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immunology review USMLE > lymphoid structures > Flashcards

lymphoid structures Flashcards

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USMLE® Step 1 flashcards
1
Q

functions of the LN (3)

A

nonspecific filtration by macrophages
storage and activation of B/T cells
antibody production

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2
Q

3 regions of LN

A

cortex
paracortex
medulla

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3
Q

what are located in the cortex?

A

B cells in follicles
1- inactive
2- active

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4
Q

what are located in the paracortex?

A

T cells

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5
Q

how do T cells and B cells from the blood inter LN?

A

through high endothelial venules located in the paracortex

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6
Q

what is contained in the medullary cords? sinuses?

A

cords- lymphocytes, plasma cells

sinuses- reticular cells, macrophages

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7
Q

lymphatic drainage of the rectum above the pectinate line

A

internal iliac nodes

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8
Q

lymphatic drainage of the rectum below the pectinate line

A

superficial inguinal nodes

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9
Q

lymphatic drainage of the testes

A

para-aortic nodes

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10
Q

lymphatic drainage of the scrotum

A

superficial inguinal nodes

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11
Q

lymphatic drainage of the lateral side of the dorsum of the foot

A

popliteal nodes

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12
Q

right lymphatic duct drains (3)

A

right arm, right chest, right half of head; everything else drained by thoracic duct

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13
Q

3 zones of the spleen

A

red pulp- RBCs
marginal zone- APCs
white pulp- WBCs

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14
Q

location of T cells in spleen

A

PALS

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15
Q

location of B cells in spleen

A

in follicles present in white pulp

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16
Q

role of macrophages in spleen (2)

A

remove encapsulated bacteria and damaged RBCs

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17
Q

consequences of splenectomy (4)

A

increased risk of infection from encapsulated organisms, Howell-Jolly bodies, target cells, thrombocytosis

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18
Q

encapsulated organisms

A 
SHiN SKiS
salmonella
H. influenza type B
Neisseria meningitidis
Strep pneumo
klebsiella
GBS
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19
Q

thymus is derived from

A

3rd branchial pouch

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20
Q

what occurs in the cortex of the thymus?

A

T cell positive selection- binding MHCI or MHCII

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21
Q

what occurs in the medulla of the thymus?

A

T cell negative selection- destruction of cells that bind self antigens too avidly

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22
Q

T cells leave the thymus as

A

naive T cells

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23
Q

histologic feature of thymus

A

Hassals corpuscles

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24
Q

only cells of innate immunity that have lymphoid origin

A

natural killer cells

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25
Q

MHC I genes

A

A,B,C

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26
Q

MCHI locations

A

all nucleated cells

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27
Q

which type of cell lacks MHCI

A

RBC (no nucelus)

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28
Q

type of infection MHCI is involved with

A

viral

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29
Q

how are peptides loaded on to MHCI (3)

A
  • antigen degraded in proteasome
  • travels through TAP into RER
  • loaded on MHCI
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30
Q

MHCII genes

A

DP, DR, DQ

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31
Q

MHCII locations

A

only APCs- macrophages, dendritic cells, B cells

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32
Q

type of infection MHCII is involved in

A

bacterial

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33
Q

how are peptides loaded on MHCII (5)

A
  • MHCII synthesized in RER
  • MHCII transported to vesicle loaded with Ii
  • in vesicle, Ii replaced with CLIP
  • HLA-DM removes CLIP
  • peptide loaded in acidified endosome
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34
Q

CDs expressed on natural killer cells (2)

A

CD16, CD56

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35
Q

what is CD16? where is it found?

A

binds Fc region of antibodies
found on NKCs, macrophages, neutrophils
helps kill Ig-coated cells via ADCC

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36
Q

what is the action of natural killer cells?

A

kills tumor cells and virally infected cells using perforin/granzyme to induce apoptosis

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37
Q

substances that increase the activity of NK cells (3)

A

IL-2, IL-12, IFNb

38
Q

NK cells are important for fighting what infection?/cells?

A

malaria-infected RBCs

39
Q

absence of __ induces NK cells to kill

A

MHCI on cell surface

40
Q

actions of interferons (2)

A

important for viral infections: decrease protein synthesis of neighboring cells and induce NK cells to kill

41
Q

how do cytotoxic T cells kill? (2)

A

induce apoptosis via perforin/granzyme or Fas/Fas-L binding

42
Q

Helper T cells induce Th1 with:

A

IL-12

43
Q

helper T cells induce Th2 with:

A

IL-4

44
Q

how are helper T cells activated? (2 signals)

A

both signals by antigen presenting cells
signal 1- CD4 to MHC II
signal 2- CD28 to B7

45
Q

how are cytotoxic T cells activated?

A

signal 1- CD8 to MHCI (any cell)

signal 2- IL-2 receptor to IL-2 (Helper T cell)

46
Q

how are B cells activated/class switching?

A

signal 1- B cell acted upon by cytokines

signal 2- CD40 to CD40-L (helper T cell)

47
Q

what is anergy?

A

lack of activity by a lymphocyte due to lack of second activating signal

48
Q

cells activated by Th1 cells (2)

A

macrophages, cytotoxic T cells

49
Q

secreted by Th1 cells (2)

A

IFNg, IL-2

50
Q

effect of IL-2

A

T cell proliferation

51
Q

effects of IFNg (2)

A

activates macrophages, suppressed Th2 cells

52
Q

secreted by Th2 cells (5)

A

IL-4, IL-5, IL-10, IL-13, IL-2

53
Q

effect of IL-4 (2)

A 
induces differentiation into Th2
class switching to IgE and IgG
54
Q

effect of IL-10

A

inhibits Th1

55
Q

what has similar activity to IL-10?

A

TGFb

56
Q

what has similar activity to IL-4?

A

IL-13

57
Q

effect of IL-5 (2)

A 
class switching to IgA
growth of eosinophils
58
Q

expressed by regulatory T cells

A

CD3, CD4, CD25

59
Q

role of regulatory T cells

A

suppress that actions of CD4 and CD8 T cells by release of IL-10 and TGFb

60
Q

what Th type is active in viral infections?

A

Th1

61
Q

part of the antibody that binds antigen

A

Fab = idiotype

62
Q

part of antibody that determines isotype

A

Fc

63
Q

composition of Fab

A

2 heavy and 2 light chains

64
Q

what types of Ig bind complement? where?

A

IgM>IgG, near hinge point

65
Q

types of heavy chains (5), determine?

A

alpha, gamma, mu, delta, epsilon

determines isotype

66
Q

types of light chains (2), ratio?

A

kappa or lambda, normally 3:1

67
Q

deviation from normal k:l indicates

A

neoplasia

68
Q

where does isotope switching occur? How?

A

in germinal center of LN, under the influence of cytokines and CD40/CD40L interaction with helper T cells

69
Q

3 general functions of antibodies

A

opsonization= promotes phagocytosis
neutralization
complement activation

70
Q

2 most important means of generating antibody diversity

A

VDJ recombination

somatic hypermutation

71
Q

where does VDJ recombination occur?

A

in the bone marrow, during B cell synthesis

72
Q

how does VDJ occur?

A

initiated by RAGs which recognize RSSs flanking the V, D, J genes, respectively

73
Q

what is the antibody “allotrope”? what can it be used for?

A

allotype = genetically determined, inherited markers on the heavy chain/can be used to determine paternity

74
Q

antibodies expressed by mature B cells (2)

A

IgM, IgD

75
Q

main antibody in the delayed/secondary antibody response

A

IgG

76
Q

main antibody in the immediate/primary antibody response

A

IgM

77
Q

most abundant antibody

A

IgG

78
Q

antibody that crosses placenta

A

IgG

79
Q

roles of IgG (3)

A

opsonizes bacteria, fixes complement, neutralizes bacterial toxins and viruses

80
Q

antibody that protects mucosal surfaces

A

IgA

81
Q

2 configurations of IgA

A

secretory form- dimer linked by J chain

circulating form- monomer

82
Q

antibody secreted in breast milk

A

IgA

83
Q

2 configurations of IgM

A

bound to B cell surface- monomer

circulating- pentamer

84
Q

most effective antibody at activating complement

A

IgM

85
Q

cells that IgE binds to (3)

A

mast cells, basophils, eosinophils

86
Q

IgE actions

A

mediates type I HST reactions, kills worms

87
Q

predominant antibody in AIDS

A

IgM (decreased CD4 T cells leads to decreased class switching)

88
Q

thymus-independent antigens

A

lack peptide component = cannot be presented to T cells = will stimulate the release of IgM but no memory

89
Q

thymus-dependent antigens

A

have peptide component = can be presents to T cells = class switching (IgG) and immunologic memory can occur

90
Q

conjugated vaccines

A

conjugate polysacharide with protein to allow for thymus-dependent response and induction of memory

immunology review USMLE (5 decks)

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