Micro 120 Posted Session Objectives Exam 2 2019

011_Autoimmunity
• Recognize that autoimmune and autoinflammatory diseases are consequences of
dysregulated function of the adaptive and innate immune systems, respectively.
• Recognize that both genetics and environmental factors contribute to pathogenesis of
autoimmune diseases.
• Describe how failure of immunological tolerance to self can lead to autoimmunity.
• Explain the different mechanisms by which autoantibodies can cause disease.
• Explain the role of immune complex formation and deposition in pathogenesis of systemic
lupus erythematosus.
• Explain different mechanisms of achieving T cell tolerance and distinguish between central
and peripheral mechanisms.
• Understand the central role of Aire gene in thymic T cell tolerance.
• Explain how infections can lead to breakdown of T cell tolerance and initiation of
autoimmune disease.
• Distinguish between approaches to treat B cell and T cell mediated autoimmune diseases.
• Describe why mutations in components of the inflammasome can lead to hereditary
autoinflammatory syndromes.
• Explain why most autoinflammatory diseases can be treated by blockade of the IL-1b
pathway
• Recognize the central role of the inflammasome in production of innate inflammatory
molecules such as IL-1b. 

012_Clinical Correlate: Autoimmunity Cases

• Describe all the clinical manifestations of rheumatoid arthritis

• Describe how anti-citrullinated protein antibodies are used in the diagnosis of rheumatoid
arthritis and why this may be a better marker of disease than rheumatoid factor.

• Compare and contrast the current biologicals available for treatment of rheumatoid arthritis
(e.g. various anti-TNF-alpha immunotherapies, IL-1 inhibition, Rituxan, and Abatacept),
including their mechanism of action and the roles they play in treating chronic inflammatory
diseases.
• Explain the role of the inflammasome in the pathogenesis of an acute gout attack.

• Explain why an immunotherapy like Remicase may loose efficacy over time in some
patients
• Describe the risks associated with treating patients with anti-TNF-alpha immunotherapies

draft April 23, 2019 !1

Micro 120 Posted Session Objectives Exam 2 2019

013_Cancer Immunology
• Describe the evidence for immune prevention of cancer in humans
• Explain the concept of “checkpoint blockade” in cancer immunotherapy
• Describe the side effects observed in checkpoint blockade
• Describe feature of monoclonal antibodies that can be harnessed to use as therapeutics
• Give examples of immunotherapeutic antibodies that target T cells
• Give examples of immunotherapeutic antibodies that target tumor itself
• Give an example of a vaccine for prevention of cancer in humans, in animals

014_Immune Response and Transplant

• Explain how T cells respond to transplanted organs with mismatched MHC alleles, leading
to transplant rejection.
• Describe the molecular basis for treatment of transplant rejection and immunological
considerations in solid tissue transplantation.
• Explain the difference between the immunological mechanisms that mediate transplant
rejection and graft versus host disease.
• Compare and contrast the role of matching HLA types in transplant outcome for solid organ
and bone marrow transplantation. Explain why some MHC alleles must be shared between
donor and recipient for successful bone marrow transplantation.
• Explain the rationale for depleting T cells from donor bone marrow prior to transplantation.
• Describe the immune disorder and clinical consequences of phagocyte deficiencies such
as chronic granulomatous disease.
• Describe the immune disorder and clinical consequences of B cell and antibody
deficiencies such as Bruton’s X-linked Agammaglobulinemia (XLA) and Hyper IgM
syndrome.
• Describe the immune disorder and clinical consequences of T cell deficiencies and severe
combined immunodeficiency (SCID).

015_Clinical Correlate: Bone Marrow Transplant

• List different cellular components in the bone marrow, and their functions in the immune
system.

• Provide a comprehensive explanation for the differences between solid organ transplant
and bone marrow transplant

• Explain the differences in the mechanism between solid organ transplant rejection and
graft-vs-host disease in bone marrow transplant.

• Name the major cytokines and cells involved in GvHD.

• Describe a common course of acute GvHD.

• Explain why bone marrow transplant patients are treated with chemotherapy,
immunosuppression, and antimicrobials prior to receiving a bone marrow transplant.
draft April 23, 2019 !2
Micro 120 Posted Session Objectives Exam 2 2019

016_Clinical Correlate: Solid Organ Transplant

• Describe the immunologic basis of solid organ transplant rejection
• Describe the types and nomenclature of solid organ transplantation

• Describe the mechanism of action of the different classes of immunosuppressive drugs

and recognize/name examples of each class
• Describe some of the common adverse effects of the various immunosuppressive drug
classes

ILM Session: Introduction to Micro

• Compare and contrast prokaryotic and eukaryotic cells regarding cell structure, nature of
outer surface, structure of ribosomes, and presence of membrane-bound organelles (ie
mitochondria)
• Compare and contrast between the cell wall structure of Gram (+), Gram (-), and acid fast
bacteria
• Describe the composition of the outer lipopolysaccharide membrane (LPS) of Gram (-)
bacteria
• Describe the biological effects of endotoxin and its role in disease
• Describe the composition & function of bacterial capsules
• Define the term “normal flora” and list 4 characteristics that describe normal flora
• Describe 3 functions of the normal flora
• Name the enzymes that tend to be deficient in anaerobic organism1

ILM: Bacterial Genetics and Antimicrobial Drug Resistance

• Describe spontaneous mutation and its role in genetic variability of microbes
• Define the term “transformation” and describe its function in genetic variability of microbes
• Describe the process of bacterial conjugation
• Define and describe lysogeny.  Compare this with lytic growth.
• Describe transposons and how they contribute to genetic variability in microbes
• Describe four major mechanisms that confer antibacterial drug resistance and give
examples
• Define and distinguish between bacteriostatic vs bactericidal antimicrobial therapies
• Describe how to calculate the minimal inhibitory concentration for an antimicrobial
• Compare and contrast disk diffusion and broth dilution susceptibility tests and describe
what each method measures.

draft April 23, 2019 !3

Micro 120 Posted Session Objectives Exam 2 2019

017_Bacterial Pathogenesis and Host Response

• Describe the major virulence mechanisms that microbes have evolved to evade, subvert or
circumvent host immune system and connect these factors with specific host defenses that
are disrupted by these factors
• Define tissue and host tropism and describe what determines this
• Compare and contrast endotoxin with exotoxin. Describe how each class of toxin
contributes to disease.
• Explain the mechanism of action of AB toxins and describe a few toxins with respect to the
downstream effects they have on the host
• Define what a superantigen is and explain how they act
• Define immunopathology and describe host immune factors that are involved in
immunopathogenesis
• Differentiate between Community Acquired and Hospital Acquired (nosocomial) infections

Exam 2 (5/7): covers sessions through and including Bacterial Pathogenesis on 5/3 (but
NOT Gram (+) Cocci)

draft April 23, 2019 !4