Dit: Immuno

Front 1

Where are B cells found in the lymph nodes?

Back 1

Follicles

Primary follicles are dark (inactive)

Secondary follicles have a pale center (active)

Front 2

Where are T cells located in the lymph node?

Back 2

Paracortex

Front 3

Where are T cells located in the spleen?

Back 3

PALS in white pulp

Front 4

Where are B cells located in the spleen?

Back 4

Follicles in white pulp

Front 5

How does splenic dyfunction affect IgM, complement activation, and C3b opsonization?

Back 5

Decreased IgM

Decreased complement activation

Decreased C3b opsonization

**SUSCEPTIBLE TO ENCAPSULATED BACTERIA**

Front 6

where do you see Howell Jolly bodies and target cells?

Back 6

post-splenectomy

Front 7

What does the medulla of the thymus contain?

Back 7

Mature T cells and Epithelial reticular cells

Front 8

Where does (-) selection take place in the thymus?

Back 8

corticomedullary junction

Front 9

This immune response is mediated by PMNs, Macrophages, dendritic cells, NK cells and complement

Back 9

Innate Immunity

(no memory)

Front 10

This immune response makes memory cells. It involves T cells, B cells and circulating antibody

Back 10

Adaptive

Front 11

This MHC is expressed on all nucleated cells except RBCs

Back 11

MHC I

Front 12

If a patient is deficient in β2-microglobulin, how will that affect immunity.

Back 12

MHC I will not be able to bind TCR and CD8

(No CD8 response)

Front 13

What are the HLA-genes for MHC I?

Back 13

HLA-A

HLA-B

HLA-C

Front 14

This form of MHC is only expressed on Antigen-presenting cells

Back 14

MHC II

Front 15

This form of MHC binds CD4

Back 15

MHC II

Front 16

What are the HLA-genes for MHC II?

Back 16

HLA-DR

HLA-DQ

HLA-DP

"A Dr. went to DQ for a DP"

Front 17

HLA type for hemochromatosis?

Back 17

A3

Front 18

HLA type for Graves Dz?

Back 18

B8

Front 19

HLA type for MS, hay fever, SLE, Goodpasture's?

Back 19

DR2

Front 20

HLA type for Diabetes type I

Back 20

DR3

Front 21

HLA type for Rheumatoid Arthritis and DM type I?

Back 21

DR4

(DM type I = DR3,DR4)

Front 22

HLA type for pernicious anemia?

Back 22

DR5

Front 23

To what lymph node do the testes drain?

Back 23

PARA-AORTIC nodes

Front 24

To what lymph nodes does the Rectum drain (above pectinate line)

Back 24

Internal iliac nodes

Front 25

To what lymph nodes does the Anal canal drain? (below pectinate line)

Back 25

Superficial inguinal nodes

Front 26

____ duct drains lymph of right side of the head and the right arm

Back 26

Right lymphatic duct

(thoracic duct drains everything else)

Front 27

Which cells act as the "dendrocytes" of MALT tissue in the gut?

Back 27

M cells --> activate IgA

Front 28

NK cells use _____ and ____ to induce apoptosis of virally infected cells

Back 28

perforin + granzyme

Front 29

NK cell activity is enhanced by which cytokines?

Back 29

IL-12

IFN-α

IFN-β

Front 30

Which cytokine released by Th 1 cells activates Macrophages?

Back 30

interferon-γ

Front 31

Where are B cells made?

Back 31

bone marrow

Front 32

Where do B cells mature?

Back 32

lymph follicles

Front 33

CD4+ Helper T cell activation requires 2 signals. What are they?

Back 33

1) Foreign Ag presented on MHC II and recognized by TCR

2) "costimulatory signal"
-Interaction of B7 (APC) and CD28 (T-cell)

Front 34

What cytokine from Th2 cells (-) Th1 cells?

Back 34

IL-10

Front 35

What cytokine from Th1 cells (-) Th2 cells?

Back 35

IFN-γ

Front 36

Which T-helper cells activate Macrophages and CD8+ T cells?

Back 36

Th1

Front 37

Cytokines released by Th1 cells?

Back 37

IL-2, IFN-γ

Front 38

Cytokines released by Th2 cells?

Back 38

IL-4, IL-5, IL-10

Front 39

What cytokines are released by Macrophages?

Back 39

IL-1, TNF-α

Front 40

Which T-helper cell mediates the humoral response?

Back 40

Th2

Front 41

Which T-helper cell mediates the innate response?

Back 41

Th1

Front 42

Which immunoglobulin crosses the placenta to form passive immunity for the fetus?

Back 42

IgG

Front 43

Does IgM cross the placenta?

Back 43

NO

Front 44

Which immunoglobulin is produced in the primary response to an antigen (imediate)

Back 44

IgM

Front 45

IgA is a ___ in circulation and a ____ when secreted

Back 45

monomer in circulation

dimer when secreted

Front 46

Which immunoglobulin mediates the immune response to worms by activating eosinophils?

Back 46

IgE

Front 47

What is the cause of Hereditary angiodema?

Back 47

C1-esterase inhibitor deficiency

(needed to prevent complement activation on self cells)

Front 48

What are 2 of the ways the body inhibits complement activation on "self" cells?

Back 48

DAF (decay accelerating factor)

C1 esterase inhibitor

Front 49

What complement inhibitor is mutated in paroxysmal nocturnal hemoglobinuria?

Back 49

DAF

Front 50

A deficiency in this complement protein may lead to reccurrernt pyogenic infections and sinusitis.

Increases susceptibility to type III hypersensitivity reactions

Back 50

C3

Front 51

Which immunoglobulin forms pentamers?

Back 51

IgM

Front 52

Which cytokine stimulates T cells?

Back 52

IL-2

Front 53

Which cytokines produce fever?

Back 53

IL-1, IL-6, TNF

Front 54

Which cytokine stimulates bone marrow?

Back 54

IL-3

Front 55

Which cytokine mediates SEPTIC shock?

Back 55

TNF-α

Front 56

Name 3 chemotactic agents:

Back 56

IL-8

C5a

Leukotriene B4

Front 57

Which cytokine stimulates IgE production?

Back 57

IL-4

Front 58

Which cytokine stimulates IgA and Eosinophil production?

Back 58

IL-5

Front 59

Which cytokine stimulates differentiation of T cells to Th1 cells, (+) NK cells, and is also secreted by B cells?

Back 59

IL-12

Front 60

___ are proteins that place uninfected cells into an anti-viral state.

They induce production of a RIBONUCLEASE that inhibits viral protein synthesis by degrading viral mRNA

Back 60

interferons

Front 61

What is the B cell receptor for the Epstein-Barr virus?

Back 61

CD21

Front 62

Cell surface proteins:

-CD3

Back 62

T-cells

Front 63

Cell surface proteins:

-CD19, CD20, CD21

Back 63

B cells

Front 64

Cell surface proteins:

-CD14, CD40

Back 64

Macrophages

Front 65

Cell surface proteins:

-CD16

Back 65

NK cells

Front 66

A state of immune unresponsiveness.

Induced when the T cell's antigen receptor is stimulated, effectively freezing T cell responses pending a "second signal" from the antigen-presenting cell.

Back 66

Anergy

**Need co-stimulatory B7-->CD28 signal**

Front 67

Endotoxins/LPS of G- bacteria directly stimulate macrophages by binding to the _____ receptor

Back 67

CD14

Front 68

What type of hypersensitivity reaction takes place in patients with:

-SLE
-Rheumatoid arthritis
-Polyartertitis nodosum
-Post-streptococal GN

Back 68

These are all Type III

(immune complexes)

Front 69

What type of hypersensitivity reaction is:

-DM 1
-MS
-Guillian-Barre
-Hashimoto's thryroiditis

Back 69

Type IV

(T-cell mediated)

Front 70

____ deficiencies tendo to produce recurrent bacterial infections

Back 70

B cell deficiencies

Front 71

____ deficiencies tend to produce more recurrent fungal and viral infections

Back 71

T-cell

Front 72

This immunosuppressant binds to cyclophilins.

Blocks differentiation and activation of T cells by inhibiting calcineurin, which prevents production of IL-2 and its receptor

Back 72

Cyclosporine

Front 73

This immunosuppressant binds to FK-binding protein and inhibits the secretion of IL-2

Back 73

Tacrolimus

Front 74

This immunosuppressant binds to mTOR and inhibits T cell proliferation in response to IL-2

Back 74

Sirolimus

Front 75

This immunosuppressant is a monoclonal Ab with high affinity for the IL-2 receptor on activated T cells

Back 75

Daclizumab

Front 76

This immunosuppressant is a precursor to 6-MP that interferes with metabolismand synthesis of nucleic acids

Back 76

Azithriopine

**avoid use of allopurinol!**
active metabolite, MP, is metabolized by xanthine oxidase

Front 77

This immunosuppressant is a monoclonal Ab that binds to CD3 and blocks T-cell signal transduction.

Back 77

Muromomab-CD3 (OKT3)

Front 78

What drugs are composed of Ab to TNF?

Back 78

Infliximab
Etanercept
Adalimumab

(used in Crohns and RA)

Front 79

This immunodeficiency is caused by:

-defect in BTK gene (tyrosine kinase)

-Blocks pro-B cells from maturing

-recurrent bacterial infections after 6 months (maternal IgG wears off)

- see ↓ B cells, ↓ Ig's, ↑ pro-B cells

Back 79

Bruton's agamaglobulinemia

(XR)

Front 80

This immunodeficiency is caused by:

-defect in CD40L on T-helper cells

-NO CLASS SWITCHING

-recurrent bacterial infection

-↑↑IgM, ↓↓IgG, IgA, IgE

Back 80

Hyper-IgM syndrome

Front 81

This immune deficiency results in:

-Defect in isotype switching

-Anaphilactic shock on exposure to Blood products with IgA

Back 81

IgA-deficiency

Front 82

This immune deficiency causes:

-Decreased Th1 response

-disseminated mycobacterial infection

-↓IFN-γ

Back 82

IL-12 receptor deficiency

Front 83

This immune deficiency:

-T helper cells fail to make IFN-γ

-PMNs unable to respond to nuclei

-coarse facies, retained primary teeth, eczema and ↑IgE

Back 83

Job Syndrome (Hyper-IgE Syndrome)

Front 84

A patient with chronic mucocutaneous candiasis most likely has a ___ cell dysfunction

Back 84

T cell dysfunction

Front 85

Name this immune deficiency:

-defective IL-2 receptor
or
-adenosine deaminase deficiency

-Failure to synthesize MHC-II Ag

-Recurrent bacterial, fungal, viral infection

-Absence of thymic shadow, absence of germinal centers on lymph node biopsy.

Back 85

SCID

Front 86

Name this Immune Deficiency:

-Defect in ATM gene

- IgA-deficiency

-**Poor smooth pursuit + cerebellar ataxia**

-↑AFP in kids older than 8 mo.

Back 86

Ataxia Telangiectasia

Front 87

Name this Immune Deficiency:

-XR inheritance

-Progressive Deletion of B and T cells

-Triad:
Thrombocytopenic purpura
Infections
Eczema

-↑IgE, IgA.. **↓ IgM**

Back 87

Wiskott-Aldrich

Front 88

Name this Immune Deficiency:

-Defect in LFA-1 integrin (CD18) on phagocytes

-recurrent bacterial infections with NO PUS

-**delayed separation of umbilicus**

-Neutrophilia

Back 88

Leukocyte Adhesion Deficiency

Front 89

Name this Immune Deficiency:

-Lack of NADPH oxidase

- ↓ Reactive oxygen species

-absent respiratory burst

-Susceptible to catalase (+) organisms (S. aureus, E. coli, Aspergilus)

Back 89

Chronic Granulomatous Dz

Front 90

Name the Transplant rejection:

-Immediate

-Ab-mediated (Type II) hypersensitivity due to pre-formed donor antibodies in patient

Back 90

Hyperacute Rejection

Front 91

Name the Transplant rejection:

-Weeks after transplant

-Cell mediated due to CTLs reacting agains foreign MHC.

-Reversible with immunosuppressants

Back 91

Acute Rejection

Front 92

Name the Transplant rejection:

-Months to Years

-Class I MHC-nonself is seen as Class I MHC-self presenting an antigen.

-T-cell and antibody mediated vascular damage

-Fibrosis of graft tissue and vessels

Back 92

Chronic Rejection

Front 93

Abciximab targets GIIb/IIIa

-It prevents ___ from binding to GIIb/IIIa and blocks platelet adhesion

Back 93

fibrinogen