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84 Cards in this Set

  • Front
  • Back
In the lymph node, what cells are in the follicle, medulla and paracortex?
follicle - B cells

medulla cords - lymphocytes
medulla sinuses - macrophages

paracortex - T cells
What lymph nodes does the arm drain to?
Axillary
What lymph nodes does the sigmoid colon drain to?
colic - inferior mesenteric
What lymph nodes does the scrotum drain into?
superficial inguinal
What lymph nodes do the testes drain into?
retroperitoneal AKA para-aortic
What are the cells of acute and chronic inflammation?
acute - PMNs

chronic - macro, baso
What are the main players in opsonization?
IgG and C3b

(bring food to macrophages)
How does APCs present antigens?
phagolysosome binds vesicle with MHC class 2 - chemicals digest the invariant chain, which free the MHC class 2 ptn - Ag binds to it
Which MHC has a beta 2 microglobulin?
MHC class 1
What is the process of making free radicals and hydrogen peroxide?
NADPH oxidase converts O2 to superoxide (resp burst.. positive NBT test)

superoxide dismutase converts superoxide to hydrogen peroxide

myeloperoxidase converts hydrogen peroxide to bleach
What are the functions of red and white pulp?
red - filters/kills old RBCs

white - make Ab, phago circulating pathogens
What do splenic macrophages do and why is it bad to not have a spleen?
macrophages remove encapsulated bacteria and present to B/T cells

w/o spleen, low Ab, low complement activation, low opsonization and high susceptibility so encapsulated organisms
What kinds of special RBC things are seen in asplenic peeps?
Howell-Jolly bodies

target cells
What are the different parts of the thymus and what happens there?
cortex - immature T cells.
positive selection (make sure they recognice MHCs)

medulla - mature T cells with epithelial reticular cells and Hassall's corpuscles
negative selection - make sure T cells doesn't react to self Ag
What induces Th cells to become Th1 cells?

What do Th1 cells produce?
IL-12... this is the cell mediated reponse

IL-2 and IFN gamma which activate macro and T cyt
What induces Th cells to become Th2 cells?

What do Th2 cells produce?
IL-4... this is the humoral response

IL-4 and IL-5 which mediate class switching and IL-10 which inhib the cell mediated response.

some of the B cells that are stim by Th2 produce antibodies, others go to germinal centers, switch classes and have somatic hypermutation
What are the HLA subtypes associated with ankylosing spondylitis?
B27
What are the HLA subtypes associated with multiple sclerosis?
DR2
What are the HLA subtypes associated with SLE?
DR 2/3
What are the HLA subtypes associated with diabetes mellitus type 1?
DR 3/4
What are the HLA subtypes associated with rheumatoid arthritis?
DR 4
What is a natural killer cell's function enhanced by?
IL-12, IFN alpha and beta.

also induced to kill cells when they don't have MHC 1

(their function is to kill virally infected cells and tumor cells)
What do superantigens do?
crosslink TCR and MHC class II.

Th1 cells release IFN-gamma

macrophages release TNF, IL-1 and IL-6.
What are the co-stimulatory signals for Th?
MHC II - TCR

B7 - CD 28
What are the co-stimulatory signals for Tcyt?
MHC I - TCR

IL2 from Th cell
What are the co-stimulatory signals for B cell class switching?
IL-4, IL-5 from Th2

B cell has CD 40 receptor that's activated by CD 40 ligand on Th cell

(class switching happens in germinal centers of lymph nodes)
What is ADCC used for and how does it work?
defense against worms and viruses

target covered in IgG and IgE... NK, monocytes, eosino have Fc-rec and kill
IgG associations
complement with IgM
opsonization with C3b
cross placenta
ADCC with IgE
IgA associations

deficiency?
mucous membranes
secretions, breast milk
dimer joined by J chain

deficiency assoc with Giardia inf
IgM associations
immediate response to antigen
pentamer joined by J chain
complement
IgE associations
hypersensitivity rxns - binds mast cells, allergen cross link Ab, mediates histamine release
worm immunity
What is a hapten?
Ag that's too small to illicit immune reaction on it's own...

can combine with body ptn and ellicit type 1 HS
IL-1

IL-2

IL-3
IL-1 acute inflam and pyrogen

IL 2 Th and Tcyt growth

IL 3 differentiation of bone marrow stem cells
IL-4

IL-5

IL 8
IL 4 switch to IgE and IgG

IL 5 switch to IgA, activate eosinophils (asthma)

IL 8 PMN chemotaxis
INF-gamma

TNF.. and inhibited by...
INF-gamma: by Th1, stim macro, activates Th1

TNF - by macro. mediates septic shock/ cachexia, WBC recruit

inhib by infliximab, etanercept
IL-10

IL-12
IL 10 activate Th2, inhib Th1

IL 12 activates Th1 and NK
macrophage cell surface proteins
CD 14, 40
Th cell surface proteins
CD3, 4, 40L
Tcyt cell surface proteins
CD3, 8,
B cell surface proteins
CD 19, 20, 21, 40
NK cell surface proteins
CD 16, 56
What chemical mediators cause a decrease in inflammation?
IL-10 and TGF beta
What are the chemical mediators for systemic inflammation?
TNF, IL 1, IL 6
What are the chemical mediators for vasodilation?
NO, histamine, PGI
What are the chemical mediators for vasoconstriction?
TXA2, leukotriene C/D/E
What are the chemical mediators for increased permeability?
histamine, bradykinin, leukotriene C/D/E, C3a, C5a
What are the chemical mediators for pain?
bradykinin, PGE
What are the chemical mediators for fever?
IL1, TNF, PGE
What are the chemical mediators for chemotaxis?
C5a, Leukotriene B4, IL8
What part of complement helps with clearance of immune complexes?
C3b
What parts of complement help prevent activation on self?
decay-accelerating factor and C1 esterase inhibitor
What parts of complement mediate anaphylaxis?
C3a, C5a
What parts of complement mediate cytolysis by MAC?
C5b - C9
What does a deficiency in C1 esterase inhibitor cause?
hereditary angioedema
What does a deficiency of C3 cause?
recurrent severe infections (cuz C3 involved in both alternative and classic pathways)
What does a deficiency in C5-C8 cause?
Neisseria infections
What does a deficiency in decay accelerating factor cause?
paraxysmal nocturnal hemoglobinuria

high complement activation.. usu pancytopenia
Symptoms of serum sickness
fever, urticaria, arthralgias, proteinuria, lymphadenopathy
What kind of hypersensitivity is multiple sclerosis?
Type 4 (delayed T cell mediated)
What is the autoantibody in primary biliary cirrhosis?
anti-mitochondrial
What disease has an anti-basement membrane antibody?
Goodpastures..

Anti alpha 3 of collagen type 4
What is the autoantibody in Pemphigus vulgaris?
anti-desmoglein
What is the autoantibody in polymyositis?
anti-Jo
What is the autoantibody in Sjogrens?
anti SSa (Ro), anti SSb (La)
What does a positive rxn to a Candida antigen test indicate?
intact T cell function
What is the defect in Bruton's agammaglobulinemia?
defective tyr kinase - blocks B cell maturation.

No B cells in periphery, no germinal follicles..

recurrent BACTERIAL inf
What is the defect in Hyper-IgM syndrome?
defective CD40L on Th ... can't class switch

recurrent BACTERIAL inf
What is the defect in selective Ig deficiency?
can't class switch to specific types.

most common is IgA deficiency
- get lots of URIs
- giardia.
- ANAPHYLAXIS on exposure to blood with IgA
What is the defect in Common Variable Immunodeficiency?
ACQUIRED defect in B cell maturation
Describe DiGeorge syndrome
no thymus and PTH
high viral/fungal inf
fish mouth
tetany
In what immuno disease do you get lots of mycobacterial infections?
IL-12 receptor deficiency.. so no Th1 activation.. see low IFN-gamma levels
Describe SCID
IL-2 rec defect
adenosine deaminase defect

recurrent bacterial, viral, fungal, protozoal inf
Describe Ataxia-Telangiectasia
defect in DNA repair enzymes - DNA sensitive to ionizing radiation

ataxia, telangiectasia and IgA def
Describe Wiscott-Aldrich syndrome
progressive deletion of T/B cells

thrombocytopenic purpura, inf, eczema
In what disease do you see delayed separation of umbilicus?
leukocyte adhesion deficiency

can't recruit WBC to inflam site - high bacterial inf, no pus
Describe Chediak Higashi syndrome
defective phagosome-lysosome fusion

Staph/Strep inf, kinda albino, peripheral neuropathy, nystagmus
Describe Chronic Granulomatous disease
no NADPH oxidase.

negative NBT test.

susceptible to S aureus, E coli, Aspergillus
and Pseudomonas cepacia, Serratia Marcescens, Nocardia
What/when is hyperacute rejection?
preformed antidonor Ab

small vessel fibrinoid necrosis?

MINUTES post transplant
What/when is acute rejection?
Tcyt against foreign MHCs

WEEKS after transplant

reversible with cyclosporine and tacrolimus (calcineurin inhib - prevent prod of IL2)
What/when is chronic rejection?
T cell and antibody mediated

obliterative vascular fibrosis

YEARS after transplant
What/when is graft versus host disease?
Grafted T cells attack host MHC

cause rash, jaundice, hepatosplenomeg, diarrhea
What microorg show classic antigen variation?
salmonella
borrelia (relapsing fever)
N gonorrhea (pilus)
influenza
trypanosomes
What is the auto antibody in systemic scleroderma?
anti-topoisomerase Ab also known as anti-Scl70
What type of hypersensitivity is SLE?
type 3 HS