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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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1. Which receptor on MACS to endotoxin directy stimulate?
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II
Hyper IgM
CD14
Other vasculitidies

2. What are the three things you find post splenectomy
Howell - Jolly bodies - Target cells - thrombocytosis
Selective Ig def - IgA most common
Primary biliary cirrohosis
PMNs recruited by IL-8 to clear infxns

3. Defectin in isotype switching
Selective Ig def - IgA most common
Other vasculitidies
DM type 1
All nucleated cells (no RBCs) A - B - C

4. What does a deficiency in C1 esterase inhibitor lead to?
Perforins and granzymes to induce apoptosis of virally infected or tumor cells
Hereditary angioedema
PMNs recruited by IL-8 to clear infxns
Chronic mucocutaneaous candidiasis

5. transplant rejection cell mediated due to cytotoxic t cells reacting against foreign MHCs
Autoimmune hepatitis
IL-2 and IFN gamma
Right arm and right half of head
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate

6. anti - Jo 1
Secondary
Poly/dermato myositis
PMNs recruited by IL-8 to clear infxns
IgM and IgD

7. Antihistone
Drug induced lupus
IgG
Scleroderma diffuse
III

8. X linked IL-2 receptor defect - adenosine deaminase deficiency - failure to synthesize MHC II
Hemochromocytosis
SCID
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

9. Which type of hypersens rxn is serum sickness?
APCs - and DR - DP and DQ
IgM and IgD
III
Fc and Fab

10. Which kind of immunity is germline encoded?
CD21
Innate
IL-10
SCID

11. Transplant rejection: preformed host antibody mediated
Hyperacute : occlusion - ischemia - necrosis
Major shift minor drift
2
III

12. What are the cell surface receptors on MACS
MHC II - B7 - CD40 - CD14 - receptors for Fc and C3b
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
Fc
Hyper IgE syndrome (Job's)

13. Which parts of the antibody to light chain contribute
Upper limb and breast
CD21
Hyper IgE syndrome (Job's)
Fab

14. What does a deficiency in C3 lead to...
CD8 cells
Severe pyogenic sinus and respiratory infections - inc suscept to type III hypersen rxn
Regulates the humoral response
Mature t cells - epithelial reticular cells - Hassalls corpuscles

15. anti basement membrane
SLE
CD14
Goodpastures
IL-12 - IFN- beta. IFN- alpha

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

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17. What is the unique cell marker for NK cells
CD56
IL-12
I
Chronic: fibrosis of graft tissue and blood vessels

18. Which cell mediates the type IV hypersens rxn?
Everything else - not right arm and right half of head
IFN gamma
CD8 cells
IgG - IgM GM makes classic cars

19. Lack of NADPH oxidase - decreased in ROS - absetn respiratory burst in PMNs
Chronic granulomatous disease
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
Right arm and right half of head
Fc

20. Which type of hypersens rxn is the arthus rxn
S. aureus and S. pyogenes
Mixed connective tissue disease
III
I

21. T cell dysfunction
Hyper IgM
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho
Chronic mucocutaneaous candidiasis
DiGeorge

22. Defect in B cell maturation
C5b -9
DM type 1
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
Common variable immunodeficiency (CVID)

23. Cell surface receptors on T cells
Leukocyte adhesion deficiency type 1
IL-12
Tetanus - Botulinum toxin - HBV or Rabies (To Be Healed Rapidly
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8

24. Where do positive and negative selection occur in the thymus?
Corticomedullary junction
Mixed connective tissue disease
IgG
S. aureus and S. pyogenes

25. HLA- DR4
MHC II 4 x 2=8
RA - DM type 1
Opsonization - neutralization and complement activation
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria

26. Where is MHC I expressed - and which HLA molecules code for it
Superficial inguinal pectinate line
MHC I
All nucleated cells (no RBCs) A - B - C
Perforins and granzymes to induce apoptosis of virally infected or tumor cells

27. What is the role of CD4 cels
Scleroderma CREST
IgG
Help B cells make antibody - secrete IFN gamma to activate macs
III

28. Which cytokine induces Th2 cell profile in CD4 cells
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7
Upper limb and breast
Howell - Jolly bodies - Target cells - thrombocytosis
Il -4

29. Which complement protein opsonizes bacteria?
CD21
C3b
Bruton's agamma
CD40 and CD40L

30. Which is the most abundant immunoglobulin in the blood?
Chronic: fibrosis of graft tissue and blood vessels
Fc and Fab
Stomach
IgG

31. What are the two signals in cytotoxic T cells activation?
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
Hemochromocytosis
Major shift minor drift

32. HLA- B27

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33. How do CD8 cells kill?
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
Perforin - granzyme - granulysin
DM type 1
Common variable immunodeficiency (CVID)

34. Cell surface receptors on B cels
CD14
Help B cells make antibody - secrete IFN gamma to activate macs
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7
SLE

35. What are the cytokines involved in macrophage/lymphocyte interaction
C3b
SLE
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant

36. What is the arthus rxn?
Neisseria bacteremia
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
All nucleated cells (no RBCs) A - B - C
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant

37. What embryologic tissue are lymphcytes derived from
Hemochromocytosis
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Chediak Higashi
Mesenchyme

38. Which complement proteins make up the MAC
APCs - and DR - DP and DQ
Bruton's agamma
Steroid - responsive nephrotic syndrome
C5b -9

39. HLA- DR7
III
IgM and IgD
IgG
Steroid - responsive nephrotic syndrome

40. Which portion of the antibody determines the isotype
Fc
CD56
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
IL-4 - 5 - 10

41. Anti Scl 70 (DNA topo I
Scleroderma diffuse
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells
CD21
Hyperacute : occlusion - ischemia - necrosis

42. Which area of the lymph node englarges in an extreme immune response
Paracortex
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
Il -4
Right arm and right half of head

43. Which bacteria secrete superantigen
S. aureus and S. pyogenes
Everything else - not right arm and right half of head
CD8 cells
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure

44. transplant rejection: grafted immunocompetent T cells from donor proliferate and attack host cells
PAIR - psoriasis - ankylosing spondylitis - inflammatory bowel dz - reiter's syndrome
I
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant
Neisseria bacteremia

45. which areas of the body are drained by the celiac lymph node?
IgM
Tetanus - Botulinum toxin - HBV or Rabies (To Be Healed Rapidly
Fc
Stomach

46. antimicrosomal - antithyroglobulin
Major shift minor drift
Hashimotos
SLE
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8

47. Which cytokines to Th1 cells secrete?
Innate
Steroid - responsive nephrotic syndrome
Secondary
IL-2 and IFN gamma

48. Which lymph node drains the anal canal below
Superficial inguinal pectinate line
Howell - Jolly bodies - Target cells - thrombocytosis
Major shift minor drift
T- lymphos - Transplant - TB skin test - Touching (contact dermatitis)

49. Which parts of the antibody to heavy chain contribute?
Everything else - not right arm and right half of head
Fc and Fab
DM type 1
Scleroderma CREST

50. How many signals are required for T cell activation or B cell class switching?
Signal 1 = IL-4 -5 -6 signal 2 = CD40 receptor on b cell binds CD40L on Th cell
2
Hereditary angioedema
T- lymphos - Transplant - TB skin test - Touching (contact dermatitis)