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Flashcards in Immuno Deck (45):
1

Encapsulated org's?

SHiNE SKiS
Strep. pneumoniae
Haemophilus influenzae type B
Neisseria meningitidis
E. coli
Salmonella
Klebsiella pneumoniae
Group B Streptococci

2

HLA subtypes assoc'd w/ dz?
A3
B27
DQ2/DQ8
DR2, 3, 4, 5

A3: hemochromatosis
B27: PAIR=Psoriasis, Ankylosing spondylitis, IBD, Reiter's synd
DQ2/8: Celiac dz
DR2: MS, hay fever, SLE, Goodpasture's
DR3: T1DM, Graves' dz
DR4: RA, T1DM
DR5: pernicious anemia -> B12 defic, Hashimoto's thyroiditis

3

C1 esterase inhibitor defic -> ?

Hereditary angioedema (don't give ACEI)

4

C3 defic -> ?

recurrent pyogenic sinus and RT infec's; incr'd susceptibility to T3 HSRs

5

C5-C9 defic -> ?

recurrent Neisseria bacteremia

6

DAF defic -> ?

C' mediated lysis of RBCs and PNH

7

IL1-5 do what?
6?
8?
10?
12?

"Hot T-Bone stEAk"
1 - F (Hot), acute inflamm, act'd endo to express adhesion molec's (from Mphage)
2 - stim's T cells (secreted by T cells)
3 - stim's BM (from T cells)
4 - stim's IgE prod and Th2, also IgG (from Th2)
5 - stim's IgA prod; Eo's (from Th2)
6 - pyrogen, stim's acute phase rcts (from Mphage and Th2)
8 - "Clean up on aisle 8" -> recruits N's to clear infec (from Mphage)
10 - modulates inflamm response, like TGFb bc decr's inflamm, inhib's Th1 (from Th2 and Treg's)
12 - induces T->Th1, act's NK cells (from Mphage and B cells)

8

Mphage secrete what cytokines?

IL-1,6, and TNFa
also IL-8, 12 (N's and Th1/NK cells)

9

IFNg does what? Secreted by who?

secreted by Th1 cells
act's Mphage and Th1, inhib's Th2, act's antiviral and antitumor properties, incr's MHC-I/II exp'n on all cells

10

Cell surface pr's on:
T cells
Th cells
CTLs
B cells
Mphage
NK cells

- TCR, CD3, CD28 (binds B7)
- CD4, CD40L
- CD8
- Ig, CD19,20,21 (R for EBV), CD40, MHC-II, B7
"Drink Beer at Bar at age 21: B cells, EBV, CD-21"
- CD14,40 (endotox's bind to activate), MHC-II, B7, Fc and C3b Rs
- CD16 (binds Fc of IgG), CD56 (unique to NK)

11

Vaccines:
Live -> ? type of immunity; ex's?
Dead -> ? type of immunity; ex's?

- cellular response (lymphocytes)
Measles, mumps, rubella, polio (Sabin), varicella, yellow fever
- humoral immunity (B cells)
Cholera, hepA, polio (Salk), rabies

12

4 hypersensitivity rxns =

ACID
1 = A = anaphylactic and atopic (vasodil at postcap venules); FAST
2 = C = cytotoxic, Ab mediated (IgM, IgG) bind fixed Ag on cell surface -> cell destruction (check w/ Coomb's test)
3 = I = imm complex (IgG:Ag) -> C' -> N's and lysosomal NZs
4 = D = delayed (T cell mediated) -> act Mphage

13

Bruton's agammaglobulinemia
- defect
- clin features

- XR, mutated BTK so B cells don't mature from pro-B cells
- sinopulm infec's after 6mo, decr'd Iggs

14

IgA deficiency
- defect
- clin features
- false (+) what test?

- IgA B cells don't become pl cells
- sinopulm infec's, giardia, decr'd IgA, anaphylaxis to bl products that have IgA
- b-HCG test due to heterophile Ab presence

15

Common variable immunodeficiency (CVID)
- defect
- clin features

- B cells don't mature to pl cells
- sinopulm infec's, GI, pneum, autoimm dz, malig; decr'd Iggs (nl # B cells)

16

DiGeorge syndrome
- defect
- clin features
- struc problems?

- 22q11 deletion; 3rd/4th pouches don't develop -> no thymus nor PT gl's
- HypoPT -> hypoCa (tetany), no thymic shadow on XR, PCP, danger of GVH rxn
- heart defects, lower face and cleft palate defects

17

SCID
- defect
- clin features
- trtmt

- AR ADA (adenosine deaminase) defic -> adenine toxic to B/T cells and less DNA syn; OR defective IL-2 R (X-linked)
- no CMI, decr'd Iggs -> failure to thrive, chronic D, thursh, recurrent infec's, no thymic shadow on XR, no germinal centers, no B cells
- gene tx, BM transplant (no allograft rejection!)

18

Wiskott-Aldrich syndrome
- defect
- clin features
- changes in Ig levels

- XR, progressive deletion of B/T cells; WASP gene mutation -> T cells can't recognize actin skeleton
- 3 (TIE): Thrombocytopenia, sinopulm Infec's, Eczema; + risk of lymphoma, no CMI
- decr'd IgM, nl IgG, incr'd IgA/E

19

Ataxia-telangectasia
- defect
- clin features
- Which Iggs are decr'd?

- AR mutation in ATM gene, which is DNA repair NZ, thymic hypoplasia
- 3: Ce ataxia, telangectasias of eyes/skin, and IgA defic...also incr'd risk lymphoma/leukemia; adenoca; incr'd serum AFP
- decr'd IgA/E/G, decr'd T cell func

20

What enhances NK activity?

IL-2,12, IFN-a,b

21

T cell act'n - 2 signals?

B cell act'n - 2 signals?

1) MHC on DC w/ TCR on T cell
2) B7 on DC w/ CD28 on naive T cell

1) MHC-II on B cell w/ TCR on T cell
2) CD40 on B cell w/ CD40L on T cell
3) T cell secretes cytokines -> B cell act's and class switches, aff maturation and Ab production

22

Th1
- secrete ?
- act ?
- inhib'd by?

- IFN-g
- Mphage
- IL-4,10 from Th2 cells

23

Th2
- secrete ?
- act ?
- inhib'd by?

- IL-4, 5, 10, 13
- recruits Eo's for parasite defense and promotes IgE prod by B cells (IL-13 is for allergy)
- inhib'd by IFNg from Th1 cells

24

How to Mphage and T cells stim ea other?

T cells release IFN-g to stim Mphage and Mphage release IL-1 and TNF-a to stim T cells (lymphocytes)

25

Regulatory T cells
- express on cell surface?
- produce ? cytokines

- CD3, 4, 25 (alpha chain of IL-2 R)
- anti-inflamm cytokines: IL-10, TGF-b

26

What cytokines are secreted by all T cells? What do they do?

IL-2 -> stim's helper, cytotox and reg T cells
IL-3 -> growth and differentiation of BM SCs, func's like GM-CSF

27

What cell is it on:
CD3
CD14
CD16, func?
CD19, 20, 21 (R for?)
CD40
CD40L
CD56
B7

T cells
Mphage (endotox R for Gm- pr's)
NK cells, binds Fc of IgG
B cells (21 is R for EBV)
B cells and Mphage
Th cells
NK - unique marker!
APC (Mphage, DC, B cells)

28

What happens w/ bac infec if you:
- don't have T cells?
- don't have B cells?
- don't have granulocytes?
- don't have C'?

- sepsis
- encap'd org's (SHiN SKiS)
- Staph, Burkholderia cepacia, Serratia, Nocardia
- Neisseria (no MAC)

29

What happens w/ fungal infec if you:
- don't have T cells?
- don't have B cells?
- don't have granulocytes?

- Candida, PCP
- GI giardiasis (no IgA)
- Candida, Aspergillus

30

What happens w/ viral infec if you:
- don't have T cells?
- don't have B cells?

- CMV, EBV, VZV, chronic infec w/ resp/GI viruses
- Enteroviral encephalitis, poliov. (don't give live vaccine!)

31

T cell defic's ->
vs. B cell defic's ->

- fungal and viral infec's
- recurrent bac infec's

32

IL-12 R defic
- defect
- clin features

- decr'd Th1 response (bc need IL-12 from Mphage and B cells to be act'd)
- disseminated mycobac infec's, decr'd IFN-g (bc Th1 aren't act'd to make it)

33

Hyper-IgE synd (Job's synd)
- defect
- clin features

- Th1 don't make IFN-g -> N's don't work
- FATED: coarse Faces, cold (noninflamm'd) staph Abscesses, keep 1* Teeth, incr'd IgE, Dermatitis
+ red hair

34

Chronic mucocutaneous candidiasis
- defect
- clin features

- T cell dysfunc'n
- Candida albicans infec's of skin and mucous mem's

35

Hyper-IgM synd
- defect
- clin features

- no CD40L on T cells so no B cell class switching
- pyogenic infec's as baby, not Ig's other than IgM

36

Leukocyte adhesion defic (type 1)
- defect
- clin features

- no LFA-1 integrin (CD18) on phagocytes
- recurrent bac infec's, no pus, delayed separation of umbilical cord; neutrophila (bc they can't migrate thr vessel)

37

Chediak-Higashi synd
- defect
- clin features
- histo shows

- AR, no LYST (lysosomal trafficking R), microtubule dysfunc in phagosome-lysosome fusion -> less phagocytosis
- recurrent pyogenic infec's by Staph and Strep, partial albinism, periph neuropathy
- giant granules in N's

38

CGD (chronic granulomatous dz)
- defect
- clin features
- abnl test

- no NADPH oxidase -> no ROS and no resp burst from N's
- infec's from cat (+) org's (Staph. aureus, E. coli, Aspergillus)
- DHR (dihydrorhodamine) flow cytometry test; nitroblue tetrazolium dye (doesn't turn blue)

39

Defective CD11a/CD18 ->

leukocyte adhesion defect

40

IFN a/b do what?
- IFNg?

IFNa/b inhib viral pr syn by producing ribonuclease that degrades viral mRNA
- IFNg incr's MHC-I/II exp'n on all cells (from Th1)

41

What 3 bac, 1 virus and 1 parasite have Ag variation on them to escape imm sys?

Bac: Salmonella (2 flagella varients), Borrelia (relapsing F), N. gonorrhoeae (pilus pr)
Virus: influenza
Parasite: trypanosomes (programmed rearrangement)

42

After exposure to what 4 bad things are you given preformed Abs (aka passive immunity)

"To Be Healed Rapidly"
Tetanus toxin
Botulinum toxin
HBV
Rabies v.

43

Serum sickness =
- usu due to?
- sx?

IC dz (T3 HSR) in which Abs to foreign pr's are made (5d) -> form ICs which deposit in mem's, fix C' and causes tissue damage
- usu due to drugs acting as haptens
- F, urticaria, arthralgias, proteinuria, lymphadenopathy

44

Arthus rxn =
- sx
- seen w/?

local subacute T3 HSR from intradermal injection of Ag -> Abs made -> IC in skin made
- edema, necrosis and act'n of C'
- swelling and inflamm post-tetanus vaccine

45

Transplant rejections:
- hyperacute is due to?
- acute?
- chronic?
- GVH?

- w/in min: T2 HSR from pt has anti-donor Abs (occludes vessels -> ischemia/necrosis)
- wks: CMI from CTLs against donor MHC, reverse w/ immsupp's (vasculitis of graft w/ inflamm infiltrate)
- mo-yrs: CTLs see donor MHC as self presenting non-self Ag (irreversible, vascular damage, fibrosis)
- graft T cells prolif in pt and reject cells self cells -> organ dysfunc (usu in BM and liver transplant -> rash, jaundice, HSM and D)