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Flashcards in Immunology Deck (60):
1

IL 4

Mediates class switching to IgE; "Four makes ya a whore--switching classiness" Secreted by Th2 cells

2

IL 5

Promotes Eosinophil Migration; FivE=Eosinophils

3

IL-6

Secreted by T-cells and Macros.  Proinflam cytokine

Osteoblasts secrete to activate clasts.

4

IL 10

Stimulates Th2 cells, and Inhibits Th1 cells; "Ten to fight the bacteriem"

also tones down immune system along with Il17

5

IL-7

HSC, B, T and NK cell maturation factor (and general lymphoid cell survival)

6

IL-8

Recruits neutrophils

"clean up on ilse 8"

7

TH2 cells secrete

IL 4, 5, 10 (particuallary in allergic reactions)

4=IgE class switching

5=Eosinohpils

10=inhibiting Th1 and promoting Th2s

8

Why do you see hypercalcemia in granulomas (and what type of granulomas?)?

Expression of 1 alpha hydroxylase in noncaseating granulomas leading to Vitamin D activation

9

Prosthetic Heart Valves

Coagulase Negative Staph (tends to be Left heart Valves) HACEK bacteria: H aemophilus aphrophilus A ctinobaccilus actinoymycetemocomitans C ardiobacterium hominis, E ikenlla corrodens K ingella kingae

10

IVDA (intravenous drug users

Staph Aureus (virulent) TENDS TO BE RIGHT SIDE OF HEART, which can cause other pulm issues

11

Susceptible Organsims upon splenectomy

Encapsulated organisms: "S SHIN": Salmonella, S. pneumoniae, H. Influenzae, N. meningitidis Post Splenectomy: Howell-Jolly Bodies, Target Cells, Thrombocytosis

12

HLA Subtype associations: A3 B27 B8 DR2 DR3 DR4 DR5 DR7

A3: Hemochomatosis

B27: Psoriasis, ankylosing spondylitis, inflammatory bowel disease, Reiter's syndroeme ("PAIR")

B8: Grave's Disease "Gr8ves"

DR2: MS, Hay fever, SLE, Goodpasture's

DR3: DM type 1 ("DR3 + DM1 = DR4")

DR4: DM type 1, Rheumatoid arhtirtis

DR5: Pernicious anemia (B12 def), Hashtimoto's thyroiditis ("Thy ~5")

DR7: Steroid-responsive nephrotic syndrome (Minimal change disease)

13

Infections that affect fetus

TORCH: Toxoplasmosis, Other (syphillis, TB), Rubella (german measles), CMV, Herpes/HIV

14

Cryptococcus Neoformans

Meningitis in HIV/Immunocomp. Monomorphic fungus--Encapsulated yeast buds always

15

Blastomyces Dermatitidis

Broad-based budding yeasts (clinical non enviro form). Skin and bone lesions most common

16

Paracoccidioides Brasiliensis

Budding yeast in pilot's wheel (clinical) Central and south america. Presents as primary pulmonary disease

17

Histoplasma Capsulatum

Intracellular yeast within macrophages NOT encapsulated. Primary pulm infection Bird Droppings

18

Aspergillus

Oppurtunistic infections Septate Hypahae with 45 degree angles Mengitis (cyrpto more common)

19

Coccidioides immitis

Fungal meningitis in immuno comp. Sonoran desert zone of US (san joaquiin valley fever)

20

Metronidazole

"GET GAP on the Metro" Giardia, Entameoba, Trichomonas, Gardnerella vaginalis, Anaerobes, h. Pylori

21

Drugs that inhibit P450 Enzymes

PICK EGS Protease inhibitors, Isonazid, Cimetidine, Ketoconazole, Erythromycin, Grapefruit Juice, Sulfanomides

22

Patients with Chronic Granulomatous Disease

Get Staph Aureus.

23

Encephalitis (6)

HSV1, HSV2, Rabies Virus, Arboviruses, T. Gondii, T. Brucei

24

Neonatal Meningitis (3)

S. Agalactiae, L. monocytogenes, E. coli

25

Meningitis 6 months to 6 yrs (3)

S. pneumoniae, N. meningitidis, H. Influenzae type B

26

Meningitis 6yrs to 60years (3)

N meningitidis, poliovirus, S. pneumoniae

27

Aseptic Menigidits(4)

Coxsackie Virus, Echovirus, Mumps Virus, Poliovirus

28

Fungal menigitidis

C. neoformans

29

Rheumatic Heart Disease

S. pyogenes

30

Myocarditis

Coxsackie type B, T. Cruzi, S. Aueus + E. faecalis (from endocarditis), C. Diphtheriae, B. Burgodrferi

31

Endocarditis: Native valve

Strep Viridans, S. Bovis, Strep Pyogenes (usually better known to cause the rheumatic fever that causes Type III hypersenstivity of heart damage)

32

Endocarditis: IV Drug Users

Staph Aureus, Strepococci, E. Faecalis, P. Aeruginosa. Candida Albicans***

33

Prosthetic Valve

S. Epi, S Aureus, Gram Negs, C. Albicans Subacturely: Streptococci

34

Protein A

Finds the Fc portion of IgG prevent Opsinization (eg Staph Aureus)

35

HIV

CD4+ Counts

800+ Healthy

600-800: Assymptomatic

400-600: Generalized Lymphadenopathy

200-400 Generalized Lympadenopathy and Thrush

Antibodies to the envelope continue to rise due to antigenic variaiton that need primary (nonCD4+) response.  p24 antibodies (capsid) decline.

36

Asplenic Pateints are at risk for 

Why?

What else can they do?

SHiNS SKI bacteria (S. pneumo, HiB, N. meningitidis, Salmonella, Klebsiella, Group B Strep).

Capuslated

Transformation--can take up DNA from environmnet

37

Drugs for Aids, Influenza, and Herpes

-avirs=for AIDs (A, A)

-ivirs for influenza (I, I)

-ovirs for herpes (O for ouch it hurts)

38

Common atpical pneumonias: 

 MLCV, My lungs can't "vreethe".  Mycoplasma legionalla, chlamydia, viruses

39

Urease Positive Organisms

PUNCH

Proteus, Ureaplasma, Nocardia, Cryptococcus, Helicobacter pylori

40

Catalase Postive organisms (what condition leaves person susceptible to these bugs? How do you test for this condition?)

PLACESS (pseudomonas, listeria, aspergillus, candida, E. coli, S. aureus, Serratia)

NADPH deficiency.  Nitroblue tetrazolium test will be negative (non blue) [it will be positvie/blue in MPO def).

MPO def is increased risk to candida infections.

41

What does Psuedomonas Cause?

PSEUDO:

Pneumonia (cf ppl), Sepesis, External otitis (swimmer's ear=think water), UTI, Drug use and Diabetic Osteomyeltitis.

And hot tub folliculitis of course.

Ecthyma gangrenosum-necrotic cutanesoul lesions rapidly progressing; in immunocomp ppl

Tx: aminoglycoside with extended spectrum penicllin (P-iperacillin for P-suedo)

42

Transplant Rejection Stages

1) Hyperacute: preformed IgG causing T2HSR

2) Acute: Cell mediated T4HSR (and you have T2HSR with new antibody devo)

3) Chronic: Host T cells can interact with graft MHC 1's however the grafts antigens that are presented on MHC 1's are seen as foreign causing RXN

4) Graft vs Host disease: graft's T-cells fight against immunocomprimised host

43

What cells participate in ADCC, what do they need?

Macrophages Positive for what CD's what do they do?

Macrophages (C14/40+)/NK cells

CD16 which binds to the Fc portion of Igs

CD14 (TLR) used to bind Endotoxin

44

Severe Recurrent Pyogenic Infections?

C3 def particularly of upper resp tract:

Strep Pneumo and H Flu

45

Type of HSR:

Polyarteritis Nodosa?

Ecyzema?

Serum Sickness?

Arthrus Reaction?

3

1

3

3

46

X linked Immuno def?

"WBC"

Wiskott, Brutons (can be), Chronic Granulomatous (can be)

47

Kid with poor smooth pursuit, small malformed blood vessels on skin, and recurrent sicknesses

ATM

Three A's A-taxia, Angiomas (teliectasias), IgA def

48

Lepramatous leprosy demonstrate weak what?

Tuberculoid Leprosy?

Weak cell mediated response thus decreased Th1, thus defective macros.

Better cell mediated thus higher Th1 CD8+

49

Interstitial Pneumonia in a lung transplant patient?

CMV***, will likely see intranuclear inclusions and GIANT cells (cytoMEGAlovirus)

50

Interferon for granuloma formation? For maintenance?

IFN Gamma for formation

TNF alpha for maintenance 

51

B cell vs T cell immunodef presentations?

B-cell: Otits media (Strep pneumo, moraxella, H flu)

T-cell: mucocandidiasis infections and pneumocystis infections

52

2 factors that drive angiogenesis?

VEGF and FGF***

53

Blood characteristic seen commonly in chronic ETOH?

Macrocytosis

Occurs either from poor nutrition (B12/Folate) or by ETOH acting as direct toxin on marrow

54

Predisposing factor for hematogenous spread of candida albicans?

Superficial spread?

Low Neutrophils

Low CD4+ cells

55

Live attenuated vaccines better at?

Generating a prolonged immune reponse, thus have more IgG's and mucosal IgA's (A's if the organism has a mucosal invasion component)

56

3*** things that are released from degranulating mast cells?

Histamine

Leukotrienes

TRYPTASE (specific to mast cells)

57

Fibrinoid Necrosis?

Fibrionid~Fibrin like telling you some immune component is present

Usually the result of type III complexes being deposited in endothelial wall (eg Polyarteritis Nodosa, Henoch Schonlein Purpura; can also be seen in malignant HTN/Preeclampsia)

58

Pertussis vaccine is what type?

H Flu is what type?

Acellular.  Think DTaP as "acellular pertussis"

Hflu conjugated to diptheria toxin

59

Protein A vs IgA protease?

Protein A binds Fc Recptor preventing ospinization

IgA Protease allows for mucosal survival/penetration

60

UTIs

What does a leukocyte esterase test tell you?

Nitrite Test?

DD for Urease test?

L Esterase tells you its bacterial in origin

Nitrite tells you its a Gram Neg*****

Urease + prolly Proteus/Kleb

Urease - prolly E. coli or enteroccocus