NSG 5003 Week 2 Study Guide
Chapter 7: Innate Immunity: Inflammation
MULTIPLE CHOICE
1. Which action is a purpose of the inflammatory process?
a. To provide specific responses toward antigens
b. To lyse cell memb
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NSG 5003 Week 2 Study Guide
Chapter 7: Innate Immunity: Inflammation
MULTIPLE CHOICE
1. Which action is a purpose of the inflammatory process?
a. To provide specific responses toward antigens
b. To lyse cell membranes of microorganisms
c. To prevent infection of the injured tissue
d. To create immunity against subsequent tissue injury
2. How do surfactant proteins A through D provide innate resistance?
a. Initiate the complement cascade. c. Secrete mucus.
b. Promote phagocytosis. d. Synthesize lysosomes.
3. Which secretion is a first line of defense against pathogen invasion that involves antibacterial and antifungal fatty acids, as well as lactic acid?
a. Optic tears c. Sweat gland perspiration
b. Oral saliva d. Sebaceous gland sebum
4. Which bacterium grows in the intestines after prolonged antibiotic therapy?
a. Lactobacillus c. Clostridium difficile
b. Candida albicans d. Helicobacter pylori
5. What causes the edema that occurs during the inflammatory process?
a. Vasodilation of blood vessels c. Endothelial cell contraction
b. Increased capillary permeability d. Emigration of neutrophils
6. What process causes heat and redness to occur during the inflammatory process?
a. Vasodilation of blood vessels c. Decreased capillary permeability
b. Platelet aggregation d. Endothelial cell contraction
7. Activation of the classical pathway begins with:
a. Viruses c. Mast cells
b. Antigen-antibody complexes d. Macrophages
8. What plasma protein system forms a fibrinous meshwork at an inflamed site?
a. Complement c. Kinin
b. Coagulation d. Fibrinolysis
9. Which component of the plasma protein system tags pathogenic microorganisms for destruction by neutrophils and macrophages?
a. Complement cascade c. Kinin system
b. Coagulation system d. Immune system
10. What is the vascular effect of histamine released from mast cells?
a. Platelet adhesion c. Vasodilation
b. Initiation of the clotting cascade d. Increased endothelial adhesiveness
11. What is an outcome of the complement cascade?
a. Activation of the clotting cascade
b. Prevention of the spread of infection to adjacent tissues
c. Inactivation of chemical mediators such as histamine
d. Lysis of bacterial cell membranes
12. The function of opsonization related to the complement cascade is to:
a. Tag of pathogenic microorganisms for destruction by neutrophils and macrophages.
b. Process pathogenic microorganisms so that activated lymphocytes can be created for acquired immunity.
c. Destroy glycoprotein cell membranes of pathogenic microorganisms.
d. Promote anaphylatoxic activity, resulting in mast cell degranulation.
13. In the coagulation (clotting) cascade, the intrinsic and the extrinsic pathways converge at which factor?
a. XII c. X
b. VII d. V
14. Which chemical interacts among all plasma protein systems by degrading blood clots, activating complement, and activating the Hageman factor?
a. Kallikrein c. Bradykinin
b. Histamine d. Plasmin
15. The chemotactic factor affects the inflammatory process by:
a. Causing vasodilation around the inflamed area
b. Stimulating smooth muscle contraction in the inflamed area
c. Directing leukocytes to the inflamed area
d. Producing edema around the inflamed area
16. What affect does the process of histamine binding to the histamine-2 (H2) receptor have on inflammation?
a. Inhibition c. Acceleration
b. Activation d. Termination
17. Frequently when H1 and H2 receptors are located on the same cells, they act in what fashion?
a. Synergistically c. Antagonistically
b. Additively d. Agonistically
18. Some older adults have impaired inflammation and wound healing because of which problem?
a. Circulatory system cannot adequately perfuse tissues.
b. Complement and chemotaxis are deficient.
c. Underlying chronic illness(es) exists.
d. Number of mast cells is insufficient.
19. Which chemical mediator derived from mast cells retracts endothelial cells to increase vascular permeability and to cause leukocyte adhesion to endothelial cells?
a. Leukotrienes c. Platelet-activating factor
b. Prostaglandin E d. Bradykinin
20. What is the inflammatory effect of nitric oxide (NO)?
a. Increases capillary permeability, and causes pain.
b. Increases neutrophil chemotaxis and platelet aggregation.
c. Causes smooth muscle contraction and fever.
d. Decreases mast cell function, and decreases platelet aggregation.
21. What is the correct sequence in phagocytosis?
a. Engulfment, recognition, fusion, destruction
b. Fusion, engulfment, recognition, destruction
c. Recognition, engulfment, fusion, destruction
d. Engulfment, fusion, recognition, destruction
22. When considering white blood cell differentials, acute inflammatory reactions are related to elevations of which leukocyte?
a. Monocytes c. Neutrophils
b. Eosinophils d. Basophils
23. In the later stages of an inflammatory response, which phagocytic cell is predominant?
a. Neutrophils c. Chemokines
b. Monocytes d. Eosinophils
24. In regulating vascular mediators released from mast cells, the role of eosinophils is to release:
a. Arylsulfatase B, which stimulates the formation of B lymphocytes
b. Histaminase, which limits the effects of histamine during acute inflammation
c. Lysosomal enzymes, which activate mast cell degranulation during acute inflammation
d. Immunoglobulin E, which defends the body against parasites
25. What is the role of a natural killer (NK) cells?
a. Initiation of the complement cascade
b. Elimination of malignant cells
c. Binding tightly to antigens
d. Proliferation after immunization with antigen
26. Which cytokine is produced and released from virally infected host cells?
a. IL-1 c. TNF-
b. IL-10 d. IFN-
27. IFN- is secreted from which cells?
a. Virally infected cells c. Macrophages
b. Bacterial infected cells d. Mast cells
28. Which manifestation of inflammation is systemic?
a. Formation of exudates c. Redness and heat
b. Fever and leukocytosis d. Pain and edema
29. The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by:
a. Endogenous pyrogens c. Antigen-antibody complexes
b. Bacterial endotoxin d. Exogenous pyrogens
30. What occurs during the process of repair after tissue damage?
a. Nonfunctioning scar tissue replaces destroyed tissue.
b. Regeneration occurs; the original tissue is replaced.
c. Resolution occurs; tissue is regenerated.
d. Epithelialization replaces destroyed tissue.
31. The role of fibroblasts during the reconstructive phase of wound healing is to:
a. Generate new capillaries from vascular endothelial cells around the wound.
b. Establish connections between neighboring cells and contract their fibers.
c. Synthesize and secrete collagen and the connective tissue proteins.
d. Provide enzymes that débride the wound bed of dead cells.
32. A keloid is the result of which dysfunctional wound healing response?
a. Epithelialization c. Collagen matrix assembly
b. Contraction d. Maturation
33. Which solution is best to use when cleaning a wound that is healing by epithelialization?
a. Normal saline c. Hydrogen peroxide
b. Povidone-iodine d. Dakin solution
34. Many neonates have a transient depressed inflammatory response as a result of which condition?
a. The circulatory system is too immature to perfuse tissues adequately.
b. Complement and chemotaxis are deficient.
c. Mast cells are lacking.
d. The respiratory system is too immature to deliver oxygen to tissues.
35. During phagocytosis, what is occurring during the step referred to as opsonization?
a. Phagocytes recognize and adhere to the bacteria.
b. Microorganisms are ingested.
c. Microorganisms are killed and digested.
d. An intracellular phagocytic vacuole is formed.
36. Fusion is the step in phagocytosis during which:
a. Microorganisms are killed and digested.
b. An intracellular phagocytic vacuole is formed.
c. Lysosomal granules enter the phagocyte.
d. Microorganisms are ingested.
37. During the process of endocytosis, the phagosome step results in:
a. Microorganisms are ingested.
b. Microorganisms are killed and digested.
c. Phagocytes recognize and adhere to bacteria.
d. An intracellular phagocytic vacuole is formed.
38. When cellular damage occurs and regeneration is minor with no significant complications, the process of returning the cells to preinjury function is referred to as:
a. Restoration c. Regrowth
b. Resolution d. Replacement
39. Newborns often have deficiencies in collectin-like proteins, making them more susceptible to what type of infection?
a. Cardiac c. Respiratory
b. Urinary d. Gastrointestinal
40. Which cell is the body’s primary defense against parasite invasion?
a. Eosinophil c. T lymphocytes
b. Neutrophils d. B lymphocytes
Chapter 8: Adaptive Immunity
MULTIPLE CHOICE
1. Which primary characteristic is unique for the immune response?
a. The immune response is similar each time it is activated.
b. The immune response is specific to the antigen that initiates it.
c. The response to a specific pathogen is short term.
d. The response is innate, rather than acquired.
2. In which structure does B lymphocytes mature and undergo changes that commit them to becoming B cells?
a. Thymus gland c. Bone marrow
b. Regional lymph nodes d. Spleen
3. What is the term for the process during which lymphoid stem cells migrate and change into either immunocompetent T cells or immunocompetent B cells?
a. Clonal diversity c. Clonal selection
b. Clonal differentiation d. Clonal competence
4. Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen?
a. Passive-acquired immunity c. Passive-innate immunity
b. Active-acquired immunity d. Active-innate immunity
5. What type of immunity is produced when an immunoglobulin crosses the placenta?
a. Passive-acquired immunity c. Passive-innate immunity
b. Active-acquired immunity d. Active-innate immunity
6. The portion of the antigen that is configured for recognition and binding is referred to as what type of determinant?
a. Immunotope c. Epitope
b. Paratope d. Antigenitope
7. Which characteristic is the most important determinant of immunogenicity when considering the antigen?
a. Size c. Complexity
b. Foreignness d. Quantity
8. When antigens are administered to produce immunity, why are different routes of administration considered?
a. Different routes allow the speed of onset of the antigen to be varied, with the intravenous route being the fastest.
b. Some individuals appear to be unable to respond to an antigen by a specific route, thus requiring the availability of different routes for the same antigen.
c. Antigen-presenting cells are highly specialized and thus require stimulation by different routes.
d. Each route stimulates a different lymphocyte-containing tissue, resulting in different types of cellular and humoral immunity.
9. The functions of the major histocompatibility complex (MHC) and CD1 molecules are alike because both:
a. Are antigen-presenting molecules.
b. Bind antigens to antibodies.
c. Secrete interleukins during the immune process.
d. Are capable of activating cytotoxic T lymphocytes.
10. Where are antibodies produced?
a. Helper T lymphocytes c. Plasma cells
b. Thymus gland d. Bone marrow
11. Which immunoglobulin is present in blood, saliva, breast milk, and respiratory secretions?
a. IgA c. IgG
b. IgE d. IgM
12. Which antibody initially indicates a typical primary immune response?
a. IgG c. IgA
b. IgM d. IgE
13. An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody?
a. IgG c. IgA
b. IgM d. IgE
14. The B-cell receptor (BCR) complex functions uniquely by:
a. Communicating information about the antigen to the helper T cell
b. Secreting chemical signals to communicate between cells
c. Recognizing the antigen on the surface of the B lymphocyte
d. Communicating information about the antigen to the cell nucleus
15. The generation of clonal diversity occurs primarily during which phase of life?
a. Fetal c. Infancy
b. Neonatal d. Puberty
16. The generation of clonal diversity includes a process that:
a. Involves antigens that select those lymphocytes with compatible receptors.
b. Allows the differentiation of cells into antibody-secreting plasma cells or mature T cells.
c. Takes place in the primary (central) lymphoid organs.
d. Causes antigens to expand and diversify their populations.
17. Which statement is true concerning clonal selection?
a. Clonal selection is driven by hormones and does not require foreign antigens.
b. This theory involves antigens that select those lymphocytes with compatible receptors.
c. Clonal selection takes place in the primary (central) lymphoid organs.
d. This process generates immature but immunocompetent T and B cells with receptors.
18. Which is an example of an endogenous antigen?
a. Yeast c. Bacteria
b. Cancer cells d. Fungus
19. Which cytokine is needed for the maturation of a functional helper T cell?
a. IL-1 c. IL-4
b. IL-2 d. IL-12
20. Th2 cells produce IL-4 and suppress which cells?
a. B lymphocytes c. Th1 cells
b. Cytotoxic T lymphocytes d. Memory T lymphocytes
21. Which statement is believed to be true concerning Th1 cells?
a. Th1 cells are induced by antigens derived from allergens.
b. They are induced by antigens derived from cancer cells.
c. Th1 cells produce IL-4, IL-5, IL-6, and IL-13.
d. They assist in the development of humoral immunity.
22. Which statement is believed to be true concerning Th2 cells?
a. Th2 cells are induced by antigens derived from allergens.
b. They are induced by antigens derived from cancer cells.
c. Th2 cells produce IL-2, TNF-ß, and IFN- .
d. They assist in the development of cell-mediated immunity.
23. When a person is exposed to most antigens, antibodies can be usually detected in his or her circulation within:
a. 12 hours c. 3 days
b. 24 hours d. 6 days
24. Vaccinations are able to provide protection against certain microorganisms because of the:
a. Strong response from IgM c. Memory cells for IgE
b. Level of protection provided by IgG d. Rapid response from IgA
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25. Why is the herpes virus inaccessible to antibodies after the initial infection?
a. The virus does not circulate in the blood.
b. It does not have antibody receptors.
c. It resists agglutination.
d. The virus is a soluble antigen.
26. Increased age may cause which change in lymphocyte function?
a. Increased production of antibodies against self-antigens
b. Decreased number of circulating T cells
c. Decreased production of autoantibodies
d. Increased production of helper T cells
27. How do antibodies protect the host from bacterial toxins?
a. Lysing the cell membrane of the toxins
b. Binding to the toxins to neutralize their biologic effects
c. Inhibiting the synthesis of DNA proteins needed for growth
d. Interfering with the DNA enzyme needed for replication
28. Which T cell controls or limits the immune response to protect the host’s own tissues against an autoimmune response?
a. Cytotoxic T cells c. Th2 cells
b. Th1 cells d. Regulatory T (Treg) cells
29. Evaluation of umbilical cord blood can confirm that which immunoglobulin level is near adult levels?
a. IgA c. IgM
b. IgG d. IgE
30. Which statement is true concerning the IgM?
a. IgM is the first antibody produced during the initial response to an antigen.
b. IgM mediates many common allergic responses.
c. IgM is the most abundant class of immunoglobulins.
d. IgM is capable of crossing the human placenta.
31. Which cell has the ability to recognize antigens presented by the MHC class I molecules?
a. T cytotoxic c. CD 8
b. CD 4 d. T helper
32. Which cell has a role in developing cell-mediated immunity?
a. Th1 c. CD8
b. CD4 d. Th2
33. How does the aging process of the T-cell activity affect older adults?
a. Poor heat regulation abilities
b. Increased risk for bone fractures
c. Tendency to develop various infections
d. Likelihood of experiencing benign skin lesions
34. Which statement is true regarding maternal antibodies provided to the neonate?
a. The antibodies enter into the fetal circulation by means of active transport.
b. The antibodies are transferred to the fetus via the lymphatic system.
c. The antibodies are directly related to the mother’s nutritional intake.
d. The antibodies reach protective levels after approximately 6 months of age.
35. Antibodies that are associated with mucosal immune system, such as immunoglobulins, function to prevent which type of infections?
a. Infections that attack the respiratory system
b. Infections that tend to be chronic in nature
c. Infections likely to be resistant to antibiotics
d. Infections that focus on epithelial surfaces of the body
36. Cytokines are vital to a cell’s ability to do which function?
a. Excrete c. Metabolize
b. Reproduce d. Communicate
Chapter 9: Alterations in Immunity and Inflammation
MULTIPLE CHOICE
1. Hypersensitivity is best defined as a(an):
a. Disturbance in the immunologic tolerance of self-antigens
b. Immunologic reaction of one person to the tissue of another person
c. Altered immunologic response to an antigen that results in disease
d. Undetectable immune response in the presence of antigens
2. A hypersensitivity reaction that produces an allergic response is called:
a. Hemolytic shock c. Necrotizing vasculitis
b. Anaphylaxis d. Systemic erythematosus
3. The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins?
a. IgE c. IgM
b. IgG d. T cells
4. Which type of antibody is involved in type I hypersensitivity reaction?
a. IgA c. IgG
b. IgE d. IgM
5. Blood transfusion reactions are an example of:
a. Autoimmunity c. Homoimmunity
b. Alloimmunity d. Hypersensitivity
6. During an IgE-mediated hypersensitivity reaction, which leukocyte is activated?
a. Neutrophils c. Eosinophils
b. Monocytes d. T lymphocytes
7. During an IgE-mediated hypersensitivity reaction, what causes bronchospasm?
a. Bronchial edema caused by the chemotactic factor of anaphylaxis
b. Bronchial edema caused by binding of the cytotropic antibody
c. Smooth muscle contraction caused by histamine bound to H1 receptors
d. Smooth muscle contraction caused by histamine bound to H2 receptors
8. During an IgE-mediated hypersensitivity reaction, the degranulation of mast cells is a result of which receptor action?
a. Histamine bound to H2
b. Chemotactic factor binding to the receptor
c. Epinephrine bound to mast cells
d. Acetylcholine bound to mast cells
9. What characteristic do atopic individuals have that make them genetically predisposed to develop allergies?
a. Greater quantities of histamine c. Greater quantities of IgE
b. More histamine receptors d. A deficiency in epinephrine
10. What is the mechanism that results in type II hypersensitivity reactions?
a. Antibodies coat mast cells by binding to receptors that signal its degranulation, followed by a discharge of preformed mediators.
b. Antibodies bind to soluble antigens that were released into body fluids, and the immune complexes are then deposited in the tissues.
c. Cytotoxic T lymphocytes or lymphokine-producing helper T 1 cells directly attack and destroy cellular targets.
d. Antibodies bind to the antigens on the cell surface.
11. When mismatched blood is administered causing an ABO incompatibility, the erythrocytes are destroyed by:
a. Complement-mediated cell lysis c. Phagocytosis in the spleen
b. Phagocytosis by macrophages d. Natural killer cells
12. When antibodies are formed against red blood cell antigens of the Rh system, the blood cells are destroyed by:
a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Phagocytosis in the spleen
d. Neutrophil granules and toxic oxygen products
13. When soluble antigens from infectious agents enter circulation, tissue damage is a result of:
a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Phagocytosis in the spleen
d. Neutrophil granules and toxic oxygen products
14. How are target cells destroyed in a type II hypersensitivity reaction?
a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Neutrophil granules and toxic oxygen products
d. Natural killer cells
15. Graves disease (hyperthyroidism) is an example of which type II hypersensitivity reaction?
a. Modulation
b. Antibody-dependent cell-mediated cytotoxicity
c. Neutrophil-mediated damage
d. Complement-mediated lysis
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16. Type III hypersensitivity reactions are a result of which of the following?
a. Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators
b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues
c. Tc cells or lymphokine-producing Th1 cells directly attacking and destroying cellular targets
d. Antibodies binding to the antigen on the cell surface
17. A type IV hypersensitivity reaction causes which result?
a. Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators
b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues
c. Lymphokine-producing Th1 cells directly attacking and destroying cellular targets
d. Antibodies binding to the antigen on the cell surface
18. In a type III hypersensitivity reaction, the harmful effects after the immune complexes that are deposited in tissues are a result of:
a. Cytotoxic T cells c. Complement activation
b. Natural killer cells d. Degranulation of mast cells
ANS: C
19. Raynaud phenomenon is classified as a type III hypersensitivity reaction and is due to:
a. Immune complexes that are deposited in capillary beds, blocking circulation
b. Mast cells that are bound to specific endothelial receptors, causing them to degranulate and creating a localized inflammatory reaction that occludes capillary circulation
c. Cytotoxic T cells that attack and destroy the capillaries so that they are unable to perfuse local tissues
d. Antibodies that detect the capillaries as foreign protein and destroy them using lysosomal enzymes and toxic oxygen species
20. Deficiencies in which element can produce depression of both B- and T-cell function?
a. Iron c. Iodine
b. Zinc d. Magnesium
21. When the maternal immune system becomes sensitized against antigens expressed by the fetus, what reaction occurs?
a. T-cell immunity c. Fetal immunity
b. Alloimmunity d. Autoimmunity
22. Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host DNA is the cause of which disease?
a. Hemolytic anemia c. Systemic lupus erythematosus
b. Pernicious anemia d. Myasthenia gravis
23. Why does tissue damage occurs in acute rejection after organ transplantation?
a. Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T cells directly attack the endothelial cells of the transplanted tissue.
b. Circulating immune complexes are deposited in the endothelial cells of transplanted tissue, where the complement cascade lyses tissue.
c. Receptors on natural killer cells recognize antigens on the cell surface of transplanted tissue, which releases lysosomal enzymes that destroy tissue.
d. Antibodies coat the surface of transplanted tissue to which mast cells bind and liberate preformed chemical mediators that destroy tissue.
24. Which blood cell carries the carbohydrate antigens for blood type?
a. Platelets c. Lymphocytes
b. Neutrophils d. Erythrocytes
25. A person with type O blood is likely to have high titers of which anti-antibodies?
a. A c. A and B
b. B d. O
26. Which class of immunoglobulins forms isohemagglutinins?
a. IgA c. IgG
b. IgE d. IgM
27. Which component of the immune system is deficient in individuals with infections caused by viruses, fungi, or yeast?
a. Natural killer cells c. B cells
b. Macrophages d. T cells
28. In which primary immune deficiency is there a partial-to-complete absence of T-cell immunity?
a. Bruton disease c. Reticular dysgenesis
b. DiGeorge syndrome d. Adenosine deaminase deficiency
29. How many months does it take for the newborn to be sufficiently protected by antibodies produced by its own B cells?
a. 1 to 2 c. 6 to 8
b. 4 to 5 d. 10 to 12
30. Considering the effects of nutritional deficiencies on the immune system, severe deficits in calories and protein lead to deficiencies in the formation of which immune cells?
a. B cells c. Natural killer cells
b. T cells d. Neutrophils
31. Urticaria are a manifestation of a which type of hypersensitivity reaction?
a. IV c. II
b. III d. I
32. Graves disease is a result of:
a. Increased levels of circulating immunoglobulins
b. The infiltration of the thyroid with T lymphocytes
c. Autoantibodies binding to thyroid-stimulating hormone (TSH)-receptor sites
d. Exposure to acetylates in substances such as rubber
33. Raynaud phenomenon is an example of which type of hypersensitivity?
a. IV c. II
b. III d. I
34. Which statement is true concerning an atopic individual?
a. They tend to produce less IgE.
b. They tend to produce more Fc receptors.
c. They tend to attract very few mast cells.
d. They tend to produce very high levels of IgM.
35. Which statement is true regarding immunodeficiency?
a. Immunodeficiency is generally not present in other family members.
b. Immunodeficiency is never acquired; rather, it is congenital.
c. Immunodeficiency is almost immediately symptomatic.
d. Immunodeficiency is a result of a postnatal mutation.
36. A person with type O blood is considered to be the universal blood donor because type O blood contains which of the following?
a. No antigens c. Both A and B antigens
b. No antibodies d. Both A and B antibodies
37. Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?
a. I c. III
b. II d. IV
38. Graves disease is an autoimmune disease that results in which maternal antibody?
a. Binding with receptors for neural transmitters on muscle cells, causing neonatal muscular weakness
b. Affecting the receptor for TSH, causing neonatal hyperthyroidism
c. Inducing anomalies in the fetus or causing pregnancy loss
d. Destroying platelets in the fetus and neonate
Chapter 10: Infection
MULTIPLE CHOICE
1. What is a significant cause of morbidity and mortality worldwide?
a. Starvation c. Cardiovascular disease
b. Traumatic injury d. Infectious disease
2. What is the first stage in the infectious process?
a. Invasion c. Spread
b. Colonization d. Multiplication
3. Which type of microorganism reproduces on the skin?
a. Viruses c. Protozoa and Rickettsiae
b. Bacteria and fungi d. Mycoplasma
4. Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms?
a. Bacteria c. Viruses
b. Fungi d. Yeasts
5. Once they have penetrated the first line of defense, which microorganisms do natural killer (NK) cells actively attack?
a. Bacteria c. Viruses
b. Fungi d. Mycoplasma
6. Which statement concerning exotoxins is true?
a. Exotoxins are contained in cell walls of gram-negative bacteria.
b. Exotoxins are released during the lysis of bacteria.
c. Exotoxins are able to initiate the complement and coagulation cascades.
d. Exotoxins are released during bacterial growth.
7. Which statement is true concerning a fungal infection?
a. Fungal infections occur only on skin, hair, and nails.
b. Phagocytes and T lymphocytes control fungal infections.
c. Fungal infections release endotoxins.
d. Vaccines prevent fungal infections.
8. Cytokines are thought to cause fevers by stimulating the synthesis of which chemical mediator?
a. Leukotriene c. Prostaglandin
b. Histamine d. Bradykinin
9. Considering the hypothalamus, a fever is produced by:
a. Endogenous pyrogens acting directly on the hypothalamus.
b. Exogenous pyrogens acting directly on the hypothalamus.
c. Immune complexes acting indirectly on the hypothalamus.
d. Cytokines acting indirectly on the hypothalamus.
10. Which statement about vaccines is true?
a. Most bacterial vaccines contain attenuated organisms.
b. Most viral vaccines are made by using dead organisms.
c. Vaccines require booster injections to maintain life-long protection.
d. Vaccines provide effective protection against most infections.
11. Vaccines against viruses are created from:
a. Killed organisms or extracts of antigens
b. Live organisms weakened to produce antigens
c. Purified toxins that have been chemically detoxified
d. Recombinant pathogenic protein
12. Which statement is a characteristic of HIV?
a. HIV only infects T-helper (Th) cells.
b. HIV is a retrovirus.
c. HIV carries genetic information in its DNA.
d. HIV has five identified strains.
13. What is the role of reverse transcriptase in HIV infection?
a. Reverse transcriptase converts single-stranded DNA into double-stranded DNA.
b. It is needed to produce integrase.
c. It transports the RNA into the cell nucleus.
d. It converts RNA into double-stranded DNA.
14. After sexual transmission of HIV, a person can be infected yet seronegative for how many months?
a. 1 to 2 c. 18 to 20
b. 6 to 14 d. 24 to 36
15. Which cells are primary targets for HIV?
a. CD4+ Th cells only
b. CD4+ Th cells, macrophages, and natural killer cells
c. CD8-positive cytotoxic T (Tc) cells and plasma cells
d. CD8-positive Tc cells only
16. What area in the body may act as a reservoir in which HIV can be relatively protected from antiviral drugs?
a. Central nervous system c. Thymus gland
b. Bone marrow d. Lungs
17. AIDS produces a striking decrease in the number of which cells?
a. Macrophages c. CD4+ Th cells
b. CD8+ T cells d. Memory T cells
18. HIV antibodies appear within how many weeks after infection through blood products?
a. 1 to 2 c. 10 to 12
b. 4 to 7 d. 20 to 24
19. What is the final stage of the infectious process?
a. Colonization c. Multiplication
b. Invasion d. Spread
20. Toxigenicity is defined as the:
a. Ability of the pathogen to invade and multiply in the host
b. Pathogen’s ability to produce disease by the production of a soluble toxin
c. Ability of an agent to produce disease
d. Potency of a pathogen measured in terms of the number of microorganisms required to kill the host
21. The ability of the pathogen to invade and multiply in the host is referred to as:
a. Infectivity c. Pathogenicity
b. Toxigenicity d. Virulence
22. Some bacterial surface proteins bind with the crystalline fragment (Fc) portion of an antibody to:
a. Hide in cells to avoid triggering an immune response
b. Form self-protecting toxins
c. Make staining possible for microscopic observation
d. Produce a protective “self” protein
23. Which organism is a common sexually transmitted bacterial infection?
a. Staphylococcus aureus c. Helicobacter pylori
b. Clostridium perfringens d. Treponema pallidum
24. Which disease is an example of a rickettsial infection?
a. Cholera c. Sleeping sickness
b. Candida d. Rocky Mountain spotted fever
Chapter 11: Stress and Disease
MULTIPLE CHOICE
1. Exhaustion occurs if stress continues when which stage of the general adaptation syndrome is not successful?
a. Flight or fight c. Adaptation
b. Alarm d. Arousal
2. Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?
a. Adrenal cortex c. Anterior pituitary
b. Hypothalamus d. Limbic system
3. During an anticipatory response to stress, the reaction from the limbic system is stimulated by the:
a. Retronucleus of the anterior pituitary
b. Anterior nucleus of the hippocampus
c. Paraventricular nucleus of the hypothalamus
d. Prefrontal nucleus of the amygdala
4. Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
a. Norepinephrine
b. Epinephrine
c. Cortisol
d. Adrenocorticotropic hormone (ACTH)
5. Perceived stress elicits an emotional, anticipatory response that begins where?
a. Prefrontal cortex c. Limbic system
b. Anterior pituitary d. Hypothalamus
6. During a stress response, the helper T (Th) 1 response is suppress by which hormone?
a. ACTH c. Prolactin
b. Cortisol d. Growth hormone
7. What is the effect that low-serum albumin has on the central stress response?
a. Impaired circulation of epinephrine and norepinephrine
b. Impaired wound healing
c. Lessened circulation of cortisol
d. Diminished oncotic pressure
8. Stress-age syndrome directly results in depressed function of which system?
a. Respiratory c. Digestive
b. Endocrine d. Immune
9. Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of:
a. Epinephrine and aldosterone c. Epinephrine and norepinephrine
b. Norepinephrine and cortisol d. Acetylcholine and cortisol
10. Stress-induced norepinephrine results in:
a. Pupil constriction c. Increased sweat gland secretions
b. Peripheral vasoconstriction d. Decreased blood pressure
11. Released stress-induced cortisol results in the stimulation of gluconeogenesis by affecting which structure?
a. Adrenal cortex c. Liver
b. Pancreas d. Anterior pituitary
12. What is the effect of increased secretions of epinephrine, glucagon, and growth hormone?
a. Hyperglycemia c. Bronchodilation
b. Hypertension d. Pupil dilation
13. Which hormone increases the formation of glucose from amino acids and free fatty acids?
a. Epinephrine c. Cortisol
b. Norepinephrine d. Growth hormone
14. What effect do androgens have on lymphocytes?
a. Suppression of B-cell responses and enhancement of T-cell responses
b. Suppression of T-cell responses and enhancement of B-cell responses
c. Suppression of B- and T-cell responses
d. Enhancement of B- and T-cell responses
15. Which gland regulates the immune response and mediates the apparent effects of circadian rhythms on immunity?
a. Anterior pituitary c. Basal ganglia
b. Adrenal d. Pineal
16. Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?
a. IL–1 and IL-6 c. IFN and IL-12
b. IL-2 and TNF- d. TNF-ß and IL-4
17. The release of which cytokines is triggered by bacterial or viral infections, cancer, and tissue injury that, in turn, initiate a stress response?
a. IL-1 and IL-2
b. IL-12, TNF-, and colony-stimulating factor
c. IFN, TNF-ß, and IL-6
d. IL-4 and IL-24
18. The action of which hormone helps explain increases in affective anxiety and eating disorders, mood cycles, and vulnerability to autoimmune and inflammatory diseases in women as a result of stimulation of the CRH gene promoter and central norepinephrine system?
a. Progesterone c. Estrogen
b. Cortisol d. Prolactin
19. What effect does estrogen have on lymphocytes?
a. Depression of B-cell functions and enhancement of T-cell functions
b. Depression of T-cell functions and enhancement of B-cell functions
c. Depression of B- and T-cell functions
d. Enhancement of B- and T-cell functions
20. Which statement is true concerning the differences between stress-induced hormonal alterations of men and women?
a. After injury, women produce more proinflammatory cytokines than men, a profile that is associated with poor outcomes.
b. Androgens appear to induce a greater degree of immune cell apoptosis after injury, creating greater immunosuppression in injured men than in injured women.
c. Psychologic stress associated with some types of competition decreases both testosterone and cortisol, especially in athletes older than 45 years of age.
d. After stressful stimuli, estrogen is increased in women, but testosterone is decreased in men.
21. Diagnostic blood work on individuals who perceive themselves to be in a chronic stress state will likely demonstrate:
a. Decreased Th lymphocytes c. Decreased Tc cells
b. Increased erythrocytes d. Increased platelets
22. What are the signs that a patient is in the adaptive stage of the general adaptation syndrome?
a. He or she begins to experience elevated heart and respiratory rates.
b. He or she finds it difficult to concentrate on a solution for the stress.
c. The patient perceives his or her only options are to run away or fight back.
d. The patient has exceeded his or her ability to cope with the current situation.
23. The most influential factor in whether a person will experience a stress reaction is his or her:
a. General state of physical health c. Intellectual abilities
b. Spiritual belief system d. Ability to cope
24. A reduction is an individual’s number of natural killer (NK) cells appears to correlate with an increased risk for the development of:
a. Depression
b. Type 1 diabetes
c. Obsessive compulsive disorder (OCD)
d. Gastroesophageal reflux disorder (GERD)
25. A nurse is providing care to a terminally ill adult who has been with his life partner for over 56 years. Research supports the nurse’s assessment of the life partner for signs of:
a. Suicidal ideations c. Severe stress reaction
b. Cardiac dysrhythmia d. Anorexia induced weight loss
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