Z Boards First Aid Immunology

Front 1

lymph nodes

b cells are in _
t cells are in _

Back 1

follicle

paracortex

Front 2

high endothelial venules are in...

fxn?

Back 2

paracortex of lymph node

high endothelial venules, through which T and B cells enter from blood

Front 3

a viral infection in the body, may affect structure of _ part of a lymph node

Back 3

enlargement of paracortex

Front 4

_ of lymph node is not well developed in _ pts

Back 4

DiGeorge syndrome

Front 5

lymph node has 3 major parts

Back 5

follicle
medulla
paracortex

Front 6

lymph node medulla has what parts, containing what cells?

Back 6

cords
--lymphocytes
--plasma cells

sinuses
--reticular cells
--macrophages

Front 7

_ of lymph node communicates with efferent lymphatics

Back 7

medullary sinuses

Front 8

lymph drainage

axillary drains

Back 8

upper limb

lateral breast

Front 9

lymph drainage

stomach -->

duodenum, jejunum -->

Back 9

celiac

superior mesenteric

Front 10

sigmoid colon

rectum

anal canal

drains to _ lymph node

Back 10

colic --> inferior mesenteric

internal iliac

superficial inguinal

Front 11

superficial inguinal lymph nodes receive drainage from...

Back 11

anal canal

scrotum

thigh (superficial)

Front 12

testes drain to

Back 12

superficial and deep plexuses

--> para-aortic

Front 13

_ lymph nodes in leg surprisingly receive drainage from...

Back 13

popliteal

lateral dorsum of foot

Front 14

R lymphatic duct receives drainage from

Back 14

R arm

R side of head

Front 15

sinusoids of spleen are in what part of spleen

describe two histological features

Back 15

red pulp

fenestrated "barrel hoop" basement membrane

macrophages found nearby

Front 16

T cells are found where in spleen

Back 16

--PALS

--white pulp

Front 17

B cells are found where in spleen?

Back 17

follicle within white pulp

Front 18

RBCs are found where in spleen?

Back 18

red pulp

(presumably w/in the sinusoids)

Front 19

5 cell types listed by FA as being w/in the spleen

what part of the spleen are they in?

Back 19

RBCs (red pulp)

T cells (PALS; white pulp)

B cells (follicles w/in white pulp)

macrophages (nearby sinusoids)

APCs (marginal zone)

Front 20

macrophages in spleen serve what immune function?

Back 20

remove encapsulated bacteria

Front 21

splenic dysfunction -->

Back 21

v IgM -->

v complement activation -->

v C3b opsonization -->

^ susceptibility to encapsulated organisms:

S SHiN

Salmonella
Strep pneumo
Haemophilus influenzae
Neisseria meningitidis

Front 22

postsplenectomy (3)

Back 22

Howell-Jolly bodies
Target cells
Thrombocytosis

Front 23

thymus develops from _

Back 23

epithelium of 3rd branchial pouches

Front 24

lymphocytes are of _ (tissue) origin

Back 24

mesenchymal

Front 25

thymus histology / cell types

cortex:

medulla:

Back 25

cortex: immature T cells

Medulla: "HEM"
--Mature T cells
--epithelial reticular cells
--Hassall's corpuscles

Front 26

MHC I binds...

Back 26

TCR

CD8

Front 27

MHC I =

MHC II =

Back 27

HLA-A, B, C

HLA-DR, DP, DQ

Front 28

MHC I vs. MHC II

expressed on...

Back 28

~ all cells except RBCs

only APCs

Front 29

MHC I mediates _ immunity

Back 29

viral

Front 30

antigen is loaded for MHC I where?

what antigen?

Back 30

RER

mostly intracellular peptides

Front 31

one of the MHCs pairs with ___

why?

Back 31

beta-2 microglobulin

aids in transport to cell surface

Front 32

antigen is loaded onto MHC II following ______

Back 32

release of invariant chain in an acidified endosome

Front 33

HLA-A3

Back 33

hemochromatosis

Front 34

hemochromatosis HLA

Back 34

HLA-A3

Front 35

HLA-B27

Back 35

PAIR

psoriasis
ankylosing spondylitis
inflammatory bowel disease
reiter's syndrome

Front 36

HLA-B8

Back 36

"your grave will B 8 feet under"

Graves' disease

Front 37

HLA-DR2

Back 37

"you think there are Multiple Good Systems for mowing Hay, but DeR are only 2."

MS
Goodpasture's
SLE
Hay fever

Front 38

diabetes type 1 HLA

Back 38

HLA-DR3, DR4

Front 39

HLA-DR4

Back 39

rheumatoid arthritis, diabetes type 1

Front 40

HLA-DR5

Back 40

pernicious anemia

hashimoto's thyroiditis

Front 41

HLA-DR7

Back 41

steroid-responsive nephrotic syndrome

Front 42

natural killer cells use _ _ to accomplish _ _

Back 42

perforin
granzymes

induce apoptosis
of virally-infected and tumor cells

Front 43

NK cells' activity is enhanced by

Back 43

IL-12, IFN-beta, IFN-alpha

"I'Ll Interfere with bacteria in 12 ways, in my Alpha and Beta brain waves, w/o even thinking about it, b/c I'm a Natural Killer"

Front 44

IL-12 a couple effects

Back 44

+ NK cells activity

Helper T --> Th1 cell

Front 45

NK cells are induced to kill when _____ is found on target cell

Back 45

nonspecific activation signal

absence of class I MHC

Front 46

which Ig neutralizes viruses

Back 46

Ig

Front 47

CD4+ T cells functions

Back 47

help B cells make antibody

make gamma-interferon --> activates macrophages

Front 48

helper T cell differentiates into _ where?

Back 48

IL-12 --> Th1 (cell-mediated)

IL-4 --> Th2 (humoral)

in lymph node

Front 49

+ selection

- selection

of T lymphocytes occurs where?

Back 49

+ selection: cortex

- selection: medulla

Front 50

which Ig mediates type II = ____

type III = ______ hypersensitivity?

Back 50

IgG

cytotoxic

immune-complex

Front 51

APCs =

Back 51

Macrophage
Dendritic cell
B cell

Front 52

APC cell stimulates CD4+ T cell by MHC II

but also talks to the CD4+ T cell's _ by APC's _

Back 52

CD28

B7

Front 53

virus infected cell talks to CD8+ T cell by MHC I

but the Th1 cell talks to the CD8+ T cell's _ by Th1's _

Back 53

IL-2R

IL-2

Front 54

Th2 cell talks to B cell by ____

Back 54

Th2 cytokines: IL-4, IL-5, IL-6

Th2's CD40L --> B cell's CD40

Front 55

Th1 cell secretes _ cytokines

Back 55

IL-2

IFN-gamma

Front 56

Th1 cell helps what?

Back 56

macrophage

CD8+ T cell

Front 57

Th1 cell is inhibited by ...

Back 57

IL-10 (from Th2)

Front 58

Th2 cell secretes _ cytokines

Back 58

IL-4, IL-5, IL-10

Front 59

Th2 cell helps...

Back 59

helps antibody production
(IgE > IgG)

Front 60

Th2 cell is inhibited by

Back 60

IFN-gamma (from Th1)

Front 61

macrophage-lymphocyte interaction

Back 61

lymphocytes (secrete IFN-gamma)

macrophages (secrete IL-1, TNF-alpha)

stimulate one another

Front 62

cytotoxic T cells kill by... _

Back 62

inducing apoptosis

Front 63

cytotoxic T cells mechanism

Back 63

release cytotoxic granules containing

--perforin
--granzyme
(serine protease; + apoptosis)
--granulysin
(antimicrobial; + apoptosis)

Front 64

complement binding part of heavy chain is...

Back 64

CH2

Front 65

complement enhances...

Back 65

opsonization
lysis

Front 66

antibody diversity is generated by (4)

Back 66

1. random "recombination" of VJ (light) or V(D)J (heavy)

2. random combination of heavy & light

3. somatic hypermutation (following antigen stimulation)

4. addition of nucleotides during (1) by terminal deoxynucleotidyl transferase

Front 67

Ig _ ... take on different forms...

Back 67

IgA--monomer in circulation;
dimer when secreted

IgM--monomer on B cell;
pentamer

Front 68

IgA crosses epithelial cells by _ and something else re: epithelial cells

Back 68

transcytosis

picks up secretory component from them before secretion

Front 69

which Ig is found in breast milk?

Back 69

IgA

Front 70

lowest [ ] Ig in serum

Back 70

IgE

Front 71

MAC defends against _ bacteria

Back 71

G -

Front 72

the two opsonins

Back 72

C3b

IgG

Front 73

_ aids in the clearance of immune complexes

Back 73

C3b

Front 74

_ help prevent complement activation on self-cells

Back 74

DAF (decay accelerating factor)

C1 esterase inhibitor

Front 75

complement _ --> viral neutralization

Back 75

C1, C2, C3, C4

Front 76

complement _ --> anaphylaxis

Back 76

C3a
C5a

Front 77

deficiencies of complement

Back 77

C1 esterase inhibitor
--> hereditary angioedema

C3
--pyogenic sinus & respiratory infections
-- ^ type III hypersensitivity

C5-C8
--> Neisseria bacteremia

DAF
--> complement-mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria

Front 78

C1 esterase inhibitor deficiency

Back 78

hereditary angioedema

Front 79

decay-accelerating factor deficiency -->

Back 79

complement-mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria

Front 80

C3 deficiency -->

Back 80

--pyogenic sinus & respiratory infections
-- ^ type III hypersensitivity

Front 81

C5-C8 deficiency -->

Back 81

Neisseria bacteremia

Front 82

pyrogens

Back 82

IL-1
IL-6

Front 83

IL-1 -->

Back 83

--fever

--acute inflammation

--endothelium expression of adhesion molecules

--chemokine secretion to recruit leukocytes

Front 84

IL-6

Back 84

--fever

--acute-phase proteins

Front 85

IL-6 is secreted by...

Back 85

macrophages
Th cells

Front 86

macrophages secrete

Back 86

IL-1, 6, 8, 12, TNF-alpha

Front 87

IL-8

Back 87

chemotactic for neutrophils

Front 88

IL-12 is secreted by...

Back 88

macrophages

B cells

Front 89

IL-12

Back 89

differentiation into Th1 cells

activation of NK cells

Front 90

TNF-alpha

Back 90

septic shock

leukocyte recruitment

vascular leak

Front 91

T cells secrete

Back 91

IL-3

Front 92

IL-3

Back 92

+ bone marrow stem cells

fxns like GM-CSF

Front 93

Th1 cells make...

Back 93

IL-2
interferon-gamma

Front 94

IL-2

Back 94

+ T cells

Front 95

interferon-gamma

Back 95

activates:
--macrophages
--Th1

suppresses Th2
antiviral
antitumor

Front 96

Th2 cells make...

Back 96

IL-4
IL-5
IL-10

Front 97

IL-4

Back 97

--differentiation into Th2 cells

--growth of B cells

--class switching to IgE and IgG

Front 98

IL-5

Back 98

differentiation of B cells

class switching to IgA

growth/differentiation of eosinophils

Front 99

IL-10

Back 99

modulates inflammatory response

- actions of activated T cells and Th1.

activates Th2

Front 100

IL-10 is secreted by...

Back 100

Th2

regulatory T cells

Front 101

interferons place .... cells in an...

Back 101

uninfected cells

antiviral state

Front 102

interferons induce production of

Back 102

a ribonuclease that degrades viral mRNA

Front 103

interferons alpha, beta, gamma interfere with viruses by...

Back 103

alpha & beta
--inhibit viral protein synthesis

gamma
-- ^ MHC I and II expression and antigen presentation on all cells

interferons
--activate NK cells (to kill virus-infected cells)

Front 104

_ is associated with TCR

Back 104

CD3

Front 105

6 T cell surface proteins

Back 105

TCR; CD3

CD28 (binds B8 on APC)

Th: CD4, CD40L

CD8

Front 106

6 B cell surface proteins

Back 106

CD 19, 20, 21 (21--receptor for EBV)

CD40

MHC II

B7 (binds CD28 on T cell)

Front 107

6 cell surface receptors on macrophages

Back 107

MHC II, B7

CD40, CD14

receptors for Fc and C3b

Front 108

3 cell surface receptors on NK cells

Back 108

receptors for MHC I

CD16 (binds Fc of IgG)

CD56 (unique to NK)

Front 109

which becomes more anergic?

Back 109

T cells

Front 110

anergy in T cells

Back 110

self-reactive T cells

become nonreactive w/o costimulation

Front 111

superantigens are found in _ bacteria

Back 111

S pyogenes
S aureus

Front 112

superantigens mechanism

Back 112

cross-link beta-region of TCR

with MHC class II on APCs

--> IFN-gamma from Th1

--> IL-1, IL-6, TNF-alpha from macrophages

Front 113

endotoxins from G - bacteria MOA

Back 113

stimulate macrophages by

endotoxin receptor CD14

Front 114

antigen variation examples (5)

Back 114

salmonella (2 flagellar variants)

borrelia (relapsing fever)

N. gonorrhoeae (pilus)

influenza (major shifts; minor drifts)

trypanosomes (programmed rearrangement)

Front 115

influenza shift MOA

Back 115

RNA segment reassortment

Front 116

half-life of IgA in breast milk and other antibodies that are passively administered

Back 116

3 weeks

Front 117

preformed antibodies are given in (4) cases

Back 117

To Be Healed Rapidly

Tetanus
Botulinum
HBV
Rabies

Front 118

Type I hypersensitivity includes

Back 118

anaphylactic
atopic

Front 119

vasoactive amines in Type I hypersensitivity act @

Back 119

postcapillary venules

Front 120

test for type I hypersensitivity

Back 120

scratch test

radioimmunosorbent assay

Front 121

Type I is mediated by Ig_

Type II is mediated by Ig_

Type III is mediated by Ig_

Back 121

E

G, M

G

Front 122

mechanisms of Type II

Back 122

antibodies...

1. complement, phagocytosis
2. recruit neutrophils or macrophages
3. bind cellular receptors & interfere

Front 123

test for Type II

Back 123

Coombs (direct or indirect)

Front 124

immune complex mechanism

Back 124

IgG complexes

--> activate complement

--> attracts neutrophils

--> release lysosomal enzymes

Front 125

types of type III

Back 125

immune complex
serum sickness
arthus reaction

Front 126

serum sickness mechanism

Back 126

antibodies are deposited in membranes where they fix complement

Front 127

arthus reaction is...

Back 127

local subacute antibody-mediated hypersensitivity

e.g. @ skin

Front 128

arthus reaction is characterized by (3)

Back 128

edema
necrosis
activation of complement

Front 129

arthus reaction test

Back 129

immunofluorescent staining

Front 130

serum sickness sxs

Back 130

PAUL has a Fever

Proteinuria
Arthralgias
Urticaria
Lymphadenopathy

Fever

Front 131

type IV mechanism

Back 131

sensitized lymphocytes encounter antigen

release lymphokines

--> macrophage activation

Front 132

type _ hypersensitivity is not transferable by serum

Back 132

IV

Front 133

type IV causes (3) clinical

Back 133

Transplant rejection

TB skin test

Contact dermatitis

Front 134

5 allergic/atopic disorders caused by Type I

Back 134

rhinitis
hay fever
eczema
hives
asthma

Front 135

Type II --> 11 disorders

Back 135

wouldn't let that Pimp with his Bull near My Grave even for a Roomful of Good Wreaths. He's just Acute Perv, and an Idiot

--pemphigus vulgaris
--bullus pemphigoid
Myasthenia gravis
Graves'
--rheumatic fever
--goodpasture's
--erythroblastosis fetalis
hemolytic anemia
acute hemloytic transfusn rxn
pernicious anemia
--idiopathic thrombocytopenic purpura

Front 136

type II vs. type III general idea

Back 136

II--specific to tissue or site of antigen

III-- vasculitis, systemic manifestations

Front 137

Graves vs. Hashimoto's which type of hypersensitivity?

Back 137

Graves: type II

Hashimoto's: type IV

Front 138

rheumatic fever vs. rheumatoid arthritis, which type of hypersensitivity?

Back 138

type II

type III

Front 139

type III disorders (7)

Back 139

SLE
Rheumatoid arthritis
Polyarteritis nodosum
--poststreptococcal glomerulonephritis
--serum sickness
--arthus reaction
hypersensitivity pneumonitis (e.g. farmer's lung)

Front 140

an example of arthus rxn

Back 140

swelling & inflammation

2^ tetanus vaccine

Front 141

type IV hypersensitivity (7) pathologies

Back 141

Type I DM

MS
Guillain-Barre

Hashimoto's
Graft-vs-host disease

PPD
Contact dermatitis (e.g. poison ivy, nickel)

Front 142

autoantibodies

nonspecific for SLE

specific for SLE

Back 142

ANA

dsDNA, Smith

Front 143

autoantibodies:

antihistone

Back 143

drug-induced lupus

Front 144

drug-induced lupus, what autoantibodies?

Back 144

antihistone

Front 145

rrheumatoid factor is anti...

Back 145

anti-IgG

Front 146

scleroderma autoantibodies

Back 146

CREST: antiCentromere

diffuse: Scl-70 (DNA topoisomerase I)

Front 147

antimitochondrial autoantibodies indicates...

Back 147

1^ biliary cirrhosis

Front 148

celiac disease has _ autoantibodies besides gliadin

Back 148

endomysial

Front 149

pemphigus vulgaris antibodies

Back 149

desmoglein ("a pimp in a glen")

Front 150

hashimoto's autoantibodies

Back 150

microsomal
thyroglobulin

Front 151

antibodies for polymyositis, dermatomyositis

Back 151

anti-Jo-1

Front 152

antibodies for Sjogren's

Back 152

SS-A (anti-Ro)

SS-B (anti-La)

Front 153

mixed connective tissue disease autoantibodies

Back 153

U1 RNP (ribonucleoprotein)

Front 154

autoimmune hepatitis autoantibodies

Back 154

smooth muscle

Front 155

type 1 diabetes autoantibodies

Back 155

anti-glutamate decarboxylase

Front 156

B-cell immune deficiencies

Back 156

i Have a B Cell Syndrome

Bruton's agammaglobulinemia
Hyper-IgM syndrome
Selective Ig deficiency
CVID (common variable immunodeficiency)

Front 157

T-cell disorders

Back 157

i Have T Cell Issues

Thymic aplasia (DiGeorge)

IL-12 receptor deficiency

Hyper-IgE syndrome (Job's)

Chronic mucocutaneous candidiasis

Front 158

DiGeorge: genetics

Back 158

22q11 deletion

Front 159

DiGeeorge presentation

Back 159

tetany (hypocalcemia)

recurrent viral/fungal infections

congenital heart and great vessel defects

Front 160

DiGeorge labs etc.

Back 160

v T cells

v PTH v Ca++

absent thymic shadow on cxr

Front 161

IL-12 receptor deficiency

defect, presentation, labs

Back 161

v Th1 response

disseminated mycobacterial infections

v IFN-gamma

Front 162

hyper-IgE syndrome

defect

Back 162

Th1 cells fail to produce IFN-gamma

--> inability of neutrophils to respond to chemotactic stimuli

Front 163

hyper-IgE syndrome presentation

Back 163

FATED

--coarse Facies
--cold (noninflamed) staphylococcal Abscesses
--retained primary Teeth
--^ IgE
--Dermatologic problems (eczema)

Front 164

chronic mucocutaneous candidiasis defect

Back 164

T-cell dysfunction

Front 165

chronic mucocutaneous candidiasis presentation

Back 165

Candida albicans

infections of skin & mucus membranes

Front 166

Bruton's agammaglobulinemia defect

Back 166

X-linked recessive ("Boys")

BTK defect (a tyrosine kinase)

--> blocks B-cell differentiation

Front 167

bruton's agammaglobulinemia presentation

Back 167

recurrent bacterial infections

(after 6 months b/c v maternal IgG)

due to opsonization defect

Front 168

Bruton's agammaglobulinemia labs

Back 168

normal pro-B

v maturation
v number of B cells
v Ig (all classes)

Front 169

hyper-IgM defect

Back 169

defective CD40L on helper T cells

--> inability to class switch

Front 170

hyper-IgM syndrome presentation

Back 170

severe pyogenic infections early in life

Front 171

selective Ig deficiency presentation

Back 171

sinus and lung infections

milk allergies and diarrhea

Anaphylaxis on exposure to blood products with IgA

Front 172

the most common selective Ig deficiency

its mechanism

Back 172

IgA

failure to mature into plasma cells

Front 173

CVID defect

Back 173

B-cell maturation

Front 174

CVID presentation

Back 174

acquired in 20s-30s

autoimmune disease

lymphoma

sinopulmonary infections

Front 175

CVID labs

Back 175

normal number of B cells

v plasma cells

v immunoglobulin

Front 176

B and T cell disorders

Back 176

SAW

SCID
Ataxia-telangiectasia
Wiskott-Aldrich

Front 177

Phagocyte dysfunction disorders

Back 177

Leukocyte adhesion deficiency type 1

Chediak-Higashi

Chronic granulomatous disease

Front 178

SCID types

Back 178

IL-2 receptor defect (most common, X-linked)

adenosine deaminase deficiency

failure to synthesize MHC II antigens

Front 179

SCID presentation

Back 179

all types of infections

Front 180

SCID rx

Back 180

bone marrow transplant (no allograft rejection)

Front 181

SCID labs

Back 181

v IL-2R --> v T-cell activation

or...

^ adenine

Front 182

ataxia-telangiectasia defect

Back 182

DNA repair enzymes

Front 183

ataxia-telangiectasia triad

Back 183

cerebellar defects (ataxia)

spider angiomas (telangiectasia)

IgA deficiency

Front 184

labs in ataxia-telangiectasia

Back 184

IgA deficiency

Front 185

Wiskott-Aldrich syndrome basic defect

Back 185

X-linked recessive

progressive delection of B and T cells

Front 186

wiskott-aldrich triad

Back 186

TIE

thrombocytopenic purpurra

infections

eczema

Front 187

wiskott-aldrich labs

Back 187

^ IgE, IgA

v IgM

Front 188

leukocyte adhesion deficiency type 1 defect

Back 188

defect in LFA-1 integrin (CD18) protein on phagocytes

Front 189

leukocyte adhesion deficiency type 1 presentation

Back 189

bacterial infections

absent pus

delayed separation of umbilicus

Front 190

leukocyte adhesion deficiency type 1 labs

Back 190

neutrophilia

Front 191

chediak-higashi syndrome

Back 191

recessive

v polymerization of microtubules

v phagocytosis

pyogenic infections (staph & strep)

partial albinism

peripheral neuropathy

Front 192

chronic granulomatous disease defect

Back 192

lack of NADPH oxidase

v reactive oxygen species

absent respiratory burst in neutrophils

Front 193

CGD presentation

Back 193

^ susceptibility to catalase-positive organisms -- SEA:

S. aureus
E. coli
Aspergillus

Front 194

CGD labs

Back 194

negative nitroblue tetrazolium dye reduction test

Front 195

a transplant from an identical twin is called a...

Back 195

syngeneic graft

Front 196

which transplant rejection is mediated by antibodies?

which type of hypersensitivity is it?

Back 196

hyperacute

type II

Front 197

hyperacute rejection

Back 197

type II

preformed antibodies

within minutes

occludes graft vessels --> ischemia, necrosis

Front 198

acute rejection is reversible by...

Back 198

cyclosporine
OKT3

Front 199

acute rejection = (3)

Back 199

cytotoxic T's against foreign MHCs

weeks

vasculitis @ graft--interstitial lymphocytic infiltrate

Front 200

chronic rejection =

Back 200

T-cell and antibody

obliterative vascular fibrosis

months to years

irreversible

fibrosis of graft tissue and blood vessels

Front 201

symptoms of graft-vs-host disease

Back 201

maculopapular rash
jaundice
hepatosplenomegaly
diarrhea