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Immunosero > LE 4 > Flashcards

LE 4 Flashcards

Applied Immunology

1
Q

Which organ can regenerate after donation removal?

A

Liver

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2
Q

What are some lifestyle diseases that are increasingly prevalent?

A

DIABETES or HYPERTENSION

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3
Q

Diabetes and Hypertension will have detrimental effects on kidney and lead to

A

hypertensive nephroscelrosis

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4
Q

Types of grafts and differentiate

A

autograft - transplant from another part of the body
isograft - transplant between genetically identical individuals (twins)
allograft - transplant between the same species
xenograft - transplant between different species

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5
Q

Why is the rate of rejection high in animal transplants to humans?

A

Needs constant immune suppression

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6
Q

What is the normal position of the kidney?

A

T12-L3

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7
Q

The kidney is attached to which blood vessels

A

aorta and inferior vena cava

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8
Q

Where is the donated kidney placed during a kidney transplant?

A

Iliac fossa

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9
Q

during transplantation of donated kidney what blood vessels are attached to donated kidney for optimum blood flow

A

renal artery and renal vein

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10
Q

What is considered the gold standard of transplantation due to its low rejection rate?

A

HLA-Identical

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11
Q

Types of MHC pairing and define

A

HLA - identical - 2 identical alleles
HAPLO - identical - 1 identical allele
HLA - different - NO identical allele/s

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12
Q

What is the chance of rejection in HLA-Identical transplantations due to HLA recombination?

A

<1% population

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13
Q

What type of HLA pairing has one allele the same?

A

Haplo-Identical

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14
Q

In which type of HLA pairing are all alleles different?

A

HLA-Different or Non-Identical

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15
Q

Why are immunosuppression drugs needed in most transplantation cases?

A

Most cases are done between unrelated donors (HLA- different)

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16
Q

mHC rejection rate

A

slow and minor rejection

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17
Q

most common/predominant Ag in mHC

A

H-Y Ag

(Other Ags can be found on Autosomal Chromosomes)

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18
Q

mHC is commonly found in what gender

A

males

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19
Q

mHC is found where

A

protein membrane

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20
Q

What causes minor histocompatibility (mHC) rejection?

A

Single nucleotide polymorphism/ Slight polymorphism

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21
Q

Which antigens cause a T-cell response in minor histocompatibility reactions?

A

H-Y Ag

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22
Q

Typical reaction of mHC

A

Tcell response (CD4, CD8)

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23
Q

Explain the concept of single nucleotide polymorphism

A

recipient does not have the same nucleotides as the donor, causing it to be taken to Tcell = cell lysis
OR,
graft of activated T cell attacks and causes cell lysis

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24
Q

What percentage of kidney rejections is due to MICA?

A

11%

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25
Q

On which cells is MICA expressed?

A

Keratinocytes, Endothelial cells, Fibroblasts, Epithelial cells [Dendritic cells, Monocytes]

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26
Q

Are MICA expressed on B and T cells? yes or no

A

No

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27
Q

Typical reaction of MICA

A

Ab-Ag reaction
Bcell response
(CD4)

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28
Q

BGA is expressed on:

A

RBC membrane, secretions and membrane of epithelium, endothelium (BV)

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29
Q

Which type of rejection is caused by blood group antigens?

A

Hyperacute Rejection

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30
Q

How does the ABO system cause transplant rejection?

A

Antibody of host attacks antigen from donor, activates complement system = cell lysis

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31
Q

Enumerate steps of Hyperacute rejection

A
  1. Antibody of host attacks antigen of donor transplant
  2. activates complement, formation of MAC unit and cell lysis
  3. vWBF from Weibel-Palade body in endothelium activates and causes Platelet Adhesion
  4. Collagen from lamina propria below the endothelium activates the intrinsic pathway (Factor 3: thromboplastin activates extrinsic pathway)
  5. Formation of clot due to factors
  6. Oxygenation to transplant is compromised
  7. Hyperacute Rejection occurs
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32
Q

What happens when strength of binding of AR is greater than IR

A

Apoptosis (lysis)

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33
Q

What does the presence of fluorescence indicate in SPC?

A

Presence of Antibody

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34
Q

unknown in antibody identification

A

naturally occurring antibodies

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35
Q

HLA testing that uses in situ hybridization

A

HLA genotyping

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36
Q

Superior HLA testing. why?

A

genotyping cuz only relies on dna thru pcr amplification

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37
Q

PCR Amplification is done with 2 methods

A
  1. Amplify a specific code or bind to target gene
  2. Amplify all HLA gene variants at specific locus and add probe
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38
Q

unknown in genotyping

A

hla gene

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39
Q

enumerate steps in HLA AI

A
  1. px serum mixed with ag beads will create binding to specific HLA antibodies resulting to agglutination
  2. addition of chromogen dye
  3. checking for fluorescence in SPC
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40
Q

What is the purpose of checking for fluorescence in SPC?

A

Detect HLA Ab/subtypes that cause rejection

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41
Q

How is HLA CROSSMATCHING performed?

A

Incubate donor RBC with recipient plasma

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42
Q

HLA testing that has the same principle and procedure as IH

A

HLA crossmatching

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43
Q

What does agglutination indicate in HLA CROSSMATCHING?

A

Not compatible

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44
Q

Which blood groups are considered the most immunogenic?

A

ABO, Rh, Kell

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45
Q

Transplant rejection

A
  1. allorecognition
  2. Host vs graft disease (HVGD)
  3. Graft vs host disease (GVHD)
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46
Q

What is allorecognition

A

NAME?

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47
Q

What is direct allorecognition?

A

MHC Class 1: CD8 T cell/ cytotoxic cell, faster recognition, causes lysis,
Usually in:
1. hyperacute rejection
2. acute rejection

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48
Q

What is indirect allorecognition?

A

APC presents via MHC Class II to CD4 T cell, slower
Usually in:
1. acute rejection
2. chronic rejection

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49
Q

What causes hyperacute rejection in transplantation?

A

ABO variations in Antibody/Antigen, thrombosis

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50
Q

direct allorecognition rely on activation of T cell. T or F

A

False. indirect allorecognition rely on activation of t cell

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51
Q

Host Vs. Graft Diseases

A

NAME?

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52
Q

how does hyperacute rejection occur?

A

abo variants in ab and ag of donor/recipient destroys tunica intima causing graft death due to formation of clot (thrombosis) blocking blood flow to transplant

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53
Q

hyperacute rejection can happen in

A

minutes to hours

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54
Q

how does acute rejection occur?

A

NAME?

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55
Q

acute rejection can happen in

A

days to weeks

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56
Q

acute rejection is characterized by:

A

parenchymal and vascular injury infiltrated by CD4, CD8 and macrophages

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57
Q

interstitial fluid of acute rejection contains:

A

CD4, CD8 and macrophages

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58
Q

chronic rejection can happen in

A

months to years

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59
Q

chronic rejection is associated with

A

delayed hypersensitivity

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60
Q

chronic rejection is characterized by

A

graft arteriosclerosis and fibrosis

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61
Q

how does chronic rejection occur?

A

cytokines and growth factors by t cells cause proliferation of tunica intima smooth muscle cell

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62
Q

primary culprit in activation of proliferation of tunica intima smooth muscle cell

A

IFNys by T cell

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63
Q

Host is destroyed by graft transplant

A

GVHD

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64
Q

GVHD is usually found in what types of individuals

A

immunocompromised px

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65
Q

process of acquiring GVHD

A
  1. pretreatment to release donor stem cell
  2. stem cell is extracted (separated from blood and removed)
  3. remaining blood is returned to px they apheresis
  4. all previous stem cells are eradicated or killed.
  5. donor stem cells are transfused
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66
Q

What is the first step in the process of a hematopoietic stem cell transplant?

A

Pretreatment to release donor stem cell

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67
Q

What must be done to the recipient’s stem cells before a hematopoietic stem cell transplant can take place?

A

Recipient’s stem cells must be removed / killed / eradicated

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68
Q

Results we can infer from transplant

A
  1. not accepted = stem cells of donor will attack cells of recipient causing GVHD
  2. accepted = transfusion/matching is successful
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69
Q

What is GVHD?

A

Graft versus host disease, where transplanted stem cells attack the recipient

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70
Q

What signifies a successful hematopoietic stem cell transplant?

A

The recipient’s acceptance of the graft

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71
Q

What is a benefit of hematopoietic stem cell transplant in the presence of leukemic cells?

A

Graft VS Leukemia (GvL) effect

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72
Q

Two outcomes of stem cell transplant

A
  1. graft vs leukemia (GVL)
  2. GVHD
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73
Q

What does HSC do to leukemic cells?

A

Kills them

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74
Q

How does GVHD differ from allorejection?

A

GVHD attacks the recipient, allorejection attacks the graft

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75
Q

What are the two kinds of GVHD?

A

Acute and Chronic

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76
Q

When does Acute GVHD occur?

A

First 100 Days

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77
Q

When does Chronic GVHD occur?

A

Beyond 100 Days

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78
Q

Which organs are affected by Acute GVHD?

A

Skin, Liver, Gastrointestinal Tract

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79
Q

What are the symptoms of Chronic GVHD?

A

Fibrosis of Skin, Eyes, Mouth, Mucosal surfaces

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80
Q

MHC Class type of t cell present in Acute Allorejection

A

Acute Allorejection (Acute GVHD) - Direct (CD8)/ Indirect (CD4) Allorejection

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81
Q

Matching DQ

A

10-Oct

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82
Q

Matching DQ and DP

A

12-Dec

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83
Q

Immunosuppressive Agent: Antimetabolic Agents examples

A
  1. Azathioprine
  2. Mycophenolate
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84
Q

What is the only ‘cure’ for very severe fibrosis?

A

No cure, Another transplantation is needed

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85
Q

What is the purpose of matching HLA between donor and recipient in organ transplantation?

A

Avoidance of transplant reactions

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86
Q

Immunosuppressive Agent: Harvested from animals

A

Polyclonal Antibodies

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87
Q

What is considered perfect compatibility in HLA matching for transplantation?

A

08-Aug

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88
Q

Matching of HLA - A,B,C or DR to px cord blood

A

08-Aug

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89
Q

Immunosuppressive Agent: Target t-cells, depleting T-lymphocyte from circulation

A

Polyclonal Antibodies

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90
Q

Why do transplant patients need chronic immunosuppression even with proper HLA matching?

A

To avoid graft rejection

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91
Q

immunosuppressive agents

A
  1. steroids
  2. antimetabolic agents
  3. calcineurin inhibitor
  4. monoclonal ab
  5. polyclonal ab
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92
Q

too much transfusion/ intake of polyclonal antibodies can cause [disease]?

A

serum sickness

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93
Q

What are the consequences of chronic immunosuppression in transplant patients?

A

Cancer & Infection

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94
Q

Immunosuppressive Agent: Binds IL-2R (CD25) to block production of IL2 [used for B cell differentiation]

A

Monoclonal Antibodies

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95
Q

Immunosuppressive agents that causes DM

A

Steroids

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96
Q

Immunosuppressive Agent: Polyclonal Antibodies

A

Thymoglobulin (rabbit serum)
ATGAM (horse)

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97
Q

What do steroids do as immunosuppressive agents in transplantation?

A

Block signaling pathways of cytokine & mediators, Anti-inflammatory, immunosuppressive

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98
Q

Immunosuppressive Agent: Monoclonal Antibodies

A
  1. Basiliximab
  2. Daclizumab
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99
Q

Immunosuppressive Agent: Impiairs IL, cytokines and IFNys

A

Calcineurin Inhibitor

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100
Q

Immunosuppressive Agent: Inhibit DNA replication/synthesis

A

Antimetabolic Agent

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101
Q

Immunosuppressive Agent: Blocks cell signaling

A

Calcineurin Inhibitor

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102
Q

HLA Antigens found in monocyte. T or F

A

True (present as WBCs)

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103
Q

Immunosuppressive Agent: Calcineurin inhibitor example

A
  1. Cyclosporine- A
  2. Tacrolimus
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104
Q

What provide the basis for donor selection in tissue transplantation?

A

Histocompatibility Antigens

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105
Q

HLA Antigen is found on RBCs. T or F

A

FALSE

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106
Q

Where are histocompatibility antigens absent?

A

RBCs, Trophoblastic cells, Sperm cells

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107
Q

Which tissues display the highest amount of antigen?

A

WBCs, Spleen, Lungs, Kidney, Heart

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108
Q

What are the most commonly transplanted organs?

A

Lungs, Kidney, Heart

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109
Q

What are Human Leukocyte Antigens (HLA)?

A

Part of the Histocompatibility Antigens located in the MHC gene on Chromosome 6

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110
Q

What chromosome is the Major Histocompatibility Complex (MHC) gene located on?

A

Chromosome 6

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111
Q

What cells detect Class I HLA molecules?

A

CD8+ T Cells

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112
Q

MHC Classes of Genes and Composition

A

Class 1 - HLA [A,B,C]
Class 2 - HLA [DR,DQ,DP]
Class 3 - Complement proteins

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113
Q

What cells detect Class II HLA molecules?

A

CD4+ T Cells

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114
Q

What is an Autograft?

A

A transplant where tissue from one part of the body is transplanted to another part of the same body

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115
Q

Other name of autograft

A

autologous graft

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116
Q

Why is there less chance for graft rejection in an autograft?

A

Because the tissue comes from the person’s own body

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117
Q

2 types of Holograft

A
  1. semi-syngeneic
  2. Allogeneic
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118
Q

Other name of isograft

A

syngeneic/ isogeneic graft

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119
Q

What is a syngeneic allograft?

A

Between genetically identical individuals

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120
Q

Other name of allograft

A

NAME?

121
Q

What is a xenograft?

A

Occurred from one species to another

122
Q

In what fossa do the kidney and renal vein attach to the present blood vessels?

A

iliac fossa

123
Q

most common kidney donation

A

Left kidney donation and transplant

124
Q

Why is Left kidney donation and transplant most common

A

Because of its long renal artery and renal vein making it easier for attachment or anastomosis of BV to transplanted kidney on illac fossa (external iliac)

125
Q

To whom is the left lobe of the liver usually given to?

A

pediatric patients

126
Q

What happens to the liver cells that grow back whole after months?

A

the cells rapidly multiply

127
Q

What is the common diagnosis that uses (in) liver transplant?

A

Fibrosis

128
Q

Fibrosis is the common diagnosis that uses what?

A

liver transplant

129
Q

HLA Antigens are prone to severe rejections. True or False

A

TRUE

130
Q

What is the HLA ANTIGEN part of?

A

Major Histocompatibility Complex

131
Q

Where is of the Major Histocompatibility Complex located?

A

Short arm of Chromosome 6

132
Q

What HLA Antigen is most polymorphic with how many loci

A

HLA-B - 61 loci

133
Q

Most polymorphic HLA Class II Antigen

A

HLA-DR

134
Q

HLA Antigens and its Transplant loci

A

A - 28
B - 61
C - 10
R - 24
Q - 9
P - 6

135
Q

What is a short arm of chromosome 6 called?

A

Locus

136
Q

Define HLA Class 1 (EHMNRH)

A
  • Expressed on all nucleated Cells
  • HLA [A, B, C (E, F, G)]
  • Most immunogenic
  • Numerous
  • compatibility of organ transplantation
  • Highly polymorphic HLA [A, B, C]
137
Q

Define HLA Class (EHH)

A
  • Expressed in APCs (Macrophage, B cells, Langerhans, Interdigitating cells, Dendritic cells)
  • HLA [DP, DQ, DR]
  • Highly polymorphic HLA-DR
138
Q

Histocompatibility Systems is inherited thru

A

mendelian pattern (Punnet square)

139
Q

Principle of Histocompatibility systems

A

codominant expression (cis-AB, or A, B)

140
Q

What causes the release of vWBF in the Endothelial cells?

A

Platelet Adhesion

141
Q

Results when Strength of binding or IR is greater than AR

A

nothing happens

142
Q

Collagen found in what is below the endothelium?

A

lamina propria

143
Q

Where are Killer Immunoglobulin-Like Receptors found?

A

NK cells

144
Q

2 major receptor KIR complex

A

inhibiting ad activating receptors

145
Q

Result when strength of binding of inhibitor is equal to the strength of binding of activating

A

nothing happens

146
Q

HLA testing

A
  1. Phenotyping
  2. Genotyping
  3. Antibody Identification
  4. Crossmatching
147
Q

classical procedure for specific type of alleles

A

phenotyping

148
Q

what is the unknown in phenotyping

A

antigen

149
Q

principle to HLA phenotyping

A

CDC - complement dependent cytotoxicity

150
Q

What type of antibodies are incubated with lymphocytes from buffy coat to be HLA typed in separate wells of a microtiter plate (terasaki plate)

A

monoclonal antibodies

151
Q

Antibodies attack the specific antigen on what in phenotyping?

A

B Cells or T Cells

152
Q

AB labeled with paramagnetic substance targeted to T-cell (CD3)/ B cell (CD20)

A

HLA Phenotyping

153
Q

Enumerate the steps of HLA phenotyping

A
  1. buffy coat preparation
  2. buffy coat incubated wt pure HLA antibodies
  3. antibodies attack specific antigen on b cells and t cells
  4. in presence of bound antibody complement is activated = cells are killed
  5. addition of fluorescent dye to be able to view on microscope
154
Q

when is complement activated in phenotyping?

A

when there is presence of bound antigen (only happens when lymphocyte expresses HLa antigen targeted by antisera

155
Q

What attack the specific antigen on B Cells or T Cells?

A

Antibodies

156
Q

What does bound antibody occur only when the lymphocyte expresses the HLA antigen targeted by the antisera?

A

if the lymphocyte expresses the HLA antigen targeted by the antisera

157
Q

What is activated in the presence of bound antibody?

A

complement is activated

158
Q

what happens when complement is activeted?

A

cells die

159
Q

What is added to be able to view agglutination in microscope ?

A

fluorescent dye

160
Q

what dyes are added for HLA phenotyping

A

acridine orange = viable cells (green)= presence of binding
ethidium bromide = nonviable cells (red) no presence of binding

161
Q

How many genes does one family member share from the mother to the child?

A

half

162
Q

How much of the mother’s genes does the child contain?

A

half

163
Q

How many genes do sibling-to-sibling share?

A

half

164
Q

Differentiate the two types of allograft

A
  1. semi-syngeneic/ semi-allogeneic - one family member donates to other family members
  2. allogeneic - from one person to another (graft to same species different individuals)
165
Q

What is used to identify with the lowest risk of complications?

A

tissue typing techniques

166
Q

How do we reduce the risk of complications?

A

increase compatibility

167
Q

What are donors ranked based on in case they become available?

A

compatibility

168
Q

Preformed Abs [detected during HLA cross-matching] may be formed during

A
  1. Pregnancy
  2. Previous Blood Transfusion
  3. Previous transplantation
169
Q

agglutination/ reaction during testing indicates ____?

A

incompatibility

170
Q

Ways to increase tissue compatibility

A
  1. HLA Typing
    • Phenotyping
    • Genotyping
    • Abs Identification
  2. Cross-matching
171
Q

When can a lot of medications be given to a patient with renal issues?

A

Before they have End-Stage Renal Disease

172
Q

Indications for Solid Organ Transplantation

A
  1. Damage is irreversible, alternative treatments are not applicable
  2. Disease must not reoccur in graft
  3. Chances of rejection must be minimized
173
Q

What happens if a patient with renal issues is not compliant with treatment?

A

They progress to End-Stage Renal Disease

174
Q

What is the only treatment for End-Stage Renal Disease?

A

Transplantation

175
Q

Why might some patients in the Philippines choose not to undergo transplantation for End-Stage Renal Disease?

A

Cost and scarcity of the kidney

176
Q

What is the concern when transplanting organs in patients with Goodpasture Syndrome?

A

Disease recurrence

177
Q

Which organ is most commonly damaged in Goodpasture’s Syndrome?

A

Kidney

178
Q

Why may a transplanted kidney be diseased again in a patient with Goodpasture’s Syndrome?

A

Presence of disease in circulating lymphocytes and not the organ itself

179
Q

What happens when you have endothelial injury?

A

Prothrombotic state

180
Q

HYPERACUTE REJECTION:
- time
- cause for rejection
- example
- schematic of rejection

A

A. immediately (minutes to hours)
B. antibodies against donor graft endothelial cells
C. Hypersensitivity II, Natural IgM antibodies against ABO antigens (MHC Class 1)
D. Complement Activation > Endothelial Injury > Thrombosis > Ischemic Necrosis

181
Q

CHRONIC REJECTION:
HYPERACUTE REJECTION:
- time
- cause for rejection

A

A. months to years after transplantation
B. graft failure

182
Q

ACUTE REJECTION:
HYPERACUTE REJECTION:
- time
- cause for rejection
- due to
- prevented by

A

A. Days to weeks
B. Early graft failure (most common), discontinued/tapered immunosuppression
C. HLA Incompatibility
D. immunosuppressive drugs/medications

183
Q

cancer in the brain/spinal chord

A

glioma

184
Q

What occurs when a thrombus forms in small blood vessels?

A

Thrombosis

185
Q

What happens to tissue when it becomes hypoxic and eventually necrotic?

A

Ischemic necrosis

186
Q

cancer/ tumor filled with hair, tissue, teeth

A

tetranoma

187
Q

How can hyperacute rejection be prevented?

A

ABO & HLA cross-matching

188
Q

Why is ABO compatibility crucial in transplantation?

A

Donor tissue may die if incompatible

189
Q

Methods of increasing graft survival

A
  1. HLA matching
  2. Immunosuppressive therapy
  3. Plasmapheresis
190
Q

cancer that forms in the lining of the blood vessels

A

Kaposi sarcoma

191
Q

What organs does not need HLA matching

A
  1. liver
  2. heart
  3. lungs
192
Q

immunosuppression leads to

A

increased susceptibility to opportunistic pathogens

193
Q

Malignancies due to latent viral infections due to immunosuppression

A

EBV-induced burkitts lymphoma
HPV-induced squamous cell carcinoma
HHV-8 induced kaposi sarcoma

194
Q

2 problems unique to HSC transplantation

A
  1. GVHD
  2. immunodeficiency
195
Q

ACUTE GVDH
a. time
b. mediated by
c. involved organs
d. presentation (s/s)

A

a. days to weeks of transplantation (within 100 days)
b. mediated by CD8+ T cells /. Cytotoxic T-cells
c. skin, liver, gastrointestinal tract (intestines)
d. rashes, jaundice and bloody diarrhea

196
Q

CHRONIC GVDH
a. time
b. mediated by
c. involved organs
d. presentation (s/s)

A

a. after 100 days
b. autoimmunity grafted from CD4+ T cells stimulating B cell differentiation
c. skin (cutaneous injury), mouth, eyes, liver and esophageal structures
d. thymic involution, lymphocyte and lymph node depletion

197
Q

fatal complications of immunodeficiency caused by HSC transplantation

A

cytomegalovirus-induced pneumonitis

198
Q

frequent complicaton of HSC transplantation

A

Immunodeficiency

199
Q

What do benign tumors generally retain?

A

Normal function

200
Q

What changes signal potential for aggressive behavior in malignant tumors?

A

Pleomorphism, abnormal nuclei, mitotic figures, loss of polarity

201
Q

What does the loss of function and obtaining new ones in tumors refer to?

A

Paraneoplastic Syndrome

202
Q

What does ‘loss of polarity’ refer to in the context of tumors?

A

Epithelial cells losing distinction between apical and basal surfaces

203
Q

What is the second most reliable discriminator of malignancy?

A

Local invasion/ systemic spread

204
Q

Can benign tumors metastasize?

A

No

205
Q

cohesive masses that remain localized to the site of origin

A

benign tumore

206
Q

What makes complete resection of malignant tumors difficult?

A

Systemic spread

207
Q

What is an unequivocal marker of malignancy?

A

Metastasis
1. reduces possibility of cure
2. stage 4 classification
3. no good prognosis

208
Q

NAME?

A

malignant tumors

209
Q

What stage are patients classified as when they have metastasis?

A

Stage 4

210
Q

spread of tumor to sites that are physically discontinuous with the original tumor

A

metastasis

211
Q

Which tumor spread (pathway) is more common in carcinomas?

A

Lymphatic spread

212
Q

Which tumor spread (pathway) is more common in sarcomas?

A

Hematogenous spread

213
Q

Do benign tumors remain localized to their site of origin?

A

Yes

214
Q

How do malignant tumors typically grow compared to benign tumors?

A

Erratic growth

215
Q

eight fundamental changes in cell physiology

A
  1. self-sufficiency in growth signals
  2. insensitive to growth-inhibitory signals
  3. altered cellular metabolism
  4. evasion to apoptosis
  5. limitless replicative potential
  6. sustained angionesis
  7. ability to evade and metastasize
  8. ability to evade host immune response
216
Q

ability of immune system to scan the body for emerging malignant cells and destroy them

A

immune surveillance

217
Q

presence of immune surveillance is demostrated by? (4)

A
  1. presence of tumor-specific t cells and antibodies
  2. immune infiltrates in cancers correlate with outcome
  3. increased incidence of cancer in immunocompromised people
  4. response of advanced cancers to therapeutic agents that stimulate latent host t-cell response
218
Q

How can cancers evade the immune system?

A

Antigen-negative variants, loss of MHC molecules, inhibiting T cell activation, immunosuppressive factors, regulatory T cells

219
Q

What are some mechanisms of immune invasion by cancers? (SELIS)

A
  1. selective outgrowth of Antigen-negative variants,
  2. loss of MHC molecules,
  3. engagement of pathways inhibiting T cell activation,
  4. secretion of immunosuppressive factors,
  5. induction of regulatory T cells (reduce CD4/8 T cell function)
220
Q

How do chemicals act as carcinogenic agents?

A

highly reactive agent that is capable od DNA damage leading to mutations

221
Q

What are the two types of chemical carcinogenesis?

A

Direct Acting, Indirect Acting

222
Q

Do direct-acting agents require metabolic conversion?

A

No

223
Q

example of direct acting agents

A

alkylating agents

224
Q

Do indirect-acting agents require metabolic conversion?

A

Yes

225
Q

What are the two processes in chemical carcinogenesis?

A

Initiation, Promotion

226
Q

chemical carcinogenesis process that induce tumor to arise from initiated cells

A

promotion

227
Q

microbe that causes chronic inflammation and gastric cell proliferation

A

helicobacter pylori

228
Q

What is the process of initiation in chemical carcinogenesis?

A

Expose cells to cause permanent mutation

229
Q

How does radiant energy contribute to carcinogenesis?

A

Mutagenic and carcinogenic

230
Q

How can radiation cause mutations and cancers?

A
  1. Chromosome breakage, translocations, and mutations,
  2. UV rays - induce pyrimidine dimer formation
  3. xeroderma pigmentosum
231
Q

microbe which causes gastric adenocarcinoma (GALT) nd MALToma (mucosa-associated lymphoma)

A

helicobacter pylori

232
Q

preformed antibodies against donor HLA may be formed during?

A

pregnancy, transfusion, and previous transplantation

233
Q

What is one of the most common organs being transplanted in the Philippines?

A

kidney

234
Q

What is optimized by HLA match?

A

Graft survival

235
Q

What match optimizes graft survival?

A

HLA match

236
Q

What is the reason why we transplant from a related person?

A

they share a similar genetic makeup compared to patients wherein we transplant from a totally unrelated person

237
Q

What type of immunosuppression is required for px with heart transplant?

A

potent immunosuppression

238
Q

Graft Antigens are processed and present by recipient APCs to recipient T cells

A

indirect pathway

239
Q

process wherein Tcells and antibodies are produced against graft (foreign body) antigens and destroy graft

A

graft rejection

240
Q

Donor graft APCs present antigens to recipient T cells

A

direct pathway

241
Q

What type of donor does a human being only have one heart, one pancreas, and patients require corneas to see?

A

cadaver or a dead person

242
Q

For what type of donor is it possible to have a live type of donor?

A

liver, kidney, stem cells

243
Q

2 pathway of recognition of donor HLA

A
  1. Direct Pathway
  2. Indirect Pathway
244
Q

main problem and consideration in all solid organ transplant

A

graft rejection

245
Q

How many kidneys do we have?

A

two

246
Q

What organ achieves the best result when there is match of HLA [A,B,C, and DR]

A

stem cells

247
Q

What type of cells can we give one to another person?

A

stem cells

248
Q

what organ is not affected by the degree of HLA matching?

A

liver

249
Q

What organ requires potent immunosuppression because HLA matching is not always possible

A

heart

250
Q

What organ does not need immunosuppression because it is avascularized

A

corneas

251
Q

What organ needs optimized HLA match for graft survival and immunosuppression?

A

Kidney

252
Q

What organ is transplanted along with kidney to diabetic patients?

A

Pancreas

253
Q

2 Types of graft rejection

A
  1. HVGD
  2. GVHD
254
Q

competent donor cells will produce an immune response against antigent of immunocompromised recipient.

A

GVHD

255
Q

recipient produce immune response against donor graft or tissue

A

HVGD

256
Q

Occurs during HSC transplantation

A

GVHD

257
Q

What is Sarcoma’s benign version called?

A

fibroma

258
Q

suffix attached to malignant tumors

A

carcinoma
sarcoma
leukemia
lymphoma

259
Q

swelling caused by inflammation

A

tumor

260
Q

What is a benign neoplasm finger-like projections’ called?”

A

papilloma

261
Q

collective term for malignant tumors

A

cancer

262
Q

What type of tumor is the suffix -oma given to?

A

benign

263
Q

collection of cells and stroma composed of new growths

A

neoplasm

264
Q

malignant form of fibroma, cancer in solid mesenchymal tissue

A

sarcoma

265
Q

malignant tumors that resembles stratified squamous epithelium

A

squamous cell carcinoma

266
Q

triggered by an acquired or inherited mutation affecting a single cell and its progeny

A

neoplasm

267
Q

malignant tumor that resemble glandular epithelium

A

adenocarcinoma

268
Q

explain the relationship between differentiation and prognosis, and anaplasia and prognosis

A

BETTER differentiation = BETTER prognosis
MORE anaplastic = WORSE prognosis

269
Q

epithelial neoplasms forming cystic masses

A

cystadenoma

270
Q

table benign or malignant:

https://docs.google.com/document/d/1hFa_m2Ynqfv3HtPVwzRyoHbPVytS6oT8HM0XCAgoCjM/edit

A

A. fibrosarcoma
b. lipoma
c. chondrosarcoma
d. osteoma
e. squamous cell papilloma
f. squamous cell carcinoma
g. Adenocarcinoma
h. papilloma
i. hepatocellular carcinoma
j. leukemia
k. lymphoma

271
Q

lack of differentiation

A

anaplasia

272
Q

extent to which neoplastic cells resemble normal cells morphologically and functionally

A

differentiation

273
Q

What type of viruses produce antigens?

A

oncogenic viruses

274
Q

What are the tumor cells expressing that are recognized as foreign ?

A

tumor antigens

275
Q

What are the three antigens expressed by tumor cells?

A
  1. neoantigens by mutated genes
  2. Overexpressed or aberrantly expressed self-proteins
  3. antigens by oncogenic viruses
276
Q

What is the principal mechanism of ANTITUMOR EFFECTOR MECHANISM

A

Killing of tumor cells by CD8+ cytotoxic T cells specific to the tumor antigen

277
Q

What is the mechanism capable of producing immune response against tumor antigens?

A

CD8+ cytotoxic T cell

278
Q

other mechanisms of antitumor effectors are? (5)

A
  1. CD8+ t cell
  2. CD4+ t cell
  3. NK cells
  4. Activated macrophages
  5. Antibodies
279
Q

schematic (how does) antitumor effector mechanism (work)

A
  1. tumor is found in cells
  2. tumor is recognized by dendritic cell
  3. travel to lymph node
  4. dendritic cell (APCs) will present tumor to T cell
  5. activation of T cell
  6. Migration of T cell to tumor
  7. Destruction of tumor
280
Q

What defect in repair of pyrimidine dimers leads to increased risk for skin cancer?

A

xeroderma pigmentosum

281
Q

Carcinogenic Agents (Microbes)

A
  1. HPV 16/18
  2. EBV
  3. HCV/HBV
  4. Helicobacter pylori
282
Q

Microbe that causes chronic inflammation, injury, and hepatocyte proliferation

A

HBV, HCV

283
Q

phenomenon which allows fetal implantation and placental development, even tho mother is capable of produce Abs against fetus

A

immune tolerance

284
Q

produce oncoproteins that inhibit tumor euppresor genes

A

HPV type 16/18

285
Q

in HPV type 16/18:
E6 targets tumor suppressor gene __?
E7 tragets?

A

a. p53
b. retinoblastoma (Rb) suppressor gene

286
Q

causes 70-85% hepatocellular carcinomas

A

hepatitis B and C virus

287
Q

maternofetal cell that expresses MHC class 1 antigen

A

Invasive Extravillous cytotrophoblast

288
Q

fetal-maternal interface is immunologically inert. T or F

A

False. NOT immunologically inert (mother can produce Abs against fetal Ags)

289
Q

immunologically inert at all gestational stages

A

villous trophoblast

290
Q

Cause squamous cell carcinoma of the cervix, anogenital region and the head and neck

A

HPV 16/18

291
Q

cause burkitt’s lymphoma, and other B cell tumors and nasopharyngeal carcinoma

A

epstein-barr virus

292
Q

maternofetal HLA antigen that protects placenta from immune rejection

A

HLA-G

293
Q

HLA antigen present in invasive extravillous cytotrophoblast

A

HLA-G

294
Q

Are MHC Class 1 and 2 (absent/present) in villous trophoblasts?

A

absent

295
Q

what kind of graft is the fetus and placenta

A

semi-allogenic graft

296
Q

What are the only fetus-derived cells in direct contact with maternal tissues and blood?

A

Trophoblastic Cells

297
Q

Cells that do not have major histocompatibility

A

villous trophoblasts

298
Q

maternofetal cells found in the placenta

A

Trophoblasts and Cytotrophoblasts

299
Q

The __ is attached to the mother thru the ___ which contains ___, by which it is attached to the __ which is attached to the ___

A
  1. fetus
  2. umbilical cord
  3. 2-3 veins
  4. placenta
  5. maternal uterus

Immunosero (2 decks)

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