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Unit 4 > Immunology > Flashcards

Flashcards in Immunology Deck (103)
1

What cells are included in granulocyte?

Neutrophils/eosinophils/basophils

2

What kind of cells are included under myeloid cells?

Monocyte/granulocyte/erythrocyte/platelet

3

What kind of cells are included under lymphoid stem cells?

Plasma cells/T cells/natural killer cells

4

What is the normal white blood cell count?

4,000 to 10,000/uL

5

What cells are included in leukocyte (WBC)?

Granulocyte/T cell/monocyte

6

What causes hypereosinophilia?

NAACP
Neoplastic/asthma/allergic reaction/collagen vascular disease/parasites

7

Histamine increase ___ production in the stomach and causes ___?

Gastric acid/peptic ulcer

8

Where are basophil and mast cells found in the body?

Basophil--->mature in bone marrow and stay in blood
Mast cell--->mature in tissues and stay in tissues

9

How does dendritic cell present antigens to B and T cell?

It carries it through lymphatic system to the lymph nodes

10

Where do B and T cell mature?

B--->bone marrow
T--->thymus

11

Which cell's nuclei has a clock face appearance?

Plasma cell

12

What are primary and secondary follicles in the lymph nodes?

B cells reside in there
Primary--->dense center (nonactive)
Secondary--->pale center (active)

13

Where are B/T/plasma cells in the lymph nodes?

B--->cortex
T--->paracortex
Plasma cell--->Cord of the medulla

14

Where do B/T cells enter the lymph node?

High endothelial venules (in paracortex)

15

Why don't you biopsy testicular cancer?

Because testicle and scrotum drains into different lymph nodes
Testicle--->periaortic
Scrotum--->superficial inguinal

16

Where do the lymph of right arm and head drain into?

Right lymphatic duct--->right subclavian vein

17

What cells are in red pulp/white pulp/PALS in the spleen?

Red--->RBC
White--->WBC
PALS--->T cells

18

Why is pt with asplenia is more susceptible to encapsulated bacteria?

Spleen makes IgM--->activate complement

19

What are the 3 signs of asplenia?

Howell-Jolly bodies/target cell/thrombocytosis

20

What happens in the cortex/corticomedullary junction/medulla in the thymus?

Immature T cells in cortex/T cell maturation in corticomedullary junction/mature T cell in medulla

21

Where are Hassall's corpuscles found?

Medulla of the spleen

22

What are the positive and negative selection of T cells?

Positive--->see if T cell bind to self MHC--->yes then survive
Negative--->see if it binds too strongly--->get rid of the ones that bind too strongly

23

List 3 examples of innate immunity

Lysosome/defencin (inside neutrophilic granules--->break cell wall)/surfactin

24

What are the 3 chemotaxis for neutrophil?

IL-8 (macrophages)/C5a/LTb4

25

What surface receptor do neutrophil use to attach to the bacteria?

TLR/C3b/IgG

26

What is the process of O2 dependent killing in the phagolysosome?

NADPH is oxidized to NADP+ in the cytoplasm--->H+ goes into the phagolysosome--->NADPH oxidase combine e- from NADPH with O2 to produces superoxide anion (O2-)--->superoxide dismutase combine O2- and H+ into H2O2--->break down to hydroxal (OH-) radical--->kill the bacteria

27

How does myeloperoxidase kill bacteria in the phagolysosome?

It converts H2O2 and Cl into OCl- (hypochloride)--->kill the bacteria

28

How does mast cells respond to inflammation?

C5a is released from the infected region--->C5a binds to C5a receptor on mast cell--->degranulation

29

What does histamine do to the endothelial cells of the blood vessel?

It regulates P-selectin

30

How does neutrophil bind to endothelial cell of the blood vessel?

Through P and E-selectin (low affinity) via integrin on neutrophil--->rolling on the surface (slow down leukocyte)--->

31

How does neutrophil diapedesis happens?

IL8 binds to proteoglycan on the endothelial cell--->neutrophil binds to IL8 (high affinity binding)

32

What is chronic granulomatous disease?

Inherited disease with defective NADPH oxidase--->can't produce superoxide (O2-) anion--->chronic infection of catalase + bacteria

33

Why is chronic granulomatous disease pt not susceptible to catalase - bacteria?

Catalase - bacteria produces H2O2--->MPO convert it to OCl- in phagolysosome and then kill the bacteria

34

Why is MPO deficiency usually asymptomatic?

Because NADPH oxidase can still produce OH- to kill the bacteria

35

What bacteria infection is MPO deficiency susceptible to?

Candida

36

What is type I leukocyte adhesion deficiency?

Beta 2 integrin (low affinity) (CD18) deficiency on leukocyte--->recurrent infection and delay in umbilical cord separation

37

Where do you find MHC class II protein?

On APCs

38

Where are the antigen loaded and presented to for MHC class I and II protein?

Class I--->loaded in rough ER and presented to CD8 cells
Class II--->loaded in endosomes and presented to CD4 cells

39

What are class I and II MHC structure compose of ?

Class I--->alpha chain and beta microglobulin
Class II--->alpha chain/beta chain/invariant chain (released when antigen is loaded)

40

What disease does the pt in risk for with HLA-B27?

Seronegative spondyloarthropathy (ankylosing spondylitis/inflammatory bowl disease/reactive arthritis/psoriasis)

41

What disease does the pt in risk for with HLA-DR3 and DR4?

DR3--->type I DM/Hashimoto
DR4--->type I DM/rheumatoid arthritis

42

Is natural killer cell a part of innate or adaptive immune response? and what protein does it look for?

Innate/MHC class I

43

What happens when natural killer cell encounter a normal cell?

Normal cell express MHC class I--->natural killer cell express KIR (killer cell immunoglobulin like receptor)--->normal cell bind to KIR and inhibit natural killer cell

44

What happens when natural killer cell encounter a foreign cell?

No MHC class I/no KIR--->KAR receptor is activated on natural killer cell--->attack by producing perforin (poke a hole) and then insert granzyme (induce apoptosis)

45

What is the most prominent cell present in graft vs. host disease?

Natural killer cell

46

What are the interleukens that are responsible for Th1 and Th2 cell differentiation?

Th1 cell--->IL-12
Th2 cell--->IL-4

47

What is the first signal for the activation of T cell by APCs?

MHC class II on the APCs bind with TCR (then CD4 binds to it) and the help of CD3 on the T cell surface

48

What is the costimulatory signal that is needed to activate T cell along with the first signal?

CD28 on the T cell surface binds with B7 on the APCs

49

What are the first and second signal that are needed to activate CD8 cells?

First signal--->Infected cells present antigen to CD8 through Class I MHC
Second signal--->Helper T cell secretes IL-2--->IL-2 binds to CD8 cells

50

Which T helper cells activate CD8 cells and which one for B cell?

Th1--->activate CD8 cells
Th2--->activate B cells

51

What are the 2 signals for activation of B cells?

1st--->CD40 ligand from Th2 cells bind to CD40 on B cell
2nd--->Interleukens (IL-4/5/6/13) are secreted from Th2 cells for B cell class switch

52

Where does B cells activation occur?

Lymph nodes/spleen

53

What do Th1 and Th2 cell secrete to inhibit each other?

Th1--->IFN gamma
Th2--->IL-10

54

How do CD8 cells kill?

Same as natural killer cells

55

What are the 2 types of antibody light chain?

Kappa and lambda

56

What are the 2 ends of a antibody and what do they consist?

Fab--->top--->bind to antigen
Fc--->bottom--->bind to APC--->determine if the antibody is IgA/G/A/D/E

57

What are the 4 ways to create antibody diversity?

1. Random recombination of genes:
light chain --- VJ recombination (v-variable/j-joined region)
heavy chain --- VDJ recombination (d-diversity region)
2. Random recombination of chains
3. Somatic hypermutation:
B cell stimulation--->B cell proliferation--->sloppy proofreading--->mutations--->more diverse antibodies produced
4. TdT add random nucleotide into the DNA

58

What are the 3 functions of antibody?

Opsonization/neutralization/complement activation

59

Which Ig can cross placenta and which is secreted as a dimer and which forms pentamer?

IgG/IgA/IgM

60

What cell does IgE bind to to initiate allergic reaction?

Mast cell

61

What are thymus independent and dependent antigens?

Independent (no peptide component)--->can not be presented to T cell (e.g. LPS of gram - rod)/stimulate IgM--->no immunologic memory
Dependent (has peptide component)--->allow antibody class switch--->has immunologic memory

62

What are the 2 IL secreted by macrophages that are responsible for fever during inflammation?

IL-1/IL-6

63

Which cytokine secreted by macrophages that is responsible for sepsis?

TNF-alpa

64

Which 5 main cytokines do macrophages secrete?

IL-1/IL-6/IL-8/IL-12/TNF-alpha

65

Wh does cytokines do Th1 and Th2 cell secrete?

Th1--->IL-2 (activate CD8 cells)/IL-3/IFN-gamma (activate macrophages)
Th2--->IL-4 (IgE and IgG production)/5 (IgA production)/10 (inhibitory)

66

What do IFN alpha and beta do?

They inhibit viral protein synthesis and are used to treat many viral infections

67

What are the 3 CD markers for B cells?

CD19/20/21

68

What are the CD marker in macrophage and what does it bind?

CD14--->bind to LPS--->release IL-1 and TNF-alpha

69

What is the CD marker for NK cell?

CD56

70

What does anergy of T cell mean?

Self reactive T cell bind to APC without costimulatory signal--->die

71

How does superantigen work? and does it relate to any specific antigen?

Cross link TCR with MHC class II--->over activation of T cells
No, it crosses link without any antigen

72

What are the 3 bacteria/1 virus/2 parasites that exhibit antigenic variation?

Salmonella/Borrelia/Gonorrhea
Influenza
Trypanosoma brucei rhodesiense
Trypanosome brucei gambiense

73

What is passive immunity and what infection do we use this to treat?

Inject preform antibodies/C. tetani, rabies, hep B, C. botulinum

74

What are the 3 pathways of complement activation?

Classical--->C1 attaches to IgG or IgM that is bound to the bacteria/virus
Lectin--->activated by lectin that binds to the mannose residuals on the surface of bacteria/fungi/viruses
Alternative--->activated by C3b binding to bacteria (mediated by properdin)

75

What does complement accomplish?

1. Makes C3b and mark it onto the target cell for opsonization
2. Makes and cleave C5 into C5a and C5b--->C5b combines with C6/7/8/9 to form membrane attack complex--->kill the bacteria

76

Which 3 anaphylatoxins do the 3 complement pathway produce and what do they do?

C3a/4a/5a--->promote inflammatory response

77

Deficiency in C1 inhibitor gives?

Hereditary angioedema

78

Deficiency in classical pathways give?

SLE and recurrent encapsulated bacteria

79

Complement deficiency pt is susceptible to what bacteria infections?

Neisseria/H. influenza/S. pneumoniae

80

Deficiency in alternative pathway indicate a deficiency in what enzyme? and what does it cause?

Properdin/fulminant N. menigitidis

81

What are the assay that are used to test the classical and alternative pathway?

CH50/AH50

82

When do you know the immunodeficiency is acquired?

When both CH50/AH50 are below 50% but still detectable

83

What is the process of antigen presenting?

Phagocytes eat a bacteria--->phagolysosome kills it--->MHC class II comes into it and pick up some antigen and go to the cell surface

84

What is the progression of B cell activation?

B cell is activated--->proliferation--->differentiation--->antibody production

85

What is TAP protein?

It's located in the ER to allow antigen in to be presented on MHC class I

86

Pt with MHC class I deficiency is susceptible to ___ infection and thus ___ vaccine?

Viral/live attenuated

87

What are the 3 bacteria/1 virus/2 parasites are known for their antigen variation?

Salmonella (2 different flagella)/Borrelia (change surface protein)/gonorrhea (pili protein)
Influenza
Trypanosoma brucei rhodesiense
Trypanosome brucei gambiense

88

What type of hypersensitivity is responsible for serum sickness (foreign protein) or arthus reaction (local reaction)?

Type III

89

What is the most common example of arthus reaction?

Tetanus vaccine

90

What kind of immune deficiency is more prone to type III hypersensitivity reaction?

C3 deficiency

91

What are common examples of type IV hypersensitivity?

Transplant rejection (excluding hyperacute)/PPD test/contact dermatitis

92

For type I hypersensitivity reaction, what is the first antibody produced?

IgM

93

Which cytokine would inhibit type IV hypersensitivity reaction?

IL-10

94

Which antibody is against which antibody in rheumoatoid arthritis?

IgM against IgG

95

Antimitochondria antibody is associated with which disease?

Primary biliary cirrhosis

96

What is B (boy) ruton's agammaglobulinemia?

X-linked/defect in BTK gene/B cell unable to differentiate

97

What is hyper IgM syndrome?

Defect in CD40L which is necessary for B cell class switch/B cell unable to differentiate into other Igs

98

DNA in Heterochromatin is methylated or acetylated? what about euchromatin?

Methylated/acetylated

99

What's the difference between nucleoside and nucleotide?

Nucleoside--->base/ribose
Nucleotide--->base/ribose/phosphate

100

Carbamoyl phosphate is involved in what 2 pathways?

De novo pyrimidine synthesis/urea cycle

101

Ornithine transcarbamylase deficiency has a build up of ___?

Carbamoyl phosphate

102

Thymidylate synthase depends on ___?

Folic acid

103

What does C3a and C5a activate?

Mast cell