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Flashcards in Ch6 Deck (126):
1

NF-Kb TF does what when turned on?

Causes production of cytokines leading to destruction of microbe by phagocytosis

2

T cell receptor has what structure?

Alpha and beta chain with disulfide bonds

3

Each T cell receptor is linked to what? 2

CD3 complex
2 zeta chains

4

CD3 complex has what in it?

gamma
delta
epsilon

5

First signal to T cell?

Antigen/MHC presentation

6

Second signal to T cell?

CD28 and B7/CD80/CD86

7

Polyclonal T cell proliferation is described how?

Non-neoplastic

8

Monoclonal T cell proliferation is described how?

Neoplastic

9

CD means what?

Clusters of differentiation

10

CD3 and CD5 define what type of cells?

T cell

11

CD19 and CD20 define what cells?

B cell

12

T lymphocytes are what percentage of lymphocytes?

60-70

13

B lymphocytes are what percentage of circulating peripheral lymphocytes?

10 to 20

14

B cells form what when stimulated?

Plasma cells that secrete Ig's

15

What 3 main receptors do B cells have?

Complement receptor
FC receptor
CD40

16

What is the complement receptor for Epstein-Barr?

Type 2 complement receptor (CR2, CD21)

17

What are the two signals to a B cell when interacting with external free antigen-complement?

1. Igalpha and Igbeta coreceptor signaling
2. Complement binding to CR2/CD21

18

Two types of dendritic cells?

Interdigitating Dendritic cells
Follicular dendritic cells

19

Interdigitating dendritic cells have what important title?

Most important APC for initiating T cell response again protein antigens

20

Immature dendritic cells in epidermis are called what?

Langerhans cells

21

Nucleus of dendritic cell is described how?

Reniform

22

What receptors do follicular dendritic cells have?

Fc receptors for IgG and C3b

23

What do follicular dendritic cells do?

Present antigens to B cells

24

How are macrophages involved in CMI?

T cells activate them to let them kill microbes

25

How are macrophages involved in HI?

Phagocytose and destroy microbes that are opsonized by IgG or C3b

26

What makes NK cells different?

Can kill infected cells without prior exposure to a microbe or antigen

27

NK cells are positive for what CD's?

CD16 and Cd59

28

CD16/FCgammaRIII is the receptor for what?

NK IgG receptor

29

What main cytokine do NK cells release?

IFN-gamma to activate macrophages

30

What stimulates proliferation of NK cells?

IL-2 and IL-15

31

What stimulates NK cells to kill and secrete IFN-gamma?

IL-12

32

More than half of the body's lymphocytes are where?

Mucosal tissues

33

B cells are concentrated where in lymph node?

Follicle cortex of lymph nodes possibly with germinal center

34

T cells are where in lymph nodes?

Paracortex

35

Follicular dendritic cells are where in lymph node? 2

Follicles (present to B) and paracortex (present to T)

36

Where are T cells in the spleen?

PALS

37

Where are B cells in spleen?

Follicles

38

Where do plasma cells go to respond to an antigen?

Stay in lymph node

39

Where are the genes for HLA encoding?

Chromosome 6

40

what type of antigen do MHC-1 molecules present?

Intracellular, usually viruses

41

Class I MHC have what genes?

HLA-A, HLA-B, HLA-C

42

Class II MHC have what genes?

DP, DQ, DR

43

What removes the CLIP from MHC II?

HLA-DM

44

How is the expression of HLA described?

Codominant: one allele from mom, one from dad

45

Ankylosing spondylitis and postinfectious anthropathies are associated with people that have what antigen?

HLA-B27

46

Rheumatoid arthritis involves what HLA allele?

DR4

47

Type 1 diabetes involves what HLA allele? (3)

DR3
DR4
DR3/DR4 (the worst risk)

48

21-hydroxylase deficiency is involves with what antigen?

HLA-Bw47

49

Hereditary hemochromatosis is associated with what antigen?

HLA-A

50

What mainly makes the cytokines for innate immunity? (3)

1. macrophage
2. dendritic
3. NK cells

51

What are the 6 cytokines of innate immunity?

1. TNF-alpha
2. IL-1
3. IL-2
4. Type 1 IFN's (alpha and beta)
5. IFN-gamma
6. chemokines

52

What are the cytokines of adaptive immunity?

1. IL-2
2. IL-4
3. IL-5
4. IL-17
5. IFN gamma

53

What makes most of the adaptive cytokines?

CD4+ lymphocytes

54

Early response of CD4 t cells to antigen is what? (2)

Secrete IL2
Express receptor for IL-2

55

What mediates functions of helper T's?

CD40
Cytokines

56

memory cells respond when?

When re-exposed to an antigen

57

What is the main basis of HS disorders?

Imbalance in effector mechanisms of immune responses and control mechanisms that limit these responses

58

What cells play a role in initiation and propagation of Type I hypersensitivity?

TH2 cells --> promote IgE production

59

What triggers mast cells to activate? (2)

1. Cross linking IgE Fc receptors
2. C5a and C3a

60

What happens in immediate reaction of Type I?

Vasodilation, leaky vessels due to prostaglandin and leukotrienes

61

Histamine has what effect? 3

1. Vasoconstriction
2. Leaky vessels
3. increase mucus

62

Leukotrienes C4 and D4 do what?

Vasoactive and spasmogenic

63

Leukotriene B4 does what?

Chemotaxis for leukocytes

64

Prostaglandin D2 does what? 2

Bronchospasm
Increased mucus secretion

65

What cells cause late response of HS Type I?

Eosinophils

66

What is it called if you are more likely to have Type I immediate eractions? (2)

1. Higher serum IgE
2. More IL-4 producing Th2 cells

67

Different Type II reactions? 4

1. transfusion rxn
2. Autoimmune hemolytic anemia
3. agranulocytosis
4. thrombocytopenia

68

Type II is due to what pathways?

Complement
Fc-receptors

69

Results of Type II HS?

Glomerulonephritis
Vascular rejection

70

5 examples of Type II?

Myasthenia gravis
Graves disease
acute rhematic fever
Goodpasture
Autoimmune hemolytic anemia

71

Examples of Type III? 4

Systematic lupus erythematosus
Poststreptococcal glomeruonephritis
Serum sickness
Arthus reaction

72

What is arthus reaction?

Localized tissue necrosis from acute immune complex vasculitis

73

Type IV HS is mediated by who?

CD4 and CD8 t cells

74

Examples of type IV?

Type 1 diabetes
multiple sclerosis
rhematoid arthritis
crohn disease
contact dermatitis

75

What is granulomatous formation?

DTH due to persistent antigens in which CD4 cells are replaced by macrophages that form giant cells

76

CTL is important for what? 2

1. Virus infections
2. tumor rejection

77

What enzymes do cytotoxic T cells have?
What special killing receptor

Perforins and granzymes
Fas

78

3 requirements for autoimmunity?

1. Presence of an immune reaction specific for self antigen
2. Reaction is of primary pathogenic significance
3. Absence of another well-defined cause

79

Autoimmune diseases encompass what HS diseases?

II, III, IV

80

What is self-tolerance?

Lack of response to one's own antigens

81

What causes anergy in B cells?
T cells?

B: Encounter self antigen but have no T cells, so unable to respond and are excluded from follicle
T: If antigen is presented without costimulator

82

Regulatory T cells have what protein?
Mutation in this causes what?

FoxP3
IPEX

83

What regulatory T cell gene has polymorphisms in MS?

CD25

84

What does PTPN-22 cause? 2

RA
Type 1 DM

85

NOD-2 causes what?

Crohn

86

IL-2 and IL-7 receptor alpha chain defect causes what?

MS

87

What characterizes SLE?

Anti-nuclear Autoantibodies against all parts of body

88

What is the lupus pneumonic?

Malar Rash
Discoid Rash
Serositis
Oral Ulcers
Arthritis
Photosensitivity
Blood abnormalities
Renal
ANA antibodies
Immune abnormalities
Neurologic

89

Antinuclear antibodies are directed against what? 4

DNA
Histones
Proteins on RNA
Nucleolar antigens

90

Test for ANA's?

Indirect immunofluorescence or EIA

91

Homogeneous ANA's find what?

Chromatin and histones

92

Rim ANA's find what?

dsDNA

93

Speckled pattern ANA's find what?

Histones and RNP's

94

Which is most common ANA pattern?

Speckled

95

Nucleolar ANA pattern means what?

RNA

96

antiphospholipid antibodies are found in what percentage of SLE patients?

40-50

97

This anti-phospholipid of SLE is used in detecting what disease?

Syphilis

98

What happens to people with anti-phospholipid SLE?

Recurrent spontaneous miscarriages
Focal cerebral or ocular ischemia

99

What is the genetic link of SLE?

HLA-DQ

100

When does SLE show up in patient?

20 or 30's

101

Who gets SLE more, females or males?

Females 9 to 1

102

Lupus nephritis as a result of SLE means what?

Immune complex deposition in glomeruli

103

Five patterns of lupus nephritis?

- Minimal mesangial (Class I)
– Mesangial proliferative (Class II)
– Focal proliferative (Class III)
– Diffuse proliferative (Class IV)
– Membranous (Class V)

104

Classes I and II of lupus nephritis see an increase in what?

Mesangial matrix and cells due to proliferation and complex deposition

105

Class III of lupus nephritis have glomeruli that show what?

1. crescent formation
2. fibrinoid necrosis
3. Proliferation of endothelial and mesangial cells

106

Which is most severe class of lupus nephritis?

Class IV

107

In class IV lupus nephritis how many glomeruli are involved?
Is this class symptomatic?

over 50%

Yes: HTN and renal insufficiency

108

Class V lupus nephritis sees what?

Diffuse thickening of capillary wall causing very severe proteinuria or nephrotic syndrome

109

Deposits in SLE can be identified with what?

Immunofluorescence

110

Membranous lupus nephritis deposits where?

Subepithelial

111

Focal and diffuse proliferative deposit where?

Subendothelial

112

What lesion results from class III and IV?

Wire loop

113

Main characteristic of SLE on skin?
What makes it worse?

Facial butterfly

Sunlight

114

What happens to heart in SLE?

Valvular endocarditis (Libman sacks)

115

What is seen in nearly every case of SLE?

Hematologic derangement: Anemia or thrombocytopenia

116

Chronic discoid lupus drythematosus is similar to SLE how?

Skin manifestations are the same

117

In Chronic DLE, what is the main sign?

Skin plaques surrounded by an elevated erythematous border of face and scalp

118

Subacute cutaneous lupus erythematosus is similar to SLE how?

Mild systemic symptoms similar

119

What is the mutation in subacute cutaneous lupus erythematosus?

Antibodies to SS-A antigen and HLA-DR3 genoptype

120

Sjogren syndrome has what two main symptoms?

Dry eyes
Dry mouth

121

What are the two forms of sjogren syndrome?

Primary = sicca syndrome
Secondary = sjogren + another autoimmune disease

122

What happens in Sjogren syndrome?

Lymphocytic infiltration and fibrosis of lacrimal and salivary glands with ANA's against SS-A and SS-B

123

What is Mikulicz syndrome?

Anything that can cause a lacrimal and salivary gland enlargement

124

What needs to be done to diagnose sjogren syndrome?

Biopsy of lip

125

Systemic sclerosis/Scleroderma means what?

Fibrosis throughout the body and mainly skin

126

Two cattegories of sclerosis?

Diffuse
Limited