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Immunology- First Aid > Immune responses > Flashcards

Immune responses Flashcards

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1
Q

what are acute phase reactants

A

factors whose serum concentrations change significantly in response to inflammation

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2
Q

where are acute phase reactants produced and what cytokines induce their modulation

A

produced in the liver; upregulated by IL-1, IL-6, TNF-alpha and IFN-gamma

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3
Q

name five acute phase reactants that are upregulated in response to inflammation

A

serum amyloid A, CRP, ferritin, fibrinogen, hepcidin

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4
Q

what does C-reactive protein do

A

CRP is an opsonin; it also fixes complement and facilitates phagocytosis

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5
Q

what does ferritin do

A

binds and sequesters iron to hide it from microbes

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6
Q

what lab value does fibrinogen correlate with

A

erythrocyte sedimentation rate

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7
Q

what does hepcidin do

A

prevents release of iron bound by ferritin

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8
Q

what acute phase reactants are downregulated during inflammation

A
  • albumin (downregulated to conserve amino acids for other acute phase reactants
  • transferrin (internalized by macrophages to sequester iron)
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9
Q

which immunoglobulins activate the classic pathway?
alternative pathway?
lectin pathway?

A

IgG and IgM activate the classic pathway
microbial surface molecules activate the alternative pathway
microbial mannose or other surface sugars activate the lectin pathway

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10
Q

what role does C3b play

A

opsonization

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11
Q

what three complement molecules mediate anaphylaxis

A

C3a, C4a, and C5a (C5a is also a chemoattractant)

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12
Q

what complement molecules are needed for formation of the MAC

A

C5b-C9

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13
Q

what is the role of C3b

A

opsonization and clearing immune complexes

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14
Q

what do DAF (decy accelerating factor) and C1 esterase inhibitor do

A

DAF and C1 esterase inhibitor help prevent complement activation on self cells

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15
Q

what disease does C1 esterase cause? and what medication is contraindicated for these patients?

A

angioedema;

ACE inhibitors are contraindicated

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16
Q

what conditions are C3 deficient patients predisposed to?

A

severe sinus and respiratory tract infections, as well as type III hypersensitivity rxns (immune complex)

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17
Q

C5-9 deficiencies predispose to what condition

A

Neiserria bacteremia

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18
Q

what conditions does DAF deficiency predispose to

A

complement-mediated hemolysis and paroxysmal nocturnal hemoglobinuria

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19
Q

what does IL-1 do

A

pyrogen
activates osteoclasts
stimulates endothelium to produce adhesion factors
stimulates chemokine secretion to recruit leukocytes

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20
Q

which cytokines are secreted by macrophages

A

IL-1, IL-6, IL-8, IL-12, TNF-alpha

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21
Q

which cytokines are secreted by all T cells

A

IL-2, IL-3

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22
Q

what’s the mnemonic for IL-1 through IL-6 main functions

A

Hot T-Bone stEAK:
1- hot (pyrogen), 2- T cell stimulation, 3-bone marrow stimulation, 4-IgE production, 5-IgA production, 6-stimulates aKute phase protein production

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23
Q

what does IL-8 do

A

chemotaxis for neutrophils

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24
Q

what does IL-12 do

A

stimulates differentiation of T cells to Th1; activates NK cells

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25
what are the four main function of TNF-alpha
1. mediates septic shock 2. activates endothelium 3. leukocyte recruitment 4. vascular leak
26
what does GM-CSF do and what interleukin shares a similar function
Granulocyte Macrophage- Colony Stimulating Factor promotes growth and differentiation of white blood cells IL-3 shares this same function
27
how does interferon gamma work
has antiviral and antitumor properties promotes MHC expression and antigen presenting activates NK cells to kill viral-infected cells
28
what else does IL-5 do besides promote IgA class switching
promotes differentiation of B cells and eosinophils
29
what does IL-4 do besides promoting class switching to IgG and IgE
promotes differentiation to Th2 cells, promotes growth of B cells
30
what two cytokines play a big role in downregulating the inflammatory response
IL-10 and TNF-beta
31
what are interferons
glycoproteins produced by virally infected cells that prime adjacent cells to be prepared to viral defense
32
what are the two processes that interferons, produced in response to viral dsRNA, activate in order to induce apoptosis
RNAase L (degredation of viral and host RNA) Protein kinase (degredation of viral and host protein)
33
what are the T cell surface proteins
TCR, CD3, CD28
34
what two cell surface proteins do T helper cells specifically have
CD4, CD40 ligand
35
what are the B cell surface proteins
Ig, CD19, CD20, CD21 (EBV receptor), CD40, MHC II, B7
36
what are the macrophage surface proteins
CD14, CD40, MHCII, B7 | Fc and C3b receptors (for enhancing phagocytosis)
37
what are the NK cell surface proteins
CD16 (binds Fc portion of IgG) | CD56 (a unique NK cell marker)
38
when does anergy occur
T cells become unreactive to self-antigens in the absence of costimulation B cells can also experience anergy, but it's not as complete as in T cells
39
how do superantigens work
superantigens bind the beta region of the TCR and cross-link it to MHC II on APC leading to T cell release of cytokines
40
name some classic examples of antigenic variation
influenza (reassorment) salmonella (2 flagellar variants) gonorrhea (variable pilus protein) trypanosomes (programmed rearrangement)
41
for what infections are preformed antibodies often given to protect the patient post-exposure
tetanus, botulinum, rabies, HBV
42
what kind of immunity does a live attenuated vaccine induce
cellular immunity; strong, often lifelong immunity
43
name some live attenuated vaccines
Sabin polio, varicella, intranasal influenza, MMR, yellow fever
44
what kind of immunity does inactivated or killed vaccines produce
humoral immunity
45
name some inactivated or killed vaccines
cholera, HAV, Salk polio, influenza injection, rabies
46
what cytokine mediates type I hypersensitivity and how
IgE; binds free antigen triggering histamine to produce anaphylaxis
47
what cytokines mediate type II hypersensitivity and how
IgG and IgM; via opsonization, complement activation (along with MACs) and complement-mediated lysis, antibody-mediated destruction via NK cells or macrophages
48
for which type of hypersensitivity would you expect a positive Coomb's test (either direct or indirect)
type II (cytotoxic) hypersensitivity
49
what happens in a type III hypersensitivity reaction
serum sickness; immune complex form and deposit in membranes where they fix complement leading to tissue damage
50
what is the Arthus reaction
a local, subacute type III hypersensitivity reaction usually seen in experimental settings (a classic example is swelling and inflammation following tetanus vaccine)
51
what is type IV hypersensitivity
delayed, T-cell mediated immune response (no antibodies involved) in which the correct sensitized T cell binds the antigen and releases lymphokines to activate macrophages
52
is type IV hypersensitivity transferable via serum
no; there are no antibodies involved
53
name some type IV hypersensitivity reactions
PPD test, contact dermatitis, transplant rejection (graft vs. host disease), Guillain-Barre, Multiple sclerosis
54
name some type III hypersensitivity reactions
Lupus, polyarteritis nodosa, post-streptococcal glomerulonephritis, serum sickness, Arthus reaction
55
name some type II hypersensitivity reactions
autoimmune hemolytic anemia, Goodpasture's, pernicious anemia, ITP, erythroblastosis fetalis (hemolytic disease of the newborn), acute transfusion reactions, rheumatic fever, bullous pemphigoid, pemphigus vulgaris
56
what are some common clinical manifestations of type I hypersensitivity reactions
allergic rhinitis/ hay ever, eczema, hives, asthma
57
what is the clinical presentation of anaphylactic reaction
hypotension/ shock, hives, bronchospasm, dyspnea / respiratory arrest
58
what's the difference between targets of febrile nonhemolytic and acute hemolytic transfusion reactions
febrile nonhemolytic: targets are HLA antigens and leukocytes acute hemolytic: RBC antigens (ABO incompatibility)
59
name the disorder associated with ACh receptor auto-antibodies
myasthenia gravis
60
name the auto-antibody associated with Goodpasture's syndrome
anti-basement membrane antibodies
61
what antibodies are associated with lupus anticoagulant syndrome
antiphospholipid antibodies
62
what antibodies are associated with limited scleroderma (CREST syndrome)
anti-centromere antibodies
63
what does the acronym CREST denote
calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly (tickening and tightening of the skin in localized regions leading to ulcers), telangectasias
64
antidesmoglein antibodies are associated with what condition
pemphigus vulgaris
65
what antibodies are associated with SLE
antinuclear antibodies, anti-dsDNA antibodies, anti-Smith antibodies, antihistone antibodies (drug-induced SLE), anti-cardiolipin antibodies
66
anti-glutamate decarboxylase antibodies are associated with what condition
type 1 diabetes mellitus
67
what antibodies are associated with bullous pemphigoid and what does the molecule targeted normally do
anti-hemidesmosome; hemidesmosome normally anchors the epithelial cell to the basement membrane by connecting the keratin in basal cells to BM
68
what antibodies are associated with polymyositis and dermatomyositis
anti-Jo 1, anti-SRP (signal recognition particle), anti-Mi-2
69
what condition is caused by anti-microsomal and antithyroglobulin antibodies
Hashimoto's thyroiditis
70
what antibodies cause primary biliary cirrhosis
antimitochondrial antibodies
71
what condition is associated with anti-Scl-70 (anti-DNA topoisomerase I)
scleroderma (diffuse)
72
what do anti-smooth muscle antibodies cause
autoimmune hepatitis
73
what antibodies are associated with Sjogren's syndrome
anti-SSA (anti-Ro), anti-SSB (anti-La)
74
what antibodies is associated with Grave's disease
anti-TSH receptor
75
what condition is associated with anti-U1 RNP (ribonucleoprotein)
mixed connective tissue disease
76
what disease is c-ANCA (PR3-ANCA) positive
granulomatosis with polyangitis (Wegner's)
77
what disease is p-ANCA (MPO-ANCA) positive
microscopic polyangitis and Churg-Strauss syndrome
78
what antibodies are associated with Celiac disease
IgA antiendomysial, IgA anti-tissue transglutaminase
79
what antibodies are associated with rheumatoid arthritis
rheumatoid factor (commonly IgM antibodies that are specific to IgG Fc region) anti-CCP (citrullinated protein)
80
what kind of bacterial infection are you most susceptible to if you have no T cells
sepsis
81
what kind of bacterial infection are you most susceptible to if you have no B cells
encapsulated bacteria (SHiNE SKiS): strep pneumo, H. flu, Neisseria meningiditis, E. coli, Salmonella, Klebsiella, GBS
82
what bacterial infections are you most susceptible to if you have no granulocytes
Staph, Burkholderia cepacia, Serratia, Nocardia
83
what bacterial infection are you susceptible to if you have no complement
Neisseria (due to no membrane attack complexes)
84
what viral infections are you most susceptible to if you have no T cells
CMV, EBV, JCV, VZV, chronic infections with respiratory and GI viruses
85
what viral infections are you most susceptible to if you have no B cells
enteroviral encephalitis, poliovirus (live vaccine contraindicated)
86
what fungi are you most susceptible to if you have no T cell
Candida and PCP
87
what parasites are you most susceptible to if you have no B cells
GI giardiasis (no IgA)
88
what fungi are you most susceptible to if you have no granulocytes
Aspergillus and Candida
89
________ deficiencies cause more recurrent bacterial infections whereas ___________ deficiencies cause more fungal/ parasite infections
B-cell deficiences cause more recurrent bacterial infections whereas T cell deficiencies cause more fungal/ parasite infections

Immunology- First Aid (5 decks)

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