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Flashcards in Immunology High Yield Deck (155):
1

What are the 3 areas of a lymph node?

1- Follicle
2- Medulla
3- Paracortex

2

Where in the lymph node are follicles located?

Outer cortex

3

What are the 2 portions of the medulla of lymph nodes?

Medullary cords--> lymphocytes and plasma cells

Medullary sinuses--> communicate with efferent lymphatics and have macrophages

4

What is located in the paracortex of lymph nodes?

T cells

5

Lymph nodes for head and neck?

Cervical

6

Lymph nodes for lung?

Hilar

7

Lymph nodes for tracheal and esophagus?

Mediastinal

8

Lymph nodes for upper limb, breast and skin above umbilicus?

Axillary

9

Lymph nodes for liver, spleen, pancreas, upper duodenum?

Celiac

10

Lymph nodes for lower duodenum, jejunum, ileum, colon to splenic flexure?

Superior mesenteric

11

Lymph nodes for colon from splenic flexure to upper rectum?

Interior mesenteric

12

Lymph nodes for lower rectum to anal canal (above pecctate line), bladder, middle 3rd vagina, prostate?

Internal iliac

13

Lymph nodes for testes ovaries, kidneys and uterus?

Para- aortic

14

Lymph nodes for anal canal (below pectate line), skin below umbilicis, scrotom?

Superficial inguinal

15

Lymph nodes for dorsolateral foot, posterior calf?

Popliteal

16

Lymph nodes for dorsolateral foot, posterior calf?

Popliteal

17

What are the 3 areas of the spleen?

Red pulp (red cells)

White pulp (lymphocytes)

Marginal zone--> APCs, specialized B cells

18

What are the 2 areas of white matter in the spleen?

PALS--> T cells

Follicles--> B cells

19

Why is there an increased risk of infection of encapsulated organism with asplenia?

Decreased IgM--> decreased complement activation--> decreased C3b opsonization

20

What are 2 RBC findings post splenectomy?

1- Howell- Jolly bodies

2- Target cells

21

Where do T cells differentiate and mature

Thymus

22

What pharyngeal pouch is the thymus derived from?

3rd

23

In the thymus...where are the mature T cells located and where are the immature T cells located?

Mature--> Medulla

Immature--> cortex

24

What type of immunity does this statement describe:

Highly specific, refined over time. Develops over long periods of time

Adaptive immunity

25

HLA types associated with MHC I?

HLA- A/ B/ C

26

HLA types associated with MHC II?

HLA- DR/ DP/ DQ

27

What binds MHC class I?

TCR and CD8

28

What binds MHC class II?

TCR and CD4

29

Where is MHC class I rexpressed?

ALL cells

30

Which MHC presents ENDOGENOUSLY synthesized antigens?

MHC I

31

Which MHC presents EXOGENOUSLY synthesized antigens?

MHC II

32

Which MHC has a beta 2 microglobulin chain?

MHC I

33

Which MHC has a full beta chain?

MHC II

34

Name the HLA type associated with:

Psoriatic arthritis
Ankylosing spondylitis
IBD
Reactive Arthritis

HLA- B27

35

Name the HLA type associated with:

Celiac diease

HLA- DQ2/ DQ8

36

Name the HLA type associated with:

Multiple sclerosis
Hay fever
SLE
Goodpasture

HLA- DR2

37

Name the HLA type associated with:

Diabetes mellitus type I
SLE
Graves diease
Hashimoto thyroiditis

HLA- DR3

38

Name the HLA type associated with:

Rheumatoid arthritis
DM type I

HLA- DR4

39

Name the HLA type associated with:

Pernicious anemia

DR5

40

What 2 substances secreted by natural killer cells induce apoptosis of cells?

Perforin
Granzyme

41

What 4 cytokines enhance the activity of NK cells?

IL-2
IL-12
IFN-alpha
IFN- beta

42

Where does positive T cell selection occur?

Thymic cortex

43

What is positive selection?

T cells with TCR have teh ability to bind self MHC molecules

44

Where does negative selection occur?

Medulla

45

What is negative selection?

T cells that bind with high affinity for self antigens undergo apoptosis

46

What do Th1 helper T cells secrete?

IFN- gamma

47

What cell types do Th1 cells activate?

Macrophages
Cytotoxic T cells

48

What cytokines can inhibit a Th1 response?

IL-4
IL-10

49

What cytokines activate a Th1 response?

IGN- gamma
IL-2

50

What cytokines activate a Th1 response?

IGN- gamma
IL-2

51

What 4cytokines do Th2 cells secrete?

IL-4
IL-5
IL-10
IL-13

52

What activates a Th2 response?

IL-4

53

What inhibits a Th2 response?

IFN gamma

54

What cell is needed to virus infected cells, neoplastic cells, donor graft cells?

Cytotoxic T cells (via induced apoptosis)

55

Which cell type suppresses CD4 and CD8 T cells?

Regulatory T cells

56

Name the cell type the displays all the following:

CD3+, CD4+, CD25+, FOXP3

T regs

57

What is the costimulatory signal needed for naive T cell activation?

B7 and CD28

58

What are the 3 signals needed for B cell activation?

1- MHC II binding to TCR
2- CD40 biding CD40L
3- Cytokines

59

What two Ig isotypes do mature B cells express?

IgM and IgD

60

What is the main antibody in secondary (delayed) response?

IgG

61

Which Ig can cross the placenta?

IgG

62

What are the functions of IgG?

Fixes compliment
Opsonizes bacteria
Neutralizes bacterial toxins and viruses

63

Which Ig prevents attachement of bacteria and viruses to mucous membranes?

IgA

64

How does IgA corss epithelial cells?

Transcytosis

65

What is the most produced antibody produced in the body?

IgA

66

Which antibody is most abundent in seum?

IgG

67

What is the secreted IgM structure?

Pentamer!

68

Which Ig binds mast cells and basophils as well as crosslinks when exposed to allergen?

IgE

69

Which Ig is involved in mediating type I (immediate) hypersensitivity?

IgE

70

What cytokine induces acute phase reactants?

IL-6

71

What is C reactive protein?

An opsonin...fixes compliment and facilitaes phagocytosis

72

What is the function of ferritin?

Binds and sequesters iron to inhibit microbial iron scavening

73

What is the function of hepcidin?

prevents release of Fe bound by ferritin--> anemia of chronic disease

74

What mediates the activation of the classical compliment pathway?

IgG and IgM

75

What activates the alternative compliment pathway?

Microbe surface molecules

76

What activates the alternative compliment pathway?

Microbe surface molecules

77

What is the function of C3b?

opsonization

78

What are the functions of C3a, C4a, C5a?

Anaphylaxis

79

What is the function of C5a?

Neutrophil chemotaxis

80

What is the functinon of C5b-9?

Cytolysis by MAC

81

What are the two primary bacterial opsonins?

C3b and IgG

82

What inhibits compliment?

C1 esterase inhibitor

83

What is the C3 convertase in the alternative pathway?

C3bBb

84

What is the classical C3 convertase?

C4b2b

85

Which complement deficnecy leads to increased risk of severe recurrent pyogenic sinus and respiratory tract infections?

C3

86

Which complement deficiency is the cause of hereditary angioedema?

C1 esterase inhibitor deficiency

87

Which complement deficiency increases risk of recurrent Neisseria bacteria?

C5- C9

88

What is the cause of compliment mediated lysis of RBC and paroxysmal nocturnal hemoglobinuria?

DAF (decay accelerating factor) deficiency

89

What is the cause of compliment mediated lysis of RBC and paroxysmal nocturnal hemoglobinuria?

DAF (decay accelerating factor) deficiency

90

"increased risk for catalase + infections"

Chronic granulomatous disease--> NADPH deficiency

91

What CD is associated with TCR and is needed for signal transduction?

CD3

92

Helper T cell surface markers?

CD4 and CD40L

93

Cell marker of Cytotoxic T cells?

CD8

94

Cell markers for T regs?

CD4 and CD25

95

Cell markers for B cells?

CD19, CD20, CD21, CD40, MHC II and B7

96

Cell markers of macrophages?

CD14, CD40, MHC I B7

97

Cell surface markers of NK cells?

CD16 (binds Fc of IgG), CD 56

98

Cell surface markers of hematopoietic stem cells?

CD 34

99

"cell cannot become activated by exposre to its allergen due to lack of costimulatory signal"

Anergy

100

How do superantigens work?

cross link the beta region of the T cell receptor to the MHC class II on APCs which leads to a massive release of cytokines

101

How do endotoxins work?

directly stimulate macrophages by binding to endotoxin recetpr TLR4/ CD14...no Th cells are involved

102

Which bacteria are know to undergo antigenic variation?

Salmonella
Borrelia recurrentis
N. gonorrhea

103

What viruses are know to undergo antigenic variation?

Influenza
HIV
HCV

104

What is passive immunity?

receiving preformed antibodies

105

What is the half life of antibodies?

3 weeks (so passive immunity does not last long)

106

For which microbial exposures are antibodies given to unvaccinated patients?

1- tetanus toxin
2- Botulinum toxin
3- HBV
4- Varicella
5- Rabies

107

What type of immune response is induced by live attenuated vaccine?

Cellular and Humoral

108

T/F: live attenuated vaccines can revert to virulent form

True

109

Which vaccine types are contraindicated in pregnancy?

Live attenuated

110

What illnesses have a live attenuated vaccine?

MMR
Polio (Sabin)
Influenza (intranasal)
Varicella
Yellow fever

111

What type of immune response doe sthe body mount to a inactivated or killed vaccine?

Humoral response

112

Which immune response is stronger...live attenuated vaccine or inactivated/ killed vaccine?

Live attenuated

113

What types of infections have inactivated/ killed vaccines?

Rabies
Influenza (Injection)
Polio (Salk)
Hep A

114

Name the type of Hypersensitivity reaction:

Free antigen cross links IgE on presensitized mast cells and basophils, triggering immediated release of vasoactve amines that act on postcapillary venules"

Type I

115

What mediates the delayed response in Type I hypersensitivty?

arachidonic acid metabolites

116

Name the type of Hypersensitivity reaction:

IgM, IgG binds to fixed antigen on "enemy" cell leading to cellular destruction

Type II

117

What are the mechanisms of cytotoxicits in type II reactions?

1- Opsonization and phagocytosis
2- Complement and Fc receptor mediated inflammation
3- Antibody mediated cellular dysfunction

118

Name the type of Hypersensitivity reaction:

immune complex complexes complement, which attracts neutrophils

Type III

119

"IMMUNE COMPLEX DISEASE IN WHICH ANTIBODIES TO FOREIGN PROTEINS ARE PRODUCED (TAKES 5 DAYS)"

serum sickness

120

What is the most common cause of serum sickness?

Drugs actin as haptens

121

"local subacute antibody- mediated hypersensitivity reaction associated with intradermal injections characterized by edema necrosis, and activation of complement"

Type III

122

Name the type of Hypersensitivity reaction:


delayed hypersensitvity mediated by T cells that enounter antigen and then release cytokines

Type IV

123

Contact dermatitis is an example of what type of hypersensitivity reaction

Type IV

124

Give 5 examples of Type I hypersensitivity reactions?

1- asthma
2- eczema
3- hives
4- rhinitis
5- bee sting/ food allergies

125

What type of hypersensitivity reaction is rheumatic fever?

II

126

What type of hypersensitivity is pemphigus vulgaris?

II

127

What type of hypersensitivity is PPD?

IV

128

What type of hypersensitivity is Guillain barre?

II

129

What type of hypersensitivity is SLE?

III

130

What type of hypersensitivity is Multiple sclerosis?

IV

131

What type of hypersensitivity is PSGN?

III

132

What type of hypersensitivity is Myasthenia gravis?

II

133

What type of hypersensitivity is Erythroblastosis fetalis?

II

134

What type of hypersensitivity is idiopathic thrombocytopenic purpura?

II

135

What type of hypersensitivity is Goodpasture syndrome?

II

136

If a blood transfusion is given and a person develops anaphylaxsis...what are they deficient in?

IgA deficienccy (these people must recieve blood without IgA)

137

What causes febrile nonhemolytic tranfusion reaction?

Type II hypersensitivity reaction--> due to host antbodies against donor HLA antigens

138

What causes acute hemplyic transfusion reaction/

Type II hypersensitivity

intravascular hemolyssi due to ABO incompatability

139

What is an allograft?

from self

140

What is a syngeneic graft?

from a identical twin or clone

141

What is an allograft?

from nonidentical individual of same species

142

What is a xenograft?

from a different species

143

What is the type of transplant rejection:

Preexisting recipient antibodies react to donor antigen

Hyperacute rejection

144

What type of hypersensitivity is hyperacute rejection

II

145

When does hyperacute rejection take place?

Within minutes

146

Name the type of rejection:

CD8+ t cells activated against donor MHC

Acute cellular

147

Name the type of rejection:

Antibodies develop after transpant to donor antigen

Acute humoral

148

When does acute rejection occur?

Weeks to months after transpont

149

Name the type of rejection:

CD4+ T cells respond to recipient APCs presenting donor peptides"

Chronic

150

When does chronic occur?

Months to years

151

Name the type of rejection:

grafted immunocompetent T cells proliferate in the immunocompromised host and reject host cells with "foreign" proteins

Graft vs host disease

152

Who s GVH disease usually seen in?

bone marrow and liver transplant recipients

153

Name the type of rejection:

Vasculitis of graft vessel with a dense lymphocytic infiltrate

Acute

154

Name the type of rejection:

Maculopapular rash, jaundice, diarrhea, hepatosplenomegaly

GVH disease

155

Name the type of hypersensitivity:

Recipient T cells react and secrete cytokines leading to prolifeation of vascular smooth muscle and parenchymal fibrosis

Chronic

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