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Immunology Flashcards

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1
Q

Asthma

A

Chronic inflammatory airway disorder with reversible bronchoconstriction triggered by hypersensitivity to enviornmental stimuli, Leukotriene D4, IL-4, IL-5 and IL-13

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2
Q

Atopic Dermatitis

A

Itchy rash on wrist, Physical exam shows a well dermarcated, erythematous, eczematous patch on the medial aspect of the left wrist, with lichenification and excoriations, allergic contact dermatitis is a type 4 HS reaction, managed with high potency topical corticosteroids, Immediate allergen avoidance and anti-inflammatory topical therapy are first line, diagnostic patch testing and systemic treatments are reserved for widespread refractory cases.

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3
Q

Celiac Disease

A

Autoantibody formation against TTG after deamination of dietary substrates. Celiac disease results from an HLA-DQ2/DQ8- associated autoimmune response to deaminated gliadin, leading to T cell mediated mucosal injury and production of anti TTG antibodies.

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4
Q

Sarcoidosis

A

Granulomatous autoimmune disease that commonly presents with bilateral hilarity lymphadenoapthy, Erythema Nodosum, and Non-casaeating granulomas. driven by activated histiocytes, producing 1-alpha hydroxylase. Oral corticosteroids, are the first line treatment for symptomatic disease.

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5
Q

Allergic Rhinitis

A

Nasal congestion, sneezing, itchy eyes and cobblestonning of the posterior pharynx

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6
Q

SLE

A

Diffuse Proliferative Glomerulonephritis, DPGN,

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7
Q

FAP (Familial adenomatous Polyposis)

A

Autosomal Dominant, APC tumor suppressor gene, Chromosome 5q22, 2-hit hypothesis, Thousands of Polyps, involves rectum, Progress to CRC.
Prophylactic Colectomy or else 100% progress to CRC.

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8
Q

Peutz- Jeghers syndrome

A

Autosomal Dominant syndrome, numerous hamartomas throughout GI tract, along with hyper pigmented macule, associated with an increased risk of Breast and GI cancers

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9
Q

Lynch Syndrome

A

HNPCC, Colorectal, Endometrial and Ovarian cancer. Autosomal Dominant condition,
Defects in DNA mismatch repair proteins, MSH2, 6, MLH 1, PMS2. Most common is CRC, (AUB) Endometrial cancer, Ovarian cancer

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10
Q

KRAS

A

Gain of function mutation in KRAS, associated with Lung and pancreatic cancer

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11
Q

Atopic Dermatitis Rash

A

IL-4, IL-13, IL-5, Atopic Dermatitis presents with dry, erythematous patches papule, that is caused in part by Th2 skewed immune-response. Th2 cytokines, IL-4 and IL-13 stimulate IgE production, suppress epidermal barrier components, impair host immune response against antimicrobial infections.

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12
Q

Psoriasis

A

IL-17 and IL-23 involved in the pathogenesis of plaque psoriasis

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13
Q

Rolling

A

P-selectin and E-selectin

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14
Q

Tight adhesion

A

Mac-1, LFA-1, CD-18, ICAM to ICAM

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15
Q

Transmigration

A

PECAM-1 to PECAM, platelet endothelial adhesion molecule, Neutrophils eventually migrate out of the valuator by squeezing in between cells via Platelet endothelial cell adhesion molecules- 1

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16
Q

Rituximab

A

Monoclonal antibody directed against CD20, a cell surface receptor against on developing and mature B cells. Binding of Rituximab to CD20 resulting in B cell cytotoxicity and phagocytosis which reduces the B cell population, this reduces inflammatory symptoms in a wide range of rheumatologic conditions.

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17
Q

Posion Ivy dermatitis

A

allergic contact dermatitis, which is a type 4 HS reaction mediated by T lymphocytes, it manifests as intensely pruritic erythematous papule, vesicles or bullae that often form linear pattern

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18
Q

Hereditary Angioedema

A

Autosomal Dominant, AD, C1 esterase inhibitor deficiency, face, oropharynx and abdomen, reduced C4 and C2 levels, Hereditary angioedema is characterized by recurrent episodes of cutaneous and mucosal swelling due to C1 inhibitor deficiency, C4 levels are low.

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19
Q

Hyperacute

A

Neutrophilic infiltration, with fibrinoid necrosis

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20
Q

Acute

A

Perivascular and submucosal lymphocytic infiltration ( blood vessels get inflamed)

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21
Q

Chronic

A

Submucosal inflammation, Bronchiolitis obliterates (airways gets affected)

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22
Q

SLE

A

Involves a type 2 hypersensitivity reaction
Lupus Nephritis is a type 3 hypersensitivity reaction

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23
Q

What is MHC class 1?

A

Molecules that present antigens to CD8 cytotoxic T cells. Each consists of a heavy chain and beta-2 microglobulin.

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24
Q

MHC class 2

A

CD4 cytotoxic helper T cells

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25
Glucocorticoids
This causes an increase in the number of neutrophils, as a result of demargination of neutrophils previously attached to vessel walls.
26
Ankylosing Spondylitis
TNF-alpha, IL-23, IL-17, HLA- B27, arthritis, Enthesis,
27
Burtons agammaglobulinemia
XLA- Brutons, X linked gammaglobulinemia, is caused by a defect in B cell maturation, resulting in absent mature B cells, T cell numbers and function remains intact, due to absence of B cells, primary Lymphoid follicles and germinal centers do not forms within lymph nodes.
28
Membrane attack Complex
Deficiency of the complement factors that form MAC (C5-C9) results in recurrent infections of the lungs and meninges by ShiN bacteria or encapsulated organisms.
29
GvHD
- Graft Veruses Host Disease, donor T cells, can perceive host tissues as a foreign antigen and mount an immune response
30
SLE antibodies
anti smith and ds-DNA
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Rifampin
Antibiotic used for N meningitides prophylaxis, Inhibition of Prokaryotic DNA dependent RNA polymerase, is the mechanism of action of Rifampin.
32
HSV infection
HSV infection can be prevented with guanosine analogues, acyclovir and valgancyclovir
33
Anaphylaxis
Type 1 HS reaction can quickly lead to respiratory compromise (bronchospasm, oropharyngeal edema and distributive shock). The most common autopsy findings include upper airway edema, hyperinflation of the lungs from airway obstruction and cerebral edema from hypoxia.
34
Aziothioprine
35
CGD
Reduced or absent DHR test, neutrophils ability for oxidative burst in CGD is reduced. Neutrophils can engulf bacteria but cannot destroy it, patients are at high risk of catalase positive species. Granuloma formation. infection can arise by staph ,Aspergillus, Burkholderia and Serratia. Diagnosis involves NBT test, DHR test has the ability to assess Neutrophil superoxide production.
36
Reactive lymphocytes
Reactive lymphocytes are pathogen specific, cytotoxic T cells or NK cells that form in response to certain intracellular infections, reactive lymphocytes are larges scalloped and have abundant cytoplasm. Reactive lymphocytosis is a feature of infectious mononucleosis.
37
Wiskott-Aldrich syndrome
Mutations in a rare genetic immunodeficiency that stops a child immune system from functioning optimally, WASP gene, it also makes it difficult for the child to produce platelets, fewer smaller platelets, low IgG and IgM levels. IgA and IgE levels are high. Eczema and reduced ability to form blood clots. Wiskott- Aldridge syndrome, thrombocytopenia, eczema and immunodeficiency
38
Allergic Contact Dermatitis
Is a Type 4 delayed hypersensitivity reaction, initially Langerhans cells present Haptens to naive T cells, leading to clonal expansion, release of interferon gamma by T cells further amplifies the immune response
39
TB granuloma
CD4 Th 1, INF- gamma, TNF- alpha, IL-2
40
Etanercept
Soluble receptor decoy protein
41
MSUD (Maple Syrup Urine Disease)
Branched chain Alpha Ketoacid dehydrogenase, Poor feeding, vomiting, lethargy and Coma Leucine, Isoleucine and Valine Maple Syrup or Burnt sugar odor
42
Galactorrhea
In case of prolactinoma, treat galactorrhea using Bromocriptine and Carbergoline which are dopamine agonists,
43
Charcot joint
Are caused by loss of sensation and proprioception, leading to repetitive micro trauma and progressive Joint destruction without patient realizing it.
44
Immunoglobulin Classes
IgG, IgA, IgD also have a hinge region between the Fab and the Fc fragments, the Hinge region is rich in cysteine and proline amino acids, which provides significant flexibility to Immunoglobulins
45
TNF alpha
This is one of the most important mediators of sepsis, an acute phase cytokine produced by activated macrophages, IL-1 and IL-6 are also responsible for inflammatory response.
46
Sarcoidosis
Characterized by noncaseating granulomas due to dysregulated cell mediated immunity, activated APCs produce IL-12, stimulates Th1 type CD4 cells. Th1 produce IL-2 and INF gamma
47
Primary Lymphoid organs
- Bone Marrow - Thymus
48
Secondary lymphoid organs
-Spleen, lymph nodes, tonsils and peyers patches
49
Follicles
Contain germinal centers, located in the outer cortex , site of B cell localization and proliferation, absent in BTK gene
50
Paracortex
Contain T cells, underdeveloped in patients with DiGeorge syndrome, this gets enlarged in extreme cellular response in case of EBV and other infections
51
Spleen
9th to 11th ribs, Splenic dysfunction, Postsplenectomy, reduced IgM and Complement activation, and C3b,
52
Post splenectomy findings
Howell- Jolley bodies, Target cells, Thrombocytosis, Lymohocytosis, Vaccinate patients undergoing splenectomy or with splenic dysfunction against encapsulated organisms (ShiNS)
53
Thymus
Located in the anterosuperior mediastinum, site for Tcell differentiation and maturation, epithelium is derived from the third pharyngeal pouch (endoderm) Thymoma is a neoplasm of the thymus, associated with MG, SVC syndrome and pure red cell aplasia, Good syndrome
54
Innate Immunity
Neutrophilsm macrophages monocytes, dendritic cells, NK cells and complement. TLR, Pattern recognition receptors and lead to activation of NF-kb
55
Adaptive immunity
T cells, B cells and circulating antibodies, memory B and T cells subsequent exposure to a previous encountered antigen causes a stronger quicker immune response
56
MHC1
HLA-A, HLA-B and HLA-C, TCR and CD8, all nucleated cells, APCs, Antigen peptides loaded onto MHC Class 1 in RER, after delivery via TAP
57
MHC2
HLA-DP, HLA-DQ, HLA-DR, TCR and CD4, to APCs, presents exogenous antigens to CD4+ T cells or T helper cells,
58
B27
Psoriatic arthritis, Ankylosing spondylitis IBD associated arthritis, Reactive arthritis,
59
DQ2/8
Celiac Disease
60
DR3
DM type 1, SLE, Graves disease, Hashimoto's thyroiditis, Addisons disease
61
DR4
Rheumatoid arthritis, DM type 1, Addisons disease
62
Natural Killer Cells (CD16 and 56)
Use perforins and Granzymes to induce apoptosis of virally infected cells and tumor cells, activity enhanced IL-2, 12, INF gamma and INF beta
63
B cells
Humoral immunity, Recogniz and present antigen- undergo somatic hypermutation, Produces antibody cytokines to recruit phagocytes and activate other leukocytes, CD4+ and CD8 + T cells(produces performs and granzymes) are involved in this
64
Positive selection
Thymic Cortex, Double positive CD4+/CD8+ T cells expresss TCRs,
65
Negative Selection
Thymic medulla, T cells are expressed on TCRs, with high affinity of antigens that undergo apoptosis,
66
CAR T cell therapy
Chimeric antigen receptor (CAR) T cell therapy, T cell therapy involves extracting T cells from a patient with malignancy, insert a CAR gene against protein expression by the malignancy, then reinfusing the modified T cell back into the patient, CAR T cell therapy against CD19, is used to treat B cell malignancy because CD19 is used to treat B cell malignancy because CD19 is expressed only by B cells. Anti- CD19 therapy can also cause hypo gammaglobulinemia due to destruction of health B cells and Plasma cells.
67
Wisckott-Aldrich Syndrome Xr
Eczema, infections and Thrombocytopenia, with small platelets, WAS gene defect, X linked recessive immunodeficiency, Unable to recognize actin cytoskeleton, normal to low IgG and IgM, high IgE and IgA, fewer and smaller platelets,
68
MAST cells
MAST cell release histamines and tryptases
69
Psoriatic arthritis
70
Selective IgA deficiency
Most common Primary Immunodeficiency, Airway and GI infections, Atophy and Anaphylaxis, reduced IgA levels, susceptibility to Giardiasis, Celiac disease
71
Hyper IgM syndrome (Xr)
Most common due to defect in CD40L on TH cells reduced class switching defect, X linked recessive, Severe pyogenic infections, Opportunistic infections, High IgM and low IgG, IgAm and IgE, failure to make germinal centers.
72
What is **X-linked agammaglobulinemia**?
Defect in BTK gene Tyrosine kinase gene no B cell maturation, X linked recessive, recurrent enteroviral infections, absent B cells on peripheral blood reduced all levels of Ig, absent or scant follicles, tonsils and lymphoid tissue is absent germinal centers are absent infections after 6 months and low levels of all Ig"S
73
Di George Syndrome
T cell deficiency disorder, absent T cells due to underdeveloped thymus, 3rd and 4th pharyngeal pouches do not develop, hypocalcemia tetany, 22q11 microdeletion, Cardiac defects abnormal facies, recurrent infection and tetany,
74
SCID
Humoral and cell mediated immunity defect, XR, adenosine deaminase deficiency, both viral, bacterial and fungal infections, small tonsils and lymph nodes and thymus Treatment is bone marrow transplant
75
Wisckott Aldridge syndrome
Mutations in WAS gene, Leukocytes, small platelets, unable to recognize actin cytoskeleton, X linked recessive, Thrombocytopenia, Eczema and recurrent infections
76
Ataxia Telangeictasia
Defect in the ATM gene, failure to detect DNA damage, AR,
77
CGD
defect NADPH oxidase, low reactive oxygen, reduced respiratory bursts, X linked, increased suscepitibility to catalase + organisms, abnormal Dihydrorhodamine test, Nitrobule tetrazolium dye reduction test, Catalase Positive organisms, staph, Burkholderia, Serratia and Nocardia and Aspergillus
78
CVID
low levels of all classes of Ig, but infections start to occur after teenage, Lack B lymphocytes and plasma cells
79
Leukocyte Adhesion deficient
Defect in LFA- 1 intern CD18 protein on phagocytes, Impaired migration and chemotaxis, AR, Recurrent skin mucosal and bacterial infections, delayed umbilical cord separated no neutrophils in pus increased neutrophils in blood, Marked neutrophilia
80
Chediak Higashi syndrome
Defect in LYST gene, Microtubule dysfunction, lysosomal trafficking regulator gene, Progressive neurodenegration, Albinism recurrent pyogenic infections, peripheral neuropathy, Giant granules and platelets and pancytopenia,
81
IPEX disease (X linked)
Regulatory T cell dysfunction, genetic defect in FOXP3 gene, characterized by enteropathy, endocrinopathy, nail dystrophy and dermatitis, associated with DM in male infant
82
IgG
Main antibody in secondary response to antigen, most abundant isotope in the serum, only isotope that can cross the placenta
83
IgA
Prevents attachment of bacteria and viruses to mucous membranes, produced by GI tract and protects against gut infections, most produced antibody overall, released into the saliva, secretions and breast milk.
84
IgM
first antibody produced during an immune response, fixes complement, associated with cold autoimmune hemolytic anemia
85
IgE
Binds to mast cells and basophils, cross linked when exposed to allergens, mediate type 1 hypersensitivity reaction, contributes immunity to parasites,
86
C3b
opsonization
87
C3a,C4a,C5a
anaphylaxis
88
C5a
Neutrophil chemotaxis
89
C5b-9
MAC cytolysis
90
Terminal complement deficiency (C5-C9)
increased susceptibility to recurrent Neisseria infections
91
C1 esterase inhibitor deficiency
Hereditary angioedema, Reduced C4 levels, Increased bradykinin
92
PNH
PIGA gene defect that prevents PIGA gene mutation that stops GPI anchors to form which attach to CD55 and CD59 prevent complement mediated hemolysis, reduced haptoglobin and dark urine, venous thrombosis
93
IL-1
Causes Fever, acute inflammation
94
IL-2
stimulated T cells to differentiate into T helper cell, cytotoxic T cells, reg cells
95
IL-3
Supports growth and differentiation of bone marrow stem cells, functions like GM-CSF
96
IL-4
Induces differentiation of T cells into TH helper cells, promotes growth of B cells enhances class switching IgE and IgG
97
IL-5
Promotes growth and differentiation of B cells, enhances class switching to IgA, stimulates growth and differentiation of eosinophils,
98
IL-6
Produces acute phase phase proteins production
99
IL-8
Neutrophil chemotactic factors
100
IL-10
Attenuates Inflammatory response, decreases expression of MHC class 2 and th1 cytokines
101
IL-12
Induces differentiation of T cells into T helper cell 1, facilitates granuloma formation
102
IL-13
Promotes IgE production by B cells
103
TNF-alpha
Activates endothelium, causes WBC recruitment, causes cachexia in malignancy, maintains granuloma in TB
104
INF- gamma
Activates macrophages to form granulomas, stimulated by NK cells and T cells in response to antigens or IL-12 from macrophages,
105
B cells
cd19, 20, 21, 40
106
Type 1 hypersensitivity
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