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Hematology and Immunology > Immunology Physiology > Flashcards

Immunology Physiology Flashcards

0
Q

Ability of a single cell to generate all mature cells

A

Pluripotency

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1
Q

What is the difference between a relative count (differential) and an absolute count?

A

Relative (differential) = general estimate of cells; given as a %
Absolute = precise number of cells; calculated by total WBC x relative %

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2
Q

Normal M:E ratio in the bone marrow

A

3:1

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3
Q

M:E ratio in bone marrow of pt. with erythroid hyperplasia

A

1:3

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4
Q

What causes an M:E ratio of 11:4?

A

Myeloid hyperplasia. Occurs most commonly with bacterial infection.

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5
Q

Describe Granulocytopoiesis

A 
Step 1) Myeloblast
Step 2) Promyelocyte
Step 3) Myelocyte
Step 4) Metamyelocyte
Step 5) Band cell
Step 6) Segmented (mature) cell
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6
Q

Describe a promyelocyte

A
  • Basophilic cytoplasm
  • Flattened nucleus pushed to one side
  • Non-specific azurophilic granules (prominent red granules)
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7
Q

Describe a metamyelocyte

A
  • Full complement of granules

- Horse-shoe shaped nucleus

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8
Q

Most common site for bone marrow draw?

A

PSIS

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9
Q

Antigen indicators for B cells

A

CD19
CD20
CD22

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10
Q

Antigen indicators for low grade B cells

A

CD5

CD43

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11
Q

Antigen indicators for lymphoid cells

A

CD45

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12
Q

What are the reactive changes in neutrophils?

A

Toxic granules and dohle bodies

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13
Q

Reaction of immature red and white blood cells due to abnormal infiltrates in the bone marrow

A

Leukoerythroblastic reaction

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14
Q

What is the difference between a leukemoid reaction and a leukoerythroblastic recation?

A 
Leukemoid = major left shift of just WBC; due to infection
Leukoerythroblastic = major left shift and immature rbcs; due to bone marrow infiltrate
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15
Q

Describe the structure of the lymph node

A

1) Cortex (superfical cortex- primary and secondary nodules; tertiary cortex- high endothelial venules and paracortex
2) Medullla (medullary cords- plasma cells and macrophages found here)
3) Hilus (consists of artery, vein and efferent lymphatic vessel)

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16
Q

When are reactive neutrophils observed

A

Leukemoid reaction and neutrophilia

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17
Q

What is the marker for a pluripotent hematopoietic stem cell?

A

CD 34+

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18
Q

What is the arterial pathway of the spleen?

A

think: STCPSSS
1) Splenic artery (from the celiac trunk)
2) Trabecular artery
3) Central artery (surrounded by periarterial lymphoid sheath)
4) Penicilliary
5) Sheathed capillaries (surrounded by macrophages)
6) Splenic cords (open circulation)
7) Splenic sinuses
8) Pulp veins

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19
Q

What is the central artery surrounded by?

A

1) Periarterial Lymphatic sheath (PALS)

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20
Q

How are the splenic sinuses made up?

A

1) endothelial cells that are separated by slit-like spaces that allow for blood to move from the cords to the sinuses2) Perforated basement membrane

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21
Q

What is the anatomy of the thymus?

A

1) Consists of two lobes with many lobules
2) Each lobule has a cortex and medulla
3) Cortex contains majority of T cells
4) Medulla contains mature T cells

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22
Q

Where are thymic bodies (Hassal’s corpuscles) found and what produces them?

A

1) Medulla of the thymus

2) Thymic epithelial cells

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23
Q

What are the indicators of thymic involution?

A

1) Age
2) Loss of cortex that is replaced with adipose cells
3) Decrease in thymic bodies

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24
Q

What do CD8 Tcells recognize? CD4?

A

1) CD8 = MHC I

2) CD4 = MHC II

25
Q

What is the site where positive selection of T cells occurs? What is this?

A

1) Cortex of thymus lobule

2) Selection of T cells that recognize MHC molecules are kept

26
Q

What is the site where negative selection of T cells occurs? What is this?

A

1) Medulla of thymus lobule

2) Selection of T cells that recognize self antigen with T cell receptor are removed

27
Q

What drains into the superficial inguinal lymph node?

A

1) Scrotum
2) Thigh
3) Anal canal (below the pectinate line)

28
Q

What does the MHC class I molecule bind to? MCH class II?

A

1) Binds to CD 8 and TCR

2) Binds to CD4 and TCR

29
Q

Which MHC class molecule is expressed on all nucleated cells?

A

MHC class I (“i’m number one”)

30
Q

How is an MHC class I molecule formed? MHC class II?

A

1) Antigen is loaded in RER; intracellular peptide; mediates viral immunity
2) Antigen is loaded following release of invariant chain in endosome

31
Q

Which MHC class molecule is expressed only by antigen presenting cells?

A

MHC class II

32
Q

What is the disease associated with each subtype:

1) HLA A3
2) HLA B27
3) HLA DQ2/DQ8
4) DR2
5) DR3
6) DR4
7) DR5

A

1) Hemochromatosis
2) Psoriasis, Ankylosing spondylitis, Inflammatory bowel disease, Reiter’s sydnrome
3) Celiac
4) MS, hay fever, SLE
5) Diabetes mellitus type 1, Graves
6) Rheumatoid arthritis
7) Pernicious anemia

33
Q

What cells use peforin and granzymes to induce apoptosis of virally infected cells and tumor cells?

A

Natural Killer Cells (CD8)

34
Q

What is required besides the MHC:TCR/CD4-8 interaction to activate a T cell?

A

B7 must be released by antigen presenting cell to be recognized by CD 28 on T cell

35
Q

What are the 2 signals for T cell activation?

A

1) MHC: CD4/8 + TCR

2) B7 : CD28

36
Q

What two signals are required for Ig class switching?

A

1) MHC II : TCR

2) CD40 receptor (on b cell) : CD40 Ligand

37
Q

What is the function of TH1 cells? TH2?

A

1) Activates macrophages (secretes IFN gamma)

2) Recruits eosinophil and IgE production (Secretes IL4, IL5, IL10, IL13)

38
Q

Protein that helps deliver granules into target cell?

A

Perforin

39
Q

Serine protease that activates apoptosis inside target cell

A

Granzyme

40
Q

Main antibody in secondary response to antigen; most abundant; fixes complement; crosses the placenta; opsonizes bacteria

A

IgG

41
Q

Antibody that prevents attachment of bacteria and viruses to mucous, does not fix complement; monomer or dimer

A

IgA

42
Q

Antibody produced in primary response to antigen; fixes complement but does not cross placenta; monomer or pentamer

A

IgM

43
Q

Antibody that binds to mast cells and basophils, mediates type I hypersensitivity

A

IgE

44
Q

What complement pathway uses the C3bBb convertase?

A

Alternative

45
Q

What complement pathway uses the C4b2a convertase?

A

1) Lectin

2) Classic

46
Q

How is the classic complement pathway initiated? Lectin? Alternative?

A

1) Activated by antigen-antibody complexes
2) Activated by microbial surfaces like mannose
3) Activated spontaneously and by microbial surfaces

47
Q

What results when C3 convertase has a C3b added?

A

Becomes C5 convertase and MAC complex can be formed

48
Q

What cytokines are secreted by macrophages and what do they do?

A

1) IL-1
2) IL-6
3) IL-8
4) IL-12
5) TNF-alpha

49
Q

What is the function of IL-1, 2, 3, 4, and 5?

A

think: Hot T-Bone stEAk
1) Fever (hot)
2) stimulates T cells
3) stimulates Bone marrow
4) stimulates IgE production
5) stimulates IgA production

50
Q

Function of INF gamma

A

1) Stimulate macrophages and TH1 cells
2) Secreted by TH1 cells
3) Places cells in an antiviral state

51
Q

What is secreted by all TH2 cells

A

1) IL-4 (IgE production)
2) IL-5 (IgA production)
3) IL-10

52
Q

CD56 and CD16

A

NK cell

54
Q

What do the following have in common?

1) T lymphocytes
2) Transplant rejections
3) TB skin tests
4) Touching (contact dermatitis)

A

Type IV Hypersensitivity

55
Q

What is the function of the following cyokines:

1) IL-6
2) IL-8
3) IL-12
4) TNF-alpha
5) IL-2
6) INF-gamma
7) IL-4
8) IL-5
9) IL-10

A

1) Pyrgoen
2) chemotaxis for neutrophils
3) Induces differentiation of T cells into Th1
4) Mediates septic shock
5) T cell stimulation
6) activates macrophages (antiviral properties) activates TH1 cells (Found only in TH1 cells)
7) Increased IgE (found in TH2 cells)
8) Increased IgA (found in TH2 cells)
9) Similar to TGF beta (inhibit inflammation)

56
Q

CD28

A

Cytotoxic T cell (CD8)

57
Q

What are secreted by all T cells? Only TH1? Only TH2?

A

1) IL 2 and 3
2) INF gamma
3) IL 4 and 5, IL-10

58
Q

Name which cell has each surface marker:

1) CD40 ligand
2) CD20
3) CD 14
4) CD 16 and CD 56

A

1) T helper cell
2) B cell
3) Macrophage
4) NK cell

59
Q

What does IL-4 produced by a macrophage cause? IL-12?

A

1) IL-4 induces T cells to differentiate into TH2

2) IL-12 induces T cells to differentiate into TH1

60
Q

What is the function of NF-kappaB?

A

Transcription factor responsible for cytokine production in the immune response

61
Q

What causes green sputum?

A

1) Myeloperoxidase

2) Involved with neutrophils and catalzyes the production of hypochlorous acid

Hematology and Immunology (6 decks)

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