Microbes are on planet earth for billions of years; they don't need us, we need them

microbes here first. Bacteria and viruses are the longest living things on the planet. 

we need the microbes for the things they make. We need them for our nutrition and well being. 

"big eater"; specialized cells involved in the detection, phagocytosis and destruction of bacteria and other harmful organisms. They also present antigens to T cells and initioate inflammation by releasing molecules (cytokines) to activate other cells

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activate naive T cells; reconcile for the initiation of adaptive immune responses

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allergic/parasitic responses mast cells mediate inflammatory repossess such as allergic reactions and hypersensitivity

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Answer: 

A, B, C, D and E

IMPORTANT FACTS

-key substances produced by eosinophils are: 

• enzymes 
• growth factors
• cytokines
• reactive oxygen species
• lipid mediators 

which of these cells is an eosinophil?

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Answer:

A. Birds 

which of the following animals would these be considered normal RBC's?

A. Birds

B. Camels

C. Cats

D. Horse

E. Humans

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Answer.

D. Mast cell

Which of these cells can act like a sentinel cell ?

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C. Cats

in which of the following animals would these be considered normal RBCs?

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B. Interleukin-6

Why? : kicks starts the adaptive immune system 

both INCREASES and DECREASES inflammation. Activates the B and T cells 

Key word: functions to kick start the adaptive immune system 

Which of the following major pro-inflammatory cytokine functions include kick-starting the adaptive immune system?

A. Interleukin-1

B. Interleukin-6

c. Interleukin-8

D. Lymphotoxin-α

E. Tumor Necrosis Factor-α

C. Small chemotactic protein

What is a chemokine?

A. cell adherence molecule 

B. neurotransmitter molecule

c. small chemotactic protein

D. type of cell 

E. vasoactive protein

sources:

• sentinel cells (macrophage, dendritic cells, mast cells)
• other cells (epithelial cells, endothelial, airway smooth muscle cells)
• main function is cell trafficking (chemoattractant for cells). mixtures of these cytokines determine the different cells present at the site of damage. 

other functions:

- release histamines, stimulate respiratory burst of neutrophils. 

- act like a antibiotics and trigger cell adhesion. 

neutrophil chemotactic factor 

Chemokine receptor: CXCR1 and CXCR2

macrophage inflammatory protein 2

Chemokine receptors: CXCR1 and CXCR2

D. CXCL4

Why? Lets break down the answers. 

B & E are receptors, so that's not the answer already

A- attracts monocytes. 

C- is specific for the macrophages

D - platelet factor 4, is present in the granules of the platelets and was the first chemokine discovered 

Which Chemokine are you likely to find in alpha granules of platelets?

A. CCL2

B. CCR2

C. CCL4

D. CXCL4

E. CXCR4

E. CXCR2

Why? : 

macrophage derived growth factor receptor; in my head, macrophages and other sentinel cells release chemokines that attract the neutrophils to the area of infection and damage. 

this receptor also recognizes CXCL2 (macrophage inflammatory protein 2), which a strong neutrophil chemoattractant 

This cow is producing watery milk because she has mastitis. She was born with the problem that results in impaired neutrophil migration. Defect in the genes for which of the following most likely leading to her mastitis?

A. CCL3

B. CCL4

C. CCR3

D. CCR1

E. CXCR2

[image] [image]

Which of the following cardinal sign of inflammation introduced by Dr. Virchow? 

A. calor

B. dolor

C. functio laesa

D. granuloma 

E. Tumor

F. Rubor

1. redness = rubor 
2. swelling = tumor
3. heat = calor
4. pain = dolor
5. loss of function = functio laesa 

1. recognition of injurious agent
2. recruitment of leukocytes
3. removal of agent
4. regulation/control of the response
5. resolution (repair)

C. macrophages 

Why?: the macrophages are phagocytic cells that will get rid of the remains of the infection/pathogen (janitorial staff of the immune system). 

An 11 year old child falls and cuts his hand. The wound becomes infected. Bacteria (idk - enters?) into the extracellular matriculates around capillaries. In the inflammatory response to this infection, which of the following cells removes the bacteria?

A. B lymphocyte 

B. fibroblast

C. macrophage 

D. mast cell

E. T lymphocytes

B. PAMPS bind to TLR's on myeloid stem cells -> neutrophilia 

Why? 

- PAMPS bind to TLR's on myeloid cells to stimulate those stem cells to MATURE INTO NEUTROPHILS

- PAMPS CAN BIND to the TLRS

Why is it not A? Macrophages don't release IL-23

C?- LPS doesn't bind to NRLs (think DAMPS)

D?- PAMPS biding to the TLRS on macrophages could contribute to neutrophilia, but its not the best answer. 

Which of the following best explains the mechanism that produces neutrophilia in a patient with acute appendicitis?

A. macrophages -> IL-23 -> Th17 -> IL-17 -> GM-CSF -> neutrophilia

B. PAMPS bind to TLRS on myeloid stem cells -> neutrophilia

C. LPS bind NLRS on myeloid stem cells -> neutrophilia

D. PAMPS bind TLRs on macrophages -> neutrophila 

VOCAB (in case)

• TLR = toll like receptors
• LPS = lipopolysaccharides 
• NLRS = nod-like receptors (PRR's expressed in cell cytosol, detect intracellular bacteria and are pro inflammatory)-- better for DAMPS

D. C5a

Why?: highly chemotactic complement component. 

Which of these complement components has potent chemotactic properties? 

A. C3bBb

B. C4a

C. C4bC2a

D. C5a

E. C5b-C9

factor that targets neutrophils, eosinophils and macrophages

potent chemoattractant 

protein that assists with chemotaxis and leukocyte activation (alongside C3a, C4a etc.)

E. perforins

Why? : glycoproteins that is responsible for pore formation in cell membranes of target cells

C9- protein that creates transmembrane tubules and is capable of perforating target cells

C9 is a member of which family of proteins?

A. acute phase proteins

B. addressing 

C. cytokines

D. immunoglobulins 

E. perforins 

B. classical pathway 

why?: produces antibodies against antigens. 

Which of these complement pathways is a component of the acquired immune system?

A. Alternative pathway 

B. Classical pathway

C. Deviant pathway 

D. mannose lectin pathway

E. responsive pathway 

Bacterial cell walls can activate which of the following?

A. alternative complement pathway

B. immunological synapse

C. plasma cells

D. Terminal complement pathway 

E. tyrosine kinase pathway 

• lymph nodes: major sites of antigen lymphocyte interactions. Has both B and T cells present. initiate protective adaptive immunity and produce antibodies, cytotoxic immune cells and memory cells against the pathogens/antigens
• tonsils: stop germs from entering the body through the mouth and nose. has many white blood cells to kill the germs and pathogens
• hemolymph nodes: similar to the lymph nodes, associated with the blood vessels. cortex contains germinal centers with B cells ; medulla contains the T cells
• tertiary lymphoid organs: develop in response to chronic inflammation (cancer, autoimmune issues, forming body) and microbial colonization

Spleen: filters the antigens from the blood. has the red pulp (with the RBC storage, filtering of the RBC and iron cycling) and the white pulp (T cells form lymphoid sheaths and B cells form follicles in the germinal centers)

• red pulp - filter RBC's
• Marginal Zone - innate and adaptive immune response (macrophages, dendritic cells, plasma cells, lymphocytes enter the white pulp)
• White pulp - adaptive immune response

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1. Eosinophil
2. Neutrophil
3. Basophil
4. Lymphocyte 
5. Monocyte
6. Band cell 
7. Platelet 

Match the cells indicated by the number on the image with its correct name.

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B. Neutrophil

Why?- The white blood cell with the most percentage found in the blood. 

Which of these is the predominant white blood cells in human blood? 

A. Eosinophil

B. Neutrophil 

C. Basophil

D. Lymphocyte

E. Monocyte

A. diminished nuclear maturation from impaired DNA synthesis 

Why? : The nucleus of the RBC is abnormal and small compared to the normal size of them. 

also the neutrophil looks abnormal because it has abnormal amount of lobes

A 62 year old man is taken to the ER in a state of inebriation. HE is well known in the ER because this scenario has been repeated many times over 15 years. On physical exam, he is afebrile. His spleen  tip palpable, and his liver edge is firm. Lab studies show hemoglobin of 8.2 g/dL, hematocrit of 25.1%, MCV of 107 m3, platelet count of 135,000/mm3, and WBC count of 3920/mm3. Figures show images of his peripheral blood smear. Which of the dollying is the most likely explanation of his lab findings and the changes in his peripheral smears?

A. diminished nuclear maturation from impaired DNA synthesis 

B. extravascular hemolysis of antibody coated cells

C. imbalance in synthesis of α-globin and  β- globulin chains 

D. reduced deformability of RBC membranes 

E. increased susceptibility to lysis by complement

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An infant is bron at 34 weeks gestation to a 28 year old G3P2 woman. At birth the infant is markedly hydronic and icteric. A cord blood sample is taken and direct Coombs test result is positive for the infants RBCs. His peripheral smear is shown in the image. Which of the following is the most likely mechanism for the finding in this infant?

A. hemolysis of antibody coated cells

B. imparted globing synthesis 

c. mechanical fragmentation of RBCs

D. oxidative injury to hemoglobin 

E. reduced deformability of RBC membranes 

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antiglobulin test

patients RBCS mixed with sera containing antibodies specific fo a human immunoglobulin 

tells that there are antibodies are present (not any specific ones, just that there is a presence)

antiglobulin test

patients SERUM is tested for its ability to clump when there is a presence of which specific certain antibodies

D. reduced erythropoiesis from parvovirus infection 

VOCAB lol: 

• erythropoiesis: production of RBCs

15 year old teenager from Copenhagen, Denmark, has had malaise and a low grade fever for the past week, along with arthralglas. On physical exam, she appears very pale, except for the bright red malaria facial rash as seen in the photo. She has a history of chronic anemia from hereditary spherocytosis and the figure shows the unusual appearance of her peripheral blood smear. Her hematocrit, which normally ranges from 35-38%, is now 28%, and her reticulocyte count is very low. The serum bilibrium level is 0.9 mg/dL. which of the following events is most likely to have produced these clinical and pathological findings?

A. accelerated extravascular hemolysis in the spleen

B. development of anti-RBC antibodies

C. disseminated intravascular coagulation

D. reduced erythropoiesis from parvovirus infection 

E. superimposed dietary iron deficiency 

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In this photomicrograph of Thymic cortex, which of these arrows is pointing out the cell responsible for removing dead lymphocytes?

A. A

B. B

C. C

D. D

E. E

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E. adults thymus 

Why? : The white areas shows the fat cells of the adults thymus 

as the person grows, the thymus starts shrinking and being replaced by fat (?)

Which of these images represents the adult thymus gland?

A. 1

B. 2

C. 3

D. 4

E. 5

[image][image]

B. B

Just remember of it looking like a sac

Which arrow is pointing to the Bursa of Fabricus?

A. A

B. B

C. C

D. D

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C. Reduction in serum antibody levels

Why? : Loss of the Bursa will impair the B cell development and cause a reduction of the antibody levels 

B cells are the cells that basically form the antibodies (antibodies are the receptors that fall off the B cell and float in the body). 

What effect would the removal of this organ from a neonatal bird have on the birds immune system?

A. cancer in chicks

B. impaired rejection of skin grafts

C. reduction in serum antibody levels

D. sharp reduction in numbers of lymphocytes

E. thymus atrophy 

E. salmonellosis 

There is an outbreak of Gumboro disease, a highly contagious disease of younh chickens and turkeys used by infectious bursal disease virus (IBDV) in a poultry farm. The baby birds are depressed and dehydrated. AS a result of this disease, the young birds will most likely be more susceptible to which of the following diseases? 

A. Avian influenza, Influenza H5N1

B. Avian tuberculosis, Mycobacterium avium

C. Bird laryngitis from Psittacid herpesvirus Type 1

D. Psittacine adenovirus syndrome 

E. Salmonellosis 

What effect would the removal of the ileum from a newborn lamb have on the lambs immune system?

A. increase of Orf lesions around the mouth 

B. impaired rejection of skin grafts.

C. reduction in serum antibody levels

D. sharp reduction in numbers of circulating lymphocytes

E. thymus atrophy 

E. 1, 2, 3 and 4

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Which of these structures constitutes Waldeyer's ring ?

[image]

A. 1- Pharyngeal tonsil 

B. 2- Tubal tonsils

C. 3- Lingual tonsil

D. 4- Palatine Tonsils 

E. 1, 2, 3 and 4

C. Lymphocyte emigration from blood to lymph node

Why?: the venues help the lymphocytes move from the blood to the lymph nodes. 

Circulating T cells Migrate through the high endothelium into the paracortex (HEV in the photo)

important for production of plasma cells 

Which of the following best expresses the most important immunologic role of the specialized venues seen in this photomicrograph of a lymph node?

[image]

A. antigen presentation

B. antigen trapping 

C. Lymphocyte emigration from blood to lymph node

D. Phagocytosis of foreign material 

E. production of plasma cells

C. 

[image] 

OTHER STRUCTURES

1 - hilum

2.  medulla

4. deep cortex 

5. capsule 

Lymphoid follicles are located in the superficial cortex. Which of the following items numbers on this lymph node indidvade the superficial cortex? (ALSO NAME THE OTHER STRUCTURES OF THE LYMPH NODE)

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A. 1

B. 2

C. 3

D. 4

E. 5

E. Primary follicles 

[image]

Memory cells for antibody production are generated at which site in the lymph node?

[image]

A. Secondary Follicle 

B. Paracortex

C. Trabecula

D. Capsule

E. Primary follicles

F. Medullary glands 

C. 3 = splenic nodule

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Identify the Splenic Structure: Which of these numbers designates splenic nodules?

[image]

A. 1

B. 2

C. 3

D. 4

E. 5

B Adult Thymus 

OTHER ANSWERS (and which part of the lymphatic system they're apart of)

1- Palatine tonsil

3- Reactive LN 

4 - spleen 

5 - MALT

Which of these is a primary lymphoid organ?

[image][image]

A. 1

B. 2

C. 3

D. 4

E. 5

B. B 

Why? It looks sort of like a brain and kidney mixed together. But also it's upside down. See.

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Which of these is most likely an image of a PIG lymph node?

[image]

A. A 

B. B

C. C

D. D

E. E

Which pathway (1 or 2) depicts the maturation and development of B cells in humans?

[image]

A. 1

B. 2

Which of the these is point to high endothelial venule?

[image]

A

B

C

D

E

B

A= medulla 

C = trabeculae

Which. of these is pointing to cortex in this photomicrograph of Thymus?

[image]

A

B

C

host defense

regulate immunity

disposal of waste

other (blood coagulation, angiogenesis (forming new blood vessels))

• main source of these proteins is the liver and immune cells (others include endothelial (found in blood vessels and lines connective tissues) cells and epithelial (surface of the body) cells)
• 3 pathways (alternative->complements, lectin->sugars, classical->antibodies)

• C3 breaks down spontaneously (C3a and C3b)

C3 b acts as a looping factor (creating more C3 convertase such as C3bBbP)

• TO TURN ON THIS PATHWAY: C3b binds to microbial surfaces, and will not come off. Then binds to separate B factor, creating C3bB, which is then cleaved by D, and ends with C3bBb, which produces the feed back loop. triggers the terminal pathway
• to TURN OFF, no microbial surface binds to the C3b, then C3b binds to H (C3bH), later binding to I, where it is broken down back to C3b

• triggered when specific lectins bind to microbial surfaces: lectins are mannose binding (MBL) OR Ficolin 1,2 or 3
• Binding activates the MASP-2
• Splits C4, which activates C4
• C4a ; C4b (binds to the sugar on a pathogen)

• 3 subunits of C1 (C1q ; C1r ; C1s)
• C1 binds clustered antibody-antigen complex

C1q changes the shape when C1r activates 1s

C1s is a protease and cleaves the C4 INTO C4a and C4b

C2 binds to C4b creating C4b2

- C1s then cleaves the C2 , resulting into C4b2b.

• Triggered when one of the IgM molecules or two closely spaced IgG molecules bind to an antigenic surface
• the complement activating site of the antibody Fc region activates C1, which results in the rest of the  C's activating. 

recognize both PAMPS and DAMPS

• crucial for activating the innate immune system and kick starting the adaptive immune system 
• render antigen presenting cells capable of activating T cells of the adaptive immune system 

(TLRS can also detect PAMPS, and can bind to nearly any PAMP)

embryo/fetus : yolk sac -> liver -> bone marrow

birth/children/young adult : red bone marrow of all bones (includes long bones-- femur and tibia)

adults : primarily in axial skeleton (flat bones -- pelvic, sacrum, ribs, sternum, cranium) and vertebrae

What are the major regions for hemopoiesis in the body?

(embryo/fetus->birth, children and young adults->adults)

hemopoiesis: production of blood cells and platelets

• red blood cell
• white blood cell
• lymphocyte
• platelet

Group A antigens have an additional sugar molecule (N-acetylgalatosomine)

Group B has different additional galactose molecule. 

AB has both of these. O has neither

O has the same base of glucose and galactose and N-acetylglucosamine 

[image]

infection and inflammation can cause a decrease in the amount of RBC's produced or an oxidative injury in the RBC's 

The liver increases the amount of Hepcidin, which binds to Ferroportin to get the iron out of cells so that they can then be used in the bone marrow to produce more RBC's 

increase in Hepcidin, decrease in plasma iron levels ; decrease in the ability to efficiently make RBC's

eosinophil 

how to remember 

- has lots of the red little granules over it

which cell is this?

[image]

neutrophil

how to remember 

• looks like two kidneys to me
• doesn't have any granules 
• the second picture ; BAND CELL; immature neutrophil. 

what cell is this?

 [image]

responsible for allergies ; high amount of these cells during an allergic reaction 

mast cells release histamines that ATTRACT (chemotaxis) these cells 

Mast cells

has granules in it

the way to tell the difference is that it has granules that it releases; also has a large nucleus. 

also looks sort of like a black hole in some of the photos (that's how I remember it, cause it has a lighter center and very dark surrounding because of the granules)

FACTS OF MAST CELLS

• derived from the stem cells in bone marrow
• live in the tissues
• increased inflammation recruits MC's 
• spray granules in nearby area when activated
• ACTIVATED BY IgE AND OTHER PRRS

what cell is this?

[image][image]

basophil 

FACTS OF THIS CELL

• LEAST abundant cell in the blood
• FcεRI = high affinity receptor for IgE
• Associated with IgE allergic/mediated responses (respond to itchy things and inflammation) -> hypersensitivity and allergy

How to remember this cell lol

- looks like a kidney with mushrooms on it

- very purple, can visibly see the granules on it. 

monocyte

• many tiny granules (not very noticeable)
• The cytoplasm is sort of fuzzy looking, and also has light blue purple color to it. 
• Large nucleus, but focus on the cytoplasm 

What cell is this?

[image]

• Primary and Secondary hemostasis 
  • Primary - seconds after injury
    • important in preventing blood loss in capillaries, small arterioles and venules 
    • Forms a platelet plug (I know I gave the answer oops)
  • Secondary (minutes after injury)
    • forms a stable fibrin plug
    • seconds to activate coagulation; minutes for fibrin to form 
    • important for LARGE vessels 

1. antigen detected
2. antigen processing cell is stimulated (antigen binds to the PRR's)
   • First order cytokines are secreted
3. T helper cell is triggered by cytokines
   • Second order cytokines secreted; leads to the production of T and B cells)
4. Effector cells (T and B cells)
5. Immune response 

(type of lymphoid tissue)

• Purpose: Site of stem cells where the lymphocytes arise
• yolk sac, fetal omentum, fetal liver, bone marrow 

Type of lymphoid tissue 

Purpose: Newly produced lymphocytes are mature, and self reactive cells eliminated 

• Thymus
• Bursa of Fabricus (birds) or Bone Marrow (human)
• Ileal Peyre's Patches (rabbits & ruminants) 

Purpose: organs where lymphocytes are stimulate by antigens 

• Lymph nodes, tonsils
• spleen
• Peyre's Patches (humans, other)

Purpose: Groups of cells that develop in mature animals to do lymphocyte-antigen interactions 

• solitary lymphoid tissues 
  • cryptopatches
  • isolated lymphoid follicles 

bone marrow 

• white circles: fat cells
• pink lines: minerals 

what is this? 

[image][image]

Facts about this area

• Has 3 roles for lymphoid development 
  • Precursor : Site of Stem cells where the lymphocytes arise
  • Primary : site where the newly produced lymphocytes mature, self reactive killed (B cells of humans/primates)
  • Secondary: B cell antigen-antibody interaction, plasma cells, antibody production 
• Major source of antibody production

• T cells 
  • immature T cells move to the thymus
• B cells  
  • immature B cells move to the bursa (birds)
  • immature B cells move to the bone marrow (humans)
• MATURE T AND B CELLS : circulate in the blood and lymph, colonize secondary lymphoid tissues (spleen, lymph nodes/follicles, Peyer's patches, tonsils)

filter the blood (eliminate the older RBCs & old platelets)

coordinate the immune responses to circulating antigens 

filter lymph, 

generate the immune responses to antigen in the lymph

lymphocytes 

FACTS ABOUT THIS CELL

• atypical cells : irregular nucleus, less dense than mature lymphocyte-- happens when theres viral infections, organ transplants and transfusion 
• resting lymphocyte has a tight compact nucleus, very little cytoplasm 
• no granules in the lymphocyte
• round oval nucleus, slightly indented sometimes but USUALLY round

what cell is this ?

[image]

B cell

• Aquire CD10 (cell surface enzyme): slowly begins to lose CD10 and increase CD20 (B cell antigen expression on the B cell)

T cell

• immature: CD34 & TbT
• 1st T cell marker : CD2 + CD7 + CD3
• Finally: CD3 disappears, CD4 and CD8 lost
  • Mature Helper CD4 and cytotoxic CD8 emerge (HAPPENS IN THYMUS)

POSITVE 

• survival of potentially useful lymphocytes. Makes sure that only T cells whose TCRs recognize MHC survive 
  • CD8 CELLS RECOGNIZE MHC 1
  • CD4 CELLS RECOGNIZE MHC 2 -> HELPER T CELL

NEGATIVE

• kills developing T lymphocytes whose TCR's bind strongly to their self antigens in the THYMUS 
• APCS show the self antigens to the T cells, and if they recognize the antigens and react to them, those reactive cells are killed and under APOPTOSIS 
  • they undergo apoptosis because they may cause immune disease

MHC 2

think of it as ... CD4 needs to TWO MHC's to be like CD8 

• Medulla : the lighter pink areas in the picture
  • CELLS IN THIS AREA: dendritic, epithelial, Hassall's Corpuscles
• Cortex : the dark blue/purple areas in the first photo
  • source of mature T cells and where the selection occurs.
• Hassall's Corpsucles: the pink circles next to the medulla in the second photo. 
  • PURPOSE: Regulates Positive Selection 

Immature T cells enter the Thymus through the corticomedullary junction 

• REMOVING THYMUS : Circulating Lymphocytes disappear. T dependent lymphoid organs will have almost no lymphocytes 

Be able to distinguish the areas of the thymus 

[image][image]

bursa of fabricus

FACTS ABOUT BURSA

• activates B cells by using Bursin secreted from the epithelial cells in the organ 
• Antibody forming system ; surviving B cells move to the secondary organs. 
• REMOVING THE BURSA WOULD PREVENT ANTIBODY PRODUCTION and drop in serum immunoglobulin 

What structure is this? 

[image]

[image]

Peyers Patches 

• part of MALT
• secondary lymphoid organ in humans 
• (2 groups of mammals)
  • Group 1: ruminants and pigs; Illeal Peyers Patches PRIMARY ORGANS; JEJUNAL patches secondary
  • Group 2: Humans, rabbits, rodent an other species ; found in the small intestine
    • ALL PEYERS PATCHES IN THIS GROUP ARE SECONDARY

What is this structure ?

[image]

D. Massive tissue damage 

Why? : massive tissue damage can lead to DIC (disseminated intravascular coagulation), meaning that it causes blood clotting in the blood vessel. 

Which of the following best characterizes the most likely initiating factor for disseminated intravascular coagulation?

A. An acute phase response 

B. laminitis 

C. macrophage activation

D. massive tissue damage

E. protein misfolding

Which of the following molecules is most responsible for Amyloidosis ?

A. α1-antirypsin 

B. α1-antichymotrypsin

C. α2-macroglobulin

D. C-reactive protein

  E.  major acute phase protein (MAP)

F. Serum amyloid A (SAA) 

Which of the following molecules is an example of a pentraxin?

A. α1-antitrypsin

B. bacterial endotoxin 

C complement factor P 

D. C reactive protein

E. serum Amyloid A 

Which of these best describes an "acute phase protein"? 

A. chemotactic factor released by damaged tissue

B. protein mainly secreted by liver as influenced by phases of the moon

C. protein mainly secreted by liver whose laves change with injury

D. antibody made in response to an antigen

E. interleukin-1 produced by macrophages

E. Prostoglandin-E₂

Why?: it acts on temperature sensitive neurons too alter the bodies overall temperature 

Pyrogenic cytokines (Il-1, IL-6, and TNF-α) induce an enzyme in the hippocampus to turn o and produce which of the following substances that leads to fever?

A. Cathepsin B

B. HMGB-1

C. Lipoxins

D. Maresins 

E. Prostoglandin-E₂

Which of these macrophage derived cytokines induces sickness behavior?

A. IL-1

B. IL-4

C. IL-10

D. G-CSF

E. GM-CSF

E. TGF-β

C. macrophages in lung capillaries 

Which of the following are the top elf cells that felines (such as tigers, lions and domestic cats) mainly use to clear bacteria from their blood stream?

A. circulating nuetrophils

B. lung neutrophils 

C. macrophages in lung capillaries 

D. Mesangial cells on the kidneys 

E. spleen and liver macrophages 

Which of the following is likely to activate a Type 1 macrophage?

A. interferon 

B. lysozyme 

C. nitric oxide 

D. nitric pxide synthase 

E. tumor necrosis factor-α

What is the name for macrophages that line the sinuses of the liver?

A. histiocytes

B. kupffer cells

C. microglial Cells

D. monocytes

E. hepatocytes 

Clostridium tetanus toxin, called "TeNT" targets SNARE-like proteins. This toxin would most likely affect which of the following defensive mechanisms used by neutrophils?

A. chemotaxis

B. heterophagy 

C. NETosis

D. respiratory burst

E. phagocytosis 

The complement component C3b on complement opsonized bacteria binds to which of the following neutrophil receptors?

A. CD11a/CD18 (LFA-1)

B. CD32 (FcγRll)

C. CD35 (CR1)

D. TLR-1/2

E. TLR-4

C. coating to neutralize electrostatic charge

q

What is an opsonin?

A. chemokine that directs chemotaxis

B. chemotactic factor that is a chemoattractant

C. coating to neutralize electrostatic charge

D. lysosomal enzyme

E. type of granulocyte

Which of the following terms is used to describe the migration of neutrophils under the influence of external chemical gradients?

A. chemolysis 

B. Chemotaxis

C. Endocytosis 

D. Exotaxis

E. phagocytosis 

During inflammation, endothelial cells express which of the following surface structures whose function is to enable neutrophils to attach to endothelial cell walls, slow down and roll?

A. acute phase proteins

B. cadherins

C. Fc receptors 

D. lectins 

E. selections

A woman with a chronic infection is showing signs of iron-deficient anemia. Which of the following Acute Phase proteins (APPs) binds to Ferroportin and is likely o contributing to her iron deficiency anemia?

A. Alpha 1 glycoprotein 

B. Ceruloplasmin 

C. C reactive protein (CRP)

D. Fibrinogen

E. Haptoglobin

F. Hepcidin

G. Major acute phase protein (MAP)

H. Serum amyloid A

Which of the following is correct regarding the mechanics of NBME questuion?

A. All options must be individual

B. correct answers should be longer than distractors

C. it is best to include all of the above as the last choice in the option set

D. distractors should include clues to the correct choice

E. Clinical case presentation is known as the lead in

C. C

Why?

Adaptive immunity takes a while to develop, and also provides a higher level of protection (attributed to the memory T and B cells)

Which of these demonstrates the curve for the development of adaptive immunity 

[image]

A. A

B. B

C. C

B. Are comprised of antigens 

Why? 

these are various structures such as toxins and organisms. 

This is the best answer to encompass all the things pictured. 

Which immunologic feature is shared by all the images in these photos?

[image]

A. Are commensal organisms that induce tolerance

B. Are comprised of antigens

C. Are pathogenic microbes that induce inflammation

D. will primarily stimulate Type 1 responses 

E. Will primarily stimulate Type 2 responses 

B. High mobility group box protein1 (HMGB-1)

Why?

Alarmins/DAMPS produced from damaged cells (one of which is HMGB-1) and is a substance commonly present in our cells

Which of these is an alarmin (also known as the danger single/DAMP)

[image]

A. Hapten formed from penicillin and albumin 

B. High mobility group box Protein1

C. Lipoteichoic acid from a Gram + bacteria

D. Lipopolysaccharide from a Gram - bacteria

E. Nucleocapsid protein from SARS-CoV2 virus 

F. TNF-α

Why?

• Produced by sentinel cells AND lymphocytes
• MEDIATES THE SIGNS OF INFLAMMATION (heat, swelling, pain, redness)

This patient accidentally hit her hand with a hammer. Which of the following (couldn't read the question, starts with mo-) (which is released by sentinel cells), is most likely primarily responsible for the pain, swelling, and redness seen on the patients finger?

A. IL-4

B. IL-5

C. IL-10

D. INF-α

E. INF-λ

F. TNF-α

C. Chronic 

Why?

• This is induced by T cells and macrophage activation to cause for chronic inflammation
• persistent stimuli that continues the inflammation, tissue injury, and healing.
• granuloma = small area of inflammation, and basically covers the antigen/source of inflammation with immune cells 

A granuloma is considered what type of inflammatory reaction?

[image]

A. acute

B. allergic

C. Chronic

D. humoral 

E. Stress induced 

D. Lysine 

Why? 

Misfolded proteins, Fibrin and Prions express resides of which of the following amino acids that allows tissue plasminogen activator (T-PA) to interact with plasminogen to produce plasmin (?, question cut off)

[image]

A. asparagine

B. Cysteine

C. Glutamine

D. Lysine

E. Proline 

D. C5a

REMEMBER: HIGHLY CHEMOTACTIC COMPLEMENT COMPONENT

Which of these complement components has potent chemotactic properties?

[image]

A. C3bBb

B. C4a

C. C4bC2a

D. C5a

E. C5b-C9

D. 

THYMUS T CELLS ARE FOUND IN THYMUS

THIS IS WHERE THEY UNDERGO POS/NEG SELECTION

C. reduction in serum antibody levels 

Why? 

PEYERS PATCHES FUNCTION FOR B CELL DEVELOPMENT 

the removal of this organ would cause decrease in the antibody levels (since B-cells are responsible for producing antibodies)

What effect would the removal of the ileum from a newborn lamb have on the lamb's immunity?

A. increase of Orf lesions around the mouth 

B. Impaired rejection of skin grafts

C. Reduction in serum antibody levels

D. Sharp reduction in tubers of circulating lymphocytes

E. Thymus atrophy 

D. Germinal center

Compare the photomicrograph of the spleen with the illustration of the spleen. B cells are located to which site in the spleen?

[image]

A. 

B.

C.

D.

E.

Which of these is the predominant Leukocyte in human blood?

[image][image]

A. Eosinophil

B. neutrophil

C. basophil

D. lymphocyte

E. monocyte

D. Lymphocyte 

Why? : innate cells (NK, NKT, ILC1) and adaptive cells (T and B cells)

The photomicrograph shows a major cell that depending on its surface makers could primarily involve innate or adaptive immunity, or both. What type of cell is in the middle of this photomicrograph?

A. Band cell

B. basophil

C. eosinophil

D. lymphocyte

E. monocyte

F. neutrophil 

G. Platelet 

H. RBC 

A. 

Why? 

Well for one thing, the first choice doesnt have an antigen inside the cell. For another thing, it shows the correct amount of cell surface signals

This illustration shows four different NK cells which are counting cells that are each displaying different cell surface makers. The neutral killer cell will kill at the cells except for the cell that has the proper mix of cell surface signaling molecules. Which of these four sets of cells will survive?

[image]

A

B

C

D

C - intravascular macrophage 

removes the particle matter in horses, pigs and cats

Which of the following are the type of cels that felines (such as tigers, lions and domestic cats) use to clear bacteria from their bloodstream?

[image]

A

B

C

D

E

D. Bull with have higher total WBC counts than heifers

Why? 

males of most mammalian species have more susceptibility to mortality and morbidity from bacterial infections than females 

There are known sex differences that alter immune response and disease progression. If (can't read this part of question) challenge beef cattle with lipopolysaccharides, which of the following sexual differences can manifest?

A. bulls will have higher fever than heifers

B. bulls have higher serum concentration of TNF-α

C. bulls will have higher neutrophil counts that heifers 

D. Bull with have higher total WBC counts than heifers

E. bulls have lower IFN-γ

F. Bulls will have less sickness behavior than heifers

C. foreign or unfamiliar substances that stimulate immunity 

Which of the following is a correct description of an antigen?

A. cells that cause organ graft rejection

B. foreign or unfamiliar cells that cause antibody formation

C. foreign or unfamiliar substances that stimulate immunity 

D.proteins found in blood

E. substances that kill invading bacteria

Which type of cell death is used by neutrophils in order to produce a matriculates of sticky DNA (can't read question) multiple antimicrobial molecules which can capture and kill microorganisms without ingesting them?

A. apoptosis 

B. autophagy

C. Necrosis 

D. necroptosis

E. Netosis 

F. Pyroptosis 

D. morning when the body has more circulating M1 cells 

The graphic helps explain what time of day increases the chance that a vaccine will be more effective. Based on the information in this graphic, which is the best time to receive a vaccine and why?

[image]

A. Evening when the Boyd has more circulating M1 cells

B. Evening when the body has more circulating M2 cells

C. Midday when there is a balance of M1 and M2 cells in circulation

D. Morning when the body has more circulating M1 cells

E. Morning when the body has more circulating M2 cells

C. Protein mainly secreted by liver whose levels change the injury 

Why?

APP mainly made by the liver

which of the following best describes an "Acute Phase Protein"?

A. a chemotactic factor released by damaged tissue 

B. a protein mainly secreted by liver as influenced by the moon

C. a protein mainly secreted by liver whose levels change with injury 

D. An antibody made in response to an antigen

E. interleukin-1 produced by macrophages 

Which of the following best characterizes the most likely initiating factor for disseminated intravascular coagulation?

[image]

A. an acute phase protein

B. laminitis 

C. macrophage activation 

D. massive tissue damage

E. protein mis-folding

B. presentation of Class 1 antigens to T cell 

The sketch depicts an essential pathway for which of the plowing elements of the immune response?

[image]

A. Degradation of phagocytosed virus

B. Presentation of Class 1 antigens to T cell

C. presentation of Class 2 antigens to T cell

D. Secretion of INF-α by activated. T cell 

E. Synthesis of newly formed virus

A. autocrine 

The secretion of IL-21 by Th17 cells is an example of which kind of signaling ?

[image]

A. autocrine

B. endocrine

C. holocrine

D. merocrine

E. paracrine

Which dendritic cell population promotes Th1 responses and cell mediated immunity?

[image]

A. cDC1 cells

b. cDC2 cells

C. pDC cells

D. immature DC's

E. lymphoid DC's

D. CD80 (B7-1)

Why?

Binds to CD28 on the T cell and helps amplify and stimulate the release of IL-2 which increased metabolism, cell division and survival genes

B lymphocytes can only function as antigen presenting cells and activated T cells if they express an additional cell surface marker. Which of the following cel surface markers on B-cells is required so they can activate a T helper cell?

[image]

A. CD4

B. CD8

C. CD28

D. CD80 (B7-1)

E MHC Class 1

Which of the following is the site where MHC Class 2 molecules bind processed exogenous antigens

A. Golgi apparatus 

B. cytoplasm

C. Mitochondrion

D. phagosome 

E. proteasome 

At which of the sites in this diagram of the Class 1a molecule would you expect to have the highest degree of polymorphism?

[image]

A. 1

B. 2

C. 3

D. 4

B. dendritic cells

ONLY CELL THAT CAN PRESENT TO NAIVE T CELLS

Which of the following cell types present antigens to naive T-cells

[image]

A. Basophils

B. dendritic cells

C. mast cells

D. macrophages

E. B-cell

C. CD8

THIS IS THE MARKER FOR CYTOTOXIC T CELLS

DISTRACTORS

CD4 = markers for helper T cells

CD21 = Type 2 B cells

CD25 = T reg cells

Multiple studies revealed, that patients with COVID-19 have reduced numbers of lymphocytes of eosinophils. The decline in cytotoxic lymphocytes was greater than the decline in helper (can't read this part) T cell or B cells. Decline in cytotoxic lymphocytes correlates with disease severity. Based on the (can't read this) which of the following lymphocyte markers would you expect to show the greatest reduction in numbers (from normal) for a COVID-19 patient who is in the ICU?

A. CD3

B. CD4

C. CD8

D. CD21

E. CD25

D. Helper Cells

CD4 -> MARKER FOR HELPER T CELLS

The antibody to CD4 was used to stain this tissue. The antibody to CD4 was detected with immunohistochemistry. This technique will most likely identify which of the following cells (maybe? cant read question)

A. B1- Cells

B. B2- Cels

C. Cytotoxic T cell

D. Helper Cells

E. Innate Lymphoid cells Type 2

A. CD21 (CR2)

WHY? 

CD21 IS A COMPLIMENT RECEPTOR. there others aren't... I think (?)

A 19 year old FIU student has malaise, fever, and a sore through for 4 weeks. On exam she had splenomegaly (big spleen). A peripheral blood smear shows the atypical lymphocytes as shown in the photomicrograph. She has an infection produced by a virus that is camouflaged by glycoproteins and mimics the human ligand C3dg and thereby enters cells via a complement receptor. Which of the following is the receptor for entry of the virus within this students infected B-cells?

A. CD21 (CR2)

B. CD23 (FcεRll)

C. CD32 (FcγRll)

D. CD124 (IL-4 receptor)

E. CD125 (IL-5Rα)

A

Why? 

CD8 attaches the MHC Class 1 molecule to the TCR 

CD8 is a DIMER (2)

FYI...

• B- represents CD4
• C- variable chain TCR
• D- CD3 signaling complex
• E- antigen

Which of these most likely represent a CD8 molecule?

[image]

A

B

C

D

E

D. Differentiation of naive T-cells to T-reg cells

Why?

IL-10 and TGF-β turn on FoxP3 which makes a naive CD4+ T-cell differentiate into a T reg cell

IL-10 and TGF-β play an important role in which of the following?

[image]

A. Antigen recognition

B. differentiation of naive T cells to Th1 cells

C. Differentiation of naive T cells to Th2 cells

D. Differentiation of naive T cells to T reg cells

E. recruitment of CD4+ T cells

E. Recruitment of mast cells

D. Differentiation of naive T-cells to T-reg cells

Why?

IL-10 and TGF-β turn on FoxP3 which makes a naive CD4+ T-cell differentiate into a T reg cell

IL-10 and TGF-β play an important role in which of the following?

[image]

A. Antigen recognition

B. differentiation of naive T cells to Th1 cells

C. Differentiation of naive T cells to Th2 cells

D. Differentiation of naive T cells to T reg cells

E. recruitment of CD4+ T cells

E. Recruitment of mast cells

C. INF-γ

Why?

most important cytokine released by Th1 cells is INF-γ. 

side note

• IL-4, IL-5 and IL-15, released by Th2 Cells, which is suppressed in the Type 1 response
• INF (both) - Type 1 interferons

A first responder came in for his annual Mantoux test (PPD test). The test detects a response to (idk) intracellular pathogen, Mycobacterium tuberculosis which illicit a type 1 response. Which of the following cytokines was most likely secreted by the T cells that responded to this intracellular bacterium?

A. INF-α

B. INF-β

C. INF-γ

D. IL-4

E. IL-5

F. IL-13

D. Infected macrophages damage organs such as liver and spleen 

Why? 

• macrophages used by the FIP virus to replicate and by infecting the macrophages thus causing organ damage and potentially being lethal to cats. 

An 8 month old female domestic cat has been presenting symptoms such as loss of weight and a high fever. However, the appearance of abdominal fluid and masses have risen concerns. Immunofluorescent staining of macrophages was positive for the mutated FCoV, confirming that the cat has Feline Infectious Peritonitis (FIP). Knowing such, what causes FIP to be so lethal for cats?

A. Asymptomatic cats spread the FCoV to healthy cats

B. There is no treatment or cure for FIP

C. Infected macrophages attack epithelium cells

D. infected macrophages damage organs such as liver and spleen 

E. Infected macrophages infect other sentinel cells

A 4 year old female German Shepherd presents with obstructed urethral opening, large humoral mass on external genitalia, and serious discharge. Laboratory exams reveal milk leukocytosis, slightly lower than normal hematocrit levels, and uncontrolled growth of cells that are uniformly round and have a prominent nuclei. Considering this, what is the most likely cause of these immunological findings?

A. Cutaneous Viral Papilloma 

B. Canine Venereal Sarcoma

C. Apocrine Gland Adenoma 

D. Canine Rhabdomyosarcoma 

E. Canine Uterine Leiomyoma 

A 22 year old African American woman has been presenting datigue, fever, weakness, shortness of breath, joint pain and swelling, edema on lower extremities, oral ulcers, and a recurring erythematous facial rash for 6 weeks. She had her first child 8 months ago and has since had multiple sexual partners. Her medical history seems noncontributory. Physical examination indicates a BP of 146/92, a systolic murmur (IV/VI), and a decreased breath sound in the base of the right lung. Laboratory findings show anemia and thrombocytopenia and the urinalysis indicates 3+ proteins, RBC at 8, WBC at 2, and hyaline and oval RBC costs. The X ray shows a right pleural effusion. Further tests show the presence of ANA, anti-DS, and anti-Smith antibodies. Anti-CCP antibodies are absent. Erythrocyte sedimentation rate is of 90 mm/hr. Which of the following is the most likely diagnosis?

a. psoriatic arthritis

B. reactive arthritis

C. Rheumatoid arthritis

D. Sarcoidosis

E. System Lupus Erythematosus

Infectious bronchitis can affect a chickens respiratory system. Symptoms presented can include, but are no limited to, coughing, sneezing and nasal discharge. These symptoms are somewhat similar to a human with bronchitis. Both birds and mammals share similarities in immune system mechanisms as well as some differences. An important difference between the two is their ability to both detect and fight foreign invaders: although, this includes birds only having three immunoglobulin classes, whereas mammals have 5. Can this difference be advantageous in a species ability to overcome an infection, such as bronchitis?

A. Hsving more immunoglobulin classes is not advantages in overcoming an infection such as bronchitis

B. Mammals having 5 immunoglobulin classes gives them an advantage in fighting an infection, compared to birds having 3

C. mammals having 5 immunoglobulin classes makes them less capable to recognize a pathogen, compared to birds having 3

D. Mammals having 5 immunoglobulin classes makes them more vulnerable when fighting an infection, compared to birds having 3

E. Mammals having 5 immunoglobulin gives them an advantage in recognizing a pathogen, compared to birds having 3

B dendritic cell

Why?

• present the antigen to naive T cells
• help to trap antigens with their dendrites (I think maybe)

Which cell type is most efficient in processing exogenous antigens?

A. B cell

B. Dendritic cell

C. macrophage

D. Neutrophil

E. T cell

F. Muscle Cell

G. RBC 

B. False

Dendritic cells are not professional. They are deputized

Langerhans Cells, macrophages, B cells, and T cells are all professional antigen presenting cells.

A. true

B. false

Type 1 cDC cells

• Produce IL-2
• IL-2 -> Trigger a Type 1 response (cell mediated)

Type 2 cDC Cells

• Produce IL-6 or IL-23
• IL-6 -> Trigger Th2 response (antibody mediated and allergies)
• IL-23 -> Trigger Th17 responses

triggers a type 1 response

type 1 response is CELL MEDIATED

produced by cDC Type 1 dendritic cells

What does IL-2 do?

Triggers a type 2 response

type 2 reponse is ANTIBODY MEIDATED OR ALLERGY MEDIATED

produced by type 2 cDC dendritic cells

triggers a Th17 response

E. Synthesized within the cell

REMEMBER

Exo = OUTSIDE

Endo = INSIDE

Which of these is correct regarding an endogenous antigen?

A. absorbed onto cell surfaces

B. Recognized by B cells

C. Recognized by CD4+ cells

D. Phagocytosed by macrophages

E. Synthesized within the cell

E. plasmacytoid dendritic cells 

AKA pDC

these bad boys increase drastically when there is inflammation or infection

These cells are bad at increasing the number of T helper cells, but produce LARGE AMOUNTS OF INFS AND IL-17

Which of these cells is the major source of interferon-α?

[image]

A. Lymphocyte 

B. Macrophage 

C. Myeloid dendritic cells

D. Neutrophils

E. plasmacytoid dendritic cells 

• specialized in recognizing viral DNA/RNA through TLR-7 and 9
• RAPIDLY PRODUCE TYPE 1 INTERFERON (INF-α INF-β)
• also produces Type lll interferons (INF-λ, 1, 2, 3, and 4)
• after releasing these APCs, which can stimulate naive T cells = adaptive immune system

What is the name of the dendritic cells in the epidermis?

[image]

A. follicular dendritic cells

B. Islet cells

C. Langerhans Cells

D. mast cell

E. veiled cells

pDC

plasmacytoid dendritic cell

What cell is this?

[image]

Which of these best describes the function of a mature dendritic cell?

A.  capture bacteria

B. induce inflammation

C. present antigen

D. Produce IL-2

E. Search for pathogens in tissues 

E. ubiquitin 

What molecule binds to and marks proteins for destruction?

A. albumin

B. globulin 

C. MHC class 1

D. proteasome 

E. ubiquitin 

Proteasomes play a key role in processing which of the following substances?

A. bacterial antigens 

B. cell surface antigens

C. endogenous antigens 

D. exogenous antigens

E. MHC Class 2 peptide

Which of the following is the site where MHC class 2 molecules bind processed exogenous antigens?

A. Golgi apparatus

B. cytoplasm 

C. mitochondrion 

D. phagosome 

E. proteasome 

Which of the following lymphocytes interacts with T-follicular helper (Tfh) cells to produce the plasma cells involved in the production of allergy to latex gloves?

A. B cells

B. CD8+ T cells

C. ILC Type 1

D. ILC type 3

E NK Cells

B. differentiation of naive T cells to Th2 cell

IL-4 ALSO INDUCES B CELL CLASS SWITCHING TO IgE AND IgG1

CONSIDERED A B CELL GROWTH FACTOR

SECRETED BY T CELLS

IL-4 plays an important role in which of the following?

A. antigen recognition

B. differentiation of naive T cells to Th2 cell

C. differentiation of naive T cells to T reg cells

D. recruitment of CD4+ T cells

E. recruitment of mast cells

B. they are powerful mitogens

Which of the following is correct regarding super antigens?

A. they are allergens 

B. they are powerful mitogens

C. they bind to immunoglobulin Fc regions

D. thye bind to complement receptors 

E. they bind only to MHC Class 2 molecules

F. They bind to specific antigens

A. apoptosis 

WHY? 

notice how there is no inflammation in the biopsy, and how the cell's death is very separated and doesn't affect the cells around them 

Which of the following best describes the type of cell death pointed out by the arrows in this biopsy from an elderly woman with a history of melanoma and diarrhea on experimental treatment with tremelimumab (anti- CTLA4 monoclonal antibody therapy) 

[image]

A. apoptosis

B. autophagy

C. necroptosis

D. necrosis

E. netosis

a. CD4/CD8 T cell ratio

Which of the these tests is most useful for identifying a patient with HIV?

a. CD4/CD8 T cell ratio

B. neutrophil count

C. platelet count

D. T reg levels

E. δ/γ T cell blood levels 

which of these is the transmembrane constant domain?

[image]

A.

B

C

D

D. MHC Class 1 molecules 

REMEMBER

CD4 BINDS TO MHC 2 BECAUSE IT NEEDS TO BE 2 TO BE LIKE CD8

CD4 (MHC 2) "=" CD8 (MHC 1)

CD8 binds to which of the following molecules?

A. antibody 

B. lipid antigen

C. peptide antigen

D. MHC class 1 molecules

E. MHC class 2 molecules 

C. IHC using an antibody against CD3

Which of the following can help distinguish a T-lymphocyte from a B-lymphocyte?

A. cytoplasmic structures

B. microvillous projection on cell surfaces

C. IHC using an antibody against CD3

D. secretory granules

E. size differences

Which of the following lymphocytes is most abundant in human blood?

A. CD4+ T cells

B. Cd8+ T cells

C. ILC-1

D. ILC-2

E. ILC-3

F. γ/δ T cells

G. NK cells

T cells constitute approximately what percent of lymphocytes in human blood?

A 2 

B. 10

C. 40 

D. 70

E. 100

Name all the structures 

[image]

E. Regulatory T cells

Why? 

T regs are responsible for the control of the immune system and inhibiting the autoimmune reactive cells. The dysfunction of these cells is common in autoimmune diseases (as the woman's history stated). 

FoxP3 gene: Transcription factor needed for T cells to specialize as T reg cells

A 22-year old woman presents to the ER with fever, chills and body aches. After genetic testing she is found to have an x-linked disorder that includes a mutation of the FoxP3 gene. Histologic samples from various organs system shows widespread inflammation most likely because she has a high degree of autoimmunity. Which immune cells most likely to be dysfunctional in this woman?

A. B-cells

B. CD4 T helper Cells

C. CD8 T cytotoxic cells

D. natural killer cells

E. Regulatory T cells

two cells are in DIRECT CONTACT using complementary receptors. 

Signals will then be DIRECTLY transmit through both the cells

cell signaling that INDIRECT; molecule is released by one cell and diffuses through extracellular fluid into the receiving cell. 

molecule diffuses to cell surface receptors

B. 

direct  transfer of information because the cells are together (connected)

chemokines (CXC, CC, C CX3C)

helps in cell motion and activation

IL-8 is a chemokine (CXCL8)

signal between the leukocytes 

interfere with viral RNA/DNA and protein synthesis 

interferon = interfere

interfere with viral RNA/DNA and protein synthesis 

interferon = interfere

produced by macrophages (TNF-α) and T cells (FasL, CD40L) to kill tumor cells

• coordinate cell defense
• help cell survive
• regulate immune system
• regulate acute or chronic inflammation

Enzymatic digestion of BCR's yields specific fragments. Papain can break up hinge region and for the Fab region that contains the antigen binding site in the variable areas. Bottom part is the Fc region. Different types of immunoglobulin bind to different Fc receptors

IgD - FcδRll (delta)

IgG - FcγRll (gamma)

IgE - FcεRll (epsilon)

IgA - FcαRll (alpha)

IgM - FcμRll (mu)

IgM

B. cows

inflammation begins and the neutrophils are activated and called in. 

 TNF and IL-1 help the neutrophils that are circulating attach to the endothelium; cytokine storm may occur (more neutrophils activated by the the release of the granules from the inflammatory mediators such as macrophages)

• macrophage eats the dead neutrophil and then releases interleukins. 

IL-23 -> released by the macrophages

- then stimulates the release of IL-17

IL-17 -> comes from the innate lymphocyte Th17 cell. 

- then stimulates G-CSF production

G-CSF -> matures the neutrophils 

• can be produced after an infection

PAMPS bind to the pattern recognition receptors on the stem cells, which then causes them to produce mature stem cells (TLR responsible for this)

neutrophils are usually present in the blood vessels but are dormant. They circulate in the blood stream, bouncing off the vessels endothelium 

When there is an infection and the blood vessels they are present in becomes sticky due to the surrounding tissues undergoing inflammation, the neutrophils stick to the endothelium 

selectins (such as P-selectin) "select" which of the neutrophils exit the blood vessel through the endothelium, and the integrins (such as ICAM-1) help the neutrophils "integrate" to where they are needed (happens because of chemotaxis)

CD32

CD35

Other name for...

FcγRll

CR1

these are the "eat me" signals. 

is a non inflammatory signal that signals that a cell is dying/undergoing apoptosis ; this helps promote immune tolerance

includes: 

• endogenous lipid and glycoproteins not present on a healthy cell
  • altered glycoproteins 
  • altered lipids 

when a dendritic cell eats a neutrophil (dying) with bacteria inside of it, the dendritic cell will release more IL-23

this causes an influx in neutrophils going towards the area and increases inflammation 

when a dendritic cell eats a neutrophil (dying) without anything inside of it, the dendritic cell will release IL-10 and TGF-β to decrease inflammation

tells the T reg cells to suppress the inflammation

M1: pro-inflammatory 

• pro-inflammatory cytokines
• ROS (Reactive oxygen species)
• RNS (Reactive nitrogen species)

M2: anti-inflammatory 

• trigger the tissue repair and the wound healing in the body

some of the ones we've spoken about many times 

Cytokine Receptors

• CD25 = IL-2Rα

Antibody receptors

• CD64, CD32, CD16
• remember that Fc means antibody receptor

Complement Receptors 

• CD35 = CR1
• CD11b/CD18 = CR3

Co-stimulatory receptors 

• Co-activator T helper cells = CD40
• Modulator (controls) for T helper cells = CD80

 CD19 - B cell marker 

CD21 (CR2)- B cell receptor

antigen is bound to the complement Cd3.

Cd3 also binds to the CD21

CD21 is next to CD19, forming the CD21/CD19 complex (which lowers B cell threshold).

when receiving signals from from CD79 and CD81 (TAPA-1) results in the dual stimulation that lowers the B cell activation threshold

explain complement system in this photo (like, what is going on here)

[image]

signalling through TLR means signaling through the Myd88 system 

-IRAK system the removes the inhibitory (ikB) of the NF-kB, allowing for gene transcription 

this would enhance B cell antigen presentation, germinal growth formation, needed antibody production aghast the T dependent antigens, memory B cells to increase the antibody production (except IgA and IgE), 

chemokine, interleukins, interferons, tumor necrosis factor family. 

chemokine - cell motion 

interleukins - between leukocytes

interferons - interfere with viral DNA and RNA 

tumor necrosis factor family - produced by macrophages and T cell that can kill the tumors cells, coordinate the cell defense, help cell survive, regulate immune responses and inflammation 

what are cytokines?

also called  CD95 ligand or CD178

important for the destruction of things 

B cell growth factor

Th2 cell differentiation and proliferation

inhibits IFN-γ macrophage activation 

IgE and IgG selection ?

activates the cytotoxic lymphocytes and macrophages 

t cel differentiation 

Fas mediated apoptosis 

proliferation of NK cells

mast cell activation 

enhances T cell survival 

promotes B and T proliferation

enhances NK cell activity 

F. Decrease in JAK/STAT signalling 

Why?

inhibits the JAK1 and JAK3, which would reduce the activation of Class 1 and Class 2 cytokine receptors, which would decrease the inflammation

C. Type 3 hypersensitivity

B. Blocked histamine attachment to histamine receptor (H1R)