Immunology/pathology Cytokines, Receptors, And Diseases

Front 1

What is the mnemonic that denotes the function of first 5 interleukins?

Back 1

Hot T-Bone stEAk

Front 2

What does the Hot in "Hot T-Bone stEAk" stand for?

Back 2

IL-1 which induces fever; Endogenous pyrogen's IL-1, IL-6 and TNF-alpha

Front 3

What does the T in "Hot T-Bone stEAk" stand for?

Back 3

IL-2 which induces T-cell proliferation

Front 4

What does the Bone in "Hot T-Bone stEAk" stand for?

Back 4

IL-3 which causes lympocyte proliferation

Front 5

What does the E in "Hot T-Bone stEAk" stand for?

Back 5

IL-4 which induces isotype switching in B-cells to IgE

Front 6

What does the A in "Hot T-Bone stEAk" stand for?

Back 6

IL-5 which increases IgA production

Front 7

What is the TCR linked to in order to be functional?

Back 7

CD3

Front 8

What structures other than the TCR are involved in the activation of "helper" T-cells?

Back 8

CD4 and CD28 which binds CD80/86 (B7) on the B-cell

Front 9

What does the helper TCR bind?

Back 9

the MHC II along with peptide antigen

Front 10

Polyclonal T-cell proliferation =?

Back 10

non-neoplastic

Front 11

Monoclonal T-cell proliferation =?

Back 11

neoplastic

Front 12

What CD molecules are used to describe T-cells?

Back 12

CD3 & CD5

Front 13

What CD molecules are used to describe B-cells?

Back 13

CD19 & CD20

Front 14

What is CR2?

Back 14

Type 2 complement binding receptor (aka CD21); Found on B-cells; receptor for epstein-barr virus

Front 15

What is CD40?

Back 15

Produced by APC and links with CD40L on T-cells which is produced after recognition of MHC II bound antigens; binding of CD40L to CD40 causes IL-4 release by T-cells which causes proliferation, isotype switching, and maturation into plasma cells of B-cells

Front 16

What is the largest circulating peripheral lymphocyte by percentage?

Back 16

T-cell; Helper (CD4) = 60%; Cytotoxic (CD8) = 30%

Front 17

What is C3b?

Back 17

opsonization fragment of complement; recognized by APC cells and phagocyte cells

Front 18

What is CD16 associated with?

Back 18

NK cells; Fc receptor for IgG

Front 19

What is CD56?

Back 19

NK cell receptor

Front 20

What is NKG2D?

Back 20

Activating receptor of NK cells

Front 21

What is the inhibitory receptor of NK cells?

Back 21

Self-class MHC I (found on almost all healthy cells); MHC I is often reduced on infected cells

Front 22

What is secreted by NK cells to activate macrophages?

Back 22

IFN-gamma; signals to destroy ingested microbes

Front 23

What interleukins stimulate proliferation of NK cells?

Back 23

IL-2 and IL-15

Front 24

What interleukin activates the killing and secretion of IFN-gamma by NK cells?

Back 24

IL-12

Front 25

What is the chemokine receptor of naive T-cells?

Back 25

CCR7

Front 26

What are the chemokines that attract T-cells to lymph nodes?

Back 26

CCL19 and CCL21

Front 27

What is the chemokine receptor of mature T-cells that attract the cell to the inflammatory site?

Back 27

CXCR3

Front 28

What is a chemokine that attracts T-cells to inflammation?

Back 28

CXCL10

Front 29

What is ICAM-4?

Back 29

adhesion molecule that is expressed by erythrocytes; binds to and moves immune complexes to organs that can safely deal with them; protects the kidneys

Front 30

What is L-selectin?

Back 30

Expressed by naive T-cells; binds to HEV L-selectin ligand

Front 31

Where are MHC genes encoded?

Back 31

Chromosome 6

Front 32

DR3/4?

Back 32

HLA type that is strongly associated with Type 1 Diabetes

Front 33

MHC I?

Back 33

Include A, B, and C

Front 34

MHC II?

Back 34

DP, DQ, and DR

Front 35

Loading of antigen on Type I MHC is done where?

Back 35

Endoplasmic reticulum

Front 36

Loading of antigen on Type II MHC is done where?

Back 36

Endocytic Vesicle

Front 37

HLA-B27?

Back 37

Ankylosing spondylitis and postinfectious arthropathies (Postgonococcal arthritis, and acute anterior uveitis)

Front 38

DR3?

Back 38

Type I diabetes or Primary Sjogren syndrome

Front 39

DR4?

Back 39

Rheumatoid arthritis

Front 40

HLA-A?

Back 40

Hereditary hemochromatosis

Front 41

HLA-Bw47?

Back 41

21-hydroxylase deficiency

Front 42

What are the cytokines of innate immunity?

Back 42

TNF, IL-1, IL-12, Type 1 IFNs, IFN-gamma, and chemokines

Front 43

What are the cytokines of adaptive immune response?

Back 43

IL-2, IL-4, IL-5, IL-17, and IFN-gamma

Front 44

What are the cytokines of adaptive immune response primarily produced by?

Back 44

CD4+ T lymphocytes

Front 45

What are the cytokines of innate immune response primarily produced by?

Back 45

Macrophages, Dendritic cells, and NK cells

Front 46

What does a Rim pattern (ANA) indicate?

Back 46

Double stranded DNA = lupus

Front 47

Lupus patients should have a positive what?

Back 47

ANA especially rim pattern; if not positive probably not lupus

Front 48

What are highly specific antibodies tested for in lupus?

Back 48

Anti-dsDNA and Anti-Sm; they are diagnostic for SLE

Front 49

What disease often gives a positive syphilis test?

Back 49

Antiphospholipid; as a result of lupus

Front 50

Do antiphospholipid patients look hypercoagualbe or hypocoaguable in tests?

Back 50

Hypocoaguable but in fact hypercoaguable; can cause thrombosis in venous or arterial circulations

Front 51

What HLA is lupus linked to?

Back 51

HLA-DQ

Front 52

What T-cell population is possibly responsible for lupus?

Back 52

CD4 T-cells

Front 53

What hypersensitivity is often caused by lupus?

Back 53

Type III (Immune complexes); can cause glomerular nephritis

Front 54

What population does lupus most commonly occur in?

Back 54

young women; 9:1 over men

Front 55

What is the difference between focal and diffuse glomerulonephritis?

Back 55

50% threshold

Front 56

Wire loop appearance?

Back 56

Membranous Glomerulonephritis; diffuse thickening of capillary wall; severe proteinuria or nephrotic syndrome in 10-15%

Front 57

Membranous has what type of deposits?

Back 57

Subepithelial

Front 58

Proliferative GN has what type of deposits?

Back 58

Subendothelial

Front 59

What characterizes the malar rash?

Back 59

Facial butterfly (characteristic for lupus; spares nosolabial fold only 50% with lupus have this) can also get other places on body; sunlight accentuates erythema

Front 60

What lupus condition affects the heart?

Back 60

Libman-Sacks (valvular endocarditis); noninfectious warty lesions on mitral and aortic valves; predisposition to CAD

Front 61

What joint problems are associated with lupus?

Back 61

Nonerosive synovitis with little deformity

Front 62

Can pericarditis or other serosal cavities be inflammed in lupus?

Back 62

Yes

Front 63

What occurs in the spleen in lupus?

Back 63

splenomegaly

Front 64

FUO, abnormal urinary findings, or joint disease?

Back 64

Lupus

Front 65

What is a common cause of death in lupus?

Back 65

Renal failure and intercurrent infections

Front 66

Chronic discoid lupus erythematosus?

Back 66

Skin manifestations without systemic manifestations; only 35% have +ANA (dsDNA is rare)

Front 67

Subacute cutaneous lupus erythematosus?

Back 67

Skin rash and mild systemic symptoms; SS-A antibodies; associated with HLA-DR3; intermediate lupus

Front 68

Drug induced lupus?

Back 68

SLE-like syndrome; Hydralazine (vasodialator) Procainamide (antiarrhythmic) Isoniazid (TB) D-penicillamine (metal chelation)

Front 69

Rheumatoid factor?

Back 69

IgM bind to Fc of IgG

Front 70

Sjogren's Syndrome?

Back 70

Chronic disease; dry eyes (keratoconjunctivitis sicca) and Dry mouth (xerostomia)

Front 71

Sicca syndrome?

Back 71

Primary Sjogren's syndrome

Front 72

Secondary Sjogren's Sydrome

Back 72

more common than primary form and is associated with other autoimmune diseases

Front 73

SS-A Sjogren's syndrome is what?

Back 73

earlier onset, longer duration, and systemic manifestations

Front 74

What is needed to confirm sjogren's syndrome?

Back 74

salivary gland biopsy (most common in lip)

Front 75

Systemic Sclerosis?

Back 75

AKA slceroderma; chronic inflammation; damages small vessels; skin first eventually involves organs; lung involvement often kills

Front 76

Diffuse Scleroderma?

Back 76

Widespread skin involvement

Front 77

Limited Scleroderma?

Back 77

Limited skin involvement

Front 78

Crest Syndrome?

Back 78

Form of limited scleroderma; Calcinosis; Raynaud's, Esophageal dysmotility; Sclerodactyly; Telangiectasia

Front 79

What atnibodies are specifc for scleroderma?

Back 79

Anti-Scl 70 (dna Topoisomerase 1); Anticentromere (limited or Crest); one or other

Front 80

Besides skin thickening what are the other signs of scleroderma?

Back 80

Tapered claw like hands; face becomes a drawn mask; alimentary tract involvement in 90% of patients

Front 81

What is the current most common COD in cleroderma?

Back 81

Lungs; used to be Kidneys due to malignant HTN

Front 82

Who is most commonly afflicted with systemic scleroderma?

Back 82

Females to males (3:3) and older (50-60 years); right sided heart failure

Front 83

Rash on upper eyelids and periorbital edema?

Back 83

Dermatocyositis

Front 84

Symmetric muscle weakness and large muscles affected

Back 84

Polymyolitis

Front 85

Multiple features suggesting SLA, polymyositis, and systemic sclerosis with Anti RNP antigen (U1RNP)?

Back 85

Mixed Connective Tissue Disease

Front 86

Direct rejection?

Back 86

Donor APC's are recognized by transplant recipient's T-cells; acute rejection

Front 87

Indirect rejection?

Back 87

Recipient T-cells recognize MHC antigens from donor as presented by recipient's APCs

Front 88

Hyperacture rejection?

Back 88

preformed antidornor antibodies are present; blood types; minutes to hours; not longer a serious problem

Front 89

Acute humoral rejection?

Back 89

exposure evokes antibodies; vasculitis; targets vasculature; days, months, years; stopped immunosuppression; necrotizing vasculitis; thickening of intima

Front 90

Cellular actue rejection?

Back 90

INterstitial mononuclear cell infiltrate cd4 and cd8; months after; biochemical signs of renal failure; endothelitis

Front 91

Chronic rejection?

Back 91

Progressive failure; 4-6 months; vascular changes, fibrosis (obliterative intimal fibrois); scarring

Front 92

GVHD?

Back 92

Graft-vs-Host Disease; most commonly occurs with bone marrow transplant but can occur with any transplant

Front 93

Acute GVHD?

Back 93

Days to weeks, bloody diarrhea (CD8); jaundice; skin rash

Front 94

Chronic GVHD?

Back 94

Destruction of appendages and fibrosis of dermis; chronic liver disease (cholestatic jaundice; esophageal structure

Front 95

Immunodeficiency (primary)?

Back 95

Genetically determined (most); affects humoral and/or cellular arms; usually seen between 6 months and 2 years

Front 96

Types of Primary immunodeficiency?

Back 96

ADA deficiency, X-linked agammaglobulinemia (Burton's), Digeorge, X-linked SCID (cytokine); MHC class II deficiency; Isolated IgA deficiency

Front 97

X-linked agammaglobulinemia (Burton's)?

Back 97

Failure of B-cells to develop = no Ab; Btk (bruton tyrosine kinase - Btk; x chromosome);
reccurent respiratory infections (bacterial); also viral and giardia; GI infections; treated via IgIV

Front 98

Common Variable Immunodeficiency?

Back 98

Low immunoglobulin but can affect only IgG; no plasma but normal matur B cells; Giardia; equal prevalence in females and males; occurs in adolescence; 21yr. female; Sinopulmonary pyogenic infections; predisposed to autoimmune disease

Front 99

Isolated IgA deficieny?

Back 99

Most common primary immunodeficiencies; can develop anaphalactic shock when transfused with IgA Containing serum; mostly asymptomatic

Front 100

Hyper IgM syndrome?

Back 100

Canty isotype swithc due to CD40L defect; 70% is x-linked or ADA mutations; low IgG but very high IgM; IgM may interact with RBC causing anemias and thrombocytopenia;

Front 101

Digeorge Syndrome?

Back 101

Thymic hypoplasia; 3rd and 4th pharyngeal pouches fail to develop; abnormal face mouth ears, and mouth; Chromosome 22q11; low calcium (tetany)

Front 102

SCID?

Back 102

Defectin in both Humoral and Cell-mediated immunity; thrush, diaper rash, failure to thrive, morbilliform rahs (GVH; maternal T cells); ADA mutation; also X-linked cytokine receptor defect; need boine marrow transplant

Front 103

Wiskott-Aldrich Syndrome?

Back 103

Eczema; X-recessive; mutation in WASP Xp11.23; no Ab to polysaccharide antigens; loss of T lymphocytes in peripheral blood; non-hodgkin B-cell lymphoma

Front 104

add complement deficiencies and HIV

Back 104

complement