PATHOPHYSIOLOGY Name REVIEW ASSIGNMENT #1 – Chapters 6, 7 and 8

Instructions:  You may use any resources you wish to answer these questions.

1. Which of the following is part of the body’s first line of defense? A. B. and C. complement proteins and interferon D. antimicrobial peptides secreted by epithelial cells

2. Overwhelming infections occur when: A. the immune response is inadequate B. any pathogens enter the body C. the overreacts to a threat D. antibodies bind to on bacteria

3. Which of the following is CORRECT about bacteria on the surface of the body? A. All bacteria are pathogenic and should be removed regularly. B. Normal bacterial flora helps to protect the body against pathogens. C. Bacteria that come in contact with the body surface are rapidly killed by body secretions, so the skin has very few bacteria at any one time. D. Body secretions promote the growth of pathogenic bacteria on the skin.

4. When the inflammatory process begins, which cells release chemicals that initiate the vascular response? A. mast cells B. vascular epithelium C. neutrophils D. macrophages

5. What is a purpose of the inflammatory process? A. To provide specific responses toward antigens B. To lyse cell membranes of microorganisms C. To limit and control tissue damage and prevent serious infection D. To create against subsequent tissue injury

6. Which mast cell product causes brief vasoconstriction followed by vasodilation? A. tumor necrosis factor-alpha B. bradykinin C. histamine D. activating factor

7. Aspirin and ibuprofen are good at controlling pain, fever and because they: A. prevent mast cell degranulation B. block binding of histamine C. interfere with the action of interleukins D. inhibit prostaglandin synthesis

8. Complement proteins have all of the following actions EXCEPT: A. inducing cell lysis B. stimulating pain receptors C. causing mast cell degranulation D. opsonizing encapsulated bacteria 2

9. A six -year-old cuts her foot on a piece of dirty glass in the morning. That evening the cut is red and inflamed. Which type of cell would be present in highest numbers at the site of the cut? A. B. C. D.

10. Which of the following is a CORRECT statement about ? A. Tumor necrosis factor-alpha and interleukin-1 both cause fever. B. Interleukins are secreted by virus-infected cells to protect their neighbors from infection. C. All cytokines stimulate the inflammatory response. D. Most cytokines are produced by neutrophils.

11. A hospitalized patient develops an unexplained fever. A differential blood count is done, which shows an increase in but a normal neutrophil count. This person is probably suffering from a: A. bacterial infection B. post-surgical reaction to anesthesia C. reaction to pain medication D. viral infection

12. Which of the following in NOT characteristic of chronic inflammation? A. inflammation for more than 2 weeks B. granuloma formation C. high fever and a differential blood cell count with many neutrophils D. presence of many lymphocytes and macrophages

13. A 22 -year-old woman suffers acute hepatitis. Within a few weeks she is recovered and her liver has fully regenerated. A biopsy of her liver tissue six months later would show: A. both healthy cells and scar tissue evenly distributed throughout the sample B. healthy tissue that looks nearly the same as a person who had not suffered hepatitis C. areas of necrosis and fibrosis interspersed with healthy tissue D. replacement of some normal liver cells with hypertrophic cells

14. When a wound pulls apart at a suture line this is referred to as: A. dehiscence B. contracture C. keloid formation D. dysfunctional collagen synthesis

15. Which of the following is NOT correct about adaptive immunity? A. It is specific. B. It produces memory cells. C. It induces a response that provides long-lasting protection from invaders. D. It takes effect very rapidly when new pathogens are first encountered.

16. An important role played by some is to alert the to the presence of foreign pathogens. They do this by: A. secretion of histamine and prostaglandins B. activating the complement cascade C. presenting engulfed antigens to lymphocytes D. releasing antibodies

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17. The process of B-cell activation by an and the subsequent formation of plasma cells that can secrete antibodies specific for that same antigen is known as: A. cell mediated immunity B. C. innate immunity D.

18. An example of active immunity is: A. development of antibodies in response to vaccination B. transfer of antibodies from mother to child through her milk C. injection with antisera to combat snake venom D. transfusion of anti-Rh antibodies to prevent an Rh-negative mother from becoming sensitized to an Rh-positive fetus.

19. Chronic infections are most likely to occur in people whose immune systems are: A. sensitive B. normal C. overactive D. compromised

20. A female student is vaccinated against polio before traveling to Africa on a mission trip. While there she encounters a patient suffering from polio, but she does not develop the disease herself. Which of the following is most important in preventing her from developing polio? A. B cells are destroying virus-infected cells before the virus can spread. B. Antibodies bind to the virus and prevent it from binding to and entering her cells. C. Memory T cells are attacking the virus particles and lysing them. D. Phagocytes in her respiratory epithelium engulf and destroy the virus before it can enter other tissues.

21. A medical student is studying why some children are less likely than others to develop “pink eye” (conjunctivitis - an infection of the conjunctiva of the eye). When tears from resistant children are analyzed, which of the following is most likely to be present? A. IgA antibodies B. cytotoxic T cells C. IgG antibodies D. complement protein

22. Which type of cell is directly responsible for the process of cell-mediated immunity? A. T lymphocytes B. B lymphocytes C. macrophages D. plasma cells

23. In which process does the body produce millions of different T and B cells that each have receptors to recognize one specific antigen? A. B. clonal diversity C. D. self-antigen selection

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24. Which statement is CORRECT about development of antigen receptors on the surface of lymphocytes? A. When a lymphocyte encounters a foreign antigen it produces the specific antigen receptors that will bind to it. B. Each lymphocyte’s particular antigen receptors are acquired while it is maturing in the bone marrow or thymus. C. All lymphocytes develop identical antigen receptors during differentiation in the bone marrow. D. Antigen receptors develop after the primary response on the surface of memory cells.

25. Which cells coordinate the immune response and activate other cells of immunity and inflammation? A. mast cells B. macrophages C. B lymphocytes D. T lymphocytes

26. Why does the secondary immune response occur faster than the primary response? A. T cells must encounter antigen twice before they will respond to it. B. Only a few plasma cells are produced during the primary response. C. Clonal selection occurs faster each time it happens. D. Memory cells are already present and can rapidly produce large amounts of .

27. Which type of antibody is transferred from the mother to the fetus across the placenta? A. IgA B. IgE C. IgG D. IgM

28. Which of the following declines the most as a result of atrophy of the thymus with increased age? A. function B. function C. D. autoimmune reactions

29. is: A. a reduced immune response found in most pathologic states. B. a normal immune response to an infectious agent. C. an excessive or inappropriate response of the immune system to a sensitizing antigen. D. antigenic desensitization.

30. Cindy, who is allergic to cats, visits a new friend who owns a cat. If you analyzed a sample of Cindy’s blood serum later that day, which of the following would be most likely? A. No change would be noticeable in her blood. B. It would contain a high number of lymphocytes. C. It would contain a low level of IgM. D. It would contain high levels of IgE antibody.

31. A woman purchases an inexpensive metal bracelet. After wearing it for a couple of days she notices a red rash in the area where it contacts her skin. Which of the following immune reactions is she experiencing? A. IgE-mediated B. Tissue specific C. D. Cell-mediated 5

32. A 16 -year-old boy who is allergic to peanuts visits a restaurant that serves unshelled peanuts to waiting customers as an appetizer. After a few minutes he begins itching and develops red, watering eyes and difficulty breathing. He is suffering from: A. alloimmunity. B. . C. anaphylaxis. D. tissue-specific hypersensitivity.

33. A 12 -year-old girl suffers a severe strep throat infection. Antigens from the strep bacteria form complexes with antibodies in her blood and become deposited in the glomeruli of her kidneys, triggering an immune response. This is an example of: A. Type I hypersensitivity B. Type II hypersensitivity C. Type III hypersensitivity D. Type IV hypersensitivity

34. After receiving penicillin for an infection, a woman develops fatigue, dyspnea on exertion, and pallor. Blood tests reveal hemolytic anemia and the presence of antibodies against her red blood cells. This is an example of: A. Type I hypersensitivity B. Type II hypersensitivity C. Type III hypersensitivity D. Type IV hypersensitivity

35. An example of a tissue-specific autoimmune disease is: A. Graves disease. B. contact dermatitis. C. transfusion reaction. D. bronchial asthma.

36. Rheumatic fever and rheumatic heart disease result from: A. autoimmunity. B. alloimmunity. C. homoimmunity. D. compromised immunity.

37. The presence of antinuclear antibodies is one of the signs of: A. B. Raynaud phenomenon C. bronchial asthma D. systemic lupus erythematosus

38. Which of the following is CORRECT about transfusion reactions: A. They are caused by immune system cells that are present in donor blood attacking cells of the recipient. B. They are caused by administration of donor blood through contaminated equipment. C. They occur when the recipient’s immune system attacks antigens on the donor blood. D. A reaction would probably occur if a person with type AB blood received a transfusion of type B blood.

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39. To increase the likelihood that an organ transplant will be successful, the donor and recipient are matched for which of the following? A. CD4 receptors B. nuclear membrane receptors C. MHC I antigens D. MHC II antigens

40. All of the following are benefits of bacteria to the body EXCEPT: A. produce B vitamins and vitamin K B. remove viruses from the blood C. prevent attachment and multiplication by pathogens D. aid digestion

41. A woman is prescribed a broad-spectrum antibiotic for a systemic bacterial infection. After finishing her course of antibiotics she develops a vaginal yeast infection, which she has never had before. What is the most probable reason for this? A. The yeast infection is probably unrelated to the first infection and its treatment. B. The yeast probably developed resistance to the antibiotic. C. The original systemic infection was probably misdiagnosed and was actually a fungal infection. D. The normal bacterial flora in her vagina was killed and the yeast was able to establish an opportunistic infection as a result.

42. Which of the following diseases is caused by protozoa? A. malaria B. ringworm C. chicken pox D. diphtheria

43. A 42 -year-old male is prescribed an antibiotic for a gram-negative bacterial infection. A few hours later the patient goes into shock. What is the most likely explanation? A. He is suffering an allergic reaction to the antibiotic. B. The gram-negative bacteria are dying and releasing endotoxin. C. He has become dehydrated as a result of the infection. D. The infection has reached his brain and is causing his brainstem to shut down.

44. Bacteria become resistant to antibiotics by: A. proliferation. B. attenuation. C. specialization. D. mutation.

45. The basic cause of a primary immune deficiency is: A. a genetic defect or a problem that occurs during prenatal development of the immune system B. an environmental toxin or pathogen that attacks the lymphoid tissues C. contracting a disease that affects the thymus or bone marrow D. an infection that targets the TH cells

46. One clinical sign of a B-cell deficiency is: A. recurrent fungal infections B. low levels of antibodies (hypogammaglobulinemia) C. low T cell counts D. elevated complement levels 7

47. DiGeorge syndrome is due to: A. the absence of B cells B. a disorder of the stem cells that form both B and T cells C. a congenital failure of the thymus and parathyroid glands to develop normally D. a failure of the bursa-equivalent lymphoid tissues to develop

48. The physiological rational for using drugs such as reverse transcriptase inhibitors and proteases for the treatment of AIDS is that they: A. boost the body’s immune response B. prevent HIV from binding to and entering target cells C. kill only cells that are infected with the virus D. interfere with enzymes needed for viral replication

49. Which of the following is the LEAST likely route of HIV transmission? A. sharing a water bottle B. sexual intercourse without a condom C. sharing a hypodermic needle D. receiving a

50. What is the usual cause of death for AIDS victims? A. heart attack B. infections C. kidney failure D. stroke