immunity Flashcards
1
Q
invovled with humoral immunity
cells and infection
A
B-cell
Neutrophils
Bacterial infections
2
Q
protect the tissues
cell mediated immunity
A
T-cells
macrophages
nonbacterial infections
3
Q
T-cell
3rd pharyngeal pouch missing
hypocalcemia
Chro 22
A
DiGeorge syndrome
4
Q
T-cell
candida infection on skin and mucous membranes
T-cell can’t fight candida
A
Chronic mucocutaneous candidiasis
chronic fatigue syndrome
5
Q
Steroids
anti-inflammatory and physiologic actions
A
6
Q
steroid best for crossing membrane
A
Dexamethasone
7
Q
Steriod good for cortisol replacement
A
hydrocortisone
8
Q
Steriod good for fluid replacement
A
Fludrocortisone
9
Q
which drug prolong longevity of transplanted organs
ihibits calcineurin
A
cyclosporine
gingival hyperplasia, hirsutism, renal failure
10
Q
decrease T-cell activation
by decreasing IL-2 transcription
A
Tacrolimus
11
Q
inhibit mTOR kinase
decrease response to IL-2
A
Sirolimus( rapamycin)
tyrosine kinase inhibitor
12
Q
2 tyrosine kinase inhibitor
A
sirolimus
imatinib
13
Q
Cells involve in a TRAP pos leukemia
A
75% B cell
25% T-cell
hairy
14
Q
T-cells characterise by indented cell membrane
A
mycosis Fungoides
Sezary Syndrome
lymphoma
15
Q
enzyme involve with SCID
affects all rapidly dividing cell
A
Adenosin deaminase
X-linked recessive
16
Q
eczema, Normal Ig-A/E levels
mc in Boys(X-linked R)
Thrombocytopenia
A
wiskott-Aldridge syndrome
17
Q
needed for class switching
A
IL-4 defect
CD-40 ligand defect
Tyrosine kinase defect
18
Q
Normal B-cell count defective function
early onset
defective cell signaling
x-linked recessive
A
Burton’s Agammaglobulinemia
Agamma globulinenia
19
Q
like Bruton’s
Lacking B-cells function with normal count
late onset
A
CVID
20
Q
cellular components of Leukemias
A
98% B cells
2% T-cells in periphery
21
Q
1 plasma cell cancer
A
plasmacytoma
22
Q
multiple plasma cell cancer
multiple osteolytic lesion
A
Multiple myeloma
23
Q
finding of MM
A
Rouleaux formation
hi Ca
Ig-G M-Spike
Kappa light chains(Bence jones proteinuria
24
Q
Heavy chain disease
A
Ig-A MM of bowel wall
Ig-A plasma cell visible
Malabsorption
25
Selective Ig-A def
Mucosal infections
transfusion anaphylaxis
May run with Selective Ig-G2
26
main opsin to coat encapsulated organism
Ig-G2
27
IgG 2 defect Sign
Recurrent encapsulated organism infection
| may run with selective Ig-A def
28
what is the G-pos encapsulated bug
Strep Pneumo
29
G-Neg encapsulated org
Salmonella
Klebsiella
H. flu B
pseudomonas
neisseria
citrobacter
30
High Ig-E
red-hair female
defective neutrophils
Job's syndrome
31
Neutrophil defects conditions
myeloperoxidase def
NADPH-oxidase (CGH)
absolute neutropenia
32
# neutrophil defect
recurrent gram-pos infection
myeloperoxidase def
33
# neutrophil
x-linked R
dihydrorhodamine pos
Neg NBT test
CGD:NADPH-oxidase
34
low absolute Neutropenia at risk for
| <1500
<1000
<500
staph and pseudomonas
| 1 antibiotic=staph
2 antibiotic=pseudomonas
35
what you see with macrophage defect
NADPH-Oxidase def (CGD)
Chediak-Higashi
36
Albinism, Lysosomal inclusions
| can't digest pathogen
chediak-Higashi syndrome
37
two populations with highest incidence of HIV
heterosexual Black women
Elderly
38
Lowest HIV risk population
Pre-pubertal female
| vaginal acidity gained at puberty..HIV💕acidic mucosae& CD-4 receptors
39
location for the most CD4 receptors
female cervix
Bld vessels
Macrophages (everywhere they go)
T-helper cells (attacked first)
CNS
Testes
40
T/F HIV penetrats cells
F
41
cancers common in HIV
| where CD4 is aboundant
Cervical cancer
Kaposi Sarcoma
CNS
testicular lymphomas
Anal cancer (HPV)
42
portal of entry for HIV RNA injection
GP41
43
HIV attachment of cell
| needs CCR5
GP120
44
Used for HIV assembly
P17 and P24
45
Use for HIV RNA integration with host
Polymerase protein
46
when to screen pregnant woman for HIV
1st tri and 3rd tri
47
use >90 days after HIV exposure
Ora-Quick
48
use for screening only in the first 18 months of life
PCR
49
AIDs defining: CD4 count<200
| Peds<20%
PJP prophylaxis
50
HIV CD 4 count <100
Toxoplasmosis
51
# HIV
at CD4 count<50
Peds CD4 < 10%
Begin HAART therapy
Highly active antiretroviral therapy (HAART) is a combination of three or more drugs used to treat HIV infection
52
# HIV prevention
PrRP
tenofeovire/emtricitabine
| pericoital period and HIV neg partner
53
# HIV
Post Exposure prophalaxis (PEP)
RET: Raltegravire
Emtricitabine
Tenofovire
54
# T/F
HIV infected mother avoid breastfeeding
T
55
# T/F
antiviral for new born up to 1st 6 month
T
56
use in mother with detectable HIV viral load
IV Azothioprine
PEP: RET
57
HIV entry inhibitor
enfuvirtide
58
CCR5 receptor antagonist
Maraviroc
59
Reverse transcriptase inhibitor
AZT
3TC
4DT
DDI
DDC
Abacavir (ABC)
Didanosine (ddI)
Emtricitabine (FTC)
Lamivudine (3TC)
Stavudine (d4T)
60
protease inhibitors
indinarvire
Saquinavir
61
integras inhibitors
Raltegrase
Elvitegravir
62
prevent megaloblasic anemia with _________for PJP treatment
| Trimethoprim/sulfamethoxazole
Leucovorin
pentamindine aerosol
63
Blocks Dihydrofolate Reductase
trimethoprim
Pyrimethamine
methotrexate
64
Block PABA
sulfamethoxazole
sulfacetamide
sulfinpyrazone
sulfasalazine
sulfadiazine
65
Mycobacterium Avium intracellular treatment
clarithromycin
azithromycin
66
Block translocase.
macrolide
clindamycin
Lincomycin
67
MOA of vasovagal syncope post vaccine administration
| hypovolumic and bradycardic
stress-induced cardioinhibitory and vasodepressor response
68
What is an antigen
molecule that sets off immune response
| Haptens
Immunogen
69
most important factor that determines immunogenicity
Variability
70
What do macrophages do for a living
ingest
phagocitize
Digest
Present
MHC II complex
Variable Beta region
Invariant chain is displaced
IL-1 is released
71
what is immunogen
| Carrier effect use in vaccines: eg: DTAP
Hapten + something else
| large enough to attract immune response
72
IL-1 function
fever
nonspecific symptoms of illness(low energy state)
Recruits T-helper cells
73
Fever effect
causes secretion of Ig-A
rapid response of immue cells
raise BP by 10 for 1degree rise in temp
74
Infections that cause Heart Block
legionella
lyme disease
chaga's disease
Diphtheria
Typhoid fever
75
what does fever mean
IL-1 show up
fever pattern can be diagnostic
104=medical emergency
76
# make less immunogenic
detergent
disrupts the adhsion of pathogen membrane
77
# make less immunogenic
antiseptic/disinfectant
destroys membrane and inactivate endotoxin
99% killer
| phenol is mc
iodine --hospital use
78
sterilization
| spores killer
121 degree C with vaporized heat for 15mn
79
most immunogenic bacteria
Shigella
80
two arms of immune system
hemoral
cell mediated
81
where do macrophages go?
82
T-cell and macrophages respond to
virus
fungus
mycobacteria
protozoa
parasite
collagen vascular Dz
neoplasm
83
first sign of cell injury
NA/K pump stops
swelling
84
swelling and neurophils show up
acute inflammation
85
seen in chronic inflammation
| cell
biopsy
x-ray
t-cells and macrophages
fibroblas: fibrosis on biopsy
calcification on x-rays
86
cells involved with immediate hypersensitivity
mast cells and eosinophils
| no complement
87
cytotoxic deliberate attack on self
type II HSensitivity
88
consumptive complement,
tissue damage,
immune complex deposition
Type III hyperS
| not an attack on self
89
cells involve with type 4
T-cell
Macrophages
90
Begins MAC complex
C-5b
91
MAC complex perforator
C-9
92
mcc of death in angioedema
suffocation (airway)
93
angioedema is caused by
hi C5-A
C-1 esterase inhibitor defect
94
Drugs that cause angioedema
| except
pril and sartan
| candy
95
RH is a problem only when
mom is neg and day is positive
96
RhoGam given
1st: post delivery
2nd: 28wk every pregnacy
repeat at each delivery
97
differency between acute and chronic rejection
fibrosis/calcification on biopsy
98
# antibody
SLE antibodies
AntiSmith
Double stranded DNA
Cardiolipin
99
# antibody
Drug Induced SLE antibody
Histone
100
# antibody
Progressive Systemic Sclerosis
Topoisomerase
101
# antibody
Graves
TSH Receptor
102
# antibody
CREST
Centromere
103
# antibody
Goodpasture's
Type 4 collagen
104
# antibody
Primary Biliary Cirrhosis
Mitochondria
105
# antibody
Alopecia Areata
Hair follicle
106
# antibody
Rheumatoid Arthritis
anticyclic citrullinated peptide (anti-CCP)
107
# antibody
Multiple Sclerosis
Myelin Receptors
108
# antibody
Celiac Sprue
Gliaden/gluten
109
# antibody
Type I Diabetes
Islet cell receptor
110
# antibody
Vitiligo
Melanocyte
111
# antibody
Myasthenia Gravis
Acetylcholine receptor
112
# antibody
Mixed Connective Tissue Diseas
Ribonuclear protein
113
# antibody
Pernicious anemia
Intrinsic factor
114
# antibody
Pemphigus vulgaris
Desmosome
115
# antibody
Bullous pemphigoid
Hemidesmosome
116
# antibody
Hashimoto's
Thyroglobulin
Microsomal
117
# antibody
Scleroderma
Smooth Muscle
SCL-70
118
# antibody
Sjogren's
Rho
La
119
# antibody
wegener's
proteinase
c-ANCA
120
# antibody
Idiopathic Thrombocytic Purpura
Glycoprotein IIb/IIIa
121
# antibody
Polyarterits Nodosa
p-ANCA
122
B cells develop in ______ and differentiate in ________
bone marrow
Germinal center of lymphoid
123
drug that target B cell
Rituximab
124
TCell develop in ______ mature in _______ and differentiate in _________
Bone marrow
thymus
paracortex of lymphoid tissue
125
drug that target t-cells
| monoclonal antibody
Muromonab
126
IL-1 inhibitor
Anakinra
127
IL-2 inhibitor
cyclosporin
Tacrolimus
Daclizumab
128
IL-4 function and inhibitor
Isotype switching
Dupilumab
129
IL-5 function and drug
Isotype switch to Ig-A
Mepolizumab
130
how do T- cell talk to B cell
CD-40 ligand
131
pre B-cell marker
Mu chain visible in cytoplasm
132
immature B-cell marker
Ig-M on surface
133
Mature B-Cell marker
Ig-M(monomer) and Ig-D on membrane
134
how do you stimulate B-cells
Endotoxin
Pokeweed mitogen
track growth with labelled thymidine
135
# IG-M
primary response
Arrives in 3 days
Peaks in 2 weeks
Lasts for 2 months
136
IG-G arrives
in 2 weeks
Peaks in 2 months
Lasts for 1 year
137
# vaccine schedule
DPT, IPV, HiB, S. Pneumo
2,4,6,18,5-6yr
| Ig-G last for 2 months
138
when does memory develop
12 month
completes at 15 months
| Ig-G only
139
memory response time
| Ig-G has highest affinity
Arrives in 3 days
Peaks at 5 years
Lasts for 10 years
140
MMR schedule
15m, 5-6yr
pre-college
141
varicellla schedule
15m
5-6yrs
142
Hep B schedule
Ig-G and vaccine in delivery room
2m, 15,
143
Live vaccines
BCG
OPV (Sabin)
Yellow fever
Smallpox
MMR
Varicella
Rotavirus
| BOYS MVP
144
which vaccine needed at 6
only half dose diphtheria (D-d)
145
isotype refers to
antibody class
| G,A,M,D,E
146
idiotype refers to
the actual antigen binding site
147
Macrophage function and
t-cell diffenentiation
Macrophage ingests antigen
Macrophage forms a phagosome
Lysosome digests the antigen
Macrophage presents the antigen
Antigen binds to MHC-II complex
Interluken released
148
how do T-cell talk to macrophages
T: B-7 molecule to CD-28
149
Thymic T cell marker
CD 3, CD4/8
150
what control clonal deletion
thymosin
thymopoietin
151
what are immunoprivileged sites
Brain
thymus
cornea
testicle
152
CD8 expresses ____ and function as
MHC I
T suppressor: stop infection spread
T-cytotoxic: destory infected cell
153
# MHC II
CD4 function
T-Helper
speaks to B cell CD40 ligand
to macrophages via B7/CD28
154
T helper 1 response to
cell mediated
155
T helper 2 response to
humoral
156
T-cell secrete
all interleukin except IL-1
produce intereron gamma and TNF gamma
controls B- cell and macrophages
157
NKiller cells marker
CD16/56
immunosurveillance
| cancer killer at 1 cell stage
158
enhance NK cell ability with
levamisole
159
A MAN SPENDS HIS HEALTH CHASING GREAT WEALTH
THEN HE SPENDS HIS WEALTH TRYING TO GET BACK HIS HEALTH
160
What are the Granulocytes
Neutrophils (60%) Never
Lymphocytes (30%) Let
Monocytes (8%) Mom
Eosinophils (2%) Eat
Basophils (1%) Beans
161
Gram stain steps
Step 1: add crystal violet (binds to exposed peptidoglycan)
Step 2: add iodine (seals blue color into wall)
Step 3: wash with alcohol (washes off excess crystal violet)
Step 4: add saffron (colors outer membranes)
162
use for staining mycobacterium
Acid fast
pink pathogen
163
partially acid fast bugs
Norcardia G-pos
Cryptosporidium (protozoa)
164
most abundant granulocyte
Neutrophils (60%)
165
who's the first line of defends
Neutophils
10% circulating
90% marginated
| 4.5---peak at 3day
166
catalase pos bug
staph A.
Pseudomonas A.
Neisseria Family
167
how to make an abscess soup
O2 burst peak @ 7days
Free radical kills everything
create anaerobic area
168
# bug
abscesses 1-3 days
staph A
169
# bug
abscess 4-7 days
S. pyogenes
170
abscess past 7 days
anaerobic
| MC in Brain
171
neutropenic management
any fever: cover Staph and pseudomonas
fever persist after 48hr cover for fungus
172
MCC of neutorpenia
viral
drugs
173
what mediates monocyte transformation
| marker
interferon
| CD4 receptors
174
mcc of monocytosis
viral
175
conditions with extreme monocytosis
salmonella typhi
TB
EBV
Listeria
Syphilis
176
primary response to allergen
Allergen ingested forms Phagosome
Digested
Presented to T-lymphocytes on MHC 2 complex (bind to V-beta region)
T-cells bind to B-cells by CD-40 ligand
T-cells produced IL-4
B-cells produced Ig-E
177
secondary response to allergen
Ig-E binds to allergen
burries F-c portion in mast cell
mast cell degranulates
178
Mast cells release
histamine (immediates)
SRS-A(4-8 hrs)
ECF-A
179
acute symptoms of allergies is caused by
Histamine
| redness flushing, wheezing, itching, warmth, swelling, conjuntivitis
180
what is reponsible for late symptoms of allergies
Slow reacting substance of anaphylaxis (SRS-A)
181
function of SRS-A
most potent bronchoconstrictor
182
attracts eosinophils in allergic reactions
eosinophil chemotactic factor of anaphylaxis
| ECF-A
183
function of eosinophils
counter-regulator of Mast cell
coats parasite
184
Released from eosinophils
histaminase
arylsulfatase
Heparin
185
1st Gen antihistamines
Block H-1 receptors
strong anticholinergic(sympathetic)
Tachyphylaxis
186
# drugs
1st gen antihistamines
diphenhydramine
Hydroxyzine
Dramamine
Meclizine
Phenylpropanolamine
phentermine
187
MOA of 2nd Gen antihistamines
H-2 receptor blocker
use for urticaria
used mc for GI peptic ulcer dz
188
# Drug
2nd Gen antihistamines
Cimetidine
Ranitidine
Nizatidine
Famotidine
| block 70% of acid output
189
# least sedative
3rd gen Antihistamine
Terfenadine
Loratadine
Astermizole
| list not complete
190
cofactor for antithrombin III
heparin
191
heparin Blocks
thrombin and factor10927
192
follow heparin with INR or PTT
PTT
193
What do you do when PTT is too high with heparin treatment
protamine sulphate
194
use ______if patient is bleeding with Heparin therapy
FFP
195
Effect of Heparin
| break clot
bleeding
hyperlipidemia(++ Hormone-sensitive lipase)
thrombocytopenia (hapten=autoimmune)
196
Benefit of low molecular weight heparin
standardized
no need for PTT
fewer bleeding
lower incident of HIT
197
allergies rashes
| type 1
urticaria
erythema multiforme
Stevens-johnson syn
Toxic epidermal necrolysis
198
allergic rashes
| type 4 HS
Atopic dermatitis
contact dermatitis
Eczema
| Eczema: spongiotic and Nummular
199
Asthma types
intrinsic asthma--born with..++cold
Extrinsic --environmental--dust mite
200
Eosinophilia
| conditions
Neoplasia
Allergies and Addison's dz
Asthma
Collagen Vascular Dz
Parasites
201
left shift means
increase bands
202
Bands are
Immature neutrophils with maximum germ killing ability
| Myeloperoxidase and NADPH-Oxidase
203
precursors of mast cells
Basophils
| semilar granules
204
what is the normal Leukocytes
penia< 4-12k
205
viruses that mc cause leukocytes suppression
B-19
Hep E/C
| all viruses can cause this
206
# drug
leukopenia
vinblastin
AZT
chloramphenicol
Benzene
207
# drug
agranulocytosis
Carbamazepine
Ticlopidine
clozapine
208
Causes of leukocytosis
| High WBC, high Alkaline phospatase
stress demargination
infectiosn
leukemoid reaction(hi band, Blast <5%)
Leukemia (hi Band, Blast >5%)
myelodysplastic syndrome
209
In Leukemia
Acute
Chronic
means?
Acute: starts in BM
Chronic: starts in Periphery
210
lymph node cancer
lymphomas
211
myelodysplastic syn involves all cell lines
high or low
| T/F
T
212
hodgkins lymphomas marker
CD 30
213
Most malignant lymph nodes
supraclavicular
Epitrochlear
Inguinal
214
# jaw mass or abdominal mass
non-hodgkin's lymphoma
| MC
follicular lymphoma
BCL-2
T(14/18)
215
associated with Burkitt's Lymphoma
BCL-2
C-Myc
T8/14
EBV
starry sky appearance
216
# staging
one group of lymph nodes involved
Stage 1
217
# staging
two groups of lymph nodes on same side of diaphragm involved
Stage 2
218
# Stage
two or more groups of lymph nodes on both sides of diaphragm involved
Stage 3
219
# staging
metastases
Stage 4
220
# *Myelodysplastic* Syndromes
Hyperproliferative:
Polycythemia Rubra Vera
Essential thrombocythemia
221
# *Myelodysplastic* Syndromes
Hypoproliferative
Aplastic Anemia
Myelophthisic Anemia (myelofibrosis; agnogenic myeloid dysplasia)
222
Aplastic Anemia: Drugs
Chloramphenicol
AZT
Benzene
Vinblastine
223
Aplastic Anemia: Viruses
| low retic count
Parvovirus B-19: 90%
Hepatitis E: pregnant women
Hepatitis C: occasional
