect on the bone marrow epithelium

A

neutrophil mobilization

399
Q

the pyogenic cytokines have what effect on the hypothalamus

A

increased body temperature resulting in decreased viral and bacterial replication, increased ag processing

400
Q

the pyogenic cytokines have what effect on fat and muscle

A

protein and energy mobilization to generate increased body temperature resulting in decreased viral and bacterial repication and increased ag processing

401
Q

what is the effect of TNF-alpha on dendritic cells

A

stimulates the migration to lymph nodes and maturation

402
Q

what are the target cells or tisues for IL-1

A

Th cells, hepatocytes and hypothalamus

403
Q

what are the target cells or tissues for IL-6

A

b cells
hepatocyes
hypothalamus

404
Q

IFN alpha and beta are secreted by

A

leukocytes and fibroblasts

405
Q

anti IL6 receptor is used to treat

A

Rheumatoid arthritis

406
Q

IL1 is secreted by

A

monocytes
macrophages
dendritic cells and endothelial cells

407
Q

total magnification=

A

objective times ocular lens

408
Q

does brightfield microscopy show viruses ?

A

NO but shows most bacteria

409
Q

dark field microscopy is used for

A

thin bacteria (spirochetes) such as treponema pallidum, borrelia, leptospira spp.

410
Q

phase contrast microscopy

A

shows internal details of the microbes (CD image)

411
Q

what type of microscopy is used for viral particles

A

Electron microscopy

412
Q

TEM

A

electrons pass through specimen

413
Q

SEM

A

electrons boundce off surface for #d image

414
Q

_____________detect, locate, quantify specific nucleic acid sequences in clinical specimens

A

DNA probes

415
Q

DNA probes are currently used to diagnose what things

A

CMV, chlyamydia, gonorrhoea, trichomonas, yeast TB

416
Q

what is the technique used for dagnosing cancer and typing HLA’s

A

DNA probes

417
Q

how do you calculate PCR amplication

A

2 to the n

418
Q

what is the diagnostic test for HIV

A

RT-PCR

419
Q

which test is more sensitive than DNA probes

A

PCR

420
Q

PCr is mainly used for

A

HIV, HSV, HPV and Hantaviruses and MRSA

421
Q

What is RFLP used for

A

helps identify the spread of pathogens between pts. and distinguish HSV1 from HSV2

422
Q

_________is used to identify specific protein in a mixture

A

western blotting

423
Q

What is THE definitive test to confirm diagnosis of HIV

A

western blot

424
Q

________________is used to detect changes in protein concentration

A

western blot densitometry (it is more qualitative than quantitative)

425
Q

____________can test or screen for large number of organisms

A

microarrays

426
Q

precipitation reactions test for

A

immune complexes

427
Q

agglutination reactions test for

A

clumping

428
Q

RBC’s and latex beads is an example of

A

agglutination reactions

429
Q

RBC agglutination is used to test for

A

EBC and ABO blood groups

430
Q

Latex beads agglutination is used for

A

diagnosis of CSF infections

431
Q

what is important in precipitation reactions

A

ab must be bivalent and Ag must be bipolyvalent, cause type III hypersensitivity reactions

432
Q

_______-is the inverse of greatest dilution of pt serium that retains activity

A

titer (1:64- titer of 64)

433
Q

in precpiptation reactions what is held constant

A

antibody

434
Q

excess ______________inhibits agglutination reactions

A

ab

435
Q

flow cytommetry used in

A

typing HLA, cancer detection and immune disorder screening

436
Q

bacillus anthracis causes ______- and the type of vaccine is

A

antrax, subunit toxoid

437
Q

corynebacterium diptheria causes ____-and the type of vaccine is

A

diptheria, subunit toxoid

438
Q

H influenxae type V causes _______- and the type of vaccine is

A

meningitis, subunit capsule

439
Q

neisseria meningitidis causes _________and the type of vaccine is

A

meningitis, subunit capsule

440
Q

B pertussus causes ________and the type of baccine is

A

whooping cough, subunit toxoid, fimbriae

441
Q

S. pneumoniae type of baccine

A

subunit capsule

442
Q

clostridium tetani

A

subunit toxoi

443
Q

S. tymphi causes ________– and the type of vaccine is

A

subunit-capsule

oral live, attenuated (given to travelers)

444
Q

mycobacterium tuberculosis

A

live attenuated BCG

445
Q

if you lose the beta subunit what cytokines do you lose

A

Gm-CSF, IL3 and IL6

445
Q

v cholerae

A

subunit toxoid

446
Q

if you lose the g130 subunit you lose

A

Il-6 and IL11

447
Q

if you lose the gamma subunit

A

you lose IL2,5,7,9 and 4

Immunology/Microbiology (10 decks)

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