Immuno Flashcards

1
Q

Bortezomib

A

proteasome inhibitor that dec ability of MHC 1 to present antigen to CD8

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2
Q

associated with beta 2 micro globulin and TAP protein

A

MCH1

TAP mutation affects T and B cell

Antigens (peptides, lipids, or polysaccharides) are transported to the RER via transporters associated with antigen processing (TAPs).

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3
Q

intracellular pathogen presentation: viruses and some bacteria present on MHC?

A

MHC 1

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4
Q

following the release of invariant chain with acidified endosome: MHC?

A

MHC II: antigen-presenting cells

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5
Q

the function of CD 16 on NK cells

A

antibody-dependent cell-mediated cytotoxicity
Binds FC region of antibody

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6
Q

target down regulated MHC I on all nucleated cells

stimulated by:

A

NK cell

Kill infected cells and tumor cell

stimulated by IL-12

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7
Q

how does NK cell cause apoptosis

A

cross-linking of CD16 causing the release of granzymes, granulysin and performs

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8
Q

enable increase antibody specificity for antigen

A

somatic hypermutation and affinity maturation

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9
Q

Main cell of humoral immunity

proliferates and differentiate in what areas

A

B cell

germinal centers

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10
Q

B cell is APC (phagocytic cell) T/F

A

True

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11
Q

similar function as CD16 Cell

A

CD 8: intracellular killer

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12
Q

cytotoxic T cell is activated by

A

binding T cell Receptors to MHC I, release granzymes, granulysin, and perforin

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13
Q

CD4 T cell= Th0

Differentiate into

A

upstream

Th1 : primarily activates macrophages
and

Th2: primarily stimulates B cells, and enables antibody production

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14
Q

Naive T cell marker

A

CD28
CD4/8
TCR

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15
Q

Nucleated/APC marker

A

B7 (-1/-2) CD80/86.
Binds CD28 ( 2nd signal)

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16
Q

Th0 –> Th1
(+)/(-)

A

(+) IL-12/IFN-y–> activate macrophages (macrophages also secreted IL-12)

(-) IL-4/IL10

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17
Q

Th0–>Th2
(+)/(-)

A

(+) IL4/IL10 (activate B cells to become plasma cell–>antibodies to kill extracellular pathogens

(-) IL-12/IFN-y

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18
Q

Th0–> Treg(+)

A

(+) TGF-Beta

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19
Q

Th0–>Th17 (+)

A

(+) IL-6/TGF-Beta

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20
Q

cells found in granuloma/chronic inflammation

A

Macrophages: histiocytes or epitheloid macrophages

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21
Q

How does Th2 activate B Cell

A

CD40 Ligand binds B cell CD40 facilitates differentiation: humor immunity

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22
Q

early process of T/B cell maturation generating antibodies and TCR with divers combinations, specificities and affinities

A

V(D)J recombination

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23
Q

B cells increase specificity antibodies

A

somatic hypermutation/affinity maturation

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24
Q

location: CD4/8 positive selection: T cell reg. self

A

Thymic cortex

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25
Q

Thymic medulla: T cell the reg. self dies

A

Negative selection of cd4 and CD 8
autoimmune checkpoint

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26
Q

IgA deficiency and Bruton X-linked Agamma

A

deficiency of humoral immunity

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27
Q

congenital Toxo lab. which Ig is pos and why.

A

IgM because it is the initial response to infection

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28
Q

defective CD40 Ligand

A

Hyper-IgM
no B cell somatic hypermutation/affinity maturation

Plasma cell stuck in IgM

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29
Q

Most abundant AB, responsible for hemolytic dz

A

IgG
2nd immune response
use in passive immunity
Eg: RhoGAM, HepB/VZV IVIg

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30
Q

Most common hereditary Immunodeficiency

mc mucosal AB in mucosal secretions

A

IgA:

atopy: seasonal allergies, asthma, eczema

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31
Q

located on surfaces of mast cells, kill parasites

A

IGE

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32
Q

IG associated with allergies and eosinophilia

A

IGE
Eosinophils secrete Major basic protein

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33
Q

Hyper Ige (FATED)

A

Abnormal Face, Abscesses (Staph), retained deciduous Teeth, hyper IgE, Derma findings(eczematoid skin lesion

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34
Q

Post-exposure IVIG examples of passive immunity

A

Hep B
VZV
tetanus, botulism, diphtheria
rabies
IgA in breast milk
transplacental IgG

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35
Q

immune system two major opsonins

A

C3b and IgG

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36
Q

completely depleted in PSGN and SLE flares

A

C3

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37
Q

anaphylatoxins, degranulation of mast cells

A

C3,C4,C5 (a)

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38
Q

Neutrophilic chemotactic molecule

A

C5a (as with IL8, LTB-4, kallikrein, Platelet-activating factor and PAMPs

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39
Q

MAC defi/ C3b deficiency

A

Gonococcal and meningococcal(Neisseria)

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40
Q

hereditary angioedema associated with

facial edema, colicky abdominal pain
inspiratory stridor, angioedema of extremity and trunk

A

C1 esterase inhibitor deficiency

Bradykinin-mediated

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41
Q

Paroxysmal nocturnal hemoglobinuria: complement-mediated RBC lysis

A

defective GPI anchors: CD55 and CD59

42
Q

Thymus-independent

A

No T cell response

43
Q

How to elicit T cell response to thymus-independent antigens

A

conjugation to a protein

44
Q

Examples of conjugate vaccines for thymus-independent immune response

A

H. Flu type B
Strep Pneumo
N. Meningitides
Typhoid (salmonella typhi)

45
Q

Is toxoid a Thymus-independent?

A

No.
Toxoid is an inactivated toxin that is a protein
Eg: Diphtheria and tetanus

46
Q

Thymus-independent response involves

A

B cell receptor
MHC II to Th2 cells

There is no memory

47
Q

Macrophages secrete

A

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

48
Q

T cell Stimulator

A

IL-2

49
Q

cytokines associated with sepsis

A

TNF-a: Low BP and cachexia factor in malignancy

and IL-1 fever; (Macrophages)

50
Q

IL-8

A

Neutrophilic chemotactic molecule

51
Q

Osteoclasti-activating factor in lytic bone lesions

A

IL-1

52
Q

target for fever with NSAID

A

prostaglandins

53
Q

Dec transcription of IL 2 by inhibiting calcineurin

A

cyclosporin and tacrolimus

54
Q

sirolimus MOA

A

dec IL-2 responsiveness

55
Q

Aldesleukin use in RCC and mets melanoma to

A

increase T cell response
increase IL-2

56
Q

defective IL3

A

affects myeloid cell line
GMCSF: sargramostim Treat neutropenia

57
Q

IL-5

A

stimulates eosinophil maturation

IL-5 antagonist
Mepolizumab
reslizumab
Benralizumab

58
Q

Stimulates acute phase protein in liver
(CRP, hepcidin)

A

IL-6
Anti IL-6 in RA: Tocilizumab

59
Q

support humoral immunity, suppress TH1, increase CD4 activation of B cell

A

IL-4

60
Q

IL-10

A

anti-inflammatory like IL 4

61
Q

cytokines that stimulate platelets

A

IL-11
Oprelvekin used post chemo

62
Q

IFN beta treats

A

treats Multiple sclerosis (acute flares use steroids )

63
Q

CD 15/30 on a large bilobed cell with abundant cytoplasm?

A

Reed-Sternberg cells in Hodgkin disease

64
Q

Marker seen in CLL

A

CD 5/23

65
Q

Macrophages TLR4 binds to LPS endotoxin

A

CD14

66
Q

CD 16/56

A

NK: 56 more specific
16 binds Fc region of IgG

67
Q

LAF-1 interin

A

CD18

68
Q

EBV uses _______ to invade B cell

A

CD19/20/21

69
Q

CD 80/86

A

B7 -1/7-2 binds CD28 on T cell

70
Q

CD found on B cell and macrophages activated by CD40L

A

CD40

71
Q

anti body associated with recurrent miscarriage

A

antiphospholipid

72
Q

Antiphospholipid syndrome associated antibodies

A

anti-beta 2 microglobulin
anti-cardiolipin
lupus anticoagulant

may show false-pos in syphilis screening in pt with SLE

73
Q

Anti-hemidesmosome

anti-desmosome(anti-desmoglein 1/3)

A

Bullous Pemp (linear deposit on IF)

Pemp Vulgaris(net-like deposit on IF)

74
Q

Anti-GBM(Anti-collagen IV linear IF

A

Goodpasture syndrome

75
Q

Mutation in collagen IV affecting lungs and kidneys

A

Alport syndrome

76
Q

Anti proteinase 3, C-ANCA seen with

Pauci-immune glomerulonephritis

A

Granulomatosis with polyangiitis

cough, dyspnea, hemoptysis
chronic ENT involvement

rapidly progressive (crescentic) glomerulonephritis (RPGN)

77
Q

necrotizing granulomatous vasculitis with eosinophilia

Eosinophilic Granulomatosis with polyangiitis presents with

A

MPO-ANCA/pANCA

Severe allergic asthma attacks (chief complaint)
Allergic rhinitis/sinusitis
Skin nodules, palpable purpura
Pauci-immune glomerulonephritis

78
Q

microscopic polyangiitis

Pauci-immune glomerulonephritis

A

anti-Myeloperoxidase
palpable purpura
No granuloma

79
Q

SLE thrombocytopenia/aplastic anemia due to

A

increase peripheral destruction (ABs destruction)

80
Q

Anti-smith (ribonucleoprotein)

A

SLE

81
Q

SLE antibodies

A

anti-double-stranded DNA,
anti-hematologic cell line (leading to aplastic anemia)
Anti-Smith (more specific)

82
Q

Anti-histone

Drugs?

A

Drug-induces SLE
MOM is HIP
Minocycline
Hydralazine
INH
Procainamide
penicilamine

83
Q

Anti-post-synaptic acetylcholine receptor (thymoma)

anti-presynaptic voltage-gated calcium channel
(small cell lung cancer)

A

M. gravis

Lambert-Eaton

84
Q

what antibody in Ovarian cancer is associated with Polymyositis/Dermatomyositis

A

Anti-Jo1 (Antisynthetase syndrome)

Anti mi-2 (helices)

85
Q

Scleroderma

Limited

Diffused

A

Anti- centromere

Anti-topoisomerase I (Scl-70)

86
Q

Anti-mitochondrial

A

Primary biliary cirrhosis

87
Q

Anti-CCP(Cyclic citrullinated peptide)

A

Specific for RA

88
Q

Anti-SS-A(anti-Ro) Anti-SS-B(anti-la)

A

Sjogren syndrome

89
Q

Anti-TSH (thyroid stimulating immunoglobulin

A

Graves
hyperthyroidism

90
Q

Hashimoto thyroiditis

transient hyper to late hypothyroidism

A

Pregnancy
Anti-thyroperoxidase(anti-microsomal
Anti-thyroglobulin

91
Q

Diffuse lymphocytic infiltration (cytotoxic T lymphocytes) with germinal center

HLA association

A

T cell and B cell
Hashimoto

Associations with HLA-DR3, and DR5

92
Q

Anti-gliadin, anti-tissue transglutaminase IgA

A

Celiac Dz

93
Q

Anti zinc transporter 8, anti-glutamic acid decarboxylase

A

DM type 1

94
Q

Matrix metalloproteinase that cleaves vWF multimers found in

A

Thrombotic thrombocytopenia purpura

95
Q

antibody in primary membranous glomerulonephritis

A

anti-phospholipase A2 receptor

96
Q

HIT(Heparin-induced thrombocytopenia
antibody

A

antibody against platelet factor 4

97
Q

Anti-21-hydoxylase

A

Addison dz
congenital adrenal insufficiency

98
Q

Sterp. Pyogenes M protein

A

Anti-myosin, anti-valve-derived protein
molecular mimicry (mitral valve)

99
Q

IgM against RBC..pos combo test

A

cold agglutination (CMV and mycoplasma, CLL)

100
Q

pos Coombs test, autoimmune hemolytic anemia
warm agglutination

A

IgG against RBCs