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171 Cards in this Set

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CD4+
T helper cells
CD8+
T suppressor cells
T cells have a _______ surface receptor
T-cell receptor (TCR-1 or TCR-2)
B cells have _______ as surface receptors.
surface immunoglobulins or complement receptors.
CD 19+ and CD 20+
B cells (20%)
CD2+ (rosette w/ sheep RBC)
CD3+ (cell receptor)
CD4+ (helper cells)
CD8+ (suppressor cells)
T cells (80%)
-become memory cell
-release lymphokines
-become cytotoxic (CD8+)
-interact with B cells
T cells
Evolve into plasma cells which secrete antibody
B cells
Normal T cell:B cell ratio
8:1
normal T helper: T suppressor ratio:
2:1

(CD4:CD8)
AIDS patient t helper: T supressor ratio
1:2

(CD4:CD8)
anaphylactic/immediate type ___ hypersensitivity reaction.
type I
antibody dependent cytotoxicity hypersensitivity reaction.
Type II
Immune complex hypersensitivity reaction.
Type III
Delayed hypersensitivity reaction
Type IV
prozone
antibody excess
postzone
antigen excess
Ability of test to give negative result if patient does not have disease (no false positives)
Clinical specificity
Ability of test to give positive result if patient has the disease (no false negatives)
Clinical sensitivity
ability of a test to detect very small amount of a substance
clinical sensitivity
ability of test to detect substance without interference from cross-reacting substances
analytical specifcity
Homogeneous (diffuse) ANA pattern
SLE

Anti-Histone Antibody
Peripheral (Rim) ANA pattern
SLE

Anti-ds DNA
Speckled ANA pattern
SLE
Scleroderma
RA
MCTD

Anti-RNA
Anti-ENA
Nucleolar
Scleroderma
Sjogren's

Anti-nucleolar RNA
HIV-1 retrovirus attacks _____ cells
CD4+ (T helper)
Western Blot:

Positive if pands for ___,___,____ or ____ are present
p24
gp41
gp120 or gp160
+ for Anti-HAV (IgM)
Recent Acute Hepatitis A infection
+ for HBsAg, HBeAg, Anti-HBc (IgM), Anti-HBc
Acute Hep B infection (highly infection
+ for HBaAg, HBeAg,Anti-HBe, Anti-HBc (IgM), Anti-HBc
Chronic Hep B/Carrier State
+ Anti-HBe, Anti-HBc, and Anti-HBs
Immunity to Hep B due to past infection
+ Anti-HBs
Immunity to Hep B due to Vaccination
+ Anti-HCV
Hep C infection
Hep B accute disease antibodies:
HBsAg
Anti-HBc
Hep B early convalescence antibodies:
Anti-HBc
Hep B late convalescence antibodies:
Anti-HBs
Anti-HBc
Graves disease: autoantibody directed against
receptors for thyroid stimulating hormone
goodpasture disease: autoantibody directed against
basement membrane (kidney & lungs)
hashimoto thyroiditis: autoantibody directed against
thyroglobulin
multiple sclerosis: autoantibody directed against
myelin sheath of nerves or myelin basic protein
myasthenia gravis: autoantibody directed against
acetylcholine receptors at neuromuscular junctions
rheumatoid arthritis: autoantibody directed against
IgG (Fc)-19s anti-IgM autoantibody known as Rheumatoid Factor
Sjogren Syndrome: autoantibody directed against
salivary duct/tear duct
Disease: Dysfunction

Chronic Granulomatous Disease
ineffective phagocytosis
Disease: Dysfunction

Chediak-Higashi Syndrome
impaired neutrophil function
Disease: Dysfunction
DiGeorge Syndrome
t cell deficiency (Absence of thymus)
Wiskott-Aldrich Syndrome
Partial Combined Immunodeficiency
Severe Combined Immunodeficiency Disease (SCID)
Complete or Marked Deficiency of T and B Lymphocytes
Human Immunodeficiency Virus
Decrease T helper cells
Decrease Th/Ts Ratio
Decrease T cell proliferation
cancer of liver, ovary, testes (tumor marker):
AFP
aflpha-fetoprotein
cancer of colon, breast, lung (tumor marker):
carcinoembryonic antigen (CEA)
cancer of breast (tumor marker):
CA 15-3, BR 27.29
Estrogen/Progesterone receptors
Cancer of ovary (tumor marker):
CA 125
cancer of pancreas (tumor marker):
CA 19-9
cancer of prostate (tumor marker):
Prostate specific antigen (PSA)
Multiple myeloma
Walderstrom's macroglobulinemia (tumor marker):
Immunoglobulins (M protein;paraprotein)
When ________ is present in Hepatitis B infection the patient is considered highly infectious.
HBeAg
Multiple, homogeneous, narrow bands are seen in the gamma zone on elecrophoresis of CSF-disease:
Multiple sclerosis

IgG oligoclonal bands
Basic structure of all immunoglobulins is two light chains joined to two heavy chains by _____ ________.
disulfide bridges
FAB fragment
antigen binding fragment

amino terminals of both the heavy and light chains
Fc fragment
carboxyl terminals of the heavy chains
a determinant capable of stimulating an immune response only when bound to a carrier
hapten

-not large or complex enough
Source of complement components???
Liver
Become memory cells
Contain surface immunoglobulins
Differentiate into plasma cells
B cells
A soluble meadiator produced by lymphocytes
lymphokine

soluble meadiator of cellular immunity reactions

most often produced by T lymphs
Antibodies are produced by ____ ____.
Plasma cells
The ____ region of an IgG molecule fits into an _____ receptor on macrophages and monocytes.
Fc region fits into a FcR
complement is normally measured by _________ _______.
radial immunodiffusion
DiGeorge syndrome is a deficiency in ___ ______.
T cells
What type of cell predominates in the germinal centers of lymph nodes?
B cells

undergo transformation after antigen stimulation

B cells located within the germinal centers are called follicular center cells.
___ ___ are located primarily in the paracortex of lymph nodes.
T cells
Plasma cells are located in the ____ ____ of lymph nodes.
medullary cord
The _____ ____ divide human immunoglobulin molecules into separate classes and subclssses.
heavy chains
The ____ molecule is a pentamer that contains 10 binding sites.
IgM
IgA, IgG, IgD, and IgE monomers each have ___ antigenic binding sites.
2
IgA is found in sero-mucous secretions as a _____ stabilized by the ______.
Dimer stabilized by the J-piece

synthesized by plasma cells and dimerized intracellularly.

IgM is held together by a J-piece but is found as pentamers
Which class of Immuoglobulin binds to basophils and mast cells to mediate immediate hyersensitivity reactions?
IgE-immediate hypersensitivity

mast cells & basos have surface receptors for the F portion of IgE

parasitic infections
Competes with enyzme-labeled antigen for binding to a specific antibody
EMIT (enzyme multiplied immunoassay technique)

The labeled ligand is designed so that following antibody binding, the enzyme is inactive. Ligand conc in test increases, more enzyme-labeled ligand reminas unbound, resulting in greater enzyme activity.
Adjuvants are added to vaccines to ____ the immune response.
increase

enhance antigenicity nonspecifically
-not cleared from injection site as quickly.
contact dermatitis is mediated by ______.
T cells
penicillin allergy and bee-sting allergy are examples of ______ mediate danaphylactic reactions.
IgE
Antibody produced in rheumatoid arthritis is of the class ____.
IgM
Mixed lymphocyte cultures detect ____ antigens
MCH class II antigens

not serologically defined
MCH class I antigens are described as ______ ____.
Serologically defined

-surface antigens can be detected w/specific antibodies
Arthus reactions are initiated by _____ antibody.
IgG

-localized reaction that takes place in and around small blodd vessels

-immune complex forms and depositied in vessel walls & activate complement to cause inflammatory reaction
The first B cells respond to antigen stimulation and produce ____ antibody.
IgM
By injecting doses of allergin, ______ antibody will be stimulated.
IgG antibody
The lymphokine able to cause proliferation and differentiation of B cells is
Interleukin 4
Lymphokine produced exclusively by activated T lymhocytes
Interleukin 2

ONLY ACTIVATED
Preformed antibody is delivered to the recipient
passive immunization-IgG class molecules

antibody available immediately but short lived

no oral administration-Ab digested in GI tract
the strength of binding between a multivailent antibody and multivalent antigen
avidity
the bond between a single antigenic determinant and an individual combining site
affinity
number of antigenic determinants on an antigen
valence
The complement-activation product ____ is chemotactic for neutrophils and macrophages
C5a
Type of immunity that follows the injection of an antigen is termed:
active

vaccines & surviving infections

stimulates the recipient to develop own immune response
type of immunity that follows the injection of antibodies snthesized by another individual or animal is termed:
passive

only temporary
_______ occurs when an extremely high titer of antibody is present.
prozone

not enough antigen is present to allow for cross-linking and lattice formation

-antibody effectively blocks all antigen sites present, so agglutination does not occur.
The antibody most frequiently present in SLE is directed against :
nuclear antigen

anti-nuclear antibody (ANA)
VDRL test for syphilis is classified as a:
flocculation reaction of cardiolipin antigen

SLE can show false positive, rheumatic fever, mono, malaria, & pregnancy
cofactors of complement cascade:
Mg2+ and Ca2+

Mg2+: C2 can complex with activated C4b

Ca2+: stabilize C1q, C1r, and C1s.
False positive reasults in the rapid plasma reagin (RPR) test for syphilis (4):
infectious mononucleosis (caused by Epstein-Barr virus)

malaria

leprosy

rheumatoid arthritis
The Fc fragment of an immunoglovulin is produced by ______ digestion of an IG monomer.
papain

the enzyme splits the molecule just above the disulfide molecule joining the heavy chains.
produced by the fusion of an antibody-producing cell with a myeloma tumor cell.
hybridoma

large quantities of highly specific antibody produced---all molecules share class, subclss and idiotype.
the type of immunity following the transfer of lymphocytes from an immune host to a nonimmune host is______.
adaptive
term given to this phenomenon whereby an immune resonse directed against one antigen may be extended to include activity against closely related antigens
Molecular mimicry
type of immunity following the transfer of lymphocytes from an immune host to a nonimmune host
Adaptive
HbsAg gives + result...indicates that the person:
Has either the active or chronic form of hep B infection
Indicator system used in complement fixation tests?
Sensitized sheep read blood cells
Hereditary angioedema has an ____ in complement activity
Increase
C3 is split into C3a and C3b
Classical Activation
Complement attaches to the ____ part of the antibody molecule.
Fc
At least ____ Fc binding sites are required for C1q to attach.
2
The correct reaction sequence of classical activation of C'
C1, 4, 2, 3

C3 is split into C3a and C3b
C3 receptor
Immunoglobulin
MCH class II antigens
B cell surface marker
Able to bind antigen
Possess CD1 antigen
Protection against intracellular parasites
T cells
Hihgly specific
Produced m malignant cell
Same idiotype
Monoclonal antibodies
Monoclonal antibodies are produced by ________.
Hybridomas
The Fc portion of an Ig molecule is produced by the action of _________ on a complete immunoglobulin molecule.
papain
Polyclonal T-cell activation
Superantigens

react w/ T cells in a direct way; stimulate all T cells, rather than stimulating only T cells bearing T-cell receptors specific for the antigens of bacterial toxins.

Massive T-cell mediated immune response=TSS (s. aureus) and Toxic shock-like syndrome (GAS)
B lymphs, macrophages/monocytes, and dendritic cells
cells that can act as APCs for exogenous antigens

Exogenous antigens are processed for presentation to specific T cells by specialized cells collectively referred to as antigen presenting cells.
nonself antigens derived from infectious agents or immunizing preparations
Exogenous antigens
The T cell receptor (TCR) recognizes antigen as a peptide complexed to an ______________ molecule on the surface of an APC.
MCH class II molecule

TCR do not respond to their specific antigen on the surface of cells other than APCs, nor do they respond to "free" antigens
T cells recognize antigens for which they have predetermined specificity by encountering ________ fragments of that antigen complexed to MCH class II molecules on the surface of an antigen presenting cell
peptide

APCs: B cells, macrophages, monocytes, and dendritic cells
Activated CD4+ Th cells produce and respond to Interleukin-2. This process is an example of:
autocrine stimulation
A situation where a given T cell both secretes and interleukin and responds to the secreted molecule:
autocrine stimulation
Situation where a given T cell responds to an interleukin molecule secreted by another cell
Paracrine stimulation
Process whereby an antigenically stimulated lymph undergoes blast transformatio nand divides to produce a clone of identical cells
Clonal selection
State of a T cell that has encountered the antigen for which it has genetically preprogrammed specificity
T-cell activation
B lymphs and T lymphs are derived from
hematopoietic stem cells
Site of maturation for B lymphocytes during fetal life
fetal liver
Contacter dermatitis is a delayed-type hypersensitivity reaction mediated by _______.
T-cells

antibody is not involved in this type of hypersensitivity
An abnormal ____ test indicates defective neutrophil function
NTB (nitroblue tetrazolium)

granulmatous disease
WHen an antigen and antibody react, bonds are formed between the two molecules. These bonds may be ________ bonds.
Hydrogen bonds
Electrostatic bonds
Hydrophobic interactions

Reversible: form, dissovle, and then re-form.
____ antigens constitute the major histocompatibility complex.
HLA antigens
Hyperacute rejection occurs within hours of transplatation of tissue to an _____ incompatible individual.
ABO incompatible
_____ rejection offurs within days to weeks in the case of an allograft transplant without immunosuppressive therapy.
Acute rejection
______ rejection, occuring months to years after an allograft trasplant, arises from soluble antigens migrating from the transplant and being recognized by the recipient's immune system
Chronic rejection
Classes of immunoglobulins are based on _____ chains.
Heavy chains
CD3+

CD2+
T cells

CD2+: rosette with sheep RBCs
CD3+: possess T cell receptor
T helper cells release ________.
lymphkines after being presented w/ antigen by APC
T helper interaction w/ B cells
T helper-CD4+
T cytotoxic interact w/ B cell
T cytotoxic-CD8+
Normal T cell: B cell ratio
8:1
Normal T helper cell: T supressor ratio (CD4:CD8)
2:1

reversed in aids
CD19+
CD20+
B cells
B cells possess cell surface immunoglobulin of ____ or ____.
IgD or IgM
______ rosette with Sheep red blood cells
T cells (CD2+)
-components

-Activated by Immune Complexes (IgG & IgM)

-Bind in numerical order except at the beginning (C1, C4, C2, C3)

-Usually "a" fragments go to plasma and "b" fragments attach to cell (exception: C2a & C2b)
Classical Complement cascade
-factors

-activated by lipopolysaccharides, polysaccharides

-involves Factor B & D

-incolves C3 at 2 points in cascade
Alternative complement cascade
Functions to control inflammation

-activates phagocytes (chemotaxis)

-Lyses target cell (foreign organism)
Complement
Complement pathways require ______ and _______.
calcium & magnesium
Factor I in complement cascade
degrades C3b
Factor H in complement cascade
competes with Factor B
Type 1 hypersensitivity reaction
anaphylactic immediate

IGE mediated (histamine released)

Ex: bee sting, hay fever, asthma
Type 2 hypersensitivity reaction
antibody dependent cytotoxicity

antibody attaches to cell bearing corresponding antigen=cell death

Ex: transfusion rxn, Autoimmune hemolytic anemia
Hashimoto thyroiditis
Goodpasture Disease
Ex: transfusion rxn, Autoimmune hemolytic anemia
Hashimoto thyroiditis
Goodpasture Disease are examples of what type of hypersensitivity reaction?
Type 2
bee sting, hay fever, and asthma are all examples of what type of hypersensitivity reaction?
Type 1
Type III hypersensitivity reaction?
Immune complex

formation of large immune complexes not cleared by mononuclear phagocytic system

Ex. RA & SLE & Serum sickness
Rheumatoid Arthitis, SLE, and serum sickness are all examples of what type of hypersensitivity reaction?
Type III (Immune complex)
Type IV hypersensitivity reaction?
Delayed hypersensitivity reaction

Sensitized T cells release IL; monocyte and lymphocyte infiltration

>12 hours to develop

Ex: Contact dermatitis, Graft vs. Host Disease, TB, Leprosy
Ex: Contact dermatitis, Graft vs. Host Disease, TB, Leprosy are examples of what type of hypersensitivity reaction?
Type IV (delayed)
associate ____ with type I hypersensitivity reactions.
IgE (anaphylactic, immediate)
Prozone is ____ excess.
Antibody excess
Postzone is ______ excess.
Antigen excess
Lattice formation in precipitation involves the ____ binding w/ Fab sites of two antibodies.
Antigen binding
soluble antigen + antibody =
visable precipitation

Ex:
-double diffusion (ouchterlony)
-Single Diffusion (radial immunodiffusion)
-Immunoelectrophoresis
-Immunofixation
particulate antigen + antibody=
clumping (agglutination)

antigen bnds w/ Fab site of two antibodies forming bridges between antigens (lattice formation)

ex:
-direct agglutination (Blood Bank)
-Passive hemagglutination
-Passive latex agglutination (antigen attached to latex particles)
Inhibition/Neutralization reaction:

no agglutination or No hemoloysis indicates ____ reaction.
Positive reaction

antibody is bound in original reaction and is not available to react with indicator cells

Ex: hemagglutination inhibition test for rubella & ASO neutralization test
add fluorescein-labled antibody to patient tissue, wash & examine under fluorescent microscope
direct immunofluorescence
add patient serum to tissue containing known antigen, wash, add labeled antiglobulin, wash & examine udner fluorescent microscope
indirect immunofluorescence
Must see ____ or 2 tube rise in titer to be clinically significant
4-fold