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Immunology > Lecture II > Flashcards

Lecture II Flashcards

1
Q

A 72-yo male comes to the physician because of a 3-wk history of blisters and severe itching that did not improve with 1% hydrocortisone therapy. Physical examination shows several 2- to 6-cm tense blisters over the abdomen, groin, and flexor surfaces of the extremities. Severe blisters appear to have ruptured, resulting in the formation of surface erosions. A skin biopsy specimen shows subepidermal, nonacantholytic blistering with a mixed eosinophilic and lymphatic perivascular infiltrate in the superficial dermis. Immunofluorescent microscopy shows a linear deposition of IgG and C3 along the basement membrane. Which of the following epithelial structures most likely contains the antigen associated with the disease process? A. Adherens junction (zonula adherens) B. Desmosome (macula adherens) C. Gap junction D. Hemidesmosome E. Tight junction (zonula occludens)

A

D. Hemidesmosome Bullous pemphigoid (seen in this scenario) is mediated by autoantibodies that react with components of hemidesmosomes, disrupting the connection of epithelial cells to the underlying tissue and resulting in bulla formation. The immune mechanism of this condition can be regard-ed as a type II hypersensitivity reactions. Pemphigus vulgaris is mediated by autoantibodies that react with desmosomes, disrupting cell-cell connections in mucosa and skin. It starts with small vesicles, usually on the oral or nasal mucosa, and then spreads to other parts of the body. Bullae are delicate and flaccid. Nikolsky’s sign (production of blistering by light stroking or rubbing of the skin) is positive. Pemphigus is most common from ages 40 to 60.

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2
Q

In the small intestine, proteins localized in the basolateral surface of epithelial cells are prevented from migrating to the apical surface of the cell by the presence of which of the following labeled structures in the diagram?

A

A. Tight junctions (zonulae occludentes)

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3
Q

Blood is drawn from a 34-year-old male with bacterial meningitis for a complete blood count. The leukocyte count is elevated. Which of the following is released by the predominant type of white blood cell present?

A. Histamine
B. Leukotrienes
C. Lysozyme
D. Peroxidase
E. Vasoactive amines

A

C. Lysozyme

This question requires you to know that bacterial infections are associated with an elevated neutrophil count. These leukocytes represent ~60% of all leukocytes, have 3-5 nuclear lobes, and are filled with granules that contain bactericidal products, including lysozyme. Had the infection been viral, there would have been an increase in lymphocytes instead.

Histamine (choice A) is released by basophils and mast cells, along with other vasoactive amines (choice E). The “slow-reacting substance of anaphylaxis” (which consists of leukotrienes LTC4, LTD4, and LTE4 (choice B)) is also released by basophils, which possess large, dark blue/black spheroidal granules. Basophils and mast cells are basophilic (thus their name) and metachromatic, because of the presence of heparin, a glycosaminoglycan.

Eosinophils contain peroxidase (choice D). These white blood cells have a bilobed nucleus and possess red acidophilic granules in their cytoplasm. They also contain hydrolytic enzymes. Note that an increased eosinophil count is associated with parasitic infections, allergies, asthma, and some neoplasms.

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4
Q

physical/mechanical barrier, chemical agents and normal flora are all

A

components of the skin immunity

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5
Q

keratinocytes

A

closely connected cells of the skin cross-linked with keratin, high turnover rate and prevents evaporation

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6
Q

the skins chemical agents

A

ph, and antimicrobial agents (cathelicidins, defensins, and dermicidins)

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7
Q

landergans cells

A

derived from bone marrow, dendritic cells located among keratinocytes, function as antigen presenting cells in immune responses to contact antigens and some skin gradts; contain birbeck granules

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8
Q
A

birbeck granula- unique to the skin and unknwon function

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9
Q

top arrow is pointing to the __________ and bottom arrow is pointing to the ______

A

langerhans cells and cytoplasmic process

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10
Q
A

langerhans cell

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11
Q

mucosa

A

epithelium, lamina propria (loose connective tissue with glands), and muscularis mucosae (smooth muscle)

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12
Q

submucosa

A

dense irregular connective tissue

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13
Q

muscularis externa

A

inner smooth muscle and outer smooth muscle

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14
Q

external layer

A

adventitia (loose CT) and serosa (loos CT)

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15
Q
A
  1. tight junction
  2. zonula adherens
  3. desmosome

H- hemidesmosome

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16
Q

tight junction

A

an occludens junction, composed of claudins and occludins (proteins); prevents leaking between cells and precents movement of membrane proteins

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17
Q

zonula adherens

A

an adherens junction, composed of cadherins, binds to actin of the terminal web (cytoskeleton)

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18
Q

desmosome

A

an adherens juntion, composed of desmoplakins and plakoglobins

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19
Q

gap junctions

A

a communicatin junction, composed of connexins

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20
Q

hemidesomosome

A

an adherns junction, connects the cell to the basement membrane so it is not an intracellular junction

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21
Q

IgA

A

resistant to proteolytic enzymes, so it can coexist with proteases in gut lumen

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22
Q

antigens in the gut are bound by ______ and undergo transcytosis into the intraepithelial pockets

A

M cells

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23
Q

__________ cells take up the antigen process it, and present it to the helper T lymphocytes

A

dendritic

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24
Q

_______ are then stimulated to differentiate into plasma cells which secrete IgA antibodies

A

B lymphocytes

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25
Q

______ is transported into the gut lymen where it binds its antigen on the surface of microorganisms, neutralizing potentially harmful invaders before they penetrate the mucosa

A

IgA

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26
Q

_______ bad bacterial species in the oral cavity

A

400

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27
Q

lamina propia in the mucosal immunity in oral cavity

A

contains macrophages, contains dendritic cells which project dendrites into the epithelium to uptake antigens and migrate to secondary lymphoid tissue and draining lymph nodes

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28
Q

saliva contains what 4 components that deal with immunity in the oral cavity

A

lysozyme, lactoferrin, histatins, and salivary IgA

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29
Q

lysozyme

A

found in oral cavity; cleaves bacteria cell walls

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30
Q

lactoferrin

A

part of oral immunity; complexes with iron and deprices microbe of nutrient

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31
Q

histatins

A

part of oral immunity; inhibits growth of candida albicans and streptococcus mutans

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32
Q

salivary IgA

A

part of oral immunity; aggregates oral bacteria, prevents formation of dental plaques

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33
Q

tonsils

A

lymphoid tissue

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34
Q

pemphigus vulgaris

A

acantholytic disorder in persons 30-60; formation of severe intraepidermal bullaw starting in oral cavity and spreading to skin; autoimmune attack of desmosomes; can be fatal

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35
Q

acantholytic

A

loss of cell connections like desmosomes ex. pemphigus vulgaris

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36
Q

bullous pemphigoid

A

resembles pemphigus vulgaris but is much less severe; features subepidermal bullae with characteristic inflammatory infiltarte of eosinophils; autoimmune attack on hemidesmosomes

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37
Q

two forms of diffuse lymphoid tissue

A
  1. loose cluster of lymphoid cells
  2. lymphoid nodules

located in the mucosa (unless senn in enlarged form in the submucosa like peyers patch)

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38
Q

GALT

A

gut associated lymphoid tissue

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39
Q

BALT

A

bronchus-associated lymphoid tissue

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40
Q

NALT

A

nose associated lymphoid tissue

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41
Q

VALT

A

vulvovaginal lymphoid tissue

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42
Q

lymphoid nodules

A

found in the lamina propria of the mucosa throughout the gut

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43
Q

in the ileum, these lymphoid nodules are especially large and press outward into the submucosa and are known as _________

A

peyers patches

44
Q
A

tonsil lymphoid tissue

45
Q
A

lymphoid tissue in trachea; BALT

46
Q
A

lymphoid nodule in illeum (peyers patch); GALT

47
Q
A

GALT, lymphoid nodule

48
Q
A

left top: resting B cells

left bottom: newly formed B cells

right: germinal center of lymph node (or follicle)

49
Q

in the respiratory tract humidifcation and turbbulent airflow cause large particles to land on the ________ surfaces

A

mucosal

50
Q

vagina epithelium secretes _____ that normal flora convert into lactic acid, creating a acidic environment that in unfavorable for pathogenic microorganisms

A

glycogen

51
Q

______ protein from kidney binds bacteria and prevents attachment to urinary tract lining

A

tamm-horsfall

52
Q

longer male urethra

A

passive protection by creating longer route for bacteria to travel to bladder

53
Q

eye immunity systems

A

blinking, lacrimal glands, meibomian glands, ciliary gland, bacteriostatic/cidal tear film

54
Q

lacrimal gland

A

tears

55
Q

meibomian glands

A

sebaceous glands on eyelids

56
Q

ciliary gland

A

apocrine sweat glands on the eyelid

57
Q

tears contain ____ and other antimicrobial substances

A

lysozymes

58
Q

the generation of most bacteria is _______ to _____ minutes

A

20; 30 whereas the development of specific immunity response with antibodies could take days

59
Q

phagocytic cells identify pathogens by recognizing _______ and ______

A

pathogen associated molecular patterns (PAMPs) and damage/necrotic self, damage-associated molecular patterns (DAMPS)

60
Q

Coagulase negative streptococci on the skin can inhibit

A

staph aureus

61
Q

Neutrophils are also known as

A

polymorphonuclear leukocytes

62
Q

Neutrophils typically last

A

2 days

63
Q

Neutrophils kill engulfed substances in vesicles called ________ where the microbe is killed and degraded

A

phagolysosome

64
Q

Macrophages are derived from _________ once they move into the connective tissue

A

Monocytes

65
Q

Macrophages serve to kill and to degrade antigens and also to _____ peptides from those antigens

A

Present

66
Q

Macrophages are professional antigen ________ cells

A

Presenting

67
Q

Conventional dendritic cells are important in ______________ because they are very efficient at presenting antigen to ____________

A

Immunosurvelliance; T cells

68
Q

________ are specialized stromal cells in lymph nodes and spleen. They are adept at trapping antigen and presenting to B cells

A

Follicular dendritic cells

69
Q

Natural kill cells arise and mature in the ___________

A

Bone marrow

70
Q

Natural killer cells contain _______ and __________

A

Granzyme and perforin

71
Q

Natural killer cells contain cell surface receptors for ___________

A

IgG

72
Q

The microbial molecules that stimulate innate immunity are called _____________

A

PAMPS (pathogen-associated molecular patterns)

73
Q

Innate immune responses are mediated by proteins that recognize and interact with components specific to microbes they are called ______________

A

Pattern recognition receptors

74
Q

Pattern recognition receptors are divided into two groups _________ and __________

A

Secreted and circulating

75
Q

pattern recognition receptors definition

A

the innnate immune system recognizes structures that are sharded by various classes of microbes and are not present on normal host cells

76
Q

examples of things pattern recognition receptors will recognize

A
  1. endotoxin, LPS
  2. GC rich oligonucleotides
  3. double stranded DNA
  4. mannose residues on bacterial glycoproteins
77
Q

lectin

A

can bind polysaccharides specific to pathogen

78
Q

pattern recognition receptor family

A

toll-like receptors

79
Q

toll-like receptors

A

recognize microbrial proteins, lipids and polusaccharides (on cell surface) and nucelic acids (in endosomoes)

80
Q

Toll like receptors (TLR) located on cell surface recognize

A

lipids, polysaccarhides and proteins

81
Q

toll like receptors (TLR) on the membrane of endosomes recognize

A

nucleic acids

82
Q

TLR-2 recognizes

A

several bacterial and parasitic glycolipids and peptidoglycans

83
Q

TLR-3,7, and 8 are specific for

A

viral single stranded and double straned RNAs

84
Q

TLR-4 is specific for

A

bacterial LPS (endotoxin)

85
Q

TLR-5 is specific for

A

a bacterial flagellar protein flagellin

86
Q

TLR-9 recognizes

A

unmethylated CpG DNA that is abundant in microbial genomes

87
Q

type I interferons

A

IFN alpha and beta

88
Q

type II interferons

A

IFN gamma

89
Q

primary reactions of the innate immune system are ___________ and ____________

A

acute inflammation and antiviral defense

90
Q

innate immune defense against intracellular viruses is mediated mainly by the help of the ________ system

A

interferon

91
Q

pattern recognition receptors on macrophages and dendritic cells detect a virus attack and secret what warning proteins _________ making them type I/type II interferon cells

A

interferon alpha and beta; type I

92
Q

innate immunity cells use TLR 7 to detect RNA/DNA and TLR 9 to detect RNA/DNA

A

RNA;DNA

93
Q

most human cells ahve type I/type II interferon cells

A

type I

94
Q

interferons can lead to

A

cell death

95
Q

macrophages secrete hormones called ________ that attract immune system cells to the site and activate cells involved in tissue repair

A

cytokines

96
Q

Natural killer cells are type I/type II interferon cells becuase they secrete interferon alpha and beta/gamma which stimulates/inhibits macrophages which in return secrete IL-2/IL-5 which inhibits/stimulates natural killer cells

A

type II; gamma; stimulates; IL-2; stimulates

97
Q

natural killer cells can destory some ________ cells

A

cancer

98
Q

the four main cytokines of innate immunity

A

tumor necrosis factor; IL-1; Interferon gamma; IL-6

99
Q

_______ is the chief stimulator of the production of most acute phase proteins, wheras the other implicated cytokines influence subgorups of acute phase proteins

A

IL-6

100
Q

an acute phase protein has been defined as

A

a protein whose plasma concentration increase (positive acute phase proteins) or decreases (negative acute phase proteins) by at least 25 % during inflammatory disorders

101
Q

the changes in concentrations of acute-phase proteins are due largelyto changes in their production by _________

A

hepatocytes in the liver

102
Q

c reactive proteins

A

can promote the recognition and elmination of pathogens and enhance the clearance of necrotic and apoptic cells

103
Q

serum amyloid A proteins influence ______ _______ during niflammatory states

A

cholesterol metabolism

104
Q

haptoglobin Nd hemopexin are __________ that protect against reactive oxygen species by removing iron-containing cell-free hemoglobin and heme from circulation

A

antioxidants

105
Q

hepcidin can contribute to increases/decreases in serum iron

A

decreases

106
Q
A

red line- lacking innate immunity

green line- lacking adaptive immunity

yellow- normal immunity

107
Q

the inteferon system is involved in eliminating ______ infevted cells

A

viral

Immunology (14 decks)

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