Lymph nodes

Section

Question	Answer
Upper limb, lateral breast	Axillary
Stomach	Celiac
Duodenum jejunum	Superior mesenteric
Sigmoid colon	Colic --> inferior mesenteric
Rectum, anal canal above the pectinate line	Internal iliac
Anal canal below the pectinate line	Superficial inguinal
Testes	Superficial and deep plexuses --> para-aortic
Scrotum	Superficial inguinal
Thigh (superficial)	Superficial inguinal
Lateral side of dorsum of the foot	Popliteal
Right lymphatic duct	drains right arm and right half of the head
Thoracic duct	drains everything else
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Question	Answer
Th1	make INF-gamma and IL-2, inhibited by IL-10 (made by Th2 cells)
Th2	make IL-4, IL-5, IL-10, inhibited by INF-gamma (made by Th1 cells)
What causes differentiation into the Th1	IL-12
What causes differentiation into Th2	IL-4
Th1 cells are humoral or cell-mediated	cell-mediated
Th2 cells are humoral or cell-mediated	humoral
What inhibits MHC II from binding antigen	lack of acidification in the lysosomes
What does MHC I have that MHC II doesn't have	B2 microglobin
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Question	Answer
HLA-A3	hemochromatosis
HLA-B27	Psoriasis, ankylosing spondilitis, inflammatory bowel disease, Reiter's syndrome
HLA-B8	Addisons disease, myasthenia gravis
HLA-DR2	Multiple sclerosis, hay fever, SLE, Goodpasture's
HLA-DR3	Diabetes mellitus type I
HLA-DR4	Rheumatoid arthritis, diabetes mellitus type I
HLA-DR5	Pernicious anemia --> B12 deficiency, Hashimoto's thyroiditis
HLA-DR7	Steroid-response nephrotic syndrome
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Question	Answer
NK cells mode of action	use perforin and granzymes to induce apoptosis in the infected cell
How does endotoxin/lipopolysacchride cause it's response	Binds to endotoxin receptor CD14 on MACROPHAGES directly stimulating them
What is the costimulatory signal	APC = B7 and Th cell = CD28 --> needed for the activation of T cell
How are cytotoxic T cells activated	IL-2 from the Th cells
What causes B cell switching	IL-4, IL-5, IL-6, CD40 ligand on Th cell
How many antigens can one B cell make antibodies for	1
Which portion of the antibody binds to the antigen	Fab
Which portion of the antibody activates complement	Ch2 part of the heavy chain Fc (IgG and IgM only)
Which part of the antibody detemines the isotype	Fc portion of the heavy chain
Does the light chain contribute to the Fc portion	No, only the heavy chain does
How does IgA exist when secreted	as a dimer
Which antibody mediates the type I hypersensitivity reaction	IgE
Ig idiotype	specific for a given antigen
Ig isotype	Ig epitope common to single class of Ig
Ig allotype	Ig epitope that differs among members of the same species
What does an antigen need to be presented by MCH to T cells	peptide antigen (ie. polysaccharide capsule and LPS from gram - will not activate T cells)
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Question	Answer
IL-1	Fever, osteoclast activating factor
IL-2	stimulates T cells
IL-3	stimulares Bone marrow
IL-4	stimulates IgE production
IL-5	stimulates IgA production, stimulates growth and development of eosinophils
IL-8, LTB4, C5a	Neutrophil chemotactic
What happens if a patient has a IL-12 deficiency	They can suffer from severe TB infections and you treat them with IFN-gamma
How can you stain for monocyte, macrophages	CD14 - you will see them in PPD
Since mature red blood cells are the only cells that do not express MHC class I what kills babesia and malaria	NK cells and they are stained with CD56
Which complement binds bacteria	C3b
Which complement mediates anaphylaxis	C3a and C5a
What happen if you are C1 esterase deficient	hereditary angioedema and you can't use ACE inhibitors in these patients
Deficiency of C3	increased susceptibility to type III hypersensitivity reactions and recurrent pyogenic sinus and respiratory tract infections
Deficiency of C5-C8	Neisseria bacteremia
Deficiency of DAF	paroxysmal nocturnal hemoglobinuria
What do inteferon-a and beta do	inhibit viral protein synthesis
What does interferon-gamma do	increase MHC I and II expression and antigen presentation in all cells
Stellate shaped granuloma	Cat-scratch fever (Bartonella henslae)
What are patients with silicosis more at risk for	TB infections due to the inhibition of macrophages by the silica
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Question	Answer
Antihistone	Drug-induced lupus
Anticentromere	Scleroderma (CREST)
Anti-Scl-70 (anti-topoisomerase I)	Scleroderma (diffuse)
Antimicrosomal	Hashimotos
Antimitrocondrial	Primary biliary cirrhosis
Anti-Jo-1	Polymyositis, dermatomyositis
Anti-Ro, Anti-La	Sjogren's syndrome
Anti-U1 RNP	Mixed connective tissue disease
Anti-smooth muscle	autoimmune hepatitis
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Question	Answer
Bruton's agammaglobulinemia	no germinal follicles (no maturation of B cells) - recurrent respiratory infections in a young boy (X-linked recessive)
Hyper IgM-syndrom	No CD40 ligand on Helper T cells --> not able to switch Ig Class --> severe pyogenic infections
Multiple Sclerosis	Type IV hypersensitivity ie. Th1 cells activate macrophages against self antigens --> demyelination
Selective IgA deficiency	Most common immunodeficiency in the US --> increased susceptibility to Giardia Lamblia
Wiskot-Aldrich	Thrombocytopenia, eczema, and increased IgE; X-linked disease; increased risk for non-hodgkin's lymphoma
Syngeneic graft	between identical twins with the same HLAs
Most important effector cells for MMR and other live viral vaccines	Cytotoxic T cells (CD8+ and CD3+)
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Question	Answer
Who causes damage to the lung during pneumonia	neutrophils - they come in and release cytokines that damage the area
Digeorge syndrome	cardiac abnormalities, abnormal facies, thymic aplasia, cleft palate, hypocalcemia (tetany), and all from a problem on chromosome 22 (CATCH-22)
Superantigens from S. aureus (TSST-1) and S. pyogenes	activate Th1 cells to produce a ton of IL-2 and INF-gamma; activate macrophages to produce a ton of TNF-a and IL-1
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Question	Answer
Postvaccinal lymphadenitis characterized by multinucleated giant cells with eosinophilic inclusions	Measles
What are the pathgnomonic Warthin-Finkeldey cells for and what are they made of	Measles, fused lymphocytes
Pernicious anemia and Graves disease type of hypersensitivity	Type II noncytotoxic hypersensitivity
What is the most important factor in getting rid of immune complexes	C3b
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Question	Answer
Vaccines to Pneumococcus and H. Influenza will only contain what if not paired with a peptide	IgM because the peptide is needed for the isotype switch
What is the other name for DiGeorge syndrome	Velocardiofacial syndrome
Patients with selective IgA deficiency have an increased risk for developing what	Atopy (they get higher IgE)
People with severe AIDS will have which kinds of immunoglobins	IgM; they won't have the T cells needed for the switch
What is the Arthus reaction	Swelling and inflammation following things such as a tetanus vaccine (Type III hypersensitivity - immune complex formation because you've seen it before)
Reiter's syndrome	campylobacter, chlamydia, salmonella, shigella, yersinia infection
Tertiary syphillus forms what type of reaction	granuloma mediated by Th1 and macrophages
What orchestrates cell mediated immunity	Th1 cells
It's TIME that I learned Wiskot-Aldrich syndrome	Thrombocytopenia, Infections, LOW IgM, and increased IgE (eczema)
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