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98 Cards in this Set
- Front
- Back
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HSV1 infection causes… identification of HSV
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Gingivostomatitis, keratoconjunctivitis, temp lobe encephalitis, herpes labialis. On Tzanks smear, see multinucleaded giant cells and intranuclear inclusions (Cowdry)
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Mediate anaphylactic shock…
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C3a, C3b
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3 conditions that raise liver enzymes above 1000…
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Acute hepatitis, ischemic hepatitis, acetaminophen or other drug/toxin injury
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2 anemias that do not have HbA synthesis…
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SCD and Beta thal major. Both have crew cut xray
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O2 binding affinity compared between normal Hb, HbS, HbC, HbA…
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Same O2 binding affinity
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Elevated urine hemosiderin in what dx…
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Paroxysmal nocturnal hemoglobinuria
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Conditions causing microangiopathic anemia…
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DIC, TTP-HUS, SLE, malignant hypertension, prosthetic valves or AS
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If patient presents w/ membranous glomerulonephritis from infxn, how often will they have spiking fevers…
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Every 72 hours (F. Malariae).
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Patient w/ endocarditis has gram +, catalase – infxn. How distinguish between two possible causes…
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Strep Viridans and Enterococci are options. Both are optochin resistant but enterococci grows in 6.5% NaCl
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Habituation…
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Repeated stimulation causes decr response
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In which bacteria is the cell wall the outermost structure… what does the cell wall contain…
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Gram positives. Contains peptidoglycans. Gram negatives have outer membrane
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Phe becomes… cofactors…
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Tyrosine, uses BH4
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Tryptophan becomes…
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Serotonin (using BH4) or Niacin (using B6)
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Osteogenesis imperfecta causes…
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Fractures w/ minor trauma, Blue sclera, Hearing loss, Dental imperfections
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Part of gram + bacteria that induces TNF and IL-1..
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Teichoid acid in Cell wall (not present in gram -) which has peptidoglycans
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Gram – bacteria do NOT have cell wall but they have something else instead…
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Outer membrane, which is endotoxin/LPS that induces TNF and IL1
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Bacteria capsule made of…
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Polysaccrides (except Anthrax which has D-glu)
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Pilus or fimbrae made of …
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Glycoprotein
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What about mycobacteria wall necessitates gram stain…
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High lipid content
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Bacteria that gram stain w/ GIEMSA…
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Trypanosomes, Chlamydia, Borrelia, Plasmodium
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Microorganisms that silver stain…
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Fungi (esp pneumocytsis), Legionella, Bartonella
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Black-blue colonies w/ metallic sheen on eosin-methylene blue agar…
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E. Coli
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Obligate aerobic organisms…
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Nocardia, Pseudomonus, Myco tb, Bacillus
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Chemical makeup of exotoxins…
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Polypeptide
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Location of genes that make the exotoxin…
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Come from plasmid or bacteriophage
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Location of genes that make the endotoxin…
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Bacterial chromosome
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Diseases that produce stimulatory antibodies…
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IgGs against TSH receptor and antibodies against PDGF in scleroderma
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Anti-scl70 antibody…
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Anti-DNA topoisomerase I antibody involved in diffuse scleroderma
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Damage in dermatomyositis due to… polymyositis…
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Dermato due to antibody mediated damage while Polymyositis due to T-cell mediated damage
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Mixed connective tissue disease… diagnosis based on…
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Raynauds, Fatigue, Arthralgias, Myalgias, Esophogeal dysmotility. Antibodies to U1Ribonucleoprotein (a mix of molecules)
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In lymph node, which follicles are active and what defines them…
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Secondary follicles, have pale germinal center
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In lymph node, medullary cords contain… medullary sinuses…
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Cords: packed lymphocytes and plasma cells. Sinuses: communicate w/ efferent lymphatics and contain reticular cells and macrophages
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Part of lymph node that becomes large in an extreme cellular immune response…
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Paracortex (between follicles and medulla) because houses T cells, and B cells
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Lymph node that stomach drains to…
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Celiac
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Lymph node that duodenum and jejunum drain to…
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SM
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Sigmoid colon drains to which lymph node…
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Colic inferior mesenteric
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Part of the body that drains to internal iliac lymph nodes…
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Lower rectum and anal cnal above pectinate line
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Lower anal canal drains to what LN>..
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Superficial inguinal
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Areas of body that drain to superficial inguinal lymph nodes…
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Lower anal canal, scrotum, inner thigh. Where you SAT: scrotum, anal canal, thigh
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Lateral side of dorsum of foot drains to which lymph node…
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Popliteal
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T cells found where in spleen…
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Periarterial lymphatic sheeth and red pulp
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B cells found where in spleen..
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Follicles within white pulp
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Splenic dysfunction characterized bychanges in antibodies, what happens..
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Decr IgM decr complement activation decr C3b opsonization
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Hassall’s corpuscles contained where…
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Medulla of the thymus, along w/ mature T cells
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Cells involved in innate immune response…
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PMNs, macros, dendritic cells, NKs, complement
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Steps involved in activation of innate immune system…
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TLR binds to endotoxin NF-kB activated and causes nuclear transcription of mediators (cytokines, NO, selectins)
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Causes helper T cells to become Th1… secreted by…
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IL-12 secreted by B cells and macrophages
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Th1 cell action, released products, and how inhibited…
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Activate macros and CD8s, secrete IL-2 and IFN-g. inhibited by IL-10
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Sample in cohort study chosen based upon…
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Risk factors
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Sample in case control study chosen based upon…
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Disease status
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MHC I pairs w/… how is antigen loaded and presented…
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Pairs w/ beta2 microglobulin; loaded in RER of peptides and then presented
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MHC II loaded how…
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Following release of invariant chain in an acidified endosome
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Diseases assoc. w/ HLA DR2…
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MS, hay fever, Goodpastures, SLE
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Diseases assoc. w/ MHC I subtype…
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Hemochromatosis (A3), Graves disease (B8)
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B cells function in which types of hypersensitiviy and which types of rejection…
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Type I (IgE), Type II (IgG) and Type III (IgG) HS. Hyperacture transplant rejection
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Only lymphocyte member of innate immune system…
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NK cells
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NK activity enhanced by…
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IL-12, IFN-beta, IFN-alpha
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If cell lacks MHC I on its surface, what will happen…
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NK cell will kill it
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How do endotoxins/LPS stimulate macrophages…
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Bind to endotoxin receptor CD14 on macrophages. They do NOT use Th cells
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How do superantigens work…
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Cross-link beta region of TCR w/ MHC II on APCs causing uncoordinated release of IFN-gamma, which activates macros
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B7 on… CD 28 on… what cell are we referring to…
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B7 APC; CD 28 on T cell (CDs are always on the T cells). Th cell
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2 signals required for Tc cell activation and where do they come from…
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1. TCR(T cell) – MHCI (viral infected cell) 2. IL-2 released from Th cell
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Causes B cell class switching and what do signals come from…
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Th1: CD40 and CD40L Th2: IL-4, IL-5, IL-6
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Part of antibody that determines isotype… what else important about this area…
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Fc. Also constant and is site for complement attachment (upper) and phagocytic cell attachment (lower)
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Most sensitive test for Cryptococcus neoformans…
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Latex agglutination
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Positive nitrite test indicates…
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Gram negative UTI infxn
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Positive leukocyte esterase test indicates…
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Bacterial infxn
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Isotype switching accomplished in the cell by…
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mRNA alternative splicing
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Form of IgA when secreted…
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Dimmer
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Allotype Ig epitopes…
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Differ among members of same species. Differences can by on heavy or light chain. Represent different alleles
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Region that is unique to a specific idiotype of Ig…
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Hypervariable region
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Interleukin that activates endothelium to express adhesion molecules and causes PGE2 prodxn by hypothalamus…
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IL-1
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IL that enhances switching to IgG…
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IL-4, also enhances to IgE
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Cell surface proteins on Th cells…
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CD4, TCR, CD3 (assoc w/ TCR, important in signal transduction), CD28, CD40L
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Cell surface proteins on Tc cells…
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CD8, TCR, CD3
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Cell surface proteins on macrophages…
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MHCII, B7, CD40, CD14 (endotoxin receptor), receptors for Fc and C3b
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Cell surface proteins on NK cells…
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Receptors for MHCI, CD16 (binds Fc of IgG), CD56
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MAC defends against…
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Gram negative bacteria
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Role of C3b…
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Primary opsonin (along w/ IgG) and aids in clearance of immune complexes
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Deficiency of C3 leads to…
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Severe, recurrent pyogenic sinus and respiratory tract infxns; incr susceptibility to type II HS rxns
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Interferon mechanism…
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Induce prodxn of a ribonuclease that inhibits viral protein synthesis by degrading viral mRNA (alpha and beta esp), gamma interferons incr MHC expression. All activate NK cells
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To fight which infxns are patients given preformed antibodies (passive immunity)…
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Tetanus, Botulism, HBV, Rabies
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Bacteria that do antigenic variation… viruses… parasites…
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Salmonella (2 different flagella), Borrelia, N. gonorrhea (pilus); Influenza; trypanosomes (programmed rearrangement)
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3 MOA of type II HS…
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1. Opsonize cells (IgG) or activate complement (IgM) 2. abs recruit PMNs and macros 3. bind to normal cell receptors and interfere w/ funxn
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MOA of immune complex hypersensitivity (type III)…
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Antigen-IgG complex activates complement C5a attracts PMNs PMNs release lysosomal enzymes
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How long after antigen exposure does serum sickness reaction take until kicks in…
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5-10 days
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Examples of type IV HS reactions…
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DM I, MS, Guillan-Barre, Hashimoto’s, GVHD, PPD, contact dermatitis
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Antibodies sensitive for SLE… specific…
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Sensitive: ANA; specific: anti-dsDNA, anti-Smith
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Anti-smooth muscle antibodies in…
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Autoimmune hepatitis
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Brutons agammaglobulinemia genetics… defect… presentation… labs…
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Xlined defect in tyr kinase blocks B cell maturation so normal pro-B but decr # B cells, decr in ALL classes of Igs. Recurrent bac infxns after 6 months, giardia
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CVID defect… presentation… labs…
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Poor B cell maturation. Have normal # of B cells but decr plasma cells and Igs. Can get in 20-30s. Incr risk of autoimmune dx, lymphoma, sinopulm infxns
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w/ IL-12 deficiency, get recurrent infxn from…
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Mycobacteria
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Hyper-IgE defect… presentation… labs…
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Th cells fail to produce IFN-gamma so PMNs are not attracted. Have coarse facies, staph abcesses, primary teeth, incr IgE, and eczema
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Ataxia-telangiectasia defect… presentation… labs…
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Defect in DNA repair enzymes, have thymc hypoplasia. Triad of ataxia (cerebellum), telangetasia, and IgA deficiency
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Labs in Wiskott-Aldrich..
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Incr IgE, IgA but decr IgM
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Chediak-Higashi syn defect… presentation… labs…
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AR defect in microtubular funxn leading to decr phago-lysosome fusion in PMNs. Get recurrent staph and strep infxns, partial albinism (melanocytes are derivatives of lysosomes), and periph neuropathy (need microtubules in axons)
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Hyperacute rejxn due to… time frame… examples…
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Preformed antidonor antibodies. Occurs w/in minutes. Eg. ABO abs, HLA-abs. will see fibrinoid necrosis and thrombosis in small vessels
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Acute rejection due to.. time frame… possible tx…
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Cell mediated due to Tc’s against foreign MHCs. Weeks after transplantation. Reversible w/ cyclosporine, OKT3, or others
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