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1
Q

Some tumor cells can escape immune system surveillance by … (and example)

A

modulation –> ex: internalizing the surface antigen so that it no longer presents a target for immune attack

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2
Q

tumors and antibodies

A

Tumor antigens can stimulate the development of specific antibodies: a. some are cytotoxic, but others called a. blocking and enhance tumor growth (perhaps by blocking recognition of tumor antibodies by host)

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3
Q

T cell tolerance - central vs peripheral according to definition

A

central tolerance –> tolerance to self antigens within tha thymus
peripheral tolerance –> tolerance acquired outside the thymus

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4
Q

beside Thymus, AIRE also act at (where and why)

A

in the peripheral lymphoid organs (such as spleen and lymph nodes) where it contributes to peripheral tolerance

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5
Q

Peripheral tolerance is necessary because

A

some self antigens are not expressed in thymus

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6
Q

Clonal ingorance?

A

self reactive lymphocyte ignore self antigens (either by physical separation (ex. BBB,) or because self antigens are in small amount)

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7
Q

Clona anergy - the failure of constimulatory signal most often occurs when

A

is an insufficient inflammatory respomse at the site of infection

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8
Q

types of B-cell tolerance (and location)

A
  1. clonal deletion (bone marrow)

2. clonal anergy (periphery)

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9
Q

Whether an antigen will iduce tolerance rather than immunologic response:

A
  1. maturity of immun system of the host (neonatal do not respond well to foreign antigens
  2. structure and dose of antigen (simple molecules induce toleranc more rapidly, and very high or very low doses of antigens may result in tolerance)
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10
Q

insulin-resistant diabetes - antibodies against

A

insulin receptor

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11
Q

hypersensitivity reactions with antibodies (and which antibodies)

A

type I –> IgE
type II –> IgG or IgM
type III –> IgG

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12
Q

hypersensitivity reactions 1st vs subsequent contacts

A

the 1st contact of the individuals with the antigen sensitize, the subsequent elicit the allergic respond

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13
Q

hypersensitivity reaction type I - complement

A

not involved

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14
Q

Non allergic respond to allergens

A

produce IgG

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15
Q

which clinical manifestations occurs in hypersensitivity type 1 depends in

A
  1. the route of entry
  2. the location of the mast cells bearing IgE
    ex. (air –> hey fever, food –> diarrhe)
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16
Q

hypersensitivity reaction type 1 - disease according to rout of entry

A
  1. lung –> asthma
  2. nose and eyes –> rhinitis, conjunctivitis, hey fever
  3. skin –> eczema, urticaria
  4. intestinal tract –> allergic gastroenteropathy
  5. Systemic –> anaphylaxis
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17
Q

the MCCs of anaphylaxis

A
  1. food such as peanuts and shellfish
  2. bee venom
  3. drugs such as penicillin
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18
Q

atopic disorders exhibit strong familial predisposition and are associated with

A

elevated IgE levels

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19
Q

hypersensitivity reaction type 2 - antibodies

A

IgG or IgM

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20
Q

hypersensitivity reaction type 4 - cells

A
  1. Th
  2. macrophages
  3. T cytotoxic
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21
Q

Prozone phenomenon is a

A

false negative response resulting from high antibody titer which interferes with formation of antigen- antibody

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22
Q

the pathway that mostcommonly activate complement the first time that a person is exposed to a bug

A

lectin and alternative (because no antibody)

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23
Q

a complement regultion beside C1 esterase and DAF

A

regulation of alternative pathway is mediated by the binding of factor H to C3b and cleavage of this complex by factor I (a protease)

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24
Q

An extra role of C3b

A

binds to its receptor in the surface of activated B cells –> enhances antibodies in by the B cells that are activated alone

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25
measles and CMC vs immune system (and examples)
they can suppress cell-mediated against other microorganisms measles infection in people with TB --> PPD (-) (suppression of il-12 by macrophagea)
26
CMV, VZV, HSV-2, - latent in
CMV --> mononuclear cells VZV --> dorsal root or trigemina ganglia HSV-2 --> sacral ganglia
27
antibody - primary response
longer lag period --> 7 - 10 days (can be longer depending on the nature and dose of the antigen) IgM
28
antibody - secondary response
IgM produced similar to the primary, but much larger amount of IgG is produced and tend to persist much longer
29
affinity maturation is the process by which
B cells produce antibodies with increased affinity for antigen during the course of an immune response
30
The first line of defence against microorganisms
intact skin and mucous membranes
31
innate humoral immunity
complement and neutrophils
32
antibodies in Th independent produced
only IgM because --> no IL-4,5 --> no class switch
33
immunity - age
less than optimal in newborn and elderly
34
Defesins?
highly positively charged peptides that create pores in the membranes of bacteria and thereby kill them
35
causes of high calcium-phosphate mediated metastatic calcification
1. chronic renal failure with 2ry hyperparathyroidism 2. long term dialysis 3. calciphylaxis 4. warfarin
36
causes of high calcium mediated metastatic calcification
1. 1ry heperparathyroidism 2. sarcoidosis 3. hypervitaminosis D
37
CD54
ICAM-1
38
CD55
DAF
39
CD106
VCAM-1
40
CD31
PECAM-1
41
Free radicals injury is initiated by
1. radiation exposure (eg. cancer therapy) 2. metabolism of drugs (phase 1) 3. REDOX 4. Nitric oxide 5. transition metals 6. WBC oxidative burst
42
CD95
Fas (receptor)
43
B - cell immunodeficiency - live vaccines
contraindicated
44
IgA transcytosis
IgA dimers bind to there polymeric immunoglobulin receptor (pIgR) found on the basolateral surface of intestinal epithelial cells + undegro trancytosis --> as they are released in the lumen, the pIgR stay attached
45
xanthine oxidase deficiency
very low uric acid | - renal calculi due to insolubility of xanthine at urine pH
46
Giardia lambila - histology of organism + of intestine
organism: pear shaped with multiple flagella + 2 nuclei (owl's eues). The cysts contain up to 4 nuclei intestine: villous atrophy, crypt hyperplasia
47
cGMP has role in physiological process such as
SMCs relaxation + retinal phototransduction
48
defected IFN-γ signaling pathway --> .....(manegment)
lifelong antimycobacterial agents
49
PD1 role
Programmed death receptor (PD1) and its lignat downregulates the immune agaist tumor cells by inhibiting cytotoxic T cells. Many types of Cancer evade the immune system by increasing expression of PD1 ligant Monoclonal antibodies agaist PD-1 help prevent T cell inhibition + promote apoptosis of tumor cells CTLA-4 has a similar role --> bind + inhibit B7
50
other chemotactic agents
n-formylated peptides | 5-HETE
51
protein that bind + inhibit B7
CTLA-4
52
anaphylaxis - time to initiate
- seconds to minutes after intravascular exposure (eg. IV medication , insect stings) - up to 2 hours with orally ingested antigens
53
marker of Mast cells activation
tryptase
54
binded IgE to mast cells --> bind to antigen --> .... (next step)
aggregation of receptors -> non-receptor tyrosine kinase --> degranulation + release
55
examples of receptor internalization
1. excessive neurotransmitter stimulation | 2. receptor mediated endocytosis (eg. transferrin receptor for iron + LDL receptor)
56
anti-Rh - type of antibody
IgG (anti-D) --> opsonization
57
CD21 - normal function
receptor of C3b complement
58
palms + soles maculopalular rash after transplantation graft vs host disease
graft vs host disease
59
Most frequtnely affected organs by graft vs host disease
1. skin --> palms + soles maculopalular rash (desquamate in severe cases) 2. GI --> diarhea, intestinal bleeding + abd pain 3. liver --> abdominal liver function test (if it is from liver transplantation, liver is not affected)
60
thimic negative selection - interaction with which cells
thymic medullary epithelial cells | + dendritic cells
61
CD7
multi-chain complex marker
62
PPSV in <2 age
not immunnogenic because their relatively immature humoral antibody response
63
candida - low T cells vs low neutrophils
low T --> superficial candida infection | low neutrophil --> systemic candida infection
64
hyper IgM syndrome - mchanism
MC: defective CD40L on Th cells (XR) Rare: defective CD40 on B cells (AR)
65
cardiolipine is found in
inner mitoch membrane
66
lupus anticoagulant - pt/ptt
increased PTT and/or PT that is not corrected with 1:1 fresh plasma
67
Bloom syndrome
generalized chromosomal instability
68
bronchoalveolar lavage fluid in sarcoidosis - CD4/8 ratio
more than 2
69
contact dermatitis - cd4 vs cd8
it depends on the etiologic agent
70
similar to SCID but not?
congenital HIV
71
Langhans cells?
(aka: Pirogov-Langhans cell) | large cells found in granulomatous conditions.
72
IgM - complement activation mechanism
IgM is able to activate complement only after antigen binding (conformation alternation)
73
melanocytes - shape?
dendritic processes that intercalate between the remaining cells of the epidermis
74
lecthinase (C. perfinges) action
phospholipase C --> platelet agregation --> vasocclusion --> ischemic necrosis of affected tissues
75
age for influenza vaccination
older than 6
76
1. HBeAg in pregnancy 2. management of infants born by HBV othes 3. infant with HBV from mother - chronicity
1. increases the risk of vertical transmission (to 95%), if HBeAg negative --> only 20% 2. passively immunized at birth with hepatitis B immun globulin, followed by active immunization with recombinant HBV vaccine 3. chance of progression to chronicity is 90%
77
poison ivy, oak, sumac - mechanism of contact dermatitis
produce urushiol --> hapten --> rash --> often linear streaks as the patients walked in the plants
78
major adaptive immune mechanism agaist influenza virus
antibodies against hemaglutin
79
eosinophils mediated defence against parasites
antibody-depended cell-mediated cytotoxicity | (IgE or IgG) --> binding --> secretion of ROS + Major basic protein
80
Bare lymphocyte syndrome
immunodeficiency resulting from a defect in expression of HLA class II antigens on the surface of antigen presenting cells
81
Fibroblasts - caseating granouloma
fibroblast proliferation + collagen production contribute to caseating granuloma formation
82
young people infected with N. meningitis - IgA levels
if very high leves of IgA --> increased risk for disseminated disease due to cover of IgG/IgM binding sites by IgA
83
reactive arthritis - skin
``` keratoderma blennorrhagicum (hyperkeratotic vesicles on palms + soles) circinate balanitis (superpiginous annular dermatitis of the glans of penis ```
84
LAD 3?
similar to to type 1 but causes severe, recurrent, bactrial infections, delayed separation of the umbilical cord, and bleeding complications (affected beta 3 integrins on platelets)
85
Peneath granular cells
small intestine cells | release α-defesin + lysozime --> immune system
86
golimumab
anti - tnf a
87
Bortezomib - mechanism of action
binds + inhibits the 26S proteasome | In MM, it can facilitate apoptosis by preventing degredation of pro-apoptotic factors
88
diagostic test for chronic granulomatous disease (and explain)
1. Nitroblue tetrazolium: involves adding NB to a sample of patients neutrophis --> normal neutrophils produce ROS that can reduce the yellow NBT to blue formazan 2. Dihydrorhodamine: production of superode radicals by measuring the conversion of DHR to rhodamine, a green compound detected by flow cytometry
89
Nef and Tat genes
both HIV genes: Tat plays a role in viral replication Nef decreases expression of MHC class I protein on the surface of infected cells
90
inf α + β against protein syntheses in virus infected cells
transcription of antiviral enzymes capable of halting protein synthesis such as RNase L + protein Kinase R (inactivates elF-2, inhibiting translation initiation) ACTIVE ONLY IN dsRNA virus which form in infected cells

Immunology (10 decks)

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