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(DIT) Rapid Fire + 4/5 Stars > Immunology > Flashcards

Immunology Flashcards

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1
Q

Peyer’s patches

A

unencapsulated
in lamina propria and submucosa of ileum

Overlying epithelium - follicule associated epithelium

  • flattened w/ M (microfold) cells interspersed
  • take up antigens to basal side

Germinal center w/ B cells - IgA

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2
Q

Innate immune system

A

non specific
rapid response
no memory

macrophages
dendritic cells -APC - activate Th cells
neutrophils
mast cells
eosinophils
basophils
NK cells
complement proteins
skin and other barriers
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3
Q

adaptive immune system

A

very specific
memory
takes longer to get activated

T and B lymphocytes
circulating Abs

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4
Q

T cell markers

A

TCR - antigen specific
CD3
CD4 - Th –> MHCII
CD8- Tc –> MCHI

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5
Q

MHCI

A

all nucleated cells (Not on RBCs since no nucleus)

HLA-A, -B, -C

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6
Q

MHCII

A

APCs

HLA-DR, -DP, -DQ

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7
Q

Dendritic cells surface markers

A

MHC I, MHC II
B7 (CD 80/86) - costimulatory
CD40 - interact w/ T cells to further activate the APC

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8
Q

Dendritic cell function

A

Peripheral sentinel - immature or Ag capturing state

  • Phagocytosis
  • receptor-mediated endocytosis via clathrin coated pits
  • pinocytosis

migrate to LN via circulation to present to Th cells

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9
Q

Langerhans cells

A

in epidermal layers of skin

cutaneous associated lymphoid tissue - CALT

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10
Q

Interstitial dendritic cells

A

in interstitial spaces of all organs except brain

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11
Q

Langerhans cell histiocytosis

A

Excessive proliferation of Langerhans Cells
not good at APC

S100+
CD1a

Birbeck granules - tennis racket shape

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12
Q

Thymus organization

A

Outer - cortex - immature T cells

Middle - medulla - mature T cells

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13
Q

T cell positive and negative selection

A

Positive selection:
Cortex has MHC to test binding strength
Too strong or weak –> cell death
-survival signal keeps T cell alive –> specificity. Become only CD4 or CD8, lose the other marker

Negative selection:
Corticomedullary junction
-bind to self antigen –> apoptosis
–> naive T cell

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14
Q

Th0 cytokines to Th1 cells vs Th2 cells

A

Th0 release IL12 –> Th1
Th0 release IL4 –> Th2
Th0 release IL10 inhibits Th1

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15
Q

Th1 cells

A

stimulate macrophages and Tc
IL2 –> stimulate Tc and Th1, T reg prolif
IL3 - stimulate bone marrow stem cells (GM-CSF like)
IFN gamma –> activated Macrophages, suppresses Th2

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16
Q

Th2 cells

A

stimulate plasma cells to make Ab
IL4 - “BEG 4” - stimulates B cell prolif, IgE and IgG; induces Th0 –> Th2
IL5 - promote B cell growth, IgA production, stimulates eosinophils
IL 10 - inhibit Th1 cells and macrophages

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17
Q

B cell activation

A
  1. Th2 activated
  2. B cell endocytoses antigen bound to Ig presents to Th2
  3. Costimulatory signal CD40 on B binds to CD40L on Th2
  4. Th2 secretes IL4, IL5 –> proliferation of B cells and Ig class switching
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18
Q

Th cell activation

A

naive Th0 binds antigen from APC MHCII on TCR w/ CD4

costimulatory signal from B7 protein (CD80/86) bind CD 28

starts T cell producing cytokines

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19
Q

Tc activation

A

Tc binds antigen from APC/virus infected cell MCHI on TCR w/ CD8

CD28-B7 costimulatory

  • -> kills infected cells
  • -> clonal expansion
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20
Q

Cytokines produced by macrophages and dendritic cells

A

IL12

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21
Q

Function of Tc - CD8+ cells

A

bind MHCI on “self” cells
kills virus infected cells
kill cancer cells
kill transplant cells

release perforin and granzyme –> aopotosis

Fas-L activates Fas receptor –> apoptosis

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22
Q

Memory T cells

A

spleen and LN
inactive state
activated against pathogen
Allow live virus vaccines to induce life long immunity

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23
Q

T reg cells

A

inhibit B cells from producing Ab
inhibit Th and Tc cells
produce IL10
produce anti-inflammatory cytokines

If not working properly –> autoimmunity - atopic dz

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24
Q

FOXP3

A
  • on X Chr
  • transcription factor - controls development and function of Treg cells

mutations –> cant control immune system

IPEX syndrome

  • Immune dysreg: eczema
  • Polyendocrinopathy: T1DM, thyroiditis
  • Enteropathy - severe D, failure to thrive
  • X-linked
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25
NK cell
innate immune induce apoptosis in cells not expressing MHCI - down reg in virus infected and cancer cells activity enhanced by: IL12 IL2 IFN alpha and beta - secreted by virus infected cells Secrete IFN-gamma --> macrophage activation
26
NK cell surface markers
CD56 CD16 --> Ab dependent cell mediated cytotoxicity (ADCC) MHC I
27
CD16
NK cells - binds AB at constant region - -> ADCC also found on macrophages, neutrophils, monocytes
28
B cell surface markers
``` CD19 CD20 CD21 IgM IgD MHCI, MHC II B7 (CD80/86) CD40 --> activate B cell ```
29
B cell stimulation
stimulated by IL4, IL5 activated B cells 1. plasma cells --> Ab 2. memory B cell --> dormant
30
Macrophage surface markers
``` CD14 - binds LPS endotoxin on gram - (--> activation) CD16 MHC I, MHC II B7 CD40 --> more sensitive to IFN gamma ```
31
Passive immunity
preformed Abs - immediate immunity IgA in breast milk 21 day t1/2 -RSV - Palivizumab - Ab against RSV Rabies - rabies Ig shots
32
Active immunity
exposure to foreign Ag takes weeks to develop --> memory T/B cells Tetanus influenza MMR pneumococcal
33
Live vaccine
weak, attenuated infect cells to present to Tc - -> cellular immunity - -> memory Tc cells
34
Inactivated (Killed) vaccine
Ag to be presented - -> humoral immunity - -> memory Th cells - need booster doses
35
Attenuated virus vaccines
"ATTENtion! Please Vaccinate Young Infants w/ MMR Regularly" ``` Attenuated virus vaccines (live) Polio vaccine (sabin - oral) Varicella Yellow fever Intranasal Influenza MMR Rotavirus ``` avoid in immunocompromised or those close to them CD4>200 can give MMR, varicella, yellow fever
36
Inactivated virus vaccines
IM influenza HAV Rabies Salk polio -inected form
37
Egg based vaccines
influenza yellow fever (MMR - very small amount)
38
Thymus-dependent Ag
present peptides via MHC to T cells in thymus --> B cell activation better immune response and immunologic memory
39
Thymus independent Ag
``` LPS -non peptide Ag -cannot present to T cells in thymus no T cell response B cell response weaker --> weaker immune memory boosters needed ```
40
Bacterial vaccines
Toxins - tetanus toxoid Capsular polysaccharides -S pneumo, H flu killed bacteria - vibrio cholerae Live attenuated bacteria - Typhoid vaccine - BCG vaccine --> humoral response to T cell response since not infecting cells
41
C1 inhibitor
aka C1 esterase inhibitor inhibits cleavage of C1 starting point of classical pathway
42
Classic pathway of compliment activation
IgG or IgM bind Ag then binds C1 complement protein
43
Alternate pathway of compliment activation
molecules on surface microbe or spontaneously
44
Lectin pathway of compliment activation
mannose binding lectin binds mannose on surface of microbe
45
Membrane attack complex
C5b, C6-C9
46
Oposonizing proteins
C3b | IgG
47
Anaphylaxis complement
C3a, C5a
48
Complement stimulating mast cells and basophils
C3a
49
Complement responsible for neutrophil chemotaxis
C5a
50
Paroxysmal nocturnal hemoglobinuria (PNH)
Complement mediated damage of RBCs by MAC complex - deficient in Glycosylphosphotidylinositol (GPI) which anchors decay accelerating factor (DAF) (CD55) to plasma membrane - deficient MAC-inhibitory protein (CD59) Present with: - chronic intravascular hemolysis - hemosiderinuria - red urine - thrombosis Dx: Ham's test - RBC in acid lyse in low pH - diagnostic -Flow cytometry - CD55/CD59 not present Tx: transfusion warfarin Eculizumab - inhibits complement
51
Deficiency of C1 esterase inhibitor
Hereditary angioendema increased bradykinin never take ACEI with these --> higher bradykinin
52
Deficiency of C3
recurrent pyogenic sinus infections and respiratory tract infections -S. pneumo, H. flu increased susceptibility to type III hypersensitivity -esp glomerular nephritis - can't clear out immune complexes
53
Deficiency in any of the MAC complement components
susceptible to Neisseria bacteremia
54
Deficiency in Decay accelerating factor (DAF) - CD55
protects self from spontaneous activated complement | --> Paroxysmal nocturnal hemoglobinuria (PNH)
55
Function of spleen
Macrophages remove damaged RBCs and encapsulated bacteria sequesters and stores platelets and RBCs -Thrombocytopenia in splenomegaly - more platelets sequestered in larger spleen
56
Asplenia
risk recurrent infections sickle cell - autoinfarct Trauma hereditary spherocytosis - splenectomy to tx hemolytic anemia
57
Macrophage secreted cytokines
IL1, IL6, TNF alpha - acute phase reactants - mediate fever, ramp up immune system - TNFa - septic shock, recruit leukocytes IL12: Th0 --> Th1; activate NK cells IL8: neutrophil chemotaxis
58
Macrophage function
``` present Ag to T cells secrete cytokines Phagocytosis of bacteria opsonized w/ IgG or C3b -digests in lysosome -NADPH oxidase --> free radicals ``` Kill w/o phagocytosis via Ab-dependent cell mediated cytotoxicity (ADCC) Form granulomas - combine to form multinucleated giant cells -secrete Vit D
59
Mast cells
mucosa o fskin granules: histamine --> type I HSR Cromoyn blocks mast cell degranulation - asthma tx- inhaled - allergy nasal spray
60
Monocytes
Leave bone marrow for blood --> circulate 8-12 hours to mature --> migrate into tissues Skin, connective tissue: dendritic cells (histiocytes) --> LN Alveoli, intestines, spleen: macrophages - stay put Liver - kupffer cells Brain - microglia Bone - osteoclasts Joints - type A synoviocytes - clean synovial fluid (type B similar to fibroblasts, secrete hyaluronic acid)
61
Differential diagnosis for eosinophila
"CANADA-P" Collagen vascular disease (PAN, dermatomyositis) Atopic dz (allergies, asthma, Churg-Strauss, allergic bronchopulmonary aspergillosis) Neoplasm Adrenal insufficiency (addison dz) Drugs (NSAIDs, PCN, cephalosporins) Acute interstitial nephritis Parasites (Strongyloides, Ascaris --> Loeffler eosinophilic pneumonitis) Other causes: HIV, hyper IgE syndrome, coccidioidomycosis
62
IL1-IL5 function
"Hot T-Bone stEAk" ``` IL1: fever IL2: stimulates T cells IL3: stimulates Bone marrow IL4: stimulates switch to IgE and IgG IL5: stimulates switch to IgA, eosinophils ```
63
IFNa and IFNb as antiviral
help neighboring cells avoid virus infeciton inhibit cell protein synthesis encourage activation of ribonuclease that degrades viral mRNA activates NK cells
64
IFN gamma as antiviral
stimulate macrophages
65
Hyperacute rejection
within minutes to hours type II HSR -preformed Ab in host to donor Ag
66
Acute rejection
within 3 mo cell mediated Tc recognize foreign MHCI give immunosuppressants to block IL2
67
Chronic rejection
months to years T cell and Ab mediated Th cells generate inflammation via interleukins --> vascular damage and fibrosis Irreversible
68
Graft vs host disease
transplanted immune cells via bone marrow graft graft T cells proliferate and attack host as foreign maculopapular rash on neck, shoulders, ears, hands, trunk -can blister hemolysis, jaundice HSM Abd pain, N/V/D

(DIT) Rapid Fire + 4/5 Stars (162 decks)

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