Term
| Cytokine released by helper T cells causing B cell maturation into plasma cells? |
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Definition
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Term
| Cytokine released by helper T cells causing maturation of cytotoxic T (CD8) cells? |
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Definition
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Term
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Definition
B cell maturation &
inhibition of macrophages |
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Term
| MHC Class I found on what type of cells? |
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Definition
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Term
| Interaction of which cells with MHC Class I results in activation? |
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Definition
CD8 T Cells
(I → CD 8)
(II → CD4) |
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Term
| MHC Class II found on what type of cells? |
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Definition
B cells, dendrites, monocytes
(Antigen Presenting Cells!) |
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Term
| Interaction of which cells with MHC Class II results in activation? |
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Definition
CD4 T cells
( "II, 4, I, 8, who do we appreciate?!") |
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Term
| Viruses get presented via which MHC molecules? |
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Definition
| Class I (presented to CD8 t cells) |
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Term
| Bacterial particles get presented via which MHC molecules? |
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Definition
| Class II (presented to CD4 cells) |
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Term
| Mechanism by which natural killer (NK) cells work? |
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Definition
Recognize cells that LACK SELF MHC
(not dependent on previous exposure, no antigen presentation required--they do it "naturally")
(body's natural immunosurveillance for cancer) |
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Term
| First antibody made in response to infection? |
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Definition
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Term
| Antibody which can cross placenta, responsible for protection in newborn period? |
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Definition
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Term
| Antibody found in gut (Peyer's patches) and in breast milk? |
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Definition
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Term
| Antibody involved in allergic reactions? |
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Definition
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Term
| Antibodies which are opsonins (activate complement)? |
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Definition
IgM (1 molecule needed cuz it is HUGE!)
or IgG (2 molecules needed) |
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Term
| Portion of immunoglobulin responsible for antigen recognition? |
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Definition
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Term
| Portion of immunoglobulin responsible for PMN and macrophage recognition? |
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Definition
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Term
| Type I hypersensitivity mediated by? |
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Definition
IgE
(Immediate type! histamine, bradykinin, serotonin released in response to release of major basic protein from eosinophils) |
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Term
| Example of type I hypersensitivity? |
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Definition
| bee sting, peanuts, hay fever |
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Term
| Type II hypersensitivity mediated by? |
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Definition
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Term
| Examples of type II hypersensitivity? |
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Definition
| ABO incompatibility, Graves disease, Myasthenia gravis |
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Term
| Type III hypersensitivity mediated by? |
|
Definition
| Immune complex deposition |
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Term
| Examples of Type III hypersensitivity? |
|
Definition
serum sickness,
(RA) Rheumatoid arthritis,
(SLE) Lupus |
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Term
| Pathophysiology of Type IV hypersensitivity? |
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Definition
Delayed-type:
Antigen stimulation of previously sensitized T cells |
|
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Term
| Examples of Type IV Hypersensitivity? |
|
Definition
TB skin test,
contact dermatitis (poison ivy, nickel) |
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Term
| Cell responsible for major source of histamine in blood? |
|
Definition
basophil
(Blood=Basophil) |
|
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Term
| Cell responsible for major source of histamine in tissue? |
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Definition
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Term
| Cytokine shown to convert lymphocytes to lymphkine-activated killer cells (LAK) and tumor infiltrating lymphocytes (TILS)? |
|
Definition
IL-2
(shown to be successful in melanoma)
*Recall, IL-2 also causes maturation of CTK cells, recruited in delayed type hypersensitivity-type IV* |
|
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Term
Give
tetanus toxoid,
tetanus immune globulin,
or nothing?
A. Non-tetanus prone wounds, patient received all three tetanus shots
B. Non-tetanus prone wounds, tetanus status unknown
C. Tetanus prone wound, patient had all 3 doses, last dose 2 years ago
D. Tetanus prone wound, patient had all 3 shots, last dose 7 years ago
E. Tetanus prone wound, patient unsure of immunization history |
|
Definition
A. Nothing
B: Toxoid
C. Nothing
D. Toxiod
E. Immune globulin |
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Term
| Which HLA classes are most important for donor-recipient matching? |
|
Definition
HLA-A, B and DR
(DR most of these) |
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Term
| A "crossmatch" mixes what with what? |
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Definition
Recipient serum with donor lymphocytes
(detects hyperacute reaction) |
|
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Term
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Definition
| Panel reactive antibody--gives % of cells that recipient serum reacts with. (High PRA undesirable) |
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Term
| Treatment of mild rejection? |
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Definition
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Term
| Most common malignancy following any transplant? |
|
Definition
| Skin cancer! (squamous cell #1) |
|
|
Term
| Second most common malignancy following transplant? |
|
Definition
Post-transplant lymphoproliferative disorder (PTLD)
*related to EBV |
|
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Term
|
Definition
1. STOP immunosuppresion
2. Possible chemotherapy and/or radiation (if aggressive tumor) |
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|
Term
| Mechanism of action of Azathioprine (Imuran)? |
|
Definition
Inhibits de novo purine synthesis (which inhibits T cells) by acting as a "fake" purine itself, and getting incorporated into DNA but not working for transcription
**used as second line after Mycophenylate) |
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Term
| Mechanism of action of Mycophenolate? |
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Definition
| Inhibits de novo purine (guanine) synthesis (which inhibits T and B cells), also inhibits leukocyte recriutment by messing with cell adhesion |
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Term
| Which immunosuppresant medications inhibit purine synthesis? |
|
Definition
| Azathioprine (Imuran) and Mycophenolate |
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Term
| Mechanism of action of steroids? |
|
Definition
| Inhibit cytokine synthesis (IL-1 and IL-6) and macrophages |
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Term
| Mechanism of action of cyclosporine? |
|
Definition
| Inhibits cytokine synthesis (IL-2, 3, 4) and IFN-gamma (CALCINEURIN INHIBITOR, Works via ***NFAT pathway) |
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Term
| Side effects of cyclosporine? |
|
Definition
| Hepatotoxicity (metabolized by liver) and *NEPHROTOXICITY*, tremors, seizures, gingival hyperplasia |
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Term
| Cytokine responsible for FEVER? |
|
Definition
| IL-1 (mediated the hypothalamus) |
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Term
| IL-1 produced by which cells? |
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Definition
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Term
| Major cytokine involved in the SIRS response? |
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Definition
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Term
| Major cause of late graft failure in a transplanted organ? |
|
Definition
| Chronic rejection (seen months to years after transplant) |
|
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Term
| Time frame with which acute rejection of a transplanted organ typically presents? |
|
Definition
| Within a few weeks after transplant (but technically can occur episodically any time after) |
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Term
| Organ least susceptible to chronic rejection? |
|
Definition
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Term
| Process by which a recipient's serum is tested specifically against donor lymphocytes? |
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Definition
| Prospective cross matching (for hyperacute rejection--done for kidney and pancreas, not liver. Kidney and panc can tolerate cold ischemic time and liver is resistant to humoral injury and doesnt need a crossmatch) |
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Term
| Corticosteroid mechanismS of action: |
|
Definition
1. Inhibit DNA/RNA transcription
2. INhibit transcription of IL-1, IL-2, IL-6, IFN-gamma, TNF-alpha
3. Inhibit margination of lymphocytes
4. Impair function of macrophages and granulocytes |
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|
Term
Side effects of Steroids, by system?
1. CV
2. Endocrine
3. GI
4.MISC |
|
Definition
1. HTN, HL
2. Hyperglycemia, growth retardation, osteroporosis
3. Pancreatitis, GI bleeding, perforation and ulceration
4. Cataract formation, psychosis, insomnia |
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Term
| Mechanism of action of tacrolimus (prograf)? |
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Definition
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Term
| Mechanism of action of Tacrolimus (Prograf)? |
|
Definition
| Calcineurin inhibitor (works via **FKBP pathway) |
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Term
| Significant side effects of Tacrolimus? |
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Definition
| ***NEPHROTOXICITY, HTN, **hypERkalemia, hypOmagnesesmia, *DIABETES, CNS toxicity |
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Term
| Mechanism of action of Sirolimus (Rapamune)? |
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Definition
| Calcineurin inhibitor (FRAP pathway specifically) |
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Term
| Side effects of Sirolimus? |
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Definition
| Much LESS nephrotoxicity than Tac, HL, HTN, acne, rashes |
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Term
| Major side effects of mycophenylate? |
|
Definition
| GI upset, bone marrow suppression |
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Term
| Mechanism of action of methotrexate? |
|
Definition
| Blocks folic acid metabolism, thereby inhibiting DNA/RNA synthesis |
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Term
| Mechanism of action of Thymoglobulin? |
|
Definition
| Rabbit antithymocyte immunoglobulin, has been sensitized to human thymocytes. Once introduced, patient's T cells are bound, and opsonized, therefore cleared from system |
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Term
| Mechanism of action of Basiliximab (Simulect)? |
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Definition
| Chimeric murine/human IgG1 immunoglobulin which acts as a competetive inhibitor of IL-2 (used primarily as induction agent in renal transplant) |
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Term
| Mechanism of action of Rituximab? |
|
Definition
| Chimeric murine/human IgG which eliminates B cells via complement activation (used primarily in PTLD) |
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