Ppal99 Dissecting The Usmle 1,2,3 Lymphocytes

Front 1

what are the lymphnodes?

Back 1

Lymph nodes include tensils and Peyer's patches

Front 2

what do you look for in a lymphnode biopsy?

Back 2

cancer

Front 3

why are most lymphomas b-cells?

Back 3

T cells: Process 1 Ag =>mature now
B cells: Take a long time to mature => that is why most lymphomas are B-cell

Front 4

where do T and B cells develop?

Back 4

bone marrow

Front 5

Maturation site of b-cells

Back 5

Bursa of Fabricius Equivalent
(unknown etiology in humans, choose lymphnode if nessary)

Front 6

Maturation site: of T-cells in kids and adults

Back 6

Kids: Thymus (Thymosin, TPO)
Adults: Lymph Nodes

Front 7

Differentiation site b-cell

Back 7

Lymph Node: Germinal center
"follicular"

Front 8

Differentiation site t-cell

Back 8

Lymph Node: paracortical

Front 9

B-cell maturation: what CD do they have when:
1) Immature B-cell
2) Mature B-cell
3) comunication device that T cells use to talk to B cells

Back 9

CD 9/10: Immature B-cell
CD 19/20: Mature B-cell
CD 40: The comunication device that T cells use to talk to B cells

Front 10

what IL is responsible for B-cell Differentiation

Back 10

IL-4/5

Front 11

how does a macrophage presents the antigen?

Back 11

MP ingests antigen
• MP forms phagosome
• Lysosome digests antigen
• MP presents antigen
• Antigen binds MHC-II

Front 12

Stages of B cell Development:
• Pre-B cell
• Immature B cell
• Mature B cell

Back 12

• Pre-B cell: heavy chain rearranges ~> μ chain in cytoplasm
• Immature B cell: Monomeric IgM on surface
• Mature B cell: secretes Ab, has "MD" on surface due to altenative RNA splicing

Front 13

IL that is responsible for B-cell Proliferation. how does it do this?

Back 13

IL-3/6:
• Label Thymidine (dividing DNA) to detect Pokeweed mitogen, Endotoxin

Front 14

what does MP activate?
what does TH cell activate?

Back 14

MP => IL-1
TH cell= > everything else

Front 15

IL-1

Back 15

recruits TH1 = > fever

Front 16

IL-2

Back 16

T-cell prolif, "The most Potent IL" ⇨recruits everyone

Front 17

IL-3

Back 17

B-cell proliferation

Front 18

IL-4

Back 18

B-cell differentiation => IgE, class switching

Front 19

IL-5

Back 19

B-cell differentiation => class switching for IgA only

Front 20

IL-6

Back 20

Acute phase reactants

Front 21

IL-6

Back 21

Acute phase reactants

Front 22

IL-8

Back 22

PMN recruiter

Front 23

IL-10

Back 23

suppresses cell-mediated immunity (T/MP)

Front 24

IL-12:

Back 24

enhances cell-mediated immunity (T/MP)

Front 25

what part of immune system does TH1 upregulates? what factors are upregulated?

Back 25

IL2, INF-y (cell-mediated)

Front 26

what part of the immune system does TH2 upregulates? what IL's does it activate?

Back 26

IL4,5,10 (humoral)

Front 27

IFN-α

Back 27

inhibits viral replication

Front 28

IFN-β
what is it a treatment for?

Back 28

inhibits viral replication (used to treat MS)

Front 29

IFN-y

Back 29

activates MP and NK cells, suppresses humoral immunity

Front 30

MOA of TNF-β and TNF-α, which one causes DIC/septic shock?

Back 30

TNF-β: weight loss (⇧BMR), secreted by T cells,=> cellular death,
TNF-α: weight loss (⇧BMR), secreted by MP = > cellular death <=DIC/septic shock

Front 31

what is the CD number for immature T cells

Back 31

CD3/ 4/8: immature T cells

Front 32

Round 1 of Tcell maturation

Back 32

Negative selection- get a label or die

Front 33

who has CD28, B7,CD8? which one has low affinity and where can they be found?

Back 33

TK-CD28
B7 -APC
CD8 = Tk/ Ts low affinity, live in tissue

Front 34

T suppressor cell

Back 34

suppresses infection from spreading

Front 35

how does Tk kill?
describe the antigen processing and how Tk kills?
what class of MHC does it respond to?
what cell do not have any MHC I?

Back 35

Tk kill via
1. perforin attack
2. send B cell to coat w / Ab ~>MP eat it "ADCC"
• Responds to MHC-1 = self
• All nucleated cells in body express MHC 1 (except RBCs/ Platelets, not recognized as self)

Front 36

who has CD 4 cells?
where do they live?
what do they respond to?
two types and describe them?

Back 36

CD4 = TH (high affinity), live in blood
Responds to MHC-Il =non-self
TH1 => cell-mediated
TH2 = > humoral

Front 37

what is Round 2 of Tcell maturation

Back 37

Positive selection lymphocytes must walk through the affinity detector Sheriff Tk cell waits by the lymph node:
Sees speedy RBC without his MHC-1 identification
Catches him when the RBC gets old and slows down (Day 120)

Front 38

why are RBC involved in all autoimmune diseases?

Back 38

RBC are not recognized as self=> involved in all autoimmune diseases

Front 39

extravascular hemolysis

Back 39

Spleen removes the dead RBC =>

Front 40

NK cells what CD

Back 40

CD16/ 56:

Front 41

how does an NK cell detect cancer or if it is invaded by a virus?

Back 41

Lymphocytes just pat your head to see if you have have MHC-1 Ag
NK cells require that you have exactly 100 .MHC-I antigens or they will kill you
<100 MHC-1 =>cell was invaded
> 100 MHC-1 => cell is cancerous

Front 42

NK Actions:

Back 42

1) Apoptosis: cell membrane degeneration
2) perforation
3) Direct B-cell to coat victim with Ab

Front 43

Immunoprivileged Sites (4)

Back 43

no lymphatic flow = > no Ag
=> easy to transplant
• Brain
• Cornea
• Thymus
• Testes

Front 44

Vaccinations:
vaccine vs. toxoid

Back 44

Vaccine= Ag
Toxoid = inactivated toxin

Front 45

Vaccination Contraindications, MMR CI and Indications

Back 45

• Previous vaccination with anaphylaxis, encephalopathy
• no MMR if febrile, pregnant, or allergy to Neomycin'
• MMR is OK with egg allergy, TB, breastfeeding

Front 46

Antibody Response Times
(Show up/ Peak/ Gone): IgM:

Back 46

Show up/ Peak/ Gone
3 days/ 2 weeks/ 2 months

Front 47

Antibody Response Times
(Show up/ Peak/ Gone): 1st IgG of baby

Back 47

Show up/ Peak/ Gone
2 week/ 2 month/ 1 year

Front 48

Antibody Response Times
(Show up/ Peak/ Gone): Memory lgG:

Back 48

Show up/ Peak/ Gone
3 day/5 year/10 year

Front 49

what is the # 1 preventable childhood dz?

Back 49

Pertussis

Front 50

Child Vaccinations:
Birth, 6 month, 18 month, 6 y/o, 16 y/o

Back 50

Child Vaccinations:
Birth: All baby has is IgM (MMR dz is uncommon in US babies)
6 mo: Baby is making IgG now
18 mo: Baby.has memory IgG now (more susceptible to MMR now)
6 y/o: can wait until memory IgG is gone
16 y/o: Not susceptible to HIB/Diphtheria/Pertussis (d is the carrier)

Front 51

MMR vaccination

Back 51

18mo: 6y: 16y:
baby is making plasma cells now. therefore give it every 10 years.

Front 52

IPV vaccination

Back 52

2mo: 4mo: 6mo: 18mo: 6y: 16y/o
vaulnerable to IPV on the 2,4 and 6 months. no own Ig yet. then ones he has it give it every 10 years.

Front 53

HIB vaccination

Back 53

2 month, 4 month, 6 month,18 month, 6 year old
not vaulnerable to HIB at teenage years.

Front 54

DPT vaccination

Back 54

2 months, 4 months, 6 months, 18 months, 6 years old

Front 55

dT vaccination

Back 55

16 years old

Front 56

Varicella vaccination

Back 56

18 months

Front 57

Hep B vaccination

Back 57

Birth, 2mo, 18mo:

Front 58

Travel Prophylaxis recommendations, what is the drug for malaria prophylaxis?

Back 58

"bring 2 (2 M's) YELLOW Hats when Traveling"
Meningococcus, Malaria, Yellow Fever, Hep A, Tyhoid
Malaria: Chloroquine

Front 59

Vaccine Allergies and what are they made from.
Measles;
Yellow Fever:
Influenza A:
Hep B:

Back 59

Measles; made from eggs
Yellow Fever: made from eggs
Influenza A: made from eggs
Hep B: made with Baker's yeast

Front 60

Adult Vaccinations: how many shots to get for a complete vaccination Hepatitis B?

Back 60

3 shots

Front 61

Adult Vaccinations:Hepatitis B: Ab titer is negative "non-responder. management

Back 61

repeat vaccination

Front 62

Adult Vaccinations: Hepatitis B: If stuck w/ infected needle, management

Back 62

• If stuck w/ infected needle ⇨2 doses of Hep B lg

Front 63

Adult Vaccinations for Influenza: Recommendations

Back 63

>65 y/o, COPD health care workers, chronic illness

Front 64

Adult Vaccinations for Pneumococcal, who should you give it to once per life time?

Back 64

>65 y/o, ill, post-splenectomy, myeloma (only give once
per lifetime)

Front 65

Adult Vaccinations for Tetanus:

Back 65

every l0 yr

Front 66

Adult Vaccinations for Varicella

Back 66

2 shots (>1 y/o)

Front 67

who should get vaccinations Hep A

Back 67

Drug users, homosexuals, liver dz, clotting factor d/o

Front 68

Toxoid

Back 68

inactivated toxin

Front 69

Killed vaccines: what part of the immunological system does it activate?

Back 69

humoral immunity

Front 70

Live vaccines: what part of the immunological system does it activate?

Back 70

humoral and cell-mediated immunity

Front 71

9 Live Vaccines

Back 71

" ROBY'S Live Vaccine was MMR"
Rota virus, BCG, Yellow Fever, OPV (Sabin): oral polio, Varicella, Measles, Mumps, Rubella, small pox

Front 72

Measles
shed in stool for 8 wk. what should you tell mom?

Back 72

tell Mom not to get pregnant now

Front 73

what is another name for rubella?
rubeolla?

Back 73

Rubella = German 3-day
Measles = Rubeola

Front 74

Isotype

Back 74

type of heavy chain

Front 75

Idiotype

Back 75

site Ag binds to (part of Fab) "hypervariable region"

Front 76

Allotype

Back 76

mu light chains/ IgG subclass heavy chains; genetic diseases

Front 77

Xenotype

Back 77

Heterotype: difference between two species

Front 78

Epitope

Back 78

Ag when it is bound to Ab

Front 79

Fab

Back 79

binds Ag, variable region (contains heavy/light chains)

Front 80

Fc: what does it bind? type of region? what does it contain?

Back 80

binds complement, constant region (contains heavy chains)

Front 81

Heavy Chains antibodies (4)

Back 81

M, A, G, E, D

Front 82

2 types of Light Chains, which one is more common?

Back 82

90% Kappa
10% Lambda

Front 83

Papain

Back 83

destroys Ab "it's a painful death"

Front 84

Pepsin/Trypsin:

Back 84

leave Fab alive

Front 85

what is a Class Switch?

Back 85

T cell talks to B cell and keeps Fab -> IL-4 hooks a new heavy chain on

Front 86

IgM: function(3), what form is it when its secreted? monomer?
what 2 diseases is it involved in?

Back 86

1st dude on the scene, most avidity (has 5 arms, most likely to bind)
• Fix complement on C1 and C3
• First to be secreted by plasma cells, then switches to other types
• Surface: monomer
• Secretions: pentamer (2-J chains) "joiner'
• Ex: Waldenstrom's hyperviscosity(⇧), Wiscott-Aldrich (⇩)

Front 87

IgG types, when does it come out? affinity, function, what diseases is it involved in? what form is it when secreted?

Back 87

2nd dude on scene, highest afftnity (only 1 arm=> has to grab on tightly)
• Fix complement on C2
• Surface: monomer
IgG1, IgG2, IgG3, IgG4
• Ex: Multiple myeloma(⇧), Selective IgG2 deficiency(⇩), Rheumatoid arthritis

Front 88

IgG1: disadvantage and what does it lead to?

Back 88

crosses placenta ⇨ erythroblastosis fetalis

Front 89

IgG2: function, what does it lead to?

Back 89

opsonin ⇨encapsulated infections, most common

Front 90

IgG4

Back 90

not fix complement

Front 91

IgA: where is it expressed? function, what form is it in blood? secretions? diseases?

Back 91

in mucosal surfaces/secretions (expressed in mother's milk)
• Fix complement on C1 - uses alternative pathway
• Blood: monomer
• Secretions: dimer
• Ex: Heavy chain dz(⇧), Ataxia Telangiectasia(⇩), Selective IgA deficiency(⇩)

Front 92

IgD:

Back 92

surface marker, no known function

Front 93

IgE:
describe
what does it realease when it binds allergens/parasites
associated diseases

Back 93

monomer, binds allergens/parasites => forces mast cells to release:
• Histamine
• SRS-A =Slow Reactive Substance of Anaphylaxis
• ECFA = Eosinophil Chemotactic Factor of Anaphylaxis
• Ex: Job-Buckley syndrome