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Immunology

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Answer 50 questions in 15 minutes.
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1. What interferes with viruses?
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Innate
RA - DM type 1

2. What are the two signals in helper T activation?
IgE
Macs - dendritic cell - B cell
Signal 1 = APC - signal 2 = B7 and CD28
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant

3. Which areas of the body are drained by the axillary lymph node
Upper limb and breast
MHC II 4 x 2=8
Ceilac disase
C5b -9

4. Anti Scl 70 (DNA topo I
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
Trypanosomes - programmed rearrangement
CD56
Scleroderma diffuse

5. Where is MHC I expressed - and which HLA molecules code for it
Perforins and granzymes to induce apoptosis of virally infected or tumor cells
All nucleated cells (no RBCs) A - B - C
Scleroderma CREST
MHC II 4 x 2=8

6. Antihistone
Drug induced lupus
MHC II - B7 - CD40 - CD14 - receptors for Fc and C3b
IV
Right arm and right half of head

7. Which kind of immunity is germline encoded?
CD56
Innate
Fab
Fc and Fab

8. What are the three things you find post splenectomy
SLE
Howell - Jolly bodies - Target cells - thrombocytosis
MHC II 4 x 2=8
IL-10

9. What is the role of CD4 cels
Help B cells make antibody - secrete IFN gamma to activate macs
Bruton's agamma
III
Macs - dendritic cell - B cell

10. transplant rejection: grafted immunocompetent T cells from donor proliferate and attack host cells
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant
Wegeners granulomatosis
Signal 1 = APC - signal 2 = B7 and CD28
Encapsulated - S SHiN (salmonella - S.pneumo - H. influ - N. menin

11. What kind of hypersens rxn in anaphylaxis
I
Stomach
Tetanus - Botulinum toxin - HBV or Rabies (To Be Healed Rapidly
Drug induced lupus

12. What is the difference in antigenic variation in viruses
Major shift minor drift
RA - DM type 1
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
Mixed connective tissue disease

13. How do CD8 cells kill?
APCs - and DR - DP and DQ
Perforin - granzyme - granulysin
Chronic granulomatous disease
Signal 1 = IL-4 -5 -6 signal 2 = CD40 receptor on b cell binds CD40L on Th cell

14. What does the Th2 response do?
Signal 1 = IL-4 -5 -6 signal 2 = CD40 receptor on b cell binds CD40L on Th cell
IgG
Regulates the humoral response
IL-4 - 5 - 10

15. HLA- DR3
DM type 1
MHC I
IgG
Pernicious anemia (to B12 def) - hashimotos thyroiditis

16. What are the classic example of bacterial antigen variation and the unique mechanims
IL-1 = fever - IL-2 = T cells - IL-3 = bone marrow - IL-4 = IgE - IL-5 = IgA
Steroid - responsive nephrotic syndrome
Salmonella - 2 flaggellar variants - Borrelia - relapsing fever - N. gono - pilus protein
Graves' dz

17. Can lipopolysaccharide from cell envelope of of gram neg bacteria induce immunologic memory?
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
Everything else - not right arm and right half of head
I
No - peptides only can can be presented on MHC molecules

18. Which parts of the antibody to heavy chain contribute?
DM type 1
Fc and Fab
Signal 1 = APC - signal 2 = B7 and CD28
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells

19. What do superantigens do?
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
Primary biliary cirrohosis
Mixed connective tissue disease

20. Which B T cell interaction allows for immunologic memory and class switching?
Autoimmune hepatitis
III
CD40 and CD40L
IgE

21. anti - Jo 1
No - peptides only can can be presented on MHC molecules
Steroid - responsive nephrotic syndrome
Fab
Poly/dermato myositis

22. Which cell mediates the type IV hypersens rxn?
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
III
Hemochromocytosis
CD8 cells

23. What does clean up on Aisle 8 stand for?
IL-4 - 5 - 10
Mature t cells - epithelial reticular cells - Hassalls corpuscles
PMNs recruited by IL-8 to clear infxns
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells

24. HLA- DR4
IgG
Mesenchyme
RA - DM type 1
Corticomedullary junction

25. Deficiency in DAF
Hemochromocytosis
Stomach
IgM and IgD
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria

26. Which parasites exhibit antigenic variation
III
Ataxia telangectasia
Trypanosomes - programmed rearrangement
IL-12

27. Which immunoglobulin is a pentamer
Fab
IgM
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM
Hashimotos

28. What is the arthus rxn?
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells
Signal 1 = APC - signal 2 = B7 and CD28

29. anti SS A/B or anti Ro/La

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30. What does a deficiency in C1 esterase inhibitor lead to?
Perforin - granzyme - granulysin
Hyperacute : occlusion - ischemia - necrosis
Hereditary angioedema
Tetanus - Botulinum toxin - HBV or Rabies (To Be Healed Rapidly

31. What is the clinical picture for serum sickness?
Bruton's agamma
SLE
S. aureus and S. pyogenes
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure

32. anti basement membrane
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
Goodpastures
IgG

33. antismooth muscle
Autoimmune hepatitis
PAIR - psoriasis - ankylosing spondylitis - inflammatory bowel dz - reiter's syndrome
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7
Hereditary angioedema

34. Which immunoglobulin is found in breast milk - tears - saliva - and mucous
Hyper IgE syndrome (Job's)
IgA
SLE
Everything else - not right arm and right half of head

35. What happens in the follicle of the lymph node
C3b
DM type 1
B cell localization and proliferation
Other vasculitidies

36. What are the 4 T's of type IV hypersense
IgE
MHC I
T- lymphos - Transplant - TB skin test - Touching (contact dermatitis)
Severe pyogenic sinus and respiratory infections - inc suscept to type III hypersen rxn

37. Transplant rejection: preformed host antibody mediated
Neisseria bacteremia
2
Adaptive
Hyperacute : occlusion - ischemia - necrosis

38. AR - defect in microtubule fxn with decreased phagocytosis
Poly/dermato myositis
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
Chediak Higashi
RA

39. Defect in DNA repair enzymes
III
Ataxia telangectasia
III
Stomach

40. Defect in CD40L on helper T
Hyper IgM
Common variable immunodeficiency (CVID)
Pemphigus vulgaris
SCID

41. Which complement protein opsonizes bacteria?
Pernicious anemia (to B12 def) - hashimotos thyroiditis
C3b
Trypanosomes - programmed rearrangement
IgG

42. How are NK cells stimulated?
Severe pyogenic sinus and respiratory infections - inc suscept to type III hypersen rxn
IgG
IL-12 - IFN- beta. IFN- alpha
CD21

43. HLA- A3
Hemochromocytosis
Steroid - responsive nephrotic syndrome
Primary biliary cirrohosis
Fab

44. What does a deficiency in C5- C8 lead to?
Pemphigus vulgaris
Neisseria bacteremia
Sjorgen's syndrome
Paracortex

45. transplant rejection: T cell and antibody mediated vasular damage
IgG
III
Chronic: fibrosis of graft tissue and blood vessels
IL-12

46. Which portion of the antibody determines the isotype
Encapsulated - S SHiN (salmonella - S.pneumo - H. influ - N. menin
Fc
IL-1 = fever - IL-2 = T cells - IL-3 = bone marrow - IL-4 = IgE - IL-5 = IgA
PAIR - psoriasis - ankylosing spondylitis - inflammatory bowel dz - reiter's syndrome

47. Which cytokine inhibits Th1 cells
IL-10
Perforins and granzymes to induce apoptosis of virally infected or tumor cells
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM

48. X- linked recessive defect with progessive deletion of B and T cells
Howell - Jolly bodies - Target cells - thrombocytosis
Steroid - responsive nephrotic syndrome
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM

49. Which parts of the antibody to light chain contribute
T- lymphos - Transplant - TB skin test - Touching (contact dermatitis)
Fab
Hashimotos
SLE

50. Which antibodies activate the classic pathway
PMNs recruited by IL-8 to clear infxns
IgG - IgM GM makes classic cars
Wegeners granulomatosis
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2

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