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Hem/Onc 2 > Immunology > Flashcards

Immunology Flashcards

1
Q

What are the 2 viral glycoprotein spikes that bind to the primary CD4 receptor?

A

Gp120 and gp41

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2
Q

What are the 2 7-transmembrane G-protein coupled receptors?

A

CCR5 and CXCR4

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3
Q

Which receptors are expressed primarily on T cells, and is called a T-trophic virus when using these receptors?

A

CD4 and CXCR4

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4
Q

Which receptors are expressed on macrophages, and are called m-trophic when using these receptors?

A

CD5 and CXCR5

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5
Q

For viral entry, what does the Gp120 do to CD4 and CCR5 ?

A

Pulls the virus closer to the cell membrane

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6
Q

Later, gp120 binds T0 CD4 and CXC4 receptors, and causes a conformational change to expose which marker?

A

Gp41

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7
Q

What is the role of Gp41 for viral entry?

A

Fuses viral and cell membranes –> allows viral RNA to penetrate the cell

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8
Q

What would happen if you are deficient in CCR5 or CXCR4?

A

You’re immune to HIV

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9
Q

What is released into the cell when the HIV virus is uncoating?

A

+ ssRNA
RT
Integrase
Protease

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10
Q

What is the role of reverse transcirptase for HIV?

A

RNA –> DNA

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11
Q

What does the HIV use to integrate into the host cell DNA?

A

Integrase

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12
Q

Which host enzyme transcribes the viral DNA?

A

RNA polymerase II

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13
Q

Which cytokine is stimulated for its transcription during extrinsic stimuli, which therefor stimulates gene transcription of the HIV genome, causing the release of viral RNA into the cytoplasm?

A

IL-2 and its R

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14
Q

What happens to the viral RNA once it’s inside the cytoplasm?

A

proteins are synthesized from it

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15
Q

What is the enzyme that cuts long protein chains into individuals proteins?

A

Protease

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16
Q

After sexual transmission, what “tissue” does HIV infect?

A

MALT

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17
Q

Which cells mediate the initial stages of HIV infection?

A

M-trophic cells

CD4/CCR5

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18
Q

A mutation in the what gene shifts the tropism of HIV to T-trophic, which allows HIV to infect CD4+ T cells?

A

Gp120

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19
Q

What reduces the # of Th cells in HIV infections?

A

Direct HIV-induced cytolysis
Cytotoxic Tc immune cytolysis
Chronic activation in response to the large HIV Ag challenge –> rapid terminal differentiation

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20
Q

Infected T cells are killed by what 4 mechanisms?

A

Accumulation of nonintegrated circular DNA copies of genoma
Increased permability of plasma membrane
Syncytia formation
Induction of apoptosis

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21
Q

What do activated CD4 Th cells release to initiate immune response, which activates macrophages, other T cells, B cells, and NK cells?

A

Cytokines

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22
Q

Under what CD4 levels do Ag-specific immune responses not work and humoral response is uncontrolled?

A

< 200 cells/uL

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23
Q

What 2 factors cause the outgrowth of opportunistic intracellular infections when CD4 levels get < 200?

A 
Lose activating of macrophages
Delayed type (IV) hypersensitivity
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24
Q

What are neutralizing antibodies generated against to cause Ab-dependent cellular cytotoxicity response?

A

Gp120

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25
Q

What happens to CD8 levels in HIV infections? Why?

A

They ↓ b/c they require activation by CD4

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26
Q

A reduction in CD8 cells cause the possibility of what type of infections in HIV?

A

viral

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27
Q

Why does the infeciton of lymphocytes and macrophages is a way for HIV to escape immune control?

A

inactivation of key element of immune defense

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28
Q

What happens to gp120 for HIV to escape immune control?

A

Antigenic drift and heavy glycosulation

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29
Q

During what time is stage 1, stage 2, and stage 3 of HIV infections?

A

Stage 1: 0-24mo
Stage 2: 24-65mo
Stage 3: 65 onwards

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30
Q

During stage 1 of the HIV infection, which of the following markers peaks from 0-12 months and then drops to low levels?

Virus
CD4/T-cell count
Anti-HIV-1 Ab

A

Virus

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31
Q

During stage 1 of the HIV infection, which of the following markers fluctuates with a steady decline?

Virus
CD4/T-cell count
Anti-HIV-1 Ab

A

CD4/T-cell count

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32
Q

During stage 1 of the HIV infection, which of the following markers slowly increases?

Virus
CD4/T-cell count
Anti-HIV-1 Ab

A

Anti-HIV-1 Ab

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33
Q

During stage 2 of the HIV infection, which of the following markers slowly increases and then drops off at 60mo?

Virus
CD4/T-cell count
Anti-HIV-1 Ab

A

Anti-HIV-1 Ab

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34
Q

During stage 2 of the HIV infection, which of the following markers stays low through the entire stage?

Virus
CD4/T-cell count
Anti-HIV-1 Ab

A

Virus

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35
Q

During stage 2 of the HIV infection, which of the following markers still steadily decreases?

Virus
CD4/T-cell count
Anti-HIV-1 Ab

A

CD4/T-cell count

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36
Q

During stage 3 of the HIV infection, which of the following markers rises sharply?

Virus
CD4/T-cell count
Anti-HIV-1 Ab

A

Virus

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37
Q

During stage 3 of the HIV infection, which of the following markers still slowly declines?

Virus
CD4/T-cell count
Anti-HIV-1 Ab

A

CD4/T-cell count

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38
Q

During stage 3 of the HIV infection, which of the following markers continues to decline and then plateau?

Virus
CD4/T-cell count
Anti-HIV-1 Ab

A

Anti-HIV-1 Ab

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39
Q

At what CD4 level is full blown AIDS?

A

< 200 cells/mm3

40
Q

During which stage do u see ARC?

A

Stage 2

41
Q

During which stage do u see AIDS dementia?

A

Stage 3

42
Q

During which stages do u see chronic lymphadenopathy?

A

Stages 1-2

43
Q

True or False: you start to see disease Sx during the middle phase of stage 2.

A

FALSE.

you dont see opportunists until stage 3

44
Q

What is the initial Sx of HIV infections?

A

Flu-like

45
Q

Which class of opportunistic diseases does these bugs belong to for HIV pts?

Toxoplasmosis (brain), cryptosporidiosis (GI), isosporiasis (GI)

A

Protozoal

46
Q

Which class of opportunistic diseases does these bugs belong to for HIV pts?

Candidiasis, PCP, cryptococcosis, Histoplasmosis, Coccidiodomycosis

A

Fungal

47
Q

Which class of opportunistic diseases does these bugs belong to for HIV pts?

CMV, HSV, EBV, HHV-8

A

viral

48
Q

Which class of opportunistic diseases does these bugs belong to for HIV pts?

Disseminated Mycobacterium spp, Salmonella speticemia

A

Bacterial

49
Q

Which infections do u see in a CD4 count of 500-200?

A

Oral thrush

50
Q

Which infections do u see in a CD4 count of 200-100?

A

PCP, AIDS dementia

51
Q

Which infections do u see in a CD4 count of <100?

A

Toxoplasmosis, cryptococcus, cryptosporidiosis

52
Q

Which infections do u see in a CD4 count of <50?

A

CMV retinitis, MAI complex, progressive multifocal leukoenceophalopathy, primary CNS lymphoma due to EBV

53
Q

What is teh test of choice for the montoring of CD4 T cell counts in AIDS pts?

A

Flow cytometry

54
Q

What is the gene that reduces cell surface expression of CD4 and MHCI molecules, alters T-cell signalling pathways, regulates the cytotoxicity of the virus, and is required to maintain high viral loads?

A

Nef gene

55
Q

True or False: the nef gene appears to be essential for causing the infection to progress to AIDS.

A

True

56
Q

This is the form of treatment which is a mixture of drugs with different mechanisms of action that leads to less potential to breed resistnace in HIV pts.

A

HAART

highly active antiretroviral treatment

57
Q

This is the class of antiretrovirals that are phosphorylated by cellular enzymes and are incoporated into cDNA by RT to cause DNA chain termination.

A

Nucleoside Analogue RT inhibitors (NRTI)

58
Q

This is the class of antiretrovirals that interefere with HIV-1 Gag-Pol polyprotein processing and inhibit the late stage of HIV-1.

A

NNRT

59
Q

This is the class of antiretrovirals that block the morphogenesis of the viron by inhibiting the cleavage of proteins and resulting virus is inactive.

A

Protease inhibitors

60
Q

This is the class of antiretrovirals that inhbiits binding to the CCR5 co-receptor with a receptor agonist or fusion or viral envelope and cell membrane witha peptide that blocks the action of the gp41 molecule and prevents the intial infection treatment.

A

Binding and Fusion inhibitors

61
Q

This is the class of antiretrovirals that inhibits the viral DNA incorporation into the genome.

A

Integrase inhbitor

62
Q

This is the leukemia virus that can replicate but cannot transform cells in vitro, and causes cancer after a long latency period of at least 30 years.

A

HTLV-1

63
Q

What are the 3 ways u can get HTLV-1?

A

Blood transfusion
Sex
breastfeeding

64
Q

Which cells does the HTLV-1 virus replicate?

A

CD4 and DTH T cells

65
Q

What is the protein that HTLV-1 makes that transactivates the celllar genes for th T cell growth factor IL-2 and its receptor which activates growth of infected cells?

A

Tax protein

66
Q

What is the HTLV-1 protein that limits tax’s activity, promoting cell survival?

A

HBZ protein

67
Q

What may happen to the chromosomes in HTLV-1 stimualted cells to cause the transition to leukemia?

A

Chromosomal abberations and rearrangements in the T cell Ag receptor

68
Q

Where is HTLV-1 endemic?

A

Southern Japan (breast milk)
Carribean
Central Africa
African Americans in the SE USA (IV drug use)

69
Q

Though HTLV-1 infections are typically asymptomatic, what can it progress to in approximately 1/20 people?

A

ATLL

adult acute T cell lymphocytic leukemia

70
Q

What are the malignant cells called in ATLL because of pleomorphism and containing lobulated nucleI?

A

Flower cells

71
Q

What is the prognosis for ATLL?

A

Usually fatal within a year

72
Q

These are antigens that vary between members of the same species.

A

Alloantigens

73
Q

This is an immune response that alloantigens provoke.

A

Alloreaction.

74
Q

What type of transplants cause Graft-vs-Host (GvH) disease?

A

Bone marrow

75
Q

What happens with the grafted bone marrow and the recipient in GvH disease?

A

Alloreaction from mature T cells in grafted bone marrow that attack and reject the recipients healthy tissue

(the foreign T cells start attacking the recipient)

76
Q

What are the 4 common affected organs in GvH disease?

A

Skin
Liver
Lungs
Intestine

77
Q

What are the skin manifestations of GvH disease?

A

Bright red rash that involves the palms and soles, starts on the face and neck and moves to the trunk and limbs.

78
Q

What are the GI manifestations of GvH disease?

A

profuse watery diarrhea, abnormal liver fxn tests

79
Q

This is self-tissue transferred from 1 body site to another, and is commonly used in burn pts and plastic surgery where some middle-aged woman wants to look like a duck so she gets her butt fat sucked out and injected into her lips.

A

Autograft

80
Q

What is the type of graft between genetically identical twins?

A

Isograft

81
Q

Which blood type has both A and B Ab;s in the plasma?

A

O

82
Q

What blood type has neither A or B Ab’s int he plasma?

A

AB

83
Q

What must be the blood type of a mother to cause anemic babies?

A

Rh-

84
Q

What type of hypersensitivity rxn is blood transfusion?

A

Type II

85
Q

What type of organ rejection occurs within the first 24 hours?

A

Hyperacute graft rejection.

86
Q

What must the most have for the graft to cause hyperacute rejection?

A

pre-existing Ab’s

87
Q

What happens to the grafted tissue in hyperacute rejection?

A

It’s infiltrated with PMNs –> massive blood clots preventing revascularization

88
Q

How can an individual have pre-exisitng Ab’s for allogenic MHC?

A

Recipients of repeated blood transfusions
Women who have had repeat pregancies
People who have already had 1 graft

89
Q

Under what conditon can the mother make Ab’s against any patenral HLA allotype expressed by the baby, since normally fetal and maternal cirulations are segregated?

A

During the trauma of child birth

90
Q

So if the mom makes Ab’s against paternal HLA’s, what can happen to future pregnancies? On future organ transplant?

A

Pregnancies- no effect

Organ transplant- complicate the search for compatible organ transplant

91
Q

This is the form of graft rejection where within 10 days there is massive infiltration of macrophages and lymphocytes at the site of tissue destruction and activation of Th cells.

A

Acute graft rejection

92
Q

What is the test that is used in the event of a donor-recipient that is not a complete mismatch to determin the degree of class II compatibility?

A

Mixed lymphocyte reaction

93
Q

In a Mixed lymphocyte reaction, the donor lymphocytes are irradiated and serve as what?

A

Simulator cells

94
Q

The simualtor cells from the donor and the reponder lymphocytes from the recipient are mixed together and what happens in a + test?

A

recipient cells that proliferate indicated a T cell activation, and the greather the MHC difference, the greater the proliferation.

95
Q

How long after the surgery does a chronic graft rejection take place?

A

Months-years

96
Q

What may provote chronic rejection?

A

viral infection

97
Q

True or False: use of immunosuppresive drugs has increased short-term survival but nothing can be done to prevent a chronic graft rejection.

A

True

Hem/Onc 2 (5 decks)

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