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Immunology Flashcards

1
Q

Cells that are in the innate immune system

A

Mast cells, macrophages, NK cells, Neutrophils, Complement

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2
Q

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

A

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

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3
Q

Features that may indicate a primary immune deficiency (6)

A

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

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4
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

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5
Q

Examples of Secondary Immune Deficiencies

A

HIV, Malignancy, nutrition disorder, infection, treatment interventions

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6
Q

Cells in the Innate Immune system (4)

A

MacrophagesNeutrophilsMast cellsNK cells

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7
Q

Phagocytes of the innate immune system (2)

A

Macrophagesneutrophils

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8
Q

Proteins of the innate immune system (3)

A

ComplementCytokinesAcute Phase Proteins

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9
Q

What does the innate immune system stimulate?

A

Rapid clearance of micro-organismsAcquired Immune response

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10
Q

What does the innate immune system recognise in infectious organisms?

A

PAMPs

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11
Q

Cells of Acquired Immune Response (2)

A

B LymphocytesT lymphocytes

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12
Q

Proteins of acquired immune response (1)

A

Antibodies

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13
Q

Which immune system is NOT genetically encoded?

A

Acquired

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14
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

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15
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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16
Q

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

A

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

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17
Q

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

A

TRUE

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18
Q

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

A

neutrophils, lymphocytes

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19
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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20
Q

Kostmann syndrome is a rare autosomal ______ disorder

A

recessive

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21
Q

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

A

neutropenia, neutrophils

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22
Q

G-CSF is

A

granulocyte colony stimulating factor which assist the maturation of neutrophils

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23
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

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24
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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25
Q

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

A

Chronic Granulomatous disease

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26
Q

consequences of chronic granulomatous disease

A

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

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27
Q

Test for chronic granulomatous disease?

A

Nitroblue tetrazolium test –> looking for release of H2O2

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28
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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29
Q

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

A

mycobacterial infections and IC bacteria

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30
Q

Where do T lymphocytes arise from?

A

haematopoetic stem cells

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31
Q

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

A

FALSE - against intracellular pathogens and viruses

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32
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

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33
Q

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

A

II - 2

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34
Q

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

A

I - 1

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35
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

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36
Q

Where are mature B lymphocytes typically found? (3)

A

bone marrow, lymphoid tissue, spleen

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37
Q

When a B lymphocyte is activated, what happens?

A

Undergoes complex genetic rearrangement, forms memory cells and plasma cells

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38
Q

Function of antibodies (3)

A

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

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39
Q

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

A

IL-2

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40
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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41
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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42
Q

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

A

thymus

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43
Q

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

A

Normal or increased B cells

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44
Q

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

A

Bacterial Resp. tract, GI

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45
Q

What does common variable Immune deficiency indicate?

A

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

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46
Q

T cells mature in the ______ gland

A

thymus

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47
Q

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

A

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

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48
Q

Where are basophils and eosinophils found?

A

circulating the blood

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49
Q

Th2 cells contribute to which hypersensitivity reaction?

A

Type 1 Hypersensitivity

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50
Q

T helper cells recognise which MHC class

A

Class II

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51
Q

What is the lymphatic system?

A

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

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52
Q

What are the kupffer cells?

A

macrophages in the liver

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53
Q

Most abundant immunoglobulin

A

IgG

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54
Q

Common antibodies involved in Type II hypersensitivity

A

IgG and IgM

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55
Q

B cells differentiate into _____ cells

A

plasma cells

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56
Q

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

A

neutrophils, macrophages

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57
Q

What is the complement system?

A

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

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58
Q

B cells mature in the ____ _____

A

bone marrow

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59
Q

What is an antigen?

A

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

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60
Q

where are monocytes found?

A

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

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61
Q

CD4 cells differentiate into what upon activation?

A

Th1 and TH2 cells

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62
Q

What is the function of CRP?

A

Opsonisation

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63
Q

What are antibodies?

A

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

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64
Q

C3b activates the rest of the complement cascade which is…

A

C5 - C9

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65
Q

Ig which can cross the placenta?

A

IgG

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66
Q

What is the purpose of phagocytic cells?

A

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

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67
Q

Cytotoxic T cells recognise which MHC class

A

Class I

68
Q

Where is the primary lymphoid tissue?

A

Bone marrow and thymus gland

69
Q

Mesangial cells

A

macrophages in the kidney

70
Q

What is the other name for neutrophils?

A

polymorphs

71
Q

Th1 cells produce which cytokine?

A

Interferon

72
Q

Immune complexes activate ______ ______ by the classical pathway

A

complement cascade

73
Q

Alveolar macrophages

A

Macrophages in the lung

74
Q

Most common location for IgA

A

Secretions and mucus

75
Q

C3b can also act as what?

A

an opsonin

76
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

77
Q

What must occur for anaphylactic shock to initiate?

A

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

78
Q

Where are mast cells found?

A

in tissues and mucosal surfaces exposed to the outside environment

79
Q

Give some examples of secondary lymphoid tissue

A

spleen, lymph nodes, lymphatic system

80
Q

CD4 cells are

A

T helper cells

81
Q

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

A

false - around 4-8 hours after exposure

82
Q

CD8 is expressed on…

A

Cytotoxic T cells

83
Q

Classic C3 pathway for activation is initiated by?

A

Ig binding to antigen

84
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

85
Q

What are the key lymphocytes?

A

T CellsB CellsNK Cells

86
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

87
Q

Interferon activates what cell type?

A

macrophages

88
Q

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

A

antigen presentation to T cells

89
Q

Where do dendritic cells migrate once mature?

A

secondary lymphoid tissue

90
Q

T cells defend against intracellular pathogens True/False?

A

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

91
Q

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

A

IgE on mast cells, Th2 cells

92
Q

What are macrophages?

A

long-lived tissue resident phagocytes

93
Q

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

A

Autoimmune conditions

94
Q

What are the key phagocytes?

A

NeutrophilsMonocytesMacrophagesDendritic cells

95
Q

What is lymphoedema?

A

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

96
Q

CD8 cells are

A

cytotoxic T cells

97
Q

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

A

IgE

98
Q

Suggest a pro-inflammatory cytokine

A

TNFa (tumour necrosis factor alpha)

99
Q

B cells defend against intracellular pathogens True/False?

A

False - they defend against extracellular pathogens

100
Q

Cytotoxic T cells are particularly important in defence against?

A

Viruses and Fungi

101
Q

What are NK cells?

A

large granular lymphocytes

102
Q

Type IV hypersensitivity is mediated by what cell type?

A

T lymphocytes

103
Q

What are the other cells of the immune system?

A

mast cells, eosinophils, basophils

104
Q

Th2 cells produce which cytokines?

A

IL-4 and IL-5

105
Q

C3a and C5a can act as what?

A

chemotaxins

106
Q

Where can mature B and T cells be found?

A

circulating the blood, lymph and secondary lymphoid tissues

107
Q

Special feature of IgM

A

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

108
Q

Largest immunoglobulin

A

IgM

109
Q

What do NK cells target?

A

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

110
Q

What are the subdivisions of T cells?

A

Helper T cellsCytotoxic T cells

111
Q

IgE is found in

A

mast cells and basophils

112
Q

Second most abundant immunoglobulin

A

IgA

113
Q

The B cell receptor is composed mainly of monomeric Ig__

A

M

114
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

115
Q

Examples of reactions experienced in patient of Type I hypersensitivity

A

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

116
Q

Examples of Type III hypersensitivity reactions

A

Farmers lung Pigeon Fanciers lungSystemic Lupus Erythematosus (SLE)

117
Q

IgM is found in the ….

A

plasma

118
Q

microglia

A

macrophages in the brain

119
Q

T cells are responsible for

A

cell-mediated immunity

120
Q

What do B cells transform into during an immune response?

A

plasma cells

121
Q

What are the soluble factors of the immune response?

A

AntibodiesComplements system proteinsCytokinesAcute Phase proteins

122
Q

Suggest an anti-viral cytokine

A

IFN (interferons)

123
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

124
Q

How long does Type IV hypersensitivity take to develop?

A

24-48 hours

125
Q

Type I hypersensitivity leads to…

A

Asthma, allergies, hayfever and anaphylactic shock

126
Q

Which cells provide immunity to Intracellular Bacteria and parasites?

A

Ab, Cytotoxic T cells, NK cells

127
Q

Examples of a type II hypersensitivity reaction

A

Good Pasture SyndromeHaemolytic anemiaTransfusion reactions

128
Q

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

A

progressive tissue damage and fibrosis

129
Q

Which cells help provide immunity against Helminths?

A

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

130
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

131
Q

What controls cell migration?

A

chemokines

132
Q

What are the additional functions of macrophages?

A

limiting inflammation, tissue repair and wound healing and antigen presentation

133
Q

What are cytokines?

A

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

134
Q

Which cells are highly granular?

A

mast cells, basophils and eosinophils

135
Q

What is the secondary lymphoid tissue?

A

site where the adaptive immune responses are initiated

136
Q

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

A

IgG or IgA

137
Q

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

A

true

138
Q

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

A

become activate by enzymatic cleavage thus activating the complement cascade

139
Q

Where are antibodies produced?

A

antigen activated B-cells

140
Q

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

A

immune complexes

141
Q

Type IV hypersensitivity reactions are also known as?

A

delayed hypersensitivity reactions

142
Q

What do mast cells, basophils and eosinophils produce?

A

histamine, heparin, cytokines - all associated with acute inflammation

143
Q

CD4 is expressed on…

A

Helper T cells

144
Q

Which cells mediate cell-mediated immunity?

A

leukocytes

145
Q

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

A

IL-4 and IL-13

146
Q

What are dendritic cells?

A

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

147
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

148
Q

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

A

true

149
Q

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

A

Cytokines, Cytotoxic T cells, Antibodies, NK Cell

150
Q

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

A
  1. direct contact between receptors
  2. indirect contact with cytokines
151
Q

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

A
  1. dilation of small blood vessels
  2. Increased and slowed blood flow
  3. cell accumulation
  4. increased permeability
152
Q

What do pathogens express which allow them to be identified?

A

Pathogen Associated Molecular Patterns (PAMPs)

153
Q

3 phases of the innate immune system:

A
  1. Recognition
  2. Activation
  3. Effector
154
Q

Identify the cell

A

Eosinophil

  • Bilobar nucleus
  • secretory vesicles ready to release toxins
155
Q

Macrophages develop from what type of cell?

A

Monocytes

156
Q

Innate immune cells identify PAMPs via…

A

Pattern-Recognition-Receptors PRRs

157
Q

Where do macrophages reside?

A

Epithelial tissue i.e. lung, skin, gut

158
Q

Four functions of macrophages

A
  1. ingest and kill EC pathogens
  2. regulate inflammatory responses
  3. promote tissue repair and wound healing
  4. antigen presentation
159
Q

What type of cells are cleared by macrophages?

A

Apoptotic

160
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

161
Q

IL-10 serves what purpose in the immune system?

A

Acts as an anti-inflammatory cytokine

162
Q

Where do mast cells reside?

A

tissues and mucosal surfaces

163
Q

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

A

Parasites

164
Q

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

A

MHC Class I

165
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
  1. NO
  2. Prostaglandins
  3. Histamine
  4. Leukotrienes
  5. Cytokines and Chemokines
  6. ROS
  7. Glycopeptides
  8. Anti-microbial peptides
166
Q
A

I-N (10 decks)

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