Block 2 Flashcards
(163 cards)
1
Q
What are the general processes that agglutination goes through?
A
- Sensitization (initial binding)
2. Lattice formation
2
Q
Naive CD8+ T cells require what kind of signals to become activated?
A
3 signals!
- TCR + MHC
- CD28 + B7
- Cytokines produced by APC or T cells
3
Q
Which immunoglobulin is found as a pentamer?
A
IgM (can be a monomer as well)
4
Q
Lambda light chain locus variable regions include what?
A
V1-30, J, C, J, C, …
5
Q
Where do cytotoxic T cells develop?
A
Thymus
6
Q
Which immunoassay takes AB in a support gel and applies antigen in the gel. The gel then diffuses out.
A
Radial immunodiffusion
7
Q
What regulatory functions do Natural killer T cells have?
A
- Secrete lots of cytokines
2. Stimulate cytotoxic T cells, NK, and DC
8
Q
Postzone is is (antibody/antigen) excess
A
antigen
9
Q
C1-9
Factor I
DAF/CD59
Factor D/P
Which deficiency can cause autoimmune-like conditions?
A
DAF/CD59
10
Q
B cells can produce AB against what kind of antigens?
A
- T independent antigens
2. T dependent antigens
11
Q
Which receptor activates BCMA?
A
Both APRIL and BLyS
12
Q
What begins the formations of MAC?
A
C5 convertase
13
Q
Which immunoglobulin is the most effective in complement activation?
A
IgM
14
Q
Anti-venom is considered (active/passive) immunity
A
Passive
15
Q
Is there anything else that is needed besides a monomor of an immunoglobulin and IgBeta/IgAlpha to activate B cells?
A
Yes, it also needs a co-receptor (CR2, the bridge)
CR2 connects C3d (on antigen bacteria) and CD81 (on B cell)
16
Q
Both AB and T cells recognize _______ epitopes
A
linear; AB can also recognize conformational + discontinuous epitopes
17
Q
What are the subtypes of TI antigens?
A
TI-1 (mitogens)
TI-2 (repetitive epitopes); B-1 cells respond
18
Q
- Idiopathic Thrombocytopenic Purpura
- Kawasaki Disease
- Erythroblastosis Fetalis
Which one is treated with RhoGAM?
A
Erythroblastosis Fetalis
19
Q
To proliferate into a plasma cell, CD40 ligand is needed, where is that located?
A
On Th2 cell
20
Q
What are some clinical usefulness of Fab fragments?
A
Neutralize AB via rattlesnake venom or digoxin overdose (EX: CroFab)
21
Q
How is the MAC formed?
A
C5 convertase produces both C5a + C5b
C5b binds to C6, then C7, C7 binds to membrane, C8 binds further into cell, and C9 is inserted and forms a pore
22
Q
What nucleotides are derived from recombination signal sequences (RSS)?
A
P-nucleotides
23
Q
What is found near or around different loci and is the site where DNA is cut for Junctional diversity?
A
RSS sequences
24
Q
What causes multiple myeloma?
A
Uncontrolled proliferation of a single plasma cell clone + high level of monoclonal AB
25
What is the main difference between passive and reverse agglutination?
Passive - coat antigens and dump it in pt sample w/ AB
Reverse - coat AB and dump it in pt sample w/ antigens
26
How is the alternative pathway initiated?
C3b binding to bacteria surface
27
Kappa light chain locus variable regions include what?
V1-40, J1-5, C
28
Which immunoglobulin is a cytophilic AB found on surfaces of B cells? Also has a role in B cell development.
IgD
29
Describe TI-2 antigens
Polysaccharide antigens via S. pneumoniae
30
How do you treat multiple myeloma?
1. Melphalan + prednisone
2. VAD therapy
3. Bisphosphonates
31
Where does somatic hypermutation occur?
Germinal centers of lymphoid tissue in response to antigen and activated Th cell
**antigen dependent unlike Junctional diversity and bringing VJ/VDJ together
32
As a result of CD8+ being activated by DC, what happens?
CD8 T cells make IL-2, which drives its own proliferation and differentiation
33
Which antigen do somatic hypermutation occur in?
T dependent antigens (fine tuning AB specificity)
34
Describe the perforin-granzyme mediated killing
```
Perforin = forms pores in membrane
Granzyme = enters the cell to induce apoptosis
```
Activates caspases
35
Which complement fragments are opsonins?
C3b + C4b (also IgG)
36
What is found in the urine of pt w/ multiple myeloma?
Bence-JOnes proteins
37
What is avidity?
Number of AB-combining sites and epitopes in a single antigen
38
What happens if mutation decreases affinity?
Cell dies via apoptosis
39
* Idiopathic Thrombocytopenic Purpura
* Kawasaki Disease
* Erythroblastosis Fetalis
Which one causes autoantibodies to bind to platelets?
Idiopathic Thrombocytopenic Purpura
40
How does the IgE affect the respiratory tract?
Contracts smooth muscle and constricts throat.
Difficulty swallowing and breathing
41
Natural exposure to a pathogen is considered (active/passive) immunity
Active
42
* Transient Hypogammaglobulinemia
* Common Variable Immunodeficiency
* Hyperimmunoglobulinemia E
Which one leads to reduced B cells?
Common Variable Immunodeficiency
43
Where are BCMA, TACl, and BR3 found?
B cell
44
C1-9
Factor I
DAF/CD59
Factor D/P
Which deficiency can cause immune complex disease?
C1, C2, C4
45
CD19 detection on a monoclonal panel is used to detect what?
Total B cells
46
What is neutralization?
Binding inhibits activity
47
During primary response, is there more or less average affinity?
Less affinity
48
How does the IgE affect the heart and vascular system?
Increase capillary permeability and entry into tissues.
Loss of blood pressure, reduced oxygen, irregular heartbeat, shock
49
What composes the B cell receptor?
Monomor of a immunoglobulin (even if it's IgM) + IgBeta and IgAlpha
50
Which immunoassay CANNOT detect individual antigen-AB interactions?
Precipitation + agglutination techniques
51
Side scatter measures what?
Granularity
52
What do Natural killer T cells able to express?
NK cell markers + CD3
53
Deficiency in MAC increases susceptibility to what?
Neisseria bacteremia
54
Which immunoglobulin has neutralizing capabilities?
IgM + IgG + IgA
55
What are the main mechanisms that CD8 T cells kill target cells?
1. Releasing lytic granules via perforin and granzyme
2. FAS ligand:FAS
3. Cytokine production
56
What are some complication of heterologous antisera?
Anaphylaxis + serum sickness
57
What are the main functions of the complement system?
1. Induce vasodilation and attract phagocytic cells
2. Opsonization
3. MAC
4. Clearance of soluble immune complexes
58
What rxn involves taking soluble antigen + soluble AB to form insoluble complexes?
Precipitation
59
How do you treat Common Variable Immunodeficiency
Antibiotics or Immunoglobulin replacement therapy
60
Which immunoassay is used to mix with blood typing?
Direct agglutination
61
What is the alternative C3 convertase?
C3bBb
62
When carrier particles are coated with an antigen that is not normally found on them, this is known as:
Passive agglutination
63
Describe Lymphokine-Activated Killer (LAK) cells
Cancer pt's cells are stimulated w/ IL-2 and then re-perfused back into pt
Some success in some, but not all
Increases synthesis of perforin and granzymes + increased killing capacity against tumor cells
64
NK cells are prevented from killing any cell that recognizes what?
MHC class I (Inhibitory signals are present)
65
Forward scatter measures what?
Size
66
During primary response, which immunoglobulin is usually present?
IgM
67
Which antigen do isotype switching occur in?
T dependent antigens (IgM to IgG)
68
Describe the FAS mediated killing
FAS ligand (on T cell) interacts w/ FAS (on target cell) activates caspases to induce apoptosis
Same w/ TNFR-1
69
Vaccination is considered (active/passive) immunity
Active
70
What co-receptors are found on cytotoxic T cells?
CD8
71
* Transient Hypogammaglobulinemia
* Common Variable Immunodeficiency
* Hyperimmunoglobulinemia E
Which one has rapid catabolism of maternal IgG?
Transient Hypogammaglobulinemia
72
What is the classical C3 convertase?
C4b2a
73
What happens once C1s is activated?
Cleaves C4 then C2 forming C4b2a
74
Where do effector CD8 T cells hang out at?
Pretty much everywhere
75
Which immunoglobulin is found in mucosal secretions, tears, and breast milk?
IgA
76
Where is C3d found to activate B cells?
Antigen/bacteria
77
What happens once C1q is bound?
C1r is activated and cleaves C1s to activate
78
What does a proteolytic cleavage via papain look like?
Hinge is no longer there and 2 Fab molecules exist
79
Where do naive CD8 T cells hang out at?
Lymph nodes + secondary tissue
80
* Idiopathic Thrombocytopenic Purpura
* Kawasaki Disease
* Erythroblastosis Fetalis
Which one may be caused by a prior infection?
Kawasaki Disease
81
What happens if there are no MHC class I receptors on a cell and it meets with a NK cell?
There's no inhibitory signal that passes thru NK cell and signals are passed to activating receptors to induce apoptosis
82
What happens after Factor B is bound?
Factor D cleaves Factor B into Bb and Ba (C3bBb)
83
How are the chains rearranged? *use heavy chain for this example*
It's RANDOM!!!
DNA between D + J is spliced, then V + DJ to form VDJ
84
Which immunoassay states that the amount of label measured is directly proportional to the amount of patient antigen?
Noncompetitive immunoassay
85
Once a CD8 cell has been activated via DC or with the help of Th cells, what else is required to help the CD8 cell perform effector function?
Nothing else
86
A deficiency in C1 esterase inhibitors causes what?
Hereditary angioneurotic edema
87
Which immunoglobulin is found as a dimer?
IgA (can be a monomer as well)
88
Which immunoassay is designed for antigens and AB that may be small or at low concentrations?
Labeled immunoassays
89
Describe TI-1 antigens
LPS endotoxin of E. coli
90
What is the exception to a being small and soluble and b being large and bound?
C2a and C2b
91
CD45RO detection on a monoclonal panel is used to detect what?
Memory T cells
92
What gene brings VDJ gene together + cuts DNA for Junctional Diversity?
RAG1 + RAG2
93
Describe how cytokines produced can mediate killing
Activated Th1 cells can produce:
1. IFN-y and CD40 ligand to activate macrophages
2. FAS ligand/TNF-B to kill infected macrophages
3. IL-2 to induce T cell proliferation
94
C1-9
Factor I
DAF/CD59
Factor D/P
Which deficiency can cause susceptibility to both capsulated bacteria and Neisseria?
Factor D/P
95
* Idiopathic Thrombocytopenic Purpura
* Kawasaki Disease
* Erythroblastosis Fetalis
Which one causes autoantibodies to bind to blood vessels and cause bleeding and heart problems?
Kawasaki Disease
96
Can a Th cell alone activate a CD8+ T cell? Why or why not?
It cannot because CD8 cells require something stronger.
97
High levels of Natural killer T cells are found in what pts?
Severe asthma or ulcerative colitis
98
How do you fix a false-negative of a postzone?
Give some time for further production of ABs, if the test is negative again the pt is unlikely to have the AB
99
Cytotoxic T cells are initially activated by what? Where?
Initially activated by DC @ secondary lymphoid tissue
100
What is in IVIG?
Pooled donors via human, 95% IgG and some IgM, IgA, complement and cytokines
101
How can Th cells help activate CD8 cells?
2 pathways
1. Induce higher levels of B7 on APC
2. Secrete IL-2 as a co-stimulatory signal for CD8 cells
102
How do you fix a false-negative of a prozone?
Dilute out AB and perform test again
103
Which immunoassay describes the amount of bound label is inversely proportional to concentration of labeled antigen?
Competitive immunoassay
104
What do I need to know about cross-reactive AB?
It is the rxn between an AB and an antigen that differs from what appears to be an unrelated to the immunogen
More cross-reactive antigen that resemble original antigen = higher affinity of AB to cross-reactive antigen
105
TI antigens are mostly what kind of immunoglobulin?
IgM
106
With activation of CD8+, where is B7 found?
On APC
107
When is the only time a B cell can express two different AB classes?
Mature (naive) B cells thru isotype switching
108
How is C5 convertase formed?
C3 convertase + cutting C3 to form C4b2a3b
109
Match please!
- omab
- umab
- ximab
- zumab
Fully mouse
Fully human
Humanized
Chimeric
- omab + fully mouse
- ximab + chimeric
- zumab + humanized
- umab + fully human
110
Which receptor activates TACl?
Both APRIL and BLyS
111
What can Natural killer T cells recognize from bacteria?
Glycolipid antigens presented on CD1
112
Which immunoassay separates antigen complexes?
Immunoelectrophoresis
113
How do you treat X-linked Agammaglobulinema (XLA)?
IgG passive immunotherapy or antibiotics for prophylaxis
114
C1-9
Factor I
DAF/CD59
Factor D/P
Which deficiency can cause susceptibility to capsulated bacteria?
C3
115
What are the signals required for a B cell to proliferate into a plasma cell?
1. Antigen binds to receptor
| 2. Th2 comes in w/ CD40 ligand and cytokines
116
___________ forms one hypervariable region of antigen binding pocket aka CR3/HV3
Junctional diversity
117
Why are NK cells needed?
Control virus replication
W/o them, virus levels can become higher and be lethal
118
With activation of CD8+, where is CD28 found?
On cytotoxic T cell
119
Which immunoassay is used to detect soluble antigens in urine, spinal fluid, or serum?
Reverse agglutionation
120
Where does C1q bind to?
Fc portion of IgM or IgG (IgM is more effective), multiple Fc's are required for activation
121
Which immunoassay is used to detect certain viruses such as hepatitis or HIV?
Indirect/Passive agglutination
122
What happens if mutation increases affinity to antigen?
B cells with those mutations are preferentially selected
123
* Idiopathic Thrombocytopenic Purpura
* Kawasaki Disease
* Erythroblastosis Fetalis
Which one is treated with IVIG?
* Idiopathic Thrombocytopenic Purpura
| * Kawasaki Disease
124
* Idiopathic Thrombocytopenic Purpura
* Kawasaki Disease
* Erythroblastosis Fetalis
Which one causes excessive bleeding and bruising to occur due to low platelet counts?
Idiopathic Thrombocytopenic Purpura
125
How is agglutination different from precipitation?
Involves soluble AB with an antigen on a complex to form an insoluble complex
126
What receptors are found on NK cells?
1. Inhibitory
2. Activating
3. Fcy (CD16 + ADCC via IgG to target cell)
4. Natural cytotoxicity receptors
127
What happens after the alternative C3 convertase is formed?
C3 convertase cleaves C3 to form C5 convertase (C3bBb3b)
128
CD16/56 detection on a monoclonal panel is used to detect what?
NK cells
129
How do you treat Transient Hypogammaglobulinemia?
Antibiotics or Immunoglobulin replacement therapy
130
Which cells participate in AB-dependent cell-mediated cytotoxicity?
NK cells, macrophages, and neutrophiles
131
What are the main functions of an antibody?
1. Neutralization
2. Opsonization
3. Complement
4. AB-dependent cell-mediated cytotoxicity
132
Maternal AB is considered (active/passive) immunity
Passive
133
Which receptor activates BR3?
Only BLyS
134
With FAS mediated killing via NK cells, where is the FAS ligand found?
NK cells
135
How does the IgE affect the GI tract?
Contracts smooth muscle
Stomach cramps, vomit, diarrhea
136
IVIG is considered (active/passive) immunity
Passive
137
What is affinity?
Binding strength between AB and a single antigenic determinant
138
What is absent in X-linked Agammaglobulinema (XLA) and what does it cause?
No BCR is made
Causes bacterial infections
139
"Somatic hypermutation contributes to __________"
Affinity maturation
140
Which immunoglobulin participates in neutralizing, opsonization, complement activation, and involved in ADCC?
IgG
141
What holds the multiple monomers found in IgA or IgM?
J chain
142
How is the classical pathway initiated?
C1q binding to immune complexes
143
Which event to determine antigen specificity is dependent?
Somatic hypermutation
144
What immunoassay is single use and disposable?
Rapid or immunochromatography immunoassay
145
Can both prozone and postzone cause false-negatives?
Yes
146
What is opsonization?
Enhance phagocytosis
147
Why can DC activate CD8+ T cells?
They gots the B7
148
What does C3b bind to on the alternative pathway?
Factor B (C3bB)
149
Where are APRIL and BLyS found?
T cell
150
C4b2a collectively is called what?
C3 convertase
151
In the B cell receptor, what allows the signal to go through?
IgBeta + IgAlpha
152
* Transient Hypogammaglobulinemia
* Common Variable Immunodeficiency
* Hyperimmunoglobulinemia E
Which one leads to allergic skin reactions and skeletal abnormalities?
Hyperimmunoglobulinemia E
153
CD45RA detection on a monoclonal panel is used to detect what?
Naive helper T cells
154
Which immunoglobulin is the first response?
IgM
155
* Transient Hypogammaglobulinemia
* Common Variable Immunodeficiency
* Hyperimmunoglobulinemia E
Which one has a imbalance of Th1
Hyperimmunoglobulinemia E
156
Where do NK cell develop?
Bone marrow via lymphoid progenitor cell
157
Heavy chain locus variable regions include what?
V1-65, D1-27, J1-6, C
158
What does a proteolytic cleavage via pepsin look like?
The 2 Fab molecules are connected, but are no longer connected to Fc
159
How do pathogens/tumors evade CD8 response?
1. Down regulate MHC class 1 expression
2. Express FAS ligand to initiate T cell apoptosis
3. Produce anti-inflammatory cytokines
4. Prevent expression of MHC class 1
5. Latent within a cell
160
What systems do the IgE affect?
1. Heart/vascular system
2. Respiratory
3. GI
161
C1-9
Factor I
DAF/CD59
Factor D/P
Which deficiency can cause Susceptibility to Neisseria?
C5-9
162
Prozone is (antibody/antigen) excess
antibody
163
Where is CD81 found to activate B cells?
On the actual B cell
