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Immunology
USMLE 1
220
Medical
Graduate
05/03/2010

Additional Medical Flashcards

 


 

Cards

Term
Site of B cell localization and proliferation
Definition
Follicle
located in outer cortex of LN
1 - dense and dormant
2 - pale, central germinal centers, active
Term
Primary follicle vs. secondary follicle?
Definition
1- dense and dormant site of B cell localization
2 - pale central germinal centers, active
Term
Consists of closely packed lymphocytes and plasma cells and sinuses
Definition
Medulla (meduallary cords and medullary sinuses) - site on antibody production
Term
Houses T cells - where is this located?
Definition
Paracortex
In LN, between follicles and medulla
Term
Area of LN that becomes greatly enlarged in extreme cellular response
Definition
Paracortex (site of T cells, viral infection)
Term
Are of LN underdeveloped in DiGeorge syndrome
Definition
Paracortex (lacking T cells)
Term
What makes up the medullary sinuses and what is its function?
Definition
Contain reticular cells and macrophages
communicate with efferent lymphatics
Term
Where does the upper limb and lateral breast drain?
Definition
axillary lymph nodes
Term
Where does the stomach drain?
Definition
celiac lymph node
Term
Where does the duodenum and jejunum drain?
Definition
Superior mesenteric lymph node
Term
Where does the sigmoid colon drain?
Definition
colic LN --> inferior mesenteric LN
Term
Where does the lower rectum, anal canal above pectinate line drain to?
Definition
internal iliac LN
Term
Where does the anal canal below pectinate line drain to?
Definition
superficial inguinal LN
Term
Where does the testes drain to?
Definition
Superficial and deep plexsuses --> para aortic LN
Term
Where does the scrotum drain to?
Definition
superficial inguinal LN
Term
Where does the superficial thigh drain to?
Definition
superficial inguinal LN
Term
Where does the lateral side of the dorsum of the foot drain to?
Definition
Popliteal LN
Term
What does the Right lymphatic duct drain?
Definition
right arm and right half of head
Term
What does the thoracic duct drain?
Definition
everything except right arm and right half of head
Term
What does the superficial inguinal LN drain?
Definition
Anal canal below pectinate line
scrotum (NOT TESTES)
superficial thigh
Term
Long vascular channels in red pulp with fenestrated barrel hoop basement membrane
Definition
spleen sinusoids
macrophages nearby
Term
Where are T cells in the spleen? B cells?
Definition
T - peri-arterial lymphatic sheath (white pulp, surrounds central arteriole) and in the red pulp of spleen
B - follicles in white pulp of spleen
Term
What removes encapsulated bacteria?
Definition
macrophages in the spleen
Term
How does splenic dysfunction causes increased susceptibility to encapsulated organisms?
Definition
decreased IgM --> decreased complement activation --> decreased C3b activation --> increased susceptibility

H. flu, S. pneumo, Klebsiella
Term
What are Howell-jolly bodies and what should they make you think of?
Definition
nuclear remnants left because of asplenia/postsplenectomy
Term
What changes on a blood smear would you see post splenectomy?
Definition
Howell-Jolly bodies
Target cells
thrombocytosis
Term
Site of T cell differentiation and maturation?
Definition
Thymus
Term
Development and structure of thymus?
Definition
Encapsulated
develops from epithelium of 3rd branchial pouches
Lymphocytes - mesenchymal origin
Cortex: dense with immature T cells
Corticomedullary junction: site of T cell selection
Medulla: pale with mature T cells and epithelial reticular cells and contains Hassall's corpuscles

Hassall's corpuscles - epithelial cells concentrically compressed and keratinized
Term
How and where are T cells selected?
Definition
Thymus - selection at corticomedullary junction
1. double negative cells proliferate (4-8-; double -) in outer region of cortex, gain cell markers (4+8+; double +)
2. Positive selection (MHC restriction) - TCR recognizes self MHC (thymic stromal cells)
3. loss of aberrant 4 or 8 (depending on MHC recognition; single +)
4. Negative selection (removal of cells that react to self, dendritic cells present peptides)

Only 2% of starting population makes it!
Term
Components of innate immunity
Definition
receptors that recognize pathogens are germline coded, fast, nonspecific response, no memory
Macrophages, PMNs, dendritic cells, NK cells, complement
Term
Components of Adaptive immunity
Definition
Receptors that recognize pathogens undergo V(D)J recombination during lymphocyte development, slow response on first exposure, memory response is fast and robust

T cells, B cells, antibody
Term
What promotes development of Th1 cell and what does this cell make?
Definition
INDUCES CELL MEDIATED IMMUNITY

IL-12 leads to Th1
Th1 makes TNFa and INFy and IL2
Acts to activate macrophages and CD8T

inhibited by IL-10
Term
What promotes development of Th2 cell and what does this cell make?
Definition
INDUCES ANTIBODY MEDIATED IMMUNITY

IL4 promotes Th2 cell generation
Th2 cells make IL4, IL5, and IL10
Stimulates B cells to make antibody (IgE>IgG)

inhibited by IFNy
Term
What encodes major histocompatibility complex?
Definition
Human Leukocyte Antigen genes
Term
MHC-I genes and cells expressed on
Definition
MHC I - HLA A, B, C
expressed on all nucleated cells
Term
MHC II genes and cells expressed on
Definition
MHC II - HLA DR, DP, DQ
expressed only on antigen presenting cells
Term
MHC I structure and antigen processing
Definition
Antigen is loaded onto MHC I in RER (virus is digested via proteasome and then transported into RER via TAP, although most frequently bound peptide is self)
Pairs with B2 microglobin that helps with transport to cell surface

MHC I structure: 3 domain a chain paired with B2 microglobulin, peptide binding groove accommodates shorter peptides

mediates viral immunity
Term
MHC II structure and antigen processing
Definition
Antigen is loaded following release of invariant chain in an acidified endosome

MHC II structure: a and B chain, peptide binding groove between chains, longer peptides
Term
What causes hyperacute organ rejection? acute? chronic?
Definition
hyperacute: antibody
acute and chronic: T cells
Term
How do NK cells kill?
Definition
reved up by IL-12, IFN-B, IFN-a

Kill when exposed to nonspecific activation signal or absence of class I MHC on target cell

Use perforin and granzymes to induce apoptosis (viral infected and tumor cells)
Term
What is the only lymphocyte member of the innate immune system?
Definition
NK cells
Term
What cytokines enhance the activity of NK cells?
Definition
IL-12
INFa and INF-B
Term
Cluster of polypeptides associated with a TCR, needed for signal transduction
Definition
CD3
Term
Name the APCs
Definition
Dendritic cells
Macrophages
B cells

NOT neutrophils
Term
How do macrophages and lymphocytes interact?
Definition
Lymphocytes - release IL12 stimulating macs
Macs - release IL1, TNFa stimulating lymphos
Term
How do superantigens work?
Definition
S. pyogenes, S. aureus
cross link B region of TCR to MHC class II on APC
causes uncoordinated release of IFNy from Th1 and subsequent release of IL1, IL6, and TNFa from macrophages
Term
How do endotoxins/LPS work?
Definition
found on G- bacteria
directly stimulates macrophages by binding to endotoxin receptor CD14

Th cells not involved
Term
Describe activation of Th cells
Definition
1. Foreign body phagocytosed by APC
2. Antigen presented on MHC II, recognized by TCR on Th cells (signal 1)
3. B7 on APC and CD28 on Th cell interact (costimulatory signal)
4. Th cell activated! produces cytokines (IL2)
Term
Describe Tc activation
Definition
1. Protein presented on MHC I, recognized by TCR on Tc cell (signal 1)
2. IL-2 from Th cell activates Tc cell to kil (signal 2)
Term
Describe B-cell class switching
Definition
- IL4/5/6 from Th2 cell (signal 1)
- CD40 receptor activation by binding CD40 ligand on Th cell (signal 2)
Term
Endotoxin receptor of APC
Definition
CD14
activation of receptor bypasses T cells
Term
Role of variable part of antibody
Definition
recognizes antigen
Term
Role of Fc portion of antibody
Definition
fixes complement (IgG and IgM only)
Term
Fc is made of?
Fab is made of?
Definition
Fc - heavy chain, carboxy terminal, determines isotype
Fab - heavy and light chains, amino terminal, determines idiotype
Term
What holds together the two heavy chains?
Definition
interchain disulfide bond
Term
Describe the Fc portion of antibodies
Definition
Constant
Complement binding (IgM, IgG)
carbohydrate side chains
determines isotype
Term
How is antibody diversity generated?
Definition
1. random recombo of VJ (light) and VDJ (heavy) chain genes
2. random combo of heavy and light chains
3. Somatic hypermutation (following antigenic stimulation)
4. Addition of nucleotides to DNA during recombination by terminal deoxynucleotidyl transferase
Term
Which side is the amino terminal of the antibody?
Definition
variable (Fab)
Term
Role of antibody (3)
Definition
1. opsonization (promotes phagocytosis)
2. neutralization (prevents bacterial adherence)
3. Complement activation (enhance opsonization and lysis)
Term
Mature B cells express what antibodies?
Definition
IgM and IgD on surface
Term
Differentiation of mature B cells leads to what?
Definition
Isotype switching (alternate mRNA splicing, mediated by cytokines and CD40 ligand) into plasma cells that secrete IgA, IgE, or IgG
Term
Most abundant antibody.
Definition
IgG
Term
Antibody that fixes complement, crosses placenta, opsonizes bacteria, neutralizes bacterial toxins and viruses
Definition
IgG
Term
Antibody that prevents attachment of bacteria and viruses to mucous membranes
Definition
IgA
Term
Where is IgA found? what is its structure?
Definition
In secretions
monomer or dimer
Term
Where does IgA's secretory component come from?
Definition
from epithelial cells before secretion
Term
Which two antibodies fix complement?
Definition
IgM and IgG
Term
Antibody that serves as antigen receptor on B cells
Definition
IgM
Term
Structure of IgM
Definition
monomer on B cells
pentamer
Term
Found on the surface of many B cells and in serum; unclear function
Definition
IgD
Term
Mediates type I (immediate) hypersensitivity
Definition
IgE
Term
How does IgE mediate type I hypersensitivity?
Definition
Binds to mast cells and basophils
releases mediators when exposed to allergen
Term
What antibody mediates immunity to worms?
Definition
IgE, activates eosinophils
Term
What antibody is in lowest concentration in serum?
Definition
IgE
Term
Ig allele that differs among members of same species
Definition
allotype (polymorphism)
determined by heavy of light chain
Term
Ig region common to single class of Ig
Definition
Isotype (IgG, IgA, etc)
determined by heavy chain
Term
Ig epitope determined by antigen binding sites
Definition
idiotype
Term
What is a thymus independent antigen? examples?
Definition
Antigen without peptide component, not presented by MHC to T cells
Stimulate release of IgM, no immunologic memory

LPS form cell envelope of G-, polysaccharide capsular antigen
Term
What is a thymus dependent antigen? examples?
Definition
Antigen with protein component, presented
Induces class switching and immunologic memory via direct contact of B cells with Th cells (CD40-CD40 ligand interaction), release of IL4/5/6

conjugated H. Flu vaccine
Term
Secreted by macrophages
causes acute inflammation
induces chemokine production to recruit leukocytes
activates endothelium to express adhesion molecules
endogenous pyrogen
Definition
IL-1
Term
Secreted by macrophages
mediates septic shock
causes leukocyte recruitment, vascular leak
Definition
TNF
Term
Secreted by macrophages
major chemotactic factor for neutrophils
Definition
IL-8
Term
Secreted by Th cells and macrophages
stimulates production of acute-phase reactants and immunoglobulin
Definition
IL-6
Term
Secreted by Th1 cells
stimulates macrophages
Definition
y-interferon
Term
Secreted by Th cells
stimulates growth of helper and cytotoxic T cells
Definition
IL-2
Term
Secreted by Th2 cells
promotes growth of B cells
Enhances class switching to IgE and IgG
Definition
IL-4
Term
Secreted by activated T cells
supports the growth and differentiation of bone marrow stem cells
function similar to GM-CSF
Definition
IL-3
Term
Secreted by Th2 cells
promotes differentiation of B cells
enhances class switching to IgA
stimulates production and activation of eosinophils
Definition
IL-5
Term
Secreted by regulatory T cells
Inhibits actions of activated T cells
Definition
IL-10
Term
Secreted by B cells and macrophages
Activates NK and Th1 cells
Definition
IL-12
Term
Cell surface proteins on Helper T cells
Definition
CD4
TCR
CD3
CD28 (interacts with B7 on APCs)
CD40L (signal for B cell class switching)
Term
Cell surface proteins on cytotoxic T cells
Definition
CD8
TCR
CD3
Term
Cell surface proteins on B cells
Definition
IgM
B7 (interacts with Th CD28, activates Th cell)
CD19, CD20, CD21 (EBV receptor)
CD40 (interacts with Th CD40L, class switching stimulated)
MHC II
Term
Cell surface proteins on macrophages
Definition
MHC II
B7 (interacts with Th CD28)
CD40
CD14 (endotoxin receptor)
Receptors for Fc and C3b
Term
Cell surface proteins on NK cells
Definition
Receptors for MHC I
CD16 (binds Fc of IgG)
CD56
Term
Cell surface proteins on all cells except mature RBCs
Definition
MHC I
Term
Complement that aids in clearance of immune complexes
Definition
C3b
Term
What helps prevent complement activation on self-cells?
Definition
Decay accelerating factor
C1 esterase inhibitor
Term
What activates classical complement pathway?
Definition
IgM or IgG on the surface of microbes
Term
What activates the alternative complement pathway?
Definition
Molecules on the surface of microbes (ie. endotoxin)
Term
What complement components are involved in anaphylaxis?
Definition
C3a, C5a
Term
What complement component is involved in neutrophil chemotaxis?
Definition
C5a (also involved in anaphylaxis)
Term
What causes hereditary angioedema?
Definition
deficiency in C1 esterase inhibitor
Term
What complement deficiency leads to increased susceptibility to type III hypersensitivity?
Definition
C3 deficiency
C3 involved in clearance on immune complexes
also makes you susceptible to recurrent pyogenic sinus and respiratory tract infections
Term
Deficiency of C5-C8?
Definition
leads to Neisseria bacteremia (no MACs)
Term
Deficiency of DAF?
Definition
DAF = GPI-anchored enzyme
deficiency leads to complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Term
What do interferons do?
Definition
Place uninfected cells in antiviral state.
Induce production of ribonuclease that inhibits viral protein synthesis by degrading viral mRNA (but not host mRNA)
Term
Roles of a, b, and y interferon
Definition
a and B - inhibit viral protein synthesis
y - increase MHC I and II expression and antigen presentation in all cells

all - activate NK cells to kill virus infected cells
Term
How long is passive immunity good for?
Definition
Ab T1/2 = 3 weeks (ie IgA in breast milk)
Term
What infections can be stopped with passive immunity?
Definition
Tetanus toxin
Botulinum toxin
HBV
Rabies virus
Term
What bacteria are capable of antigen variation?
Definition
1. Salmonella (2 flagellar variants)
2. Borrelia (relapsing fever)
3. N. Gonorrhoeae (pilus protein)

variation mechanisms: DNA rearrangement, RNA segment rearrangment
Term
What parasite is capable of antigen variation?
Definition
Trypanasomes (programmed rearrangement)
Term
What causes anergy?
Definition
Self reactive T cells become nonreactive without costimulatory molecule

B cells - also occurs, but less complete than in T cells
Term
Components of granuloma
Definition
Giant cells
epithelioid cells
fibroblasts
lymphocytes
Term
Name 8 granulomatous diseases
Definition
1. TB
2. Leprosy
3. Cat scratch fever
4. Syphilis
5. Fungal infections (histo)
6. Sarcoidosis
7. Crohn's
8. Berylliosis
Term
How does granulomatous disease develop?
Definition
APC cell presents antigen
Th cell activated (promoted by self IL2 release)
Releases IFN-y
stimulates Monocyte, macrophage, epithelioid cell and giant cell development

granuloma = epitheloid cell+giant cell+fibroblast+lymphocytes
Term
What is a Type I hypersensitivity
Definition
Anaphylactic and atopic
due to preformed antibody (IgE) on presensitized mast cells and basophils, triggers release of vasoactive amines that act at postcapillary venules
Term
A scratch test or radioimmunosorbent assay test what?
Definition
Type I hypersensitivity
Term
What is a type II hypersensitivity?
Definition
Antibody mediated - IgM/IgG bind to fixed antigen on enemy cell, leads to lysis (by complement) or phagocytosis

cytotoxic

test: direct and indirect coombs
Term
Direct and indirect Coombs test what?
Definition
Type II hypersensitivity
Term
What 3 mechanisms does a type II hypersensitivity work through?
Definition
1. activates complement or opsonize cell
2. Ab recruit neutrophils and macrophages that incite tissue damage
3. bind to normal cellular receptors and interfere with function
Term
How does type III hypersensitivity happen?
Definition
antigen+antibody (IgG) complexes activate complement, attracts neutrophils which release lysosomal enzymes
Term
What is serum sickness?
Definition
Type III hypersensitivity (immune complex disease)
-ab to foreign proteins are produced (5 days), immune complexes form, deposited in membranes, fix complement, leads to tissue damage

most often caused by drugs - fever, urticaria, arthralgias, proteinuria, lymphadenopathy 5-10d post antigen exposure
Term
Arthus reaction
Definition
local subacute Type III reaction
intradermal injection of Ag induces Ab = form complexes in skin

edema, necrosis, activation of complement
Term
Immunofluorescent staining tests for this hypersensitivity
Definition
Type III
Term
Delayed hypersensitivity
Definition
sensitized T cells encounter antigen
release lymphokines
activate macrophages

cell mediated, not transferable by serum

Transplant rejections, TB skin test, Touching (contact dermatitis)

patch test
Term
Name the type of hypersensitivity: anaphylaxis
Definition
Type I
Term
Name the type of hypersensitivity: allergic rhinitis
Definition
I
Term
Name the type of hypersensitivity: contact dermatitis
Definition
IV
Term
Name the type of hypersensitivity: hemolytic anemia
Definition
II (RBCs)
Term
Name the type of hypersensitivity: pernicious anemia
Definition
II (IF on parietal cells)
Term
Name the type of hypersensitivity: idiopathic thrombocytopenic purpura
Definition
II (gpIIb/IIIa on platelets)
Term
Name the type of hypersensitivity: erythroblastic fetalis
Definition
II (antigens on newborns erythrocytes)
Term
Name the type of hypersensitivity: rheumatic fever
Definition
II (M proteins on Group B strep and then myocardium)
Term
Name the type of hypersensitivity: Goodpastures syndrome
Definition
II (renal BM)
Term
Name the type of hypersensitivity: Bullous pemphigoid
Definition
II
Term
Name the type of hypersensitivity: pemphigus vulgaris
Definition
II (epidermis cadherins)
Term
Name the type of hypersensitivity: Graves disease
Definition
II (thyroid TSH receptor)
Term
Name the type of hypersensitivity: myasthenia gravis
Definition
II (Ach receptors post synaptic)
Term
Name the type of hypersensitivity: SLE
Definition
III
Term
Name the type of hypersensitivity: RA
Definition
III
Term
Name the type of hypersensitivity: Polyarteritis nodosum
Definition
III (HBV antigen-ab complex leads to systemic vasculitis)
Term
Name the type of hypersensitivity: poststrep glomerulonephritis
Definition
III
Term
Name the type of hypersensitivity: serum sickness
Definition
III
Term
Name the type of hypersensitivity: swelling/inflammation following tetanus vaccine
Definition
III (arthus reaction)
Term
Name the type of hypersensitivity: farmer's lung
Definition
III (hypersensitivity pneumonitis)
Term
Name the type of hypersensitivity: hypersensitivity pneumonitis
Definition
III (farmer's lung)
Term
Name the type of hypersensitivity: type I DM
Definition
IV
Term
Name the type of hypersensitivity: MS
Definition
IV
Term
Name the type of hypersensitivity: Guillain-Barre syndrome
Definition
IV
Term
Name the type of hypersensitivity: Hashimotos syndrome
Definition
IV
Term
Name the type of hypersensitivity: GVHD
Definition
IV
Term
Name the type of hypersensitivity: PPD
Definition
IV
Term
Where is the problem in SCID?
Definition
1. ADA deficiency
Blocks Lymphoid SC development into pro-B and pro-T cells

2. defective IL-2 receptor, no development of T cells beyond pro-T cells

3. MHC II deficiency - no activation of CD4+ T cells
Term
What is the problem in Burton's agammaglobulinemia?
Definition
No generation of immature B cells from Pre-B cell
Term
What is the problem in Di george syndrome?
Definition
No development of Immature T cells
Term
What is the problem in CVID?
Definition
No development of immature B cells (no IgM or IgG B cells, etc.)
Term
What is the problem in hyper-IgM syndrome?
Definition
No class switching
only IgM producing B cells
Term
What is the inheritance of Burton's agammaglobulinemia? Gene?
Definition
X-linked
Tyrosine Kinase
Term
Associated with low levels of all classes of Ig but normal number of pro-B cells in marrow
Definition
Burtons agammaglobulinemia
Term
Immunologic condition that presents with tetany. Why?
Definition
DiGeorge
hypocalcemia due to missing parathyroid glands
Term
Describe problems seen in Di George syndrome
Definition
hypocalcemia (tetany)
athymic (recurrent viral and fungal infections)
Congenital heart defects
Congenital great vessel defects
22q11 deletion
Term
Most common form of SCID? what are the other forms?
Definition
Defective IL-2 receptors (X linked)

others: failure to synthesize MHC II antigens, adenosine deaminase deficiency

no rejection fo allografts
Term
Presents with disseminated mycobacterial infections due to decreased Th1 response
Definition
IL-12 Receptor deficiency of T cells
Term
Defect in CD40L on CD4 T cells
Definition
HyperIgM syndrome
no class switching
high IgM, low IgG/A/E
Term
Inheritance of Wiskott-Aldrich syndrome? Triad of symptoms?
Definition
X-linked defect in ability to mount IgM response to capsular polysaccharides
Recurrent pyogenic infection
Thrombocytopenic purpura
Eczema
Term
Recurrent pyogenic infections, thrombocytopenic purpura, eczema
Definition
Wiskott-aldrich (X-linked defect in ability to mount IgM response to encapsulated bacteria)
Term
Failure of IFN-y production by helper T cells
Definition
Job's syndrome
neutrophils fail to respond to chemotactic stimuli
Coarse facies, Abscesses (cold, staph), Teeth retained, increased IgE, derm problem (eczema)
Term
Coarse facies, cold Staph abscesses, retained primary teeth, increased IgE, dermatologic problems
Definition
Jobs syndrome (failure of IFN-y production by Th cells, no neutrophil response)
Term
Recurrent bacterial infections, absent pus formation, neutrophilia, delayed separation of umbilicus
Definition
Leukocyte adhesion deficiency
defect in LFA-1 integrin (CD18) proteins on phagocytes
Term
Inheritance of Chediak higashi syndrome? defect?
Definition
AR, defect in microtubule function and lysosomal emptying
Term
Presents with recurrent pyogenic infections by staph and strep, partial albinism, peripheral neuropathy
Definition
Chediak higashi (AR)
Term
Lack of NADPH oxidase activity
Definition
Chronic granulomatous disease
defect in microbiocidal activity on neutrophils
Term
How do you confirm diagnosis of CGD?
Definition
negative nitroblue tetrazolium dye reduction test
Term
Presents with skin and mucous membrane Candida infections? caused by what dysfunction?
Definition
Chronic mucocutaneous candidiasis
T cell dysfunction
Term
Most common selective Ig deficiency? how does it present?
Definition
IgA
sinus, lung infections, milk allergies, diarrhea, anaphylaxis with exposure to blood products containing IgA
Term
Defect in DNA repair enzymes and associated IgA deficiency
Definition
Ataxia telangiectasia
Term
Cerebellar problems, spider angiomas, IgA deficiency
Definition
Ataxia telangiectasia (defect in DNA repair enzyme)
Term
Normal number of circulating B cells but decreased plasma cells and Ig
Definition
CVID
can be acquired in 20-30s
increased risk of autoimmune disease and lymphoma
Term
CVID has an increased risk of what associated with it?
Definition
autoimmune disease
lymphoma
Term
Disease association: ANA
Definition
SLE
Term
Disease association: Anti-dsDNA
Definition
SLE specific
Term
Disease association: Anti-smith
Definition
SLE specific
Term
Disease association: Antihistone
Definition
Drug induced lupus
Term
Disease association: Anti-IgG
Definition
RA (rheumatoid factor)
Term
Disease association: Anti-centromere
Definition
Scleroderma (CREST)
Term
Disease association: Anti-Scl-70
Definition
Scleroderma (diffuse)
Term
Disease association: Anti-mitochondrial
Definition
Primary biliar cirrhosis
Term
Disease association: Anti-gliadin
Definition
Celiac sprue
Term
Disease association: Anti-endomysial
Definition
Celiac sprue
Term
Disease association: Anti-basement membrane
Definition
Goodpastures
Term
Disease association: Anti-desmoglein
Definition
pemphigus vulgaris
Term
Disease association: Anti-microsomal
Definition
Hashimotos thyroiditis
Term
Disease association: Anti-thyroglobulin
Definition
Hashimoto's thyroiditis
Term
Disease association: Anti-Jo-1
Definition
polymyositis
dermatomyositis
Term
Disease association: Anti-SS-A
Definition
Ro, Sjorgen's syndrome
Term
Disease association: Anti-Ro
Definition
Anti-SS-A
Sjorgen's syndrome
Term
Disease association: Anti-SS-B
Definition
Anti-La
Sjorgen's syndrome
Term
Disease association: Anti-La
Definition
Anti-SS-B
Sjorgen's syndrome
Term
Disease association: Anti-U1 RNP
Definition
mixed CT disease
Term
Disease association: Anti-smooth muscle
Definition
Autoimmune hepatitis
Term
Disease association: Anti-glutamate decarboxylase
Definition
Diabetes mellitus type I
Term
Disease association: c-ANCA
Definition
Wegener's granulomatosis
Term
Disease association: p-ANCA
Definition
Other vasculitides
Term
Disease association: HLA A3
Definition
Hemochromatosis
Term
Disease association: HLA B27
Definition
Psoriasis, Ankylosing spondylitis, IBD, Reiter's syndrome (PAIR)
Term
Disease association: HLA B8
Definition
Grave's disease
Term
Disease association: HLA DR2
Definition
MS, hay fever, SLE, goodpastures
Term
Disease association: HLA DR3
Definition
DM Type I
Term
Disease association: HLA DR4
Definition
DM Type I, RA
Term
Disease association: HLA DR5
Definition
Pernicious anemia
Hashimoto's thyroiditis
Term
Disease association: HLA DR7
Definition
Steroid responsive nephrotic syndrome
Term
Graft from self
Definition
autograft
Term
Graft from identical twin or clone
Definition
syngeneic graft
Term
Graft from nonidentical individual of same species
Definition
allograft
Term
Graft from different species
Definition
xenograft
Term
Hyperacute rejection
Definition
Ab mediated, preformed antidonor antibodies in transplant recipient

minutes post transplantation
Term
Acute rejection
Definition
cell mediated
cytotoxic T cells react against foreign MHCs

weeks post transplant
reversible with immunosuppressants (cyclosporine, OKT3)
Term
Chronic rejection
Definition
T cell and Ab mediated vascular damage (obliterative vascular fibrosis)

months to years post transplant
irreversible

Class I-MHC (nonself) is perceived by CTLs as class I-MHC(self) presenting nonself antigen
Term
GVHD
Definition
grafted immunocompetent T cells proliferate in irradiated ICH
reject cells with foreign proteins
results in severe organ dysfunction

maculopapular rash, jaundice, hepatosplenomegaly, diarrhea
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