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Anatomy & Physiology II Exam Bank – Topic 4 Immunity Difficulty Level 1 Neutrophils and other white blood cells are attracted to an inflammatory site by the process of a. chemotaxis c. diapedesis b. margination d. leucocytosis Cancer cells and virus infected cells can be killed before activation of adaptive (specific) immunity by a. B lymphocytes c. T lymphocytes b. natural killer cells d. complement The redness and heat of an inflamed area are due to local hyperemia caused by a. vasoconstriction c. phagocyte mobilization b. vasodilation d. vascular permeability The term that describes the movement of a leukocyte through a capillary wall into surrounding tissues is: a. b. chemotaxis diapedesis c. inflammation d. margination Arteriolar vasodilation that occurs during an inflammatory process causes which of these symptoms? a. b. c. d. e. redness and heat redness and swelling swelling and pain heat and pain swelling and heat A chemical that enhances phagocytosis by serving as a link between a microbe and a phagocytic cell is known as a(n): a. opsonin b. allergen c. reagin d. perforin The classical, lectin and alternative pathways in complement activation lead to the formation of a. C1 b. C3 c. C4 d. C2 e. factor B Which of the following complements is essential for opsonization a. C3b c. C5 b. C3a d. C6 Place the steps of inflammation in the correct order 1. neutrophils enter the tissue via diapedesis 2. neutrophils move into the injured area by chemotaxis 3. neutrophils adhere to the capillary walls by margination 4. neutrophils phagocytize microorganisms a. 3, 2, 1, 4 c. 3, 2, 1, 4 b. 1, 2, 3, 4 d. 3, 1, 2, 4 T cells can recognize and bind to free antigens present in body fluids. a. true b. false T cells that attack and kill other cells are a. helper T b. cytotoxic T c. regulatory T d. complement cells The lymphocyte that is most responsible for activating both humoral and cell mediated immune responses is the: a. b. c. d. e. cytotoxic T cell plasma cell natural killer cell helper T cell regulatory T cell A vaccination is one way to acquire immunity that is: a. b. c. d. e. active and artificial active and natural passive and artificial passive and natural innate Antibodies that act against a particular foreign substance are released by a. T lymphocytes c. B lymphocytes b. plasma cells d. natural killer cells Which of the following is characteristic of antibodies? a. they are carbohydrates c. there are three antigen binding sites b. they are composed of heavy and light d. they cannot be passes from one person to chain polypeptides another B lymphocytes develop immunocompetence in the a. bone marrow c. lymph node b. thymus gland d. spleen The activation of cytotoxic T cells can result in the a. lysis of target cells c. production of memory T cells b. production of cytokines d. all of the above can occur Porcine (pig) heart valves were used as replacements for damaged human valves. This is an example of a(n) a. allograft c. autograft b. xenograft d. isograft A newborn gets passive immunity from its mother as a result of placental transfer of _____ during pregnancy: a. IgA b. IgD c. IgE d. IgG e. IgM Small molecules that bind with self-proteins to produce antigenic substances are called ________. a. b. c. d. e. haptens epitopes antibodies opsonins reagins Which of the following types of cells release histamine in acute hypersensitive reactions? a. plasma cell b. CD 8+ cell c. CD 4+ cell d. type II alveolar cell e. mast cell Which type of T cell activates macrophages, stimulates inflammation, and promotes cytotoxic t cell activation? a. Th1 c. regulatory T cells b. Th2 d. gamma delta T cells Substances that are capable of mobilizing adaptive (specific) immunity and provoking an immune response are called a. dendritic cells c. regulatory T cells b. hapten d. antigens The portion of the antigen that is immunogenic is a(n) a. epitope c. heavy chain b. variable chain d. antigen binding site Humoral mediated immunity is accomplished by the secretion of ___________ by ________cells. a. antibody, B cell c. antigen, B cell b. antibody, helper T d. antigen, helper T cells Helper T cells can kill virus infected or cancer cells directly. a. true Interferons a. block the entry of a virus into uninfected cells b. inhibit macrophages Interleukins are a. released by cytotoxic T cells, that perforate the plasma membrane of virus infected cells b. are proteins produced in the liver that activate complement proteins b. false c. activate natural killer cells d. activate complement proteins c. molecules that induce apoptosis in the target cell d. released by helper T cells that are necessary for the activation of B lymphocytes and cytotoxic T cells T lymphocytes develop immunocompetence in the a. bone marrow c. lymph nodes b. spleen d. thymus gland A helper T cell is activated by a. dendritic cell b. macrophage c. B lymphocyte d. all of the above can activate helper T cell Substances capable of triggering the adaptive immune system and provoking an immune response are called a. antibodies c. haptens b. antigens d. complement It is possible that some immunocompetent cells will never be called to service in your lifetime. a. true b. false Adaptive immunity is provided only by lymphocytes that secrete antibodies. a. true b. false Which of the following is an example of passive immunity? a. you are exposed to an antigen c. you get a booster shot of a vaccine b. you receive a vaccine of weakened viruses d. passage of IgG antibodies from a pregnant mother to her fetus The redness and heat of an inflamed area are due to a local hyperemia caused by ________. a. vasodilation c. phagocyte mobilization b. vasoconstriction d. production of complement and interferon Movement of neutrophils and monocytes from the bloodstream through a vessel wall is called : a) capture b) diapedesis c) exudation d) margination Given the following events, which is the correct sequence concerning phagocytosis? a. adherence, digestion, killing, ingestion, c. chemotaxis, adherence, ingestion, chemotaxis digestion, killing b. chemotaxis, ingestion, digestion, d. ingestion, adherence, chemotaxis, adherence, killing digestion, killing Interferons (select the most appropriate statement) a. are virus-specific, so that an interferon c. are routinely used in nasal sprays for the produced against one virus could not common cold protect cells against another virus b. act by increasing the rate of cell division d. interfere with viral replication within cells B cells respond to the initial antigen challenge by ________. a. reducing its size c. forming of a large number of cells that are unlike the original B cell b. immediately producing antigen-specific d. producing progeny cells that include antibodies plasma cells and memory cells Complement proteins and antibodies coat a microorganism and provide binding sites, enabling macrophages and neutrophils to phagocytize the organism. This phenomenon is termed ________. a. diapedesis c. opsonization b. agglutination d. precipitation Delayed hypersensitivities ________. a. are mediated by B cells b. include allergic contact dermatitis Select the correct statement about antigens. a. "Self-antigens" is another name for incomplete antigens. b. The largest type of antigen is called a hapten. c. include anaphylactic shock, a systemic vasodilation that results in inadequate blood delivery to all tissues d. do not involve T cells 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. Select the correct statement about the function of antibodies. a. Antibodies may directly destroy c. Complement fixation is the main "invaders." mechanism by which antibodies provide protection. b. Neutralization is the process by which d. The most potent agglutinating agent is antibodies cause invading cells to clump IgG. together. Which of the following cells is the most critical cell in immunity? a. B cell c. cytotoxic T cell b. helper T cell d. antigen presenting cell Which of the following immunoglobulins combine with mast cells a. Ig G c. Ig M b. Ig E d. Ig A Which of the following would be released during a primary infection a. IgD c. IgM b. IgG d. IgA Self -antigens are expressed using: a. MHC Class I b. MHC Class 2 Which of the following suppress the immune response a. Helper T cell c. Cytotoxic T Cell b. Regulatory T Cell d. Gamma Delta T Cell Which of the following can directly attack a bacterium? a. Cytoxic T Lymphocyte c. B Lymphocyte b. Regulatory T Lymphocyte d. Suppresor T Lymphocyte Antibodies passing from mother to fetus results in which type of acquired immunity a. Artificial Passive c. Artificial Active b. Natural Active d. Natural Passive A vaccine containing a weakened disease-causing organism is injected into the body a. active immunity c. passive immunity b. allergies d. tissue rejection NK cells tend to work against: a. parasitic worms c. b. bacteria d. cancerous cells fungi The secondary immune response is due to the presence of : a. plasma cells c. memory cells b. suppressor cells d. complement Complement and antibody attachment both cause __________________ so that an antigen is more likely engulfed by a macrophage. a) lysis b) opsonization c) agglutination d) coagulation Which of these innate defense events comes last? a. neutrophils actively phagocytize toxins, bacteria and debris b. neutrophils move into the injured area through chemotaxis c. neutrophils move toward and adhere to capillary walls d. neutrophils migrate through capillary walls e. neutrophils are replaced by macrophages derived from monocytes Lymphokines (such as leukotrienes) are produced by __________ to aid the activation and proliferation of B cells and T cells. a. CD4 cells c. CD8 cells b. NK cells d. regulatory T cells Very small antigens that need to combine with another molecule in order to induce an immune response are called : a. haptens c. epitopes b. immunogens d. allergens Once a CD8 cell is activated, it will secrete: a. antibodies c. lymphokines b. cytotoxins d. TNF-α Jose receives a kidney transplant from Juan, his identical twin brother. This would be an example of a ____________ transplant. a. autograft b. isograft c. allograft d. xenograft Select the correct statement about active and passive immunity. a. A vaccination with dead or attentuated pathogens is an example of passive immunity . b. Immunological memory is established by passive immunization. c. Active and passive humoral immunity are both mechanisms of specific immunity that use antibodies. d. The antibodies utilized in active immunity are acquired from another organism. The only immunoglobulin to exist as a pentamer is ________, which is why it is frequently part of a primary immune response. a. IgD c. IgG b. IgM d. IgA The innate defense system includes all of these except : a) mucous membranes b) macrophages c) complement d) B lymphocytes The only antibody that crosses the placental barrier is: a. IgA d. IgG b. IgM e. IgE c. IgD Which of the following would be classified as a delayed hypersensitivty reaction? a. anaphylaxis c. allergic contact dermatitis b. cytotoxic hypersensitivity d. all of the above When a tissue is transplanted between two members of the same species it is called: a. xenograft c. allograft b. isograft d. autograft Immediate hypersensitivities: a. are also called type IV hypersensitivities b. include cytotoxic injury and immune complex disease c. allergens cross link IgE antibodies found on the surface of mast cells and basophils and subsequently release histamine and other mediators d. occurs 1-3 hours of contact and lasts 1015 hours The following are steps in the cell mediated response 1. antigen is engulfed and presented by a macrophage 2. cytotoxic cells migrate to the site of infection 3. undifferentiated T cells with specific receptors recognize the antigen 4. T cells differentiate into cytotoxic T cells and T memory cells 5. cytotoxic T cells release perforins and / or lymphotoxin Place them in the correct order of occurrence a. 1, 2, 3, 4, 5 b. 2, 3, 1, 5, 4 c. 2, 4, 1, 3, 5 d. 1, 3, 4, 2, 5 Immunoglobulins that attach to mast cells and basophils and are involved in allergic reactions are a. IgA d. IgE b. IgG e. IgD c. IgM Difficulty Level 2 Which of the following cells does not express MHC class I? a. erythrocyte c. dendritic cell b. lymphocyte d. hepatocyte(liver cell) Select the correct statement (s) concerning complement. 1. Complement can be activated through three pathways, classic, alternative, and secondary 2. Coats bacterial surfaces which enhances phagocytosis 3. Stimulates inflammation 4. Are proteins produced by the thymus gland a. 1 and 3 d. 2 and 3 b. 2 and 4 e. 1, 2, 3, and 4 c. 1, 2, and 3 Which of the following have important antiviral effects a. Neutrophils b. Interferon c. Natural Killer Cells d. A and B e. B and C Which of the following would not occur during the inflammatory response? a. histamine and other chemical mediators c. vasoconstriction of blood vessels are released b. chemotaxis of phagocytes d. increased permeability of blood vessels Which of the following is an example of innate immunity? a. tears and saliva help wash away d. the stratified keratinized epithelium of microorganisms the skin b. basophils release histamine e. all of the above c. the complement cascade is activated Which pairing is incorrect? a. redness - vasodilation b. edema - increased capillary permeability c. pain - increased capillary permeability Which of the following is not a type of T cell? a. helper b. regulatory d. heat - vasodilation e. loss of function - vasodilation c. cytotoxic d. Antigenic In clonal selection of B cells, which substance is responsible for determining which cell will proliferate? a. antigen c. cytokine b. antibody d. interleukin 2 (IL 2) Which of the following is not a method used by antibodies to combat antigens? a. agglutination of antigen b. complement activation c. trigger antigen apoptosis d. precipitation of antigen e. neutralization of antigen Select the correct statement (s) about antibodies. 1. Complement fixation is the main mechanism by which antibodies provide protection 2. Antigen binds to the constant region 3. IgA is found in body secretions such as saliva, sweat, and intestinal juice 4. They are glycoproteins secreted by B lymphocytes 5. IgM is the first antibody to be released during the primary infection. a. 3 and 5 c. 1, 3, and 5 b. 2, 4, and 5 d. 5 only A single IgG molecule: a. acts as the B cell receptor b. contains both heavy and light chains c. has a variable region that binds to complement d. has a constant region that binds to antigens Which of the following statements regarding CD8 cytotoxic T cells is false? a. they are activated by MHC I and MHC II c. they induce apoptosis in their target cell antigens via granzyme B b. their targets include virus infected cells d. their activation requires costimulation by and cancer cells helper T cells Which of the following cells would not have MHC class I antigens? a. liver cell d. macrophage b. neuron e. neither c or d would have an MHC class I antigen c. red blood cell Which of the following statements best describes IgA antibodies? a. They trigger the release of histamine c. The first antibody released during a during allergic reactions primary immune response b. Found in plasma and interstitial fluid and d. Found in saliva and prevents the are very effective against bacteria attachment of pathogens Which of the following statements is/are true concerning major histocompatibility antigens? 1. MHC class II antigens are found on the surface of hepatocytes (liver cells) 2. MHC are self -antigens 3. MHC I antigens are recognized by cytotoxic T cells 4. MHC class II antigens complexed with a foreign antigen would be found on the surface of an antigen presenting cell a. 1 and 3 only b. 2 and 4 only c. 1 and 4 only d. 1, 2, 3, and 4 The variable regions on the arms of an antibody a. make the antibody specific for an antigen d. enable the antibody to bind to mast cells b. enable the antibody to activate e. all of the above are true complement c. are part of the constant region The cell mediated response is effective against 1. virus infected cells 2. transplanted cells (non-self) 3. haptens 4. tumor cells a. 1, 2, and 3 b. 1 and 3 c. 2 and 4 d. 1, 2 and 4 e. 1, 2, 3 and 4 Which of the following is not a function of the inflammatory response? a. prevents the spread of the injurious agent c. replaces injured tissues with connective to nearby tissue tissue b. disposes of cellular debris and pathogens d. sets the stage for repair processes Which of the following statements regarding NK cells is a false or incorrect statement? a. NK cells are a type of neutrophil. c. NK cells attack cells that display abnormal MHC antigens. b. NK cells are present in the blood, spleen, d. NK cells attack cancer cells and viruslymph nodes, and red bone marrow. infected body cells. Select the correct definition about tissue grafts. a. Isografts are between identical twins. c. Allografts are between different species. b. Xenografts are between individuals of the d. Autografts are between two genetically same species. identical individuals. Which of the following statements is incorrect or false? a. Haptens lack immunogenicity unless attached to protein carriers. b. Class 1 MHC molecules are built into the plasma membranes of all body cells. c. Class II MHC molecules appear only on the surface of antigen-presenting cells, thymic cells, and T cells that have been activated by exposure to antigens. d. MHC proteins are the cell’s identity markers. Helper T cells ________. a. bind tightly to target cells and release a lymphotoxin called perforin b. release C3a proteins c. often function to decrease the immune response d. function in the adaptive immune system activation Antibody functions include all of the following, except ________. a. binding and inactivating chemical toxins c. linking soluble antigens together so that released by bacteria or other they fall out of solution microorganisms b. cross-linking cell-bound antigens on red d. targeting foreign cells so that blood cells when blood types are properly complement proteins can cause cellular matched lysis What is the role of interferon in defense against disease? a. protects cells that have not yet been c. activates the complement mechanism infected by viruses b. protects cells that have not yet been d. activates the inflammatory process infected by bacteria Which of the following is true regarding B Lymphocytes: a. They stimulate Cytotoxic T cells b. They are antigen presenting cells c. They are essential in the production of antibodies Activated T Helper Cells a. Activates Naïve Cytotoxic cells b. Stimulates Natural Killer Cells c. d. Stimulates Macrophages All of the above Which response usually occurs after an individual receives a vaccination for influenza virus? a. Hormones in the blood inhibit reproduction of the virus b. Antibodies against the virus form in the blood. C Enzymes released from platelets hydrolyze the virus. c. Antigens from the vaccine deactivate the virus In order for a cell to release interferons: a. complement must be activated b. an APC must present an antigen c. d. the cell must be infected with a virus helper T-cells must induce release Select the correct statement about immunodeficiency. a. Immunodeficiencies are conditions where immune cells, phagocytes, or complement function normally. b. The causative agent in acquired immune deficiency syndrome (AIDS) is a virus. c. Severe combined immunodeficiency (SCID) disease is an acquired, not genetic condition. d. Immunodeficient conditions are the same as autoimmune reactions. After a macrophage has engulfed a bacteria, as is happening in the photo here, what happens next? a) the bacterium is destroyed within a phagosome b) the macrophageundergoes apoptosis c) interferons are released d) NK cells destroy the macrophage How are B cells activated? a. APC presentation and antigenic binding to IgD on the B cell surface b. antigenic binding to IgD on the B cell surface and lymphokine release by CD4 cells c. APC presentation and lymphokine release by CD4 cells d. Unknown Which of the following is matched incorrectly? a. type 1 hypersensitivity: IgE b. type II hypersensitivity: IgG d. type IV hypersensitivity: IgG e. type IV hypersensitivity: delayed hypersensitivity c. type III hypersensitivity: immune complexes A baby has a transient immunity as the result of IgG molecules passing across its mother’s placenta into its bloodstream. This is an example of __________________ immunity. a. naturally acquired, active c. artificially acquired, active b. naturally acquired, passive d. artificially acquired, passive If someone is stricken with botulism, they will be administered horse antitoxin, which contains antibodies against the botulinum toxin. This would be an example of _____________ immunity. a. artificially acquired passive b. artificially acquired active c. naturally acquired active d. naturally acquired passive “Bubble boy syndrome” is more properly referred to as: a) acquired immune deficiency syndrome b) systemic lupus erythromatosis c) severe combined immunodeficiency d) tubercular leprosy Which of the following is true of immediate (acute) hypersensitives: a. They involve T cells activating an inflammatory response. b. They involve IgE antibodies and the release of histamine from mast cells and basophils c. They are also called type IV hypersensitivities. d. An example would include allergic contact dermatitis from hair dye or cosmetics. Antibody function includes all of the following EXCEPT a. bind and inactivate chemical toxins c. released by bacteria and other microorganisms b. link soluble antigens together so that they d. fall out of the solution target foreign cells so that the complement proteins can cause cellular lysis cross- link cell bound antigens on red blood cells when blood types are properly matched Males transplanted with bone marrow from their sisters have received a(n): a. allograft b. autograft c. isograft d. xenograft Class I MHC proteins are found on the surface of _____________ ; Class II MHC proteins are found on the surface of _______________ a. T lymphocyte; B lymphocyte c. B lymphocyte; nucleated cell b. nucleated cells; antigen presenting cell d. antigen presenting cell; nucleated cell Difficulty Level 3 You have been bitten by an animal with rabies. You are given a gamma globulin injection. This is an example of a. active, natural immunity c. passive, natural immunity b. active, artificial immunity d. passive artificial immunity In AIDS our main concern is the decrease in the level of: a. B Lympocytes c. Memory Cells b. Plasma Cells d. T Lymphocytes Which of the following may be low in an active HIV infection a. CD4 b. CD8 The fact that humans generally cannot contract diseases from other species (such as a human contracting equine encephalitis) is because of: a. mechanical barriers c. complement b. species resistances d. phagocytosis A Which of the following would be classified as a delayed hypersensitivity reaction? a. c. transfusion reaction organ rejection b. d. anaphylaxis from a bee sting rash from wearing a bracelet made of nickel When a tissue or organ is rejected, this is an example of a _______ hypersensitivity reaction. a) type I b) type II c) type III d) type IV Erthyroblastosis fetalis is best described by which category of hypersensitivity? a) type I b) type II c) type III d) type IV Type I hypersensitivities that release histamines and other vasodilators systemically can cause: a) hypovolemic shock b) vascular shock c) cardiogenic shock d) orthostatic shock One type of bare lymphocyte syndrome is caused by a genetic defect in MHC class II transactivator (CIITA) which results in the inability to synthesize MHC class II and display it on the cell surface. The consequence of this would be that a. B lymphocytes are unable to develop d. phagocytes cannot process antigens b. CD8 T cells cannot function e. antigens cannot be neutralized c. CD 4 T cells cannot function In a routine examination, some blood is taken and analyzed. The results show a high IgM levels for the mumps antigen. This would indicate the person a. has just recovered from mumps c. is just coming down with mumps b. is allergic to mumps d. has never been exposed to mumps If the thymus failed to produce the hormone thymosin, we would expect to see a decrease in the number of: a. B lymphocytes d. cytotoxic T cells b. NK cells e. all of the above c. neutrophils Identify each of these antibodies by the proper class. (1 point each) ________________ ________________ B cell membrane ________________ Mast cell ________________ Other types of questions across all objectives of the topic - Immunity MATCHING a. Interferon b. granzyme c. interleukins d. C- protein e. perforins 1. released by cytotoxic T cells, molecules that insert into the membrane of a target cell and cause cell lysis 2. released by helper T cells function as co-stimulator to B lymphocytes and cytotoxic T cells 3. a molecule that induces apoptosis in target cells 4. produced by the liver this molecule binds to the surface of pathogens and activates complement 5. proteins released by virus infected cells that protects non-infected cells SHORT ANSWER List and describe the events of humoral immunity. Pick either MHC I or MHC II class histocompatibility antigens (circle the one you’ve chosen) and A. Name the cell type(s) that possess the antigen B. Which cells recognize the antigen? C. What is the function of the antigen? Describe two ways that antibodies inactivate antigen. Vascular changes lead to 2 of the hallmarks of inflammation. What are the vascular changes? Name two chemical mediators that cause these changes. What are the specific symptoms of inflammation that result from the vascular changes. Explain the connection between the vascular changes and the symptoms. Explain why is there no immunological memory associated with passive immunity. To fully answer this question you need to describe how immunological memory comes about! Describe how the following terms are different: Th1 and Th2 MHC Class 1 and MHC Class 2: Complete antigen and hapten: What is complement? How are the classical, lectin and alternative pathways activated? Describe 2 ways that complement proteins provide protection against pathogens. Describe how a cytotoxic T cell kills a virus infected cell? Describe two methods that antibodies use to inactivate antigen. Describe positive and negative selection Describe two ways that complement proteins help in defense against pathogens. Children born without a thymus must be kept in a germ-free environment if they are to survive. Explain why this is necessary. Why does HIV ultimately result in overall immunodeficiency when it only attacks one type of lymphocyte? Why does the EpiPen work in cases of hypersensitivities to bee stings? Describe what is happening to the blood vessels, as well as the effects of the EpiPen on the vessels. List the four cardinal signs of inflammation, and describe how each develops. What benefit is derived from the development of each sign? Describe the roles of helper T cells. Compare and contrast IgM and IgG antibodies.