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Y1 Respiratory > Immunology > Flashcards

Immunology Flashcards

1
Q

Examples of Type III hypersensitivity reactions

A

Farmers lung Pigeon Fanciers lungSystemic Lupus Erythematosus (SLE)

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2
Q

Where do macrophages reside?

A

Epithelial tissue i.e. lung, skin, gut

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3
Q

What happens to the complement proteins when they enter an inflammed tissue?

A

become activate by enzymatic cleavage thus activating the complement cascade

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4
Q

TRUE OR FALSE - phagocytes are particularly important in the defence against viruses and bacteria

A

FALSE - they are important in the defence against bacteria and fungi

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5
Q

microglia

A

macrophages in the brain

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6
Q

Most abundant immunoglobulin

A

IgG

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7
Q

What role do mast cells, basophils and eosinophils have in the immune response?

A

protect against large pathogens which cannot be phagocytosedalso play a role in mediating allergic reactions

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8
Q

Functions of Phagocytes (5)

A

Initiation and amplification of inflammatory response Scavenging of cellular and infectious debris Ingest and kill micro-organisms Resolution and repair Produce inflammatory molecules regulating immune system

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9
Q

IL-4 and IL-13 result in the production of further…

A

IgE

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10
Q

Cytotoxic T cells recognise which MHC class

A

Class I

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11
Q

G-CSF is

A

granulocyte colony stimulating factor which assist the maturation of neutrophils

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12
Q

Type III hypersensitivity reactions are the result of deposition or formation of ______ _____ in situ

A

immune complexes

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13
Q

Examples of Secondary Immune Deficiencies

A

HIV, Malignancy, nutrition disorder, infection, treatment interventions

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14
Q

What does the innate immune system recognise in infectious organisms?

A

PAMPs

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15
Q

where are monocytes found?

A

circulating the blood - move into peripheral tissues and differentiate into macrophages

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16
Q

Proteins of acquired immune response (1)

A

Antibodies

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17
Q

When a B lymphocyte is activated, what happens?

A

Undergoes complex genetic rearrangement, forms memory cells and plasma cells

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18
Q

Cytotoxic T cells are particularly important in defence against?

A

Viruses and Fungi

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19
Q

Describe the IL-12 –> IFNy network

A

infected macrophages produce IL-12IL-12 induces Th1 cells to secrete IFNyIFNy feeds back to macrophages and neutrophils Leads to production of TNF –> NADPH oxidaseOxidative pathways

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20
Q

What level of B cells would you expect in a DiGeorge patient?

A

Normal or increased B cells

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21
Q

Where is the primary lymphoid tissue?

A

Bone marrow and thymus gland

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22
Q

What are the subdivisions of T cells?

A

Helper T cellsCytotoxic T cells

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23
Q

How long does Type IV hypersensitivity take to develop?

A

24-48 hours

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24
Q

Phagocytes of the innate immune system (2)

A

Macrophagesneutrophils

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25
Q

Which cells are highly granular?

A

mast cells, basophils and eosinophils

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26
Q

What does the innate immune system recognise in infectious organisms?

A

PAMPs

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27
Q

What is IL-2 involved in?

A

ability to respond to other cytokines T cell and NK development production of B cells

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28
Q

What are the other cells of the immune system?

A

mast cells, eosinophils, basophils

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29
Q

What level of B cells would you expect in a DiGeorge patient?

A

Normal or increased B cells

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30
Q

What is lymphoedema?

A

a condition of localised fluid retention and tissue swelling caused by a compromised lymphatic system

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31
Q

Mast cells are key in protecting against what type of pathogen?

A

Parasites

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32
Q

Macrophages, Mast cells and NK cells all have the ability to produce what pro-inflammatory mediators?(8)(you don’t need to know them all but be aware of the main ones in bold)

A

* NO Prostaglandins Histamine Leukotrienes Cytokines and Chemokines * ROS * Glycopeptides * Anti-microbial peptides

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33
Q

What do mast cells, basophils and eosinophils produce?

A

histamine, heparin, cytokines - all associated with acute inflammation

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34
Q

Cells of Acquired Immune Response (2)

A

B Lymphocytes T lymphocytes

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35
Q

What are the kupffer cells?

A

macrophages in the liver

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36
Q

In phagocyte deficiencies it is not uncommon to see the following infections…

A

Common - staph. aureus Unusual - burkholderia cepacia Mycobacteria Fungi - candida, aspergillus

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37
Q

Example of a disease where there is failure of oxidative killing mechanisms

A

Chronic Granulomatous disease

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38
Q

What must occur for anaphylactic shock to initiate?

A

Systemic Type I response - rather than just at the point of entry

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39
Q

Th2 cells contribute to which hypersensitivity reaction?

A

Type 1 Hypersensitivity

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40
Q

CD8+ lymphocytes recognise peptides present on HLA class __ molecules?

A

I - 1

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41
Q

Th2 cells produce which cytokines?

A

IL-4 and IL-5

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42
Q

What do B cells transform into during an immune response?

A

plasma cells

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43
Q

Where do T lymphocytes arise from?

A

haematopoetic stem cells

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44
Q

CD4 cells differentiate into what upon activation?

A

Th1 and TH2 cells

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45
Q

Proteins of acquired immune response (1)

A

Antibodies

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46
Q

Classic C3 pathway for activation is initiated by?

A

Ig binding to antigen

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47
Q

Which immune system is NOT genetically encoded?

A

Acquired

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48
Q

CD8 cells are

A

cytotoxic T cells

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49
Q

What sort of recurrent infections would you expect to see in B cell deficiencies?

A

Bacterial Resp. tract, GI

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50
Q

IgE is found in

A

mast cells and basophils

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51
Q

Type III hypersensitivity reactions occur at the time of exposure - true or false?

A

false - around 4-8 hours after exposure

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52
Q

What are the soluble factors of the immune response?

A

AntibodiesComplements system proteinsCytokinesAcute Phase proteins

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53
Q

What will happen upon prolonged exposure to antigen in Type IV hypersensitivity reactions?

A

progressive tissue damage and fibrosis

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54
Q

Features that may indicate a primary immune deficiency (6)

A

Weight loss/Failure to thrive Severe skin rashes Chronic diarrhoea Mouth Ulceration Unusual Autoimmune Disease Family History

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55
Q

The CD4+ lymphocyte recognises peptides present on HLA class __ molecules?

A

II - 2

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56
Q

What is the secondary lymphoid tissue?

A

site where the adaptive immune responses are initiated

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57
Q

What is IL-2 involved in?

A

ability to respond to other cytokinesT cell and NK developmentproduction of B cells

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58
Q

What controls cell migration?

A

chemokines

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59
Q

Reactions are triggered by what sequence of events in Type II hypersensitivity?

A

Antibody binding to antigen on cell surface resulting in cell lysis and inflammatory response at the site

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60
Q

In reticular dysgenesis, a lack of both innate and adaptive immune response is due to a failure of ______ ______ differentiating along a ______ lineage

A

stem cells, myeloid

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61
Q

DiGeorge patients suffer from immune deficiencies, which organ fails to develop sufficiently?

A

thymus

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62
Q

Four functions of macrophages

A

* ingest and kill EC pathogens * regulate inflammatory responses * promote tissue repair and wound healing * antigen presentation

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63
Q

Cells that are in the innate immune system

A

Mast cells, macrophages, NK cells, Neutrophils, Complement

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64
Q

When a B lymphocyte is activated, what happens?

A

Undergoes complex genetic rearrangement, forms memory cells and plasma cells

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65
Q

Why does a loss of function of a receptor or antigen recognition marker not cause severe disease?

A

there is usually other receptors or antigens which can be picked up

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66
Q

Proteins of the innate immune system (3)

A

ComplementCytokinesAcute Phase Proteins

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67
Q

3 phases of the innate immune system:

A

Recognition Activation Effector

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68
Q

What does common variable Immune deficiency indicate?

A

low levels of IgG, IgA, IgE recurrent bacterial infections autoimmune diseases

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69
Q

Kostmann syndrome is a rare autosomal ______ disorder

A

recessive

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70
Q

The CD4+ T Lymphocyte has immunoregulatory functions - give some examples (3)

A

Provides co-stimulatory signals for CD8 and B lymphocytes Produces cytokines Regulates other lymphocytes and phagocytes

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71
Q

Is it advisable to give vaccines to X-linked SCID patients?

A

No - there is a defect in acquired immune response so could actually produce more problems than solutions

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72
Q

IL-10 serves what purpose in the immune system?

A

Acts as an anti-inflammatory cytokine

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73
Q

Largest immunoglobulin

A

IgM

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74
Q

T cells mature in the ______ gland

A

thymus

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75
Q

The CD4+ lymphocyte recognises peptides present on HLA class __ molecules?

A

II - 2

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76
Q

Where are basophils and eosinophils found?

A

circulating the blood

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77
Q

Special feature of IgM

A

first molecule to appear in immune response, produced by immature B cells

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78
Q

Function of antibodies (3)

A

Identification of pathogensRecruitment of other immune system components for pathogen removalNeutralisation of toxins

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79
Q

Macrophages develop from what type of cell?

A

Monocytes

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80
Q

Kostmann syndrome is a rare autosomal ______ disorder

A

recessive

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81
Q

CD4 cells are

A

T helper cells

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82
Q

What is the other name for neutrophils?

A

polymorphs

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83
Q

What type of cells are cleared by macrophages?

A

Apoptotic

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84
Q

Which immune system is NOT genetically encoded?

A

Acquired

85
Q

In a condition where issues arise in the ability to bind endothelial adhesion markers, you may see…

A

increased levels of neutrophils with recurrent bacterial and fungal infections.There can be deep infections with no pus formation

86
Q

CD8+ lymphocytes recognise peptides present on HLA class __ molecules?

A

I - 1

87
Q

Give some examples of secondary lymphoid tissue

A

spleen, lymph nodes, lymphatic system

88
Q

What are the two methods of activating an innate immune cells response?

A

direct contact between receptors indirect contact with cytokines

89
Q

Where do dendritic cells migrate once mature?

A

secondary lymphoid tissue

90
Q

Where do mast cells reside?

A

tissues and mucosal surfaces

91
Q

TRUE OR FALSE - phagocytes are important in reducing the numbers of infections as can be seen in stem cell transplant recipients

A

TRUE

92
Q

X-Linked SCID is involved with a mutation in which cytokine receptor?

A

IL-2

93
Q

Where are mature B lymphocytes typically found? (3)

A

bone marrow, lymphoid tissue, spleen

94
Q

G-CSF is

A

granulocyte colony stimulating factor which assist the maturation of neutrophils

95
Q

Where are antibodies produced?

A

antigen activated B-cells

96
Q

Why does a loss of function of a receptor or antigen recognition marker not cause severe disease?

A

there is usually other receptors or antigens which can be picked up

97
Q

TRUE OR FALSE - phagocytes are important in reducing the numbers of infections as can be seen in stem cell transplant recipients

A

TRUE

98
Q

What is the function of CRP?

A

Opsonisation

99
Q

Proteins of the innate immune system (3)

A

Complement Cytokines Acute Phase Proteins

100
Q

T helper cells recognise which MHC class

A

Class II

101
Q

TRUE or FALSE - T lymphocytes defend against intracellular pathogens and bacteria

A

FALSE - against intracellular pathogens and viruses

102
Q

IgM is found in the ….

A

plasma

103
Q

With regards to immune deficiency, what does SPUR refer to?

A

S - serious infectionsP - Persistent infectionsU - Unusual infectionsR - Recurrent Infections

104
Q

B cells mature in the ____ _____

A

bone marrow

105
Q

TRUE or FALSE - T lymphocytes defend against intracellular pathogens and bacteria

A

FALSE - against intracellular pathogens and viruses

106
Q

CD4 is expressed on…

A

Helper T cells

107
Q

What are the additional functions of macrophages?

A

limiting inflammation, tissue repair and wound healing and antigen presentation

108
Q

What are dendritic cells?

A

immature cells present in the peripheral tissues and phagocytose antigens when they mature

109
Q

What is the lymphatic system?

A

a system of vessels draining fluid from body tissues with lymph nodes positioned regularly to trap pathogens

110
Q

Examples of reactions experienced in patient of Type I hypersensitivity

A

Swollen and leaky mucosaContraction of smooth muscle - bronchospasmGlandular production of mucus Congestion

111
Q

Cells of Acquired Immune Response (2)

A

B LymphocytesT lymphocytes

112
Q

Which cells mediate cell-mediated immunity?

A

leukocytes

113
Q

Cells in the Innate Immune system (4)

A

MacrophagesNeutrophilsMast cellsNK cells

114
Q

Normal pathway stimulated in people without Type I hypersensitivity on exposure to antigen?

A

IgG or IgA

115
Q

B cells defend against intracellular pathogens True/False?

A

False - they defend against extracellular pathogens

116
Q

Defects in IL-12:IFNy network may increase susceptibility to…

A

mycobacterial infections and IC bacteria

117
Q

What does the innate immune system stimulate?

A

Rapid clearance of micro-organisms Acquired Immune response

118
Q

C3a and C5a can act as what?

A

chemotaxins

119
Q

Type IV hypersensitivity is mediated by what cell type?

A

T lymphocytes

120
Q

Examples of a type II hypersensitivity reaction

A

Good Pasture SyndromeHaemolytic anemiaTransfusion reactions

121
Q

Where are mature B lymphocytes typically found? (3)

A

bone marrow, lymphoid tissue, spleen

122
Q

Type I hypersensitivity is mediated by what region of the immune system?

A

IgE on mast cells, Th2 cells

123
Q

What does common variable Immune deficiency indicate?

A

low levels of IgG, IgA, IgE recurrent bacterial infectionsautoimmune diseases

124
Q

Th1 cells produce which cytokine?

A

Interferon

125
Q

Interferon activates what cell type?

A

macrophages

126
Q

C3b can also act as what?

A

an opsonin

127
Q

consequences of chronic granulomatous disease

A

failure to degrade chemoattractants and antigens as well as disease –> accumulation of neutrophils, macrophages and lymphocytes

128
Q

What is the role of the dendritic cell in the secondary lymphoid tissue?

A

antigen presentation to T cells

129
Q

Defects in IL-12:IFNy network may increase susceptibility to…

A

mycobacterial infections and IC bacteria

130
Q

Reticular Dysgenesis is characterised by an absence of _____ and other myeloid cells with almost complete deficiency of _______ in peripheral blood.

A

neutrophils, lymphocytes

131
Q

Which cells provide immunity to extracellular bacteria, fungi and parasites?

A

neutrophils, macrophages, complement system, antibodies, cytotoxic T cells, NK cells

132
Q

What do NK cells target?

A

tumour cells, virally infected cells, antibody bound cells and pathogens

133
Q

B cells differentiate into _____ cells

A

plasma cells

134
Q

Type III hypersensitivity reactions may be local or generalised - true or false

A

true

135
Q

NK cells specifically kill infected cells and cancer cells which are no longer expressing what key molecule?

A

MHC Class I

136
Q

The main difference between primary and secondary immune deficiencies is…

A

that primary only tends to involve one component of the immune system, secondary tends to involve multiple

137
Q

What is the role of cytokines in the immune response?

A

to modulate the behaviour of cells and thus co-ordinating the immune system

138
Q

Phagocytes of the innate immune system (2)

A

Macrophages neutrophils

139
Q

Type III hypersensitivity reactions result in the accumulation of which cell types?

A

neutrophils, macrophages

140
Q

In reticular dysgenesis, a lack of both innate and adaptive immune response is due to a failure of ______ ______ differentiating along a ______ lineage

A

stem cells, myeloid

141
Q

What are NK cells?

A

large granular lymphocytes

142
Q

The B cell receptor is composed mainly of monomeric Ig__

A

M

143
Q

MHC Class II regulates NK cells - T/F?

A

False - NK cells are regulated by MHC Class I proteins which disappear if a cell is infected

144
Q

Second most abundant immunoglobulin

A

IgA

145
Q

Describe the IL-12 –> IFNy network

A

infected macrophages produce IL-12 IL-12 induces Th1 cells to secrete IFNy IFNy feeds back to macrophages and neutrophils Leads to production of TNF –> NADPH oxidase Oxidative pathways

146
Q

What is the purpose of phagocytic cells?

A

they ingest and clear debris from the body including dead/dying apoptotic cells

147
Q

CD8 is expressed on…

A

Cytotoxic T cells

148
Q

Identify the cell

A

Eosinophil * Bilobar nucleus * secretory vesicles ready to release toxins

149
Q

Effects of the innate immune system on blood flow (4)

A

dilation of small blood vessels Increased and slowed blood flow cell accumulation increased permeability

150
Q

T cells defend against intracellular pathogens True/False?

A

True - they defend against intracellular pathogens such as viruses or mycobacteria

151
Q

Kostmann syndrome is a severe, chronic _____ where normal levels of ______ are >3000µL and in sufferers is <200µL

A

neutropenia, neutrophils

152
Q

In Type I hypersensitivity reactions, Th2 cells produce which cytokines important to the response?

A

IL-4 and IL-13

153
Q

CD8+ lymphocytes are specialised killer cells…give examples (3)

A

Production of pore-forming molecules - perforintriggering of apoptosis of targetsecretion of cytokines i.e. IFNy

154
Q

What are the key features of the immune system?

A

Ability to identify self and non-self pathogensAbility to modify the response to different pathogensAbility to actively promote tissue repairAbility to remember the pathogens it encounters

155
Q

Is it advisable to give vaccines to X-linked SCID patients?

A

No - there is a defect in acquired immune response so could actually produce more problems than solutions

156
Q

What do pathogens express which allow them to be identified?

A

Pathogen Associated Molecular Patterns (PAMPs)

157
Q

How many signals are required for complete B cell activation?

A

2 - one from antigen binding, another from T cell binding or complement proteins

158
Q

What are the key phagocytes?

A

NeutrophilsMonocytesMacrophagesDendritic cells

159
Q

consequences of chronic granulomatous disease

A

failure to degrade chemoattractants and antigens as well as disease –> accumulation of neutrophils, macrophages and lymphocytes

160
Q

What does the innate immune system stimulate?

A

Rapid clearance of micro-organismsAcquired Immune response

161
Q

Type I hypersensitivity leads to…

A

Asthma, allergies, hayfever and anaphylactic shock

162
Q

phagocytic cells are an important source of cytokines - t/f?

A

true

163
Q

The main difference between primary and secondary immune deficiencies is…

A

that primary only tends to involve one component of the immune system, secondary tends to involve multiple

164
Q

What is the complement system?

A

a family of approx. 30 proteins produced in the liver and circulating the blood as inactive precursors

165
Q

Suggest an anti-viral cytokine

A

IFN (interferons)

166
Q

In phagocyte deficiencies it is not uncommon to see the following infections…

A

Common - staph. aureusUnusual - burkholderia cepaciaMycobacteriaFungi - candida, aspergillus

167
Q

What sort of recurrent infections would you expect to see in B cell deficiencies?

A

Bacterial Resp. tract, GI

168
Q

Functions of Phagocytes (5)

A

Initiation and amplification of inflammatory responseScavenging of cellular and infectious debrisIngest and kill micro-organismsResolution and repairProduce inflammatory molecules regulating immune system

169
Q

Where do T lymphocytes arise from?

A

haematopoetic stem cells

170
Q

Where are mast cells found?

A

in tissues and mucosal surfaces exposed to the outside environment

171
Q

Test for chronic granulomatous disease?

A

Nitroblue tetrazolium test –> looking for release of H2O2

172
Q

Suggest a pro-inflammatory cytokine

A

TNFa (tumour necrosis factor alpha)

173
Q

Function of antibodies (3)

A

Identification of pathogens Recruitment of other immune system components for pathogen removal Neutralisation of toxins

174
Q

Examples of Secondary Immune Deficiencies

A

HIV, Malignancy, nutrition disorder, infection, treatment interventions

175
Q

Common antibodies involved in Type II hypersensitivity

A

IgG and IgM

176
Q

Which parts of the immune system work as anti-virals?

A

Cytokines, Cytotoxic T cells, Antibodies, NK Cell

177
Q

Alveolar macrophages

A

Macrophages in the lung

178
Q

Features that may indicate a primary immune deficiency (6)

A

Weight loss/Failure to thriveSevere skin rashesChronic diarrhoeaMouth UlcerationUnusual Autoimmune DiseaseFamily History

179
Q

X-Linked SCID is involved with a mutation in which cytokine receptor?

A

IL-2

180
Q

Which cells help provide immunity against Helminths?

A

eosinophils, mast cells, basophils and antibodies (thus also B cells)

181
Q

Innate immune cells identify PAMPs via…

A

Pattern-Recognition-Receptors PRRs

182
Q

The appearance of what molecule on the cell surface indicates that a cell is undergoing apoptosis and is ready to be engulfed?

A

Phosphatidyl serine

183
Q

C3b activates the rest of the complement cascade which is…

A

C5 - C9

184
Q

What are cytokines?

A

small proteins and peptides that are produced in response to infection, inflammation and tissue damage

185
Q

Kostmann syndrome is a severe, chronic _____ where normal levels of ______ are >3000µL and in sufferers is <200µL

A

neutropenia, neutrophils

186
Q

Mesangial cells

A

macrophages in the kidney

187
Q

With regards to immune deficiency, what does SPUR refer to?

A

S - serious infections P - Persistent infections U - Unusual infections R - Recurrent Infections

188
Q

Cells in the Innate Immune system (4)

A

Macrophages Neutrophils Mast cells NK cells

189
Q

Reticular Dysgenesis is characterised by an absence of _____ and other myeloid cells with almost complete deficiency of _______ in peripheral blood.

A

neutrophils, lymphocytes

190
Q

What are the key lymphocytes?

A

T CellsB CellsNK Cells

191
Q

CD8+ lymphocytes are specialised killer cells…give examples (3)

A

Production of pore-forming molecules - perforin triggering of apoptosis of target secretion of cytokines i.e. IFNy

192
Q

What are antibodies?

A

proteins that are produced in response to an antigen and bind specifically to that antigen

193
Q

TRUE OR FALSE - phagocytes are particularly important in the defence against viruses and bacteria

A

FALSE - they are important in the defence against bacteria and fungi

194
Q

Cytokines produced by phagocytes can have systemic as well as local effect. Give an example of a systemic effect

A

Production of CRP from liver cells

195
Q

Immune complexes activate ______ ______ by the classical pathway

A

complement cascade

196
Q

T cells are responsible for

A

cell-mediated immunity

197
Q

Most common location for IgA

A

Secretions and mucus

198
Q

Which cells provide immunity to Intracellular Bacteria and parasites?

A

Ab, Cytotoxic T cells, NK cells

199
Q

Type IV hypersensitivity reactions are also known as?

A

delayed hypersensitivity reactions

200
Q

Where can mature B and T cells be found?

A

circulating the blood, lymph and secondary lymphoid tissues

201
Q

What are macrophages?

A

long-lived tissue resident phagocytes

202
Q

What is an antigen?

A

any substance which can stimulate an adaptive immune response i.e. lipids, proteins, carbohydrates

203
Q

Example of a disease where there is failure of oxidative killing mechanisms

A

Chronic Granulomatous disease

204
Q

The CD4+ T Lymphocyte has immunoregulatory functions - give some examples (3)

A

Provides co-stimulatory signals for CD8 and B lymphocytesProduces cytokinesRegulates other lymphocytes and phagocytes

205
Q

Type II reactions are more common in what sort of conditions?

A

Autoimmune conditions

206
Q

DiGeorge patients suffer from immune deficiencies, which organ fails to develop sufficiently?

A

thymus

207
Q

In a condition where issues arise in the ability to bind endothelial adhesion markers, you may see…

A

increased levels of neutrophils with recurrent bacterial and fungal infections. There can be deep infections with no pus formation

208
Q

Test for chronic granulomatous disease?

A

Nitroblue tetrazolium test –> looking for release of H2O2

209
Q

Ig which can cross the placenta?

A

IgG

Y1 Respiratory (20 decks)

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