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Medicine 1 > Week 9 - Immunity > Flashcards

Week 9 - Immunity Flashcards

1
Q

What are the primary lymphoid organs?

A

Bone marrow

Thymus

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2
Q

What are the anti-microbial secreted immunity mediators?

A

Antibodies

Defensins

Interferons

Lytic enzymes

Cytotoxins

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3
Q

What are the regulatory / inflammatory secreted immunity mediators?

A

Cytokines

Chemokines

Prostaglandins

Histamine

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4
Q

What are the properties of innate immunity?

A

Quick activation

Same upon repeated exposure to same microbe

Moderate efficiency

General response to microbes

Recognition of PAMPs (pathogen-associated molecular patterns)

Recognition by PRRs (pattern recognition receptors)

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5
Q

What are the properties of acquired immunity?

A

Slower activation

Improvement on repeated exposure to same microbe

High efficiency

Specific response to individual microbes

Recognition of antigens specific to each microbe type

Recognition by antigen-specific receptors clonally expressed by lymphocytes

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6
Q

What is the primary immune response?

A

Epithelial barrier

Immediate local response / innate response (complement proteins and macrophages)

Early induced response / innate / inflammatory response (inflammatory mediators from complement, macrophages, mast cells –> attract leucocytes and serum proteins)

Later adaptive response (antigens carried to lymphoid tissue by dendritic cells –> T / B lymphocyte activation and Ab production –> recirculation to infection site)

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7
Q

What is immunopathology?

A

Diseases involving defects in the immune system (immunodeficiency, allergy, autoimmunity, transplant rejection, lymphoproliferative diseases)

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8
Q

What are the properties of B lymphocyte antigen recognition?

A

Antigen recognition receptors = membrane bound immunoglobulins

Surface immunoglobulins = surface receptors

Secreted immunoglobulins = antibodies

All receptors are identical on 1 cell

Interaction of antigen and receptor = B cell activation / proliferation

Further differentiation to form plasma cells

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9
Q

What happens during clonal selection?

A

Clone with most specific surface immunoglobulins = have primary response then secondary response to the infection –> less specific don’t undergo response to infection

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10
Q

What are the properties of blood?

A

A tissue

8% body mass

45% RBCs

1% WBCs and platelets

55% is plasma –> albumins = transport, colloidal osmotic pressure – globulins = transport, clotting, precursors to hormones, defence – fibrinogen = clotting

Serum = coagulated plasma

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11
Q

What are the properties of blood cells?

A

Discoid

No nucleus

Has haemoglobin for O2 / CO2 transport

120 day lifespan

Foetus and neonatal production = liver and spleen

Neonatal, child and adult production = bone marrow

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12
Q

What are the 5 leucocyte types and their proeprties?

A

Neutrophils = microorganism phagocytosis

Eosinophils = parasite killing and inflammation

Basophils = histamine release in hypersensitivity reactions

Monocytes = phagocytic, leave blood and become macrophages

Lymphocytes = produce antibodies

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13
Q

What are the types of phagocytes and immunocytes?

A

Granulocytes

Monocytes

Lymphocytes

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14
Q

How is white blood cell production controlled?

A

Colony-stimulating factors

CSFs stimulated by infection

Recombinant CSFs = improve reduced WBC count after anticancer drugs

Interleukins

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15
Q

What are the different blood groups and their properties?

A

Determined by RBC antigens

ABO and Rhesus = clinically important ones

A = A antigens, b-antibodies

B = B antigens, a-antibodies

AB = AB antigens

O = no A or B antigens, has a and b antibodies

O Rh -ve = universal emergency donor

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16
Q

What are the properties of blood counts?

A

Cells per volume –> machine or manually calculated

Haematocrit / packed cell volume –> centrifuge blood and find RBC % (male = 40-52%, females = 36-48%)

Haemoglobin –> amount per 1 Litre (males = 135-175 g/L, females = 115-155 g/L)

Identify anaemias

Mean corpuscular volume –> volume of individual RBCs –> identifies microcytic, macrocytic anaemia and alcohol abuse

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17
Q

What is Hb/RBC and Hb/PCV?

A

Hb/RBC = mean corpuscular Hb – reduced with iron deficiency or small cell size

Hb/PCV = mean corpuscular Hb conc. – reduced when large cells with impaired haem production

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18
Q

What are Rhesus D antigens required for?

A

+ve or -ve

Required in pregnancy –> new-born haemolytic disease

Prevent with Anti-D immunisation – Anti-D immunoglobulin

Give to mother after 1st child delivery

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19
Q

What are the components of blood and their functions?

A

RBCs:

Oxygen transport

WBCs:

Immune defence

Platelets:

Clotting

Plasma

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20
Q

What are not detected in blood?

A

Plasma calles

Macrophages

Mast cells

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21
Q

What are the properties of mast cells?

A

Recruit circulating leukocytes. Widening of vessels –> slower flow, induce arrestins –> inflammation, swelling

In most slides, mast cells have lost their granules due to the preparation Toluidine stained resin sections

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22
Q

What are the properties of macrophages?

A

Engulf foreign substances and cells and digest their contents.

Large cells, nucleus generally light, oval or even dented, often with nucleolus

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23
Q

What are the properties of plasma cells?

A

“antibody factories” differentiated from B-lymphocytes

Characteristic round nucleus with heterochromatin clumps around the periphery and in the middle. The nucleus is often off centre.

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24
Q

What are the properties of leukocytes?

A

Attracted to infected site from bloodstream –> swelling = caused by loosening of epithelial junctions for cell transit

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25
What are secreted immune mediators?
Granulocytes, macrophages, natural killer cells, mast cells Limited specificity + destructive power
26
Where are B and T lymphocytes generated?
In bone marrow
27
What happens during clonal selection of T cells?
Epitope binds to T cell receptor T cell multiplies rapidly Identical progeny formed
28
What happens during B cell differentiation?
Antigen binds with epitope to B cell receptor Clonal amplification Differentiate into plasma cells Shed receptors, forming antibodies
29
What happens at the secondary lymphoid system?
Matching venues (lymph follicles, tonsils, lymph nodes, spleen): where antigens and lymphocytes are matched
30
What are matching venues?
Appear as aggregates of many lymphocytes Site of antigen presentation, T and B cell activation and expansion Reticular fibres allow lymphocytes and APCs to circulate around them Lymphocytes exit/enter via blood vessels with broadened epithelia
31
What is a lymph nodule? What are tonsils? What are lymph nodes?
Just underneath epithelia, no distinct connective tissue capsule --\> common in airways and digestive tract Aggregate of lymph follicles in partial collagen capsule Encapsulated aggregates of follicles with lymph percolating through them
32
How are subclavian veins formes?
Leaky capillary system around lymph nodes Liquid is pressed into interstitial tissue Liquid is collected in lymph capillaries These congregate into lymph vessels Subclavian veins form with lymph nodes in-between
33
What is a complement?
Collection of proteins found in tissue fluids and circulation Act as activation enzymes, immune defence molecules, control proteins Infection and immune activation activate complement proteins, occurring as chain reaction Activation steps = involve enzymes splitting complement proteins
34
What does Fc region of antibody bind to and when?
C1q, only is it is bound to an antigen too
35
What happens during the MBL pathway?
MBL = interacts with microbial surface instead of antibody --\> activates MASP-1/2 Generates C3 convertase
36
What happens during the alternative pathway?
Uses compliment proteins to form C3 convertase
37
How does the membrane attack complex work?
Destroys microbe by punching holes in its membrane
38
What are the properties of extracellular digestion?
For parasites as they vary in size Attaches to antibodies Releases digestive vesicles instead of phagocytosis
39
What happens during mast cell mediator release?
Soak up IgE on surface Gain antigenic specificity of antigen Cross-linking = IgE binds to both receptors Activates mast cell C3a and C5a compliment proteins also activate mast cell Mediators released, causing inflammation
40
What happens during the acute phase response to infection / systematic inflammatory response?
Inducing cytokines – act on hypothalamus, liver and bone marrow Fever Leucocytosis from bone marrow Acute phase proteins released from liver
41
What is bacterial taxonomy important for?
Handling information Learning Communication Identification Evolution
42
What are the ways bacteria is phenotypically classified?
- Morphology (Growth on agar medium: shape, margin, elevation, size, texture, appearance, pigmentation, optical density) (Single cells: Shape – rod, club, coccus, curved, spirillum, spirochaete, size, staining characteristics – Gram stain = true bacteria, Acid fast stain = mycobacteria, arrangement) Spores + capsules - Bio-typing - Serotyping - Antibiogram patterns - Phage typing
43
What are the ways bacteria is genotypically claffisied?
DNA hybridisation Nucleic acid sequence analysis Chromosomal DNA fragment analysis Ribotyping
44
What are the properties of gram stain on bacteria?
Differentiates bacteria on cell wall structure First test for bacterial infection diagnosis Gram positive = thick cell wall Gram negative = thin cell wall
45
What are the bacteria cell wall functions?
Maintain cell rigidity and structure Maintains osmolarity (prevents osmotic lysis) Survival Cell division
46
How is bacteria cell wall synthesised?
Synthesis of peptidoglycan precursor in cell Exported across cell membrane Enzymic action creates site in existing wall New nucleotide is incorporated minus terminal D-ala Cell grows
47
What are the properties of a mycobacterium cell wall?
Mycolic acid waxy coat Poor gram stain Acid fast
48
What are the properties of a mycoplasma cell wall?
No cell-wall Steroids in cell membrane
49
What are the properties of bacteria cell membrane?
Hydrophobic lipid bilayer No steroids Gram + and – bacteria Ion transport and energy production Mesosomes for cell division
50
What are the growth characteristice for bacteria?
O2/CO2 Temp Water pH Light Osmolarity
51
What are bacteria nutritional requirements?
Carbon source Nitrogen source Inorganic salts Organic compounds
52
What were the effects of groups on weight loss, smoking cessation and alcohol use?
Mostly female, significant weight change after 12 months in group than individual 5 weekly sessions, led by group members, self-help and nicotine replacement therapy, double rate of quitting in group than alone Inconclusive
53
What are the types of social support?
Perceived support, received support and structural support (integration into social network) Emotional Tangible (financial) Informational Companionship
54
What is loneliness? What is social isolation? What is solitude?
Difference in preferred and actual level of social contact Having minimal social contact Voluntary distance from social network
55
What is test sensitivity? What is test specificity?
Proportion of those with diseases which it correctly identifies Proportion of those without disease which it correctly identifies
56
What is positive predictive value? What is negative predictive value?
Probability a subject has disease given they have positive result --\> determined by prevalence and sensitivity and specificity Probability a subject doesn’t have disease given they have negative result
57
What is a diagnostic test? What is a screening test? What is a prognostic test?
Confirm or exclude presence of a disease Asses risk of disease in asymptomatic person to determine need for further diagnostic testing Asses risk of future disease and need for preventative measures
58
What is likelihood ratio?
Likelihood a positive test would be expected in a patient with disease compared to likelihood in patient without disease
59
What are the 3 components of attitude?
Affective component - emotions Behavioural component - actions Cognitive component - thoughts / beliefs
60
What must attitudes be to be consistent?
Stable Important Certain Consistent between cognition and affect Easily accessed Formed through direct experience
61
What is stigma? What is cognitive dissonance?
Cluster of negative attitudes and beliefs, motivating general public to fear, reject, avoid and discriminate against a particular group based on identifying feature When thoughts / beliefs / feelings don’t match behaviour or action - can cause attitude change or avoidance
62
What is discredited and discreditable stigma?
Visible stigma Invisible stigma
63
What is B cell antigen receptor made of? What is T cell antigen receptor made of?
Surface immunoglobulin 2 polypeptide chains (TCR 'alpha' and 'beta' chains) Both are anchored in surface membrane Each composed of 2 immunoglobulin-like domains
64
How many antigen combining sites do B and T cells have?
65
What is the role of T helper cells? What is the role of T cytotoxic cells?
- Help other immune cells fulfill their function - Activate B cells - Stimulate phagocytotic activity of macrophages
66
What are HLA proteins and their role?
- Human antigen-binding proteins - Associate with proteins that hold peptides on APC surface
67
What are the properties of HLA class 1 proteins?
- Have large 'alpha' chain non-covalently associated with 'beta'2-microglobulin polypeptide - 'alpha' domains of 'alpha' chain form cleft/groove on surface of protein - Groove formed distal to surface membrane - Present antigen peptides to Tc cells - Interact with CD8 on Tc cells
68
What are the properties of HLA class 2 proteins?
- 2 polypeptide chains (class ll 'alpha' and 'beta' chains) - Have immunoglobulin-like domains Proximal to surface membrane - Distal domains form peptide binding cleft - Present proteins to Th cells - Interacts with CD4
69
What is the purpose of CD8-Class 1 and CD4-Class 2 interactions?
- Strengthen overall APC and T cell binding - Provide additional activation signals - Both members of Ig superfamily
70
What happens during processing of antigens for presentation by HLA class 1 proteins?
- Degradation of endogenous protein antigens in cytoplasm - Degraded in proteasome enzyme complex - Some peptides transferred for endiplasmic reticulum vie peptide transporter proteins - Some associate with new HLA class 1 proteins - New compelxes translated to cell surface for recognition by Tc cells expressing CD8
71
What happens during the process of antigen processing for presentation by HLA class 2 proteins?
- Internalisation of exogenous protein antigen into vesicle by endocytosis - Antigen degraded by enzymes entering vesicle - New HLA class 2 in endoplasmic reticulum associate with invariant chain and go to vesicle - Invariant chain is degraded and antigen associate with HLA class 2 protein - HLA class 2 transported to cell surface for recognition by Th cells expressing CD4
72
What are the differences between HLA class 1 and 2 proteins in the body?
- HLA class 1 expressed by most cells in body - HLA 2 expression restricted to immune system cells
73
What are the properties of DCs (dendritic cells)?
- Primary stimulators of naïve resting T cells - Capture antigens and transport them to lymphoid tissue - Can activate both Tc and Th cells as their peptides bind to both HLA class 1 and 2 molecules - Activated when microbial molecules bind to them - Produce cytokines which activate T cells, once activated

Medicine 1 (28 decks)

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