Item: 1 of 14
QIO: 3068
- ,•
~
Mark -<J
P~v•ous
[:::>
N@xt Labl
"'I
lues
~ ··
Notes
~
Calculator
. 1
A 3-year-old girl is brought t o th e pediat ri cian because of a "barking" cough, fever, and cervical lymphadenopathy. Resu
•2
are negative and she is diagnosed wit h v iral croup.
·3
• 4 Which of the following regions of the lymph node is most likely affected by this patient's viral infection?
·5
·6 A. Efferent lymphatic
·7
B. Follicle
·8
•9 C. Marginal zone
• 10 0 . Medulla
· 11
E. Paracortex
• 12
• 13
• 14
8
Lode.
, Item: 1 of 14 ~ ,• Mark <::J [:::> ""I ~· ~'j
QID: 3068 J.. Previous Next LAbfaiUI~S Notes Calculator
1
•2
The correct a nswer is E. 62°/o chose this .
•3
The paracortex of the lymph node is t he region of cortex between t he follicles of t he cort ex and t he medulla. It contain
•4 become act ivat ed during a cell -mediat ed im mune response, as in a viral infect ion such as croup (commonly caused by
. 5 This area expands as t he T lymphocytes activate and prolife rate, result ing in adenopat hy. Not e t hat none of t he ot her r
.6 specif ically involved in t he immune response to a virus.
Lymph node Lymphadenopathy Immune system Lymphocyte Virus Cell-mediated immunity Hair follicle Lymph T cell Viral disease Human parainfluenza viruses Croup
• 7
•8 A is not correct . 3°/o chose t his.
•9
Lymph ent ers the lymph node through afferent lymphatics, which pierce t he capsule, dra in int o t he subcapsular space,
lymph node, and recollect in t he hilum of t he lymph node. I n t he hilum, lymph exits through efferent lymphatics, even
• 10 t horacic duct before rejoining t he bloodst ream .
· 11 Lymph node Thoracic duct Hilum (anatomy) Root of the lung Thoracic vertebrae Lymphatic system Lymph Circulatory system Afferent nerve fiber Thorax
• 12
B is not correct. 14% chose this .
• 13 The foll icles are within the c01tex of t he lymph node and house B lymphocyt es. As T lymphocyt es are largely responsib
• 14 t o viral infections, one would not expect t o see great ly expanded follicl es in t his patient.
Lymph node B cell Lymphocyte T cell Lymph Cortex (anatomy) Hair follicle Virus
C is not correct. 1 2% chose this .
The marginal zone is a region in the spleen between t he red pulp and t he white pulp t hat cont ains B-cells.
Red pulp White pulp Spleen Marginal zone B cell
D is not correct. 9°/o chose this.
The medulla consists of medullary cords and sinuses. Within the cords are lymphocyt es and plasma cells, and wit hin t h
macrophages.
Macrophage Medulla oblongata Blood plasma Lymphocyte Plasma cell Paranasal sinuses
Bottom Line :
Vira l infection elicits a cell- mediat ed immune response in which T lym phocyt es are activat ed and proliferat e. T lympho
paracort ex of lymph nodes.
Lymph node Viral disease Immune system T cell Lymphocyte Cell-mediated immunity Lymph Virus Infection
8
Lock
,Item: 1 of 14 - ,• Mark --<) [::> ""'I ~· 1!';:'1
QIO: 3068 ~ Prev1ous Next Labfa lues Notes Calculator
1
•2
·3 Lymph node A zolymphoid organ that has many afferents, I or more efferents. Encapsulated, with t
•4 Functions are nonspecific filtration by macrophagcs, storage of BandT cells, and im
·5 response activation.
·6
Follicle Site of B-cell localization and
·7
proliferation. In outer cortex. 1° follicles Afferent
·8
·9
· 10
· 11
are dense and dormant. 2° follicles have
pale central germinal centers and are
active.
FoiiKies (B cells)~
Paracortex
u
~/
lymphatic
CTcells) ~)
• 12 Medulla Consists of medullary cords (closely
::.....__ ~
• 13 packed lymphocytes and plasma cells) -......
• 14 and medullary sinuses. Medullary ~---
sinuses communicate with efferent Postcap1Uary
lymphatics and contain reticular cells venule
~
and macrophages.
......
Capillary
Paracortex Houses T cells. Region of cortex between supply
follicles and medulla. Contains high
endothelial venules through which T
and B cells enter from blood. 1 otwell
developed in patients with OiCcorge
syndrome.
Trabecula A..;__
Capsule _/
Medulla
(reticula
macrop
Paracortex enlarges in an extreme cellular
immune response (eg, ,·iral infection).
8
L.odt
, Item: 1 of 14 - ,• Mark --<) [::> ""'I ~· 1!';:'1
QIO: 3068 ~ Prev1ous Next Labfa lues Notes Calculator
1 p g
Capilklry '-
•2 Paracortex Houses T cells. Region of cortex between supply
·3
follicles and medulla. Contains high
•4
endothelial venules through'' hich T
·5
·6
·7
·8
and B cells enter from blood. ot \\Cll
developed in patients with OiCcorge
srndrome.
Trabecula At---
Capsule _/
Medulk
(rebcuk
macrop
Paracortex enlarges in an extreme cellular
·9
· 10
immune response (eg, ,·ira I infection).
· 11
• 12
• 13 Major functions of B and T cells
• 14
B cells llumoral immunity.
Recognize antigen-undergo somatic hypermutation to optimize antigen specificity.
Produce antibody-differentiate into plasma cells to secrete specific immunoglobulins.
Maintain immunologic memory-memory B cells persist and accelerate future respons
T cells Cell-mediated immunity.
C D4+ T cells help B cells make antibodies and produce cytokines to recruit phagocyte
activate other leukocytes.
C D8+ T cells directly kill virus-i nfected cells.
Delayed cell-mediated hypersensitivity (type IV).
Acute and chronic cellular organ rejection.
Rule of 8: MHC II x CD4 =8; II IC I x CD8 =S.
8
L.odt
QIO: 3068
- ,•
~
Mark -<J
P~v•ous
[:::>
N@xt Labl
"'I
lues
~ ··
Notes
~
Calculator
. 1
A 3-year-old girl is brought t o th e pediat ri cian because of a "barking" cough, fever, and cervical lymphadenopathy. Resu
•2
are negative and she is diagnosed wit h v iral croup.
·3
• 4 Which of the following regions of the lymph node is most likely affected by this patient's viral infection?
·5
·6 A. Efferent lymphatic
·7
B. Follicle
·8
•9 C. Marginal zone
• 10 0 . Medulla
· 11
E. Paracortex
• 12
• 13
• 14
8
Lode.
, Item: 1 of 14 ~ ,• Mark <::J [:::> ""I ~· ~'j
QID: 3068 J.. Previous Next LAbfaiUI~S Notes Calculator
1
•2
The correct a nswer is E. 62°/o chose this .
•3
The paracortex of the lymph node is t he region of cortex between t he follicles of t he cort ex and t he medulla. It contain
•4 become act ivat ed during a cell -mediat ed im mune response, as in a viral infect ion such as croup (commonly caused by
. 5 This area expands as t he T lymphocytes activate and prolife rate, result ing in adenopat hy. Not e t hat none of t he ot her r
.6 specif ically involved in t he immune response to a virus.
Lymph node Lymphadenopathy Immune system Lymphocyte Virus Cell-mediated immunity Hair follicle Lymph T cell Viral disease Human parainfluenza viruses Croup
• 7
•8 A is not correct . 3°/o chose t his.
•9
Lymph ent ers the lymph node through afferent lymphatics, which pierce t he capsule, dra in int o t he subcapsular space,
lymph node, and recollect in t he hilum of t he lymph node. I n t he hilum, lymph exits through efferent lymphatics, even
• 10 t horacic duct before rejoining t he bloodst ream .
· 11 Lymph node Thoracic duct Hilum (anatomy) Root of the lung Thoracic vertebrae Lymphatic system Lymph Circulatory system Afferent nerve fiber Thorax
• 12
B is not correct. 14% chose this .
• 13 The foll icles are within the c01tex of t he lymph node and house B lymphocyt es. As T lymphocyt es are largely responsib
• 14 t o viral infections, one would not expect t o see great ly expanded follicl es in t his patient.
Lymph node B cell Lymphocyte T cell Lymph Cortex (anatomy) Hair follicle Virus
C is not correct. 1 2% chose this .
The marginal zone is a region in the spleen between t he red pulp and t he white pulp t hat cont ains B-cells.
Red pulp White pulp Spleen Marginal zone B cell
D is not correct. 9°/o chose this.
The medulla consists of medullary cords and sinuses. Within the cords are lymphocyt es and plasma cells, and wit hin t h
macrophages.
Macrophage Medulla oblongata Blood plasma Lymphocyte Plasma cell Paranasal sinuses
Bottom Line :
Vira l infection elicits a cell- mediat ed immune response in which T lym phocyt es are activat ed and proliferat e. T lympho
paracort ex of lymph nodes.
Lymph node Viral disease Immune system T cell Lymphocyte Cell-mediated immunity Lymph Virus Infection
8
Lock
,Item: 1 of 14 - ,• Mark --<) [::> ""'I ~· 1!';:'1
QIO: 3068 ~ Prev1ous Next Labfa lues Notes Calculator
1
•2
·3 Lymph node A zolymphoid organ that has many afferents, I or more efferents. Encapsulated, with t
•4 Functions are nonspecific filtration by macrophagcs, storage of BandT cells, and im
·5 response activation.
·6
Follicle Site of B-cell localization and
·7
proliferation. In outer cortex. 1° follicles Afferent
·8
·9
· 10
· 11
are dense and dormant. 2° follicles have
pale central germinal centers and are
active.
FoiiKies (B cells)~
Paracortex
u
~/
lymphatic
CTcells) ~)
• 12 Medulla Consists of medullary cords (closely
::.....__ ~
• 13 packed lymphocytes and plasma cells) -......
• 14 and medullary sinuses. Medullary ~---
sinuses communicate with efferent Postcap1Uary
lymphatics and contain reticular cells venule
~
and macrophages.
......
Capillary
Paracortex Houses T cells. Region of cortex between supply
follicles and medulla. Contains high
endothelial venules through which T
and B cells enter from blood. 1 otwell
developed in patients with OiCcorge
syndrome.
Trabecula A..;__
Capsule _/
Medulla
(reticula
macrop
Paracortex enlarges in an extreme cellular
immune response (eg, ,·iral infection).
8
L.odt
, Item: 1 of 14 - ,• Mark --<) [::> ""'I ~· 1!';:'1
QIO: 3068 ~ Prev1ous Next Labfa lues Notes Calculator
1 p g
Capilklry '-
•2 Paracortex Houses T cells. Region of cortex between supply
·3
follicles and medulla. Contains high
•4
endothelial venules through'' hich T
·5
·6
·7
·8
and B cells enter from blood. ot \\Cll
developed in patients with OiCcorge
srndrome.
Trabecula At---
Capsule _/
Medulk
(rebcuk
macrop
Paracortex enlarges in an extreme cellular
·9
· 10
immune response (eg, ,·ira I infection).
· 11
• 12
• 13 Major functions of B and T cells
• 14
B cells llumoral immunity.
Recognize antigen-undergo somatic hypermutation to optimize antigen specificity.
Produce antibody-differentiate into plasma cells to secrete specific immunoglobulins.
Maintain immunologic memory-memory B cells persist and accelerate future respons
T cells Cell-mediated immunity.
C D4+ T cells help B cells make antibodies and produce cytokines to recruit phagocyte
activate other leukocytes.
C D8+ T cells directly kill virus-i nfected cells.
Delayed cell-mediated hypersensitivity (type IV).
Acute and chronic cellular organ rejection.
Rule of 8: MHC II x CD4 =8; II IC I x CD8 =S.
8
L.odt
