Block 3 Flashcards
(159 cards)
1
Q
If previously exposed to TB, what will react in your body against the PPD antigen?
A
Memory T cells and macrophages will cause a rxn within 48-72 hrs
2
Q
Examples of molecular mimicry?
A
STDs, rheumatic fever, S. pyogenes (strep throat)
3
Q
Natural active
Natural passive
Artificial active
Artificial passive
AB are injected via serum
A
Artificial passive
4
Q
Conjugate polysaccharides has T-(dependent/independent) B cell response
A
T - dependent
5
Q
What is an advantage of biologic response modifiers?
A
With biologic agents, they can reduce side effects and increase potency
6
Q
What causes pernicious anemia?
A
AB are generated against the intrinsic factor (which transports B12) in the intestinal lumen
7
Q
What does diphtheria cause?
A
Lots of mucus in the throat + makes it hard to breath
8
Q
What do Th2 cells secrete to activate B cells show they can differentiate into IgE producing plasma cells?
A
IL-4, IL-5, and IL-13
9
Q
Which pneumococcal vaccine has T dependent B cell response?
A
Conjugate polysaccharide (Prevnar)
10
Q
Goodpasture Syndrome is a result of what?
A
Smoking, viral infection, inhaled hydrocarbons
Pt cough blood, have SOV, feel weak
11
Q
What can you use to test for AB cross-matching prior to transplantation?
A
Lymphocytotoxicity assay; serum from recipient is cultured with donor lymphocytes
12
Q
What is a rescue immunosuppressive therapy?
A
Used short-term and at time of rejection
13
Q
What is graft versus host disease (GVHD) caused by?
A
Mismatch of HLA and/or minor histocompatibility antigens
14
Q
What is an allograft?
A
Between unrelated individuals of the same species
15
Q
What is the mechanism behind hyperthyroidism?
A
AB bind to TSH receptors which causes rapid HR, sweating, etc
TNF-alpha and IL-1 stimulates GAG which increases osmotic pressure of the eye and cause bulging
16
Q
Contact dermatitis is mediated by what?
A
Nickel, poison ivy/oak, latex, etc
17
Q
Which medications can cause photocontact dermatitis?
A
- Quinolones
- Sulfonamides
- Tetracyclines
- Trimethoprim
18
Q
How does catecholes (urushiol) found in poison ivy cause contact dermatitis?
A
Taken up by Langerhans cells and loaded via MHC class I molecules.
Activated CD8 T cells now attack any cell that has urushiol which lyses skin cells and cause fluid filled lesions
19
Q
What causes photocontact dermatitis?
A
Metabolites (haptens) bind to class II molecules on Langerhans cells of the skin
Exposure of sunlight causes structural change to bound hapten and MHC class II molecules create antigen recognized by CD4 T cells
CD4 T cells release cytokines and recruit neutrophils and other leukocytes that cause skin inflammation
20
Q
What are some non-allergic food reaction examples?
A
Histamine in eggplants, cheese, etc
21
Q
What Rx inhibit IL-2? What do they bind to?
A
Daclizumab and Basiliximab
CD25 (alpha chain of IL-2 receptor)
22
Q
What causes systemic lupus erythematosus?
A
AB generated against ds DNA and small nuclear ribonucleoproteins
23
Q
What kind of response do live (attenuated) vaccines provide?
A
Cell-mediated and humoral
24
Q
What is the mechanism of action on biological response modifiers?
A
Stimulate or dampen immune cells
Inhibit actions of soluble factors by binding to them
25
What is the benefit of using a polysaccharide in the vaccine formulation?
Longer lived memory cells + no booster needed
Stimulates T cells + changes immunoglobulin to IgG
26
What are the minor histocompatibility antigen differences?
Due to bound peptide antigen, not MHC molecules
27
What kind of response do conjugate vaccines provide?
Memory T cell
28
What is an indirect transplant rejection?
Recipient APCs process and present donor allogeneic proteins to recipient T cells;
If donor and recipient are genetically same, less possible consequences
29
What is a chronic rejection?
Rxn occurs within 6 months to a year after transplant
30
What causes exophthalmos (bulging eye) in hyperthyroidism?
Increased production of TNF-a and IL-1 stimulate fibroblasts to secrete glycosaminoglycan mucopolysaccharide (GAG)-increases osmotic pressure in the eye
31
Pseudoallergic reactions (are/are not) IgE mediated
are NOT
32
G-CSF are used for what?
Stimulate neutrophil production with non-myeloid malignancies and neutropenia
33
What are the primary cells that mediate allergic rxns?
Mast cells, eosinophils, and basophils
34
IFN-beta is used to treat what?
Multiple sclerosis
35
What kind of graft is the most common?
Allograft
36
What kind of response do nonviable vaccines provide?
Humoral
37
What kind of response do capsular polysaccharide vaccines provide?
T independent B cell response (not immunogenic in infants or elderly)
38
What is a direct transplant rejection?
Donor APC (Dendritic cells) migrate to recipient's lymph nodes and stimulate recipient T cells
Depletes graft APC prior to transplantation will slow rejection
39
Capsular polysaccharides has T-(dependent/independent) B cell response
T - independent
40
What is delayed-type hypersensitivity reaction?
Cell-mediated rxn that occurs within 24-72 hrs after exposure of antigen
41
What causes Type 1a Diabetes?
Destruction of B-islet cells by self-reactive CD4 and 8 T cells
42
What is an example of a conjugate vaccine?
Haemophilus influenzae B
Pneumococcal (Prevnar only)
Menactra + Menveo (N. menigitidis)
43
What are some contributors to autoimmunity?
1. Genes
2. Infections; virus can cause B cell activation which makes autoantibodies
3. Molecular mimicry
4. Hormones
5. Heavy metals; loss of Treg cells
6. Tissue damage
44
Latex allergies are mediated by which protein?
Hevein and hevein amine
45
Which vaccines can help prevent disease transmitted via fecal route
Salk
Sabin
Hep. A
Rotavirus
46
How do mites cause allergies?
Degrades tight junctions in epithelium
| Allow entry of allergens and stimulate IgE
47
Celiac disease is mediated by what?
T cells that react with gliadin (in gluten). Primarily CD4 Tcell, macrophage, and IFN-y mediated
48
Where do mast cells reside?
Mucosal and epithelial tissue lining the body surfaces
49
Infliximab binds to ________ and is associated with what?
Binds - SOLUBLE TNF alpha
Associated with rheumatoid arthritis
50
Expsosure to M. tuberculosis generates what in the body?
Membroy lymphocytes, especially T cells
51
What are the 3 types of immunosuppressive therapies?
1. Induction
2. Maintenance
3. Rescue
52
Natural active
Natural passive
Artificial active
Artificial passive
AB are passed from mom to fetus via placenta
Natural passive
53
Besides being a suitable match for transplantation, what else is the recipient's serum tested for?
Presence of anti-endothelial cell AB via ELISA or cytotoxic assays
54
Natural active
Natural passive
Artificial active
Artificial passive
Antigens enter body and produces AB naturally
Natural active
55
What does TNF-alpha do to fibroblasts in rheumatoid arthritis?
Fibroblasts degrade bone and interrupts osteoclasts and osteablasts
Causes swollen joints and bones
56
Contact dermatitis is ___ mediated
T cell
57
What causes autoimmune hemolytic anemia?
Drugs (penicillin, cephalosporin, etc) coat RBC and elicit IgG complement
Treat with cyclophosphamide, azathioprine, or plasmapheresis
58
How does chronic GVHD occur?
Result of mismatched minor histocompatibility antigens
59
What is molecular mimicry?
Pathogen expresses antigens that resemble human tissue antigen
After infection, AB can cross-react w/ human tissue and cause inflammation
60
What causes rheumatoid arthritis?
RF deposits in vessels and activates complement
| CD4 and 8 infiltrates and causes inflammation
61
Mast cells are present in all ________ tissues (except the ____ + ____)
Present in all vascularized tissue except CNS and retina
62
How do you treat Hashimoto's Thyroiditis?
Levothyroxine (T4)
63
Celiac disease is a type ___ reaction
4 (delayed type response)
64
What is a toxoid?
Inactivated toxin (botox is the only TOXIN used)
65
How does exercise cause asthma?
Mouth breathing causes changes to humidity and temperature.
Existing airway edema causes reflex bronchoconstriction
66
How does desensitization work?
Repeated inj. of small amounts of antigen over time
Induces IgG that binds to allergen
67
What is a xenograft?
Between different animal species
68
Which immunoglobin is found in breast milk?
IgA
69
What are the type II IFN?
gamma
70
What Rx inhibit IL-2? What do they bind to?
Daclizumab and Basiliximab
CD25 (alpha chain of IL-2 receptor)
71
Contact dermatitis is a type ___ rxn
4 (delayed)
72
IFN-alpha is used to treat what?
Hep. C w/ Ribavirn
73
Examples of molecular mimicry?
STDs, rheumatic fever, S. pyogenes (strep throat)
74
What do mast cells do?
Defend and maintain tissues where they live.
75
What ia an acute rejection?
Direct and indirect alloreactive T cells; rxn occurs within a week
76
How do infections cause asthma?
Viral load can damage and stimulate nerve endings in respiratory tracts
Colds inhibit M2 receptor which keeps on releasing ACh (smooth muscle contraction)
77
Which pneumococcal vaccine has T independent B cell response?
Capsular polysaccharides (Pneumovax; PPV23)
78
What is a wheal-and-flare reaction?
When something breaches the skin barrier and induces serum into the tissue and causes vasodilation
```
Wheel = rapid edema
Flare = redness caused by RBC accumulation
```
79
What does IFN-gamma do?
1. Regulatory
| 2. Stimulate macrophages + promote Th1
80
What is the main instigator for allergies?
IgE
81
Rituximab removes ___ cells + what cell helps remove it?
B cells
Macrophage
Neutrophils
NK
82
What are the type I IFN?
alpha and beta
83
Recombinant IL-2 (Aldesleukin) treats what?
Metastatic renal cell carcinoma
84
The inflammation in celiac disease is mediated CD4 T cells, macrophages and what else?
IFN-gamma (type 2 IFN)
85
Rituximab targets ______ receptors
CD20
86
Most common form of hypothyroidism is due to what disease?
Hashimoto's Thyroiditis
87
What can cause anaphylactoid reactions?
1. Opiates
2. Vanco
3. Polymyxins
4. Cipro
88
What activates late phase mediators?
Activation of mast cell (hours later)
89
What does diphtheria cause?
Lots of mucus in the throat + makes it hard to breath
90
How do you treat Goodpasture Syndrome?
1. Glucocorticoids
| 2. Cytoxic alkylating agent (rituximab; depletes mature B cells)
91
What are the mucosal vaccines?
Flu (Nasal + ATTENUATED)
Sabin (Oral + ATTENUATED)
Rotavirus (Oral + ATTENUATED)
92
What are the three nonfood, non-allergic asthma?
1. Infectious
2. Exercised induced
3. Aspirin
93
What is a maintenance immunosuppressive therapy?
Long-term
94
Which pneumococcal vaccine should children get?
Prevnar
95
If a pair of sibling's HLA match for transplantation for each other, could they still suffer from graft versus host disease (GVHD)?
Yes, they can still react w/ minor histocompatibility antigens
EX: female bone marrow grafted into male recipient; female T cells will see antigen of Y chromosome as foreign
96
What is injected in your skin on a Mantoux or PPD test?
Purified protein derivative of TB (PPD) antigen
97
Hives are a type __ rxn
I (immediate)
98
What does Interleukin-1 do?
Recruits neutrophils into inflammatory sites by stimulating endothelial cells to express adhesion molecules and releasing cytokines
99
What must allergens crosslink with to release preformed mediators?
Crosslink w/ FCeR + mast cell will degranulate
100
What causes rheumatic fever?
S. pyogenes infection, molecular mimicry
Tx with antibiotics, NSAIDs, and prednisone
101
What is an isograft?
Occurs between genetically identical individuals
102
Does IgE or IgG cross the placenta?
No
103
What is atopy?
Localized ability to develop immediate hypersensitivity (Type I) rxn to a variety of allergens
104
Which immunoglobulin exist typically in an hyperacute rejection?
IgM (usually from previous blood transfusion)
105
Which vaccine is used for polio? Which one is attenuated?
Salk + Sabin
Sabin = attenuated
106
IFN-gamma is used to treat what?
Chronic granulomatous disease
107
What is used to prevent organ transplant rejection?
IL-2 inhibitors (Daclizumab and Basiliximab)
108
What part of the cockroach cause allergies?
Saliva, feces, secretions, skin, body (Bla g1,2,4 and 5)
Bla g1 (proteinase) stimulates IgE
109
Which vaccines are used to protect elderly people against shingles?
Zostavax
110
GM-CSF are used for what?
Granulocytes in adults with acute myelogenous leukemia
111
What causes ankylosing spondylitis? Treatments?
CD8 T cell mediated
Tx with NSAIDs and analgesics, Anti-TNFa(infliximab) or methotrexate
112
How do corticosteroids work in transplantation?
Halts T cell proliferation + B cell maturation
Removes CD4 cells from peripheral circulation and moves them to spleen and bone marrow
113
What drugs are the categorized as calcineurin inhibitors?
Cyclosporine and tacrolimus
114
Which IL-1 inhibitor is used to treat rheumatoid arthritis?
Anakinra
115
What is a hyperacute rejection?
Pre-existing AB; rxn occurs within minutes
116
How does nickel cause contact dermatitis?
Result of TH17 cells??
117
All routes of immunization should generate which immunoglobulin?
IgG
118
TNF inhibitors are used for what?
Rheumatoid arthritis, Crohn's disease, ulcerative colitis, and other inflammatory diseases
119
What drugs are categorized as a mTOR inhibitor?
Sirolimus
120
Urticaria (hives) is ___ mediated
IgE
121
How do you Tx Graves' disease?
1. Propylthiouracil, methimazole
2. Radiolabeled iodine-131
3. Surgery
122
Natural active
Natural passive
Artificial active
Artificial passive
Antigens enter body via vaccine
Artificial active
123
What disease is the most common cause of hyperthyroidism?
Graves' disease
124
When does the patient have the highest risk of rejection?
Post-surgery
125
How does acute GVHD occur?
Donor cells release cytokines which upregulate HLA molecules and T cells on recipient cells
126
What causes reactive arthritis? Treatments?
Usually after 1 month of having a STD (mainly men), genetic predisposition, molecular mimicry
Tx with antibiotics, NSAIDs, steroids, DMARDS
127
If allografts are initially accepted, is there any potential problems in the future?
Yes, 10 to 13 days later it can be rejected
Rejection occurs faster if graft is from the same person given a second time
128
How do you treat myasthenia gravis?
1. Corticosteroids
2. acetylcholinesterase inhibitors
3. Cyclosporine
129
What specifically causes anaphylactoid reactions?
Result of complement activation
130
What is the major antigen responsible for rapid rejection of grafts?
MHC I
MHC II can cause it, but not as fast
131
What part of the mites cause allergies?
Feces (Der p1 and Der p2)
132
What synthesizes IL-2?
Activated T cells
133
What causes hypothyroidism?
AB and T cells attack thyroid tissue
TH2 cells produce IL-12, TNF-alpha, and IFN-y induces apoptosis of thyrocytes
134
How do calcineurin inhibitors work in transplantation?
Block cyclophilin and immunophilin to prevent IL-2 expansion
135
What are the vaccines for N. meningitidis? Which one is T-independent one?
***Menomune*****
Menactra
Menveo
136
TB skin test is used to determine if a person is exposed to what?
M. tuberculosis
137
PPV23 or Pneumovax is a (capsular/conjugate) polysaccharide
Capsular
138
Celiac disease is a type ___ reaction
4 (delayed type response)
139
What causes exophthalmos (bulging eye) in hyperthyroidism?
Increased production of TNF-a and IL-1 stimulate fibroblasts to secrete glycosaminoglycan mucopolysaccharide (GAG)-increases osmotic pressure in the eye
140
What makes IL-2? What is its receptor?
T cells
CD25
141
Does IgE cross placenta?
No
142
What synthesizes IL-1?
Via monocytes, macrophages, DC, keratinocytes
143
Which vaccines are conjugated? What are they paired up with?
PCV13 (Prevnar)
Hib
Menactra, Menveo
Polysaccharide + Toxoid
144
What does IFN-beta do?
Antiviral related
Inhibits host cell processes that support viral replication
145
How does aspirin cause asthma?
Accumulation of acetylsalicylic acid which stimulates mast cells to produce leukotrienes
146
What makes IL-2? What is its receptor?
T cells
CD25
147
What is used to identify HLA differences between donor and recipient to test for tissue cross-matching?
PCR; used to stretch DNA that encodes for HLA molecules
148
What role does IgE have on allergens?
Cells w/ IgE on surface are sensitized and quickly degranulated once exposed to allergen.
149
What is used to treat cryopyrin-associated periodic syndrome (CAPS)?
IL-1 inhibitors
150
Prevnar is a (capsular/conjugate) polysaccharide
Conjugate
151
Oral and nasal vaccinations should generate which immunoglobulin?
IgG + IgA
152
How do mTOR inhibitors work in transplantation?
Prevent IL-2 production
153
When is a radio-allergoabsorbent test (RAST) used? What does it test for?
When skin test is not an option
Indirect ELISA that tests for antigen specific IgE in serum
154
How do biologics work in transplantation?
Remove and inhibit T cells
155
What is the purpose of CTLA-4?
Dampens T cell activation by disrupting the CD28 / B7 interaction
***higher affinity towards B7
156
What causes myasthenia gravis?
AB inhibit binding of ACh to its receptor + down-modulate ACh receptors
Prevents impulse at neuromuscular junction leading to muscle weakness/paralysis
157
What is an autograft?
Between sites of the same person
158
What drugs are IL-1 inhibitors?
Anakinra
Canakinumab
Rilonacept
159
What is an induction immunosuppressive therapy?
Short-term + used at time of transplant
