Term
| What is the inflammatory nature of Th1 vs. Th2 cells? |
|
Definition
Both are T-helper (CD4+)
Th1 = pro-inflammatory
Th2 = anti-inflammatory |
|
|
Term
| The condition of Tuberculoid Leprosy would be seen in a _________ dominant individual |
|
Definition
|
|
Term
| Who developed the smallpox vaccine? |
|
Definition
| Jenner - taken from cow pox |
|
|
Term
| Difference between serum and plasma |
|
Definition
| Serum = plasma w/o clotting factors |
|
|
Term
| Relative concentrations of leukocytes in blood |
|
Definition
Neutrophils = 50-65%
Lymphocytes = 20-40%
Monocytes = 2-8%
Eosinophils = 1-4%
Basophils < 1% |
|
|
Term
| Why do innate responses not increase with repeat exposure to the same pathogen? |
|
Definition
|
|
Term
| What allows us to have "prime-boost immunization"? |
|
Definition
| The immunological memory which exists in adaptive immunity |
|
|
Term
| Where are the main Ag's targeted by Ab's vs. T-cells in relation to the cell? |
|
Definition
Ab's = target EXTRACELLULAR Ag's
T-cells = target INTRACELLULAR Ag's |
|
|
Term
| What were the 2 proposed theories of how Ag's are recognized by our immune system? |
|
Definition
1) Instructional Theory - Ag used as template for synthesis of new Abs; Ag instructs Ab synthesis (WRONG)
2) Clonal Selection Theory - have PRE-EXISTING repertoire of lymphocytes, each which makes Ab's of a certain specificity; Ag selects the right clone from the repertoire |
|
|
Term
| Are all antigens immunogenic? |
|
Definition
NO - not all Ag's causeimmune responses on their own
****All immunogens are antigenic though |
|
|
Term
|
Definition
| Small, organic molecule that does not generate an immune response on its own, but can once covalently linked to a protein carrier |
|
|
Term
| In regards to haptens, what are Ab's generated with specificity towards? |
|
Definition
| The hapten, the protein carrier and the hapten:protein complex |
|
|
Term
| Example of a medically relevant hapten:protein complex... |
|
Definition
| B-lactam = hapten; B-lactam:protein conjugates react with the IgE that mediates penicillin allergies |
|
|
Term
|
Definition
| A substance that enhances immunogenicity of the substance they are administered with |
|
|
Term
| How long does it usually take for an adaptive immune response to kick in for a novel antigen? |
|
Definition
|
|
Term
| Where is class I MHC (HLA) present on? |
|
Definition
|
|
Term
| What cells express class II MHC (HLA)? |
|
Definition
pAPCs
Recognized by CD4+ cells |
|
|
Term
| Which cells can recognize FOREIGN MHC? |
|
Definition
| Alloreactive T-cells (make up about 10% of T cell population) |
|
|
Term
| What are the only cells that can activate naive T cells? |
|
Definition
|
|
Term
| What are the characteristics of immature vs. mature DCs? |
|
Definition
Immature - good at taking up Ag's, bad at presenting to T cells
Mature - poor at taking up (phagocytosing) Ag's, but good at presenting to T cells |
|
|
Term
| What CD upregulation occurs when DC cells go from immature to mature? |
|
Definition
Increased B7-1 (CD80) and B7-2 (CD86)
Co-stimulatory molecules that enhance T-cell activation |
|
|
Term
| Are NK cells MHC restricted? |
|
Definition
| NO - part of innate defenses against virally infected cells and tumors; not MHC restricted and have no memory |
|
|
Term
|
Definition
| Idea that NK cells can lyse cells that have downregulated their MHC to try and hide from them |
|
|
Term
| What is the prototype endogenous pyrogen? |
|
Definition
|
|
Term
| What does IL-6 stimulation cause? |
|
Definition
Production of C reactive protein in the liver (acute phase reactant)
CRP can act as an opsonin on bacterial/fungal surfaces
Also CRP = non-specific marker for inflammation |
|
|
Term
| What % of polio cases are asymptomatic? |
|
Definition
|
|
Term
| Paralytic polio occurs every ___in____ cases |
|
Definition
|
|
Term
| What is the infectious period for Polio? |
|
Definition
In respiratory droplet = 36 hrs to 2 wks post exposure
In stool = 72 hrs to 2 months post exposure |
|
|
Term
| When is Rubella infectious? |
|
Definition
From 7 days prior to 7 days following rash onset
Incubation period = 2 weeks |
|
|
Term
| In the current Immunization of School Pupils Act, which vaccines are monitored? |
|
Definition
| MMR, tetanus, diphtheria, polio |
|
|
Term
| Regarding Immunization of School Pupils, which diseases are being added in 2014? |
|
Definition
Varicella Zoster
Meningococal
Pertussis |
|
|
Term
| For inflammation to occur, the injury cannot be ________ |
|
Definition
| LETHAL - need living tissue |
|
|
Term
| What are the events in the "Triple Response of Lewis"? |
|
Definition
Local vasoconstriction (Transient) - area becomes pale
Vasodilation of microcirculation - then becomes red
Increased vascular permeability - then becomes swollen |
|
|
Term
| Which part of microcirculation generally has the greatest increase in permeability during an inflammatory response? |
|
Definition
|
|
Term
| Characteristics of inflammatory exudate |
|
Definition
High specific gravity
High protein levels
Lots of cells/cell fragments
*Unlike transudate (watery, no cells; not associated with inflammation) |
|
|
Term
| In inflammation, the increase in permeability is due to which two main factors? |
|
Definition
Increase hydrostatic pressure from the vasodilation
Wider epithelial junctions |
|
|
Term
| What is the immediate transient response of increased vascular permeability? |
|
Definition
| Endothelial contraction - widens intercellular gaps; transient (15-30 mins); only in venules |
|
|
Term
| What mediates the endothelial cell contractions observed in the immediate transient response to inflammation? |
|
Definition
|
|
Term
| What is the immediate sustained mechanism that leads to increased vascular permeability in inflammation? |
|
Definition
| Direct endothelial injury (detachment); secondary to thrombosis; lasts for hours-days |
|
|
Term
| 5 mechanisms of increased vascular permeability |
|
Definition
Endothelial cell contraction (immediate transient)
Junfctinoal retraction
Direct injury, detachment (immediate sustained)
Leukocyte-dependent
Increased transcytosis |
|
|
Term
| What chemical factors mediate junctional retraction in increased vascular permeabiity? |
|
Definition
|
|
Term
| In increases in vascular permeability, increased transcytosis is caused by... |
|
Definition
|
|
Term
| Adhesion of WBCs to BVs in inflammation is mediated by |
|
Definition
VCAM, ICAM-1 - endothelial adhesion molecules
Bind to integrins on leukocytes when they have been activated by inflammatory factors |
|
|
Term
| In viral infections, which cells generally arrive first? |
|
Definition
|
|
Term
| Which are the two prominent opsonins of phagocytosis |
|
Definition
|
|
Term
| What are the 2 major consequences of histamine release? |
|
Definition
Vasodilatation
Increased venule permeability |
|
|
Term
| Functions of leukotrienes |
|
Definition
Are arachidonic acid metabolites (with PGs)
Increase permeability, chemotaxis |
|
|
Term
| Difference between regeneration and repair |
|
Definition
Regeneration = replacement by IDENTICAL cells; can be physiological or patholog
Repair = replacement by either identical or different cells; pathological process (granulation tissue, CT) |
|
|
Term
| What is an example of "useless cellular regeneration"? |
|
Definition
| Cirrhosis of the liver - mostly scar tissue; non-functional regenerative tissue |
|
|
Term
| Types of cells in regards to characteristics of cell division... |
|
Definition
Labile - constantly regenerating
Permanent - do not divide post-natally
Stable - divide sometimes when induced into G1 state |
|
|
Term
| Characteristics of granulation tissue |
|
Definition
Pink, soft, painless
Composed of fibroblasts, inflammatory cells in a soft ECM mesh |
|
|
Term
| What happens to the # of BVs in granulation tissue as it develops further? |
|
Definition
| Capillaries DISAPPEAR - get fewer BVs as scar matures (don't need as much blood) |
|
|
Term
| Which types of collagen are fibrillary vs. amorphous? |
|
Definition
I, II, III = fibrillary
IV, V = amorphous |
|
|
Term
| What type of collagen is present in adult skin vs. granulation tissue? |
|
Definition
Adult skin = type I collagen
Granulation tissue = type III collagen |
|
|
Term
|
Definition
The replacement of type III by type I collagen in the repair with granulation tissue
Conversion of granulation tissue to a scar |
|
|
Term
| Most wounds regain ______% of their original tensile strength |
|
Definition
| 70-80% (will get that by about 3 months) |
|
|
Term
| Why do you get no crust formation in wound repair in the eye or uterine mucosa? |
|
Definition
| Because there is no blood (avascular) |
|
|
Term
|
Definition
| post-traumatic repair CT proliferation that exceeds necessary amounts |
|
|
Term
| Difference between primary and secondary wound repair (first vs. second intention)? |
|
Definition
Primary - if edges of wound are in apposition
Secondary - if edges of wound cannot be approximated; need granulation tissue for repair to occur |
|
|
Term
| Which hormones can increase/decrease rate of wound repair? |
|
Definition
Increase - deoxycorticosterone, somatotropic hormone
Decrease - ACTH, cortisol |
|
|
Term
| Which TLRs recognize which PAMPs for bacteria? |
|
Definition
TLR-1,2,6 - Gram Positive
TLR-4 - Gram Negative (LPS)
TLR-3,7,8,9 - nucleic acids (intracellular TLRs) |
|
|
Term
| Which TLRs are intracellular? |
|
Definition
| TLR-3,7,8,9 -> detect microbial nucleic acids |
|
|
Term
| In tissue, monocytes become_______ |
|
Definition
|
|
Term
| What are the different types of monocytes in various tissues? |
|
Definition
Kupffer cells - liver
Microglia - CNS
Osteoclasts - bone |
|
|
Term
| What are N-formylmethionyl peptides? |
|
Definition
| They are PAMPs recognized by receptors on leukocytes (all bacterial proteins are capped with N-formyl Met to identify) |
|
|
Term
| How is LPS presented to its TLR in innate immnuity? |
|
Definition
| CD14 binds LPS and presents to TLR-4 |
|
|
Term
| Chronic Granulomatous Disease is caused by a deficiency in ________ |
|
Definition
|
|
Term
| Why are our own cells not killed by NK cells? |
|
Definition
| Have an inhibitory ligand on host cells |
|
|
Term
| In the B-cell receptor, what is the mIg associated with? |
|
Definition
| Non-covalently associated with the Ig-alpha/Ig-Beta heterodimer |
|
|
Term
|
Definition
| 2 identical light chains + 2 identical heavy chains + Ig-a/Ig-B heterodimer |
|
|
Term
| The mIg in the B-cell receptor is either... |
|
Definition
IgM or IgD (if naive)
*Once experienced, can make any type of Ig as the mIg |
|
|
Term
| How does the B-cell receptor perform intracellular signalling? |
|
Definition
Uses the Ig-a/Ig-B heterodimer
BCR cannot signal on its own because the intracytoplasmic tail is too short |
|
|
Term
| How does the Ig-a/Ig-B heterodimer accomplish intracellular signaling? |
|
Definition
| via ITAM (Tyr-activation motif) - upon Ag binding, Tyr residues are phosphorylated |
|
|
Term
| In total, what are the 3 components of the BCR complex? |
|
Definition
mIg
Ig-a/Ig-B heterodimer
Co-receptor complex (CD19,21,81) |
|
|
Term
| What are the functions of each part of the BCR co-receptor complex? |
|
Definition
CD19 = long cytoplasmic tail
CD21 = cellular receptor for EBV; C3d receptor (CR2)
CD81 = promote CD19 expression |
|
|
Term
| Can Ab's of different isotypes be produced by the same B-cell? |
|
Definition
| YES - can create Ab's with the same Fab regions, but different Fc regions (isotypes have same Ag specificity, but different biological characteristics) |
|
|
Term
| For BCR cross-linking, need the Ag to be at least _______ |
|
Definition
|
|
Term
| Most Ag's that induce humoral responses are ________ dependent |
|
Definition
|
|
Term
| When considering thymus-dependent Ag's, what does the B-cell act like to the CD4+ cell? |
|
Definition
| Acts like an APC (presents Ag to CD4+ so it can be activated) |
|
|
Term
| What is the co-stimulatory signal needed to get B-cell activation from T-cells? |
|
Definition
| Need CD40 (present on B-cells) to bind to CD40L (on T-cells) |
|
|
Term
| What are the two types of thymus independent antigens? |
|
Definition
TI-1 - have intrinsic B-cell stimulating properties (mitogens); can activate both mature and immature B-cells (e.g. LPS)
TI-2 - NO intrinsic B-cell stimulating properties; can only activate mature B-cells |
|
|
Term
| LPS is an example of a _________________ Ag |
|
Definition
| Thymus indpendent (TI-1 = intrinsic B-cell stimulating properties) |
|
|
Term
| Differences between B-1 and B-2 cells |
|
Definition
B-1 = only about 5% of B-cells; innate like behaviour; react mainly to TI-2 antigens; DO NOT need T-cell activation
B-2 = conventional B-cells; need CD4+ T-cell activation |
|
|
Term
| Which CD mediates opsonization ? |
|
Definition
CD64 (Fc-gamma-RI)
Needed for phagocytosis |
|
|
Term
|
Definition
| Mediated by NK cells and CD16 (Fc-gamma-RIIIA) |
|
|
Term
| What is the 1st Ab produced in the primary immune response? |
|
Definition
| IgM (best for complement activation) |
|
|
Term
| What is the most abundant Ig in the blood? |
|
Definition
|
|
Term
| What is the only Ab isotope that can cross the placenta? |
|
Definition
|
|
Term
| What are the types of subunits that can make up the TCR? |
|
Definition
Most (95%) are alpha and beta chains
Remaining (5%) are delta and gamma chains |
|
|
Term
| What is the equivalent of the Ig-a/Ig-B heterodimer for the TCR? |
|
Definition
| CD3 complex (needed for intracellular signalling and complex expression on membrane) |
|
|
Term
| What components make up the TCR co-receptor complex? |
|
Definition
CD4 or CD8 = interact with either MHC II or I, respectively
For intracellular signally, interact with Lck (Tyr kinase) |
|
|
Term
| Class I (HLA A, B, C) presentation of Ag's |
|
Definition
For cytoplasmic Ag's - make 8-11 aa residues and load onto MHC class I into closed groove
Recognized by CD8+ cells |
|
|
Term
| Class II (HLA DP, DQ, DR) presentation of Ag's |
|
Definition
For endocytosed external Ag's; degraded into 13+ aa resides into open groove of MHC II molecules
Recognized by CD4+ cells |
|
|
Term
| What is the immunological synapse? |
|
Definition
Interface between T cell and APC (SMAC)
pSMAC = peripheral; adhesion moc
cSMAC =central; has TCRs, CD28, CD4 or CD8 |
|
|
Term
| What is the co-stimulatory signal needed for naive T cell activation? |
|
Definition
| CD28 (on T cell) interacting with B7 (on APC) |
|
|
Term
| What are the two different methods of CD8+ activation? |
|
Definition
DIRECT priming - pAPC gets antigenic material from env't
INDIRECT priming - pAPC gets Ag from 3rd party non-pAPC whcih cannot activate on its own |
|
|
Term
| Type I vs II Bare Lymphocyte Syndrome |
|
Definition
I = TAP1 or TAP2 mutation; defect in MHC Class I expression
Quantitative T-cell defect in CD8+
II = mutations in genes that regulate MHC II (HLA DP, DQ, DR) transcription; get quantitative CD4+ defect, and functional B-cell defect |
|
|
Term
| Examples of diffuse lymph tissue |
|
Definition
|
|
Term
| Which type of lymphoid nodules have active lymphocytes? |
|
Definition
|
|
Term
| What are the 2 layers of cortex in lymph nodes? |
|
Definition
Deep cortex = T cells; between nodules & medulla
Superficial/nodular cortex = B cells; lymph nodules |
|
|
Term
| What are high endothelial venules? |
|
Definition
Located in lymph nodes - where B and T cells enter the nodes
Endothelium is columnar/cuboidal (not squamous) |
|
|
Term
| Where do B&T cells enter the lymph nodes vs. DCs |
|
Definition
B&T = enter via HEVs
DCs = afferent lymphatics |
|
|
Term
| Where are the sinusoids located in the spleen? |
|
Definition
| RED PULP - are vascular spaces lined by endothelial cells |
|
|
Term
| Difference between lymphatic vs. splenic nodules? |
|
Definition
| Splenic nodules are associated with a central artery - can present blood-borne Ag's to white pulp |
|
|
Term
| Main difference between spleen and lymph nodes? |
|
Definition
| NO afferent lymphatics (both have efferent, only lymph nodes have afferents) |
|
|
Term
| What are the two paths blood may take in the spleen? |
|
Definition
Stroma of red pulp = OPEN circulation
Marchphage-sheathed capillaries = CLOSED circulation (stays in BVs) |
|
|
Term
| What does blood leave the splenic nodules via? |
|
Definition
| Pencillar arteries - then either to stroma (open) or capillaries (closed) |
|
|
Term
| What are the types of thymic cells in the cortex? |
|
Definition
Type I = no MHC I or II, tight junctions for barrier
Type II = stellate cells; both MHC I and II
Type III = act like type I and II cells; at junction of cortex/medulla |
|
|
Term
| In the thymus, are there more T cells in the cortex or medulla? |
|
Definition
| CORTEX (medulla has fewer because only positively selected T cells can exit the cortex) |
|
|
Term
| ______ selection occurs in the thymic cortex |
|
Definition
|
|
Term
| _________ selection occurs in the thymic medulla |
|
Definition
|
|
Term
| What type of epithelioreticular cells form Hassal's corpuscles in the thymus? |
|
Definition
|
|
Term
| How do T cells enter/leave the thymus? |
|
Definition
| HIGH ENDOTHELIAL VENULES (located at cortico-medullary junction) |
|
|
Term
| Where is the blood-thymus barrier located in the thymus? |
|
Definition
|
|
Term
| 3 major functions of primary/central lymph organs (BM and thymus)... |
|
Definition
Generate specific antigen receptors (random gene recombination)
Self-tolerance
MHC restriction (T cell only) |
|
|
Term
| What are the 5 stages of B cell development |
|
Definition
Early pro-B
Late pro-B
Large pre-B
Small pre-B
Immature B |
|
|
Term
| What are the two types of light chain in Ig's? |
|
Definition
|
|
Term
| What happens in the early and late pro-B cell stages of development? |
|
Definition
| First get D-J then V-DJ rearrangement of the mu chain (heavy) - get intact heavy chain expression |
|
|
Term
| When is the primitive BCR seen on the B-cell in development |
|
Definition
|
|
Term
| When does surrogate light chain expression occur in B-cell development? |
|
Definition
| In the small pre-B cell stage - get surrogate light chain (K or lambda)and V-J light chain rearrangement |
|
|
Term
| What causes Bruton's X-linked agammaglobulinemia? |
|
Definition
Btk mutation - Tyr kinase; arrest of B-cell development in between pre-B and immature B stage
Get no mature B cells and no Ab's (on immunoelectrophoresis see no gamma globulin band) |
|
|
Term
| Immature T cell precursors are called? |
|
Definition
|
|
Term
| What are the stages of T cell development in the thymus? |
|
Definition
Thymocyte
Double negative pro-T cell
Pre-T cell (with primitive TCR)
Double Positive T cell
Naive T cell (after undergoing negative selection) |
|
|
Term
| Positive selection of T cells dictates _______ |
|
Definition
|
|
Term
| Negative selection of T cells dictates __________ |
|
Definition
|
|
Term
| Negative selection is mediated by _______________ in the thymus |
|
Definition
|
|
Term
| What CD's are expressed by Treg cells? |
|
Definition
| They are CD4 and CD25 positive |
|
|
Term
| When is CD25 expressed in T-cells? |
|
Definition
Treg cells - always expressed, even in rest state
Conventional T cells = only express CD25 when activated (acts as IL-2a receptor) |
|
|
Term
| What is DiGeorge Syndrome? |
|
Definition
| Congenital thymic aplasia - have few T cells with normal/elevated B cell # with very few Ab's (cannot get activated by CD4+) |
|
|
Term
| What is the classic triad of DiGeorge Syndrome? |
|
Definition
Hypocalcemia
Cardiac structural abnormalities
Immune deficiencies |
|
|
Term
| Why do you see increased autoimmunity in children with DiGeorge syndrome? |
|
Definition
| You lack negative selection AND lack Treg cells |
|
|
Term
| What are the "lymph node homing receptors" of naive T cells? |
|
Definition
L-selectin (CD62L)
CCR7 (chemokine receptor) |
|
|
Term
| Activated T cells and memory T cells lose expression of which receptor? |
|
Definition
| CD62L (lymph homing receptor) - causes them to LEAVE lymph node to fulfill role |
|
|
Term
| What is the main activation factor of T-cells? |
|
Definition
| IL-2 = cytokine, main T cell growth factor (activation, expansion, differentiation) |
|
|
Term
| What is the difference between the IL-2 receptor expressed by resting vs. active T cells? |
|
Definition
Resting = only have beta and gamma units
Active = addition of alpha subunit; ready to bind IL-2 |
|
|
Term
|
Definition
25
Expressed by all Treg cells and by activated T cells |
|
|
Term
| Which factors promote differentiation to Th1 vs. Th2 cells? |
|
Definition
Th1 = IL-12,IFN-gamma, other Th1 cells
Th2 = IL4, 10, 13 |
|
|
Term
| Th1 cells are more concerned with defending against... |
|
Definition
INTRACELLULAR pathogens & virally infected cells
Pro-inflammatory; produce IFN-gamma, opsonizing IgG4 |
|
|
Term
| Th2 cells are more concerned with defending against... |
|
Definition
Extracellular pathogens by helping with humoral immunity (make IL-4,5,13; IgE)
Recruits mainly eosinophils |
|
|
Term
| Which type of Th cell would you expect to be upregulated in a parasitic infection? |
|
Definition
| Th2 - increases IgE production and recruits eosinophils |
|
|
Term
| What are invariant NK T cells |
|
Definition
iNKT cells co-express T cell and NK cell markers
Dependent on double positive thymocytes for positive selection
Can produce Th1 cytokines (IFN-gamma) or Th2 cytokines (IL-4,13) via PRE-FORMED mRNA (don't need denovo) |
|
|
Term
| What is the main source of INITIAL wave of cytokines leading to either Th1 or Th2 differentiation? |
|
Definition
|
|
Term
| What are the two pathways of cytotoxicity for CD8+ cells? |
|
Definition
Granule Exocytosis - perforin + granzymes
Fas/Fas - type II transmembrane protein; Fas-FasL binding fucks shit up y'all |
|
|
Term
|
Definition
| Transcription factor in the thymus that turns on ectopic peripheral Ag's in thymus to allow autoreactive T cells to be deleted |
|
|
Term
| Somatic hypermutation involves only the ________ regions of the Ig's |
|
Definition
| Only the V regions (NOT C-regions) |
|
|
Term
| When does somatic hypermutation occur? |
|
Definition
| AFTER B-cell meets Ag -> create mutant Ig's which may bind Ag better, leading to their preferential selection |
|
|
Term
| What does somatic hypermutations in B cells lead to? |
|
Definition
| Affinity maturation of B cells - causes stronger secondary respnoses than primary responses in humoral immnuity |
|
|
Term
|
Definition
|
|
Term
| Plasma cells ________ undergo somatic hypermutation and isotype switching |
|
Definition
|
|
Term
| Plasma cell morphology in multiple myeloma? |
|
Definition
| Auer-rod like inclusions, flamed plasma cells (more Ig's than normal) |
|
|
Term
| Hyper IgM syndrome is caused by? |
|
Definition
| Mutation in CD40L - increased susceptibility to pyogenic/opportunistic infections |
|
|
Term
| Most common cause of immunodeficiency worldwide vs. in Canada? |
|
Definition
World = malnutrition (protein-calorie)
Canada = drug therapy |
|
|
Term
| When is immunity at its lowest point in a baby? |
|
Definition
| At around 6 months - lose mom's IgG, havent made own Ig's yet |
|
|
Term
|
Definition
Severe-Combined Immunodeficiency - NO B or T cell response
Lack T cells, B-cell response absent because no CD4+ to activate |
|
|
Term
| What cytokines are produced by Th1 vs. Th2 cells? |
|
Definition
Th1 = IFN-g, IL-2 (pro-inflamm)
Th2 = IL4,5,13 |
|
|
Term
| TGF-beta is considered to be _____-inflammatory |
|
Definition
|
|
Term
| How can bacterial LPS lead to auto-immunity? |
|
Definition
| Polyclonal lymphocyte activator - will activate ALL B cells in body (any autoreactive ones will then proceed to go to town on us) |
|
|
Term
| What is an example of moc. mimicry with dem teeth things? |
|
Definition
| P. gingivalis - mimics a-enolase |
|
|
Term
| MHC Class ___ are most strongly assocaited with autoimmunity |
|
Definition
|
|
Term
| Ankylos spondylitis moer common in _____ |
|
Definition
|
|
Term
| SLE more common in ______ |
|
Definition
|
|
Term
| Organ specific autoimmunities... |
|
Definition
| MS, Graves', DM type I, Myasthenia Gravis |
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Term
| Ab-mediated Auto-immunities... |
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Definition
Myasthenia Gravis - target AChR
Hemolytic Anemia - target RBCs
Graves' - target TSH-R
SLE - target dsDNA (Ab-cmplex) |
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Term
| T-cell mediated auto-immunities.. |
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Definition
DM type I - target B-cells in pancreas
MS - target myelin of CNS |
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Term
| Rheumatoid arthritis is Ab-dependent or T-cell dependent auto-immunity? |
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Definition
| TRICK QUESTION ITS BOTH Y'ALL |
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Term
| Which autoimmunities are T-cell mediated? |
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Definition
Multiple sclerosis
DM type I |
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Term
| Difference in Ig isotype of Rheum Factor vs. ACPAs |
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Definition
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Term
| Shared epitope is located on... |
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Definition
B-subunit of DR4 of HLA class II molecules
SE binds citrullinated peptides |
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Term
| When can live vaccines be given? |
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Definition
| After 1 year (need to wait for baby's immune system) |
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Term
| Examples of toxoid vaccines? |
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Definition
| Diphtheria, tetanus (vaccinated against toxoid) |
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Term
| Example of vaccine preservative = ? |
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Definition
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Term
| In terms of Th cells, we are born in a predominantly ______ state |
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Definition
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Term
| What mediates the early vs. late phase rxns of type I hypersensitivity? |
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Definition
Immediate - histamine
Delayed - arachidonic acid metabolites (leuko3, PGs - they are NOT present in mast cell granules, synthesized after Ag-cross-linking) |
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Term
| What kind of triggers tend to prevent allergy formation? |
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Definition
Environmental exposures - later born children, viral ifnection, GI flora
Tend to switch to more of a Th1 response as supposed to a Th2 response |
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Term
| What happens to risk of sensitization to cat allergen as exposure to cat increases? |
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Definition
| Decreased risk of sensitization (developing allergy) - may be due to desensitization, may be due to increased exposure to ca fecal material |
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Term
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Definition
| Ppl from northeast US, more likely to have Epi-Pen than other places |
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Term
| Can skin test children at what age? |
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Definition
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Term
| For chronic urticaria, recommend... |
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Definition
| H2 antihistamines (non-sedating) |
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Term
| What is atopic dermatitis also known as? |
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Definition
| The ITCH THAT RASHES (primary symptom is itch, then rash) |
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Term
| Where is atopic dermatitis most common in infants vs. children vs. adults |
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Definition
Infants = face, cheeks
Children = flexor surfaces
Adults = extensor surfaces |
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Term
| Which anti-inflammatories can be used to treat Atopic Dermatitis? |
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Definition
Tacrolimus = moderate to severe
Pimecrolimus = mild to moderate |
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Term
| Acute vs. chronic urticaria - which is more common in young vs. old |
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Definition
Acute (<6 wks) = young
Chronic (>6 wks) = old |
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Term
| Urticaria is the same mechanism as ________, but more superficial in the skin |
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Definition
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Term
| In cholinergic urticaria the lesions... |
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Definition
| BURN, not itch (2ndary to neural response from sweating) |
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Term
| When is Darier's sign seen? |
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Definition
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Term
| What is the molecular basis of hereditary angioedema? |
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Definition
| Malfunction or deficiency of C1 inhibitor protein (get normal C3 levels, low C4 levels); bradykinin mediated |
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Term
| Different treatments for asthma management... |
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Definition
1st line = fast acting bronchodilator
2nd = inhaled corticosteroids or LTRA
3rd = add LABA or LTRA |
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Term
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Definition
| Anti-IgE therapy (monoclonal Ab) |
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Term
| For bee stings, when is epinephrine indicated? |
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Definition
Any anaphlaxis in past, large systemic rxn in adults
NOT if - large local rxn, systemic rxn in child < 16 yrs |
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Term
| What are the non-IgE mediated food reactions? |
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Definition
Food protein induced protocolitis
Food protein enduced enterocolitis
BOTH in infnats
Celiac disease - autoimmunity (IgA) |
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Term
| Where does epinephrine need to be injected for anaphlaxis treatment? |
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Definition
| Mid anterolateral thigh IM = vastus lateralis |
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Term
| What is the main event that leads to graft rejection? |
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Definition
| Recognition of allograft MHC antigen |
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Term
| What does the panel reactive Ab measure? |
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Definition
Used for transplant tissue matching - want to know which HLA Ab's the patient already possesses (measure of pre-formed Ab's)
Measured against panel of Ag's from multiple donors in population |
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Term
| Difference in panel reactive antibody vs. HLA cross match |
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Definition
PRA = patients preformed Ab's vs multiple donors in population
HLA CM = test serum for preformed Ab's vs. SINGLE donor |
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Term
T cell cross match is a _____ contraindication for tx
B cell cross match is a _________ contraindication |
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Definition
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