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IMMUNOLOGY QUIZ Matching Questions Figure 21.1 Using Figure 21.1, match the following: 1) Heavy chain. Answer: B Diff: 1 Page Ref: 807; Fig. 21.13a 2) Light chain. Answer: D Diff: 1 Page Ref: 807; Fig. 21.13a 3) Variable region. Answer: C Diff: 1 Page Ref: 807; Fig. 21.13a 4) Constant region. Answer: E Diff: 1 Figure 21.2 Using Figure 21.2, match the following: 6) Area where B cells become immunocompetent. Answer: C Diff: 2 7) Area where T cells become immunocompetent. Answer: B Page Ref: 807; Fig. 21.13a 5) Antigen-binding site. Answer: A Diff: 1 Page Ref: 801; Fig. 21.8 Diff: 2 Page Ref: 801; Fig. 21.8 8) Area where activated immunocompetent B and T cells recirculate. Answer: E Page Ref: 807; Fig. 21.13a Diff: 2 Page Ref: 801; Fig. 21.8 9) Area seeded by immunocompetent B and T cells. Answer: D Diff: 2 Page Ref: 801; Fig. 21.8 10) Area where antigen challenge and clonal selection are most likely to occur. Answer: D Diff: 2 Page Ref: 801; Fig. 21.8 Match the following: 11) First line of defense. Answer: B Diff: 1 Page Ref: 789 12) Second line of defense. Answer: C Diff: 1 Page Ref: 789, 791 13) Third line of defense. Answer: A A) Immune response B) Skin and mucous membranes C) Inflammatory response D) Inflammatory response and skin and mucous membranes. Match the following: 21) Main antibody of both primary and secondary immune response. Answer: A Diff: 2 Page Ref: 807‐808 22) Protects mucosal barriers. Answer: B Diff: 2 Page Ref: 807‐808 23) Involved in allergies. Answer: D Diff: 1 Page Ref: 789 Diff: 2 Page Ref: 807‐808 14) Innate defense system. Answer: D 24) Along with IgM, this is a B cell receptor. Answer: C Diff: 1 Page Ref: 789 15) Adaptive defense system. Answer: A Diff: 2 Page Ref: 807‐808 25) Activates complement. Answer: E Diff: 1 Page Ref: 789 Match the following: 16) Small proteins secreted by virus‐
containing cells. Answer: D Diff: 2 Page Ref: 795 17) Major innate mechanism that mediates destruction of foreign substances in the body. Answer: C Diff: 2 Page Ref: 796 18) Stimulate the proliferation of other lymphocytes. Answer: B Diff: 2 Page Ref: 814 19) Dampen the activity of both T cells and B cells. Answer: A Diff: 2 Page Ref: 816‐817 20) Present the double activation signal to T cells. Answer: E Diff: 2 Page Ref: 803 Diff: 2 Page Ref: 807‐808 A) Regulatory T cells B) Helper T cells C) Complement D) Interferon E) Macrophage APCs A) IgG B) IgA C) IgD D) IgE E) IgM True/False Questions 1) A graft from a monkey to a human is an example of an allograft. Answer: FALSE Diff: 1 2) The mechanism of the ʺlethal hitʺ of cytotoxic T cells involves a protein called perforin. Answer: TRUE 3) Cellular ingestion and destruction of particulate matter is called phagocytosis. Answer: TRUE 4) The respiratory burst produced by some macrophages releases free radicals. Answer: TRUE Diff: 1 5) The directional movement of cells in response to chemicals is called chemotaxis. Answer: TRUE 6) Substances capable of triggering the adaptive immune system and provoking an immune response are called antigens. Answer: FALSE Diff: 1 Diff: 2 Page Ref: 799 16) During fetal development, all lymphocytes that do not react to self-antigens are destroyed. Answer: FALSE Diff: 2 Diff: 1 17) Somatic recombination by B cells allows each B cell to form its own unique antibody genes. Answer: TRUE Diff: 3 Diff: 1 Page Ref: 800 18) Perforins are cytolytic chemicals used by NK cells. Answer: TRUE Diff: 3 19) Antigens can be complete or incomplete. Answer: TRUE Diff: 1 20) It is our genes, not antigens, that determine what specific foreign substances our immune system will be able
to recognize and resist. Answer: TRUE Diff: 1 Multiple-Choice Questions 1) Which of the following is characteristic of antibodies? A) carbohydrate structure B) composed of heavy and light polypeptide chains C) three binding sites per antibody monomer D) incapable of being transferred from one person to another Answer: B Page Ref: 798 Diff: 1 2) Which of the following is associated with passive immunity? A) long-term immune protection B) infusion of weakened viruses C) passage of IgG antibodies from a pregnant mother to her fetus D) booster shot Answer: C 11) Autoimmune diseases are more common in men than in women. Answer: FALSE Page Ref: 821-822 12) Some immunocompetent cells will never be called to service in our lifetime. Answer: TRUE Diff: 1 Page Ref: 800-801 Page Ref: 806-807 Page Ref: 810 Diff: 1 Page Ref: 805-806 Diff: 1 Page Ref: 799 9) Fever is seldom beneficial because it speeds up the cellular metabolic rate and will not allow antigenantibody reactions to occur. Answer: FALSE 10) Monoclonal antibodies can be specific for several antigenic determinants. Answer: FALSE Page Ref: 816 Diff: 1 Page Ref: 803 Page Ref: 806 8) Tolerance for self-antigens is abnormal. Answer: FALSE Page Ref: 825-826 7) Soluble proteins secreted by plasma cells are called antibodies. Answer: TRUE Page Ref: 822 Page Ref: 795 Page Ref: 789 15) A transfusion reaction is a subacute hypersensitivity to foreign red blood cells. Answer: TRUE Page Ref: 790 Diff: 1 Diff: 2 Page Ref: 790 Page Ref: 822-823 14) Adaptive immunity is provided by lymphocytes that secrete antibodies. Answer: FALSE Page Ref: 815-816 Diff: 1 Diff: 1 Page Ref: 818, 820 Diff: 1 13) Atopy is an inherited tendency to spontaneously develop immediate (type I) allergies to certain environmental antigens. Answer: TRUE Diff: 1 Page Ref: 806-807 3) Which of the following is not a type of T cell? A) cytotoxic B) antigenic C) helper D) regulatory Answer: B Diff: 1 9) The system that recognizes foreign molecules and acts to immobilize, neutralize, or destroy them is the ________. A) integumentary system B) renal system C) immune system D) lymphatic system Answer: C Page Ref: 810 Diff: 1 4) B lymphocytes develop immunocompetence in the ________. A) thymus B) spleen C) bone marrow D) lymph nodes Answer: C Diff: 1 10) The process whereby neutrophils and other white blood cells are attracted to an inflammatory site is called ________. A) diapedesis B) chemotaxis C) margination D) phagocytosis Answer: B Page Ref: 800 5) Which of the following is not a function of the inflammatory response? A) prevents the spread of the injurious agent to nearby tissue B) replaces injured tissues with connective tissue C) disposes of cellular debris and pathogens D) sets the stage for repair processes Answer: B Diff: 1 Diff: 1 Diff: 1 11) Small molecules that bind with self-proteins to produce antigenic substances are called ________. A) haptens B) antibodies C) ions D) reagins Answer: A Page Ref: 791, 793 Diff: 1 Diff: 1 12) The chief antibody-mediated mechanism used against cellular antigens, such as bacteria, is ________. A) interferon production B) complement fixation C) neutralization D) agglutination Answer: B Page Ref: 793 Diff: 1 Diff: 1 Page Ref: 796-797 13) The only T cells that can directly attack and kill other cells are the ________. A) regulatory cells B) helper cells C) cytotoxic cells D) plasma cells Answer: C Page Ref: 807 8) In clonal selection of B cells, which substance is responsible for determining which cells will eventually become cloned? A) antigen B) lymphocyte C) antibody D) macrophage Answer: A Page Ref: 799 7) The antibody molecule is held together by ________ bonds. A) disulfide B) hydrogen C) amino acid D) sodium Answer: A Page Ref: 795 6) The redness and heat of an inflamed area are due to a local hyperemia caused by ________. A) vasodilation B) vasoconstriction C) phagocyte mobilization D) production of complement and interferon Answer: A Page Ref: 789 Diff: 1 Page Ref: 815 14) Select the correct statement about phagocytic cells. A) Neutrophils may destroy themselves when they phagocytize large quantities of a foreign substance. B) Macrophages release defensins during killing. C) The respiratory burst characterizes eosinophil phagocytosis. D) Kupffer cells are a type of neutrophil. Answer: A Page Ref: 804 Diff: 1 Page Ref: 790 15) ________ predominate at the sites of chronic infections. A) Basophils B) Eosinophils C) Macrophages D) B cells Answer: C Diff: 1 21) ________ are released by activated T cells and macrophages to mobilize immune cells and attract other leukocytes into the area. A) Cytokines B) Perforins C) Interleukin 1 proteins D) Interleukin 2 proteins Answer: A Page Ref: 790 Diff: 1 16) Interferons ________. A) are virus-specific, so that an interferon produced against one virus could not protect cells against another virus B) act by increasing the rate of cell division C) interfere with viral replication within cells D) are routinely used in nasal sprays for the common cold Answer: C Diff: 1 22) Which of the following is a part of the second line of defense against microorganisms? A) keratin B) cilia C) gastric juice D) phagocytes Answer: D Page Ref: 795 Diff: 1 Page Ref: 790 17) ________ determine(s) what specific foreign substances our adaptive immune system will be able to recognize and resist. A) The type of antigen B) Memory cell production C) Enzymes present at the time of the invasion D) Our genes Answer: D Diff: 1 Page Ref: 800 23) Which of the following is characteristic of complete antigens? A) small molecules B) reactivity with an antibody C) contain many repeating chemical units D) inhibit production of antibodies Answer: B Diff: 2 24) B cells respond to the initial antigen challenge by ________. A) reducing its size B) immediately producing antigen-specific antibodies C) forming of a large number of cells that are unlike the original B cell D) producing progeny cells that include plasma cells and memory cells Answer: B 18) Regulatory T cells ________. A) release cytokines that increase the activity of cytotoxic T cells and activated B cells B) decrease their activity as antigenic stimulus decreases C) may function in preventing autoimmune reactions D) are the most thoroughly understood T cells Answer: C Diff: 1 Page Ref: 817 Diff: 2 25) Graft rejection may be caused by ________. A) using a xenograft B) use of immunosuppressive drugs C) treatment with antilymphocyte serum D) total body irradiation Answer: A 19) Select the correct definition about tissue grafts. A) Isografts are between identical twins. B) Allografts are between different species. C) Xenografts are between individuals of the same species. D) Autografts are between two genetically identical individuals. Answer: A Page Ref: 818 Diff: 2 26) Cancer cells and virus-infected body cells can be killed before activation of the immune system by ________. A) natural killer cells B) T lymphocytes C) B lymphocytes D) pinocytosis Answer: A 20) The only immunoglobulin to exist as a pentamer is ________. A) IgD B) IgM C) IgG D) IgA Answer: B Page Ref: 807 Page Ref: 820 Diff: 1 Page Ref: 804 Diff: 1 Page Ref: 799 Page Ref: 814 Diff: 2 Page Ref: 791 27) Complement proteins and antibodies coat a microorganism and roughen its surface, enabling macrophages and neutrophils to phagocytize the organism. This phenomenon is termed ________. A) diapedesis B) agglutination C) opsonization D) chemotaxis Answer: C Diff: 2 33) Phagocyte mobilization involves ________. A) diapedesis, during which cells line up against the capillary wall B) margination, which is the process of white cell movement through the walls of capillaries into injured tissues C) mainly neutrophil and macrophage migration into inflamed areas D) monocytes as the most active phagocyte Answer: C Page Ref: 790 Diff: 2 28) Which of the following is not characteristic of the adaptive immune system? A) It is antigen-specific. B) It is systemic. C) It has memory. D) It is specific for a given organ. Answer: D Diff: 2 34) Fever ________. A) is a higher-than-normal body temperature that is always dangerous B) decreases the metabolic rate of the body to conserve energy C) production is regulated by chemicals that reset the bodyʹs thermostat to a higher setting D) causes the liver to release large amounts of iron, which seems to inhibit bacterial replication Answer: C Page Ref: 798 Diff: 2 Page Ref: 800 29) Monoclonal antibodies are used for the diagnosis of all of the following except ________. A) juvenile diabetes B) hepatitis C) rabies D) pregnancy Answer: A Diff: 2 35) Immunocompetence ________. A) occurs in one specific organ of the adaptive immune system B) is the ability of individual cells to recognize a specific antigen by binding to it C) prevents intercellular communication so that only specific cell types respond to the invader D) requires exposure to an antigen Answer: B Page Ref: 810 Diff: 2 Page Ref: 800 30) Which of the following would be classified as a delayed hypersensitivity reaction? A) immune complex hypersensitivity B) anaphylaxis C) cytotoxic hypersensitivity D) allergic contact dermatitis Answer: D Diff: 2 36) Select the correct statement about the prevention of immune attack on ʺself.ʺ A) The development of tolerance is specific to B cells only. B) Neutrophils capable of binding to self-antigens are chemically inactivated. C) Tolerance to self is due to the action of foreign antigens that inactivate the immune response to oneʹs own tissues. D) Tolerance is developed during fetal life. Answer: D Page Ref: 824 Diff: 2 31) Innate immune system defenses include ________. A) B cells B) T cells C) plasma cells D) phagocytosis Answer: D Diff: 2 37) Select the correct statement about active and passive immunity. A) Immunological memory is established by passive immunization. B) A vaccination is an example of the introduction of passive immunity into the body. C) The antibodies utilized in active immunity are acquired from another organism. D) Active and passive humoral immunity are both mechanisms of specific immunity that use antibodies. Answer: D Page Ref: 790 Diff: 2 32) Select the correct statement about inflammation. A) Only the lymphocyte functions in the transport and release of the mediators of inflammation at the site of injury. B) Exudate is the cause of localized edema. C) Leukopenia-inducing factors are released by damaged tissues. D) Aspirin and other anti-inflammatory substances act by promoting histamine release. Answer: B Diff: 2 Page Ref: 825-826 Page Ref: 790 Page Ref: 805-806 38) Cytotoxic T cells ________. A) are the only T cells that can directly attack and kill other cells B) require the double recognition signal of I MHC plus II MHC on the target cell in order to function C) function mainly to stimulate the proliferation of other T cell populations D) self-destruct once the antigen has been neutralized Answer: A Page Ref: 791, 793 Diff: 2 Page Ref: 815 39) Helper T cells ________. A) bind tightly to target cells and release a lymphotoxin called perforin B) often function to decrease the immune response C) release B7 proteins D) function in the adaptive immune system activation Answer: D Diff: 2 45) Clonal selection of B cells ________. A) occurs during fetal development B) results in the formation of plasma cells C) cannot occur in the presence of antigens D) only occurs in the secondary immune response Answer: B Page Ref: 814 Diff: 2 40) Select the correct statement about immunodeficiency. A) Severe combined immunodeficiency (SCID) disease is an acquired condition. B) The causative agent in acquired immune deficiency syndrome (AIDS) is a virus that recognizes CD4 proteins. C) Hodgkinʹs disease is a hereditary immunodeficiency found in children. D) The most common form of immunodeficiency is graft versus host (GVH) disease. Answer: B Diff: 2 Page Ref: 820-821 46) The primary immune response ________. A) occurs more rapidly and is stronger than the secondary response B) occurs when memory cells are stimulated C) is another name for immunological memory D) has a lag period while B cells proliferate and differentiate into plasma cells Answer: D Diff: 2 41) Immediate hypersensitivities ________. A) are also called type IV hypersensitivities B) are adaptive immune responses C) include allergic contact dermatitis D) include anaphylaxis, triggered by a second (or later) exposure to an allergen to which the individual has been sensitized Answer: D Diff: 2 47) Select the correct statement about the function of antibodies. A) Antibodies may directly destroy ʺinvaders.ʺ B) Neutralization is the process by which antibodies cause invading cells to clump together. C) Complement fixation is the main mechanism by which antibodies provide protection. D) The most potent agglutinating agent is IgG. Answer: C Diff: 2 Diff: 2 48) There are over ________ different types of antigen receptors. A) ten B) a thousand C) a million D) a billion Answer: D Page Ref: 822 Diff: 1 49) Which of the following is not an autoimmune disease? A) multiple sclerosis B) type II diabetes C) systemic lupus erythematosus D) glomerulonephritis Answer: B Diff: 2 Diff: 2 50) Which of the following is not a mechanism for the development of autoimmune disorders? A) exposure of previously ʺhiddenʺ self-antigens to the adaptive immune system B) a second exposure to an allergen C) mutation followed by the appearance of membrane proteins not previously present D) cross-reaction of antibodies formed against foreign antigens with self-antigens Answer: B Diff: 2 Page Ref: 799 Page Ref: 821-822 Page Ref: 791 44) Select the correct statement about antigens. A) ʺSelf-antigensʺ is another name for incomplete antigens. B) The largest type of antigen is called a hapten. C) Only small antigens exhibit reactivity. D) One antigen may have many different antigenic determinants and may therefore cause the formation of more than one antibody. Answer: D Page Ref: 805 Page Ref: 824 43) Natural killer (NK) cells ________. A) are also called cytotoxic T cells B) are a type of phagocyte C) are cells of the specific immune system D) can kill cancer cells before the immune system is activated Answer: D Page Ref: 809-810 42) Delayed hypersensitivities ________. A) are mediated by B cells B) include allergic contact dermatitis C) include anaphylactic shock, a systemic vasodilation that results in inadequate blood delivery to all tissues D) do not involve T cells Answer: B Page Ref: 804 Page Ref: 804 Diff: 3 Page Ref: 821-822 51) Select the correct statement about complement. A) A specific immune mechanism is often involved in directing complement to its target. B) Complement can be activated through three pathways: classical, secondary, and alternate. C) The membrane attack complex consists of complement proteins C3a through C5. D) Complement proteins C1 through C9 act exclusively in the classical pathway. Answer: A Diff: 3 57) Tc cells check each cell to see if ________. A) each cell has the proper surface code or ʺidentity flagʺ B) it has a lack of class 1 MHC C) the surface code or ʺidentity flagʺ looks the way it should D) it is coated with antibodies Answer: C Page Ref: 796-797 Diff: 1 Page Ref: 816 52) Which of the following is true about the number of binding sites per functional antibody unit? A) IgD contains 4 binding sites. B) IgA contains 6 binding sites. C) IgG contains 6 binding sites. D) IgM contains 10 binding sites. Answer: D Diff: 3 Fill-in-the-Blank/Short Answer Questions 1) ________ are grafts taken from another animal species. Answer: Xenografts Diff: 2 2) Pure antibody preparations specific for a single antigenic determinant are called ________ antibodies. Answer: monoclonal 53) Antibody functions include all of the following except ________. A) binding and inactivating chemical toxins released by bacteria or other microorganisms B) cross-linking cell-bound antigens on red blood cells when blood types are properly matched C) linking soluble antigens together so that they fall out of solution D) targeting foreign cells so that complement proteins can cause cellular lysis Answer: B Diff: 3 Diff: 1 3) ________ is the most common type of immediate hypersensitivity. Answer: Anaphylaxis Diff: 2 Diff: 3 Page Ref: 822-823 Page Ref: 808-809 4) ________ cells can lyse and kill cancer cells and virus-infected body cells before the immune system is activated. Answer: Natural killer Diff: 2 Page Ref: 791 5) ________ is a dangerous condition where the cytokines are released unchecked, making the capillaries very leaky and thus depleting blood fluids. Answer: Septic shock or Sepsis Page Ref: 814 Page Ref: 810 54) Which statement is true about T cells? A) They usually directly recognize antigens, which then activates a subpopulation of killer cells. B) Their proliferation is enhanced by interleukins 1 and 2. C) Once activated, they cannot secrete cytokines. D) They will develop into cytotoxic T cells if antigen is complexed with class II MHC proteins. Answer: B Page Ref: 820 Page Ref: 807 Diff: 2 Page Ref: 826 55) Toll-like receptors (TLRs) trigger the release of ________ to attract white blood cells to the scene. A) cytokines B) histamine C) prostaglandins D) complement Answer: A Diff: 2 6) Harmful or disease-causing microorganisms are called ________. Answer: pathogens Diff: 2 7) ________ refers to a group of at least 20 plasma proteins that normally circulate in an inactive state and are a major mechanism for destroying foreign substances in the body. Answer: Complement Page Ref: 793 Diff: 2 56) Interleukin ________ inhibits or turns down the immune response. A) 4 B) 7 C) 10 D) 13 Answer: C Diff: 2 Page Ref: 789 Page Ref: 796-797 8) ________ becomes bound to mast cells and basophils and causes the cells to release histamine and other chemicals. Answer: IgE Diff: 2 Page Ref: 807 9) A ________ is a cell hybrid formed from the fusion of tumor cells and B lymphocytes. Answer: hybridoma Page Ref: 818 Diff: 2 Page Ref: 810 10) ________ cells are the only T lymphocytes that can directly attack and kill other cells. Answer: Cytotoxic T Diff: 2 Page Ref: 815 11) ________ is an autoimmune disease that severely impairs renal function. Answer: Glomerulonephritis Diff: 2 19) Name four autoimmune diseases. Answer: Multiple sclerosis, myasthenia gravis, Gravesʹ disease, juvenile (type I) diabetes, systemic lupus erythematosus, glomerulonephritis, rheumatoid arthritis. Page Ref: 822 12) List and briefly discuss innate body defenses to disease. Answer: Innate body defenses to disease include surface membrane barriers, such as the skin and mucous membranes, as the first line of defense. Not only do the skin and mucous membranes act as a physical barrier to microorganisms, but they also secrete chemicals such as saliva, sebum, mucus, and HCl that kill microorganisms. Innate cellular and chemical defenses include the use of phagocytes and natural killer cells. Inflammation occurs in response to injury. The inflammation response includes vasodilation, increased vascular permeability, and phagocyte mobilization. Antimicrobial substances such as interferon and complement are also produced as innate defenses by the body. Diff: 2 Diff: 2 20) What are three mechanisms by which autoimmune diseases could arise? Answer: (1) Ineffective lymphocyte programming, (2) appearance of new self-proteins in the circulation that have not previously been exposed to the immune system, (3) cross-reaction of antibodies produced against foreign antigens with self-antigens. Diff: 2 Diff: 2 21) Elderly people tend to develop cancer more frequently than younger people. Give an explanation for this observation that relates to immune function. Answer: As one ages, the efficiency of the immune system begins to decline. This may allow cancer to become established more easily. Page Ref: 789-790 Diff: 2 Diff: 2 22) Why do schools require inoculations for childhood diseases such as mumps, measles, and whooping cough? Why are the inoculations of value? Answer: The inoculations are required to try to prevent epidemics of these microbiological infections. The inoculations are of great benefit in preventing the diseases because the vaccines cause immunity to the pathogens by stimulating both the formation of protective antibodies and the establishment of immunological memory against future infection. Page Ref: 810 Diff: 2 23) Tom gets a cut on his hand. After several days he notes swelling, pain, heat, and redness. Upon opening the wound to relieve the pressure, the presence of pus is noted. What has happened to the wound? Answer: The wound has become infected, probably with bacteria. The initial symptoms indicate acute inflammation. Pus indicates the presence of dead or dying neutrophils, broken-down tissue cells, and living and dead pathogens. Page Ref: 804 15) Why are regulatory T cells important to the immune process? Answer: They are vital in the final stopping of an immune response after the antigen is inactivated. They may also help prevent autoimmune reactions. Page Ref: 816-817 Diff: 2 Diff: 3 Page Ref: 824 24) What are some of the drawbacks of passive humoral immunity? Answer: The effects are short lived; it does not trigger memory cell production; and your body degrades the antibodies. Diff: 2 Clinical Questions 1) A 36-year-old man enters the hospital in an extremely debilitated condition. He has purple-brown skin lesions (a symptom of Kaposiʹs sarcoma) and a persistent cough. A physical examination reveals swollen lymph nodes, and laboratory tests find a very low lymphocyte count. Information taken during the personal history reveals that he has multiple sex partners with whom he frequently engages in unprotected sex. What is likely to be the manʹs problem and what is his outlook? Answer: He is probably suffering from AIDS. His outlook is extremely poor since there is currently no known cure or effective treatment for AIDS, and spontaneous remission is unknown. 17) Children born without a thymus must be kept in a germ-free environment if they are to survive. Explain why this is necessary. Answer: If the thymus fails to develop, the T cells will not mature and become immunocompetent. If T cell function is disrupted, there is no resistance to disease. Page Ref: 825-826 18) What are the signs of inflammation, and how does inflammation serve as a protective function? Answer: The four signs of inflammation are swelling, redness, heat, and pain. The signs are caused by local vasodilation and increased capillary permeability. This is of benefit because the process helps to dilute harmful substances that may be present; brings in large quantities of oxygen, nutrients, and cells necessary for the repair process; and allows the entry of clotting proteins. Pain helps immobilize the injury. Diff: 2 Page Ref: 791-793 Page Ref: 806 Diff: 2 Page Ref: 790-792 16) What is the most likely type of hypersensitivity associated with an agonizingly itchy case of poison ivy, appearance of hives after eating shellfish, or a positive TB test? Answer: The hypersensitivity associated with poison ivy is delayed hypersensitivity allergic contact dermatitis. The hypersensitivity associated with hives is a local anaphylactic reaction. The hypersensitivity associated with a positive TB test is delayed hypersensitivity. Page Ref: 805-806 Diff: 2 Page Ref: 825-826 14) What is the antigen challenge, and where does it usually take place? Answer: The antigen challenge is the first encounter between an immunocompetent lymphocyte and an invading antigen. It usually takes place in the spleen or a lymph node, but may happen in any lymphoid tissue. Page Ref: 821-822 13) What are monoclonal antibodies? How are they produced, and what are some of their clinical uses? Answer: Monoclonal antibodies are pure antibody preparations that exhibit specificity for a single antigenic determinant. They are produced from the progeny of a single B cell hybridoma ʺclone,ʺ prepared by injecting a specific antigen into a lab animal and then harvesting sensitized B cells from its spleen. The cells are mixed with myeloma cells and incubated, and the resulting hybridoma cells (B cells fused with myeloma cells) produce the monoclonal antibody. They are used for the diagnosis of pregnancy, certain sexually transmitted diseases, hepatitis, rabies, and for other purposes. Page Ref: 821-822 Diff: 3 Page Ref: 820-821 2) A young girl requires a liver transplant due to failure of her liver to function. What is required for her to have a good prognosis and why? Answer: The ABO and other blood group antigens of the donor and recipient must be determined. Next, donor and recipient tissues are matched as closely as possible (at least a six-antigen match is essential). Following surgery she must receive immunosuppressive therapy to keep her body from rejecting the new liver as foreign tissue. Diff: 3 Page Ref: 820 3) A woman comes into the hospital emergency room complaining that she is having problems swallowing and her neck is swelling. She was involved in an automobile accident a couple days ago but only bruised her neck. What could be the problem? Answer: The woman is suffering from Hashimotoʹs thyroiditis. The automobile accident injured the thyroid gland and released thyroidglobulin into the bloodstream. The immune system has mounted an attack on the thyroid gland. Diff: 2 Page Ref: 826 4) Max is bitten by a rattlesnake while on a camping trip. His friends immediately apply ice packs to the bitten area to slow the spread of the protein-based toxin; they then rush him to an emergency facility. What treatment would be given and why? Answer: Max could be given an immune serum to the rattlesnake venom, thereby conferring passive immunity. The reason for passive immunization is that the venom could kill the person before active immunity could be established. The passive immunity would last until the ʺborrowedʺ antibodies naturally degraded in the body. No immunological memory would be established because B cells are not activated. Diff: 3 Page Ref: 806 5) A physician orders Tylenol for a temperature greater than 101 degrees F. The patientʹs temperature is 100.4 F. Explain the rationale for not medicating a fever of 100.4 F. Answer: A mild or moderate fever is an adaptive response that seems to benefit the body. Diff: 2 Page Ref: 798 6) Nursing care of a client with acquired immunodeficiency syndrome (AIDS) includes monitoring of T lymphocyte counts. Explain why. Answer: The primary defect in clients with AIDS is depletion of helper T cells, and therefore the cell-mediated response. This immunodeficiency makes the patient more susceptible to infection and unusual cancers. Diff: 2 Page Ref: 820-821 7) After receiving penicillin intravenously, a 32-year-old male patient has an anaphylactic reaction. The nurse understands that therapeutic management includes what critical items? Answer: Therapeutic management includes speed in recognition of signs and symptoms of an anaphylactic reaction because death can occur within minutes. Maintaining an open airway is critical, because the bronchioles constrict making it difficult to breathe. Diff: 3 Page Ref: 823 8) When the white blood cell count is depressed, the classic signs of infection such as redness, heat, and swelling are not manifested. In this case, the nurse should avoid administering aspirin. Explain why. Answer: Aspirin would disguise a fever which would indicate infection. Diff: 2 Page Ref: 798