Vol. II - Immunology and Pathology Flashcards
1
Q
Colon from splenic flexure to upper rectum drains tohy
A
Inferior mesenteric nodes
2
Q
SCID causes
A
defective IL-2R gamma chain (x linked, most common), adenosine deaminase deficiency (AR), RAG mutation
3
Q
Pathogenesis of hyperacute transplant rejection
A
preformed antibodies (type II hypersensitivity) –> rejection within minutes
4
Q
IFN-gamma
A
stimulates macrophages to kill phagocytosed pathogens. Induces IgG switching.
5
Q
TH2 cytokines
A
IL-4, 5, 6, 10, 13 –> activate eos and IgE production
6
Q
Tumor markers: Calcitonin
A
Medullary thyroid carcinoma
7
Q
Job syndrome presentation
A
ABCDEF: Abscesses, retained Baby teeth, Coarse facies, Derm problems, high IgE, Fractures
8
Q
IL-1
A
Fever and acute inflammation. Activates adhesion molecule expression on endothelium.
9
Q
Leukocyte adhesion deficiency (type 1)
A
defect in LFA-1 integrin (CD18) –> impaired migration and chemotaxis
10
Q
Thymic aplasia syndromes
A
Di George and velocardiofacial
11
Q
IL-12 receptor deficiency
A
Autosomal recessive causing decreased Th1 response –> decreased IFN-gamma –> mycobacterial and fungal susceptibility
12
Q
Hyper IgM syndrome
A
Usually X linked defect of CD40L on T cells –> defective class switching –> severe pyogenic, opportunistic, and CMV infections –> no germinal centers or other Ig classes
13
Q
TH17 cytokines
A
IL-17, 21, 22 –> induce neutrophil inflammation
14
Q
Tumor markers: Chromogranin
A
neuroendocrine tumors
15
Q
Rapamycin indication
A
kidney transplant rejection prophylaxis
16
Q
NK cell activity is enhanced by
A
IL-2, IL-12, IFN alpha and beta
17
Q
mechanism if fever in acute inflammation
A
Pyrogens –> magrophages produce IL-1 and TNF –> increased COX in anterior hypothalamus –> increased PGE2 –> increased temp set point
18
Q
Wiskott-Aldrich presentation
A
WATER: Wiskott-Aldrich causes Thrombocytopenia, Eczema, and Recurrent pyogenic infections
19
Q
Most common primary immunodeficiency
A
Selective IgA deficiency
20
Q
Tumor markers: alkaline phosphotase
A
Mets to bone and liver, Paget’s disease, seminoma
21
Q
testes, ovaries, and kidneys drain to
A
para-aortic nodes
22
Q
HLA DR4 association
A
rheumatoid arthritis and DM1
23
Q
Pathogenesis of chronic transplant rejection
A
CD4s respond to donor peptide –> type II and type IV reaction –> fibrosis etc, dominated by arteriosclerosis –> rejection in months to years
24
Q
Tacrolimus indication
A
immunospression after solid organ transplant
25
T-cell costimulation is
B7 on DC binds CD28 on T cell
26
Type I hypersensitivity
anaphylactic and atopic
| IgE mediated degranulation of presensitized mast cells
27
Treg cytokines
TGF-beta, IL-10, 35
28
Sirolimus (Rapamycin) MOA
mTOR inhibitor --> prevents response to IL-2
29
Protein product in proliferative phase of wound healing
Collagen Type III
30
X linked (Bruton) agammaglobulinemia
BTK defect --> no B cell maturation --> decrease in all Ig types --> recurrent bacterial infections (after 6 months b/c maternal Abs)
31
cervix, superior bladder, body of uterus drain to
external iliac nodes
32
What tissue does not undergo coagulative necrosis after infarct
brain
33
IL-6
causes fever and production of acute phase proteins
34
TH1 cytokines
IFN-gamma and IL-2 --> activate macrophages and CTLs
35
C5-C9 deficiency
increased Neisseria bacteremia susceptibility
36
role of leukotrienes in inflammation
endothelial contraction --> swelling
37
Chediak-Higashi presentation
PLAIN: progressive neurodegeneration, lymphohistiocytosis, Albinism, recurrent pyogenic Infections, peripheral Neuropathy
38
Type II hypersensitivity
Antibody mediated
39
Actue phase reactants
FFiSHH P in the C: Ferritin, Fibrinogen, Serum amyloid A, Hepcidin, Haptoglobin, Procalcitonin, C-reactive protein
40
Azathioprine MOA
precursor of 6-MP --> blocks PRPP amidotransferase --> reduced purine synthesis --> inhibits lymphocyte proliferation
41
fibril protein in hereditary amylodoses
mutated transthyretin (ATTR)
42
B cell costimulation is
CD40 binds CD40L on Th cell
43
Tumor markers: CA 27-29
Breas Cancer
44
Ataxia Telangiectasia
ATM defect --> Can't detect DNA damage --> accumulation of mutations --> increased AFP / risk of lymphoma and decreased IgA, IgG, and IgE + lymphopenia
45
Chronic Granulomatous Disease presentation
increased susceptibility to catalase positives, recurrent infections and granulomas, Dx on flow or nitroblue tetrazolium
46
Warm autoimmune hemolytic anemia association
IgG
47
Paroxysmal Nocturnal Hemoglobinuria cause
PIGA defect --> loss of GPI anchors --> no DAF --> MAC mediated hemolysis --> decreased haptoglobin and dark urine
48
BCL-2 is overexpressed in what disease?
follicular lymphoma (t[14:18])
49
Alternate macrophage activation
Th2 secretion of IL-4 and IL-13 --> repair and anti inflammatory
50
MHC I antigen loading occurs in
rough ER
51
HLA DR3 association
SLE and DM1
52
IL-12
induces Th1 differentiation and activates NK cells
53
MAC components
C5b-9
54
Predominant cell late in acute inflammation
macrophages (2-3 days)
55
Cyclosporin indication
psoriasis and RA
56
MAC defends against
Gram - bacteria, esp Neisseria
57
C3b function
opsonization and clearance of Ab complexes
58
IL-5
Class switching to IgA. Stimulates eos.
59
Which Ig suptype is a dimer
IgA
60
role of bradykinin in inflammation presentation
vasodilation --> redness and warmth, sensitization of nerve endings --> pain
61
Deficiency in Leukocyte Adhesion Deficiency type 2
sialyl lewis X --> loss of margination and rolling
62
Tumor markers: CA 15-3
Breast Cancer
63
Autosomal dominant hyper-IgE syndrome (Job syndrome)
STAT3 mutation --> deficiency of Th17 cells --> impaired neutrophil recruitment --> high IgE and eos
64
Cause of chronic mucocutaneous candidiasis
AIRE defect --> T cell dysfunction
65
earliest manifestation of cellular injury
swelling
66
C5a function
neutrophil chemotaxis
67
Mycophenylate Mofetil MOA
reversibly inhibits IMP dehydrogenase --> prevents purine synthesis
68
Lower duodenum, jejunum, ileum, and colon to splenic flexure drain to
superior mesenteric nodes
69
Direct Coombs test
Ab bound to RBCs
70
Which Ig subtype crosses the placenta
IgG
71
Tumor markers: CA 125
Ovarian Cancer
72
HLA B57 is associated with
Abacavir hypersensitivity
73
C3 convertase is
C4bC2b
74
Thymic aplasia presentation
CATCH-22: Cardiac defects, Abnormal Facies, Thymic hypoplasia, Cleft palate, Hypocalcemia caused by 22q11 microdeletion
75
Tumor markers: CEA
colorectal and pancreatic cancer
76
Classic complement activation is by
IgG or IgM
77
Ovarian teratoma paraneoplastic syndrome
Anti-NMDA receptor encephalitis
78
Deficiency in chronic granulomatous disease
NADPH oxidase
79
Thymus epithelium is derived from
3rd pharyngeal pouch
80
loss of AIRE causes
autoimmune polyendocrine syndrome (PT, adrenal, and candida infection)
81
Common variable immunodeficiency
Defect in B cell maturation, decreased plasma cells and Ig, increased risk of AI and lymphoma
82
delay in proliferative phase of wound healing is caused be
Vitamin C and copper deficiency
83
Type III hypersensitivity
Immune complex mediated
84
Cold autoimmune hemolytic anemia association
IgM
85
Classical macrophage activation
Th1 secretion if IFN-gamma --> pro inflammatory
86
Wilson's disease is accumulation of...
copper
87
Thymic aplasia
22q11 microdeletion --> failure fo 3rd and 4th pharyngeal pouches --> no thymus or parathyroids --> low T cells, PTH, and Ca
88
Mycophenylate Mofetil indication
glucocorticoid sparing agent in RA (but associated with CMV infection)
89
Glucocorticoid MOA
Inhibit NF-kappaB --> decreased cytokine production and increased T cell apoptosis
90
Tumor markers: alpha-fetoprotein
hepatocellular carcinoma, yolk sac tumor, mixed germ cell tumor
91
Which Ig subtype is a pentamer
IgM
92
Predominant cell early in acute inflammation
neutrophils
93
Azathioprine indications
RA, Crohns, glomerulonephritis, AI in general
94
Cytokines mediated cachexia
TNF-alpha, INF-gamma, IL-1, IL-6
95
Thymus dependent antigens
contain a protein component --> immunological memory
96
diapedesis is mediated by
PECAM-1 (CD31)
97
Basilixamab MOA
Blocks IL-2R
98
Deficiency in Leukocyte Adhesion Deficiency type 1
CD18 integrin --> failure of tight binding
99
cortex zones most susceptible to infarct
3, 5, 6
100
Celiac disease HLA subtypes
DQ2/DQ8 - I 8 2 much gluten at DQ
101
splenectomy increases vulnerability to
encapsulated organisms (via decreased IgM and complement mediated opsonization)
102
liver, stomach, spleen, pancreas, and upper duodenum drain to
Celiac nodes
103
Chediak-Higashi syndrome
defect in lysosomal trafficking regulator (LYST) --> microtubule dysfunction in phagosome-lysosome fusion --> giant granules, pancytopenia, mild coag defects
104
Type IV hypersensitivity
delayed type, T cell mediated
105
Cancer associated with liver fluke
cholangiocarcinoma
106
Wiskott-Aldrich syndrome
X linked mutation in WAS --> unable to reorganize actin --> defective antigen presentation --> low to normal IgM and IgG, few and small platelets
107
C1 esterase inhibitor deficiency
Causes hereditary angioedema due to unregulated activation of bradykinin --> ACE inhibitors contraindicated
108
IL-8
major chemotactic factor for neutrophils
109
complement is synthesized in
the liver
110
Tumor markers: LDH
Germ cell tumors
111
Pathogenesis of acute transplant rejection
Can be cellular or humoral response to donor antigens --> rejection in weeks to months
112
Vinyl chloride causes (PVC pipes)
hepatic angiosarcoma
113
MHC II antigen loading occurs in
acidified endosome
114
Basalixamab indication
kidney transplant rejection prophylaxis
115
C1-C4 deficiency
increased risk fo severe, recurrent, pyogenic sinus and respiratory tract infections. Increased risk of SLE.
116
dominant cell in chronic inflammation
macrophages
117
Protein product in remodeling phase of wound healing
Collagen Type I
118
IPEX syndrome is caused by
deficiency of FOXP3
119
Tumor markers: hCG
choriocarcinomas, testicular cancer, mixed germ cell tumor
120
Psammoma bodies are seen in
PSAMMOMaS: Papillary Carcinoma of thyroid, Somatostatinoma, Adrenals, Meningioma, Mesothelioma, Ovarian serous carcinoma, Prolactinoma (Milk), Serous endometrial carcinoma
121
Tumor markers: CA 19-9
Pancreatic Adenocarcinoma
122
HLA B27 disease
seronegative arthropathies: psoriatic arthritis, ankylosing spondylitis, IBD-associated arthritis, Reactive arthritis
123
lower rectum, bladder, middle vagina, cervix, and prostate drain to
internal iliac nodes
124
Most abundantly produced Ig
IgA (but low in serum b/c it is secreted at epithelium)
125
IL-4
Th2 differentiation and class switching to IgG and IgE
126
cancer associated with Schistosoma
squamous cell bladder cancer
127
Delay in remodeling phase of wound healing is caused by
zinc deficiency (required by collagenases)
128
Rapamycin toxicity
pancytopenia, insulin resistance and hyperlipidemia
129
Selective IgA deficiency
cause unknown, often asymptomatic, increased giardiasis susceptibility, anaphylaxis to IgA in blood products
130
Calceineurin inhibitor toxicity
nephrotoxicity, hypertension, hyperlipidemia, neurotoxicity (and gums and hair for Cyclosporin)
131
anal canal below pectinate line, scrotum, and vulva drain to
superficial inguinal nodes
