Immune Responses

Question 1

Classic Pathway Activating Antibodies

Answer 1

• GM makes classic cars

- IgG and IgM

Question 2

What Activates the Alternative Complement Pathway?

Answer 2

Microbe surface molecules

Question 3

What activates the Lectin Complement Pathway?

Answer 3

Mannose or other sugars on the microbe surface

Question 4

What does C3b do?

Answer 4

Binds Bacteria

Question 5

What do C3a and C5a do?

Answer 5

Anaphylaxis (both) and Neutrophil Chemotaxis (C5a)

Question 6

The two primary opsonins in bacterial defense

Answer 6

C3b and IgG

Question 7

What do C5b-9 mediate?

Answer 7

Cytolysis by MAC

Question 8

C1 Esterase Inhibitor Deficiency leads to

Answer 8

• Hereditary Angioedema
• Edema of skin (esp. Periorbital) and mucosal surfaces.
• ACE Inhibitors are contraindicated

Question 9

C3 Deficiency leads to

Answer 9

• Severe, recurrent Pyogenic Sinus and respiratory tract infections
• Increased susceptibility to type III HS reactions.

Question 10

C5-9 Deficiencies lead to

Answer 10

Recurrent Neisseria bacteremia

Question 11

DAF (GPI anchored enzyme) Deficiency leads to

Answer 11

Complement-mediated lysis of RBC’s and paroxysmal nocturnal hemoglobinuria (PNH)

Question 12

Cytokines secreted by Macrophages

Answer 12

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

Question 13

Cytokines secreted by all T cells

Answer 13

IL-2 and IL-3

Question 14

Cytokine secreted by Th1 cells

Answer 14

Interferon-gamma

Question 15

Cytokines secreted by Th2 cells

Answer 15

IL-4, IL-5, and IL-10

Question 16

What do Interferons do?

Answer 16

• INTERFERE with viruses

- Get cells to produce a ribonuclease that inhibits viral protein synthesis by degrading viral mRNA

Question 17

B cell surface proteins

Answer 17

Ig (binds antigen), CD19, CD20, CD 21 (receptor for EBV), CD40, MHC II, and B7

Question 18

NK cell Surface Proteins

Answer 18

CD16 (binds Fc of IgG) and CD56 (unique to NK)

Question 19

Type III HSR mechanism

Answer 19

• Antigen-antibody (IgG) complexes activate complement which attracts neutrophils which then release lysosomal enzymes.

Question 20

Type II HSR Mechanism

Answer 20

Igm/IgG bind to fixed antigen on “enemy” cell, leading to cellular destruction by opsonization, complement-mediated lysis (C5-9) and Antibody-dependent cell-mediated cytotoxicity (ADCC), usually by NK cells.

Question 21

Test for Type II HSR

Answer 21

Direct and Indirect Coombs’

Question 22

Test for Type I HSR

Answer 22

Skin test for IgE

Question 23

Test for Type IV HSR

Answer 23

Patch test, PPD

Question 24

4 T’s associated with Type IV HSR

Answer 24

T Lymphocytes, Transplant Rejections, TB Skin Tests, Touching (contact dermatitis)

Question 25

Immune Complex Disease (type III) in which antibodies to foreign proteins (haptans, bacteria, etc) are produced, complexes are formed and deposited in membranes where they fix complement and produce damage -->

Answer 25

Serum Sickness

Question 26

Local subacute type III HSR from intradermal injection --> complexes in the skin --> edna, necrosis, and complement activation.

Answer 26

Arthus Reaction

Question 27

Quick Mnemonic to remember the HSRs

Answer 27

ACID - Anaphylactic and Atopic (type I) - Cytotoxic (antibody mediated, type II) - Immunce Complex (type III) - Delayed (cell mediated, type IV)

Question 28

Antinuclear Antibodies (ANA) Associated With

Answer 28

SLE, nonspecific

Question 29

Rheumatoid Factor, anti-CCP Associated With

Answer 29

Rheumatoid Arthritis

Question 30

IgA Antiendomysial, IgA anti-tissue transglutaminase Associated With

Answer 30

Celiac Disease

Question 31

Anti-desmoglein Associated With

Answer 31

Pemphigus Vulgaris

Question 32

Anti-SSB (anti-La) Associated With

Answer 32

Sjogren's Syndrome

Question 33

Anti-smooth muscle Associated With

Answer 33

Autoimmune Hepatitis

Question 34

p-ANCA (MPO-ANCA) Associated With

Answer 34

Microscopic Polyangiitis, Churg-Strauss Syndrome

Question 35

Anticentromere Associated With

Answer 35

Scleroderma (CREST syndrome)

Question 36

Anti-U1 RNP (ribonucleoprotein) Associated With

Answer 36

Mixed Connective Tissue Disease

Question 37

Anti-glutamate Decarboxylase Associated With

Answer 37

Type I Diabetes Mellitus

Question 38

Antihistone Associated With

Answer 38

Drug-induced Lupus

Question 39

Antimitochondrial Associated With

Answer 39

Primary Biliary Cirrhosis

Question 40

Anti-SSA (anti-Ro) Associated With

Answer 40

Sjogren's Syndrome

Question 41

c-ANCA (PR3-ANCA) Associated With

Answer 41

Granulomatosis with polyangiitis (Wegener's)

Question 42

Anti-Jo-1, anti-SRP, anti-Mi-2 Associated With

Answer 42

Polymyositis, dermatomyositis

Question 43

Antimicrosomal, antithyroglobulin Associated With

Answer 43

Hashimoto's Thyroiditis

Question 44

Anti-basement membrane Associated With

Answer 44

Goodpasture's Syndrome

Question 45

Anti-Scl-70 (anti-DNA topoisomerase I) Associated With

Answer 45

Scleroderma (diffuse)

Question 46

Anti-dsDNA, anti-Smith Associated With

Answer 46

SLE

Question 47

What do alpha and beta interferons do specifically?

Answer 47

The inhibit viral protein synthesis.

Question 48

What does gamma interferon do specifically?

Answer 48

Increase MHC I and II expression and antigen presentation in all cells.