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192 Cards in this Set
- Front
- Back
What test is done to diagnose CGD?
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Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
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What is the valence of an Ig molecule equal to?
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The number of Ags that the Ab can bind
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What is the name of the process that ensures that each B cell produces only one heavy-chain variable domain and one light chain?
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Allelic exclusion. It is to ensure that one B cell produces only one Ab.
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What is the major Ab of the primary immune response?
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IgM
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What form of immunity is responsible for removal of intracellular infections?
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Cell-mediated immunity
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True or false? Direct fluorescent Ab test is used to detect Abs in a patient?
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False. Direct tests detect Ags; indirect tests detect Abs.
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What is the triad of Wiskott-Aldrich syndrome?
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Thrombocytopenia, eczema, and immunodeficiency is the triad of this X-linked recessive disorder.
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What complement factor deficiency leads to
• Increased susceptibility to pyogenic infections? |
C3 deficiency
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What complement factor deficiency leads to
• Recurrent gonococcal infections? |
C5-C8 deficiency
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What complement factor deficiency leads to
• Leukocyte adhesion deficiency with poor opsonization? |
C1, C2, or C4 deficiency
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What complement factor deficiency leads to
• Hereditary angioedema? |
C1 inhibitor (C1-INH)
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Which IgG cannot activate complement?
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IgG4
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Name the T-cell CD marker:
• Essential for Ab isotype switching (for B cell binding) |
CD40 ligand
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Name the T-cell CD marker:
• Interacts with MHC class I molecules |
CD8
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Name the T-cell CD marker:
• Expressed on all T cells and is needed as a signal transducer for the T cell receptor |
CD3
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Name the T-cell CD marker:
• Interacts with MHC class II molecules |
CD4
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Name the T-cell CD marker:
Is a costimulatory molecule in T cell activation |
CD28
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What three cells are essential for T-cell differentiation in the thymus?
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Dendritic cells, macrophages, and thymic epithelial cells
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What is the only specific Ag-presenting cell?
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B cells; macrophages and dendritic cells are nonspecific.
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What is the tetrad of Jarisch-Herxheimer reaction?
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Rigors, leukopenia, decrease in blood pressure, and increase in temperature
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What is the name of the B cell that secretes Ig?
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Plasma cell (mature B lymphocyte)
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What would be the result if an Ab were cleaved with papain?
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There would be two Fab and Fc regions.
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What is the bone marrow maturation time for a phagocytic cell?
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14 days
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Which leukotrienes are associated with the late-phase inflammatory response?
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LTC4 and LTD4
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What is the term for the strength of the association between Ag and an Ab?
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Affinity (one of each)
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True or false? More Ag is needed to produce a secondary immune response than a first immune response.
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False. Fewer Ags are needed to trigger a secondary response.
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What is the term for the strength of association between multiple Abbinding sites and multiple antigenic determinants?
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Avidity (more than one binding site)
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What Ig mediates ADCC via K cells, opsonizes, and is the Ig of the secondary immune response?
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IgG
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What test is used to detect anti-RBC Abs seen in hemolytic anemia?
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Coombs test
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What subset of T cells recognizes the MHC class I Ags?
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CD8+ T cells (cytotoxic)
Remember, 8×1=8 (CD×8×MHC class I=8); 4×2=8 (CD×4 MHC class II 8) |
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What cell surface marker is found on activated helper T cells?
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CD40
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What are the five Ig isotypes?
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IgA, IgD, IgE, IgG, and IgM
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Which integrin mediates the adhesion to endothelial cells for migration in and out of the blood during an immune response?
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Beta2-integrins
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What type of hypersensitivity is an Ab-mediated response against our own cells, receptors, or membranes via IgG or IgM?
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Type II hypersensitivity reaction
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What is the term to describe the limited portion of an Ag that is recognized by an Ab?
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Antigenic determinant (epitope)
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What cytokine do Th1 cells secrete to inhibit Th2 cell function?
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INF-gamma
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What three cells are essential for T-cell maturation?
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Thymic epithelial cells, dendritic cells, and macrophages
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What is the term for a single isolated antigenic determinant?
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Hapten (not immunogenic)
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What are the two opsonizing factors?
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The Fc region of IgG and C3b
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What is the most common Ig deficiency?
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IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
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What is the name of the B cell–rich area of the spleen?
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Primary follicle (in the white pulp)
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What IL, produced by macrophages, is chemotactic for neutrophils?
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IL-8. It not only is chemotactic, it also acts as an adhesive for neutrophils.
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What Ig prevents bacterial adherence to mucosal surfaces?
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IgA
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What are the three rules of clonal selection?
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1. One cell type
2. One Ab type 3. Random selection of hypervariable regions, and only cells with bound Ag undergo clonal expansion |
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What is a plasma cell's life expectancy?
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7 to 14 days
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What are defined by Ag-binding specificity?
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Idiotypes
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What type of binding occurs with one Fab or one idiotype of IgG?
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Affinity
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What molecule that is needed to trigger T cell activation is noncovalently linked to TCR?
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CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
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What is the term for Ags that activate B cells without T-cell signaling?
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Thymus-independent Ags
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What are the three rules governing a secondary immune response?
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1. Covalent bonding between the hapten and carrier
2. B-cell exposure to hapten twice 3. T-cell exposure to carrier twice |
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What type of hypersensitivity is a T cell-mediated response to Ags that are not activated by Ab or complement?
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Type IV hypersensitivity reaction (delayed type because of the 48–96 hour latency)
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Name the macrophages by location:
• Liver |
Kupffer cells
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Name the macrophages by location:
• Lungs |
Alveolar macrophages
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Name the macrophages by location:
• CNS |
Microglial cells
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Name the macrophages by location:
• Kidney |
Mesangial macrophages
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What is the first human disease successfully treated with gene therapy?
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Adenosine deaminase (ADA) deficiency
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What receptors are the best markers for NK cells?
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CD16 and CD56
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True or false? Ag-Ab binding is irreversible
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False. It is reversible because the Ags and Abs are not linked covalently.
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What three major cell lines participate in the acquired immune system?
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T cells, B cells, and macrophages
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What test is used to screen for HIV?
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ELISA. It detects anti-p24 IgG.
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During what stage of B-cell development is IgM first seen on the surface?
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Immature B cells
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What Ig is responsible for Antibody-Dependent Cell-mediated Cytotoxicity of parasites, has a high-affinity Fc receptor on mast cells and basophils, and is responsible for the allergic response?
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IgE
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True or false? B-cell Ag receptors can be secreted.
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True. B cell antigen receptors are Abs.
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Are more Abs produced in a primary or a secondary immune response?
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More Ab is produced in less time in a secondary immune response (shorter lag period).
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By which process do Abs make microorganisms more easily ingested via phagocytosis?
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Opsonization
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What MHC class acts to remove foreign Ags from the body?
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MHC class II Ags. This is accomplished via CD4 T cells.
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What disorder is characterized by autoantibodies to IF?
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Pernicious anemia
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What cytokines do Th2 cells secrete to inhibit Th1 cell function?
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IL-4, IL-10, and IL-13
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What is the term for the number of Ag-binding sites on an Ig?
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Valence
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Which major cell type is found in the red pulp of the spleen?
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RBCs. That is why it is called red pulp.
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What is the name of the pathway that produces leukotrienes?
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Lipoxygenase pathway, from arachidonic acid
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What is the term to describe basophils that have left the bloodstream and entered a tissue?
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Mast cells
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What are the three major functions of secretory IgA?
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1. IgA receptor
2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases |
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What IL is important in myeloid cell development?
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IL-3 (3 face down is an M)
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What is the term for different classes and subclasses of the same gene products?
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Isotypes
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What is the first Ab a baby makes?
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IgM
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What test, by using specific Abs to different receptors, allows for rapid analysis of cell types in a blood sample?
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Flow cytometric analysis
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What is the name of the T cell–rich area of the spleen?
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PALS (Parietolateral lymphocytic sheath)
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What three complement fragments are also anaphylatoxins?
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C3a, C4a, and C5a
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Name the B-cell CD marker:
• Required for class switching signals from T cells |
CD40
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Name the B-cell CD marker:
• Receptor for EBV |
CD21; it is a complement receptor for cleaved C3
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Name the B-cell CD marker:
• Used clinically to count B cells in blood |
CD19
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What immunologic test checks for a reaction between Abs and a particular Ag? (hint: ABO typing)
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Agglutination test
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Which leukotriene is chemotactic for neutrophils?
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LTB4
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What Ig is associated with mucosal surfaces and external secretions?
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IgA
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What are the genetic variants of a molecule within members of the same species?
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Allotypes
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What cytokine do CD4 T cells secrete to activate B cells when the specific peptide in the groove of the MHC II molecule interacts with the TCR?
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IL-4 is secreted to activate B cells. This begins the second step in the immune response, known as Activation. CD4 T cells secrete INF-alpha to activate macrophages
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Which protein prevents internal binding of self proteins within an MHC class II cell?
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Invariant chain
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What would be the result if an Ab were cleaved with pepsin?
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There would be a Fab' region; thus, it would still be able to participate in precipitation and agglutination.
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Why are patients with Chronic Granulomatous Disease not prone to develop infections from catalase-negative bacteria?
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Catalase-negative bacteria secrete H2O2 as a byproduct (remember, catalase breaks down H2O2), allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase-positive bacterial infections.
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What are the two chains of the TCR that are mainly found on the skin and mucosal surfaces?
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gamma and delta chains
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Which IL is associated with increases of IgG and IgE?
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IL-4
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What branch of the immune system is acquired in response to an Ag?
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Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.
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True or false? T cells can recognize, bind, and internalize unprocessed Ags.
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False. B cells recognize unprocessed Ags, but T cells can recognize only processed Ags.
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What type of hypersensitivity is a result of high circulating levels of soluble immune complexes made up of IgG or IgM Abs?
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Type III hypersensitivity reaction
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At what stage of B-cell development can IgM or IgD be expressed on the cell surface?
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Mature B cell; the memory B cell can have IgG, IgA, or IgE on its surface.
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What T cell deficiency syndrome is associated with facial anomalies, hypoparathyroidism, thymic hypoplasia, and recurrent viral and fungal infections?
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DiGeorge syndrome, which is due to a failure of the third and fourth pharyngeal pouch development. Remember, B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
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What is the stimulus for the classical pathway activation?
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Ag-Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
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What is the first membrane-bound Ig on B cell membranes?
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IgM; IgD follows shortly thereafter.
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What region of the Ig does not change with class switching?
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Hypervariable region
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In MHC class II molecules, what chain blocks access to the peptide-binding groove during transportation within the cell, ensuring that the MHC class II–peptide complex is transported to the surface?
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Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
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What chromosome codes for HLA gene products?
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The short arm of chromosome 6
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What cells are atypical on a peripheral blood smear in heterophil-positive mononucleosis?
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T cells, not B cells
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What is the major Ig of the secondary immune response in the mucosal barriers?
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IgA
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What AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections, uncoordinated muscle movements, and dilation of the blood vessels?
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Ataxia-telangiectasia
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What are the four chemotactic agents?
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1. C5a
2. Leukotriene B4 3. IL-8 4. Bacterial peptides |
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What subset of CD4 helper T cells stimulate B-cell division and differentiation?
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Th2
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Which region of the variable domain comprises the Ag-binding site of the Ab?
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Hypervariable region (three per light chain; three per heavy chain)
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True or false? The increased oxygen consumption after phagocytosis is for ATP production.
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False; it is for the production of toxic metabolites.
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What is the limited portion of a large Ag that will actually be recognized and bound to an Ab and that contains approximately five to six amino acids or four to five hexose units?
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Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
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What complement factor or factors are associated with
• Chemotaxis? |
C5a
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What complement factor or factors are associated with
• Membrane attack complex (MAC)? |
C5–C9
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What complement factor or factors are associated with
• Opsonization? |
C3b
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What complement factor or factors are associated with
• Anaphylaxis? |
C3a, C4a, C5a
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What happens to the Ab specificity when class switching occurs in mature B cells?
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As the isotype is switched, the Ab specificity does not change because it does not affect the variable chains.
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What IL down-regulates cell mediated immunity?
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IL-10
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Name the type of graft described by these transplants:
• From one site to another on the same person |
Autograft
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Name the type of graft described by these transplants:
Between genetically identical individuals |
Isograft
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Name the type of graft described by these transplants:
• From one person to the next (the same species) |
Allograft
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Name the type of graft described by these transplants:
• From one species to another |
Xenograft
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What is the name of the process in which cells migrate toward an attractant along a concentration gradient?
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Chemotaxis
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What are the two functions of the thymus in T-cell differentiation?
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Hormone secretion for T-cell differentiation and T-cell education to recognize self from nonself
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What is the name of the T cell–rich area of the lymph node?
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Paracortex
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What cell surface marker do all T cells have?
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CD3
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True or false? Patients with common variable hypogammaglobinemia have B cells in the peripheral blood.
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True. Common variable hypogammaglobinemia first appears by the time patients reach their 20s and is associated with a gradual decrease in Ig levels over time.
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What is the Ig associated with the primary immune response?
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IgM
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What MHC class of antigens do all nucleated cells carry on their surface membranes?
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MHC class I antigens; they are also found on the surface of platelets.
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What Ig is responsible for activation of complement, opsonization, and ADCC and is actively transported across the placenta?
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IgG
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What type of Ag do T cells recognize?
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Processed antigenic peptides bound in the groove of the MHC molecule
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What Ig is the major protective factor in colostrum?
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IgA
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What is the second cell involved in the immune response?
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The CD4 T cell; the APC is the first cell in the immune response.
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What is the term for thymic induction of T cells with high-affinity Ag receptors for self that are programmed to undergo apoptosis?
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Negative selection. This helps to prevent autoimmune diseases.
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What five main oxidizing reactions are used to kill ingested organisms?
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1. H2O2
2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid |
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What Ig is associated with ADCC for parasites?
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IgE
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True or false? RBCs do not have MHC class I Ags on their surface.
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True. Remember, all nucleated cells (and platelets) have MHC class I Ags, and RBCs are not nucleated.
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What Ig is associated with mast cell and basophil binding?
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IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
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What IL do T cells secrete to induce T-and B-cell division?
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IL-2. T cells express IL-2 receptors on their surface to induce self-expression.
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Development of what T cell line follows low affinity for self-MHC class II Ags in the thymus?
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CD4+T cells
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What is the term for a substance secreted by a leukocyte in response to a stimulus?
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Cytokine. If a cytokine affects another class of leukocytes, it is called an interleukin.
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What subset of CD4 T cells is responsible for mast cell and eosinophil precursor proliferation?
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Th2 cells
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What are the four major functions of the acquired immune system?
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1. Recognize self from nonself
2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material |
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What endotoxin receptor is the best marker for macrophages?
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CD14
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What is the term for the inherent ability to induce a specific immune response?
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Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
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What molecule differentiates the MHC class I from II Ag? (Hint: it's in the light chain.)
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The Beta-2-microglobin. It is the separately encoded Beta-chain for class I Ags.
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What B cell disorder is characterized by pre-B cells in the bone marrow, no circulating B cells in plasma, normal cell-mediated immunity, low Igs, and appearance by 6 months of age?
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Bruton X-linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
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What subtype of IgG does not bind to staphylococcal A protein?
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IgG3
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What mast cell mediator is a chemotactic agent?
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Eosinophil chemotactic factor A
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What is the major Ig of the secondary immune response?
|
IgG
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What T-cell surface projection recognizes and reacts to foreign Ags (presented by APCs)?
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TCR
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What is the confirmatory test for HIV?
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Western blot
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What is the name of the major chemotactic agent released from
• Neutrophils? |
Leukotriene B4 (LTB4)
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What is the name of the major chemotactic agent released from
• Macrophages? |
IL-8 (IL-1 and TNF-gamma also)
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What is the name of the major chemotactic agent released from
• The blood serum? (Hint: it is a complement factor.) |
C5a
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What is the name of the major chemotactic agent released from
• Bacteria? |
F-Met-Peptides
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What cell surface marker is found on blood B cells?
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CD19
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What is the name of the B cell–rich area in the lymph node?
|
Primary follicle of the cortex
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What are the four ways to down-regulate the immune system?
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1. Decrease concentrations of Ag levels
2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti-Ab |
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What is the only Ig that crosses the placenta?
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IgG
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What is given to pregnant women within 24 hours after birth to eliminate Rh+ fetal blood cells from their circulation?
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Rho (D) immune globulin (RhoGAM), an anti-RhD IgG antibody, prevents generation of RhD-specific memory B cells in the mother.
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What IL is essential for lymphoid cell development?
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IL-7 (A 7 upside down is an L; L is for Lymphoid)
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What type of cell can never leave the lymph node?
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Plasma cell
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Via what pathway is glycolysis increased after phagocytosis?
|
HMP shunt
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What is the term for a delay in the onset of normal IgG synthesis seen in the fifth to sixth month of life?
|
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
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What subset of CD4 helper T-cell function is helping the development of CD8 T cells?
|
Th1; they are also responsible for delayed-type hypersensitivity (type IV)
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What is the term for the strength of the association between Ags and Abs?
|
Avidity. There is a positive correlation between valence numbers and avidity.
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What type of Ag do B cells recognize?
|
Free, unprocessed Ag
|
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What Ig is associated with Ag recognition receptor on the surface of mature B cells?
|
IgD; IgM is also correct.
|
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Which chromosome is associated with MHC genes?
|
Chromosome 6
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What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
|
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
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What is the most common precipitin test used in clinical medicine?
|
Radial Immuno Diffusion (RID) for Ig levels.
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What Ig activates the complement cascade most efficiently?
|
IgM
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What assay is used to identify MHC class I molecules?
|
Microcytotoxic assay
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Which IL increases IgA synthesis?
|
IL-5. It also stimulates eosinophil proliferation.
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What is the term for an immunogenic agent that is too small to elicit an immune response?
|
Hapten; if it is coupled with a carrier, it may become immunogenic.
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What type II hypersensitivity disorder is defined as
• Autoantibodies directed against ACh receptors? |
Myasthenia gravis
|
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What type II hypersensitivity disorder is defined as
• Autoantibodies directed against platelet integrin? |
Autoimmune thrombocytopenia purpura
|
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What type II hypersensitivity disorder is defined as
• Autoantibodies against the type IV collagen in the basement membrane of the kidneys and lungs? |
Goodpasture syndrome
|
|
What type II hypersensitivity disorder is defined as
• Autoantibodies directed against the TSH receptor? |
Graves disease
|
|
What type II hypersensitivity disorder is defined as
• Autoantibodies directed against RBC Ag I? |
Autoimmune hemolytic anemia
|
|
What Ig activates the alternate pathway, neutralizes bacterial endotoxins and viruses, and prevents bacterial adherence?
|
IgA
|
|
What enzyme is deficient in patients with CGD?
|
NADPH oxidase is deficient, resulting in an inability to produce toxic metabolites.
|
|
What subtype of IgG does not activate complement cascade?
|
IgG4
|
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What two cell lines of the immune system do not belong to the innate branch?
|
T and B-cells belong to the adaptive branch, whereas PMNs, NK cells, eosinophils, macrophages, and monocytes belong to the innate branch.
|
|
What subset of T cells recognizes the MHC class II Ags?
|
CD4+ T cells (helper)
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|
What T cell line arises from low affinity for self-MHC class I Ags in the thymus?
|
CD8+ T cells
|
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What MHC class functions as a target for elimination of abnormal host cells?
|
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells, virus-infected cells—anything the body recognizes as nonself via CD8+ T cells.
|
|
What are the three polymorphonuclear leukocytes? Be specific.
|
Neutrophils, eosinophils, and basophils
|
|
What disease is associated with the HLA-A3 allele
|
Primary Hemochromatosis
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|
What diseases are associated with the HLA-B27 allele
|
Psoriasis, ankylosing spondylitis, inflammatory bowel disease, and Reiter's syndrome
|
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What disease is associated with the HLA-DR2 and HLA-DR3 alleles
|
Systemic lupus erythematosus
|
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What diseases are associated with the HLA-DR3 allele
|
Sjogren's syndrome, active hepatitis, systemic lupus erythematosus (with HLA-DR2) and type 1 diabetes (with HLA-DR4)
|
|
What diseases are associated with HLA-DR4
|
Rheumatoid arthritis and type 1 diabetes (with HLA-DR3)
|