lizamariereagan's version from 2015-05-04 23:44


Question Answer
What is localized in the follicle in a lymph node?B cells
How do primary follicles appear?dense and dormant
How do secondary follicles appearpale central germinal centers and active
What is the medulla of the lymph node consist of ?medullary cords and medullary sinuses
What are medullary cords made up of?closely packed lymphocytes and plasma cells


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What is the role of medullary sinuses?they communicate with efferent lymphatics and contain reticular cells and macrophages
What lies within the paracortex?t cells
When is the paracortex not well developed?digeorge syndrome
When does the paracortex enlarge?in an extreme cellular immune response
Cervical LN drainhead and neck


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Hilar LN drainlungs
Mediastinal LN draintrachea and esophagus
Axillary LN drainupper lumb, breast, skin above umbilicus
Celiac LN drainliver, stomach, spleen, pancreas, upper duodenum
Superior mesenteric LN drainlower duodenum, jejunum, ileum, colon to splenic flexure


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Inferior mesenteric LN draincolon from splenic flexure to upper rectum
Internal iliac LN drainlower rectum to anal canal (above pectinate line), bladder, vagina (middle third), prostate
Para-aortic LN draintestes, ovaries, kidneys, uterus
Superficial inguinal LN draindrain all cutaneous lymph from umbilicus to feet
Deep inguinal LN drainglans penis and superficial nodes


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Popliteal LN draindorsolateral foot, posterior calf
What does the right lymphatic duct drain?right side of body above diaphragm
What does the thoracic duct draineverything else into junction of left subclavian and internal jugular veins


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What’s in the white pulp of the spleen?T cells, found within the periarterial lymphatic sheath (PALS), B cells within the follicles
What is in the marginal zone of the spleen?APCs and specialized B cells; where APC’s preset blood borne antigens
What do macrophages within the spleen do?remove encapsulated bacteria
What do you see postsplenectomy?howell-jolly bodies (nuclear remnants), target cells, thrombocytosis, lymphocytosis


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What is the thymus derived from?the epithelium of the third pharyngeal pouch
Describe cortex of thymusdense with immature t cells
Describe medulla of thymuspale with mature t cells and Hassall corpuscles containing epithelial reticular cells


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Components of innate immunityneutrophils, macrophages, monocytes, dendritic cells, NK cells, complement
Components of adaptive immunityT cells, B cells, circulating antibodies
What are the two cell lines?myeloid and lymphoid
What is part of the myeloid cell linemonocyte, macrophage, dendritic cell, neutrophil, eosinophil, basophil, mast cell
What is a monocyte?phagocyte in the blood stream; differentiates into macrophage in the tissues


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What is a macrophage?phagocyte in the tissue (histiocyte; a differenetiated monocyte); synthesizes and secretes various cytokines
What is a dendritic cellefficient APC to lymphocytes (has long arms)
What is a neutrophil; nucleus?has toxic cytoplasmic granules with potent bactericidal capability; multilobed
What is an eosinophil; nucleus?has large pink granules containing major basic protein which attacks against parasitic and helminthic infections; bilobed
What is a basophil; nucleus?has large blue granules ; bilobed


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What is a mast cell; nucleus?has large cytoplasmic granules with histamine ; small nucleus
What is in the lymphoid lineage?lymphocytes ( B and T cells), and NK cells
What do b cells differentiae into ?further differentiate into either memory b cells or plasma cells which produce antibodies
What do t cells differentiate into?into CD4+ helper T cells, CD8+ cytotoxic T cells, regulatory t cells or memory t cells
What are NK cells; marker?CD56+; has cytoplasmic toxic granules (granzymes), and can kill malignant cells, virus-infected cells or antibody coated (opsonized) cells


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How do NK cells induce apoptosiswith perforin and granzymes
What interleukin’s enhance NK activity?IL-2, IL-12, IFN-alpha, beta and gamma
When are NK cells induced to kill?when there is a nonspecific activation on target cell OR the ABSENCE of class I MHC (like virus infected cells and tumor cells
Two ways NK can kill?innate immune system and antibody-dependent cell-mediated cytotoxicity (CD16 binds Fc region of bound Ig, activating NK cell)


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What is MHC encoded by?HLA genes
What is the loci for MHC IHLA-A, B, C
What is the loci for MHC IIHLA-DR, DP, DQ
Who do MHC I present to?CD8+ cytotoxic T cells ; endogenous antigens
Who do MHC II present to?to CD4+ helper t cells; exogenously synthesized proteins


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Where are antigens loaded for MHC IRER after delivery vis TAP peptide transporter
Where are antigens loaded for MHC IIloaded following release of invariant chain in an acidified endosome
What is the mode of transport to cell surface for MHC Ibeta 2 microglobulin
What does antigen presentation result in in MHC Iapoptosis of presenting cell
What does antigen presentation result in in MHC IIactivation of TH cells, which activate humoral and cell medicated immune responses


Question Answer
B8graves disease
Dq2/dq8celiac disease
Dr2MS, hay fever, SLE, goodpastures
Dr3diabetes mellitus type 1, SLE, graves disease, hashimoto thyroiditis
Dr4rheumatoid arthritis, diabetes mellitus type 1
Dr5pernicious anemia → vitamin B12 deficiency, hasimoto thyroiditis


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Where does positive selection take place?cortex of thymus
Who do t cells interact with in positive selection?thymic cortical epithelial cells
What is positive selection?t cells expressing TCRs capable of binding surface self MHC molecules survive
Where does negative selection take place?in the thymic medulla
Who do t cells interact with in negative selection?thymic medullary epithelial and dendritic cells


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What is negative selection?t cells expressing TCRs with high affinity for self antigens undergo apoptosis
Helper T cell to Th1 cell needIL-12 and INF – gamma (macrophage release IL-12 to simulate T cells to differentiate into Th1; Th1 cells release IFN-gamma to stimulate macrophages
Helper T cell to Th2 cell needIL-4
Helper T cell to Th17 cell needTGF-beta +IL-6


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Helper T cell to Treg cell needTGF beta
What do naïve Th0 cells have?TCR, CD3 and CD4
What do immature t lymphocytes have?CD4, CD8 and a complete pro-TCR


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What are the APCsB cells, macrophages, dendritic cells
What is the co-stimulatory signal in naïve t cell activation?b7 on dendritic cell and cd28 on naïve t cell
What is the second signal in b cell activation?CD40 receptor on b cell binds CD40 ligand on Th cell
What cell mediates non-caseous granuloma formation?Th1 cell
Is th1 cell mediated or humoral ?cell mediated


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What do th1 cells secrete?IFN-gamma (t oactivate APCs for efficient killing), IL-2 (activates cytotoxic CD8+ cells to kill virally infected cells and also activation and proliferation of itself ) and lymphotoxin beta
What do th1 cells activate?macrophages to produce TNF and cytotoxic T lymphocytes
What inhibits th1 cells?IL-4 and IL-10
Is th2 cell mediate or humoral?humoral
What does th2 secrete?IL-4, IL-5, IL-6, IL-13, IL-10


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What is the function of th2 cells?recruit eosinophiles for parasite defense and promote IgE production by B cells; activates B cells and promotes class switching
What inhibits th2 cells?IFN-gamma
Result of th2 cell activationsecretion of antibodies
Result of th1 cell activationcytotoxicity; delayed hypersensitivity ; they activate APCs for efficient killing
What markers do regulatory t cells have?cd3, cd4, cd25 and transcription factor FOXP3
Activated regulatory t cells produce anti-inflammatory cytokines (il-10 and tgf-beta)


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What does the Fc portion of an antibody do on IgM and IgGfixes complement
Where does complement bind?near the hinge point
What do mature b lymphocytes express on their surface?IgM and IgD
What do plasma cells secrete?IgA, IgE and IgG
What is the most abundant Ig in serum?IgG


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What Ig fixes complement?IgG, IgM
What Ig crosses the placenta?IgG
What Ig opsonizes bacteriaIgG
What is IgA in circulation?a monomer
What is IgA when secreted?a dimer


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What is the most produced ab overall but has lower serum concentration?IgA
What is early breast milk called?colostrum
Where does IgA get its secretory component?picks it up from epithelial cells before secretion
What is produced in the immediate response to an antigen?IgM
What is produced in the secondary delayed response to an antigenIgG


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What is IgM on a b cellmonomer
What is IgM when secretedpentamer
What does IgE bind?mast cells and basophils
What happens when you’re exposed to an allergen in relation to IgEit crosslinks and mediates the immediate (type 1) hypersensitivity through release of inflammatory mediators like histamine


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What can MHC’s present?antigens with a peptide component
What are acute phase reactants?factors whose serum concentrations change significantly in response to inflammation
Where are acute phase reactants produced?in the liver in both acute and chronic inflammatory states
What induces acute phase reactants?IL-6, IL-1, TNF-alpha and IFN-gamma
What acute phase reactants are upregulated?serum amyloid A, c-reactive protein, ferritin, fibrinogen and hepcidin


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What is c-reactive protein?opsonin; fixes complement and facilitates phagocytosis
What does ferritin do?finds and sequesters iron to inhibit microbial iron scavenging
What is fibrinogen?a coagulation factor that promotes endothelial repair and correlates with ESR
What is hepcidin?prevents release of iron bound by ferritin; leads to anemia of chronic disease
Who synthesizes hepcidin?the liver


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What increases hepcidin levels?high iron and inflammatory conditions
What decreases hepcidin levels?hypoxia and increased erythropoiesis
What acute phase reactants are downregulated?albumin and transferrin
What does albumin do in this instancereduction conserves amino acids for positive reactants
What does transferrin do in this instanceinternalized by macrophages to sequester iron


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What IL are secreted by macrophages?IL-1,6,8,12, and TNF-alpha
What is the acronym hot t bone steak?1=fever (hot), 2= stimulates t cells, 3=stimulates bone marrow, 4= stimulates IgE production, 5= stimulates IgA production, 6= stimulates aKute phase protein production
What does IL-1 do?fever, stimulates helper T cells and induces systemic inflammatory response
What IL are secreted by all T cells?IL-2 and IL-3
What does IL-2 dostimulates growth of helper , cytotoxic and regulatory t cells ; activates proliferation of B lymphocytes and NK cells ; activates monocytes ; used to treat renal malignancies and melanoma
What does IL-3 dosupports growth and differentiation of bone marrow stem cells; functions like GM-CSF


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What does Th1 cells secrete ?IFN-gamma
What does Th2 cells secrete?IL-4,5, and 10
What does IL-4 do?induces differentiation into Th2 cells; promotes growth of B cells; enhances class switching to IgE and IgG
What secretes IL-13 and what does it dosensitized Th2 cells, and it also enhances class switching to IgE and IgG
What does IL-5 dopromotes differentiation of B cells; enhances class switching to IgA; stimulates eosinophils to do their thing


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What does IL-6 doendogenous pyrogen
Who secretes IL-6macrophages and Th2 cells
What does IL-8 domajor chemotactic factor for neutrophils ; induces phagocytosis; mediates accumulation of pus
What are chemotactic factors for neutrophils?n-formylated peptides, leukotriene B4, 5-HETE (leukotriene precursor) and c5a
What does IL-10 doinhibits IL-2 and IFN-gamma production by Th1 ; enhances IL-4 and IL-5 production by Th2; suppresses cell-mediated immunity and stimulates humoral immunity