Immunology High Yield Flashcards
1
Q
What are the 3 areas of a lymph node?
A
1- Follicle
2- Medulla
3- Paracortex
2
Q
Where in the lymph node are follicles located?
A
Outer cortex
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
4
Q
What is located in the paracortex of lymph nodes?
A
T cells
5
Q
Lymph nodes for head and neck?
A
Cervical
6
Q
Lymph nodes for lung?
A
Hilar
7
Q
Lymph nodes for tracheal and esophagus?
A
Mediastinal
8
Q
Lymph nodes for upper limb, breast and skin above umbilicus?
A
Axillary
9
Q
Lymph nodes for liver, spleen, pancreas, upper duodenum?
A
Celiac
10
Q
Lymph nodes for lower duodenum, jejunum, ileum, colon to splenic flexure?
A
Superior mesenteric
11
Q
Lymph nodes for colon from splenic flexure to upper rectum?
A
Interior mesenteric
12
Q
Lymph nodes for lower rectum to anal canal (above pecctate line), bladder, middle 3rd vagina, prostate?
A
Internal iliac
13
Q
Lymph nodes for testes ovaries, kidneys and uterus?
A
Para- aortic
14
Q
Lymph nodes for anal canal (below pectate line), skin below umbilicis, scrotom?
A
Superficial inguinal
15
Q
Lymph nodes for dorsolateral foot, posterior calf?
A
Popliteal
16
Q
Lymph nodes for dorsolateral foot, posterior calf?
A
Popliteal
17
Q
What are the 3 areas of the spleen?
A
Red pulp (red cells)
White pulp (lymphocytes)
Marginal zone–> APCs, specialized B cells
18
Q
What are the 2 areas of white matter in the spleen?
A
PALS–> T cells
Follicles–> B cells
19
Q
Why is there an increased risk of infection of encapsulated organism with asplenia?
A
Decreased IgM–> decreased complement activation–> decreased C3b opsonization
20
Q
What are 2 RBC findings post splenectomy?
A
1- Howell- Jolly bodies
2- Target cells
21
Q
Where do T cells differentiate and mature
A
Thymus
22
Q
What pharyngeal pouch is the thymus derived from?
A
3rd
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
24
Q
What type of immunity does this statement describe:
Highly specific, refined over time. Develops over long periods of time
A
Adaptive immunity
25
HLA types associated with MHC I?
HLA- A/ B/ C
26
HLA types associated with MHC II?
HLA- DR/ DP/ DQ
27
What binds MHC class I?
TCR and CD8
28
What binds MHC class II?
TCR and CD4
29
Where is MHC class I rexpressed?
ALL cells
30
Which MHC presents ENDOGENOUSLY synthesized antigens?
MHC I
31
Which MHC presents EXOGENOUSLY synthesized antigens?
MHC II
32
Which MHC has a beta 2 microglobulin chain?
MHC I
33
Which MHC has a full beta chain?
MHC II
34
Name the HLA type associated with:
Psoriatic arthritis
Ankylosing spondylitis
IBD
Reactive Arthritis
HLA- B27
35
Name the HLA type associated with:
Celiac diease
HLA- DQ2/ DQ8
36
Name the HLA type associated with:
Multiple sclerosis
Hay fever
SLE
Goodpasture
HLA- DR2
37
Name the HLA type associated with:
Diabetes mellitus type I
SLE
Graves diease
Hashimoto thyroiditis
HLA- DR3
38
Name the HLA type associated with:
Rheumatoid arthritis
DM type I
HLA- DR4
39
Name the HLA type associated with:
Pernicious anemia
DR5
40
What 2 substances secreted by natural killer cells induce apoptosis of cells?
Perforin
| Granzyme
41
What 4 cytokines enhance the activity of NK cells?
IL-2
IL-12
IFN-alpha
IFN- beta
42
Where does positive T cell selection occur?
Thymic cortex
43
What is positive selection?
T cells with TCR have teh ability to bind self MHC molecules
44
Where does negative selection occur?
Medulla
45
What is negative selection?
T cells that bind with high affinity for self antigens undergo apoptosis
46
What do Th1 helper T cells secrete?
IFN- gamma
47
What cell types do Th1 cells activate?
Macrophages
| Cytotoxic T cells
48
What cytokines can inhibit a Th1 response?
IL-4
| IL-10
49
What cytokines activate a Th1 response?
IGN- gamma
| IL-2
50
What cytokines activate a Th1 response?
IGN- gamma
| IL-2
51
What 4cytokines do Th2 cells secrete?
IL-4
IL-5
IL-10
IL-13
52
What activates a Th2 response?
IL-4
53
What inhibits a Th2 response?
IFN gamma
54
What cell is needed to virus infected cells, neoplastic cells, donor graft cells?
Cytotoxic T cells (via induced apoptosis)
55
Which cell type suppresses CD4 and CD8 T cells?
Regulatory T cells
56
Name the cell type the displays all the following:
CD3+, CD4+, CD25+, FOXP3
T regs
57
What is the costimulatory signal needed for naive T cell activation?
B7 and CD28
58
What are the 3 signals needed for B cell activation?
1- MHC II binding to TCR
2- CD40 biding CD40L
3- Cytokines
59
What two Ig isotypes do mature B cells express?
IgM and IgD
60
What is the main antibody in secondary (delayed) response?
IgG
61
Which Ig can cross the placenta?
IgG
62
What are the functions of IgG?
Fixes compliment
Opsonizes bacteria
Neutralizes bacterial toxins and viruses
63
Which Ig prevents attachement of bacteria and viruses to mucous membranes?
IgA
64
How does IgA corss epithelial cells?
Transcytosis
65
What is the most produced antibody produced in the body?
IgA
66
Which antibody is most abundent in seum?
IgG
67
What is the secreted IgM structure?
Pentamer!
68
Which Ig binds mast cells and basophils as well as crosslinks when exposed to allergen?
IgE
69
Which Ig is involved in mediating type I (immediate) hypersensitivity?
IgE
70
What cytokine induces acute phase reactants?
IL-6
71
What is C reactive protein?
An opsonin...fixes compliment and facilitaes phagocytosis
72
What is the function of ferritin?
Binds and sequesters iron to inhibit microbial iron scavening
73
What is the function of hepcidin?
prevents release of Fe bound by ferritin--> anemia of chronic disease
74
What mediates the activation of the classical compliment pathway?
IgG and IgM
75
What activates the alternative compliment pathway?
Microbe surface molecules
76
What activates the alternative compliment pathway?
Microbe surface molecules
77
What is the function of C3b?
opsonization
78
What are the functions of C3a, C4a, C5a?
Anaphylaxis
79
What is the function of C5a?
Neutrophil chemotaxis
80
What is the functinon of C5b-9?
Cytolysis by MAC
81
What are the two primary bacterial opsonins?
C3b and IgG
82
What inhibits compliment?
C1 esterase inhibitor
83
What is the C3 convertase in the alternative pathway?
C3bBb
84
What is the classical C3 convertase?
C4b2b
85
Which complement deficnecy leads to increased risk of severe recurrent pyogenic sinus and respiratory tract infections?
C3
86
Which complement deficiency is the cause of hereditary angioedema?
C1 esterase inhibitor deficiency
87
Which complement deficiency increases risk of recurrent Neisseria bacteria?
C5- C9
88
What is the cause of compliment mediated lysis of RBC and paroxysmal nocturnal hemoglobinuria?
DAF (decay accelerating factor) deficiency
89
What is the cause of compliment mediated lysis of RBC and paroxysmal nocturnal hemoglobinuria?
DAF (decay accelerating factor) deficiency
90
"increased risk for catalase + infections"
Chronic granulomatous disease--> NADPH deficiency
91
What CD is associated with TCR and is needed for signal transduction?
CD3
92
Helper T cell surface markers?
CD4 and CD40L
93
Cell marker of Cytotoxic T cells?
CD8
94
Cell markers for T regs?
CD4 and CD25
95
Cell markers for B cells?
CD19, CD20, CD21, CD40, MHC II and B7
96
Cell markers of macrophages?
CD14, CD40, MHC I B7
97
Cell surface markers of NK cells?
CD16 (binds Fc of IgG), CD 56
98
Cell surface markers of hematopoietic stem cells?
CD 34
99
"cell cannot become activated by exposre to its allergen due to lack of costimulatory signal"
Anergy
100
How do superantigens work?
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
How do endotoxins work?
directly stimulate macrophages by binding to endotoxin recetpr TLR4/ CD14...no Th cells are involved
102
Which bacteria are know to undergo antigenic variation?
Salmonella
Borrelia recurrentis
N. gonorrhea
103
What viruses are know to undergo antigenic variation?
Influenza
HIV
HCV
104
What is passive immunity?
receiving preformed antibodies
105
What is the half life of antibodies?
3 weeks (so passive immunity does not last long)
106
For which microbial exposures are antibodies given to unvaccinated patients?
```
1- tetanus toxin
2- Botulinum toxin
3- HBV
4- Varicella
5- Rabies
```
107
What type of immune response is induced by live attenuated vaccine?
Cellular and Humoral
108
T/F: live attenuated vaccines can revert to virulent form
True
109
Which vaccine types are contraindicated in pregnancy?
Live attenuated
110
What illnesses have a live attenuated vaccine?
```
MMR
Polio (Sabin)
Influenza (intranasal)
Varicella
Yellow fever
```
111
What type of immune response doe sthe body mount to a inactivated or killed vaccine?
Humoral response
112
Which immune response is stronger...live attenuated vaccine or inactivated/ killed vaccine?
Live attenuated
113
What types of infections have inactivated/ killed vaccines?
Rabies
Influenza (Injection)
Polio (Salk)
Hep A
114
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"
Type I
115
What mediates the delayed response in Type I hypersensitivty?
arachidonic acid metabolites
116
Name the type of Hypersensitivity reaction:
IgM, IgG binds to fixed antigen on "enemy" cell leading to cellular destruction
Type II
117
What are the mechanisms of cytotoxicits in type II reactions?
1- Opsonization and phagocytosis
2- Complement and Fc receptor mediated inflammation
3- Antibody mediated cellular dysfunction
118
Name the type of Hypersensitivity reaction:
immune complex complexes complement, which attracts neutrophils
Type III
119
"IMMUNE COMPLEX DISEASE IN WHICH ANTIBODIES TO FOREIGN PROTEINS ARE PRODUCED (TAKES 5 DAYS)"
serum sickness
120
What is the most common cause of serum sickness?
Drugs actin as haptens
121
"local subacute antibody- mediated hypersensitivity reaction associated with intradermal injections characterized by edema necrosis, and activation of complement"
Type III
122
Name the type of Hypersensitivity reaction:
delayed hypersensitvity mediated by T cells that enounter antigen and then release cytokines
Type IV
123
Contact dermatitis is an example of what type of hypersensitivity reaction
Type IV
124
Give 5 examples of Type I hypersensitivity reactions?
```
1- asthma
2- eczema
3- hives
4- rhinitis
5- bee sting/ food allergies
```
125
What type of hypersensitivity reaction is rheumatic fever?
II
126
What type of hypersensitivity is pemphigus vulgaris?
II
127
What type of hypersensitivity is PPD?
IV
128
What type of hypersensitivity is Guillain barre?
II
129
What type of hypersensitivity is SLE?
III
130
What type of hypersensitivity is Multiple sclerosis?
IV
131
What type of hypersensitivity is PSGN?
III
132
What type of hypersensitivity is Myasthenia gravis?
II
133
What type of hypersensitivity is Erythroblastosis fetalis?
II
134
What type of hypersensitivity is idiopathic thrombocytopenic purpura?
II
135
What type of hypersensitivity is Goodpasture syndrome?
II
136
If a blood transfusion is given and a person develops anaphylaxsis...what are they deficient in?
IgA deficienccy (these people must recieve blood without IgA)
137
What causes febrile nonhemolytic tranfusion reaction?
Type II hypersensitivity reaction--> due to host antbodies against donor HLA antigens
138
What causes acute hemplyic transfusion reaction/
Type II hypersensitivity
intravascular hemolyssi due to ABO incompatability
139
What is an allograft?
from self
140
What is a syngeneic graft?
from a identical twin or clone
141
What is an allograft?
from nonidentical individual of same species
142
What is a xenograft?
from a different species
143
What is the type of transplant rejection:
Preexisting recipient antibodies react to donor antigen
Hyperacute rejection
144
What type of hypersensitivity is hyperacute rejection
II
145
When does hyperacute rejection take place?
Within minutes
146
Name the type of rejection:
CD8+ t cells activated against donor MHC
Acute cellular
147
Name the type of rejection:
Antibodies develop after transpant to donor antigen
Acute humoral
148
When does acute rejection occur?
Weeks to months after transpont
149
Name the type of rejection:
CD4+ T cells respond to recipient APCs presenting donor peptides"
Chronic
150
When does chronic occur?
Months to years
151
Name the type of rejection:
grafted immunocompetent T cells proliferate in the immunocompromised host and reject host cells with "foreign" proteins
Graft vs host disease
152
Who s GVH disease usually seen in?
bone marrow and liver transplant recipients
153
Name the type of rejection:
Vasculitis of graft vessel with a dense lymphocytic infiltrate
Acute
154
Name the type of rejection:
Maculopapular rash, jaundice, diarrhea, hepatosplenomegaly
GVH disease
155
Name the type of hypersensitivity:
Recipient T cells react and secrete cytokines leading to prolifeation of vascular smooth muscle and parenchymal fibrosis
Chronic
