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