Immunology

Front 1

Macrophage marker:

Back 1

CD 14

Front 2

****B-Cell Marker:

Back 2

CD 19, 20, 21

Front 3

T Cell Marker:

Back 3

CD3

Front 4

NK lymphocyte marker:

Back 4

CD 16+CD 56

Front 5

What are the Ag receptor for naive B cells (mature B-cells)?

Back 5

IgM & IgD

Front 6

What are the latin designation for LC?

Back 6

Kappa
or
Lamda

Front 7

Idiotype VS Isotype

Back 7

3D shape formed by AA in variable region (N-terminus)

Class (C-terminus)

Front 8

BCR will bind _____, TCR only bind ____.

Back 8

Unprocessed Ag; Peptide

Front 9

What is the structure of TCR?

Back 9

Alpha/Beta chain anchored by Cytoplasmic C-terminus

Rigid b/c no hinge

Front 10

What are the signalling complex of BCR?

Back 10

Ig-alpha, Ig-beta, Cd 19&21

Front 11

What is the signalling complex of TCR?

Back 11

CD3

Front 12

**5 MOA of Diversity (4 works w/ TCR too)

Back 12

1.V/D/J segments
2. V/D/J recombinations
3. N-nucleotide addition (B=HC only, T=both chain)
4. Combinatorial Association of LC (or Beta) & HC (or Alpha) (eg: multiply the combinations of both)
5. Somatic Hypermutation (BCR only, after Ag stimulation)

Front 13

**Production of HC is just like production of __ chain in T-cell;
Production of LC is just like production of __ chain in T-cell.

Back 13

Beta

Alpha

Front 14

****CV: Showing diagram of the Lymphocyte Ag receptor genes:
1. How to differentiate between HC & LC?

2. How do u know if a gene can be expressed?

Back 14

HC and D

VDJ if separated by intron--> Not rearranged --> CAN'T be expressed (germ-line DNA cannot be expressed w/o recombination)

Front 15

What are the steps in HC (or B-chain) production?

Back 15

1. D-J joining (gene rearr)
2. V-D/J joining (gene rearr)
3. Tc
4. RNA Splice joining V/D/J-C

D=For recombo
C=Idiotype

Front 16

What are the steps in LC (or Alpha-chain) production?

Back 16

1. V-J joining (gene rearr)
2. Tc
3. RNA splicing joining V/J-C

(K/lamda constant domain are added at the end to complete LC)

Front 17

**What is the function of Tdt (terminal deoxyribonucleotidyl transferase)?

Back 17

Randomly insert bases at jct of V/J/D creating more variability

Front 18

**What is Tdt a marker for?

Back 18

ALL (acute b/c starting to make T & B cells)

Front 19

What is allelic exclusion?

Back 19

Once rearrangement achieves a viable product, the cell shuts of rearrangement AND expression of the other allele on the homologous chromosome (the reason homologous chromosome is there is that if rearrangement screws up the first chromosome, the homologous chromosome provide 2nd chance for a viable rearranged product)

Front 20

What are the first two constant domain on HC and thus are made first?

Back 20

IgM & IgD

(Proximity allow co-expression on same B-Cell)

Front 21

What are the only LC constant domains?

Back 21

Kappa

Lamda

Front 22

****What is RAG?

Back 22

Recombination Activation Gene--> Cause recombination --> Gene expression

Front 23

Omenn Syndrome/SCID:

Back 23

Omenn: RAG have only partial activity --> Decrease B/T cell

SCID: NO RAG--> No B/T cell

Front 24

What does Il-3 do?

Back 24

Stimulate Myeloid SC development

Front 25

What does Il-7 do?

Back 25

Stimulate Lymphoid SC development

Front 26

What is the difference between primary and secondary lymphoid organs?

Back 26

Site of development VS site of Ag exposure

Front 27

What are the steps of B-Cell maturation?

Back 27

BM: Lymphoid SC -->Progenitor -->Pre-B -->Immature B

Periphery: Immature B --> Mature B (IgM+/D+) --> Ag --> Blast B (aka Activated) --> Plasma/Memory

Front 28

How is tolerance in B-Cells cultivated?

Back 28

Clonal Deletion (BM)= Overactivates apoptosis if binding to cells in BM

Clonal Anergy (Periphery)= Stay immature B Cells

Front 29

What are the two primary lymphoid organs?

Back 29

BM

Thymus

Front 30

**How is tolerance in T-Cell cultivated?

Back 30

In thymus, MHC I & II loaded w/ self-peptide interact w/ T cells:

1. Positive selection: Low affinity for MHC
2. Negative selection: High affinity for MHC
3. No positive selection: No affinity for MHC (no cross talk--> no growth signal)

Front 31

Difference between MHC1 & 2:

Name=
Distribution=
Structure=

Back 31

A/B/C (1 letter) VS DP/DQ/DR (2 letters)

All (except RBC) VS APC only

Tong VS Hot-dog bun

Front 32

What are the general steps in the synthesis of a T cell?

Back 32

1. CD3 expression(signal transduction)
2. CD4 & 8 simultaneously (co-receptor that enhance binding so TCR can see closer)
3. TCR expression

Front 33

When does CD4 & 8 stop being co-expressed?

Back 33

Until T-cell reach portal-medullary junction

Front 34

What is CD2's function in T-cell?

Back 34

Adhesion

Front 35

What are the general structures of MHC I & II?

Back 35

I: alpha chain + B2-microglobulin (help MHC I get to membrane)

II: Alpha + B chain

Front 36

AChEI OD S/S & Tx:

Back 36

DUMBBELSS=PANS + Sweating + Sk. mm. contraction

Atropine + 2-PAM (pralidoxime)=regenerate AChE or else permanent depolarization of diaphragm

Front 37

Atropine (M-blocker) OD S/S & Tx:

Back 37

SANS + Block sweating

Ctrl hyperthermia + Physostigmine (tert. amine --> cross BBB)

Front 38

CO OD MOA & Tx

Back 38

Shift O2 dissociation curve L (N/V/Vertigo)

Hyperbaric chamber

Front 39

What is the main difference between atropine and amphetamine, since both make you hot?

Back 39

Atropine: Hot + DRY

Amphetamine: Hot + MOIST

Front 40

CNS stimulant OD (eg: amphetamine) S/S & Tx:

Back 40

Warm and sweaty, psychosis

Ctrl CV/Hyperthermia/seizure+ BZD/Antipsychotics

Front 41

OD opioids S/S & tx:

Back 41

Respiratory depression/Miosis

Naloxone

Front 42

ASA OD S/S & tx:

Back 42

Tinnitis

Urinary alkalinization

Front 43

Sedative-hypnotics/EtOH OD S/S & tx:

Back 43

Disinhibition (initial), lethargy

Flumazenil (BZD only)

Front 44

SSRI OD S/S & tx:

Back 44

Serotonine syndrome

Ctrl hyperthermia & seizure

Front 45

TCA OD S/S & tx:

Back 45

Block M (like atropine) & Alpha1

Ctrl seizure and hyperthermia

Front 46

What is the environmental source of As?

Back 46

H2O

Coal burning

Front 47

S/S of As poisoning:

Back 47

Acute: Gastroenteritic, garlic breath

Chronic: Stocking glove neuropathy

Front 48

**Fe OD S/S:

Back 48

Blood out both ends
(Necrotizing gastroenteritis + hematemesis)

Front 49

**Tx of Fe OD:

Back 49

Deferoxamine

Front 50

**Pb OD S/S:

Back 50

Acute: Lead colic, encephalopathy, tinnitis

Chronic: Lead palsy (Wrist drop)

Front 51

**Tx of Pb poisoning:

Back 51

Succimer PO (mild)

Dimercaprol (severe)

Front 52

**CV: Kid w/ microcytic sideroblastic anemia, what does lab show?

Back 52

Decrease heme synthesis --> Increase delta-ALA in plasma

Front 53

What is the biochemical defect in sideroblastic anemia?

Back 53

Enough Fe, but can't be incorporated in heme -->accumulate Fe in mito around nucleus

Front 54

What are the differentials for Sideroblastic anemia?

Back 54

Decrease B6 (INH, Chronic alcholism)

Pb poisoning

Front 55

What is Hg's route of entry?

Back 55

Acute: Vapor/Inorganic salt ingestion

Chronic: Organic Hg ingestion