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Immunology > USMLE STEP 1 IMMUNOLOGY > Flashcards

USMLE STEP 1 IMMUNOLOGY Flashcards

0
Q

What part of the lymph node consists of medullary cords and medullary sinuses?

A

Medulla

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1
Q

What is the site of B cell localization and proliferation? In outer cortex the primary “site” is dense and dormant while secondary “site” have pale central germinal centers and are active.

A

Follicle

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2
Q

What part of the lymph node consists of closely packed lymphocytes and plasma cells?

A

Medullary Cord

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3
Q

What part of the lymph node communicates with efferent lymphatics and contains reticular cells and macrophages?

A

Medullary Sinus

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4
Q

What part of the lymph node houses T cells, is the region of cortex between follicles and medulla, contains high endothelial venues through which T and B cells enter from the blood, becomes greatly enlarged in an extreme cellular immune response, and is not well developed in patients with DiGeorge syndrome/velocardiofafial

A

Paracortex

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5
Q

In what region of the spleen are T cells found?

A

Periarterial lymphatic sheath (PALS) within the white pulp of the spleen

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6
Q

In what region of the spleen are B cells found?

A

Follicles within the white pulp of the spleen

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7
Q

What is the site of T cell differentiation and maturation, is encapsulated, contains lymphocytes of mesenchymal origin and is created from epithelium of 3rd branchial pouches?

A

Thymus

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8
Q

What area is dense with immature T cells in the thymus?

A

Cortex

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9
Q

Before leaving the thymus what area is pale with mature T cells and epithelial reticular cells containing Hassall’s corpuscles?

A

Medulla

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10
Q

Positive selection, MHC restriction, occurs in what part of the thymus?

A

Cortex

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11
Q

Negative selection, non reactive to self, occurs in what part of the thymus?

A

Medulla

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12
Q

What part of the immune system has receptors that recognize pathogens that are germline encoded, has a response to pathogens that is fast and nonspecific, no memory is produced, consists of: neutrophils, macrophages, dendritic cells, natural killer cells ( lymphoid origin) and complement?

A

Innate

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13
Q

What part of the immune system has receptors that recognize pathogens and undergo V(D)J recombination during lymphocyte development, have a slow response on first exposure, has a fast memory response that is robust, consists of: T cells, B cells, and circulating antibody

A

Adaptive

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14
Q

What MHC consists of HLA-A, HLA-B, HLA-C, binds to TCR and CD8, expressed on all nucleated cells (not expressed on RBC’s), antigen is loaded in ER with mostly intracellular peptides, mediates viral immunity, pairs with beta-2-microglobulin (aids in transport to cell surface)

A

MHC I

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15
Q

What MHC consists of HLA-DR, HLA-DP, HLA-DQ, binds TCR and CD4, expressed only on antigen presenting cells (APC’s), antigen is loaded following release of invariant chain in an acidified endosome?

A

MHC II

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16
Q

What disease is associated with HLA-A3?

A

Hemochromatosis

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17
Q

What diseases are associated with HLA-B27?

A

Psoriasis, Ankylosing spondylitis, Inflammatory bowel disease, Reiter’s syndrome

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18
Q

What disease is associated with HLA-DQ2/DQ8?

A

Celiac disease

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19
Q

What diseases are associated with HLA-DR2?

A

Multiple Sclerosis, Hay Fever, SLE, Goodpasture’s

20
Q

What diseases are associated with HLA-DR3?

A

Diabetes mellitus type I, Graves’ disease

21
Q

What diseases are associated with HLA-DR4?

A

Rheumatoid arthritis, diabetes mellitus type I

22
Q

What type of diseases are associated with HLA-DR5?

A

Pernicious anemia - B12 deficiency, Hashimoto’s thyroiditis

23
Q

What cells use perforin and granzymes to induce apoptosis of virally infected cells and tumor cells, is the only lymphocyte member of the innate immune system, activity enhanced by: IL-2, IL-12, IFN-beta, IFN-alpha, induced to kill when exposed to a nonspecific activation signal on target cell and/or to an absence of class I MHC on target cell surface?

A

NK cells

24
Q

What cells make antibody that: opsonize bacteria, neutralize viruses (IgG), activate complement (IgM,IgG), sensitize mast cells (IgE), is responsible for allergy (type I hypersensitivity: IgE), cytotoxic and immune complex (type II/III hypersensitivity: IgG), and hyperactute and humorally mediated acute and chronic organ rejection?

A

B cells

25
Q

What type of cells help B cells make antibody and produce cytokines to activate other cells of the immune system?

A

CD4+ T cells

26
Q

What type of cells kill virus infected cells directly, are responsible in a delayed cell-mediated hypersensitivity type IV reaction, play a role in acute and chronic cellular organ rejection?

A

CD8+ T cells

27
Q

In the thymic cortex, T cells expressing TCR’s capable of binding surface self MHC molecules survive is known as what?

A

Positive selection

28
Q

In the medulla, T cells expressing TCR’s with high affinity for self antigen undergo apoptosis is known as what?

A

Negative selection

29
Q

What cells are known as professional antigen presenting cells?

A

Dendritic cell ( only APC that can activate naive T-cell)
Macrophage
Dendritic cell

30
Q

The following scenario is characteristic of what: foreign body is phagocytosed by DC, foreign antigen is presented on MHC II and recognized by TCR on TH cell or antigen is presented on MHC I to cytotoxic T cells (signal 1), costimulatory signal is given by interaction of B7 and CD28 (signal 2), TH cell activates and produces cytokines/ Tc cell activates and is able to recognize and kill virus infected cells

A

Naive T cell activation

31
Q

The following scenario is characteristic of what: TH cell activation, B cell receptor-mediated endocytosis causing foreign antigen to be presented on MHC II and recognized by TCR on TH cell (signal I), CD40 receptor on B cell binds CD40L on TH cell (signal 2), TH cell secretes cytokines that determine Ig class switching of B cell, B cell activates and undergoes class switching, affinity maturation and antibody production

A

B cell activation and class switching

32
Q

What type of T cell secretes IFN-gamma, activates macrophages, and is inhibited by IL-4 and IL-10 from TH2 cells?

A

TH1 cell

33
Q

What type of cell secretes IL-4, IL-5, IL-10 and IL-13, recruits eosinophils for parasite defense and promotes IgE production by B cells, and is inhibited by IFN-gamma production from TH1 cells?

A

TH2

34
Q

What type of cells kill virus infected, neoplastic and donor graft cells by inducing apoptosis, release cytotoxic granules containing preformed proteins ( perforin- helps to deliver the content of granules into target cell; granzyme - a serene protease, activates apoptosis inside target cell; granulysin - anti microbial induces apoptosis, have CD8 which bind MHC I on virus infected cells?

A

Cytotoxic T cells

35
Q

What type of cell helps maintain specific immune tolerance by suppressing CD4 and CD8 T cell effector functions, express CD3, CD4 and CD25 (alpha chain of IL-2 receptor) cell surface markers, produce anti inflammatory cytokines like IL-10 and TGF-beta

A

Treg cells

36
Q

What part of an antibody recognizes antigen?

A

Variable part of L and H chains

37
Q

What portion of IgM and IgG fix complement?

A

Fc portion

38
Q

The light chain only contributes to what region of the antibody?

A

FAB region

39
Q

Antigen binding fragment, determines idiotype: unique antigen binding pocket only 1 antigenic specificity expressed per B cell describes what?

A

Fab region

40
Q

Constant, carboxyl terminal, complement binding at CH2 (IgG and IgM only) carbohydrate side chains, determines isotype (IgM,IgG,IgD,IgA,IgE), describes what?

A

Fc region

41
Q

Random recombination of VJ (light chain) or V(D)J (heavy chain) genes, random combination of heavy chains with light chains, somatic hyper mutation (following antigen stimulation), addition of nucleotides to DNA during recombination by terminal deoxynucleotidyl transferase generates what?

A

Antibody diversity

42
Q

What is the main antibody in a secondary, delayed, response to an antigen, most abundant isotype, fixes compliment, crosses the placenta, provides infants with passive immunity, opsonize bacteria, neutralizes bacterial toxins and viruses?

A

IgG

43
Q

What antibody prevents attachment of bacteria and viruses to mucous membranes, does not fix compliment, is a monomer in circulation and a dimer when secreted, crosses epithelial cells by transcytosis, found in secretions (tears, saliva and mucus), and early breast milk known as colostrum, picks up secretory component from epithelial cells before secretion?

A

IgA

44
Q

What antibody is produced in the primary, immediate, response to an antigen, fixes compliment but does not cross the placenta, antigen receptor on the surface of B cells, monomer on B cells or pentamer, shape of pentamer allows it to efficiently trap free antigens out of tissue while humoral response evolves?

A

IgM

45
Q

What antibody has Unclear function, found on the surface of many B cells and in serum?

A

IgD

46
Q

What antibody binds mast cells and basophils, cross-links when exposed to allergen, mediates immediate type I hypersensitivity through release of inflammatory mediators such as histamine, mediates immunity to worms by activating eosinophils, lowest concentration in serum?

A

IgE

47
Q

What are antigens lacking a peptide component, cannot be presented by MHC to T cells (ex: lipopolysaccharide from cell envelope of gram-negative bacteria and polysaccharide capsular antigen), stimulate release of antibodies and doesn’t result in immunologic memory?

A

Thymus-independent antigen

48
Q

What are antigens containing a protein component (ex: diphtheria vaccine), class switching and immunologic memory occur as a result of direct contact of B cells with Th cells (CD40-CD40L interaction)

A

Thymus-dependent antigens

Immunology (5 decks)

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