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Immunology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What does a deficiency in C3 lead to...
CD40 and CD40L
Severe pyogenic sinus and respiratory infections - inc suscept to type III hypersen rxn
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Prevents attachment of bacteria and viruses to mucous membranes

2. Which cytokines to Th1 cells secrete?
IL-2 and IFN gamma
Hereditary angioedema
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho
CD21

3. How are NK cells stimulated?
Bruton's agamma
IL-4 - 5 - 10
Ceilac disase
IL-12 - IFN- beta. IFN- alpha

4. X linked IL-2 receptor defect - adenosine deaminase deficiency - failure to synthesize MHC II
CD14
Sjorgen's syndrome
Right arm and right half of head
SCID

5. HLA- DR5
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
DM type 1
Pernicious anemia (to B12 def) - hashimotos thyroiditis
IgA

6. 22q11 deletion - failure of 3rd and 4th pharyngeal arches
Leukocyte adhesion deficiency type 1
S. aureus and S. pyogenes
DiGeorge
Il -4

7. c - ANCA
III
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II
Wegeners granulomatosis
IL-2 and IFN gamma

8. Defect in CD40L on helper T
IL-10
Hyper IgM
IgA
Perforins and granzymes to induce apoptosis of virally infected or tumor cells

9. What does the Th2 response do?
Superficial inguinal pectinate line
Perforin - granzyme - granulysin
IgG
Regulates the humoral response

10. which follicles (primary or secondary) have active germinal centers?
Secondary
Wegeners granulomatosis
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Chronic: fibrosis of graft tissue and blood vessels

11. Which type of hypersens rxn is the arthus rxn
III
Superficial inguinal pectinate line
Pemphigus vulgaris
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho

12. which areas of the body are drained by the celiac lymph node?
Mesenchyme
Stomach
RA - DM type 1
III

13. HLA- B27

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14. transplant rejection cell mediated due to cytotoxic t cells reacting against foreign MHCs
PMNs recruited by IL-8 to clear infxns
SLE - nonspecific
Corticomedullary junction
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate

15. Which type of hypersens rxn is antibody mediated?
II
Help B cells make antibody - secrete IFN gamma to activate macs
Bruton's agamma
Major shift minor drift

16. Which portion of the antibody determines the isotype
Fc
IgG
IV
Everything else - not right arm and right half of head

17. What are the 3 funxtions of antibodies?
SLE
Hyper IgM
Opsonization - neutralization and complement activation
Pemphigus vulgaris

18. What do mature B lymphos express on their surface?
IgM and IgD
Pemphigus vulgaris
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
CD8 cells

19. p - ANCA
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells
RA
IV
Other vasculitidies

20. Defect in DNA repair enzymes
II
Corticomedullary junction
Bruton's agamma
Ataxia telangectasia

21. HLA- DR4
Howell - Jolly bodies - Target cells - thrombocytosis
No - peptides only can can be presented on MHC molecules
Leukocyte adhesion deficiency type 1
RA - DM type 1

22. What happens in the follicle of the lymph node
Howell - Jolly bodies - Target cells - thrombocytosis
B cell localization and proliferation
Upper limb and breast
IgG

23. Anticentromere
Chronic mucocutaneaous candidiasis
Scleroderma CREST
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
Pernicious anemia (to B12 def) - hashimotos thyroiditis

24. Defect in B cell maturation
IgG - IgM GM makes classic cars
SLE
Common variable immunodeficiency (CVID)
Selective Ig def - IgA most common

25. Which antibody mediates a type Hypersens rxn?
IV
Fab
IgE
III

26. Which cytokine induces Th2 cell profile in CD4 cells
SCID
Il -4
Trypanosomes - programmed rearrangement
Chediak Higashi

27. Which parts of the antibody to light chain contribute
Fab
Pemphigus vulgaris
Opsonization - neutralization and complement activation
PAIR - psoriasis - ankylosing spondylitis - inflammatory bowel dz - reiter's syndrome

28. Which type of hypersens rxn is immune complex mediate
IL-1 = fever - IL-2 = T cells - IL-3 = bone marrow - IL-4 = IgE - IL-5 = IgA
III
Chronic: fibrosis of graft tissue and blood vessels
Graves' dz

29. What are the two signals required for B cells class switching?
Primary biliary cirrohosis
IgG
C3b
Signal 1 = IL-4 -5 -6 signal 2 = CD40 receptor on b cell binds CD40L on Th cell

30. Which immunoglobulin is a pentamer
APCs - and DR - DP and DQ
RA - DM type 1
IgM
IgM and IgD

31. antimicrosomal - antithyroglobulin
Scleroderma diffuse
RA - DM type 1
Hashimotos
Common variable immunodeficiency (CVID)

32. What does a deficiency in C1 esterase inhibitor lead to?
IgM and IgD
Hereditary angioedema
Steroid - responsive nephrotic syndrome
PAIR - psoriasis - ankylosing spondylitis - inflammatory bowel dz - reiter's syndrome

33. What are the cell surface receptors on MACS
CD56
MHC II - B7 - CD40 - CD14 - receptors for Fc and C3b
Sjorgen's syndrome
Chronic mucocutaneaous candidiasis

34. What is the role of CD4 cels
Upper limb and breast
Help B cells make antibody - secrete IFN gamma to activate macs
Selective Ig def - IgA most common
IL-12

35. Anti - IgG (RF)
IgG
RA - DM type 1
All nucleated cells (no RBCs) A - B - C
RA

36. What cytokines to Th2 cells secrete?
IL-12 - IFN- beta. IFN- alpha
Other vasculitidies
RA - DM type 1
IL-4 - 5 - 10

37. What do you find in the medulla of the thymus?
C3b
Mesenchyme
Mature t cells - epithelial reticular cells - Hassalls corpuscles
S. aureus and S. pyogenes

38. Anti Scl 70 (DNA topo I
Graves' dz
Mixed connective tissue disease
Scleroderma diffuse
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II

39. Where is MHC II expressed and and which HLA molecules codes for it
Right arm and right half of head
IL-10
APCs - and DR - DP and DQ
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement

40. What does the thoracic duct drain?
CD21
Major shift minor drift
Everything else - not right arm and right half of head
IgA

41. Which parts of the antibody to heavy chain contribute?
Fc and Fab
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
IL-4 - 5 - 10
Ataxia telangectasia

42. HLA- DR3
Hyper IgE syndrome (Job's)
DM type 1
SLE - nonspecific
IgM

43. Defectin in isotype switching
T- lymphos - Transplant - TB skin test - Touching (contact dermatitis)
Macs - dendritic cell - B cell
Selective Ig def - IgA most common
Goodpastures

44. AR - defect in microtubule fxn with decreased phagocytosis
MHC II - B7 - CD40 - CD14 - receptors for Fc and C3b
Mesenchyme
Secondary
Chediak Higashi

45. Which bacteria secrete superantigen
Drug induced lupus
Leukocyte adhesion deficiency type 1
Sjorgen's syndrome
S. aureus and S. pyogenes

46. Defect in LFA-1 integrin CD18 protein on phagocytes
IgM
MHC I
Leukocyte adhesion deficiency type 1
IgM and IgD

47. Which is the most abundant immunoglobulin in the blood?
Other vasculitidies
Opsonization - neutralization and complement activation
Prevents attachment of bacteria and viruses to mucous membranes
IgG

48. What are the two signals in cytotoxic T cells activation?
CD14
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
Fc

49. anti glutamate decarboxylase
DM type 1
Adaptive
MS - hay fever - SLE - goodpasture's
2

50. Which immunoglobulin is found in breast milk - tears - saliva - and mucous
IL-1 = fever - IL-2 = T cells - IL-3 = bone marrow - IL-4 = IgE - IL-5 = IgA
IgG
IgA
Autoimmune hepatitis