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Flashcards in Immunology Deck (209):
1

Examples of Type III hypersensitivity reactions

Farmers lung Pigeon Fanciers lungSystemic Lupus Erythematosus (SLE)

2

Where do macrophages reside?

Epithelial tissue i.e. lung, skin, gut

3

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

become activate by enzymatic cleavage thus activating the complement cascade

4

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

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

5

microglia

macrophages in the brain

6

Most abundant immunoglobulin

IgG

7

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

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

8

Functions of Phagocytes (5)

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

9

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

IgE

10

Cytotoxic T cells recognise which MHC class

Class I

11

G-CSF is

granulocyte colony stimulating factor which assist the maturation of neutrophils

12

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

immune complexes

13

Examples of Secondary Immune Deficiencies

HIV, Malignancy, nutrition disorder, infection, treatment interventions

14

What does the innate immune system recognise in infectious organisms?

PAMPs

15

where are monocytes found?

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

16

Proteins of acquired immune response (1)

Antibodies

17

When a B lymphocyte is activated, what happens?

Undergoes complex genetic rearrangement, forms memory cells and plasma cells

18

Cytotoxic T cells are particularly important in defence against?

Viruses and Fungi

19

Describe the IL-12 --> IFNy network

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

20

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

Normal or increased B cells

21

Where is the primary lymphoid tissue?

Bone marrow and thymus gland

22

What are the subdivisions of T cells?

Helper T cellsCytotoxic T cells

23

How long does Type IV hypersensitivity take to develop?

24-48 hours

24

Phagocytes of the innate immune system (2)

Macrophagesneutrophils

25

Which cells are highly granular?

mast cells, basophils and eosinophils

26

What does the innate immune system recognise in infectious organisms?

PAMPs

27

What is IL-2 involved in?

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

28

What are the other cells of the immune system?

mast cells, eosinophils, basophils

29

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

Normal or increased B cells

30

What is lymphoedema?

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

31

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

Parasites

32

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)

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

33

What do mast cells, basophils and eosinophils produce?

histamine, heparin, cytokines - all associated with acute inflammation

34

Cells of Acquired Immune Response (2)

B Lymphocytes T lymphocytes

35

What are the kupffer cells?

macrophages in the liver

36

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

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

37

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

Chronic Granulomatous disease

38

What must occur for anaphylactic shock to initiate?

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

39

Th2 cells contribute to which hypersensitivity reaction?

Type 1 Hypersensitivity

40

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

I - 1

41

Th2 cells produce which cytokines?

IL-4 and IL-5

42

What do B cells transform into during an immune response?

plasma cells

43

Where do T lymphocytes arise from?

haematopoetic stem cells

44

CD4 cells differentiate into what upon activation?

Th1 and TH2 cells

45

Proteins of acquired immune response (1)

Antibodies

46

Classic C3 pathway for activation is initiated by?

Ig binding to antigen

47

Which immune system is NOT genetically encoded?

Acquired

48

CD8 cells are

cytotoxic T cells

49

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

Bacterial Resp. tract, GI

50

IgE is found in

mast cells and basophils

51

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

false - around 4-8 hours after exposure

52

What are the soluble factors of the immune response?

AntibodiesComplements system proteinsCytokinesAcute Phase proteins

53

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

progressive tissue damage and fibrosis

54

Features that may indicate a primary immune deficiency (6)

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

55

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

II - 2

56

What is the secondary lymphoid tissue?

site where the adaptive immune responses are initiated

57

What is IL-2 involved in?

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

58

What controls cell migration?

chemokines

59

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

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

60

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

stem cells, myeloid

61

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

thymus

62

Four functions of macrophages 

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

63

Cells that are in the innate immune system

Mast cells, macrophages, NK cells, Neutrophils, Complement

64

When a B lymphocyte is activated, what happens?

Undergoes complex genetic rearrangement, forms memory cells and plasma cells

65

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

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

66

Proteins of the innate immune system (3)

ComplementCytokinesAcute Phase Proteins

67

3 phases of the innate immune system:

Recognition Activation Effector

68

What does common variable Immune deficiency indicate?

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

69

Kostmann syndrome is a rare autosomal ______ disorder

recessive

70

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

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

71

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

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

72

IL-10 serves what purpose in the immune system?

Acts as an anti-inflammatory cytokine

73

Largest immunoglobulin

IgM

74

T cells mature in the ______ gland

thymus

75

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

II - 2

76

Where are basophils and eosinophils found?

circulating the blood

77

Special feature of IgM

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

78

Function of antibodies (3)

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

79

Macrophages develop from what type of cell?

Monocytes

80

Kostmann syndrome is a rare autosomal ______ disorder

recessive

81

CD4 cells are

T helper cells

82

What is the other name for neutrophils?

polymorphs

83

What type of cells are cleared by macrophages?

Apoptotic

84

Which immune system is NOT genetically encoded?

Acquired

85

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

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

86

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

I - 1

87

Give some examples of secondary lymphoid tissue

spleen, lymph nodes, lymphatic system

88

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

direct contact between receptors indirect contact with cytokines

89

Where do dendritic cells migrate once mature?

secondary lymphoid tissue

90

Where do mast cells reside?

tissues and mucosal surfaces

91

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

TRUE

92

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

IL-2

93

Where are mature B lymphocytes typically found? (3)

bone marrow, lymphoid tissue, spleen

94

G-CSF is

granulocyte colony stimulating factor which assist the maturation of neutrophils

95

Where are antibodies produced?

antigen activated B-cells

96

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

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

97

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

TRUE

98

What is the function of CRP?

Opsonisation

99

Proteins of the innate immune system (3)

Complement Cytokines Acute Phase Proteins

100

T helper cells recognise which MHC class

Class II

101

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

FALSE - against intracellular pathogens and viruses

102

IgM is found in the ....

plasma

103

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

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

104

B cells mature in the ____ _____

bone marrow

105

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

FALSE - against intracellular pathogens and viruses

106

CD4 is expressed on...

Helper T cells

107

What are the additional functions of macrophages?

limiting inflammation, tissue repair and wound healing and antigen presentation

108

What are dendritic cells?

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

109

What is the lymphatic system?

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

110

Examples of reactions experienced in patient of Type I hypersensitivity

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

111

Cells of Acquired Immune Response (2)

B LymphocytesT lymphocytes

112

Which cells mediate cell-mediated immunity?

leukocytes

113

Cells in the Innate Immune system (4)

MacrophagesNeutrophilsMast cellsNK cells

114

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

IgG or IgA

115

B cells defend against intracellular pathogens True/False?

False - they defend against extracellular pathogens

116

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

mycobacterial infections and IC bacteria

117

What does the innate immune system stimulate?

Rapid clearance of micro-organisms Acquired Immune response

118

C3a and C5a can act as what?

chemotaxins

119

Type IV hypersensitivity is mediated by what cell type?

T lymphocytes

120

Examples of a type II hypersensitivity reaction

Good Pasture SyndromeHaemolytic anemiaTransfusion reactions

121

Where are mature B lymphocytes typically found? (3)

bone marrow, lymphoid tissue, spleen

122

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

IgE on mast cells, Th2 cells

123

What does common variable Immune deficiency indicate?

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

124

Th1 cells produce which cytokine?

Interferon

125

Interferon activates what cell type?

macrophages

126

C3b can also act as what?

an opsonin

127

consequences of chronic granulomatous disease

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

128

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

antigen presentation to T cells

129

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

mycobacterial infections and IC bacteria

130

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

neutrophils, lymphocytes

131

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

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

132

What do NK cells target?

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

133

B cells differentiate into _____ cells

plasma cells

134

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

true

135

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

MHC Class I

136

The main difference between primary and secondary immune deficiencies is...

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

137

What is the role of cytokines in the immune response?

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

138

Phagocytes of the innate immune system (2)

Macrophages neutrophils

139

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

neutrophils, macrophages

140

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

stem cells, myeloid

141

What are NK cells?

large granular lymphocytes

142

The B cell receptor is composed mainly of monomeric Ig__

M

143

MHC Class II regulates NK cells - T/F?

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

144

Second most abundant immunoglobulin

IgA

145

Describe the IL-12 --> IFNy network

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

What is the purpose of phagocytic cells?

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

147

CD8 is expressed on...

Cytotoxic T cells

148

Identify the cell

Eosinophil * Bilobar nucleus * secretory vesicles ready to release toxins

149

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

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

150

T cells defend against intracellular pathogens True/False?

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

151

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

neutropenia, neutrophils

152

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

IL-4 and IL-13

153

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

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

154

What are the key features of the immune system?

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

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

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

156

What do pathogens express which allow them to be identified?

Pathogen Associated Molecular Patterns (PAMPs)

157

How many signals are required for complete B cell activation?

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

158

What are the key phagocytes?

NeutrophilsMonocytesMacrophagesDendritic cells

159

consequences of chronic granulomatous disease

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

160

What does the innate immune system stimulate?

Rapid clearance of micro-organismsAcquired Immune response

161

Type I hypersensitivity leads to...

Asthma, allergies, hayfever and anaphylactic shock

162

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

true

163

The main difference between primary and secondary immune deficiencies is...

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

164

What is the complement system?

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

165

Suggest an anti-viral cytokine

IFN (interferons)

166

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

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

167

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

Bacterial Resp. tract, GI

168

Functions of Phagocytes (5)

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

169

Where do T lymphocytes arise from?

haematopoetic stem cells

170

Where are mast cells found?

in tissues and mucosal surfaces exposed to the outside environment

171

Test for chronic granulomatous disease?

Nitroblue tetrazolium test --> looking for release of H2O2

172

Suggest a pro-inflammatory cytokine

TNFa (tumour necrosis factor alpha)

173

Function of antibodies (3)

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

174

Examples of Secondary Immune Deficiencies

HIV, Malignancy, nutrition disorder, infection, treatment interventions

175

Common antibodies involved in Type II hypersensitivity

IgG and IgM

176

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

Cytokines, Cytotoxic T cells, Antibodies, NK Cell

177

Alveolar macrophages

Macrophages in the lung

178

Features that may indicate a primary immune deficiency (6)

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

179

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

IL-2

180

Which cells help provide immunity against Helminths?

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

181

Innate immune cells identify PAMPs via...

Pattern-Recognition-Receptors PRRs

182

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

Phosphatidyl serine 

183

C3b activates the rest of the complement cascade which is...

C5 - C9

184

What are cytokines?

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

185

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

neutropenia, neutrophils

186

Mesangial cells

macrophages in the kidney

187

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

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

188

Cells in the Innate Immune system (4)

Macrophages Neutrophils Mast cells NK cells

189

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

neutrophils, lymphocytes

190

What are the key lymphocytes?

T CellsB CellsNK Cells

191

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

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

192

What are antibodies?

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

193

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

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

194

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

Production of CRP from liver cells

195

Immune complexes activate ______ ______ by the classical pathway

complement cascade

196

T cells are responsible for

cell-mediated immunity

197

Most common location for IgA

Secretions and mucus

198

Which cells provide immunity to Intracellular Bacteria and parasites?

Ab, Cytotoxic T cells, NK cells

199

Type IV hypersensitivity reactions are also known as?

delayed hypersensitivity reactions

200

Where can mature B and T cells be found?

circulating the blood, lymph and secondary lymphoid tissues

201

What are macrophages?

long-lived tissue resident phagocytes

202

What is an antigen?

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

203

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

Chronic Granulomatous disease

204

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

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

205

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

Autoimmune conditions

206

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

thymus

207

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

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

208

Test for chronic granulomatous disease?

Nitroblue tetrazolium test --> looking for release of H2O2

209

Ig which can cross the placenta?

IgG