Immuno
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| Lymph Node Organization | Cortex Follicle: B Cells (Inactive & Germinal), Paracortex: T Cells, Medullary Sinus: Macrophages, Medullary Cords: Plasma Cells. | ||||
| Lateral dorsal foot lymph drainage | Popliteal nodes. | ||||
| Lymph drainage of anal canal above & below pectinate line | Internal Illiac, Superficial inguinal | ||||
| Upper limb & lateral breast lymph drainage | Axillary Nodes | ||||
| Spleen Sinusoid Organization | Arteriole -> White Pulp PeriArterial Lymphatic Sheath (T Cells) -> White Pulp: (B cells) -> Marginal zone (macrophages) -> Red pulp (RBCs, T Cells) | ||||
| Innate Immunity | Neutrophils, Macs & Dendritics, Complement. | ||||
| Adaptive Immunity | T Cells & B Cells | ||||
| Th1 Cells | Induced by IL-12. Make IL-2, IFN-gamma, activate macrophages & CD8s. | ||||
| Th2 Cell | Induced by IL-4. Make Il-4,5, B Cell IgE>IgG. Inhibited by IFN-gamma | ||||
| IgG | Opsonize bacteria. Induce Cytotoxic MAC attack (Type 2 Hypersensitivity) & Immune Complex (Type 3 hypersensitivity). | ||||
| IgE | Induce Type 1 Allergic Hypersensitivity | ||||
| IL-2 | Th Cells-> Cytotoxic & Th cell growth | ||||
| B Cell Receptor | CD 19, 20, 21 & 40; B7 | ||||
| Macrophage Receptors | B7, CD40, CD 14, Fc & C3b receptors | ||||
| NK Cells | CD16, CD 56 | ||||
| T Cell Receptors | CD3, 4, 8, 28, CD40L | ||||
| APC Receptor | B7, CD14 | ||||
| Terminal Deoxynucleotidyl Transferase | Utilized to produce antibody diversity. | ||||
| IL-1 | Macrophages -> Inflammation & chemokine production | ||||
| IL-3 | Activated T Cells -> Bone marrow stem cells (like GM-CSF) | ||||
| IL-4 | Th2 Cells ->B Cell growth, IgG & IgE | ||||
| IL-5 | Th2 Cells -> B Cell differentiation, IgA, Eosinophil activation | ||||
| IL-6 | Th2 Cells & Macrophages -> Acute Phase Reactants, Ig production | ||||
| IL-8 | Macrophages -> Neutrophil chemotaxis | ||||
| IL-10 | Tr Cells -> Inhibit Th1 cells | ||||
| IL-12 (+ deficiency) | B Cells & Macrophages -> Th1 & NK cell stimulation. LOF-> mycobacterial infx. | ||||
| IFN-Alpha, Beta, Gamma | General: NK Activation. Alpha & Beta: Inhibits viral protein synthesis. Gamma: Th1 cells -> Macrophage stimulation, inhibits TH2 cells, amps up MHC I, II expression | ||||
| TNF | Macrophages -> Septic shock & vascular leak, leukocyte recruitment | ||||
| Macrophage Cytokines: | IL-1, IL-8, IL-12, TNF | ||||
| Th2 Cytokines | IL-4, IL-5, IL-6 | ||||
| Antiviral Complement | C1,2,3 & 4 | ||||
| Anaphylactic/Inflammatory Complement | C3a, 5a | ||||
| Neutrophil Chemotaxis Complement | C5a | ||||
| MAC ATTACK! | C5b-C9 | ||||
| C1 Esterase Deficiency | Angioedema Kalikrein –(C1)-> Bradykinin | ||||
| C3 Deficiency | Recurrent pyogenic respiratory infections (H. Flu, Pneumococcus) | ||||
| C6-C8 Deficiency | Neisseria bacteremia- no MAC | ||||
| DAF deficiency | Paroxysmal nocturnal hemoglobinuria (Lack of RBC MAC inhibition) | ||||
| Passive Immunity | Ig administered to patients w/ Botulinum, Tetanus, Rabies, HBV (recall report w/ Robbie). Active immunity is IS production of antibodies | ||||
| Antigenic Variation Pathogens | Salmonella (2 flagellae), Borellia (cause the relapsing fever), N Gonorrhoea (pillus protein). FLU!, Trypanosomes (Chagas, Sleeping sickness) | ||||
| Type 1 Hypersensitivity Mech | Anaphylaxis. Preformed IgE antibody -> Mast or Basophil granule release (histamine). | ||||
| Type 2 Hypersensitivity Mech | Cytotoxic: IgM/G binding->Complement MAC attack or phagocytosis of cell | ||||
| Type 3 Hypersensitivity Mech | Immune-Complex: 1) Antibody-antigen-Complement -> Neutrophil recruitment & Inflammation 2)Serum Sickness: antibody to drug. Reaction 5+ days after administration. 3)Arthus Reaction: SubQ antigen injection->edema, necrosis, complement. | ||||
| Type 4 Hypersensitivity Mech | T-Cell mediated -> macrophage recruitment. Delayed. Mechanism of TB test, transplant rejection, touching (contact dermatitis). | ||||
| Type 1 Hypersensitivity Examples | Anaphylaxis, allergic rhinitis (hay fever) | ||||
| Type 2 Hypersensitivity Examples | Hemolytic anemia, Erythroblastosis Fetalis, Idiopathic Thrombocytopenic purpura, Rheumatic Fever, Bullous pemphigoid, Graves, Myasthenia, SLE | ||||
| Type 3 Hypersensitivity Examples | SLE, RA, Polyarteritis Nodosum, Post-Strep Glomerulonephritis, Serum Sickness, Arthus Rx, Hypersensitivity Pneumonitis | ||||
| Type 4 Hypersensitivity Examples | DM1, MS, Guillain-Barre Synd, Hashimoto’s, Graft v. Host, PPD, Contact dermatitis. | ||||
| Burton’s Agammaglobulinemia | XR. Tyrosine kinase defect -> low B cell activation. Low B #s, in Boys 6 mos+, Bacterial infx. | ||||
| DiGeorge Syndrome | No 3rd & 4thPharyngeal pouch development -> no Thymus, parathyroids. Tetany, no Ts (Viral & Fungal infx), TwentyTwo “q”11 syndrome: persistent Truncus, TofF | ||||
| Severe Combined Immunodeficiency | LOF MHC II, IL-2, Adenosine Deaminase -> no B or T differentiation. More susceptible to all infx. | ||||
| Hyper IgM Syndrome | T Cell CD40 LOF-> no Ig class switching from IgM-> Pyogenic infx | ||||
| Wiskott-Aldrich Syndrome | X-Linked. W-A -> low IgM, high IgA. WIPE: Wiskott-> pyogenic Infx, thrombocytopenic Purpura, Eczema. | ||||
| Job’s Syndrome | INF-gamma LOF-> no neutrophil chemotaxis. FATED: coarse Facies, Abscesses, primary Teeth, IgE, Derm (eczema). | ||||
| Leukocyte Adhesion Deficiency Synd Type 1 | Integrin defect on phagocytes -> no diapedesis -> bacterial infx, no pus, slow umbilicus separation. | ||||
| Chediak-Higashi Disease | AR. Microtubule & phagocytic lysosomal defect -> Pyogenic Staph & strep infx, partial albinism, peripheral neuropathy | ||||
| Chronic Granulomatous Disease | NADPH Oxidase def-> no antibacterial/antifungal ROS in phagosomes -> S. Aureus, E. Coli, Aspergillus infx. Dx: (-) Nitroblue tetrazolium dye reduction test | ||||
| Chronic Mucocutaneous Candidiasis | T cell dysfunction -> persistent C. Albicans infx (LIKE IN AIDS) | ||||
| Selective Ig Deficiency | Isotype switching defect . Lack of IgA-> Sinus, lung infx, milk allergies, diarrhea. | ||||
| Common Variable Immunodeficiency | No B Cell maturation -> no plasma cells, low Ig. CAN BE ACQUIRED. | ||||
| ANA, Anti-dsDNA, Anti-Smith, Anti-Histone | SLE (Sensitive, Specific, Specific, Drug-induced) | ||||
| Anti-IgG | Rheumatoid Arthritis, (Rheumatoid factor) | ||||
| Anticentromere, Anti-Scl-70 | Scleroderma (Crest, Diffuse) | ||||
| Antimitochondrial Ab | Primary Biliary Cirrhosis | ||||
| Anti-BM | Goodpastures | ||||
| Anti-epithelial cell | Pemphigus Vulgaris | ||||
| Antimicrosome + other | Hashimotos (+ antithyroglobulin) | ||||
| Anti-Jo-1 | Poly/Dermato-myositis | ||||
| Anti-Rho, La | Sjogren’s Syndrome (SS-A, -B) | ||||
| Anti-U1 Ribonucleoprotein | Mixed CT Disease | ||||
| Anti-Smooth Muscle | Autoimmune Hepatitis | ||||
| Anti-Glutamate Decarboxylase | DM1 | ||||
| c-ANCA | Wegener’s | ||||
| p-ANCA | Churg-Straus, Polyarteritis Nodosa | ||||
| HLA-B27 | PAIR: Psoriasis, Ankylosing spondylitis, IBD, Reiters | ||||
| HLA-B8 | Graves, Celiac | ||||
| HLA-DR2 | MS, hay fever, SLE, Goodpasture’s | ||||
| HLA-DR3 | DM1 | ||||
| HLA-DR4 | RA, DM1 | ||||
| HLA-DR5 | Pernicious Anemia, Hashimotos | ||||
| HLA-DR7 | Nephrotic syndrome |
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Created by:
Kyle Tiemeier
on 2008-12-30