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Step 1 Review > Immunology High Yield > Flashcards

Immunology High Yield Flashcards

1
Q

What are the 3 areas of a lymph node?

A

1- Follicle
2- Medulla
3- Paracortex

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2
Q

Where in the lymph node are follicles located?

A

Outer cortex

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3
Q

What are the 2 portions of the medulla of lymph nodes?

A

Medullary cords–> lymphocytes and plasma cells

Medullary sinuses–> communicate with efferent lymphatics and have macrophages

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4
Q

What is located in the paracortex of lymph nodes?

A

T cells

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5
Q

Lymph nodes for head and neck?

A

Cervical

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6
Q

Lymph nodes for lung?

A

Hilar

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7
Q

Lymph nodes for tracheal and esophagus?

A

Mediastinal

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8
Q

Lymph nodes for upper limb, breast and skin above umbilicus?

A

Axillary

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9
Q

Lymph nodes for liver, spleen, pancreas, upper duodenum?

A

Celiac

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10
Q

Lymph nodes for lower duodenum, jejunum, ileum, colon to splenic flexure?

A

Superior mesenteric

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11
Q

Lymph nodes for colon from splenic flexure to upper rectum?

A

Interior mesenteric

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12
Q

Lymph nodes for lower rectum to anal canal (above pecctate line), bladder, middle 3rd vagina, prostate?

A

Internal iliac

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13
Q

Lymph nodes for testes ovaries, kidneys and uterus?

A

Para- aortic

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14
Q

Lymph nodes for anal canal (below pectate line), skin below umbilicis, scrotom?

A

Superficial inguinal

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15
Q

Lymph nodes for dorsolateral foot, posterior calf?

A

Popliteal

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16
Q

Lymph nodes for dorsolateral foot, posterior calf?

A

Popliteal

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17
Q

What are the 3 areas of the spleen?

A

Red pulp (red cells)

White pulp (lymphocytes)

Marginal zone–> APCs, specialized B cells

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18
Q

What are the 2 areas of white matter in the spleen?

A

PALS–> T cells

Follicles–> B cells

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19
Q

Why is there an increased risk of infection of encapsulated organism with asplenia?

A

Decreased IgM–> decreased complement activation–> decreased C3b opsonization

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20
Q

What are 2 RBC findings post splenectomy?

A

1- Howell- Jolly bodies

2- Target cells

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21
Q

Where do T cells differentiate and mature

A

Thymus

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22
Q

What pharyngeal pouch is the thymus derived from?

A

3rd

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23
Q

In the thymus…where are the mature T cells located and where are the immature T cells located?

A

Mature–> Medulla

Immature–> cortex

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24
Q

What type of immunity does this statement describe:

Highly specific, refined over time. Develops over long periods of time

A

Adaptive immunity

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25
Q

HLA types associated with MHC I?

A

HLA- A/ B/ C

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26
Q

HLA types associated with MHC II?

A

HLA- DR/ DP/ DQ

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27
Q

What binds MHC class I?

A

TCR and CD8

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28
Q

What binds MHC class II?

A

TCR and CD4

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29
Q

Where is MHC class I rexpressed?

A

ALL cells

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30
Q

Which MHC presents ENDOGENOUSLY synthesized antigens?

A

MHC I

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31
Q

Which MHC presents EXOGENOUSLY synthesized antigens?

A

MHC II

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32
Q

Which MHC has a beta 2 microglobulin chain?

A

MHC I

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33
Q

Which MHC has a full beta chain?

A

MHC II

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34
Q

Name the HLA type associated with:

Psoriatic arthritis
Ankylosing spondylitis
IBD
Reactive Arthritis

A

HLA- B27

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35
Q

Name the HLA type associated with:

Celiac diease

A

HLA- DQ2/ DQ8

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36
Q

Name the HLA type associated with:

Multiple sclerosis
Hay fever
SLE
Goodpasture

A

HLA- DR2

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37
Q

Name the HLA type associated with:

Diabetes mellitus type I
SLE
Graves diease
Hashimoto thyroiditis

A

HLA- DR3

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38
Q

Name the HLA type associated with:

Rheumatoid arthritis
DM type I

A

HLA- DR4

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39
Q

Name the HLA type associated with:

Pernicious anemia

A

DR5

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40
Q

What 2 substances secreted by natural killer cells induce apoptosis of cells?

A

Perforin

Granzyme

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41
Q

What 4 cytokines enhance the activity of NK cells?

A

IL-2
IL-12
IFN-alpha
IFN- beta

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42
Q

Where does positive T cell selection occur?

A

Thymic cortex

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43
Q

What is positive selection?

A

T cells with TCR have teh ability to bind self MHC molecules

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44
Q

Where does negative selection occur?

A

Medulla

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45
Q

What is negative selection?

A

T cells that bind with high affinity for self antigens undergo apoptosis

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46
Q

What do Th1 helper T cells secrete?

A

IFN- gamma

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47
Q

What cell types do Th1 cells activate?

A

Macrophages

Cytotoxic T cells

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48
Q

What cytokines can inhibit a Th1 response?

A

IL-4

IL-10

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49
Q

What cytokines activate a Th1 response?

A

IGN- gamma

IL-2

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50
Q

What cytokines activate a Th1 response?

A

IGN- gamma

IL-2

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51
Q

What 4cytokines do Th2 cells secrete?

A

IL-4
IL-5
IL-10
IL-13

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52
Q

What activates a Th2 response?

A

IL-4

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53
Q

What inhibits a Th2 response?

A

IFN gamma

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54
Q

What cell is needed to virus infected cells, neoplastic cells, donor graft cells?

A

Cytotoxic T cells (via induced apoptosis)

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55
Q

Which cell type suppresses CD4 and CD8 T cells?

A

Regulatory T cells

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56
Q

Name the cell type the displays all the following:

CD3+, CD4+, CD25+, FOXP3

A

T regs

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57
Q

What is the costimulatory signal needed for naive T cell activation?

A

B7 and CD28

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58
Q

What are the 3 signals needed for B cell activation?

A

1- MHC II binding to TCR
2- CD40 biding CD40L
3- Cytokines

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59
Q

What two Ig isotypes do mature B cells express?

A

IgM and IgD

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60
Q

What is the main antibody in secondary (delayed) response?

A

IgG

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61
Q

Which Ig can cross the placenta?

A

IgG

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62
Q

What are the functions of IgG?

A

Fixes compliment
Opsonizes bacteria
Neutralizes bacterial toxins and viruses

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63
Q

Which Ig prevents attachement of bacteria and viruses to mucous membranes?

A

IgA

64
Q

How does IgA corss epithelial cells?

A

Transcytosis

65
Q

What is the most produced antibody produced in the body?

A

IgA

66
Q

Which antibody is most abundent in seum?

A

IgG

67
Q

What is the secreted IgM structure?

A

Pentamer!

68
Q

Which Ig binds mast cells and basophils as well as crosslinks when exposed to allergen?

A

IgE

69
Q

Which Ig is involved in mediating type I (immediate) hypersensitivity?

A

IgE

70
Q

What cytokine induces acute phase reactants?

A

IL-6

71
Q

What is C reactive protein?

A

An opsonin…fixes compliment and facilitaes phagocytosis

72
Q

What is the function of ferritin?

A

Binds and sequesters iron to inhibit microbial iron scavening

73
Q

What is the function of hepcidin?

A

prevents release of Fe bound by ferritin–> anemia of chronic disease

74
Q

What mediates the activation of the classical compliment pathway?

A

IgG and IgM

75
Q

What activates the alternative compliment pathway?

A

Microbe surface molecules

76
Q

What activates the alternative compliment pathway?

A

Microbe surface molecules

77
Q

What is the function of C3b?

A

opsonization

78
Q

What are the functions of C3a, C4a, C5a?

A

Anaphylaxis

79
Q

What is the function of C5a?

A

Neutrophil chemotaxis

80
Q

What is the functinon of C5b-9?

A

Cytolysis by MAC

81
Q

What are the two primary bacterial opsonins?

A

C3b and IgG

82
Q

What inhibits compliment?

A

C1 esterase inhibitor

83
Q

What is the C3 convertase in the alternative pathway?

A

C3bBb

84
Q

What is the classical C3 convertase?

A

C4b2b

85
Q

Which complement deficnecy leads to increased risk of severe recurrent pyogenic sinus and respiratory tract infections?

A

C3

86
Q

Which complement deficiency is the cause of hereditary angioedema?

A

C1 esterase inhibitor deficiency

87
Q

Which complement deficiency increases risk of recurrent Neisseria bacteria?

A

C5- C9

88
Q

What is the cause of compliment mediated lysis of RBC and paroxysmal nocturnal hemoglobinuria?

A

DAF (decay accelerating factor) deficiency

89
Q

What is the cause of compliment mediated lysis of RBC and paroxysmal nocturnal hemoglobinuria?

A

DAF (decay accelerating factor) deficiency

90
Q

“increased risk for catalase + infections”

A

Chronic granulomatous disease–> NADPH deficiency

91
Q

What CD is associated with TCR and is needed for signal transduction?

A

CD3

92
Q

Helper T cell surface markers?

A

CD4 and CD40L

93
Q

Cell marker of Cytotoxic T cells?

A

CD8

94
Q

Cell markers for T regs?

A

CD4 and CD25

95
Q

Cell markers for B cells?

A

CD19, CD20, CD21, CD40, MHC II and B7

96
Q

Cell markers of macrophages?

A

CD14, CD40, MHC I B7

97
Q

Cell surface markers of NK cells?

A

CD16 (binds Fc of IgG), CD 56

98
Q

Cell surface markers of hematopoietic stem cells?

A

CD 34

99
Q

“cell cannot become activated by exposre to its allergen due to lack of costimulatory signal”

A

Anergy

100
Q

How do superantigens work?

A

cross link the beta region of the T cell receptor to the MHC class II on APCs which leads to a massive release of cytokines

101
Q

How do endotoxins work?

A

directly stimulate macrophages by binding to endotoxin recetpr TLR4/ CD14…no Th cells are involved

102
Q

Which bacteria are know to undergo antigenic variation?

A

Salmonella
Borrelia recurrentis
N. gonorrhea

103
Q

What viruses are know to undergo antigenic variation?

A

Influenza
HIV
HCV

104
Q

What is passive immunity?

A

receiving preformed antibodies

105
Q

What is the half life of antibodies?

A

3 weeks (so passive immunity does not last long)

106
Q

For which microbial exposures are antibodies given to unvaccinated patients?

A 
1- tetanus toxin
2- Botulinum toxin
3- HBV
4- Varicella
5- Rabies
107
Q

What type of immune response is induced by live attenuated vaccine?

A

Cellular and Humoral

108
Q

T/F: live attenuated vaccines can revert to virulent form

A

True

109
Q

Which vaccine types are contraindicated in pregnancy?

A

Live attenuated

110
Q

What illnesses have a live attenuated vaccine?

A 
MMR
Polio (Sabin)
Influenza (intranasal)
Varicella
Yellow fever
111
Q

What type of immune response doe sthe body mount to a inactivated or killed vaccine?

A

Humoral response

112
Q

Which immune response is stronger…live attenuated vaccine or inactivated/ killed vaccine?

A

Live attenuated

113
Q

What types of infections have inactivated/ killed vaccines?

A

Rabies
Influenza (Injection)
Polio (Salk)
Hep A

114
Q

Name the type of Hypersensitivity reaction:

Free antigen cross links IgE on presensitized mast cells and basophils, triggering immediated release of vasoactve amines that act on postcapillary venules”

A

Type I

115
Q

What mediates the delayed response in Type I hypersensitivty?

A

arachidonic acid metabolites

116
Q

Name the type of Hypersensitivity reaction:

IgM, IgG binds to fixed antigen on “enemy” cell leading to cellular destruction

A

Type II

117
Q

What are the mechanisms of cytotoxicits in type II reactions?

A

1- Opsonization and phagocytosis
2- Complement and Fc receptor mediated inflammation
3- Antibody mediated cellular dysfunction

118
Q

Name the type of Hypersensitivity reaction:

immune complex complexes complement, which attracts neutrophils

A

Type III

119
Q

“IMMUNE COMPLEX DISEASE IN WHICH ANTIBODIES TO FOREIGN PROTEINS ARE PRODUCED (TAKES 5 DAYS)”

A

serum sickness

120
Q

What is the most common cause of serum sickness?

A

Drugs actin as haptens

121
Q

“local subacute antibody- mediated hypersensitivity reaction associated with intradermal injections characterized by edema necrosis, and activation of complement”

A

Type III

122
Q

Name the type of Hypersensitivity reaction:

delayed hypersensitvity mediated by T cells that enounter antigen and then release cytokines

A

Type IV

123
Q

Contact dermatitis is an example of what type of hypersensitivity reaction

A

Type IV

124
Q

Give 5 examples of Type I hypersensitivity reactions?

A 
1- asthma
2- eczema
3- hives
4- rhinitis
5- bee sting/ food allergies
125
Q

What type of hypersensitivity reaction is rheumatic fever?

A

II

126
Q

What type of hypersensitivity is pemphigus vulgaris?

A

II

127
Q

What type of hypersensitivity is PPD?

A

IV

128
Q

What type of hypersensitivity is Guillain barre?

A

II

129
Q

What type of hypersensitivity is SLE?

A

III

130
Q

What type of hypersensitivity is Multiple sclerosis?

A

IV

131
Q

What type of hypersensitivity is PSGN?

A

III

132
Q

What type of hypersensitivity is Myasthenia gravis?

A

II

133
Q

What type of hypersensitivity is Erythroblastosis fetalis?

A

II

134
Q

What type of hypersensitivity is idiopathic thrombocytopenic purpura?

A

II

135
Q

What type of hypersensitivity is Goodpasture syndrome?

A

II

136
Q

If a blood transfusion is given and a person develops anaphylaxsis…what are they deficient in?

A

IgA deficienccy (these people must recieve blood without IgA)

137
Q

What causes febrile nonhemolytic tranfusion reaction?

A

Type II hypersensitivity reaction–> due to host antbodies against donor HLA antigens

138
Q

What causes acute hemplyic transfusion reaction/

A

Type II hypersensitivity

intravascular hemolyssi due to ABO incompatability

139
Q

What is an allograft?

A

from self

140
Q

What is a syngeneic graft?

A

from a identical twin or clone

141
Q

What is an allograft?

A

from nonidentical individual of same species

142
Q

What is a xenograft?

A

from a different species

143
Q

What is the type of transplant rejection:

Preexisting recipient antibodies react to donor antigen

A

Hyperacute rejection

144
Q

What type of hypersensitivity is hyperacute rejection

A

II

145
Q

When does hyperacute rejection take place?

A

Within minutes

146
Q

Name the type of rejection:

CD8+ t cells activated against donor MHC

A

Acute cellular

147
Q

Name the type of rejection:

Antibodies develop after transpant to donor antigen

A

Acute humoral

148
Q

When does acute rejection occur?

A

Weeks to months after transpont

149
Q

Name the type of rejection:

CD4+ T cells respond to recipient APCs presenting donor peptides”

A

Chronic

150
Q

When does chronic occur?

A

Months to years

151
Q

Name the type of rejection:

grafted immunocompetent T cells proliferate in the immunocompromised host and reject host cells with “foreign” proteins

A

Graft vs host disease

152
Q

Who s GVH disease usually seen in?

A

bone marrow and liver transplant recipients

153
Q

Name the type of rejection:

Vasculitis of graft vessel with a dense lymphocytic infiltrate

A

Acute

154
Q

Name the type of rejection:

Maculopapular rash, jaundice, diarrhea, hepatosplenomegaly

A

GVH disease

155
Q

Name the type of hypersensitivity:

Recipient T cells react and secrete cytokines leading to prolifeation of vascular smooth muscle and parenchymal fibrosis

A

Chronic

Step 1 Review (62 decks)

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