Download 4.2 Homework for Chapter 6 - 6th ed

PATHOPHYSIOLOGY
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Homework for Chapter 6 - Innate Immunity: Inflammation
Instructions:
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Use your lecture notes and textbook to find the answers to these questions.
When finished, enter your answers on the electronic version of the homework posted on Canvas.
You may do this up to three times until you are happy with your grade.
1. The first line of defense against pathogens is the:
A) skin, mucous membranes and other physical barriers.
B) inflammatory response.
C) primary immune response.
D) hypersensitivity response.
2. Which of the following is NOT considered part of the body’s first line of defense against pathogens?
A) saliva
B) coughing and sneezing
C) antimicrobial peptides made by epithelial cells
D) complement protein
3. If the surface barriers such as the skin or mucus membranes are breached, the next line of defense in innate
immunity is the:
A) lymph node.
B) lymphocyte response.
C) inflammatory response.
D) memory cells.
4. What is the purpose of vasodilation and increased vascular permeability during inflammation?
A) To bring white blood cells to the area of injury
B) To transport inflammatory chemicals to the area of injury
C) To dilute toxins
D) All of the above
5. The first cell to react to tissue injury is the:
A) macrophage.
B) mast cell.
C) fibroblast.
D) neutrophil.
6. Which of the following stimuli are known to induce mast cell activation?
A) Thermal injury
B) The presence of toxins
C) Immunologic tissue injury
D) All of the above
7. Which of the following chemicals of inflammation are produced by mast cells from arachidonic acids in the
cell membrane after degranulation?
A) Platelet-activating factor
B) Histamine and chemotactic cytokines
C) Leukotrienes and prostaglandins
D) Complement proteins
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8. During degranulation the mast cells release chemotactic cytokines that perform which of these functions?
A) Vasodilation and increased vascular permeability
B) Attraction of neutrophils and eosinophils
C) Activation of the complement cascade
D) Opsonization of bacteria
9. What is the function of the H1 receptor for histamine?
A) Activation of neutrophils and macrophages
B) Causes vasodilation and bronchoconstriction
C) Increases capillary permeability
D) All of the above
10. In the respiratory system, the release of leukotrienes during an inflammatory response induces:
A) bronchoconstriction.
B) bronchodilation.
C) coughing.
D) free radical formation.
11. Which of the following inflammatory chemicals are blocked by nonsteroidal anti-inflammatory drugs
such as ibuprofen?
A) Histamine
B) Prostaglandins
C) Leukotrienes
D) All of the above
12. Prostaglandins differ from histamine in which of the following ways?
A) Site of production
B) Duration of effect
C) Vascular effect
D) All of the above
13. The components of the complement and kinin system are:
A) antibodies.
B) white blood cells.
C) growth factors.
D) plasma proteins.
14. Activated complement proteins C3a and C5a act as:
A) opsonins.
B) membrane attack complexes.
C) anaphylatoxins.
D) vasoconstrictive agents.
15. Functions of the clotting cascade during inflammation include which of the following?
A) Keeps bacteria close to the inflammatory cells
B) Helps stop bleeding
C) Prevents the spread of infection
D) All of the above
16. Activation of the clotting system results in the production of:
A) platelets.
B) Hageman factor.
C) platelet-activating factor.
D) fibrin.
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17. Which of the following inflammatory chemicals are responsible for inducing pain during inflammation?
A) Bradykinin and prostaglandins
B) Histamine and chemotactic cytokines
C) Lymphokines
D) Nitrous oxide and platelet-activating factor
18. What is the role of plasmin in the inflammatory response?
A) It inhibits the complement system.
B) It directly stimulates mast cell degranulation.
C) It stimulates proliferation of fibrocytes.
D) It controls clotting by breaking down fibrin.
19. How long does it take neutrophils to arrive at the site of inflammation?
A) 1 to 2 hours
B) 6 to 12 hours
C) 24 to 48 hours
D) At least 48 hours
20. A monocyte is a circulating white blood cell that transforms into which of the following cells once it
enters the tissue during an inflammatory response?
A) Neutrophil
B) Macrophage
C) Mast cell
D) Fibroblast
21. Which of the following cells is responsible for prolonging the inflammatory response and are present at
the site of chronic bacterial infections?
A) Neutrophils
B) Eosinophils
C) Macrophages
D) Lymphocytes
22. Which white blood cell plays an important role in inhibiting the inflammatory response?
A) Neutrophil
B) Mast cell
C) Eosinophil
D) Basophil
23. The process of a phagocyte squeezing through retracted endothelial cells to enter into the tissues is called:
A) fusion.
B) diapedesis.
C) phagocytosis.
D) margination.
24. Opsonization promotes the process of:
A) phagocytosis.
B) vasodilation.
C) increased vascular permeability.
D) clotting.
25. Which of the following molecules are opsonins?
A) Histamine and serotonin
B) Endotoxin and exotoxin
C) Bacteria and parasites
D) Antibodies and complement proteins
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26. Prior to engulfment of a bacterium during phagocytosis, which of the following events must occur?
A) Release of lysosomal enzymes
B) Fusion
C) Recognition and adherence
D) Formation of a phagolysosome
27. Which of the following substances are used by phagocytes to destroy engulfed bacteria?
A) Lysozomal enzymes
B) Lactic acid
C) Oxygen radicals
D) All of the above
28. Which of the following cytokines is an anti-inflammatory chemical?
A) IL-1
B) IL-6
C) IL-10
D) TNF-alpha
29. Cells defend against viral invasion through the production and secretion of:
A) histamine.
B) interferon.
C) growth factors.
D) prostaglandins.
30. Manifestation of local inflammation includes:
A) edema.
B) pallor.
C) bruising.
D) necrosis.
31. Warmth and redness of the skin are indicators of inflammation. Which of the following processes is
responsible for this clinical manifestation?
A) Stimulation of nerve endings
B) Phagocytosis
C) Vasoconstriction
D) Vasodilation
32. All of the following chemicals will induce a fever during inflammation except:
A) TNF-alpha.
B) IL-1.
C) histamine.
D) prostaglandin E2.
33. A differential rise in which white blood cell is typically seen with viral infections?
A) Neutrophils
B) Lymphocytes
C) Monocytes
D) Eosinophils
34. Which of the following characteristics concerning the acute phase reactant C-reactive protein is (are) true?
A) Produced by the liver
B) Plasma indicator of inflammation
C) Significant risk factor for heart disease
D) All of the above
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35. Which of the following exudates would be present in highest concentration at the site of a persistent
bacterial infection?
A) Fibrinous
B) Serous
C) Hemorrhagic
D) Purulent
36. Which of the following types of exudate is characterized by the movement of watery fluid, containing few
cells and little protein, into the tissues?
A) Fibrinous
B) Serous
C) Purulent
D) Hemorrhagic
37. Which of the following is a characteristic feature of chronic inflammation?
A) Granuloma formation
B) Bleeding
C) Neutrophilia
D) All of the above
38. A deep pressure ulcer heals through the process of:
A) primary intention.
B) secondary intention.
C) reepithelialization without significant scarring.
D) retraction.
39. Which of the following events occurs during the proliferation (reconstructive) phase of wound healing?
A) Epithelialization
B) Scar tissue remodeling
C) Dehiscence
D) Degranulation
40. Which of the following cells plays an active role in collagen deposition during wound contraction and scar
tissue formation?
A) Mast cell
B) Macrophage
C) Fibroblast
D) Osteocyte
41. The development of contractures during wound healing can result in which of the following problems?
A) Limited movement at joints
B) Impaired blood flow
C) Organ strictures
D) All of the above
Critical Thinking Questions (these are similar to the level of questions you can expect on tests)
42. Why are the first and second lines of defense collectively referred to as innate immunity?
A) Because they are defenses which are specific to particular disease organisms.
B) Because they are located deep within the body.
C) Because they are things we are born with that are built into the structure of our body.
D) Because they are only activated after injury occurs.
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43. What is the benefit of the vasodilation that occurs early in the inflammatory response?
A) It allows more white blood cells and other plasma proteins to be delivered to the site of injury.
B) It increases the pressure in the injured area so that cells are compressed.
C) It shunts blood away from the injured area and towards healthy tissue.
D) It stretches the walls of blood vessels so that they are less permeable.
44. Why do people with advanced liver disease often have problems with their innate immune system?
A) Excess toxins accumulate which impair the function of lymphocytes.
B) The plasma proteins that form the complement, kinin and coagulation systems are made by the liver.
C) This causes the intestinal lining to become more permeable so more bacteria enter from the gut.
D) Impaired liver function causes more bilirubin to build up in the blood which impairs immunity.
45. A person suffering from a deficiency of complement protein would be most likely to have trouble fighting
off which of the following?
A) viral infections
B) fungal infections
C) bacterial infections
D) malignant cells
46. Which of the following statements is TRUE about chronic inflammation?
A. Chronic inflammation occurs immediately after infection with microbes that have a high lipid and was
content.
B. Chronic inflammation involves macrophages, while acute inflammation does not.
C. Chronic inflammation rarely involves development of caseous necrosis.
D. Chronic inflammation involves lymphocytes and macrophages, rather than neutrophils.