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Flashcards in Immuno Deck (110):
1

anti hemagglutinin (IgG and IgA)

hemagluttinin promotes Influenza viral entry into the cell
these antibodies in circulation and mucous account for decrease in reinfection

2

recurrent sinus/airway infection, lymphoid hyperplasia

hyper IgM
-def in isotype/class switching
either def in CD40R on B cell or CD40 ligand on T cell,
tx: IVIG

3

proximal muscle weakness, endomysial infiltration with Macrophages and CD8+, MHC overexpression, anti Jo, increased CK anti SRP, anti Mi2

polymyositis

4

recurrent skin infections without pus, delayed umbilical cord attachment, poor wound healing

leukocyte adhesion deficiency (type 1)
lack CD 18 and no formation of Beta 2 integrins necessary to leukocyte tight adhesion with integrin ligand ICAM
+bleeding complications=LAD type 3 (caused by impaired cytokine signaling which prevents integrin activation)

5

IgA protease

cleaves IgA at hinge region
produced by N. gonorrhea and N meningitid, prevent IgA from binding pili/fimibriae and preventing mucosal penetration

6

recurrent sinopulm/Gi infections, anaphylaxis wtih blood products

IgA deficinecy
have IgG against IgA

7

CD 19, 20, 21

B cell surface markers
low in agammaglobulinemia
(Bruton)

8

common otitis media organisms

strep pneumo
moraxella
H flu

9

clustered gram + with polar granules that stain deeply with aniline dyes

Corynebacterium diptheriae
-non-motile unencapsulated,
produces AB exotoxin
B: binding-binds heparin-binding epidermal growth factor on cardiac an neural tissue
A: inhibits cell protein synthesis

10

superantigens

produced by staph and strep, bind to t cells and MHC II causing widespread T cell activation

11

Botulinum toxin

blocks release of Ach causing cranial and peripheral nerve palsies

12

tetanus toxin

inhibts the release of inhibitory GABA and glycine neurotransmitters

13

ETEC, camplyobacter jejnia, vibiocholera, yersinia entercolitica

have tAB exotoxins that activate electrolyte transport

14

alpha toxin/lecithinase/phospholipase C

a cytolytic toxin that is released by clostridium perfringens that degrades cell membrane phospholipids, causing cell destruction
increases platelet aggregation and adherence molecule expression

15

nitroblue tertrazolium testing

characteristic of CGD
-susceptible to catalase + organisms
impaired intracellular killing by neutrophils and macrophages

16

omalizumab

anti IgE antibody used for moderate to severe persistent asthma, sensitivity to perennial allergen and incomplete response with steroiids,

17

bilateral hilar adenopathy, high ace, high Ca

sarcoid
-non caseating graulomas
-granulomas produce ACE and vita D
-predominance of CD4+ cells in bronchoalveolar lavage fluid

18

hypersensitivity pneumonitis

expsure to birds
high predominance of CD8+ cells in bronchoalveolar lavage

19

acute hemolytic transfusion reaction

wihtin minutes to hours
-fever/chills hypotension, dyspnea, chest and/or back pain, and hemoglobinuria
type II antibody mediated
-complement activated leading to cell lysis
ABO blood group incompatibility or extravascular hemolysis (host antibody reaction against foreign antigen on donor RBCs)

20

green metallic sheen on EMB agar

organism that can ferment lactose ie E. COli

21

anti ANA
anti dsDNA
anti SM

SLE

22

anticardiolipin antibody
beta 2 glycoprotein I antibody

antiphospholipid antibody syndrome
-paradoxical aPTT prolongation (although actually hypercoaguable)
FALSE RPR
can be primary or secondary to SLE

23

defects in interferon gamma signaling pathway

lead to increased mycobacterial infections in infancy or early childhood, patients require lifelong treatment with anitmycobacterial agents (also disseminated infection by the bcg vaccine strain if administered)

24

recurrent pyogenic infections, albinism, nystagmus, peripheral/cranial neuropathy

chediak higashi defect in neutrophil phagosome lysosome fusion
-abnormal giant lysosomal inclusions seen on light microscopy of peripheral blood smear
-abnml melanin storage in melanocytes
-recurrent staph/strep infections
-defective neutrophil funciton
-autosomal recessive

25

immunodeficinecy, eczema, thrombocytopenia

wiskott-aldrich syndrome
X linked
-combined t and B disorder

26

neurological sx (nystagmus, ataxia), superficial blanching nests of distended capillaries, recurrent pulmonary infections

ataxia telangiectasia
-due to deficiency in DNA break repair mechanisms, highly sensitive to radiation causing DNA breaks
-immunodef, usually manifests as IgA def
increased risk of hematologic malignancies
ATM gene

27

defect in expression of HLA class II antigens on surfaces of APCs

bare lymphocyte syndrome
-

28

HIV viral entry into cell

HIV gp120 binds CD4 protein + CCR% chemokine co receptor
- deletion of both CCR5 receptors renders individuals resistant to HIV
-one deled copy get symptoms later

29

persistent fever, splenomegaly, anterior and posterior cervical LAD

infectious mono due to EBV-which infects B lymphocytes via CD21+ cel surface receptor
-CD8+ clonally expand in response to virus

30

stellar cells with intracytoplasmic granules haveing the shape of a tennis racket, found on epidermis and interact closely with T cells

Langerhans cell, skin dendritic cell

31

kupffer cells

macrophage derived cells that present int the liver-remain in the hepatic sinuisoids

32

urethritis, conjunctivits, mono-oligoarticular arthritis

reactive arthritis
-seronegative HLA b27
sx 1-4 week safter infection causing urethritis or enteritis
caused by an autoimmune reaction initiated by the infecting pathogen
-keatderma blennorrhagicum (hyperkeratotic vesicles on the palsm and soles)

33

IgM antibody specific for the Fc component of self IgG

rheumatoid factor
-binds IgG and forms immune complexes that circulate in the serum
-cartilage activate CD4+ which stimulate B cells cells to make Rf

34

antiinflammatory cytokine

IL 10 and TGF beta

35

cytokines critical to granuloma formation

Il12, infgamma tnfalpha are crucial in recruiting macrophages and forming a granuloma to wall off an infection ie mycobacterium

36

interluekin involved in pus formation

IL 8
responsible for neutrophil chemotaxis

37

bradykinin

causes vasodilation, increased vasc permeability, stimulates nonvascular smooth muscle contraction, mediates pain

38

inflammatory anaphylotoxins in complement pathway

C3a, C4a, C5a

39

Interleukin that stimulates hematopoiesis

IL 3

40

leukotriene C4

triggers intense vasoconstriction, increased vascualr permeability, bornchospasm

41

chemotactic agents

interleukin 8, n forylated peptides, leukotrience B4, 5HETE (a leukotrience precursor) and complement component 5a

42

lysozyme

hydrolyzed peptidoglycan walls of bacterial organisms

43

lymph node drain of head and neck

cervical

44

LN drainage of lungs

hilar

45

LN drainage of trachea and esophagous

mediastinal

46

LN drainage of upper limb, breast, skin above umbillicus

axillary

47

LN drainage of upper duodenum, liver, pancreas, stomach, spleen

Celiac

48

LN drainage of Lower duodenum, jejunum, iluem, colon to splenic flexure

superior mesenteric

49

LN drainage of colon from splenic flexure to upper rectum

inferior mesenteric

50

LN drainage from lower rectum to anal canal (above pectinate line,) bladder, vagina (middle third), prostate

internal iliac

51

LN drainage from testes, ovaries, kidneys, uterus

para-aortic

52

LN drainage of anal canal (below pectinate line), skin below umbilicus (except popliteal territory), scrotum

superficial inguinal

53

Ln drainage of dorsolateral foot, posterior calf

popliteal

54

end of Lymphatic drainage

right lymphatic duct drains everything on right side above the diaphragm, thoracic duct drains everything else into the junction of the left subclavian and internal jugular veins

55

encapsulated organisms

Strep pneumo
Hib
Neisseria Menigitidis
E coli
Salmonella
Klebsiessa
GB Strep

56

antibody dependent cellular toxicity

mech of killing parasite infested cells, EOS help IgE mediate damage.destruction of parasites

57

multiple nuclei organized peripherally in the shape of a horseshoe

formedby actiated macrophages (epitheliod cells)
macrophages are stimulated by CD4 Th1 hefcells and give them the ability to kill intracellular M tuberculosis orgnaisms

58

CD14

marker of themonocyte/macrophage lineage

59

CD7

mulitchain complex T cell markeer

60

HBeAg

marker of infectivity and viral replication

61

newborn of all mothers with active Hep B

passively immunized at birth with Hep B immune globin folowed by activae immunization with recombinant HBV vaccine

62

diagnosis of acute hepatitis B

IgM and anti-HBc (once HBs has cleared and anti Hbs has not been formed yet )

63

superantigens

like TSS, enterotoxin, exfoliative toxin --> cause a large inflammatory response through the activaion of Th cells through MHC II antigen presentation, bind beta region of T cell receptor the large immune response is responsible for the effects of the superantigens

64

athralgias, fever, pruritic rash, LAD, small vessel vasculitis with fibrinoid necrosis and intense neutrophil infiltration, hypocomplementemia

Serum sickness caused by tissue depoisiotn of circulating immune complexes
Type III hypersensitivity
occurs after exposure to chimeric monoclonal antibodies (rituximan or infliximab) or nonhuman immunoglobulins (venom antitoxins) can also occur with penicillin or bactrim

65

nitrobluetetrazolium test

tests amount of nuetrophil superoxide production
-used to diagnose CGD
-also can use dihydrorhodamine test

66

palpable purpura, arthralgias, abdominal pain

Henoch Schonlein Purpura
-a preceding infection (usually URI) causes formation of IgA and C3immune complexes which deposit on blood vessel walls, in renal mesagnium,
have elevated IgA

67

why does isoimmunization not occur due to AB mismatch?

antibodies against specific bloody types are IgM and do not cross the placenta
-can occur with type O because they have IgG antibodies (Anti-A and Anti B)

68

third and fourth pharyngeal pouch deformity

DiGeorge syndrome

69

mechanism of injury in hepatitic B reaction

CD8+ lymph response to viral antigen on the cell surface result in hepatocyte damage

70

acute sore throat, fever, lymphadenopathy, upper airway dyspnea, gray pharyngeal exudate odynophagia in pt without vaccination

Diptheria
-corynebacterium diphtheriae causes pseudomembranous pharyngitis
-produces exotoxin AB that is specific for neural and cardiac tissue
-treatment includes :
1. diptheria antitoxin: inactivates circulating toxin
2. Penicillin or erythromycin: kills bacteria and prevents further release of exotoxin
3. DPT vaccine

71

pseudomembransous pharyngitis

corynebacterium diphtheriae

72

IgA and C3 deposition presentation

skin rash and abdominal pain
-Leukocytoclastic angiits, HSP
-acute glomerulonephritis is a possible complication
common in male children aged 3-11

73

saddle nose and oliguria

granulomatosis with polyangiits
wegener's
associated with C ANCA (cytoplasmic staining antineutophil cytoplasmic antibodies)
C anca target neutophil-3 proteinase

74

Il-1, Il-6, TNF alpha

mediators of shock

75

facial swelling, difficulty breathing, recently started on ACEi

angioedema-swelling og tongue, lips or eyelide with larygneal edema and difficulty breathing
due to bradykinin accumulation (bradykinin normally broken down by ACE) bradykinin potent vasodilator

76

HLA3

hemochromatosis

77

HLA B27

seronegative arthopathies
Psoriatic arthritis
Ankylosing arthritis
Ibd associated arthritis
Reactive arthritis

78

HLA DQ2/DQ8

celiac disease

79

types of cells killed by CD8+

tumor, viral infected, donor graft cells -induce apoptosis via perforin and granzymes

80

HLA DR2
HLA DR3
HLA DR4
HLA DR5

2: Multiple sclerosis, Hay fever, SLE, Good pastures
3: Diabetes, SLE, Graves disease, Hashimoto
4: Rheumatoid arthritis, Diabetes Mellitus
5: Pernicious anemia(B12 def), Hashimoto,

81

CD3 CD4 CD25 FOXP3

regulatory T cells-suppress CD4 CD8
can pro duce anti inflammatory cytokine IL10, TGF beta

82

two signals necessary for T cell activation

antigen must bind TCR and B7 on APC must bind CD 28 on T cell

83

two signals necessary for B cell activation

MCH II/antigen must bind TCR on Th, CD40 on B cell must bind CD40L on Th

84

3 mechs of antibodies

opsonization, neutralization, complement activation

85

acute phase reactants

produced in liver
elevated:
ferritin (binds free iron and prevents microbial scavenging),
hepcidin (keeps iron bound to ferritin), fibrinogen (repairs endotheial breaks),
CRP (opsonin, fixes complement, facilitates phagocytosis)
serum amyloid A (prolonged elevated can lead to amyloidosis)
decreased:
albumin (to save protein for upregulated reactants)
transferrin (to sequester iron stores)

86

PAMPS

pathogen associated molecular pattern
CD14 on macrophages-TLR recognizes LPS-on outer membrane of gram - and activates immune system via NFKbeta

87

C3a, C4a, C5a

complement products that cause anaphylaxis, mast cell degraulation
C5a also neutrophil chemotaxis

88

MAC

C5b-9

89

C3b, IgG

primary opsonins

90

decay accelerating factor/CD55

prevent complement from occuring on self cells ie RBCs
works with Cl esterase

91

C3 deficiency

increased risk of severe pyogenic sinopulomary infections (less opsonization), increased susceptibility to type III hypersensitivity reactions

92

recurrent Neisseria bactermia

C5-9 deficinecy
no MAC

93

paroxysmal nocturnal hemoglobinuria

complement mediated RBC lysis due to decay accelerating factor DAF deficiency (nmly prevents complement from affecting RBCs)

94

HOT T-BONE stEAK

IL 1-(hot) fever
IL 2-T cell stimulation
IL 3-bone-hematopoiesis
IL 4- igE
IL 5- IgA
IL 6-aKute phase reactants

95

pyocyanin

made from P auruginosa and generates ROS to kill compting microbes

96

CD34

hematopoietic stem cells

97

CD16, Cd56

NK cells
16 binds FC of IgG
CD56 NK unique marker

98

CD14, 40

macrophages

99

calssic antigenic variation examples

salmonella-2 flagellar variants
borrelia-recurrent fever
n gonorrhoeae-pilus protein
viruses-influenza, HIV, HCV
parasites-typanosomes

100

passive immunity

IgA in breast milk, IgG from placenta, antitoxin, humanized monoclonal antibodies
-shorter duration of action

101

when to used antitoxin

To Be Healed Very Rapidly
-tetanus
-Botulinium
-HBV
-Varicella
-Rabies
(also corynea diptheriae)

102

only live attenuated virus given to HIV pts

MMR

103

live vax

MMR, polio, intranasal influenza, varicella, yellow fever
-cellular and humoral response

104

inactivated vax

RIP A
-Rabies, Influenza, Polio, hepatits A
only humoral response

105

fever, hypotension, hemoglobinuria, tachypnea, tachycardia, flank pain, jaundice

acute hemolytic transfusion reaction
-antibodies against donor RBC or ABO incompatibility or foreign antigen

106

fever, chills, headache, flushing

febrile nonhemolytic transfucion reaction

107

dyspnea, bronchospasm, hypotension, resp arrest, shock

anaphylactic reaction
treat with epi

108

defect in BTK

agammaglobinulinemia
defective B receptor tyrosine kinase-no B cell maturation

109

decreased plasma cells, decreased immunoglobulins

common variable immunodeficiency
-unown cause, can be acquired
icnreased risk of autoimmune disease, bronchieectasis, lymphoma, sinopulmonary infections

110

coarse faces, cold inflamed staph abscesses, retained primary teeth, increased IgE, dermatologic problems

Job, hyper IgE syndrome
increased IgE, decreased IFN gamma
-STAT 3 mutations def of th17 cells-->impaired recruitment of neutrophils