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  1. Measurement of which isotype of immunoglobulin is most appropriate to detect acute infection in the neonate?
  2. What is an enzyme-linked immunosorbent assay used for?
    It is used to determine antibodies to a particular virus.

    • Viral protein is bound to microtiter plate,
    • patient serum is added,
    • enzyme-coupled reaction is used to produce visible pigment and quantify the amount of bound antibody.
  3. What is brutons agammaglobulinemia?
    An X-linked disease that involves a defect in B lymphocytes which causes low levels of Igs and recurrent infection with H. Influenza, Streptococcus pneumoniae, and staphylococci.
  4. What are the characteristics of Sarcoidosis?
    • More common in African American females between the age of 20-40.
    • noncaseating granulomas in various organs

    • - hilar adenopathy and pulmonary infiltration
    • - uveitis, erythema nodosum(lesions on LE), arthritis, central and peripheral neuropathies, cardiomyopathy, and hypercalcemia.
  5. High titers of anti-ribonucleoprotein ab with low titers of RF and anti-ssDNA lead to what?
    Mixed connective tissue disease
  6. What cells are important reservoirs of HIV?
    Follicular dendritic cells in the germinal centers of lymph nodes.
  7. Oligodendorcytes are directly infected by which 2 viruses?
    • JC virus -> progressive multifocal leukoencephalopathy
    • measles virus -> subacute sclerosing panencephalitis
  8. What can one not be protected against with selective IgA deficiency?
    Susceptibile to mucosal surface pathogens.

    Giardia lamblia- is an extracellular parasitic protozoan that adheres to the surface of mucosa via a ventral suckling disk.
  9. What is the difference between a type 1 and a type IV hypersensitivity reaction to latex gloves?
    Type I = within minutes IgE reaction to the latex gloves.

    Type IV = within 48-72 hours cell mediated response to the chemicals of the latex glove. (contact dermatitis)
  10. How is desensitization achieved?
    Small amounts of allergen to create IgG antibodies that will compete with IgE ab and help prevent mast cell degranulation.
  11. What are the 7 acute phase proteins?
    • Ceruloplasmin
    • A2- macroglobulin
    • B2- microglobulin
    • Haptoglobin
    • a-fetoprotein
    • A-antiprotease
    • Hemoprexin
  12. What plasma proteins are not produced by the liver?
    Immunoglobulins (They come from plasma cells)
  13. What cells will predominate in infectious mononucleosis that is caused by Epstein-Barr virus?
    Infect B lymphocytes by binding CD21 receptor -> CD8+ T cells to predominate in the blood.
  14. The streptococcus pneumoniae capsular polysaccharide vaccine will produce what immune response?
    An IgM response because there is no protein antigen which is needed for T cells to be activated in order to start class switching.
  15. Microscopically what is Kaposi sarcoma(HHV8 in AIDS)  similar to?
    • Angiosarcoma
    • spindle-shaped endothelial cells
  16. What is leukocyte adehsion deficiency
    • Autosomal recessive
    • \Defect in beta-2 integrins(CD11/CD18) which normally function in the adhesion of leukocytes to other cells and in the phagocytosis of complement-coated material.

    • No migration to sites of inflammation
    • recurrent chronic bacterial infections
    • cannot form pus or abscesses
  17. What is selective IgA deficiency characterized by?
    • Increased susceptibilty to mucosal pathogens
    • Increased incidence of atopic allergy (b/c of high IgE)
  18. What marker is used to count macrophages?
    CD14 (endotoxin receptor)
  19. What is the most protective immunologic mechanism against strep pneumoniae?
    Opsonization with IgG and/or C3b in the spleen(spleen slows down blood flow).
  20. What are well circumscribed wheals with raised, erythematous borders and blanched centers?
    Urticaria (type I hypersensitivity reaction) with preformed IgE antibody bound to mast cells or basophils.
  21. Describe Reed-Sternberg cells
    • large cell with abundant cytoplasm and bilobed nucleus with an "owl's-eye" appearance
    • In mixed cellularity Hodgkin disease it is positive for CD30 and CD15.
  22. What helps the macrophages transform into epithelioid cells occuring in granulomatous inflammation?
    • TH1 lymphocytes with interferon gamma.
    • - Also secrete IL-2 TNF-beta
  23. What is LFA-1
    member of beta-2 integrin family that interacts with intracellular adhesion molecule ICAM-1

    Responsible for strong binding between monocytes, T cells, macrophages, neutrophils, dendritic cells, and injured endothelium.
  24. Why does C3 deficiency lead to an increased susceptibility to type III hypersensitivity?
    • C3 removes complexes from the bloodstream and enhances opsonization.
    • If immune complexes can not clear then complement will be activated leading to tissue damage.
  25. What are 2 causes of HyperIgM syndrome?
    • The Most Common:
    • Deficiency of CD40L of the T cells

    • Deficiency of CD40 of B cell

    • Both lead to impaired isotype switch of Ig.
    • (IL-4 is also needed)
  26. What would a deficiency in IL-2 produce?
    An impaired cell-mediated immune response -> inability to fight intracellular microorganisms
  27. What is IL-3 responsible for?
    Growth factor for hemopoeitic stem cells and mast cells.
  28. What is the difference between a deficiency in MHC I vs MHC II?
    MHC I deficiency will lead to an absence of cytotoxic T cells -> increased susceptibility to intracellular organisms

    • MHC II deficiency will lead to bare lymphocytic syndrome inwhich CD4+, CD8+ and CD19+ are all decreased.
    • Manifest as severe combined immunodeficiency.
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2012-08-19 20:55:29

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