Ihr Exam I

Front 1

Complement Receptor Type I

Back 1

Found on phagocytes, neutrophils, B cells, Eosinophils, RBC

Serve to phagocytize and clear immune complexes

cleaves c3b and c4b as a regulatory control - make sure their isnt over production of complement

Front 2

Complement Receptor Type II

Back 2

Found on B cells, Dendritic Cells

B cells - helps to activate

dendritic cells - helps to trap antigens in the germinal center

Serves as a receptor for EBV -HIJACKER

Front 3

Complement Receptor Type III

Back 3

Found on Mononuclear phagocytes, neutrophils, and NK Cells

Serves to phagocytize

Helps the WBC adhere to the endothelium via ICAM

Front 4

Complement Receptor Type IV

Back 4

Found on mononuclear phagocytes, neutrophils, and NK Cells

Serves to phagocytize

Helps the WBC adhere to the endothelium

Front 5

Purpose of Complement (3)

Back 5

1. to opsonize the macrophage for phagocytosis (c3b or c4b)

2. stimulate immune response (c3a and c5a)

3. cell lysis via mac - c3b

4. B Cell Activation - C3d (cleavage product of C3b) binds to C receptors on B cells; initiates immune responses

Front 6

Complement Deficiencies of the Classical Pathway

Back 6

C2 & C4 - autoimmune dieases (SLE)

C3 - leads to gram + bacterial infections

Front 7

Complement Deficiencies of the Alternative Pathway

Back 7

Properdin & Factor D - leads to gram + bacterial infections

Front 8

Complement Deficiencies of the MAC

Back 8

CD5-9 leads to Neisseria bacterial infections

Front 9

Receptors on T helper lymphocytes, T cytotoxic cells, B lymphocytes, and NK Cells

Back 9

T helper cells: CD 3+. CD 4+

T cytolytic cells: CD 3+, CD 8+

B lymphocytes: Fc Receptors; Class II MHC, CD 19 & CD 21

NK Cells: Fc receptor for IgG

Front 10

Name all 5 Immunoglobulins and their subclasses

What are elevated Ig indicative of?

Back 10

IgG - gamma 1-5

IgM - none

IgA - alpha 1 and alpha 2

IgE - none

IgD

-ANy Ig elevations are indicative of cancer

Front 11

IgG

IgG3

Back 11

- principal mediator of secondary immunity

- can cross the placenta and provide passive protection to the fetus

IgG3 - most effective at binding complement bc it has a large hinge region, however the large hinge is susceptible to proteases

Front 12

Elevated IgG levels are indicative of:

Back 12

infections, liver diseases, autoimmune diseases, cystic fibrosis, sarcoidisis

severe: myeloma, monoclonal gammopathy

Front 13

IgM

Back 13

-prinicipal mediator of primary immune response

- pentamer with s-s bond to a j chain

- increases antigen agglutination visibility

Front 14

Elevated IgM levels are indicative of:

Back 14

IgM monoclonal gammopathy, infection,PARASITIC INFECTION, liver diseases, autoimmune diseases, nephrotic syndrome, polycythemia vera, HEROIN ADDICTION, Waldenstrom's macroglubulinemia

Front 15

IgA1 & IgA2

Back 15

IgA1 - monomer present in the circulation

IgA2 - dimer is the predominant antibody in mucosal secretions

Front 16

Elevated IgA levels are indicative of:

Back 16

IgA monoclonal gammopathy, infections, liver diseases, cystic fibrosis, CELIACS, Berger's disease, sarcoidosis,

memory jog: A = Angel Hair Pasta can't be eaten in Celiacs

Front 17

IgD

Back 17

rare; found on surface of B cells

Front 18

IgE

Back 18

-binds to very high affinity Fc receptor on mast cells & basophils, lymphocytes

- mediator of hypersensitivity, allergies, asthma

- primary antiparasitic antibody, sensitizes worms and other parasites for destruction by eosinophils

- sends signals to mast cells saying "fire"

Front 19

Elevated IgE levels are indicative of:

Back 19

allergic disorders, hypersensitivity disorders, parasitic infections, immunologic disorders, infectious mononucleosis, IgE myeloma

Front 20

Toll like receptors

Back 20

-found on phagocytes

TLR 1, 2, 4, 5 9 - bacteria sensitive
- TLR 2 - bacterial comp
- TLR 4 - for LPS
- TLR 9 - for bacterial and
viral DNA sequences

TLR 3, 7, 8 are viral sensitive and found on the endosome - not the plasma membrane
- TLR 3 - recognizes ds RNA

Front 21

Chromosome location of heavy chain gene

Back 21

chromosome 14

Front 22

Chromosome location of light chain kappa

Back 22

chromosome 2

Front 23

chromosome location of light chain gamma

Back 23

chromosome 22

Front 24

Origin of Acute Lymphocitic Leukemia

Back 24

Pro B Cell

Front 25

Origin of Chronic Lymphocytic Leukemia

Back 25

Mature B Cell with overexpression of kappa or lambda light chains

Front 26

Origin of Myeloma

Back 26

Mature Plasma Cell leading to Bence Jones Proteinuria - light chains in the urine

Front 27

Burkitt's Lymphoma

Back 27

translocation of chromosomes 14 and 8 . So the heavy chains on chromosome 14 are affected.

C-myc gene is placed in front of the heavy chain promoter which leads to gross overproduction of heavy chains

Front 28

Isotype Switching Methods

Back 28

1. IL - 4 induces IgE isotype switching
2. TGF - B increases IgA production
3. IFN- Gamma enhances IgG2a

Front 29

An increased sedimentation rate for erythrocytes is associated with:

Back 29

Induction of fibrinogen by IL-6

Front 30

Which neurotransmitter associated with the induction of fever?

Back 30

Prostaglandin E

Front 31

Role of IL 1/ TNF

Back 31

Leukocyte migration to site of injury

Front 32

Role of EGF

Back 32

epithelial and fibroblast growth

Front 33

Role of TGF Beta

Back 33

inhibits the division of the cell

Front 34

Role of TGF alpha

Back 34

promotes the division of the cell

Front 35

Immunodeficiency Disease Types

Back 35

- B & T Cell Maturation deficits
- B & T cell activation deficits
- signaling deficits
- multi - system deficiencies
-phagocyte disorders
- complement system deficiencies

Front 36

SCIDS - signs

Back 36

-failure to thrive
- candidiasis
- chronic diarrhea

Front 37

SCIDS - causes

Back 37

-IL 2 gamma receptor deficits - 2, 7, 9, and 4 - especially 7
-JAK
-ADA - adenosine deaminase
- RAG 1/RAG2 deficits - so no TCR or Ig

Front 38

DiGeorge's Syndrome - signs

Back 38

-Deficient T cells - so susceptible to intracellular microbes and viruses
-absent parathyroids = Tetany due to Ca2+ deposits
- facial deformities
-

Front 39

X-Linked agammaglobulinemia - causes

Back 39

-B Cell tyrosine kinase gene deficiency leading to lack of maturation past Pre-B stage

Front 40

Di Georges - Causes

Back 40

failure of development of the third and the fourth pouch

Front 41

X linked Agammaglobulinemia - signs

Back 41

-reduced plasma cells
- no germinal centers
- normal t cells
- autoimmune diseases

Front 42

Bare lymphocyte Syndrome - types and differences

Back 42

-MHC Class II deficit - affects both MHC I and MHC II

- MHC Class I deficit - TAP deficiency and shows up as NK Cells and gamma-delta T cells

Front 43

Bare Lymphocyte Syndrome - symptoms

Back 43

-Frequent URIs
- chronic lung infections
-skin lesions

Front 44

Signaling Defects

Back 44

-Zap 70 defects
-CD3 error
- X-Linked Hyper IgM

Front 45

Ataxia Telangiectasia - cause

Back 45

mutation @ ATM gene on chromosome 11 leading to neurologic deficits and hematopoietic cancer

Front 46

Wiskott ALdrich Syndrome

Back 46

No platelets leads to Eczema .

- due to mutation in WAS protein
- results in low IgM levels

hint: Baby with Ezcema

Front 47

Chronic Grabulomatous Disease

Back 47

deficit in cytochrome b558 results in inability to produce peroxide

- results in inflammatory reactions and non malignant granulomas

hint: Michael Jackson nose

Front 48

Leukocyte Adhesion Deficiency - LAD 1

Back 48

deficiency of CD 18 Beta 2 on WBC prevents it from migrating to inflammatory site

Front 49

Leukocyte Adhesion Deficiency - LAD2

Back 49

No fucose - so Leukocyte can not interact with E and P selectins

Front 50

Heriditary Angioneurotic Edema

Back 50

failure of C1 inhibitor to stop complement cascade resulting in edema

Front 51

Location of B cells in the Lymph node and spleen

Back 51

B cells are found primarily in the marginal zone of the spleen and in the follicles of the lymph nodes

Front 52

Location of T helper & T cytolytic cells in the Lymph nodes and spleen

Back 52

T helper cells localize in the periarteriolar lymphoid sheath (PALS) in the spleen ad the paracortex of lymph nodes.

Front 53

Purpose of Pcam

Back 53

diapedesis of WBC

Front 54

Purpose of Il 1 and TNF alpha

Back 54

stimulation of inflammatory response

Front 55

LFA Icam

Back 55

involved in wbc adhesion

Front 56

Positive Selection

Back 56

Process by which T cells which express a low avidity to MHC are selected to survive

Front 57

Negative Selection

Back 57

process by which T cells which express a high avidity to MHC are eliminated

Front 58

Medullary areas of the Lymph node are inhabited by:

Back 58

activated T cells and plasma B cells

Front 59

Where are idiotypic determinants found on on Antibodies

Back 59

In the variable region

Front 60

What does TdT regulate?

Back 60

Increased diversity in both the TCR and Ig molecules.

Front 61

What cells are capable of antigen presentation?

Back 61

B cells, macrophages, activated T cells and others

Front 62

what bonds are responsible for the formation of antibody/antigen interactions?

Back 62

All non covalent bonds

1. hydrogen bonds,
2. electrostatic interactions,
3. Van Der Waals interactions [induced dipoles],
4. hydrophobic interactions [exclusion of water]).

Front 63

true or false: Before Th Cells differentiate into Th1 and Th2 they are doubly positive

Back 63

false: T helper cells are not shown to be doubly positive at any point

Front 64

How are Th1 cells stimulated from Th Cells? What do they produce?

Back 64

-Th 1 cells are stimulated by IL 12 and make :
-IFN gamma which is involved in macrophage activation and isotype switching
- LT and TNF activate and recruit WBC to the site of inflammation

* think : CMI responses to viruses/intracellular pathogens.

Front 65

How are Th 2 cells stimulated from Th Cells and what do they produce?

Back 65

-Th2 cells are stimulated by IL-4 and make :
-IL 4 - stimulates IgE production
-IL - 5 - stimulates Eosinophil recruitment
- IL 10 which inhibits the activation of macrophages

Front 66

What can happen if you mount the wrong Th (1 v 2) response to a bacterial infection?

Back 66

If a person is infected w/ M. Leprae, two responses can occur:
-Th1 = tuberculoid leprosy
- Th2 = Lepramatous Leprosy --> FAR HIGHER BACTERIAL COUNT!!

Front 67

During development, which of the following is the first protein product synthesized by a B cell?

Back 67

Mu heavy chain

Front 68

define epitope and paratope

Back 68

-epitope - part of antigen that binds directly to the antigen
- paratope - region of the antibody that binds directly to the antigen

Front 69

what components of CTL are important for killing?

Back 69

Perforin and granzyme B stored in granules

-also contains IFN gamma, but it is not stored in granules

Front 70

What cells are associated with a granulomatous reaction?

Back 70

epithelioid macrophage

Front 71

What is the characteristic inflammatory cell associated with an allergic response?

Back 71

Eosinophil

Front 72

A patient with severe asthma gets no relief from antihistamines. The symptoms are MOST likely caused by:

Back 72

Leukotrienes

Front 73

Where is IgD most often seen?

Back 73

IgD is primarily seen on the surface of B cells and is used as a marker of B cell development

Front 74

Poison Ivy

Back 74

A T cell response to a specific antigen

Front 75

Where in the Antibody does somatic hypermutation occur?

Back 75

Occurs in the hypervariable region

Front 76

What immunoglobulins to peripheral or circulating immunoglobulins express?

Back 76

IgM and IgD, after undergoing rearrangement of heavy and light chain genes