FA 2014: Immunology Flashcards Preview

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Flashcards in FA 2014: Immunology Deck (103):
1

The growth of germinal centers from B cells depends on 3 elements: name them.

T cell, antigen, and CD40L

2

Dense and dormant follicles

Primary follicles

3

Pale central germinal centers, active follicles

Secondary follicles

4

No B cell follicles

Agammaglobulinemia

5

Plasma cells and lymphocytes, tightly packed in LN

Medullary cords

6

The medullary cords in the LN correspond to the ___ in the spleen

Red pulp

7

The diffuse cortex in the LN corresponds to the ____ in the spleen

PALS

8

Postcapillary (high-endothelial) venules

Where B/T cells enter paracortex from the blood

9

No paracortex or poorly developed

DiGeorge Syndrome

10

R. lymphatic duct drains ___

R side of body above diaphragm

11

Popliteal LN drain ___

Dorsolateral foot, posterior calf

12

Superficial inguinal LN drain ___

Anal canal below pectinate line, skin below umbilicus (except popliteal territory)

13

Para-aortic LN drain __

Kidneys, ovaries, testes, uterus

14

Internal iliac LN drain ___

Lower rectum to anal canal above pectinate line, bladder, vagina, prostate

15

Sinusoids of spleen: describe histo

Long vascular channels with fenestrated "barrel loop" BM and nearby macrophages (red pulp)

16

Spleen is protected by ribs ____

9-12 posterolaterally

17

White pulp in spleen contains ___

T cells (PALS) and B cells (follicles)

18

Marginal zone

Crossover between white/red pulp, contains APCs and specialized B cells

19

How does splenic dysfunction lead to susceptibility to encapsulated organisms?

IgM down --> complement activation reduced --> reduced C3b opsonization --> increased susceptibility to SHiNE SKiS organisms

20

SHiNE SKiS

Encapsulated organisms: s. pneumo, h.flu, n. meningitidis, e. coli, salmonella spp., klebsiella, group B strep

21

Post-splenectomy findings

Howell-Jowell bodies (nuclear remnants), target cells, thrombocytosis

22

How does thalassemia impair the spleen?

Red pulp SHOVES white pulp THE FUCK OUT OF THE WAY

23

Spleen produces ____ of the body's Ig

50%

24

Thymus cortex is ___ and contains immature T cells

Dark

25

Thymus medulla is ___ and contains mature T cells as well as Hassall corpuscles, epithelial reticular cells

Pale

26

Haploidentical means. . .

50% of MHC correspond (parents are always haploidentical to kids)

27

Siblings have ___ chance of being haploidentical and ___ chance of being complete matches

75%;25%

28

Responsible for viruses and intracellular bacteria antigen processing

MHC I (9-11aa peptides, CD8 cells)

29

Responsible for extracellular pathogens and protein vaccines

MHCII (12-16aa peptides, CD4 cells)

30

TLRs

1/6 - lipopeptides, 2 - peptidoglycan, 3 - dsRNA, 4 - LPS, 5 - flagellin, 7/8 - ssRNA, 9 - CpG DNA

31

TLR signaling pathway

NFkB

32

HLA A3

Hemochromatosis

33

HLA B27

PAIR - psoriatic arthritic, ankylosing spondylitis, IBD arthritis, reactive arthritis ("seronegative arthropathies")

34

HLA DQ2/DQ8

Celiac disease

35

HLA DR2

MS, hay fever, SLE, Goodpasture's

36

DR3

T1D, SLE, Graves disease

37

DR4

RA, T1D

38

DR5

Hashimoto thyroiditis, pernicious anemia

39

HLA BW22

Kawasaki disease

40

NK cell markers

CD16+CD56+

41

What drives NK cells?

il-2, il-12, ifn-beta/alpha

42

How do NK cells kill?

1. Perforin/granzymes in absence of MHC I
2. ADCC (CD16 binds Fc region of bound Ig)

43

GATA3/IL-4

TH2

44

T-bet/IL-12

TH1

45

T cell development

proT --> beta chain rearrangement (VDJ) --> pre-T cell --> alpha chain arrangement (VJ) --> DP cell --> positive selection --> SP cell --> negative selection --> you pass!

46

Medullary epithelial cells express ___ to demonstrate self-antigens

AIRE

47

RORgT/TGF-beta+IL-10

Th17

48

TGFb / FOXP3

Treg cell

49

T cell producing IFN-gamma, IL-2, lymphotoxin

TH1

50

T cell producing IL-4, IL-5, IL-6, IL-10, IL-13

TH2

51

T cell producing IL-17

TH17

52

T cell producing TGF-beta, IL-10

Treg

53

FOREIGN signal

MHCII:THC

54

DANGER signal

B7:CD28, CD40:CD40L (for B cells)

55

Allelic exclusion

B cell only expresses 1 BCR

56

Isotype switching

Post CD40:CD40L interaction: class switching, affinity maturation/somatic hypermutation, antibody production

57

What inhibits Th1 cells?

IL-4, IL-10

58

What inhibits Th2 cells?

IFN-gamma

59

What releases IL-12 for Th1 differentiation?

Macrophages

60

Tc cells kill by 3 mechanisms:

1. Perforin (entry into cell)
2. Granzyme (serine protease activating apoptosis)
3. Granulysin (antimicrobial, induces apoptosis)

61

Treg cell markers

CD3, CD4, CD25 (a chain of IL-2R)

62

Complement binding region of ab

CH2 (near hinge)

63

Idiotype of antibody determined by ___

Fab

64

Fc: 5 associations (think C)

Constant, carboxy terminal, complement binding, carbohydrate side chains, determines isotype (E, D, A etc.)

65

BCR structure

Membrane Ig and Ig-alpha/beta

66

TCR structure

Alpha chain, beta chain, and CD3 associated

67

Most abundant isotype in serum

IgG

68

Main antibody in secondary response

IgG

69

Allotype

Inherited differences in constant region (i.e. IgG1)

70

Functions of IgG

1. Fixes complement; 2. crosses placenta (passive immunity); 3. opsonization; 4. neutralizes toxins/viruses

71

Most produced isotype

IgA

72

Most abundant isotype in secretions

IgA

73

Function of IgA

Neutralizes/prevents binding by bacteria, viruses

74

Secretory component of IgA

Tacked on by epithelial cells during transcytosis --> prevents proteolysis

75

Main isotype in colostrum

IgA

76

IgA is found in ____ form and IgM is found in ___ form

Monomeric (serum)/dimeric (mucus) ; pentameric

77

Main isotype in primary response

IgM

78

Best isotype at fixing complement

IgM

79

Binds mast cells and basophils and cross-links receptors when exposed to allergen

IgE

80

Mediates immunity to worms by activating eos

IgE

81

Lowest concentration in serum

IgE

82

Acute-phase reactants

Serum amyloid A, CRP, ferritin, fibrinogen, hepcidin, albumin, transferrin

83

CRP function

Opsonin, fixes complement and facilitates phagocytosis

84

Ferritin function

Binds up iron in cell its hidey-hole (ALL MINE BITCHES); corresponds to amt of total iron in body

85

Fibrinogen function

Coagulation factor; promotes endothelial repair; correlates with ESR

86

Hepcidin function

Prevents iron release from ferritin --> ACD

87

Downregulated in acute phase response

Albumin (reduction conserves amino acids for + reactants), transferrin (internalized by macrophages to conserve iron)

88

Classical complement isotypes

GM makes classic cars

89

C1 esterase inhibitor deficiency

Hereditary angioedema (painless swelling, abdominal pain, laryngospasm)

90

C3 deficiency

Severe, recurrent pyogenic sinus/RT infections; increased susceptibility to T3 HS

91

PNH sx

Red urine, thrombosis, pancytopenia, hemolytic anemia (intravasc)

92

Chemotactic factors

N-formyl met, LTB4, C5a/C3a, LTA, IL-8, TGFbeta

93

IL 1-6 functions

HOT T-bone stEAK: 1 = fever, 2= stimulates T cells, 3= stim bone marrow, 4= stim IgE, 5 = stim IgA, 6 = stim. aKute phase protein production

94

Anti-U1 RNP

Mixed CT disorder

95

pANCA alternative name

MPO-ANCA

96

cANCA alternative name

PR3-ANCA

97

anti-glutamate decarboxylase (GAD

T1D

98

Antimicrosomal

Hashimoto thyroiditis

99

Antimitochrondial

Primary biliary cirrhosis

100

Anti-smooth muscle

Autoimmune hepatitis

101

Drug-induced lupus associations

Hydralazine, INH, procainamide, quinidine, minocycline in slow acetylators

102

What secretes IL-1

Macrophages, B cells, monocytes, osteoblasts

103

What does IL-1 do? (6)

Fever, endothelial activation, acute inflammation, chemokine secretion, stim T/B cells, activates osteoclasts