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Immunology

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Answer 50 questions in 15 minutes.
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1. What are the two signals in cytotoxic T cells activation?
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
Scleroderma diffuse
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
CD14

2. What does clean up on Aisle 8 stand for?
Pernicious anemia (to B12 def) - hashimotos thyroiditis
PMNs recruited by IL-8 to clear infxns
Common variable immunodeficiency (CVID)
Superficial inguinal pectinate line

3. c - ANCA
Wegeners granulomatosis
Perforin - granzyme - granulysin
Selective Ig def - IgA most common
Innate

4. which areas of the body are drained by the celiac lymph node?
SLE - nonspecific
2
III
Stomach

5. What does a deficiency in C3 lead to...
Macs - dendritic cell - B cell
APCs - and DR - DP and DQ
Chronic: fibrosis of graft tissue and blood vessels
Severe pyogenic sinus and respiratory infections - inc suscept to type III hypersen rxn

6. Which B T cell interaction allows for immunologic memory and class switching?
CD40 and CD40L
Macs - dendritic cell - B cell
IgG
Severe pyogenic sinus and respiratory infections - inc suscept to type III hypersen rxn

7. 22q11 deletion - failure of 3rd and 4th pharyngeal arches
SLE
IgA
DiGeorge
DM type 1

8. Defect in LFA-1 integrin CD18 protein on phagocytes
CD8 cells
Leukocyte adhesion deficiency type 1
CD40 and CD40L
Poly/dermato myositis

9. anti basement membrane
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
DM type 1
Chronic mucocutaneaous candidiasis
Goodpastures

10. What are the 3 funxtions of antibodies?
Opsonization - neutralization and complement activation
Chronic granulomatous disease
CD56
SCID

11. Anti - IgG (RF)
MS - hay fever - SLE - goodpasture's
Prevents attachment of bacteria and viruses to mucous membranes
Il -4
RA

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

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13. X linked IL-2 receptor defect - adenosine deaminase deficiency - failure to synthesize MHC II
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant
Ataxia telangectasia
Paracortex
SCID

14. Which type of hypersens rxn is immune complex mediate
IFN gamma
III
Innate
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement

15. What embryologic tissue are lymphcytes derived from
MHC II 4 x 2=8
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM
Mesenchyme
III

16. Anticentromere
III
Scleroderma CREST
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
Severe pyogenic sinus and respiratory infections - inc suscept to type III hypersen rxn

17. antismooth muscle
Autoimmune hepatitis
APCs - and DR - DP and DQ
Encapsulated - S SHiN (salmonella - S.pneumo - H. influ - N. menin
CD21

18. Which cytokines to Th1 cells secrete?
Ceilac disase
I
IL-2 and IFN gamma
CD8 cells

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

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20. What are the two signals in helper T activation?
IFN gamma
Signal 1 = APC - signal 2 = B7 and CD28
IL-2 and IFN gamma
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II

21. How do NK cells kill?
Hyper IgE syndrome (Job's)
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Common variable immunodeficiency (CVID)
Perforins and granzymes to induce apoptosis of virally infected or tumor cells

22. antigliadin - antiendomysial
IgG
Neisseria bacteremia
Everything else - not right arm and right half of head
Ceilac disase

23. What are the classic example of bacterial antigen variation and the unique mechanims
III
Salmonella - 2 flaggellar variants - Borrelia - relapsing fever - N. gono - pilus protein
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7
Trypanosomes - programmed rearrangement

24. HLA- DR7
IgM
Help B cells make antibody - secrete IFN gamma to activate macs
Steroid - responsive nephrotic syndrome
IgE

25. What cytokines to Th2 cells secrete?
Trypanosomes - programmed rearrangement
IL-4 - 5 - 10
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM
Fc

26. What is the clinical picture for serum sickness?
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
IgA
MHC II 4 x 2=8
Fc

27. Which immunoglobulin is a pentamer
I
S. aureus and S. pyogenes
IgM
Graves' dz

28. What do you find in the medulla of the thymus?
IgM and IgD
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
III
Mature t cells - epithelial reticular cells - Hassalls corpuscles

29. What is the unique cell marker for NK cells
IL-1 = fever - IL-2 = T cells - IL-3 = bone marrow - IL-4 = IgE - IL-5 = IgA
CD56
Perforin - granzyme - granulysin
Hyper IgM

30. Transplant rejection: preformed host antibody mediated
RA - DM type 1
Hyperacute : occlusion - ischemia - necrosis
DM type 1
Ataxia telangectasia

31. What are the three APCs
SLE - nonspecific
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant
Macs - dendritic cell - B cell
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho

32. Antimitochondrial
IgA
III
Fab
Primary biliary cirrohosis

33. Which is the most abundant immunoglobulin in the blood?
I
Primary biliary cirrohosis
IgG
IL-2 and IFN gamma

34. Defectin in isotype switching
Scleroderma CREST
Selective Ig def - IgA most common
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
Fab

35. How are NK cells stimulated?
Wegeners granulomatosis
IL-12 - IFN- beta. IFN- alpha
DiGeorge
Trypanosomes - programmed rearrangement

36. What is the difference in antigenic variation in viruses
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
Major shift minor drift

37. p - ANCA
Signal 1 =peptide expressed on MHC I - signal 2 = Il -2
Other vasculitidies
Perforin - granzyme - granulysin
Hashimotos

38. Which complement proteins make up the MAC
S. aureus and S. pyogenes
SLE
C5b -9
Scleroderma diffuse

39. decreased Th1 response
Chronic mucocutaneaous candidiasis
IL-12 def
IgM and IgD
B cell localization and proliferation

40. Lack of NADPH oxidase - decreased in ROS - absetn respiratory burst in PMNs
IgM and IgD
CD21
Chronic granulomatous disease
All nucleated cells (no RBCs) A - B - C

41. HLA- B27

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42. transplant rejection cell mediated due to cytotoxic t cells reacting against foreign MHCs
RA
Selective Ig def - IgA most common
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
Neisseria bacteremia

43. What does the Th2 response do?
DM type 1
CD56
Regulates the humoral response
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7

44. anti glutamate decarboxylase
DM type 1
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant
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 from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho

45. Which cell mediates the type IV hypersens rxn?
Hyperacute : occlusion - ischemia - necrosis
CD8 cells
Hashimotos
B cell localization and proliferation

46. Anti Scl 70 (DNA topo I
III
Scleroderma diffuse
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
IgM

47. HLA- A3
Stomach
DM type 1
IFN gamma
Hemochromocytosis

48. HLA- B8

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49. Defect in B cell maturation
Corticomedullary junction
Common variable immunodeficiency (CVID)
Trypanosomes - programmed rearrangement
IgE

50. Anti ds DNA - anti Smith
SLE
CD14
DM type 1
Neisseria bacteremia

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