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Flashcards in immunology Deck (89):
1

lymph node Cx

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

2

lymph node medullar

medullary cords and sinuses

3

lymph node paraCx

T cells
underdeveloped in DiGeorge

4

mediastinal nodes

drain trachea and esophagus

5

celiac nodes

drain liver, stomach, spleen, pancreas, upper duodenum

6

superior mesenteric nodes

lower duodenum, jejunum, ileum, colon to splenic flexure

7

inferior mesenteric nodes

colon from splenic flexure to upper rectum

8

internal iliac nodes

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

9

para-aortic nodes

testes, ovaries, kidneys, uterus

10

superficial inguinal nodes

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

11

popliteal nodes

dosolateral foot, post calf

12

what infections are asplenic pts prone to?

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

13

where are T cells in spleen

perarteriolar lymphatic sheath (PALS)

14

where are B cells in spleen

follicles in white pulp

15

what is in the marginal zone?

APCs

16

what do you see in blood of asplenic?

Howell-jolly bodies
target cells
thrombocytosis
lymphocytosis

17

what is thymus derived from?

3rd pharyngeal pouch

18

MHCI

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

19

MHCII

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

20

HLA-A3

hemochromatosis

21

HLA-B27

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

22

HLA-DQ2/DQ8

celiac disease

23

HLA-D2D

MS
hay fever
SLE
goodpastures

24

HLA-DR3

DMI
SLE
graves
hashimotos

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