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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 is the difference in antigenic variation in viruses
Pernicious anemia (to B12 def) - hashimotos thyroiditis
Major shift minor drift
PAIR - psoriasis - ankylosing spondylitis - inflammatory bowel dz - reiter's syndrome
IgM and IgD

2. How do NK cells kill?
Mixed connective tissue disease
Perforins and granzymes to induce apoptosis of virally infected or tumor cells
Pernicious anemia (to B12 def) - hashimotos thyroiditis
Chronic mucocutaneaous candidiasis

3. anti basement membrane
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho
Goodpastures
Upper limb and breast
IgG

4. Cell surface receptors on B cels
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7
IgG
Ceilac disase
Right arm and right half of head

5. Which lymph node drains the anal canal below
Common variable immunodeficiency (CVID)
Perforins and granzymes to induce apoptosis of virally infected or tumor cells
IgA
Superficial inguinal pectinate line

6. X- linked recessive defect with progessive deletion of B and T cells
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho
Pemphigus vulgaris

7. Which type of hypersens rxn is serum sickness?
III
Ceilac disase
Fc
Chediak Higashi

8. Which parts of the antibody to heavy chain contribute?
Fc and Fab
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
Autoimmune hepatitis
IL-4 - 5 - 10

9. Transplant rejection: preformed host antibody mediated
IL-4 - 5 - 10
Hyperacute : occlusion - ischemia - necrosis
Encapsulated - S SHiN (salmonella - S.pneumo - H. influ - N. menin
Poly/dermato myositis

10. What is the unique cell marker for NK cells
Signal 1 = APC - signal 2 = B7 and CD28
IgG
All nucleated cells (no RBCs) A - B - C
CD56

11. What does a deficiency in C5- C8 lead to?
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
IgA
Neisseria bacteremia
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure

12. How many signals are required for T cell activation or B cell class switching?
CD56
Right arm and right half of head
PMNs recruited by IL-8 to clear infxns
2

13. anti U1 RNP
RA - DM type 1
Chronic mucocutaneaous candidiasis
Mixed connective tissue disease
SLE - nonspecific

14. Which parasites exhibit antigenic variation
PAIR - psoriasis - ankylosing spondylitis - inflammatory bowel dz - reiter's syndrome
Chronic mucocutaneaous candidiasis
Trypanosomes - programmed rearrangement
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure

15. Where is MHC I expressed - and which HLA molecules code for it
PMNs recruited by IL-8 to clear infxns
All nucleated cells (no RBCs) A - B - C
IFN gamma
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7

16. Defect in CD40L on helper T
II
CD21
Hyper IgM
Innate

17. What are the two signals required for B cells class switching?
Corticomedullary junction
S. aureus and S. pyogenes
Signal 1 = IL-4 -5 -6 signal 2 = CD40 receptor on b cell binds CD40L on Th cell
PMNs recruited by IL-8 to clear infxns

18. What does a deficiency in C3 lead to...
IgG
Pemphigus vulgaris
Severe pyogenic sinus and respiratory infections - inc suscept to type III hypersen rxn
Drug induced lupus

19. p - ANCA
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Other vasculitidies
III
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2

20. Can lipopolysaccharide from cell envelope of of gram neg bacteria induce immunologic memory?
No - peptides only can can be presented on MHC molecules
Scleroderma CREST
Wegeners granulomatosis
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II

21. What cytokines to Th2 cells secrete?
IL-4 - 5 - 10
Howell - Jolly bodies - Target cells - thrombocytosis
DiGeorge
Drug induced lupus

22. What are the 3 funxtions of antibodies?
IgM and IgD
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho
IgG - IgM GM makes classic cars
Opsonization - neutralization and complement activation

23. What does a deficiency in C1 esterase inhibitor lead to?
Autoimmune hepatitis
CD40 and CD40L
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells
Hereditary angioedema

24. ANA
Ceilac disase
Other vasculitidies
Fc
SLE - nonspecific

25. Which type of hypersens rxn is delayed
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
IV
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant
Right arm and right half of head

26. How are NK cells stimulated?
IL-12 - IFN- beta. IFN- alpha
All nucleated cells (no RBCs) A - B - C
IgG
Scleroderma diffuse

27. What are the three APCs
Chronic: fibrosis of graft tissue and blood vessels
Macs - dendritic cell - B cell
Help B cells make antibody - secrete IFN gamma to activate macs
IFN gamma

28. What does clean up on Aisle 8 stand for?
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II
Paracortex
PMNs recruited by IL-8 to clear infxns
Innate

29. What does the Th2 response do?
Steroid - responsive nephrotic syndrome
IgG
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
Regulates the humoral response

30. transplant rejection: T cell and antibody mediated vasular damage
IgM and IgD
IFN gamma
Bruton's agamma
Chronic: fibrosis of graft tissue and blood vessels

31. HLA- A3
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
Hemochromocytosis
Graves' dz
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM

32. What are the two signals in cytotoxic T cells activation?
Wegeners granulomatosis
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
CD14
C3b

33. What do mature B lymphos express on their surface?
MHC II 4 x 2=8
III
IgM and IgD
B cell localization and proliferation

34. What inhibits Th2 cells
IFN gamma
Ataxia telangectasia
Fc
Chronic: fibrosis of graft tissue and blood vessels

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

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36. Which antibodies activate the classic pathway
IgG - IgM GM makes classic cars
Corticomedullary junction
SLE - nonspecific
CD56

37. Which immunoglobulin is found in breast milk - tears - saliva - and mucous
Drug induced lupus
IL-12 def
III
IgA

38. What is the role of CD4 cels
Help B cells make antibody - secrete IFN gamma to activate macs
SLE
Paracortex
Chronic granulomatous disease

39. Which complement protein opsonizes bacteria?
Fab
C3b
Common variable immunodeficiency (CVID)
IgA

40. transplant rejection cell mediated due to cytotoxic t cells reacting against foreign MHCs
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
IL-12
Hemochromocytosis
Opsonization - neutralization and complement activation

41. HLA- DR7
Help B cells make antibody - secrete IFN gamma to activate macs
SCID
Steroid - responsive nephrotic syndrome
Leukocyte adhesion deficiency type 1

42. 22q11 deletion - failure of 3rd and 4th pharyngeal arches
DiGeorge
Scleroderma CREST
APCs - and DR - DP and DQ
Other vasculitidies

43. 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
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho
2
IV

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

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45. Which antibody (IgM or IgG) crosses the placenta?
Hashimotos
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM
MHC I
IgG

46. Which MHC complex to CD4 cells bind
IL-1 = fever - IL-2 = T cells - IL-3 = bone marrow - IL-4 = IgE - IL-5 = IgA
MHC II 4 x 2=8
Paracortex
B cell localization and proliferation

47. Which type of hypersens rxn is immune complex mediate
CD8 cells
IL-12 - IFN- beta. IFN- alpha
III
Salmonella - 2 flaggellar variants - Borrelia - relapsing fever - N. gono - pilus protein

48. Which B T cell interaction allows for immunologic memory and class switching?
Fc and Fab
C3b
CD40 and CD40L
DM type 1

49. HLA- DR4
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II
IFN gamma
RA - DM type 1
Help B cells make antibody - secrete IFN gamma to activate macs

50. Antihistone
DM type 1
Drug induced lupus
IgM and IgD
IgE