Pathology - L1 - Immunologic Diseases Flashcards

(48 cards)

1
Q

antigen

A

any substance able to induce a specific immune response

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2
Q

B-lymphocyte functions?

A

neutralizes microbes, phagocytosis, complement activation

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3
Q

where are B-cells found?

A

in lymphoid follicles of lymph nodes, bone marrow, and extranodal lymphatic tissue (i.e. tonsils, appendix, Peyer’s patch)

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4
Q

types of T lymphocytes?

A

helper, cytotoxic, regulatory

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5
Q

helper T-cells functions?

A

activation of mac’s, in inflamm, activation (proliferation & differentiation) of T & B lymphocytes

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6
Q

Cytotoxic T lymphocyte function?

A

killing of infected cell or cells harboring microbes

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7
Q

regulatory T lymphocyte function?

A

suppression of immune response

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8
Q

where are 60-70% of circulating lymphocytes found?

A

in thymus and paracortical areas of lymph nodes.

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9
Q

60% of lymphocytes have what ?

A

CD4+ marker; so they are T-helper cells

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10
Q

T-helper cells regulate T and B cell rxns by secretion of _____.

A

cytokines

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11
Q

30% of circulating lymphocytes have ____. What cells are these?

A

CD8+ marker; = cytotoxic T-cells (kill cells harboring microbes).

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12
Q

To respond, T cells must have what?

A

the antigen presented by antigen-presenting cells (APC).

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13
Q

APCs express what molecules?

A

major histocompatibility molecules (MHC)

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14
Q

T-helper lymphocytes recognized antigens expressed on ____ molecules, whereas cytotoxic lymphocytes recognized antigens expressed on ____ molecules.

A

class II MHC; class I MHC

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15
Q

antibody-dependent cell-mediated cytotoxicity (ADCC)

A
  • mechanism of cell-mediated immune defense whereby an effector cell of the immune system actively lyses a target cell, whose membrane-surface antigens have been bound by specific antibodies.
  • one of the mechanisms through which antibodies, as part of the humoral immune response, can act to limit and contain infection.
  • Classical ADCC is mediated by natural killer (NK) cells; macrophages, neutrophils and eosinophils can also mediate ADCC.
  • ADCC is part of the adaptive immune response due to its dependence on a prior antibody response.
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16
Q

natural killer cells make what % of blood lymphocytes?

A

10-15%

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17
Q

Natural killer cells ?

A
  • have no T-cell markers or Ab production
  • lyse tumor cells or infected cells w/o previous sensitization
  • 1st line of defense against some tumors & viruses
  • also can lead to AB-dependent cell-mediated cytotoxicity (ADCC)
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18
Q

function of macrophages?

A

1) required to process and “present” antigens to lymphocytes;
2) effectors of cell-mediated immunity; produce cytokines influencing growth and function of lymphocytes, inflammation, fibroblast proliferation, and collagen deposition;
3) Phagocytic in response to T-cell activation or opsonization.

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19
Q

members of the macrophage family, although weakly phagocytic?

A

dendritic cells (in lymphoid tissue); Langerhans cell (in epidermis, oral mucosa)

  • important for presenting antigens
  • also produce anti-viral cytokines
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20
Q

Ag-Ab activates what…?

A

9 sequential components aka complement

21
Q

Complement activates ?

A
  • anaphylaxis (i.e. c3a, c5a)
  • chemotaxis (c5a)
  • opsoninization (c3b)
  • lysis of cells (MAC)
22
Q

what are cytokines of innate immunity?

A

intercellular mediators produced in response to microbes and other stimuli and mediate inflammation and anti-viral defense (TNF, IL-1, type 1 IFNs)

23
Q

functions of cytokines of adaptive immunity?

A

promote lymphocyte proliferation and differentiation and to activate effector cells (IL-2, IFN-y)

24
Q

____ stimulates hematopoiesis (colony stimulating factors).

25
innate immunity?
defense mechanisms that are present before infection (i.e. epidermis, phagocytic cells, dendritic cells, NK cells)
26
adaptive immunity?
- lymphocytes and their products | - humoral vs cell-mediated
27
humoral immunity?
- associated w/ AB production\ - B lymphocytes and ABs play predominant role - AB (IgA, IgE, IgG, IgM) act on Ags, resulting in neutralization, lysis, phagocytosis.
28
cell-mediated immunity?
- cellular neutralization of Ags - predominant role is played by T-lymphocytes - Ags are destroyed by lymphocytes, macrophages, etc directly or via cytokines
29
X-Linked Agammaglobulinemia?
aka Bruton Disease - failure of pre-B cells to differentiate into B cells - Ig molecules are not assembled due to failure of light chain production
30
Clinical features of X-liked Agammaglobulinemia?
- absent or decreased #'s of B cells - depressed serum levels of all Ig classes - normal T cell-mediated - germinal centers (composed mostly of B cells) reduced in size - recurrent bacterial (pharyngitis, sinusitis, pneumonia) and certain viral infections (enteroviruses)
31
tx of X-linked Agammaglobulinemia?
replacement therapy w/ human Ig
32
DiGeorge Syndrome?
- failure of development of 3rd and 4th phraryngeal arches - absence of thymus, as well as parathyroids - facial structures will also be underdeveloped
33
Severe combined immunodeficiency?
- X-linked, associated w/ failure in lymphocyte (esp T-lymphocyte) development - autosomal recessive form associated w/ deficiency of adenosine deaminase
34
Isolated IgA deficiency?
typically asymptomatic; compromised mucosal defenses; respiratory, GI, urogenital infections
35
Complement deficiency?
- angioedema--repaid swelling under dermis - causes: 1. allergy 2. complement deficency
36
HIV primarily targets what?
the immune system and CNS
37
how is HIV transmitted?
sexual contact, parenteral exposure to blood, maternal/fetal
38
what is the target cell of HIV?
cells w/ CD4 receptors (primarily T-helper lymphocyte)
39
Viral RNA is permanently integrated into host DNA via... ?
reverse transcription
40
What is the half-life of HIV?
half-life of 2 days; rapid turnover of HIV
41
what are the 3 things HIV virus can do?
1. remain silent 2. cause cell death 3. disrupt normal cell function
42
what is the clinical course of HIV infection?
- acute, self-limited response (similar to infectious mononucleosis) - 8-10 year asymptomatic stage - symptomatic stage (AIDS-related complex)
43
AIDS?
- endpoint of HIV deficiency - 5 yrs after infection- 18% have AIDS - 13 yrs after infection - 65% have AIDS, 20% have symptoms, & 15% have no symptoms
44
AIDS-related complex (ARC) clinical features?
- fever, wt loss, diarrhea, candidiasis, herpes zoster, hairy, leukoplakia - increased infections: cytomegalovirus, herpes simplex, toxoplasmosis - pulmonary - pneumocystis carinii oneumonia (presenting sign in 50%) - AIDS-dementia complex
45
Type 1 hypersensitivity
allergy/anaphylaxis; IgE mediated | - IgE binds to mast cells, releasing HISTAMINE and other vasoactive amines
46
Type II hypersensitivity
antibody dependent - complement dependent (transfusion rxns, erythroblastosis fetalis) - Ab-dependent cell-mediated cytotoxicity (ADCC) - Ab-mediated cellular dysfunction (myasthenia gravis, Grave's disease)
47
Type III hypersensitivity
- immune complex-mediated (SERUM SICKNESS, glomerulonephritis) - Ag + Ab + Complement - Recruitment of neutrophils, resulting in tissue destruction
48
Type IV Hypersensitivty
cell-mediated - delayed type - TUBERCULIN RXN, poison ivy, contact rxns) T- cells & mac's; chronic rxns may result in granulomatous inflamm - T- cell mediated cytotoxicity - type I diabetes - tissue is destroyed by cytotoxic (CD8+) T cells