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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 interferes with viruses?
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells
III
IFN gamma
S. aureus and S. pyogenes

2. T cell dysfunction
IgG
Pemphigus vulgaris
Hereditary angioedema
Chronic mucocutaneaous candidiasis

3. Which type of hypersens rxn is serum sickness?
III
Other vasculitidies
IgG
Leukocyte adhesion deficiency type 1

4. Which cytokine induces Th2 cell profile in CD4 cells
Hyper IgE syndrome (Job's)
Scleroderma CREST
Il -4
Trypanosomes - programmed rearrangement

5. Deficiency in DAF
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
IL-1 = fever - IL-2 = T cells - IL-3 = bone marrow - IL-4 = IgE - IL-5 = IgA
Steroid - responsive nephrotic syndrome
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho

6. Which antibody (IgM or IgG) crosses the placenta?
IgG
PAIR - psoriasis - ankylosing spondylitis - inflammatory bowel dz - reiter's syndrome
APCs - and DR - DP and DQ
SCID

7. Anti ds DNA - anti Smith
Regulates the humoral response
SLE
Drug induced lupus
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II

8. What do mature B lymphos express on their surface?
Ceilac disase
DiGeorge
IgM and IgD
SCID

9. X linked recessive defect in BTK no B cell differentiation

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10. What does a deficiency in C5- C8 lead to?
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II
Neisseria bacteremia
Perforin - granzyme - granulysin
IL-12

11. Which B T cell interaction allows for immunologic memory and class switching?
CD40 and CD40L
Trypanosomes - programmed rearrangement
IgG - IgM GM makes classic cars
IgG

12. Defect in LFA-1 integrin CD18 protein on phagocytes
Fab
Leukocyte adhesion deficiency type 1
Mixed connective tissue disease
IgG

13. What does a deficiency in C3 lead to...
Hyper IgE syndrome (Job's)
Trypanosomes - programmed rearrangement
Chronic granulomatous disease
Severe pyogenic sinus and respiratory infections - inc suscept to type III hypersen rxn

14. Which infections require administering passive immunity?
RA
Common variable immunodeficiency (CVID)
Tetanus - Botulinum toxin - HBV or Rabies (To Be Healed Rapidly
Right arm and right half of head

15. What is the main function of IgA
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant
PAIR - psoriasis - ankylosing spondylitis - inflammatory bowel dz - reiter's syndrome
Signal 1 = IL-4 -5 -6 signal 2 = CD40 receptor on b cell binds CD40L on Th cell
Prevents attachment of bacteria and viruses to mucous membranes

16. What is the difference in antigenic variation in viruses
Major shift minor drift
Primary biliary cirrohosis
Fc
I

17. How are NK cells stimulated?
IL-12 - IFN- beta. IFN- alpha
CD14
S. aureus and S. pyogenes
IgA

18. What does a deficiency in C1 esterase inhibitor lead to?
Scleroderma diffuse
Hereditary angioedema
RA - DM type 1
Fab

19. What does the thoracic duct drain?
Mixed connective tissue disease
Everything else - not right arm and right half of head
IgA
MS - hay fever - SLE - goodpasture's

20. Th cells don't produce IFN gamma - no PMN response

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21. which kind of immunity is characterized by receptors that undergo VDJ recombination?
B cell localization and proliferation
Neisseria bacteremia
Adaptive
Ceilac disase

22. Which complement proteins make up the MAC
Graves' dz
Fab
C5b -9
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2

23. What are the cytokines involved in macrophage/lymphocyte interaction
2
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho
C5b -9
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7

24. What are the three things you find post splenectomy
IL-10
B cell localization and proliferation
IL-4 - 5 - 10
Howell - Jolly bodies - Target cells - thrombocytosis

25. Antimitochondrial
Help B cells make antibody - secrete IFN gamma to activate macs
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
Paracortex
Primary biliary cirrohosis

26. Which kind of immunity is germline encoded?
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
IgG
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
Innate

27. What embryologic tissue are lymphcytes derived from
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
Wegeners granulomatosis
Leukocyte adhesion deficiency type 1
Mesenchyme

28. HLA- DR3
Hyper IgM
APCs - and DR - DP and DQ
DM type 1
CD56

29. which follicles (primary or secondary) have active germinal centers?
Common variable immunodeficiency (CVID)
Secondary
Graves' dz
CD56

30. Which parts of the antibody to heavy chain contribute?
Fc and Fab
Scleroderma CREST
Paracortex
PMNs recruited by IL-8 to clear infxns

31. What cytokines to Th2 cells secrete?
Signal 1 = IL-4 -5 -6 signal 2 = CD40 receptor on b cell binds CD40L on Th cell
Goodpastures
IgM and IgD
IL-4 - 5 - 10

32. HLA- DR4
Chronic: fibrosis of graft tissue and blood vessels
RA - DM type 1
Steroid - responsive nephrotic syndrome
Leukocyte adhesion deficiency type 1

33. Which MHC complex to CD8 cells bind
MHC I
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
No - peptides only can can be presented on MHC molecules
CD56

34. transplant rejection: T cell and antibody mediated vasular damage
Chronic: fibrosis of graft tissue and blood vessels
III
S. aureus and S. pyogenes
Mixed connective tissue disease

35. Which parasites exhibit antigenic variation
Hyper IgM
Trypanosomes - programmed rearrangement
IL-12 - IFN- beta. IFN- alpha
Help B cells make antibody - secrete IFN gamma to activate macs

36. anti basement membrane
Chronic mucocutaneaous candidiasis
Goodpastures
Howell - Jolly bodies - Target cells - thrombocytosis
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho

37. X- linked recessive defect with progessive deletion of B and T cells
PMNs recruited by IL-8 to clear infxns
Wegeners granulomatosis
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM

38. Cell surface receptors on B cels
Sjorgen's syndrome
CD8 cells
Opsonization - neutralization and complement activation
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7

39. What is the clinical picture for serum sickness?
Chediak Higashi
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
DM type 1
SLE - nonspecific

40. What are the three APCs
IL-2 and IFN gamma
RA
IL-12
Macs - dendritic cell - B cell

41. Which immunoglobulin is found in breast milk - tears - saliva - and mucous
SLE - nonspecific
Poly/dermato myositis
Stomach
IgA

42. Which antibody mediates a type Hypersens rxn?
IgE
PMNs recruited by IL-8 to clear infxns
Pemphigus vulgaris
III

43. Which immunoglobulin is a pentamer
Superficial inguinal pectinate line
Innate
IgM
All nucleated cells (no RBCs) A - B - C

44. Which antibody mediates type II and type III hypersens rxn
IgG
Hyper IgM
Hyper IgE syndrome (Job's)
IgM and IgD

45. Which area of the lymph node englarges in an extreme immune response
Primary biliary cirrohosis
All nucleated cells (no RBCs) A - B - C
Paracortex
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement

46. Where is MHC I expressed - and which HLA molecules code for it
IL-12 def
All nucleated cells (no RBCs) A - B - C
Primary biliary cirrohosis
Fab

47. anti - Jo 1
Poly/dermato myositis
Innate
Ataxia telangectasia
Fab

48. thwat does the Right lymphatic duct drain?
Major shift minor drift
Right arm and right half of head
IFN gamma
DM type 1

49. Lack of NADPH oxidase - decreased in ROS - absetn respiratory burst in PMNs
Chronic granulomatous disease
IL-10
Perforin - granzyme - granulysin
Signal 1 = APC - signal 2 = B7 and CD28

50. Transplant rejection: preformed host antibody mediated
Leukocyte adhesion deficiency type 1
Hyperacute : occlusion - ischemia - necrosis
Hashimotos
Scleroderma diffuse