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Inflammation and Immunity > USMLE Road Map by Dr. Parmely > Flashcards

USMLE Road Map by Dr. Parmely Flashcards

1
Q

What is the role of IFN-alpha and IFN-beta?

A

Blocking virus replication within cells

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2
Q

What is the role of INF-gamma?

A

Potent activator of macrophages for killing of intracellular bacteria or fungi

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3
Q

What is the role of mucocilliary movement in the lung epithelium and peristalsis of GI tract involvement in the immune system?

A

These move microbes and other foreign agents across mucosal surfaces and out of the body

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4
Q

After the microbe is uptaken and subsequent fusion with a lysosome yields what?

A

Phagolysosome

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5
Q

Chronic granulomatous disease is caused by a mutation in what?

A

NADPH oxidase - leads to problems with the oxidative burst

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6
Q

What are the main functions of TNF-alpha?

A

Fever, leukocyte adhesion to endothelium, acute phase protein synthesis, oxidative burst, disseminated intravascular coagulation and shock

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7
Q

What are the main functions of IL-6 and IL-1?

A

Fever, leukocyte adhesion to endothelium, acute phase protein synthesis and B lymphocyte co-activation

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8
Q

IFN-alpha and beta have what role against viruses?

A

Blocking viral replication within cells

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9
Q

What is the role of IFN-gamma?

A

Activation of macrophages for the killing of intracellular bacteria and fungi

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10
Q

What is the role of CRP?

A

Binding to bacterial surface and activation of complement, serves as an opsonin

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11
Q

What is the cause of the ESR in response to inflammation?

A

Increased fibrinogen

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12
Q

Patients with hereditary angioedema have what?

A

Significantly decreased levels of plasma C1 inh, which is an important regulator of the classical pathway

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13
Q

Complement peptide C3d binds to what?

A

B cell coreceptor CR2

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14
Q

Can severe congenital neutropenia be treated with G-CSF?

A

No, this is a defect in the receptor for G-CSF

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15
Q

What is interesting about a patients thymus with DiGeorge’s syndrome?

A

Patients with DiGeorge syndrome lack a thymus

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16
Q

Where are B cells concentrated in lymph nodes?

A

Primary and secondary follicles within the cortex of lymph nodes

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17
Q

Where do memory B cells develop in the LN?

A

Germinal centers of the cortex

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18
Q

Where are T cells located in the LN?

A

Primarily in the paracortex where they associate with DCs

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19
Q

Secreted antibodies exit the lymph node via?

A

Efferent lymphatics

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20
Q

Use of the invariant chain is associated with what MHC class presentation?

A

MHC class II presentation

21
Q

Use of TAP protein is associated with what MHC class presentation?

A

MHC class I

22
Q

Patient presents with sever lymphopenia. Flow cytometry demonstrates low number of CD3 lymphocytes but normal IgM. What could be the disease?

A

DiGeorge Syndrome

23
Q

What two clinical abnormalities would be associated with a defective CD18 protein?

A

Defective leukocytosis and recurrent bacterial infections.

24
Q

A patient presents with lymphocytosis and enlarged lymph nodes. 90 percent of the patients bone marrow cells stain with CD3. What is a possible diagnosis?

A

T cell leukemia

25
Q

What is the best explanation for the reason that patients with antibody deficiencies can often present with the same types of infections as patients with phagocytic cell deficiencies?

A

Antibodies are important opsonins that promote microbe recognition by phagocytes

26
Q

What is a Coombs test?

A

To determine if an anemia has an immune basis by determining whether IgG antibodies are present on the patients erythrocytes

27
Q

What is the primary benefit of IVIG?

A

In immunodeficient patients it is to provide protection against extracellular microbial pathogens or their toxic products

28
Q

Dimeric IgA is associated with what?

A

Intestinal mucosa and is translocated across the mucosal epithelium. This is made possible by the secretory component

29
Q

What mediates opsonic activity of IgG antibodies?

A

The Fc fragment on antibodies bindgs to the Fc receptor on phagocytic cells

30
Q

RAG1/2 is responsible for what?

A

VDJ recombination

31
Q

Mutations in Rag1 or Rag2 genes lead to what disease?

A

SCID - characterized by a T-B-NK+ lymphopenia.

32
Q

What is allelic exclusion?

A

When successful rearrangement at one allele is achieved a signal is created that inhibits further rearrangements at the homologous allele

33
Q

If both alleles fail to productively rearrange what will happen?

A

They will most likely undergo apoptosis

34
Q

In order to generate junctional diversity nucelotides are added by what enzyme?

A

TdT

35
Q

Patient presents with recurrent bacterial infections that come back a week after finishing antibiotics. Lab test show mild neutropenia, low levels of IgG and IgA, and increased levels of IgM. When given a vaccination they make no detectable IgG. What could be the underlying cause of this?

A

Failure of her B cells to undergo Ig class switching.

36
Q

A population of plasma cells from a patient who was recently immunized with a protein vaccine has been isolated. Her cells secrete IgG but lack membrane IgG. What accounts for this?

A

Differential RNA processing favors the synthesis of a secreted form of gamma-heavy chains

37
Q

Th1 cells have a role in?

A

Cytokine production that is primarily associated with cell-mediated immunity; cytotoxic T cell growth and macrophage activation

38
Q

Th2 cells have a role in?

A

Production of cytokines that is primarily associated with humoral immunity; B cell activation, proliferation and differentiation and Ig class switching

39
Q

IL-4 induces what Th response?

A

IL-4 induces Th2 response

40
Q

IFN-gamma is an important inducer of what Th response?

A

Th1 response

41
Q

What is the transcription factor responsible for Th1 development?

A

T-bet responds to IFN-gamma promoting Th1 development

42
Q

What transcription factor is responsible for Th2 development?

A

GATA-3 activation leads to Th2

43
Q

Patient was given cyclosporine following organ transplant. 3 wks later patient developed a cytomegalovirus infection. A decrease in what response would be the best explanation for this opportunistic infection?

A

Cyclosporine inhibits the phosphatase calcineurin - important in activating NFAT. NFAT regulates cytokine genes in T cells including those that coinduce virus specific CD8 T cells to differentiate.

44
Q

If you were to design an experimental therapy directed at reducing cytokine production in allergic responses what would be a good target for this?

A

IL-4

It plays a central role in the development of allergy by promoting class switching to IgE and inducing more Th2 cells to produce IL-4

45
Q

Is Lck involved in TCR or BCR signaling?

A

TCR

46
Q

What is the TCR signaling pathway?

A

Lck phosphorylates ITAMs (zeta chains) leading to ZAP-70 then PLC-gamma-1

Louise inhabits zoo prohibitly

47
Q

What is the BCR signaling pathway?

A

Lyn - ITAMs (Ig-alpha and beta) - Syk - Btk - PLC-gamma-2

Lonnie I Sick Because Pineapple

48
Q
A

Inflammation and Immunity (51 decks)

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