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131 Cards in this Set
- Front
- Back
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lymph drainage of upper limb and lateral breast
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axillary
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lymph drainage of stomach
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celiac
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lymph drainage of duodenum and jejunum
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superior mesenteric
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lymph drainage of sigmoid colon
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colin --> inferior mesenteric
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lymph drainage of rectum (lower part), anal canal above pectinate line
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internal iliac
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lymph drainage of anal canal below pectinate line
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superficial inguinal
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lymph drainage of testes
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superficial and deep plexuses --> para-aortic (retroperitoneal) LN
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lymph drainage of scrotum
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superficial inguinal
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lymph drainage of thigh (superficial)
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superificial inguinal
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lymph drainage of lateral side of dorsum of foot
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popliteal
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what does th1 secrete?
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IL-2, IFN-gamma and activates macrophages and CD8 T cells
inhibited by IL-10 |
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what does Th2 cell secrete ?
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IL4/5 and IL-10 help B cells make antibody IgE>G
inhibited by IFN gamma |
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what pairs with beta 2 micro globulin and what does it do?
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binds to MHC 1 to aid in transport to cell surface (essential for expression)
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for MHC 2 what happens before antigen is loaded
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release of invariant chain in an acidified endosome
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HLA A3 is with what disease?
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hemochromatosis
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HLA B8?
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graves disease
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HLA DR 2
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MS
hay fever SLE goodpastures |
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HLA DR 3?
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DM type 1
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HLA DR4
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DM type 1
RA |
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HLA DR 5?
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Pernivious anemia --> B12 deficiency
Hashimoto's thyroiditis |
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HLA DR 7?
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Steroid positive nephrotic syndrome
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what do macrophages release?
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IL-1 and TNF alpha
IL-6 |
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how do endotoxins/lipopolysaccharides stimulate macrophages?
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binding directly to endotoxin receptor CD 14
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what do regulatory T cells secrete? Also what CD makers do they express?
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express CD 3, CD 4, CD 25
IL-10 and TGF beta |
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where does antigen attach on an antibody?
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FAB region
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where do phogocytic cells attach to on antibody?
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binds to fc portion carboxy terminal
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where is site of compliment activation on antibodies?
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at Fc portion near hidnge
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what molecular process is involved in B cell isotope switching?
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alternative splicing of mRNA mediated by cytokines and CD40L
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what is the main antibody in secondary delayed response to antigen?
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IgG
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what antibody has the highest affinity for material toxins and viruses?
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IgG
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what antibody is a monomer in circulation?
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IgA
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what antibody is a dimer when secreted?
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IgA - tears, saliva, mucus and breast milk aka colostrum
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what antibody has a poly Ig receptor to J chain for transportation?
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IgA
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what antibody is produced in primary immediate response to an antigen?
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IgM
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what is a monomer or pentamer on B cells?
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IgM
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what is the purpose of having a pentamer shape?
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trap free antigens out of tissue while humoral response evoles
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what antibody has the highest avidity?
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IgM
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what antibody has the lowest concentration in serum?
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IgE
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what is allotrope - polymorphism?
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Ig epitope that differs among members of SAME species
can be on light or heavy chain |
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isotype?
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ig epitope common to a single class of Ig - 5 class on heavy chain FC region
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idiotype?
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specific for a given antigen - ig epitope determined by antigen binding site - hyper variable region is unique
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give example of thymus independent antigen?
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lack a peptide component - can't be presented by MHC to T cells = lipopolysaccharaide from cell envelope of gram neg bacteria and polysaccharide capsular antigen --> stimulate release of igM antibodies only DO NOT result in memory!!
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thymus dependent antigens?
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antigens with protein component like conjugated H influenze vaccine --> class switching and immunologic memory occur due to direct contact of B cells with Th cells (CD40-CD40L interaction) and release of IL4/5/6
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what is the receptor for EBV?
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CD 21
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what is on macrophages for receptor for Fc and C3b?
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CD 14
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what cytokines are specific for NK cells?
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CD 16 - bind Fc of IgG
CD 56 |
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what does parvovirus B19 bind to?
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erythrocyte P antigen
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what cell surface protein protects against complement mediated damage?
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CD 55
CD 59 |
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what aids in the clearance of immune complexes?
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C3b
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deficiency of C3?
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severy recurrent pyogenic sinus and resp tract infections
increase type 3 hypersentivitity reactions |
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what helps prevent complement activation on self cells?
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decay accelorating factor (CD55/59) and C1 esterase
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what are the neutrophil chemotaxis?
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IL8
leukotriene B4 C5a |
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Deficiency of C1 esterase inhibitor?
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hereditary angioedema = increase brady kinin
ACE INHIBITORS ARE CONTRAINDICATED |
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deficiency of C5-C8
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neisseria bactermia
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deficiency of DAF (GPI-anchored enzymes)?
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leads to complement-mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
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what do interferons do?
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induce production of ribonuclease to block viral protein synthesis by degrading viral mRNA (but not host mRNA)
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what infections if exposed to them would be treated by giving a patient passive immunity?
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"to be healed rapidly"
tetanus toxin botulinum toxin HBV rabies also premature babies in winter are given RSV monthly |
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what are some granulomatous diseases?
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tuberculosis - only caseasting one
fungal infections - histoplasmosis, blastomycosis etc syphilis - tremponema pallidum leprosy - m leprae cat scratch fever - bartonella henselae sarcoidosis crown's disease berylliosis listeria foreign bodies wegners chronic granulamotis disease larger epithelia macrophages w/ pale pink granular cytoplasm w/ CD 14 at periphery |
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immunology behind granulomatous diseases?
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th1 cells secrete IFN gamma activating macrophages
TNF alpha from macrophages induce and maintain granuloma formation anti-TNF drugs can break down granulomas leading to disseminated disease |
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type 1 hypersensitivity what happens on exposure then 2nd exposure?
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exposure = th2 --> IL4/5 = IgE production
2nd exposure = IgE from mast cells |
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tryptase?
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marker for has cell activation increased in type 1 hypersentivitiy response
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what reaction has edema necrosis and activation of complement?
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arthus reaction 5-12 hours it's type 3
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serum sicknesS?
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takes 5-10 days after antigen exposure
immune complexes form and fix complement - leads to tissue damage fever urticaria arthralgia proteinuria lmphadenopathy low serum C3 |
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type of hypersensitivity reaction of eczema?
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type 1
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type of hypersentivitiy of autoimmune hemolytic anemia
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antibody to RBC - type 2
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type of hypersneitivyt reaction of idiopathic thrombocytopenic purpura
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2
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type of hypersentivitiy of graves?
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anti-TSH antibody = 2
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type of hypersensitivity of rheumatoid arthritis?
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3 - rhematoid factor IgM against fc portion of IgG
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rheumatic fever hypersentiivgy reaction?
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2
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polyarteritis nodosa reactoin type?
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3
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what type of hypersensitivity reaction is hypersensitivity pneumonitis - farmers lung?
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type 3
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what type of hypersensitivity is type 1 DM?
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type 4
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what type of hypersensitivity is multiple sclerosis?
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spastic paralysis - type 4
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what type of hypersensitivity reaction is guillain-barre syndrome?
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4 molecular mimicry
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what type of reaction is hashimoto's thyroiditis
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type 4
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what type of hypersensitivity is graver vs host disease?
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type 4
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acute hemolytic transfusion reaction?
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type 2 reaction - activates compliment
intravascular hemolysis or extravascular fever hypotension tachypnea tachycardia flank pain hemoglobinemia (intravascular) or jaunace (extrvascular) chills shortness of breath |
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febrile nonhemolytic transfuction reaction?
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type 2 host antibodies against donor HLA antigens and leukocytes
fever chills headache flushing |
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autoantibody for scleroderma CREST?
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anti-centromere
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anti-scl 70
antiDNA topoisomerase I autoantibody |
diffuse scleroderma
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autoantibody to primary biliary cirrhosis?
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antimitochondrial
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antiendomysial autoantibody?
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celiac disease
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antimicrosomal antibody?
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hashimoto's thyroiditis
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anti-jo 1
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dermatomyositis polymyositis
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anti SSA (ro) anti SS b (la)
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sjogren's + SLE
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antiU1 RNA (ribonucleoprotein)
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mixed CT dissease
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anti-smooth muscle
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autoimmune hepatitis
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anti glutamate decarboxylase
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type 1 DM
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MPA ANH
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pauci immune cresentic glomerulonephritis
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what disease has defective CD40 L on helper T cells?
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inability to class switch --> hyper IgM syndrome
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what immune deficiency can be acquired in 20s-30s
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CVID - defect in b cell maturation many causes
increases risk of autoimmune disease, lymphoma, sinopulmonary infections normal b cell numbers but decrease plasma cells, immunoglobulins |
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what immune deficiencies have absent thymic shadows on CXR?
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di george
SCID |
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what gives you disseminated mycobaterial infections?
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defective il-12 --> decreased the response --> decrease IFN gamma
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hyper IgE jobs syndrome?
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th cells fail to produce IFN gamma --> inability of neutrophils to respond to chemotactic stimuli
FATED course facies abcess - cold staph teeth - 2 rows increase IgE derm probs - eczema |
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localized candida albicans infections of skin and mucus membranes?
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t cell deficiency - chronic mucocutaneous candidia
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what disease has cerebellar defects (ataxia), spider angiomas (telangiectasia), IgA deficiency
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ataxia telangiectasia (AR)
hypersentive to ionizing radiation defect in DNA repair enzymes ==> increase risk of cancer chronic giardias and repeated sino-pulmonary infections |
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wiskott-aldrich syndrome triad?
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TIE!!
thrombocytopenic purpura infection eczema |
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what is the defect in wiskott aldrich syndrome and what lab value results?
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x linked recessive defect
progressive deletion of B and T cells increase IgE/A decrease IgM |
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Defect in LFA-1 integrin CD 18 protien on phagocytes?
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LAD type 1
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LAD presentation and lab?
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recurrent bacterial infections
absent pus formation delayed separation of umbilicus - omphalitis neutrophilia |
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AR defect in microtubular function with decrease phagocytosis?
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chediak higashi syndrome
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chediak higashi syndrome presentation?
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recurrent pyogenic infection by staph and strep
partial albinism peripheral neuropathy like nystagmus, peripheral and cranial neuropathies |
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negative nitroblue tetrazolium dye reduction test?
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chronic granulmatous disease
lack of NADPH oxidase --> dec reactive o2 species and absent resp burt in neutrophils ---> increase susceptibility to catalase positive organisms |
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vascular fibrinoid necrosis and neutrophil infiltration in transplant?
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hyperacute rejection
antibody mediated type 2 --> preformed antidonar antibodies occurs w/in minutes |
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dense interstiial neutrophil infiltration after transplant?
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cell mediated due to cytotoxic T lymphocytes against MHCs --> ACUTE rejection - weeks after transplant
reversible w/ immunosuppressants like cyclosporine and OKT3 |
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obliterative vascular fibrosis after transplant
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chronic rejection - t cell and antibody mediated vascular damage - months to years after
irreversible!! class 1 MHC non self is perceived by CTLs as class 1 MHC self presenting to non self |
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how does chronic transplant rejection look in lungs?
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broncholitis obliterates of small airways
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symptoms of graft vs host disease
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maculopapular rash
jaundice hepatosplenomegaly diarrhea grafted immunocompetent T cells proliferatee in irradiated immunocompromised host and reject cells w/ foreign proteins = severe organ dysfunction |
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cells in hyper acute rejection
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antibody mediated type 1
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cells in acute rejection?
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cell mediated due to cytotoxic T lymphocytes against foreign MHC
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chronic rejection cells involveD?
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t cell and antibody mediated vascular damage
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what organs don't need immune suppression?
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eye
uterus testes brain thymus |
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MOA of cyclosporine?
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block calcineurin - prevents IL2 production and receptor
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a/e of cyclosporine?
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nephrotoxicity - preventable w/ mannitol diuresis
predisposes patients to viral infections and lymphoma |
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tacrolimus MOA?
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binds to FK binding protein = block IL2
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tacrolimus a/e?
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nephrotoxicity
peripheral neuropathy hypertension pleural effusion hyperglycemia |
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azathioprine Moa?
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precursor of 6-mercaptopurine - interferes w/ metabolism and synthesis of nucleic acids
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azathiprine a/e?
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BM supression
increased by allopurinol |
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muromonab-CD3 (OKT3) MOA and a/e
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bind to CD 3 to block interaction w/ CD3/T cell
cytokine relase syndrome, hypersentivity reaction |
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sirolimus (rapamycin) MOA?
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bind to mTOR on FKBP12 to block IL-2
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sirolimus (rapamycin) a/e?
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hyperlipidemia, thrombocytopenia, leukopenia
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sargramostim a/e?
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1st dose hypotension
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use for aldesleukin (IL2)
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renal cell carcinoma
metastatic melanoma |
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use of alpha interferon?
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hep b and c
kaposi's sarcoma leukemias malignang melanoma |
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use of beta interferon
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MS
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use of gamma interferon?
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chronic granulomatous disease
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use of oprelvekin (IL11)
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thrombocytopenia
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how does thyrombopeoitin for thrombocytopenia work?
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synthesized in liver to act on cell membrane of megakaryocytes
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trastuzumab target and use?
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erb-B2
her 2 over expression breast cancer |
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rituximab target and use?
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CD20
b cell non-hodkins lymphoma |
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omalizumab target and use?
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IgE
severe asthma |
