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Immunology

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Answer 50 questions in 15 minutes.
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1. What are the 3 funxtions of antibodies?
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant
Hashimotos
Opsonization - neutralization and complement activation
IgG

2. How many signals are required for T cell activation or B cell class switching?
IgA
Primary biliary cirrohosis
Hyper IgE syndrome (Job's)
2

3. What is the arthus rxn?
APCs - and DR - DP and DQ
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
CD8 cells
Wegeners granulomatosis

4. What does the thoracic duct drain?
C5b -9
Hyper IgE syndrome (Job's)
CD56
Everything else - not right arm and right half of head

5. Which kind of immunity is germline encoded?
Hyper IgM
IgG
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
Innate

6. What is the clinical picture for serum sickness?
IFN gamma
Hyperacute : occlusion - ischemia - necrosis
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
IgM and IgD

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

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8. HLA- DR7
Encapsulated - S SHiN (salmonella - S.pneumo - H. influ - N. menin
Steroid - responsive nephrotic syndrome
Other vasculitidies
Right arm and right half of head

9. c - ANCA
Selective Ig def - IgA most common
DiGeorge
Wegeners granulomatosis
IgM and IgD

10. X- linked recessive defect with progessive deletion of B and T cells
Wilskott Aldrich (TIE = thrombocytopenia - infections - eczema) high IgE and IgA - low IgM
III
IgG
Mesenchyme

11. What are the cell surface receptors on MACS
Neisseria bacteremia
Graves' dz
MHC II - B7 - CD40 - CD14 - receptors for Fc and C3b
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant

12. Where is MHC I expressed - and which HLA molecules code for it
Ceilac disase
All nucleated cells (no RBCs) A - B - C
Mesenchyme
IL-2 and IFN gamma

13. Defect in LFA-1 integrin CD18 protein on phagocytes
Leukocyte adhesion deficiency type 1
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
Superficial inguinal pectinate line
Graft versus host: severe organ dysfunction - maculopapular rash - jaundice - hepatosplenomegaly - diarrhea often in bone marrown and liver transplant

14. Cell surface receptors on B cels
Chronic granulomatous disease
Ig - CD19 - 20 - 21 - CD40 - MHCII - B7
Hyperacute : occlusion - ischemia - necrosis
Signal 1 = IL-4 -5 -6 signal 2 = CD40 receptor on b cell binds CD40L on Th cell

15. which areas of the body are drained by the celiac lymph node?
Stomach
Paracortex
DM type 1
Fab

16. Which antibody mediates type II and type III hypersens rxn
APCs - and DR - DP and DQ
Innate
IgG
Mixed connective tissue disease

17. Defect in DNA repair enzymes
Ataxia telangectasia
CD14
IL-10
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria

18. Antihistone
Prevents attachment of bacteria and viruses to mucous membranes
IgM and IgD
IgG
Drug induced lupus

19. Anti Scl 70 (DNA topo I
SLE
Scleroderma diffuse
S. aureus and S. pyogenes
MHC I

20. Which immunoglobulin is a pentamer
C5b -9
IgM
Adaptive
SLE

21. Defectin in isotype switching
Hashimotos
Selective Ig def - IgA most common
Major shift minor drift
Perforin - granzyme - granulysin

22. What kind of bacteria do macrophages remove from the spleen?
Fab
Innate
Encapsulated - S SHiN (salmonella - S.pneumo - H. influ - N. menin
CD56

23. Which type of hypersens rxn is serum sickness?
Chronic mucocutaneaous candidiasis
III
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
Corticomedullary junction

24. Which antibody mediates a type Hypersens rxn?
DM type 1
IgE
MHC II - B7 - CD40 - CD14 - receptors for Fc and C3b
IL-1 = fever - IL-2 = T cells - IL-3 = bone marrow - IL-4 = IgE - IL-5 = IgA

25. anti U1 RNP
Mixed connective tissue disease
DM type 1
IL-12 - IFN- beta. IFN- alpha
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho

26. Which immunoglobulin is found in breast milk - tears - saliva - and mucous
Wegeners granulomatosis
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
IgA
IL-1 = fever - IL-2 = T cells - IL-3 = bone marrow - IL-4 = IgE - IL-5 = IgA

27. Which cell mediates the type IV hypersens rxn?
CD8 cells
II
Hereditary angioedema
Regulates the humoral response

28. Where is MHC II expressed and and which HLA molecules codes for it
Fab
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate
APCs - and DR - DP and DQ
Drug induced lupus

29. X linked IL-2 receptor defect - adenosine deaminase deficiency - failure to synthesize MHC II
Everything else - not right arm and right half of head
Hyper IgE syndrome (Job's)
SCID
Signal 1 = APC - signal 2 = B7 and CD28

30. HLA- DR3
DM type 1
MHC II 4 x 2=8
C5b -9
Interfereon alpha - beta gamma. Alpha/beta inhibit viral protein synthesis - gamma upregulate MHC I and II - all three activate NK cells

31. What does clean up on Aisle 8 stand for?
PMNs recruited by IL-8 to clear infxns
Chronic: fibrosis of graft tissue and blood vessels
Complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria
Drug induced lupus

32. Defect in B cell maturation
Corticomedullary junction
CD56
Uncoordinated release of IFN gamm leading to IL-1 - IL 6 and TNF alpha from MACS - via crosslinking of TCR and MHC II
Common variable immunodeficiency (CVID)

33. Which cytokine induces Th1 cell profile in CD4 cells
I
II
IL-12
Mixed connective tissue disease

34. Can lipopolysaccharide from cell envelope of of gram neg bacteria induce immunologic memory?
No - peptides only can can be presented on MHC molecules
IL-4 - 5 - 10
S. aureus and S. pyogenes
Innate

35. HLA- DR4
Hyperacute : occlusion - ischemia - necrosis
Graves' dz
Scleroderma diffuse
RA - DM type 1

36. What do you find in the medulla of the thymus?
IL-12 def
Mature t cells - epithelial reticular cells - Hassalls corpuscles
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho
IL-2 and IFN gamma

37. How are NK cells stimulated?
PMNs recruited by IL-8 to clear infxns
IL-12 - IFN- beta. IFN- alpha
Regulates the humoral response
MHC II 4 x 2=8

38. AR - defect in microtubule fxn with decreased phagocytosis
IgG
Selective Ig def - IgA most common
Opsonization - neutralization and complement activation
Chediak Higashi

39. Which MHC complex to CD8 cells bind
Scleroderma diffuse
Selective Ig def - IgA most common
MHC I
Regulates the humoral response

40. Anticentromere
Scleroderma CREST
CD3 - CD28 - helper t - CD4 - CD40L - cyto t CD8
Prevents attachment of bacteria and viruses to mucous membranes
Opsonization - neutralization and complement activation

41. HLA- D2

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42. antimicrosomal - antithyroglobulin
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
Hashimotos
Pemphigus vulgaris

43. Which antibody (IgM or IgG) crosses the placenta?
Stomach
CD40 and CD40L
Selective Ig def - IgA most common
IgG

44. antigliadin - antiendomysial
S. aureus and S. pyogenes
IL-12 def
Fab
Ceilac disase

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

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46. anti - Jo 1
Poly/dermato myositis
Macs - dendritic cell - B cell
Common variable immunodeficiency (CVID)
IgG - IgM GM makes classic cars

47. What are the cytokines involved in macrophage/lymphocyte interaction
Graves' dz
Type III hypersens rxn after intradermal rxn with antigen - antibodies in the skin causing edema - necrosis and activation of complement
Superficial inguinal pectinate line
IFN gamma from lymph activate MAC - IL-1 and TNF alpha from MAC activate lympho

48. Anti ds DNA - anti Smith
Ataxia telangectasia
RA - DM type 1
DM type 1
SLE

49. What are the classic example of bacterial antigen variation and the unique mechanims
Right arm and right half of head
Caused by drugs mostly - fever - urticaria - arthralgias - proteinuria - lymphadenopathy 5-10 days after exposure
Poly/dermato myositis
Salmonella - 2 flaggellar variants - Borrelia - relapsing fever - N. gono - pilus protein

50. What kind of hypersens rxn in anaphylaxis
I
IL-12 - IFN- beta. IFN- alpha
Scleroderma CREST
Acute: vasculitis of graft vessels and interstitial lymphcytic infiltrate

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