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199 Cards in this Set
- Front
- Back
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What type of immunoglobulins make up cryoagglutinin?
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IgM
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Young child has tetany, candidiasis, hypocalcemia, and immunosuppression. What immune cell is deficient?
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T-cell
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Young child has recurrent lung infections and granulomatous lesions. His neutrophils are deficient in:
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NADPH oxidase
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Patient presents with recurrent neisseria infections. Which complement proteins are deficient?
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C6, C7, C8
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Woman complains of malar rash and arthritis. Which antibodies are in her blood?
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anti-dsDNA and anti-Smith
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Patient has dermatitis, enteritis, and hepatitis after bone marrow transplant. What disease is occurring?
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Graft-verus-Host disease
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What processes happen in lymph nodes?
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filtration by macrophages, activation and storage of lymphocytes, antibody production by plasma cells
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What part of the lymph node do B cells proliferate in?
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The follicle
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Active follicles look like this on micrographs:
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dark outside, pale centers
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Where are follicles located in the lymph node?
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in the cortex, out at the edges
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Where do macrophages live in the lymph node?
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medullary sinuses
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Where do T-cells live in the lymph node?
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paracortex.
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Where is the paracortex in the lymph node?
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between the follice and the medullary sinus
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Which lymph nodes do the upper limbs and breast drain to?
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Axillary
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Which organs drain to the axillary lymph nodes?
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upper limbs and breast
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Which lymph nodes does the stomach drain to?
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celiac
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Which organ drains to the celiac lymph nodes?
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the stomach
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Which lymph nodes does the duodenum and jejunum drain to?
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superior mesenteric
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Which organs drain to the superior mesenteric lymph nodes?
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duodenum and jejunum
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Which organs drain to the colic and inferior mesenteric lymph nodes?
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sigmoid colon
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Which lymph nodes does the sigmoid colon drain to?
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colic and inferior mesenteric
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which lymph nodes does the rectum and upper anal canal drain to?
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Internal iliac
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Which organs drain to the internal iliac lymph nodes?
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rectum and upper anal canal
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Which lymph nodes does the lower anal canal drain to?
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superficial inguinal
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Which organs drain to the superficial inguinal lymph nodes?
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lower anal canal, scrotum, thigh
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Which lymph nodes do the testes drain to?
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para-aortic
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Which organs drain to the para-aortic lymph nodes?
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testes and ovaries
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Which lymph nodes do the ovaries drain to?
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para-aortic
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Which lymph nodes does the scrotum drain to?
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superficial inguinal
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Which lymph nodes does the thigh drain to?
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superficial inguinal
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Which lymph nodes does the top of the foot drain to?
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popliteal
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Which organs drain to the popliteal lymph nodes?
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top of the foot
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Where do B cells live in the spleen?
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follicles within the white pulp
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What type of cell lives in the white pulp of the spleen?
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B-cells
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What type of cell lives in the red pulp of the spleen?
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T-cells and RBCs
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Where do T-cells live in the spleen?
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Peri-arterial lymphatic sheath, and the red pulp
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What is the embryonic origin of the thymus?
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3rd branchial pouch
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What would you find in the cortex of the thymus?
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densely-packed immature T-cells
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what would you find in the medulla of the thymus?
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mature T cells, Hassall's corpuscles, reticular cells
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Where does T-cell selection occur in the thymus?
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at the cortico-medullary junction
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What components make up the innate immune system?
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neutrophils, macrophages, dendritic cells, complement
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What components make up the adaptive immune system?
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T cells, B cells, circulating antibodies
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In the innate immune system, receptors that recognize pathogens are encoded for where?
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In the genome
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In the adaptive immune system, receptors that recognize pathogens are encoded for where?
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Nowhere, they are produced during VDJ recombination during lymphocyte development
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What is the speed of response to pathogens by the innate immune system?
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fast, nonspecific
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what is the speed of response to pathogens by the adaptive immune system?
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Slow at first, but faster on subsequent exposures
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What surface receptors does a T-cell precursor in the bone marrow have on its surface?
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None
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What surface receptors does a T cell in the thymus have on its surface?
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T-cell receptor, CD4, CD8
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Some T cells in the thymus lose their CD8 receptor, and keep their CD4 receptor. These are.....?
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Helper T cells
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Some T cells in the thymus lose their CD4 receptor, and keep their CD8 receptor. These are.....?
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Cytotoxic T cells
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Th1 and Th2 cells are examples of ___________ lymphocytes.
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Helper T cell
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What two cytokines do Th1 helper cells make?
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IL-2, IFN-gamma
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What two cytokines do Th2 helper cells make?
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IL-4, IL-5
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What cytokine inhibits Th1 helper cell activity?
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IL-4
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What cytokine inhibits Th2 helper cell activity?
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INF-gamma
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What cells do Th1 helper cells actually help?
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macrophages and cytotoxic T cells
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What cells do Th2 helper cells actually help?
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they help B cells make antibodies
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On what cells will you find MHC-1 receptors?
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All nucleated cells
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What are some examples of MHC-1 molecules?
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HLA-A, HLA-B, HLA-C
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What do HLA-A, HLA-B, and HLA-C molecules do?
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present intracellular proteins for T cells to look at
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Where do cells load antigen onto MHC-1 receptors before presenting them on the surface?
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In the rough endoplasmic reticulum
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On what cells would you find surface MHC-2 class receptors?
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Only on antigen presenting cells (B cells, dendritic cells, macrophages)
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What are some examples of MHC-2 molecules?
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HLA-DR, HLA-DP, HLA-DQ
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Where do cells load antigen onto MHC-1 receptors before presenting them on the surface?
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In an acidified endosome
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What do MHC-2 receptors do?
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present foreign body antigen to passing T cells
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What is the main purpose of B cells?
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To make antibody
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What is the main purpose of CD8 (cytotoxic) T cells?
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To kill cells infected with viruses
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What is the main purpose of CD4 (helper) T cells?
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help B cells make antibody, activate macrophages
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What cytokine activates macrophages?
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interferon-gamma
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Which receptor does CD4 bind to?
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MHC-2 on APC's
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Which receptor does CD8 bind to?
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MHC-1 on virus-infected nucleated cells
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T cells require 2 steps to become activated. For Helper T cells, these steps are:
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1) CD4 binding to MHC-1 with antigen
2) elsewhere between the two cells, CD28 binding to B7 |
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T cells require 2 steps to become activated. For Cytotoxic T cells, these steps are:
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1) CD8 binding to MHC-2 with antigen
2) IL-2 receptor activated by IL-2 released from helper T cells |
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Which portion of the antibody binds to antigen?
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Fab
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Which portion of the antibody does complement attach to?
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Fc
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Which section of an antibody is constant across all antibodies?
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Fc
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Which section of an antibody is variable across all antibodies?
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Fab
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The carboxyl end of the protein making up antibody is in which section?
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Fc
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The amino end of the protein making up antibody is in which section?
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Fab
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The Fc region of the antibody is made up of what chains?
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2 heavy chains
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The Fab region of an antibody is made up of which chains?
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2 heavy chains, 2 light chains
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What are 3 ways antibody can stop pathogens in their tracks?
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1)opsonization - promotes phagocytosis
2)neutralization - prevents adherence 3)complement activation |
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Antibody diversity is obtained through what 4 ways?
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random recombination of light (VJ) and heavy (VDJ) chains, random pairing of heavy and light chains, somatic hypermutation, adding randomly to B-cell DNA
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Mature B cells express which Ig's on their surface?
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IgM and IgD
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What are the characteristics of IgG?
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most abundant Ig, crosses placenta, fixes complement, opsonizes, neutralizes viruses and bacterial toxin
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What are the characteristics of IgA?
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found in secretions, prevents pathogen adhesion to mucosa, does not activate complement, works at low pH
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What are the characteristics of IgM?
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largest Ig, first one produced in resposne to stimulation, does not cross placenta
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What are the characteristics of IgD?
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found on B-cell surface. don't know what they do.
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What are the characteristics of IgE?
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least common Ig. stimulates mast cells and basophils in response to allergens, stimulates eosinophils in response to parasites
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What is an allotype?
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the specific epitope than binds an antigen
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What is an isotype?
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Different Ig (IgM, IgG, IgA) that binds the same antigen (has the same epitope)
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What is an idiotype?
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The specific epitope a certain antigen fits into
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What secretes IL-1? What does IL-1 do?
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Macrophages secrete IL-1. Chemotactic for leukocytes, causes endothelium to become sticky. Inflammatory mediator.
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What secretes IL-2? What does IL-2 do?
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Helper T cells secrete IL-2. It stimulates activity of helper T cells and cytotoxic T cells.
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What secretes IL-3? What does IL-3 do?
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Activated T cells secrete IL-3. stimulates bone marrow. similar actions as GM-CSF.
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What cells secrete IL-4? What does IL-4 do?
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Th2 cells secrete IL-4. It helps B cells switch classes to IgE and IgG, and helps them grow
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What cells secrete IL-5? What does IL-5 do?
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Th2 cells secrete IL-5. It help B cells switch classes to IgA, and helps eosinophils to grow
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What cells secrete IL-6? What does IL-6 do?
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Helper T cells and Macrophages secrete IL-6. It stimulates immunoglobin production
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What cells secrete IL-8? What does IL-8 do?
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Macrophages secrete IL-8. It is chemotactic for neutrophils
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What cells secrete IL-10? What does IL-10 do?
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Regulatory T cells secrete IL-10. It inhibits other T cells.
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What cells secrete IL-12? What does IL-12 do?
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B cells and macrophages secrete IL-12. It activates Th1 and Natural Killer cells
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What cells secrete interferon-gamma? What does interferon-gamma do?
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Th1 cells secrete interferon gamma. It stimulates macrophages
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What cells secrete TNF? What does TNF do?
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Macrophages secrete TNF. It mediates septic shock, recruits leukocytes, and causes vascular leakage
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What important cell surface receptors are on Helper T Cells?
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CD4, TCR, CD3, CD28, CD40L
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What important cell surface receptors are on Cytotoxic T Cells?
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CD8, TCR, CD3
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What important cell surface receptors are on B cells?
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IgM, B7, CD19, CD20, CD21, CD40, MHC-2
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What important cell surface receptors are on Macrophages?
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MHC-2, B7, CD40, CD14, receptors for Fc and complement 3b
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What important cell surface receptors are on Natural Killer Cells?
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receptors for MHC-1, CD16, CD56
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What immunity-important cell surface receptors are on all nucleated cells?
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MHC-1
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What are the two complement activation pathways, and what activates each one?
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classic: IgG or IgM binds to pathgens, complememnt binds to Fc region.
alternative: complement binds directly to microbe surface |
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What is the special action of the C3b component of complement?
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it opsonizes bacteria
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What is the special action of the C5a and C3a components of complement?
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they are anaphylactic
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What are the two special actions of the C5a component of complement?
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It is anaphylactic and chemotactic for neutrophils
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Which components of complement form the Membrane Attack Complex (MAC)?
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C5b-C9 all form the MAC
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Which two substances prevent complement from attacking our own cells?
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C1 esterase inhibitor, and Decay-Accelerating Factor (DAF)
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Deficiency in C3 results in what symptoms?
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severe, recurrent pyogenic infections in the respiratory tract and sinuses
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Deficiency in C6-C9 results in what symptoms?
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can lead to neisseria bacteremia
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Deficiency in C1 esterase inhibitor results in what symptoms?
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hereditary angioedema
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Deficiency in DAF results in what symptoms?
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paroxysmal nocturnal hemoglobinuria, complement-mediated RBC lysis
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In general, what do interferons do?
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put normal body cells into an anti-viral state
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What is the mechanism by which interferon alpha and beta put cells into an anti-viral state?
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they inhibit viral protein synthesis inside your body's cells
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What is the mechanism by which interferon gamma puts cells into an anti-viral state?
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it up-regulates MHC-1 and MHC-2
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What is the effect of interferons on NK cells?
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It activates them
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What can interferon alpha do that interferon beta does not do, to help your body fight infection?
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It causes fever
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What is the difference between active and passive immunity?
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Active:you make the antibodies yourself
Passive: you get the antibodies from someone else(maternal, injection) |
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What is anergy?
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When a lymphocyte can't respond to stimulation by antigen. Usually this is because it doesn't get the 2nd signal
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Which type of antibody is involved in Type I hypersensitivity reactions?
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IgE
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Anaphylaxis is an example of Type ___ Hypersensitivity
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I
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What chemical is released in large amounts during a Type I Hypersensitivity Reaction?
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histamine
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Of the 4 Hypersensitivity reactions, which ones involve antibodies?
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I, II, and III
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Which antibodies are involved in Type II hypersensitivity reactions?
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IgM and IgG
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What happens during a Type II hypersensitivity reaction?
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antibodies coat the cell, activating complement and phagocytosis by macrophages
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Serum Sickness is an example of a Type ______ Hypersensitivity reaction
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III
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The Arthus Reaction is an example of a Type ______ Hypersensitivity reaction
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III
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What happens during a type III hypersensitivity reaction?
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antibodies bind to protein, forming immune complexes that lodge in tissues and cause damage due to complement, neutrophilic infiltrate, and inflammation
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What type of cell mediates the Type IV hypersensitivity reaction?
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T-cells
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What happens during a Type IV hypersensitity reaction?
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antigen activates T-cells, which release lymphokines that attract and activate macrophages
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Which hypersensitivity reaction is the slowest?
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Type IV
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Which type of hypersensitivity reaction causes hayfever?
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Type I
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Which type of hypersensitivity reaction causes hemolytic anemia?
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Type II
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Which type of hypersensitivity reaction causes ITP?
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Type II
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Which type of hypersensitivity reaction causes Rheumatic Fever?
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Type II
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Which type of hypersensitivity reaction causes Goodpasture's Syndrome?
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Type II
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Which type of hypersensitivity reaction causes Bullous Pemphigoid?
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Type II
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Which type of hypersensitivity reaction causes Grave's Disease?
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Type II
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Which type of hypersensitivity reaction causes Myasthenia Gravis?
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Type II
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Which type of hypersensitivity reaction causes Lupus?
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Type III
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Which type of hypersensitivity reaction causes Rheumatoid Arthritis?
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Type III
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Which type of hypersensitivity reaction causes Post-Strep Glomerulonephritis?
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Type III
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Which type of hypersensitivity reaction causes Hypersensitivity pneumonitis?
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Type III
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Which type of hypersensitivity reaction causes Type 1 diabetes?
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Type IV
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Which type of hypersensitivity reaction causes Multiple Sclerosis?
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Type IV
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Which type of hypersensitivity reaction causes Gullian-Barre Syndrome?
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Type IV
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Which type of hypersensitivity reaction causes Hashimoto's Disease?
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Type IV
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Which type of hypersensitivity reaction causes Graft-versus-Host disease?
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Type IV
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Which type of hypersensitivity reaction causes the PPD reaction?
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Type IV
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Which type of hypersensitivity reaction causes contact dermatitis?
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Type IV
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Which cell is affected in Bruton's Agammaglobinemia?
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B-cells
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What is the inheritance pattern for Bruton's Agammaglobinemia?
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X-linked recessive
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What symptoms would you see in a person with Bruton's Agammaglobinemia?
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recurrent bacterial infections after 6 months of age (when maternal IgG runs out)
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What is the defect in the B-cell in a person with Bruton's Agammaglobinemia?
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B cell can make antibody, but can't secrete it
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What 3 structures are affected in a person with DiGeorge's Syndrome?
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parathyroids, thymus, and great vessels of the heart
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What is the name of the disease where the 3rd and 4th pharyngeal pouches fail to differentiate embryonically?
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DiGeorge Syndrome
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What are some symptoms seen in a person with DiGeorge Syndrome?
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recurrent viral and fungal infections, hypocalcemia with tetany, congenital heart defects
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How does DiGeorge Syndrome affect immunity?
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No thymus -> no place for T cells to develop -> no functional T cells
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DiGeorge Syndrome results from what genetic abnormality?
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deletion in 22q11
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Kids with congenital defects in early bone marrow stem cell differentiation have a disease called.....?
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SCID (Severe Combined Immuno Deficiency)
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What are some symptoms seen in SCID kids?
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recurrent infections by bacteria, viruses, fungi, and parasites
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Name 3 defects in bone marrow stem cells that might lead to SCID:
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1) can't make MHC-2 antigens
2) can't make IL-2 receptors 3) deficient in adenosine deaminase |
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A kid with SCID due to adenosine deaminase deficiency can be treated with......?
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irradiated RBC transfusion
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Which disease involves B-cells that can't make IgM?
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Wiskott-Alldrich syndrome
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What is the inheritance pattern of Wiskott-Alldrich Syndrome?
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X-linked
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What levels of antibody would you see in a person with Wiskott-Alldrich syndrome?
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high IgA, normal IgE, low IgM
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What are some symptoms seen in people with Wiskott-Alldrich Syndrome?
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Eczema, recurrent pyogenic infections, purpura
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If helper T-cells can't make IFN-gamma, what disease is present?
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Job's Syndrome
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What are some symptoms seen in people with Job's Syndrome?
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coarse facies, noninflamed staph abscesses, retained baby teeth, skin problems
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Where is the defect found in HyperIgM Syndrome?
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Helper T cells can't activate CD40 on B cells, so B cells can't class switch. They only make IgM, and nothing else
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What are some symptoms of HyperIgM syndrome?
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severe pyogenic infections, high viscosity blood
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Where is the defect in Chediak-Higashi Disease?
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Cells have non-functional microtubules, and phagocytes can't empty their lysosomes
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Where is the defect in Chronic Granulomatous Disease?
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Neutrophils can't use the NADPH myeloperoxidase system
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What are some symptoms found in people with Chronic Granulomatous Disease?
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Recurrent infections by bacteria, especially staph aureus, e coli, aspergillus.
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What test will come out negative if and only if a perosn has Chronic Granulomatous Disease?
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the nitroblue tetrazolium dye reduction test
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What is going on in people with Common Variable Immunodeficiency?
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B-cells don't always turn into plasma cells. Low IgG.
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What is going on in patients with Selective Immunoglobin Deficiency?
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B-cells can't switch to a certain type of antibody
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What is the most common antibody deficiency in people with Selective Immunoglobin Deficiency?
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IgA
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What symptoms appear in people with Selective Immunoglobin Deficiency?
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recurrent lung and sinus infections, milk allergies, diarrhea
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A person with HLA subtype B27 is at risk for:
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Psoriasis, Ankylosing Spondylitis, Inflammatory bowl disease, Reiter's Syndrome (PAIR)
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A person with HLA subtype B8 is at risk for:
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Grave's Disease, Celiac Sprue
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A person with HLA subtype DR2 is at risk for:
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Multiple Sclerosis, hay fever, lupus, Goodpasture's
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A person with HLA subtype DR3 is at risk for:
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Type 1 Diabetes
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A person with HLA subtype DR4 is at risk for:
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Rheumatoid Arthritis, Type 1 diabetes
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A person with HLA subtype DR5 is at risk for:
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pernicious anemia and B12 deficiency, Hashimoto's Thyriditis
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A person with HLA subtype DR7 is at risk for:
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nephrotic syndrome
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What are some toxicities associated with cyclosporine?
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predisposes to viral infections and lymphoma, and is nephrotoxic
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What are some toxicities associated with tacrolimus?
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nephrotoxic, peripheral neuropathy, hypertension, pleural effusion, hyperglycemia
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What are some toxicities associated with azathioprine?
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bone marrow suppression
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What are some toxicities associated with muromonab?
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hypersensitivity, cytokine release
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What are some toxicities associated with sirolimus?
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hyperlipidemia, thrombocytopenia, leukopenia
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How does daclizumab work as an immunosuppressant?
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antibody that binds to IL-2 receptors on activated T cells
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