Anatomy and Physiology 2

1. What do all nonspecific defenses have in common?

A) They are present at birth.

B) They work against all potential invaders.

C) They provide immediate protection.

D) They are considered innate defenses.

E) All of these are correct.

2.  The first line of defense against pathogens includes

A) inflammation and phagocytosis.

B) the skin and mucous membranes.

C) interferon and complement.

D) fever and lysozyme.

E) skin and phagocytosis.

3.  All of the following mechanisms actually expel pathogens from the body EXCEPT:

A) vaginal secretion

B) emesis (vomiting)

C) phagocytosis

D) urination

E) defecation

14) Which of the following is an antimicrobial protein found in the blood and interstitial fluid?

A) interferon

B) complement

C) transferring

D) A and B are correct.

E) A, B and C are correct.

4.  Which substance prevents viral replication?

A) interferon

B) complement

C) transferring

D) lysozyme

E) sebum

5.  Natural killer (NK) cells

A) are large, specialized monocytes.

B) ingest microbes.

C) secrete perforin and granzymes to destroy target cells.

D) 50-70% of all lymphocytes.

E) cannot attack body cells.

6.  Place the stages of phagocytosis in the order in which they occur:

1. adherence    2. chemotaxis 3. killing          4. ingestion      5. digestion

A) 1, 2, 4, 5, 3

B) 2, 1, 5, 4, 3

C) 2, 4, 1, 5, 3

D) 2, 1, 4, 5, 3

E) 2, 1, 4, 3, 5

7.  Inflammation

A) is a tissue response to injury.

B) is characterized by redness, swelling, heat and pain.

C) is the body’s first and foremost defense against infection.

D) A and B are correct.

E) A, B and C are correct.

8.  The first stage of the inflammation response is

A) vasodilation

B) vasoconstriction

C) chemotaxis

D) phagocytosis

E) tissue repair

9.     All of the following are examples of passive humoral immunity, EXCEPT:

a.     Nutrients crossing placenta
b.     Rhogam (Anti-D Immunoglobulin)
c.     Snake bite treatments
d.     Streptococcus infection
10.  Mast cells release _____________, which promotes the inflammatory response.

a.     Histamine
b.     Dermcidin
c.     Lysozyme
d.     Prostaglandins
e.     Complement

11.  Animal dander and some detergents are ____________ and cause hypersensitivities in some individuals.
a.     Self- antigens
b.     T lymphocytes
c.     Haptens
d.     Antigen presenting cells
e.     Toll-like receptors

12.  Which of the following is a correct sequence of events in the immune process?
I.               Neutrophils squeeze through capillary walls
II.             Inflamed endothelial cells develop cell adhesion molecules
III.           Chemotaxis of various white blood cells
IV.          Margination
V.            Neutrophils flood to site of injury

a.     V, I, II, IV, III
b.     I, V, III, II, IV
c.     V, II, IV, I, III
d.     III, II, V, I, IV
e.     II, V, IV, I, III

13.  Which one of the following is most likely to kill a cell that is infected by a virus?

a. Natural killer cell
b. Eosinophil
c. Mast cell
d. Helper T cell
e. B cell

14.  Which of the following is true of opsonization?
a.     Increases release of pyrogens
b.     Coating of pathogen surface to enhance phagocytosis
c.     Ability to stimulate proliferation of specific lymphocytes
d.     Recognization of self-antigens

15.  Immunological memory does not occur in the passive humoral immunity response.
A-   True

B-   False

16.  B lymphocytes are involved in:
a.     Humoral immunity
b.     Non specific immunity
c.     Cell-mediated immunity
d.     None of the above

17.  These cells engulf antigens and display their fragments on their plasma membrane surfaces:
a.     Immunoglobulins
b.     Cytotoxic T cells
c.     Natural killer cells
d.     Antigen-presenting cells
e.     CD4 cells

18.  Antibodies are also known as immunoglobulins.
a.     True

b.     False

19.  All of the following are signs of inflammation, EXCEPT:
a.     Edema
b.     Apoptosis
c.     Erythema
d.     Heat
e.     Pain

20.  Which of the following describes neutralization, a mechanism used by antibodies?
a.     Complement fixation is triggered
b.     Virus can’t bind to receptors on body cells
c.     Clumping of foreign cells
d.     Soluble molecules are cross linked into large complexes

21) How does immunity differ from nonspecific defenses?

A) Immunity provides protection against specific foreign antigens.

B) Immunity displays memory.

C) Immunity requires distinction between self and nonself antigens.

D) A and B are correct.

E) A, B and C are correct.

22.  Which of the following is NOT correct?

A) Immunocompetent cells are able to conduct immune responses when properly stimulated.

B) Immunocompetent cells include B cells and NK cells.

C) Immunocompetent cells have distinct plasma membrane proteins.

D) Immunocompetent cells that will become plasma cells complete development in bone marrow.

E) Immunocompetent cells that will be CD4 or CD8 cells complete development in the thymus.

23.  Cell-mediated immunity

A) conversion of CD8 cells to cytotoxic (killer) T cells.

B) differentiation of CD4 cells into helper T cells.

C) always involves cells attacking cells.

D) works best against intracellular pathogens, cancer cells, and transplanted cells.

E) All of these are correct.

24.  Which of the following is NOT true of antigens?

A) They have immunogenicity; they can provoke immune responses.

B) They have reactivity; they can react with the antibodies or cells they provoked.

C) They have small parts called haptens that stimulate an immune response.

D) They are often large protein molecules.

E) They may be natural or man-made molecules.

25.  Why can the body recognize so many different antigens?

A) The body has billions of genes for antigen receptors.

B) A given antigen receptor can bind many very different antigens.

C) Most antigens differ only slightly; one receptor can recognize closely related antigens.

D) The genes for antigen receptors can be recombined to form many different receptor proteins.

E) All of these are correct.

26.  MHC antigens

A) are self-antigens.

B) include type I antigens, which are found on virtually all nucleated cells in the body.

C) include type II antigens, which are found only on activated antigen presenting cells.

D) A and B are correct.

E) A, B and C are correct.

27.  Which of the following is correct?

A) T cells only recognize antigenic fragments that are processed and presented in specific ways.

B) Exogenous antigens trigger production of abnormal MHC I complexes.

C) Endogenous antigens cause production of MHC II complexes by antigen presenting cells.

D) A and B are correct.

E) A, B and C are correct.

28.  Which of the following is correct?

A) At any given time, most T cells are actively attacking antigens.

B) Antigen-MHC complex binding to TCRs is required but not sufficient to activate T cells.

C) CD4 and CD8 proteins are alternate forms of MHC proteins that can activate T cells.

D) Costimulated T cells enter a state of anergy.

E) Activated T cells shrink and lose mitotic ability.

29.  Helper T cells

A) bear CD4 proteins in their plasma membranes.

B) secrete interleukins.

C) interact with APCs.

D) A and B are correct.

E) A, B and C are correct.

30.  Cytotoxic T cells

A) arise from CD4 cells.

B) are most effective against extracellular pathogens.

C) need exposure to antigen associated with both MHC-I and MHC-II molecules for full activity.

D) do not need stimulation by interleukins to become activated.

E) All of these are correct.

31.  Cytotoxic cells may destroy pathogens and abnormal body cells via all of the following mechanisms EXCEPT:

A) releasing of granzymes, causing apoptosis of the target cell.

B) phagocytosis of the target cell.

C) creating channels in the target plasma membrane using perforin, thereby causing cytolysis.

D) using granulysin to create holes in the pathogen’s plasma membrane.

E) secreting lymphotoxin, which activates enzymes in the pathogen and destroys its DNA.

32. B cells do each of the following EXCEPT

A) bear BCRs in their plasma membranes that are similar to the antibodies they will secrete.

B) can recognize unprocessed antigens.

C) react more strongly to unprocessed antigens than processed ones.

D) proliferate and differentiate in response to helper T cell secretions.

E) become plasma cells.

33.  Which is NOT true of antibodies?

A) They are protein molecules that bind to specific antigens.

B) They are produced by T cells.

C) They consist of 2 heavy and 2 light chains.

D) They contain fixed and variable regions.

E) They are also called immunoglobulins.

34.  How do antibodies disable antigens?

A) agglutinating and precipitating antigens

B) immobilizing bacteria and enhancing phagocytosis

C) activating complement

D) A and B are correct.

E) A, B and C are correct.

35.  Complement

A) is a series of proteins that assist in fighting infections.

B) is associated with phagocytosis, cytolysis, and inflammation.

C) is made by the spleen.

D) A and B are correct.

E) A, B and C are correct.

36.  Which of the following correctly describes a pathway leading to activation of complement C3 protein?

A) classical: lipid-carbohydrate complexes on microbe surfaces interact with factors B,D, and P

B) alternate: antigen-antibody complexes bind to and activate C1

C) lectin: liver produces lectins in response to chemicals from macrophages digesting pathogens

D) A and B are correct.

E) A, B and C are correct.

37.  Immunological memory

A) provides rapid response to subsequent infections by the same pathogen.

B) is due to the presence of long-lasting antibodies and very long-lived lymphocytes.

C) provides the basis for vaccination.

D) can be measured, in part, by an antibody titer.

E) All of these are correct.

38.  Which of the following is correct?

A) B and T cells display self-tolerance.

B) T cells must be able to recognize self-antigens.

C) T cells must not display self-recognition.

D) A and B are correct.

E) A, B and C are correct.

39.  Negative selection

A) by deletion results in T cells that remain alive but cannot be activated.

B) by anergy results in apoptosis of T cells that would destroy self tissues.

C) leads to development of self-tolerance.

D) A and B are correct.

E) A, B and C are correct.

40.  Which of the following lists contains only antigen presenting cells (APCs)?

A) B cells, dendritic cells, macrophages

B) neutrophils, macrophages, eosinophils

C) B cells, T cells, natural killer cells

D) B cells, plasma cells, memory B cells

E) helper T cells, cytotoxic T cells, memory T cells

41.  Which of the following lists contains only cells involved in antibody-mediated immunity?

A) B cells, dendritic cells, macrophages

B) neutrophils, macrophages, eosinophils

C) B cells, T cells, natural killer cells

D) B cells, plasma cells, memory B cells

E) helper T cells, cytotoxic T cells, memory T cells

42.  Exogenous antigens are displayed on Class ________ MHC proteins.

a.     I
b.     II
c.     III
d.     None of the above

43.  The process of phagocytes clinging to the inner walls of capillaries in the immune response is:

a.     Chemotaxis
b.     Margination
c.     Leukocytosis

d.     Diapedesis

44.  What type of cells must recognize non-self antigens and self antigens before becoming activated?
a.     T cells
b.     B cells
c.     Natural killer cells
d.     Regulatory B cells
e.     Antigen-presenting cells

45.   The adaptive immune response cannot occur without the aid of helper T cells.
a.     True

b.     False

46.  These cells are the only T cells that can directly kill other cells by perforins or stimulating apoptosis by granzymes:
a.     Natural killer cells
b.     Regulatory T cells
c.     Cytotoxic T cells
d.     Helper T cells
e.     Mast cells

47.  Which of the following is true concerning regulatory T cells?
a.     ‘look’ for lack of Class I MHC
b.     Start T cell proliferation
c.     Prevent autoimmune reactions
d.     Stimulates apoptosis of pathogens
e.     Cause clonal selection

48.  Natural killer cells are a component of the adaptive immune system.
a.     True

b.     False

49.  What is the direct result of pyrogens secreted from white blood cells?
a.     Fever
b.     Edema
c.     Complement activation
d.     Immunological memory
e.     Increase in mucus production

50.  These proteins are secreted by cells infected with viruses to stimulate nearby, uninfected cells to produce viral replication inhibiting substances:
a.     Kinins
b.     Histamine
c.     Antibodies
d.     Cytotoxin
e.     Interferons

51.  The primary immune response of humoral immunity takes approximately 3-6 days to occur.
a.     True

b.     False

52.  Which of the following is NOT considered an example of a 1st line of defense?
a.     Protein digesting enzymes in the stomach
b.     Lysozyme in lacrimal fluid
c.     Interferons
d.     Acidity of skin secretions
e.     Mucus

53.  This type of immunity occurs when you receive a flu vaccination:
a.     Naturally acquired passive
b.     Naturally acquired active
c.     Artificially acquired passive
d.     Artificially acquired active

54.  The membrane attack complex causes:
a.     Immunogenicity
b.     Lysis of pathogenic cells
c.     Liver to sequester iron & zinc
d.     Surface proteins to mark cell as ‘self’
e.     Clonal selection

55.  A developing fetus receives what type of immunity from its mother?
a.     Naturally acquired active
b.     Naturally acquired passive
c.     Artificially acquired active
d.     Artificially acquired passive

56.  The linking of soluble antigens by antibodies is known as:
a.     Complement fixation
b.     Self lysis/Autolysis
c.     Neutralization
d.     Agglutination
e.     Precipitation

57.  All of the following are functions of the paranasal sinuses, EXCEPT:
a.     Lightens the skull
b.     Provides resonance of sound
c.     Warms and humidifies the air
d.     Produces mucus

58.  This structure allows ear pressure to equalize with atmospheric pressure:
a.     Nasopharynx
b.     Pharyngeal tonsil
c.     Auditory tube
d.     Epiglottis
e.     Alveolar pores

59.  Epinephrine release during exercise causes bronchiolar smooth muscle to:
a.     Dilate
b.     Constrict

60.  An increase in carbon dioxide levels in the blood causes all of the following to occur, EXCEPT:
a.     Excites central chemoreceptors
b.     increase in respiratory rate and depth
c.     pH increases
d.     hydrogen ions dissociate

61.  During a secondary immune response, the antibody titer decreases.
a.     True

b.     False

62.  Which of the following is NOT TRUE?

a. The lag period is longer during the secondary immune response than during the primary immune response.

b. Tonsils contain crypts that “trap” pathogens, which can result in the destruction of the pathogen and the production of memory cells.

c. Peyer’s patches are found in the distal small intestine.

d. Serious chronic inflammation can result in formation of pus.

e. The primary function of the spleen is red blood cell removal/recycling.

63.  Which of the following is an example of natural passive immunity?

a. Getting sick with monkey pox.

b. Getting vaccinated for monkey pox.

c. Getting an injection of antibodies from a passive nurse

d. Transfer of antibodies from maternal blood to fetal blood

e. Transfer of Helper T cells from maternal blood to fetal blood.

64.   Which of the following are characteristics of skin that help it prevent pathogen invasion?

1. Keratin             2. Sweat          3. Sebum

a. 1, 2, and 3

b. 1 and 2

c. 2 and 3

d. 1 only

e. 3 only

65.  The binding of complement proteins to a bacterium causes the likelihood of that bacterium being phagocytized to:

a. Increase

b. Decrease

c. Stay the same

66.   An immunocompetent B lymphocyte:

a. Cannot respond to pathogens

b. Contains many copies of a single antigen receptor on its surface

c. Matured in the thymus

d. Can respond to antigens of many different shapes and sizes

e. None of the above

67.  During a moderate fever, plasma levels of Zn and Fe would be expected to:

a. Increase

b. Decrease

c. Stay the same

68.  A membrane attack complex:

a. Is an important part of the specific immune system

b. Is composed of activated antibodies

c. Acts to cause bacterial cell lysis

d. Has the same function as cilia

e. None of the above

69.  The linking of soluble antigens by antibodies is known as:

a. Agglutination

b. Self lysis

c. Neutralization

d. Aggrandization

e. Precipitation

70.   Which of the following is NOT an antibody class?

a. IgE

b. IgD

c. IgF

d. IgA

e. IgG

71.  Which of the following cells build the framework upon which lymphoid tissues and organs are constructed?

a. Dendritic cells

b. Monophages

c. Reticular cells

d. APC’s

e. Lymphocytes

72.  Alexander Fleming made a serendipitous discovery.  One day when he was suffering from a cold, he sneezed on a bacterial culture of Micrococcus lysodeikticus.  Following his usual routine of leaving his bacterial cultures lying about, 10 days later he observed that the bacteria near his own nasal mucus had dissolved.  The best explanation for this is that:

a. His mucus contained large quantities of lysozyme

b. His mucus had a low osmotic pressure

c. His mucus contained B lymphocytes that had recently matured in the thymus

d. His mucus lacked T lymphocytes

e. His mucus contained a large quantity of natural killer cells

73.  Which of the following organs contains these structures: – Connective tissue capsule – Afferent lymphatic vessels – B lymphocytes – T lymphocytes

a. Spleen

b. Lymph node

c. Thymus

d. Pharyngeal tonsil

e. Appendix

74.  Which of the following cells is “in charge” of the specific immune system?

a. Dendritic cells

b. CD4 cells

c. Cytotoxic T cells

d. CD8 cells

e. Granular leukocytes

75.  Which of the following is NOT TRUE?

a. Cisterna chyli is the beginning of the thoracic duct

b. Plasma cells’ primary function is secreting complement proteins

c. Diffuse lymphatic tissue is in the lining of the digestive tract

d. Lymphoid follicles are found in the appendix

e. Spleen is a site of fetal RBC production

76. Which of the following is/are true of dendritic cells?

a. They are capable of phagocytosis

b. They present antigens to T lymphocytes

c. They contain MHC 1 proteins

d. They contain MHC 2 proteins

e. All of the above

77. During inflammation, local blood vessel resistance will:

a. Increase

b. Decrease

c. Stay the same

78.  Which one of the following is most likely to kill a cell that is infected by a virus?

a. Natural killer cell

b. Eosinophil

c. Interferon

d. Helper T cell

e. Dendritic cell

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