Sileramram Usmle Immuno

Front 1

Antibodies for RA?

Back 1

anti-IgG (rheumatoid factor)

Front 2

Antibodies for SLE?

Back 2

ANA, dsDNA, Smith

Front 3

Antibodies for scleroderma?

Back 3

centromere- CREST
Scl-70- diffuse

Front 4

Anti-Jo?

Back 4

polymyositis, dermatomyositis

Front 5

Anti-Ro, Anti-La

Back 5

Sjogren's

Front 6

Anti-U1 RNP

Back 6

mixed connective tissue disease

Front 7

Anti-glutamate decarboxylase

Back 7

Type 1 DM

Front 8

Hormones that signal through a steroid receptor

Back 8

Glucocorticoids, estrogen, progesterone, testosterone, aldosterone, vitamin D, T3/T4

- adrenal cortex hormones + vit D + T3/T4

Front 9

Hormones that signal through a tyrosine kinase

Back 9

Insulin, IGF-1, FGF, PDGF, Prolactin, GH

Front 10

Hormones that signal through IP3

Back 10

GnRH
GHRH
Oxytocin
ADH
TRH

"GGOAT"

Front 11

Hormones that signal through cGMP

Back 11

ANP, NO (vasodilators)

Front 12

Hormones that signal through cAMP?

Back 12

FSH, LH, ACTH, TSH, CRH
hCG
ADH
MSH
PTH
Calcitonin
Glucagon

Front 13

Cells in medullary cords in lymph node

Back 13

lymphs, plasma cells

Front 14

cells in medullary sinuses in lymph node

Back 14

reticular cells, macrophages- communicates with lymph

Front 15

Paracortex not well developed

Back 15

DiGeorge syndrome

- where T an B cells enter form blood

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lymph node drainage from sigmoid colon

Back 16

colic --> Inferior mesentery

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lymph node drainage from rectum (above pectinate line)

Back 17

Internal iliac

Front 18

Anal canal below pectinate line - lymph drainage

Back 18

superficial inguinal

Front 19

Testes- lymph node drainage

Back 19

para-aortic

Front 20

Lateral side of the dorsum of the foot lymph node drainage

Back 20

popliteal

Front 21

Spleen- where are the t cells?

Back 21

red pulp, periarterial lymphatic sheath (PALS)

Front 22

spleen- where are the B cells?

Back 22

white pulp- follicle

Front 23

signs of post splenectomy

Back 23

1. Howell-Jolly bodies (nuclear remnants)
2. Target cells
3. Thrombocytosis

Front 24

which cytokine blocks Th1 maturation?

Back 24

Il- 10 (produced by Th2)

Front 25

Which cytokine blocks Th2 development

Back 25

IFN-gamma (produced by Th1)

Front 26

IgE

Back 26

- stimulated by IL4
- binds mast cells (type1)
- helminths - eosinophil activation

Front 27

IgA

Back 27

- stimulated by IL5
- Secretions
- monomer in circulation, dimer when secreted
- Does not fix complement --> prevents attachment of bacteria and viruses to mucous membranes

Front 28

loading of MHCI

Back 28

RER- intracellular peptides
- viral immunity
- pairs with beta2-microglobulin- transport to cell surface

Front 29

loading of MHCII

Back 29

- APCs
- invariant chain leaves in acidified endosome
- alpha and beta chains of MHCII

Front 30

HLA A3

Back 30

hemochromatosis

Front 31

HLA B27

Back 31

Psoriasis
Ankylosing spondylitis
IBS
Reiter's syndrome

Front 32

HLA B8

Back 32

Graves' disease

Front 33

HLA DR2

Back 33

MS
hay fever
SLE
Goodpasture's

Front 34

HLA DR3

Back 34

DM1

Front 35

HLA DR4

Back 35

RA
DM1

Front 36

HLA DR5

Back 36

Pernicious anemia
Hashimoto's thyroiditis

Front 37

HLA DR7

Back 37

nephrotic syndrome- steroid responsive

Front 38

NK cells enhanced by which cytokines

Back 38

IL12
IFN-beta
IFN-alpha

*kills when no MHC I on cell

Front 39

superantigen effect

Back 39

cross link beta region of TCR to MHCII on APC --> IFNgamma from Th1 --> IL1, IL6, TNFalpha from macrophages

Front 40

endotoxin receptor?

Back 40

CD14 on macrophages

endotoxin = LPS

Front 41

costim signal between Th cell and APC?

Back 41

Th- CD28
APC- B7

Front 42

signal 2 in Tc and MHCI interaction?

Back 42

IL2 from Th cell activates Tc cell to kill virus infected cell

Front 43

Signal 2 in B cell class switching?

Back 43

B cell- CD40 receptor
Th- CD40 ligand

Front 44

isotype

Back 44

IgM, IgD etc

Front 45

idiotype

Back 45

antigen determines

Front 46

antibodies that cross placenta?

Back 46

IgG

NOT IgM

Front 47

LPS on gram neg bacteria and polysaccharide capsular antigen- stimulate which part of immune response

Back 47

1. macrophages via CD14
2. IgM antibodies but no immunologic memory
- not a peptide so cannot be presented on MHCI to T cells
- IgM is an antigen receptor on the surface of B cells

Front 48

Deficiency of C5-C8 leads to susceptibility to which bug?

Back 48

Neisseria

Front 49

cytokine needed in differentiation of Th1

Back 49

IFN gamma

Front 50

Anaphlyaxis when exposed to blood products

Back 50

Selective IgA deficiency

Front 51

Cytokine with a function similar to GMCSF?

Back 51

IL3

Front 52

Cytokine: "Stimulates production of acute phase reactants and immunoglobulins."

Back 52

IL-6
- secreted by Th and macrophages

Front 53

IL8

Back 53

- Secreted by macrophages
- Major chemotactic factor for neutrophils and C5a

Front 54

IL-10

Back 54

Secreted by Tregs
- Stimulates Th1, inhibits Th2

Front 55

TNF

Back 55

- Secreted by macrophages
- Mediates septic shock
- Causes leukocytie recruitment, vascular leak

Front 56

CD16

Back 56

Binds Fc and IgG
- NK cells

Front 57

CD56

Back 57

NK cells

Front 58

Activation of classical complement pathway

Back 58

IgG and IgM

Front 59

Activation of alternative complement pathway

Back 59

endotoxin or other molecules on the surface of microbes

Front 60

C1-4

Back 60

viral neutralization

Front 61

C3b

Back 61

opsonization, removal of immune complexes

Front 62

C3a, C5a

Back 62

Anaphylaxis

Front 63

C5a

Back 63

neutrophil chemotaxis

Front 64

Classic and alternative pathways converge at...

Back 64

C5

Front 65

Cause of hereditary angioedema

Back 65

Deficiency of C1 esterase inhibitor
- unregulated complement --> release of vasoactive substances

Front 66

C3 deficiency

Back 66

- severe, recurrent pyogenic sinus infections etc
- Increased Type III hypersensitivity- no clearing of immune complexes

Front 67

DAF deficiency

Back 67

GPI anchoring enzyme- cells can no longer anchor --> complement mediated lysis

- PNH of RBCs

Front 68

Interferons in virus protection?

Back 68

- inhibit viral protein synthesis by degrading viral mRNA

Front 69

Bacteria that use antigen variation to evade immune system?

Back 69

1. Salmonella - 2 flagellar variants
2. Borrelia - relapsing fever (except in lyme disease)
3. Neisseria gonorrhoeae- pilus protein

Front 70

Parasites that use antigenic variation?

Back 70

Trypanosomes

Front 71

Granulomatous diseases

Back 71

1. TB
2. Fungal (histo etc)
3. Syphilis
4. Leprosy
5. Cat scratch fever
6. Sarcoidosis
7. Crohn's disease
8. Berylliosis

Front 72

Arthus reaction

Back 72

Type III hypersensitivity
- Intradermal injection --> induces antibodies --> complex
- preformed antibodies circulation
- Seen 4-12 hours after a tetanus or diptheria vaccine

Test: immunofluorescent staining

Front 73

Serum sickness

Back 73

- Type III hypersensitivity
- 5-10 days after antigen exposure
- Mostly caused by drugs
- antibodies produced --> complex and deposit in membranes --> fix complement --> tissue damage

Front 74

TB skin test- which kind of hypersensitivity?

Back 74

Type IV- delayed
- T lymphs that have seen antigen bgefore release cytokines --> macrophage activation

NO ANTIBODY INVOLVED

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characteristic of the Type II hypersensitivity diseases

Back 75

- Specific to tissue where antigen is found

eg. hemoltyic anemia, pernicious anemia, ITP, erthyroblastosis fetalis, transfusion reactions, rheumatic fever, goodpasture's, bullous pemphigoid, pemphigus vulgaris, graves' disease, myasthenia gravis

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Characteristic of Type III hypersensitivity diseases

Back 76

Associated with vasculitis, systemic manifestaions

eg. SLE, RA, Polyarteritis nodosa, poststrep GN, serum sickness, arthus reaction, hypersensitivity pneumonities

Front 77

MS- type of hypersensitivity?

Back 77

IV

Front 78

Guillan-Barre syndrome- type of hypersensitivity?

Back 78

IV

Front 79

Hashimoto's thyroiditis- type of hypersensitivity?

Back 79

IV- some antibodies to TPO etc present but also cell mediated

Front 80

Bruton's agammaglobuinemia

Back 80

X-linked recessive
Defect in BTK (tyrosine kinase --> blocks B cell differentiation and maturation

Presents: recurrent bacterial infections after 6 months, no opsonization

Front 81

Mutation in hyper IgM syndrome?

Back 81

- CD40L on Th --> no class switching

Presents: severe pyogenic infections early in life

Front 82

IgA deficiency

Back 82

anaphylaxis on exposure to blood product with IgA
- hyper IgE --> rashes, itching etc

Front 83

Common variable immunodeficiency

Back 83

Decreased plasma cells, normal number of B cells
- defect in B cell maturation

Front 84

Tetany, recurrent infections, congenital heart and great vessel defects

Back 84

DiGeorge syndrome
- 22q11
- failure of 3rd and 4th arch development
- no thymus or parathyroids

Front 85

retained primary teeth

Back 85

Hyper IgE (Job's syndrome)
- No IFNgamma from Th cells --> no neutrophils recruited

Signs: course facies, cold staph abscesses, retained primary teeth, Increased IgE, derm- eczema

FATED

Front 86

Causes of SCID

Back 86

1. Defective IL-2 receptor - X linked
2. adenosine deaminiase deficiency- increase adenine--> toxic to B and T cells
3. Failure to synthesize MHC II antigens

- both B and T cells deficient

Tx: bone marrow transplant

Front 87

Ataxia telangiectasia- immune problem?

Back 87

- defect in DNA repair

Cerebellar defects, spider angiomas, IgA DEFICIENCY

Front 88

Wiskott-Aldrich syndrome

Back 88

WASP mutation, X linked
- Progressive deletion of B and T cells

TIE:
Thromboctyopenic purpura, Infections, Eczema

Low IgM, increased IgE, IgA

Front 89

Leukocyte adhesion deficiency (LAD)

Back 89

- LFA-1 integrin (CD18) defect on phagocytes
- autosomal recessive
- neutrophils cannot get to tissues or cannot phagocytose once they are there

signs: infections, no pus, delayed separation of umbilicus

Neutrophilia- unable to leave blood vessels to stuck in blood

Front 90

Chediak-Higashi

Back 90

- Decreased phagocytosis- defect in microtubular function
- autosomal recessive

signs: recurrent staph and strep with fever, PARTIAL ALBINISM, peripheral neuropathy

Front 91

CGD

Back 91

- lack of NADPH oxidase --> decreased ROS --> no respiratory burst in neutrophils

- Increased susceptibility to catalase positive organisms

test: negative Nitroblue tetrazolium dye reduction test

Front 92

acute transplant rejection

Back 92

weeks after transplant
- Tc against foreign MHC

tx: cylcosporine, OKT3

Front 93

chronic rejection

Back 93

Tcell and antibody
- vascular damage
- irreversible
- sees MHC presenting non self when it is really non self MHC

- months - years after transplant

Front 94

GVHD

Back 94

- graft T cells attack donor

Front 95

Four immunosuprression drugs that lead to effects of decreased IL2?

Back 95

1. cyclosporin- inhibits calcineurin, nephrotoxic
2. Tacrolimus- binds FK-binding protein- inhbits IL2 secretion, nephrotoxic
3. Sirolimus (rapamycin)- mTOR inhibitor- no T cell proliferation with IL-2 stimulation. NOT NEPHROTOXIC
4. Daclizumab- antibody against IL-2 recepton on T cells

Front 96

Azathioprine

Back 96

- converted to 6MP in body
- DNA synthesis inhibitor --> toxic to proliferating lymphs

6MP metabolized by xanthine oxidase --> do not use allopurinol

SE: bone marrow suppression

Front 97

muromonab-CD3 (OKT3)

Back 97

- binds CD3 on T cells --> blocking T cell signal transduction

Front 98

mycophenolate mofetil

Back 98

- block de novo guanine synthesis--> blocks lymphocyte production

Front 99

Aldesleukin

Back 99

IL2
used in renal cell carcinoma, metastatic melanoma

Front 100

Oprelvekin

Back 100

IL11

Used for thrombocytopenia

Front 101

Rheumatoid factor

Back 101

IgM Antibody against Fc portion of IgG

Front 102

Anti desmin antibodies?

Back 102

Crohn's disease

Front 103

Antibodies to SS-A ribonucleoprotein

Back 103

Sjogren's