Lymphoid structures Flashcards
1
Q
What is the function of lymph nodes?
A
Filtration by macrophages, storage of T and B cells
2
Q
What are primary follicles?
A
Lymph nodes that are dormant
3
Q
What are secondary follicles?
A
Lymph nodes that are actively producing B and T cells
4
Q
What cells are contained within the medulla of a lymph node?
A
Lymphocytes and plasma cells
5
Q
What cells are contained within the paracortex of the lymph node?
A
T cells
6
Q
Where does lymph drain from the head and neck?
A
Cervical lymph nodes
7
Q
What are the lymph nodes that drain the lungs?
A
Hilar lymph nodes
8
Q
What are the lymph nodes that drain the trachea and the esophagus?
A
Mediastinal lymph nodes
9
Q
What are the lymph nodes that drain the Upper limb, breast, and skin above the umbilicus?
A
Axillary lymph
10
Q
What are the lymph nodes that drain the liver, stomach, spleen, pancreas, and upper duodenum?
A
Celiac
11
Q
What are the lymph nodes that drain the colon from the splenic flexure to the upper rectum?
A
Inferior mesenteric
12
Q
What are the lymph nodes that drain the tests, ovaries, kidneys, and uterus?
A
Para-aortic nodes
13
Q
What are the lymph nodes that drain the anal canal (below the pectinate line), and skin below the umbilicus?
A
Superficial inguinal
14
Q
What are the lymph nodes that drain the dorsolateral foot and posterior calf?
A
Popliteal
15
Q
What part of the spleen houses T cells?
A
WhiTe pulp
16
Q
What part of the spleen houses B cells?
A
Red pulp
17
Q
What is contain within the marginal zone of the spleen ( the area between the white and red pulp)?
A
APCs and B cells
18
Q
Asplenic pts are susceptible to infections with which bacteria? (6)
A
Strep pneumoniae HIB N. Meningitidis E. Coli Salmonella GBS
(SHiNE SKiS)
19
Q
What are Howell–Jolly bodies, and in what condition are they seen in?
A
DNA inclusions in RBCs, caused by splenectomy
20
Q
Why is there thrombocytosis in pts who are asplenic?
A
Spleen normally removes platelets
21
Q
What is the site of maturation for B cells, and T cells?
A
B cells = bone
T cells = Thymus
22
Q
Is adaptive immunity inheritable?
A
No
23
Q
TLRs and PAMPs are key in the innate immune response, or the adaptive?
A
Innate
24
Q
What are the gene loci for MHC class I?
A
HLA-A, B, and C
25
What are the gene loci for MHC class II?
HLA-DR, DP, DQ
26
CD4 binds to MHC I or II?
II
27
CD8 binds to MHC I or II?
I
28
Which MHC class is responsible for presenting endogenously synthesized antigens, class I or II?
I
29
Which MHC class is responsible for presenting exogenously synthesized antigens to Th cells, class I or II?
II
30
Which class of MHC loads peptides in the RER?
I
31
Which class of MHC proteins loads peptides following the release of invariant chain in acidified endosome?
II
32
HLA haplotype A 3 is associated with what disease?
Hemochromatosis
33
What is the HLA haplotype that is associated with Psoriatic arthritis, ankylosing spondylitis, IBD, and reactive arthritis?
B27
34
What is the HLA haplotype that is associated with celiac disease?
DQ2/DQ8
35
What is Goodpasture syndrome?
Autoimmune attack of BM or lungs and kidneys
36
What is the HLA haplotype that is associated with Goodpasture syndrome, MS, and SLE?
DR2
37
What is the HLA haplotype that is associated with DM I, SLE, and Grave's disease?
DR3
38
What is the HLA haplotype that is associated with RA?
DR4 ("There are 4 walls in a 'room'")
39
What is the HLA haplotype that is associated with pernicious anemia?
DR5
40
Pernicious anemia is caused by what?
B12 deficiency
41
What are two protein/enzyme that NK cells utilize to kill tumor cells?
Perforin and granzymes
42
NK cells are activated by which ILs? (4)
IL2, IL12, IFN beta and alpha
43
What is the role of Th 4 cells?
Help B cells make antibodies and produce cytokines
44
What is the role of CD8 T cells?
Kill infected cells
45
Positive selection of T cells occurs in which part of the thymus? What is positive selection?
Cortex
T cells expressing TCRs capable of binding self MHC survive
46
Negative selection of T cells occurs in which part of the thymus? What is negative selection?
Medulla
T cells bindings too tightly with self antigens die
47
What is the cytokine that induces CD4 T cells to differentiate into Th1 cells? Th2? Th17? Treg?
```
Th1 = IL 12
Th4 = IL2
Th17 = TGF-beta + IL6
Treg = TGFbeta
```
48
What are the three types of APCs?
B cells
Macrophages
Dendritic cells
49
What are the costimulatory signals involved in T cell activation?
B7 and CD28
50
CD40 receptor on B cells binds to what ligand on Th cells?
CD40 ligand
51
What are the steps of T cell activation?
Dendritic cell presentation via MHC II to Th.
| Th cell presents to CD8 T cells
52
What are the steps of B cell activation?
Th cell stimulated, then B cell activation. Work together to achieve full activation
53
What determines the class switching from IgM?
Th cell cytokines
54
Th1 cells secrete what cytokine?
IFN-gamma
55
Th2 cells secrete what cytokines (4)?
IL 4, 5, 6, 13
56
Th1 cells do what?
Activate Macrophages and CTLs
57
Th2 cells do what?
Recruits eosinophils for parasite defense and promote IgE production
58
Th1 cells are inhibited by what two cytokines?
IL4 and IL10
59
Th2 cells are inhibited by what cytokine?
IFN-gamma
60
Macrophages release what cytokine to stimulate T cells to differentiate into Th1 cells?
IL12
61
Th1 cells release what cytokine to stimulate macrophages?
IFN-gamma
62
What are the proteins that CTLs release to destroy cells?
Perforin and granzymes
63
What is the role of regulatory T cells?
Suppressing CD4 and CD8 T cells
64
Transcription factor FOXP3 is found in what immune cells?
Tregs
65
What part of IgM and IgG fixes complement?
Fc portion
66
What parts of antibodies recognize antigens?
Variable portions of the heavy and light chains
67
Which chain contributes to both Fc and Fab portions of an antibody? What part of the antibody does the other contribute?
Heavy chain contributes both
| Light portion only contributes to Fab portion
68
What part of the antibody determines the isotype of the antibody (Fc or Fab region)?
Fc region
69
What are the four Cs of the Fc portion of antibodies?
Constant
Carboxy terminal
Complement binding
Carbohydrate side chains
70
How is antibody diversity generated?
random recombination of V(D)J genes
71
True or false: IgG crosses the placenta
True
72
True or false: IgA fixes complement
False
73
True or false: IgM crosses the placenta
False
74
What is the function of IgD?
Unknown
75
Which antibody mediates Type I hypersensitivities, by binding to mast cells and basophils?
IgE
76
What is the primary antibody?
IgM
77
What is the secondary antibody?
IgG
78
Which antibody can be found as a dimer, and crosses mucus membranes?
IgA
79
Which antibody can be found as a pentamer, and is the main antibody found on immature B cells?
IgM
80
What are thymus independent antigens?
Antigens that lack a peptide component
81
What are thymus dependent antigens?
Antigens that contain a protein component, allowing for class switching, and all the goodies that come with adaptive immunity
82
What organ produces acute phase reactant proteins?
Liver
83
Prolonged elevation of serum amyloid A can lead to what?
Amyloidosis
84
What is the role of CRP?
Opsonizes, fixes complement
85
What is the role of ferritin?
Binds and sequesters Fe
86
What is the role of fibrinogen?
Coagulation factor.
87
What is the role of hepcidin?
Prevents the release of Fe bound by ferritin
88
What are the two acute phase reactants that are downregulated in inflammation?
Albumin
| Tranferrin
89
What is the role of albumin?
Transport protein for bunches of stuff
90
What is the role of transferrin?
Fe sequestration
91
The MAC complex defends against what type of bacteria?
Gram negative
92
What is the classic pathway for complement activation?
IgG or IgM binds to bacteria (GM makes classic cars)
93
What is the alternative pathway for complement activation?
Microbe surface molecules
94
What is the Lectin pathway for complement activation?
Complement fixes mannose
95
What is the function of C3b?
Binds bacteria (b for binds)
96
What is the function of C3a, C4a, and C5a?
anaphylaxis
97
What is the function of C5a?
PMN chemotaxis
98
What complements combine to form the MAC complex?
C5b-9
99
What are the two primary opsonins in bacterial defense?
C3b and IgG
100
True or false: C3b helps clear immune complexes
True
101
What are the two inhibitors of complement, that prevent hemolysis of RBCs?
Decay accelerating factor + C1 esterase inhibitor
102
C1 esterase inhibitor deficiency leads to what? What type of medication is contraindicated in this disease?
Hereditary angioedema
| ACE inhibitors
103
C3 deficiency causes what?
Increases the risk of bacterial infections
104
C5-C9 deficiency leads to a predisposition to develop infection from what genus of bacteria?
Neisseria
105
Decay accelerating factor (DAF) deficiency leads to what?
Complement mediated lysis of RBCs and nocturnal hemoglobinuria
106
What is the functions of IL1-6?
```
IL-1 = Fever
IL-2 = T cells production
IL-3 = Bone marrow stimulation
IL-4 = IgE production
IL-5 = IgA production
IL-6 = acute phase protein stimulation
```
("Hot T-bone stEAC)
107
What is the role of IL8?
Chemotaxis for PMNs
108
What is the role of IL-12?
T cell differentiation into Th1 cells
109
What is the chemokine that mediates septic shock?
TNF-alpha
110
What is the chemokine that activates NK cells to kill virus infected cells?
IFN-gamma
111
What is the role of IL-10?
Modulates inflammatory response. (inhibits T cells)
112
What is interferon?
Glycoproteins synthesized by cells to alert nearby cells of infection.
113
What are the two enzymes that are upregulated with exposure to Interferon?
RNAase L
| Protein kinase
114
All nucleated cells have MHC class I or II?
I
115
What is the role of the TCR protein found on T cells?
T cell receptor--binds to MHC complexes
116
What is the role of CD3 on T cells?
Associated with TCR for activation
117
What is the role of CD28 on T cells?
Binds B7 on APCs
118
What is the protein that B7 on APCs binds to, that is present on T cells?
CD28
119
What is the protein on Th cells and APCs that allow for Th cells activation?
CD40 and CD40 ligand
120
CD8 or CD4 to CTLs?
CD8
121
What is the CD protein that is a receptor for Epstein Barr virus?
CD21 (beer at the bar when 21)
122
What is the role of CD16 on NK cells?
Binds Fc portion of IgG
123
What is the CD protein that is unique to NK cells?
CD56
124
What is clonal anergy?
Inactivation of T cells when exposed to Self-protein without other costimulatory molecules
125
What is the MOA of superantigens on Strep pyogenes and Staph Aureus?
Cross-link Beta region of T cell receptors to MHC II on APCs, leading to massive release of cytokines.
126
Which is a more severe mutation for the Flu, antigenic shift or drift?
Shift
127
What are the four bacterial/virus exposures where giving passive abs is indicated?
Tetanus
Botulinum
HBV
Rabies
128
Which is a live attenuated, and which is an inactivated vaccine: sabin and salk polio?
```
Sabin = Live attenuated
Salk = Inactivated
```
129
What is a type I hypersensitivity?
Antigen cross linking of IgE on presensitized mast cells
130
What are the chemokines that are produced in the delayed Type I hypersensitivity?
Leukotrienes
131
What is a Type II hypersensitivity?
IgM and IgG bind to antigen on self cells
132
What is a Type III hypersensitivity?
Immune complexes (antigen+antibody+complement)
133
What is serum sickness?
Type III hypersensitivity d/t ab introduction or drugs
134
What is Arthus reaction?
Local, subacute type III hypersensitivity when injecting antigen in the skin.
135
What is a type IV hypersensitivity?
T-cell mediated activation of macrophages (NO antibody involvement)
136
Which type of hypersensitivity does NOT involve antibodies?
IV
137
Transplant rejections are what type of hypersensitivity?
IV
138
TB skin tests are what type of hypersensitivity?
IV
139
Poststreptococcal Glomerulonephritis is what type of hypersensitivity?
III
140
What is pemphigus vulgaris?
type III attack against desmosomes, causing painful blisters
