Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USMLE Step 1 > Immunology - First Aid / Pathoma > Flashcards

Immunology - First Aid / Pathoma Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

Cervical lymph drainage

A

Head and neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hilar lymph drainage

A

Lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mediastinal lymph drainage

A

Trachea and esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Axillary lymph drainage

A

Upper limb, breast, and skin above umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Celiac lymph drainage

A

liver, stomach, spleen, pancreas, upper duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Superior mesenteric lymph drainage

A

Lower duodenum, jejunum, ileum, colon to splenic flexure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Inferior Mesenteric lymph drainage

A

Colon from splenic flexure to upper rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Internal iliac lymph drainage

A

Lower rectum to anal canal (above pectinate line), bladder, vagina (middle third), prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Para-aortic lymph drainage

A

Testes, ovaries, kidneys, uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Superficial inguinal lymph drainage

A

Anal canal (below pectinate line), skin below umbilicus (except popliteal territory), scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Popliteal lymph drainage

A

Dorsolateral foot, posterior calf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

End lymphatic drainages

A

Right lymphatic duct: drains right side of body above diaphragm
Thoracic duct: drain everything else into junction of left subclavian and internal jugular veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What chromosome are HLA genes on?

A

Chromosome 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

HLA subtype assoc. diseases: A3

A

Hemochormatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

HLA subtype assoc. diseases: B27

A 
PAIR
Psoriatic arthritis
Ankylosing spondylitis
arthritis of Inflammatory Bowel Disease
Reactive arthritis (Reiter syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HLA subtype assoc. diseases: DQ2/DQ8

A

Celiac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

HLA subtype assoc. diseases: DR2

A 
(memory hook: MHGs gave me headaches in DR 2)
Multiple sclerosis
hay fever
Goodpasture syndrome
SLE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

HLA subtype assoc. diseases: DR3

A 
DHGS
T1DM
Hashimoto thyroiditis
Graves disease
SLE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

HLA subtype assoc. diseases: DR4

A

Rheumatoid arthritis
T1DM

(memory hook: a Rheum has 4 walls)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

HLA subtype assoc. diseases: DR 5

A 
Pernicious anemia (Vit B12 deficiency)
Hashimoto thyroiditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What induces NK cell activity

A

IL2, IL12, IFN alpha, IFN beta.

Innate immune cell that uses perforin and granzyme to induce apoptosis of virally infected cells or tumor cells.
Either recognizes lack of MHC, a nonspecific activation signal, or Ab dependent when Fc region binds CD16 on NK cell.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Th1

A

Activated by INF gamma and IL12.

Secretes IFN gamma.
Activates macs and CD8+ T cells.

*Note that IL4 and IL10 (from Th2) inhibit it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Th2

A

Activated by IL4.

Secretes IL4, IL5, IL10, IL13. 
Recruits eosinophils for parasite defense and promotes class switching of B cells.

*Inhibited by IFN gamma from Th1 cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tregs

A

Activating signal = TGFß and IL2

CD3, CD4, CD25, and FOXP3 +
Need IL2 to survive.
Help maintain specific immune tolerance by suppressing CD4 and CD8 T cell effector functions.
Activated Tregs produce anti-inflammatory cytokines (IL10, TGFß)

**Inhibit second signal for T cells by upregulating CTLA4 which binds up B7?

25
Q

Co-stimulatory signals

A

T cell activation: Bind to either MHC I or MHC II w/TCR (depending on what T cell type it is); Second signal is B7 on it’s CD28 rs.

B cell activation: Present antigen to Th, bind via MHC II and TCR, Th cell then upregulates CD40L to bind B cells CD40! Th cell releases cytokines that induce class switch/maturation/Ab production/etc.

26
Q

Acute phase reactants

Stimulated by IL6

A

*Produced by liver in acute and chronic inflammatory states.

Positive/Upregulated:
C-reactive protein
Ferritin
Fibrinogen (ESR)
Hepcidin (anemia of chronic disease)
Serum Amyloid A

Negatiave/Downregulated:
Albumin
Transferrin (internalized by macs to sequester iron)

27
Q

C1 esterase inhibitor deficiency

A

Hereditary angioedema.

ACEi’s are contraindicated

28
Q

C3 deficiency

A

Increases risk severe, recurrent pyogenic sinus infections and RTIs.
Increases susceptibility to type III hypersensitivity reactions (immune complex diseases).

29
Q

C5-C9 deficiencies

A

Terminal complement deficiencies all increase susceptibility to recurrent Neisseria bacteremia, since MAC can’t be formed

30
Q

Delay accelerating factor (DAF) deficiency / CD55

A

This is an inhibitor of complement.

Deficiency means complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria

31
Q

Chemotactic factors for PMNs

A

LTB4, C5a, IL8, bacterial products

32
Q

Complement for opsonization

A

C3b

*Note that IgG and C3b are two primary opsonins in bacterial defense, enhance phagocytosis

33
Q

Complement for anaphylaxis

A

C3a, C4a, C5a

34
Q

Complement for MAC

A

C5-C9

35
Q

Secreted by macrophages

A

IL1: fever; inflammation; osteoclasts
IL6: stimulates acute phase reactants
IL8: chemotaxis for PMNs
IL12: drives Th0 to Th1; activates NK cells
TNF alpha: Causes cachexia in malignancy/chronic inflammation; mediates septic shock. Activates endothelium

36
Q

Secreted by ALL T cells

A

IL2: stimulates growth of helper/ cytotoxic/ Tregs/ NK cells
IL3: growth/differentiation of bone marrow (acts like GM-CSF)

37
Q

Secreted by Th1 cells

A

IFN gamma

38
Q

Secreted by Th2 cells

A 
IL4  (enhances class switching to IgE and IgG)
IL5 (enhances class switching to IgA)
IL10
39
Q

Which cytokines attenuate the immune response?

A

TGFß

IL10

40
Q

Antigenic variation

A

Bacteria:
Salmonella (2 flagellar variants)
Borrelia recurrentis (relapsing fever)
N. gonorrhoeae (pilus protein)

Viruses: 
Influenza
HIV
HCV
Rhinovirus?

Parasites:
Trypanosomes

Mechanisms:
Antigenic shift: point mutations
Antigenic drift: reassortment

41
Q

Which infections to give passive immunity?

A 
"To Be Healed Very Rapidly"
Tetanus
Botulinum
Hepatitis B virus
Varicella
Rabies

Which to also give active immunization to?
HBV
Rabies exposure

42
Q

Blood transfusion reactions

A

Allergic reaction: Type 1 HS against plasma proteins in transfused blood

Anaphylactic reaction: severe allergic reaction, ex. IgA deficient individual given blood with IgA in it

Febrile nonhemolytic transfusion reaction: Type 2 HS with host Ab against donor HLA antigens/WBCs

Acute hemolytic transfusion rx: would see a positive DAT/Coombs test
Ex. intravascular hemolysis: ABO blood group incompatibility
Ex. extravascular hemolysis: host Ab reaction against foreign antigen on donor RBCs

43
Q

Autoantibodies

A

Page 213 of First Aid!!

44
Q

Systemic lupus erythematous

A

Type III HSR.

Antinuclear antibody (ANA) - sensitive, but not specific 
Anti-dsDNA or anti-Sm antibodies - highly specific!

Note there are:
Anti-phospholipid Ab in about 1/3 of pts: anticardiolipin, anti-ß2-glycoprotein I, and lupus anticoagulant (which can falsely elevate PPT and cause Budd Chiari)

Anti-histone Ab w/drug induced lupus:
procainamide, hydralazine, and isoniazid

45
Q

X linked agammaglobulinemia

A

Bruton’s agammaglobulinemia.

Defect in BTK, a tyrosine kinase. No B cells in peripheral blood.

46
Q

Common Variable Immunodeficiency

A

Defect in B cell differentiation

Decreased plasma cells, decreased Ig.

47
Q

Selective IgA deficiency

A

mc primary immunodeficiency.

No IgA, nl IgG and IgM

48
Q

Thymic aplasia (DiGeorge syndrome)

A

22q11 deletion

“CATCH 22” - cleft palate, abnl facies, thymic aplasia, cardiac defects, hypocalcemia from parathyroid aplasia

49
Q

IL12 rs deficiency

A

Decreased Th1 response.

Auto recessive.

50
Q

Autosomal dominant hyper-IgE syndrome (Job syndrome)

A

Deficiency of Th17 cells due to STAT3 mutation.
“FATED” - coarse Facies, cold/noninflammed staph Abscess, retained primary Teeth, increased IgE, Dermatologic problems (eczema)

51
Q

Chronic mucocutaneous candidiasis

A

T cell dysfunction. Many causes.

52
Q

SCID (severe combined immunodeficiency)

A

Auto rec. type: Adenosine deaminase deficiency

mc X linked type: IL2R defective

53
Q

Ataxia telangiectasia

A

Defects in ATM gene - failure to repair DNA double strand breaks (ie defect of nonhomologous end joining)
IgA/IgG/IgE deficiency, ataxia/cerebellar atrophy, spider angiomas, increased AFP, lymphopenia

54
Q

Hyper IgM syndrome

A 
Defective CD40L on Th cells leading to class switching defect.
Lots of IgM; not really any other Ig.
55
Q

Wiskott Aldrich Syndrome

A

X linked mutation on WAS gene and T cells are unable to reorganize actin cytoskeleton.

Basically: Bleeding (TPP), Eczema, and recurrent infections

56
Q

Leukocyte adhesion deficiency

A

Defect in LFA integrin (CD18) on phagocytes leads to impaired migration and chemotaxis.

*Increased PMNs in blood since they can’t access sites outside of blood

57
Q

Chediak Higashi syndrome

A

Defect in lysosomal trafficking regulator gene (LYST).
Microtubule dysfunction in phagosome-lysosome fusion.
ie PMNs can take shit up, but they can’t break it down.

58
Q

Chronic granulomatous disease

A

Defect of NAPDH oxidase (which leads to decreased ROS and oxidative burst)

Increased suscpetibility to catalase positives:
“Need PLACESS”
Nocardia, Pseudomonas, Listeria, Aspergillus, Candida, E. coli, S. aureus, Serratia

59
Q

Encapsulated bacteria

A 
"SHiNE SKiS"
Streptococcus pneumoniae
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli. 
Salmonella.
Kelbsiella pneumonia
group B Strep

USMLE Step 1 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions