Download Chapter 22 - The Lymphatic System and Immunity

Chapter 22 - The Lymphatic System and Immunity
Choose the single best answer to each question.
1) The lymphatic system functions include
A) reabsorbing fluid lost from the capillaries and transporting it to the blood.
B) absorbing fats from the digestive system.
C) defending the body against infectious disease.
D) A and B are correct.
E) A, B and C are correct.
Answer: E
Reference: Page 805, Lymphatic System Structure and Function
Level of Difficulty: Easy
2) Which of the following is NOT considered part of the lymphatic system?
A) lymph
B) lymphatic vessels
C) yellow bone marrow
D) lymph nodes
E) spleen
Answer: C
Reference: Page 805, Lymphatic System Structure and Function
Level of Difficulty: Medium
3) Lymphatic vessels
A) include capillaries that are open at both ends.
B) resemble thin walled veins with extra valves in structure.
C) follow the routes of arteries in the skin.
D) follow the routes of veins in the abdomen and thorax.
E) drain lymph into urine at the kidney.
Answer: B
Reference: Page 805, Lymphatic System Structure and Function
Level of Difficulty: Medium
4) Place the following in the order that lymph would travel through them from the right
thigh to the blood supply:
1. cysterna chyli
2. thoracic (left lymphatic) duct
3. right lymphatic duct
4. right lumbar trunk
A) 4, 1, 2, but never 3
B) 4, 1, 3, but never 2
C) 3, 1, 2, but never 4
D) 3, 1, 4, but never 2
E) 1, 3, 2, but never 4
Answer: A
Reference: Page 805, Lymphatic System Structure and Function
Level of Difficulty: Hard
5) Lymph
A) is nearly identical to interstitial fluid in most parts of the body.
B) formation helps return fluid and plasma proteins that leaked from capillaries to the
blood. .
C) flow is dependent on pressure arising from contraction of the left ventricle of the
heart.
D) A and B are correct.
E) A, B and C are correct.
Answer: D
Reference: Page 805, Lymphatic System Structure and Function
Level of Difficulty: Medium
6) The thymus
A) is a bilobed organ found between the heart and the thoracic vertebrae.
B) grows in size and function throughout adulthood.
C) contains many immature T cells in its cortex.
D) contains many mature B cells in its medulla.
E) contains thymic macrophages that release thymosin and other hormones.
Answer: C
Reference: Page 805, Lymphatic System Structure and Function
Level of Difficulty: Medium
7) Lymph nodes
A) occur in superficial and deep groups along the lymphatic vessels.
B) receive lymph via efferent vessels.
C) contain mostly T cells in their outer cortexes.
D) contain mostly B cells in their inner cortexes.
E) contain only T cells in their medullae.
Answer: A
Reference: Page 805, Lymphatic System Structure and Function
Level of Difficulty: Medium
8) The spleen
A) contains white pulp, which consists mostly of lymphocytes and macrophages.
B) contains red pulp, which performs functions related to blood cells.
C) is located on the inferior surface of the liver in the right hypochondriac region.
D) A and B are correct.
E) A, B and C are correct.
Answer: D
Reference: Page 805, Lymphatic System Structure and Function
Level of Difficulty: Medium
9) Lymphatic nodules
A) include the tonsils and Peyer’s patches.
B) are surrounded by a capsule.
C) are scattered among the serous membranes of the viscera.
D) A and B are correct.
E) A, B and C are correct.
Answer: A
Reference: Page 805, Lymphatic System Structure and Function
Level of Difficulty: Medium
10) Which of the following is NOT true of the development of lymphatic tissues?
A) Lymphatic vessels develop from lymph sacs, which arise from mesoderm.
B) Lymph sacs develop in conjunction with veins, but most ultimately lose connection
with them.
C) The spleen develops from ectoderm.
D) The thymus develops from the 3rd pharyngeal pouch.
E) Development of the lymphatic system begins by the 5th week after conception.
Answer: C
Reference: Page 814, Development of Lymphatic Tissues
Level of Difficulty: Medium
11) 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.
Answer: E
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Easy
12) 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.
Answer: B
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Medium
13) All of the following mechanisms actually expel pathogens from the body EXCEPT:
A) vaginal secretion
B) emesis (vomiting)
C) phagocytosis
D) urination
E) defecation
Answer: C
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Medium
14) Which of the following is an antimicrobial protein found in the blood and interstitial
fluid?
A) interferon
B) complement
C) transferrin
D) A and B are correct.
E) A, B and C are correct.
Answer: E
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Medium
15) Which substance prevents viral replication?
A) interferon
B) complement
C) transferrin
D) lysozyme
E) sebum
Answer: A
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Medium
16) Natural killer (NK) cells
A) are large, specialized monocytes.
B) ingest microbes.
C) secrete perforin and granzymes to destroy target cells.
D) constitute 50-70% of all lymphocytes in the blood.
E) cannot attack body cells.
Answer: C
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Medium
17) Which of the following is NOT a phagocyte?
A) histiocyte
B) lymphocyte
C) monocyte
D) microglia
E) Kupffer cell
Answer: B
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Medium
18) 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
Answer: D
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Medium
19) 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.
Answer: D
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Medium
20) The first stage of the inflammation response is
A) vasodilation
B) vasoconstriction
C) chemotaxis
D) phagocytosis
E) tissue repair
Answer: A
Reference: Page 815, Nonspecific Resistance (Innate Defenses)
Level of Difficulty: Medium
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.
Answer: E
Reference: Page 820, Specific Resistance: Immunity
Level of Difficulty: Medium
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.
Answer: B
Reference: Page 820, Specific Resistance: Immunity
Level of Difficulty: Medium
23) Cell-mediated immunity
A) includes conversion of CD8 cells to cytotoxic (killer) T cells.
B) includes 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.
Answer: E
Reference: Page 820, Specific Resistance: Immunity
Level of Difficulty: Medium
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.
Answer: C
Reference: Page 820, Specific Resistance: Immunity
Level of Difficulty: Medium
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.
Answer: D
Reference: Page 820, Specific Resistance: Immunity
Level of Difficulty: Medium
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.
Answer: E
Reference: Page 820, Specific Resistance: Immunity
Level of Difficulty: Medium
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.
Answer: A
Reference: Page 820, Specific Resistance: Immunity
Level of Difficulty: Medium
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.
Answer: B
Reference: Page 825, Cell-mediated Immunity
Level of Difficulty: Medium
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.
Answer: E
Reference: Page 825, Cell-mediated Immunity
Level of Difficulty: Medium
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.
Answer: C
Reference: Page 825, Cell-mediated Immunity
Level of Difficulty: Medium
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.
Answer: B
Reference: Page 825, Cell-mediated Immunity
Level of Difficulty: Medium
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.
Answer: C
Reference: Page 828, Antibody-mediated Immunity
Level of Difficulty: Medium
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.
Answer: B
Reference: Page 828, Antibody-mediated Immunity
Level of Difficulty: Medium
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.
Answer: E
Reference: Page 828, Antibody-mediated Immunity
Level of Difficulty: Medium
35) The antibody that can cross the placenta and is the most abundant antibody produced
is
A) IgG
B) IgD
C) IgA
D) IgM
E) IgE
Answer: A
Reference: Page 828, Antibody-mediated Immunity
Level of Difficulty: Medium
36) 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.
Answer: D
Reference: Page 828, Antibody-mediated Immunity
Level of Difficulty: Medium
37) 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.
Answer: C
Reference: Page 828, Antibody-mediated Immunity
Level of Difficulty: Medium
38) 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.
Answer: E
Reference: Page 828, Antibody-mediated Immunity
Level of Difficulty: Medium
39) 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.
Answer: D
Reference: Page 834, Self-recognition and Self-tolerance
Level of Difficulty: Medium
40) 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.
Answer: C
Reference: Page 834, Self-recognition and Self-tolerance
Level of Difficulty: Medium
41) 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
Answer: A
Reference: Page 834, Self-recognition and Self-tolerance
Level of Difficulty: Medium
42) 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
Answer: D
Reference: Page 834, Self-recognition and Self-tolerance
Level of Difficulty: Medium
43) How does increased stress impact immunity?
A) by encouraging bad habits (e.g. drinking, smoking)
B) by depressing cortisol levels
C) by causing excessive sleep
D) by encouraging exercise
E) All of these are correct.
Answer: B
Reference: Page 836, Stress and Immunity
Level of Difficulty: Medium
44) Which of the following is NOT associated with aging of the immune system?
A) higher susceptibility to malignancies
B) higher susceptibility to infections
C) increased recognition of self vs. nonself
D) decreased effectiveness of cell-mediated immunity
E) slowed antibody-mediated immunity
Answer: C
Reference: Page 836, Aging and the Immune System
Level of Difficulty: Medium
45) AIDS
A) is caused by the human immunodeficiency virus.
B) is transmitted by exchange of blood or other body fluids.
C) is observed in both heterosexual and homosexual individuals.
D) A and B are correct.
E) A, B and C are correct.
Answer: E
Reference: Page 838, Disorders: Homeostatic Imbalances
Level of Difficulty: Medium
46) Which of the following is NOT correct?
A) Current, widely used diagnostic tests for AIDS detect HIV particles in the blood.
B) AIDS is characterized by a helper T cell count less than 200 cells/µL.
C) AIDS is characterized by frequent opportunistic infections.
D) HIV usually triggers a brief, flu-like illness soon after initially infecting someone.
E) AIDS patients usually receive a combination of reverse transcriptase and protease
inhibitors.
Answer: A
Reference: Page 838, Disorders: Homeostatic Imbalances
Level of Difficulty: Medium
47) Which of the following is correct?
A) Allergies are immune hyposensitivity disorders.
B) Type I reactions are delayed reactions associated with tuberculosis and poison ivy.
C) Type II reactions are caused by IgG or IgM antibodies reacting to blood cells.
D) Type III reactions are common and occur within minutes of exposure to an allergen.
E) Type IV reactions occur when immune complexes escape phagocytosis.
Answer: C
Reference: Page 838, Disorders: Homeostatic Imbalances
Level of Difficulty: Hard
48) Loss of self-tolerance, or autoimmunity, is associated with which of the following?
A) rheumatoid arthritis
B) systemic lupus erythematosus
C) rheumatic fever
D) type I diabetes mellitus
E) All of these are correct.
Answer: E
Reference: Page 838, Disorders: Homeostatic Imbalances
Level of Difficulty: Medium
49) Infectious mononucleosis
A) is caused by Staphylococcus bacteria.
B) makes B cells look more like monocytes.
C) most commonly affects adults over the age of 25 years.
D) is most commonly transmitted by ingestion of food contaminated with feces.
E) causes severe diarrhea.
Answer: B
Reference: Page 838, Disorders: Homeostatic Imbalances
Level of Difficulty: Medium
50) Lymphomas
A) are cancers of the lymph nodes and other lymphatic organs.
B) includes Hodgkin disease, which has a high cure rate if detected early.
C) includes non-Hodgkin lymphoma, which is less common than Hodgkin disease.
D) A and B are correct.
E) A, B and C are correct.
Answer: D
Reference: Page 838, Disorders: Homeostatic Imbalances
Level of Difficulty: Medium