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Pathology Pre-Midterm > Immunopathology Basics > Flashcards

Immunopathology Basics Flashcards

1
Q

There are 2 divisions innate (natural) and adaptive (acquired) immunity. what are some characteristics of them?

A

Innate: Not ag specific and ready for immediate action
TNF,IL-1,IL-12,IFNgamma and chemokines
Adaptive: develops after exposure= response slower than innate (memory) (makes B and T cells) (includes humoral and cellular/cell mediated)
IL-2,IL-4,IL-5,IL-17,IFNgamma

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2
Q

Complement activation is mediated by classical and alternative pathway. what are some characteristics of both?

A 
Classical: Ag/Ab complex 
Alternative: Microbe suface 
inflammation response via C3/5a anaphylatoxins 
opsonization via C3b = phagocytosis 
Lysis of microbe via MAC
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3
Q

Wha is the most important cell of the immune system?

A

Ag Presenting Cells(APCs)

—dendritic aka Langerhans: most important; located under epithelium

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4
Q

Adaptive (Acquired) immunity produces T lymphocytes, what are some features of T lymphocytes?

A

Thymus derived
Effector cells of cellular immunity
Stimulate Ab responses
Peripheral blood lymphocytes recognize Ags to MHC molecules on other cells
—-CD4 T cells bind class II MHCs expressed by mature Ts and helper Ts (Secrete cytokines that stimulate B cells)
—CD8+ T cells bind class I MHCs expressed by 30% of mature Ts (Cytotoxic Ts — kills directly)

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5
Q

Adaptive (Acquired) immunity produces B lymphocytes what some features of B lymphocytes?

A

Bone marrow derived

  • -transform into plasma cells when stimulated = effector cells of humoral immunity
  • -recognize Ags via surface IgM
  • -Produce 1 of 5 classes of Ig: M, D, A, G ,E
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6
Q

What is a epitope, idiotype and isotype in regards to B lymphocytes?

A

Epitope: part of the Ag that is recognized by the immune system
Idiotype: unique Ag-binding site of an Ab molecules
Isotype: type of Ab: IgA, IgM, IgG, and IgE

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7
Q

What are features of MHC class I?

A

HLA: A, B, C
all nucleated cells
endogenous inside cell
elimination of abnormal (infected cells)
B-2 microglobulin: required for proper folding of MHC1

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8
Q

What are features of MHC class II?

A 
HLA: DP,DQ,DR
APCs, Ts, Bs, activated endothelial 
Exogenous outside cell 
Presentation of Ag 
Invariant chain: transiently binds MHCII
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9
Q

CD4 THO are considered master cells, what are TH1 cells?

A

Increase proliferation: IFNgamma and IL-12

Inhibited by: IL-4, IL-10 and cytokines released IL-2, TNF, and IFNgamma

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10
Q

what are TH2 cells?

A

Increased proliferation: IL-4
Inhibited by IFNgamma
Cytokines released: IL-4,5,6,10,13,TGF-Beta support Bs/humoral immunity

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11
Q

Type I HSR: IgE mediated is an interaction with IgE attached to surface of mast cell. Effector cells are what?

A

Masts, basophils and eosinophils
TH2 cells play a pivotal role
Role in parasitic infection

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12
Q

What are the two waves of rxn for Type I HSR?

A
  1. Sensitization: Ag presented to TH2 by APC — production of IgE and IgE binds masts
  2. Activation: re-exposure to allergen — allergen binds to IgE on masts — masts release granules
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13
Q

What are the two activation phases?

A
  1. Immediate response: immediately and release of mast cell contents
  2. Late phase response: PMNs, eosinophils, lmyphocytes
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14
Q

What are examples of type I HSR?

A

Atopic Extrinsic asthma

Allergic Aspergillosis: asthma, alveolitis, can lead to COPD if untreated; allergic rxn to fungi in bronchi

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15
Q

What are type II HSRxn?

A

Antibodies against Antigens present on cell surface or other tissue components

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16
Q

What are examples of type II HSrxn?

A 
Autoimmune hemolytic anemia
Hemolytic transfusion rxn
Goodpasture syndrome
Graves disease 
Myasthenia gravis 
Pemphigus vulgaris 
Kawasaki syndrome 
Wegener's Granulomatosis/G polyarteritis 
SLE
17
Q

What are type III HSRxn?

A

Immune complex mediated

  • -injury secondary to deposition of Ag-Ab immune complexes
  • -Ag can be exogenous or endogenous
18
Q

What are examples of type III HSRxn?

A

SLE
Post streptococcal Glomerulonephritis
PNA
Reactive arthritis
Serum sickness (foreign Ag as xenobiotic serum like abx)
Hypersensitivity Pneumonia aka Extrinsic allergic alveolitis–organic Ag (farmers)

19
Q

Compare staining patterns of post strep glomerulonephritis and goodpasture syndrome

A

Post Strep: granular

Goodpasture syndrome: linear deposition of IgG, IgA, and IgM on alpha 3 collagen of BM

20
Q

What is a type IV HSR?

A

T cell mediated: initiated by sensitized T lymphocytes

–broad range of offending Ags

21
Q

What are the two mechanisms of type IV HSR?

A 
Delayed Type HS (CD4 Ts react with Ag presented by MHC II on APCs)(TH1 and TH17) 
Direct Cytotoxicity (autoimmune diseases and viral infections)
22
Q

What ares some delayed type HS rxn tests?

A

Tuberculin/Mantoux test: M. tuberculae for TB
Lepromatous Leprosy: negative lepra test
Tuberculoid Leprosy: positive
Sarcoidosis: anergy to skin tests with candida/PP b/c all CD4Ts are in alveoli/other

23
Q

What are examples of type IV HSRxns?

A 
TB
Type I diabetes 
MS 
RA
Contact dermatitis 
Giant cell/temporal arteritis 
Transplant rejection 
Graft vs host 
Hypersensitivity Pneumonia aka Extrinsic allergic alveolitis 
Sarcoidosis
24
Q

SLE is a multisystem autoimmune disease with numerous antibodies against what?

A

Nuclear components + phospholipids (+others)

  • –positive antinuclear Ab test
  • –anti-phospholipid Ab syndrome: hypercoagulable state = increase in blood clots and thrombosis
25
Q

What are the lab investigations for SLE?

A

Indirect IF for anti-nuclear Abs (ANA)

Specific Abs: anti-dsDNA, anti-Smith (RNA binding proteins) and anti-phospholipid

26
Q

Systemic Sclerosis (Scleroderma) is excessive fibrosis throughout the body and affects females and also affects the fingers first. What humoral abnormalities are specific for SS?

A

Anti-topoisomerase I/anti-Scl 70: highly specific dx
Anti-centromere: highly specific for CREST
(Calcinosis, raynauds, esophageal dysfunction, sclerodactyly and telangiectasias)

Pathology Pre-Midterm (35 decks)

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