Immunology Midterm

Front 1

bacteria and viruses

Back 1

Th1, IgG, IFNgamma

Front 2

worms and allergies

Back 2

Th2, IgE, IL4, IL5, IL13

Front 3

tolerance to food

Back 3

Th3/TReg, IgA, TGFbeta

Front 4

Asthma

Back 4

Th9, IgE, IL9

Front 5

mold, autoimmunity

Back 5

Th17, IgG, IL17

Front 6

Th0

Back 6

a naive T cell, Th2 helps T cells divide

Front 7

Name three of the proteins (not cytokines) involved in inflammation and/or innate immunity and what they do.

Back 7

Kinins - pain and itching
CRP - activates complement
Defensins - kill microbes

Front 8

We have antibodies for everything due to

Back 8

gene rearrangment

Front 9

Explain or draw how bacteria is taken up by macrophages in the donor liver and peptides are presented on the surface of a cell.

Back 9

Bacteria are phagocytosed by the macrophage and go into a phagosome or endosome. (Could have binding to a TLR). The phagosome fuses with a lysosome to break down the bacteria. The MHC comes from the ER, and the compartments fuse. The peptide from the bacteria binds to the MHC and the complex goes to the surface.

Front 10

which cells take up the flu virus and carry it to the lymph nodes

Back 10

macrophages and dendritic cells from the nasal mucosa

Front 11

What differs if a flu vaccine is injected in the arm of the patient?

Back 11

The macrophages or dendritic cells go to a different lymph node, the nearest lymph node, rather than to those in the throat. Also the virus delivered to us may be different from the flu that is circulating in the environment. it may also be dead.

Front 12

The immune response to flu is primarily T cell mediated. Explain what T cells do

Back 12

CD4 T cells make cytokines
CD8 T cells kill

Front 13

What is the issue with infants under 9 months of age who might be given the flu vaccine?

Back 13

Babies under 9 mos of age don't make IFNgamma. They can't have a Th1 response, which is necessary to flight the flu.

Front 14

viewing
Name____Answer Key_________________

Mailbox #___________________________

This is your midterm exam. There are 5 questions, each worth a total of 20 points. Please use short answers when possible. PUT YOUR NAME and mailbox number on the exam. Thanks. Remember to put in keywords—and try to answer as you may get partial credit.

1. A 28 year-old female, presents at your office with obesity, arthritis/inflammation in her joints, and low back pain. Inflammation is associated with an increase in cytokines and acute phase proteins. Name three of the proteins (not cytokines) involved in inflammation and/or innate immunity and what they do. (6 points—2 points each)

kinins – pain and itching;

CRP – activates complement;

defensins – kill microbes

Which cytokines are involved in a pro- inflammatory response? What sickness behaviors do these cytokines elicit? (6 points)

IL-1 – sleepiness, malaise, tired, depression

IL-6 – anxiety

TNF – hostility

*fever could be for any of them

How does innate immunity differ from specific immunity? (6 points)

Innate Specific

Born with it Develop it

Have it for life Can live without it

Non Specific Specific

Mac, Neuts, DCs Ts and Bs

Granulocytes

Name 2 cell types associated with the innate immune system. (2 points)

Macs, Neuts, DCs, Eosinophils, Basophils, NKs, Mast cells





2. Your cousin has mononucleosis, commonly called kissing disease. In order to test for mono, she had an antibody test for the Epstein Barr virus. Antibody for viral antigen confirms diagnosis for mono. What antibody isotype would you expect during acute (early) phase of disease, and why? (4 points)

IgM. IgM is made early in disease to sop up as much antigen as possible. Could have that it’s Pentameric.



What isotype of antibody would you expect later during disease, and why? (4 points)

IgG. EBV is a viral antigen and IgG is made to bacteria and viruses.



What is the order of class switching? (5 points)

M D G E A





Draw an antibody and circle the part of the antibody that binds to antigen. (4 points)







The Epstein Barr Virus infects B cells and makes them expand. If you look at the specificity of antibodies in a patient who has mono, what would you expect to see? (3 points)

Antibodies specific for EBV

AND antibodies specific for everything – because there would be non-specific expansion of B cells.











3. Frank is a 57-year old veteran who needs a liver transplant. The doctors want to test his sister and brother to see if they are matches for Frank. What proteins on the surface of the liver cells are they going to look at? (2 points)

MHC



Explain to Frank in non-technical language why he must match to the donor liver. (4 points)

Your body asks, Are you me? Are you Dangerous? In order to do that, cells called T cells recognize MHC molecules on other cells. If the MHC isn’t yours, the T cells will kill the foreign cells. Something like that….



Frank reads about an experimental liver transplant study happening at UCLA. A pig xenograft could be used for transplantation. Explain to Frank the advantage to using pig organ (4 points)

Since a pig organ is different from human, the T cells won’t recognize pig MHC. Therefore, the T cells won’t kill the pig. Won’t have to be on immunosuppressants.



Before transplanting pig liver into Frank, circulating anti-pig antibodies must be removed from Louis. Why might Louis have antibodies for pig? (2 points)

Either from eating pork or

You have antibodies for everything due to gene rearrangement

Unacceptable: from his mother or father or parents.

When the doctors harvest the donor liver, it has an infection. Explain or draw how bacteria is taken up by macrophages in the donor liver and peptides are presented on the surface of a cell. (8 points)

Bacteria are phagocytosed by the macrophage and go into a phagosome or endosome. (Could have binding to a TLR). The phagosome fuses with a lysosome to break down the bacteria. The MHC comes from the ER, and the compartments fuse. The peptide from the bacteria binds to the MHC and the complex goes to the surface.





4. Flu vaccine is being advertised at many pharmacies around town. If a person were to be exposed to flu through inhalation, which cells take up the flu virus and carry it to the lymph nodes? (2 points)

Macrophages or DCs in the nasal mucosa take up the flu virus.



What differs if a flu vaccine is injected in the arm of the patient? (4 points)

The macrophages or DCs would go to a different lymph node—one in the arm instead of in the throat. May also have something about amount of virus exposed to is different. Virus may be dead. Etc.



The immune response to flu is primarily T cell mediated. Explain what T cells do (include what CD4 T cells do, and what CD8 T cells do.) (4 points)

CD4 T cells make cytokines – IFNg if it’s a virus.

CD8 T cells kill.



What is the issue with infants under 9 months of age who might be given the flu vaccine? (4 points)

Babies under 9 months of age don’t make IFNgamma. Therefore they can’t have a Th1 response which is necessary to fight off flu.







There are many herbs that increase the number of T cells in a person who takes them. Would these herbs be good to administer with the vaccine, or bad? Why? (6 points)

Either answer is fine if they justify it.

Good- increase the response to the vaccine. Might shorten the duration. Might increase the memory to the vaccine. More efficient response.

Bad- could cause too severe a reaction to the vaccine. More severe symptoms.







5. Cecilia is a 24 year old female who suffers from allergies to cats. She is also allergic to grass, ragweed, and golden rod. What is Cecilia’s type of allergies called?

Back 14

atopic

Front 15

When Cecilia is exposed to cats, her eyes immediately swell, her nose runs, and she feels miserable. What is happening in Sarah?

Back 15

Th2 response

Front 16

Which cytokines are involved in this type of immune response, and what do they do?

Back 16

IL-4 – Causes B cells to class switch to IgE, continues to drive Th2 response

IL-5 – Stimulates eosinophils

IL-13 – Mucus production

Front 17

IL13

Back 17

cytokine that produces mucus

Front 18

IL1, IL6, TNFalpha

Back 18

depression, anxiety, hostility

Front 19

Cecilia gets a runny nose when she is exposed to cats. What isotype of antibody would you expect in Cecilia’s nose?

Back 19

IgE

Front 20

What type of T cells respond to cat dander (CD4 or CD8)?

Back 20

CD4

Front 21

How come every time Cecilia is exposed to cats her allergies get worse?

Back 21

There is a memory response – so more cells are involved every time. Also IgE is pre-bound to mast cells.

Front 22

What are some reasons Sue might be allergic to so many things?

Back 22

She makes too much of the Th2 cytokines because she didn’t have infections (hygiene hypothesis)

Poor diet

Worms