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immunology Flashcards

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1
Q

lymph node Cx

A

follicles of B cells
primary follicles dense and dormant
secondary follicles pale central germinal center and are active

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2
Q

lymph node medullar

A

medullary cords and sinuses

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3
Q

lymph node paraCx

A

T cells

underdeveloped in DiGeorge

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4
Q

mediastinal nodes

A

drain trachea and esophagus

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5
Q

celiac nodes

A

drain liver, stomach, spleen, pancreas, upper duodenum

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6
Q

superior mesenteric nodes

A

lower duodenum, jejunum, ileum, colon to splenic flexure

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7
Q

inferior mesenteric nodes

A

colon from splenic flexure to upper rectum

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8
Q

internal iliac nodes

A

drain lower rectum to anal canal above pectinate line, bladder, vagina (middle 1/3), prostate

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9
Q

para-aortic nodes

A

testes, ovaries, kidneys, uterus

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10
Q

superficial inguinal nodes

A

anal canal (below pectinate line), skin below umbilicus, scrotum

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11
Q

popliteal nodes

A

dosolateral foot, post calf

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12
Q

what infections are asplenic pts prone to?

A 
encapsulated
SHiNE SKiS:
S. pneumoniae
H. influenza B
N. menigitidis
E. coli
Salmonella
Klebsiella
group B Strep
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13
Q

where are T cells in spleen

A

perarteriolar lymphatic sheath (PALS)

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14
Q

where are B cells in spleen

A

follicles in white pulp

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15
Q

what is in the marginal zone?

A

APCs

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16
Q

what do you see in blood of asplenic?

A

Howell-jolly bodies
target cells
thrombocytosis
lymphocytosis

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17
Q

what is thymus derived from?

A

3rd pharyngeal pouch

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18
Q

MHCI

A 
HLA-A/B/C
expressed on all nucleated cells
present endogenously synthesized Ags (viral) to CD8 cells
Ag loaded in RER 
associated w/beta2 micrglobulin
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19
Q

MHCII

A

HLA-D
expressed on APCs
present exogenously synthesized Ags (bacterial) to CD4 cells
associated w/invariant chain

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20
Q

HLA-A3

A

hemochromatosis

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21
Q

HLA-B27

A 
seronegative arthropathies
PAIR 
psoriatic arthritis
ankylosing spondylitis
arthritis of IBD
Reactive arthritis (reiter syndrome)
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22
Q

HLA-DQ2/DQ8

A

celiac disease

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23
Q

HLA-D2D

A

MS
hay fever
SLE
goodpastures

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24
Q

HLA-DR3

A

DMI
SLE
graves
hashimotos

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25
DR4
RA (4 walls to a rheum) | DMI
26
DR5
pernicious anemia -> vit B12 deficiency | hashimotos
27
what enhances NK cells
IL2, 12 INF-alpha INF-beta detect cells w/o MHCI on surface
28
TH1
secrete INF-y to activate macros and CD8 cells activated by INF-y and IL-12 inhibited by IL-4 and IL-10
29
TH2
secretes IL-4, 5, 10, 13 recruits eos, promotes IgE activated by IL-4 Inhibited by INF-y
30
Treg
surpress CD4 and CD8 express CD3,4,25, and FOXP3 produce IL10, TGF beta
31
naive T cell activation
DC presents Ag to T cells in lymph node | B7 (on DC) and CD28 (on Tcell) must interact as well
32
B cell activation and class switching
B cell presents Ag to activated Th cell | CD40L (on Th) binds CD40R (on B cell)
33
fab
variable region fragment Ag binding determine idiotype
34
Fc
``` Constant Carboxy terminal C' binding Carbohydrate side chains determine isotype (IgM, IgG etc) ```
35
IgG
``` main Ab in secondary response most abundant type in serum fixes C' crosses placenta opsonizes bacteria neutralizes bacterial toxins and viruses ```
36
IgA
``` mucous membranes does NOT fix C' monomer in circulation, dimer when secreted most produced Ab overall in breast milk ```
37
IgM
``` primary response fixes C' does not cross placenta monomer on B cells pentamer when secreted ```
38
IgD
unknown fnx
39
IgE
binds mast cells and basophils cross links when exposed to allergen - type 1 hypersensitivity rxn lowest concentration in serum
40
acute phase reactants that are upregulated
``` mostly d/t IL-6 CRP Ferritin Fibrinogen Hepcidin Serum amyloid A ```
41
downregulated acute phase reactants
``` albumin transferrin (internalized by macros) ```
42
CRP
opsonin and fixes C'
43
ferritin
binds and sequesters Fe
44
Fibringoen
coagulation factor | promotes endothelial repair, correlates w/ESR
45
hepcidin
prevents release of Fe bound by ferritin | leads to Anemia of chronic disease
46
serum amyloid A
prolonged elevation -> amyloidosis
47
classic activation of C'
IgG or IgM mediated | GM makes classic cars
48
alternative activation of C'
microbe surface molecules
49
lectin pathway activation of C'
mannose of other sugars on microbes surface
50
C3b
opsonization | 3b binds bacteria
51
C3a, C4a, C5a
anaphylaxis
52
C5a
neutrophil chemotazis
53
MAC
C5B-9
54
C' inhibitors
decay-accelerating factor (DAF, aka CD55) | C1 esterase inhibitor
55
C1 esterase inhibitor deficeincy
hereditary angioedema | ACE inhibitors CI
56
C3 deficiency
increases risk of severe recurrent pyogenic sinus and respiratory tract infections increased susceptibility to type III hypersensitivity rxns
57
C5-9 deficiencies
Neisseria
58
DAF deficiency
aka CD55 or CPI anchored enzyme | C' mediated lysis of RBCs -> paroxysmal nocturnal hemoglobinuria
59
C3 nephritic factor Ab
usually stabilizes C' convertase w/o it you get too much C3b -> stuck in kidneys -> membranoproliferative glomerulonephritis serum C3b is low
60
cytokines secreted by macros
``` IL-1 IL-6 IL-8 IL-12 TNFalpha ```
61
cytokines from all T cells
IL-2 | IL-3
62
cytokines from Th1
INF-y
63
cytokines from Th2
IL-4 IL-5 IL-10
64
Hot T-bone stEAK
``` IL-1 hot (fever) IL-2 stimulates T cells IL-3 stimulates bone marrow IL-4 stimulates IgE IL-5 stimulates IgA IL-6 stimulates aKute phase protein production ```
65
IL-8
major chemotactic factor for neutros
66
IL10
atTENuates immune response decreases expression of MHC class II and Th1 cytokines inhibits activated macros and dendritic cells
67
IL-12
induces differentiation of T cells into Th1 | activates NK
68
INF-y
stimulates macros | activates NK cells
69
what gives sputum color?
myeloperoxidase | blue-green heme containing pigment
70
chronic granulomatous disease
at risk fro catalase + species S. aureus Aspergillus etc
71
INF- alpha and beta
defense against viruses for apoptosis of infected cells
72
T cell markers
TCR (binds Ag MHC complex) CD3 CD28 (binds B7 on APC)
73
Th markers
CD4 | CD40L
74
Cytotoxic T cell markers
CD8
75
Treg markers
CD4 | CD25
76
B cell markers
``` Ig CD19, 20, 21 CD40 MCH II B7 ```
77
macro markers
``` CD14 CD40 MCH II B7 Fc and C3b Rs ```
78
NK cell markers
CD16 | CD56
79
HSC markers
CD34
80
what organisms can be Tx w/preformed Abs?
``` To Be Healed Very Rapidly Tetanus toxin Botulinum toxin HBV Varicella Rabies ```
81
what is the difference in immune response to live vs killed vaccine
live- cellular and humoral response | killed- humoral only response
82
type I hypersensitivity rxn
skin test for specific IgE
83
direct coombs test
detects Abs that have adhered to pts RBCs
84
indirect coombs test
detects serum Abs that can adhere to other RBCs
85
Serum sickness
type III- IC deposit in membranes and fix C' usually caused by drugs 5-10 days after exposure fever, urticaria, arthralgia, proteinuria, lymphadenopathy
86
arthus rxn
local subacute type III- IC occurs after subdermal injection edema, necrosis, activation of C' test w/immunoflorescence staining
87
type IV rxns
``` T cell mediates transplant rejections TB skin tests Touching- contact dermatitis MS ```
88
type II rxns
``` acute hemolytic transfusion rxn autoimmune hemolytic anemia bullous pemphigoid erythroblastosis fetalis ITP pemphigus vulgaris ```
89
type III RXNS
``` arthus rxn SLE polyarteritis nodosa poststreptococcal glomerulonephritis serum sickness ```

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