15. Cell Biology, Disorders of Neutrophils, Infectious Mononucleosis, and Reactive Lymphocytosis

Question 1

1. The enzymatic contents of primary (azurophilic) gran-ules include:
   a. NADPH oxidase and hydrogen peroxide
   b. Cytochrome b and collagenase
   c. Myeloperoxidase and lysozyme
   d. Alkaline phosphatase and gelatinase

Answer 1

c. Myeloperoxidase and lysozyme

Question 2

2. Directional migration toward a gradient stimulated by a chemoattractant is referred to as:
   a.Chemotaxis
   b.Random mobility
   c.Opsonization
   d.Chemokinesis

Answer 2

a.Chemotaxis

Question 3

3. The marking of an invading microbe with IgG and com-plement to facilitate recognition is referred to as:
   a. Chemokinesis
   b.Opsonization
   c.Phagolysosome fusion
   d.Signal transduction

Answer 3

b.Opsonization

Question 4

4.Which sequence reflects the correct order for phago-cytosis?
a. Release of cytoplasmic granules; binding of particle;ingestion; fusion of phagolysosome
b. Ingestion; binding of particles; fusion of phagolyso-some;release of cytoplasmic granules
c. Binding of particle; ingestion; fusion of phagolySO-some; release of cytoplasmic granules
d. Fusion of phagolysosome; binding of particle;release of cytoplasmic granules; ingestion

Answer 4

c. Binding of particle; ingestion; fusion of phagolySO-some; release of cytoplasmic granules

Question 5

5. In oxygen-dependent killing, the enzyme responsible for meditating the production of active oxygen metabolites during the respiratory burst is:
   a.Myeloperoxidase
   b.Lysozyme
   c.Lactoferrin
   d.NADPH oxidase

Answer 5

d.NADPH oxidase

Question 6

6.The two most important biochemical products of the res-piratory burst that are involved with particle digestion during active phagocytosis are:
a.Lactoferrin and gelatinase
b. Superoxide dismutase and catalase
c. Glutathione peroxidase and copper-zinc enzymes
d. Superoxide anion and hydrogen peroxide

Answer 6

d. Superoxide anion and hydrogen peroxide

Question 7

7.The morphological characteristic(s) associated with Chediak-Higashi syndrome is (are):
a.Giant lysosomal granules
b.Hypersegmented agranular neutrophils with vacuolization
c. Prominent dark-staining granules and pyknotic nuclei
d. Pale blue inclusions in cytoplasm of neutrophils and giant platelets

Answer 7

a.Giant lysosomal granules

Question 8

8.The defect in chronic granulomatous disease is attributed to:
a. Delayed degranulation
b.Inefficient ingestion of microbes
c. Defective bacterial killing
d. Abnormal phagolysosome formation

Answer 8

c. Defective bacterial killing

Question 9

9.Identify the disease characteristic(s) associated with Chediak-Higashi syndrome.
a. Partial albinism, recurrent infections, and mild bleed-ing tendencies
b.Granulomas,osteomyelitis,and hepatic abscesses
c.Hypopigmentation of skin and chronic, swollen lymph nodes
d. Periodic pneumonia that may result in lesions called pneumatoceles

Answer 9

a. Partial albinism, recurrent infections, and mild bleed-ing tendencies

Question 10

10.Pelger-Huët anomaly may be described by:
a.Large neutrophils and hypersegmentation of the nucleus with greater than six lobes
b.Dark-staining, coarse granules in cytoplasm of neu-trophils,eosinophils,basophils,and monocytes
c. Pale blue inclusions of the cytoplasm of neutrophils and giant platelets
d. Hyposegmentation of the nucleus with the majority of neutrophils being bilobed or monolobed

Answer 10

d. Hyposegmentation of the nucleus with the majority of neutrophils being bilobed or monolobed

Question 11

11.Reactive lymphocytes may best be distinguished from blasts by the presence of which of the following mor-phological features?
a.Prominent nucleoli
b.Fine chromatin
c.Heterogeneous cell population
d.High N:C ratio

Answer 11

c.Heterogeneous cell population

Question 12

12.Which of the following antigens is detectable first by ELISA?
a.EBNA
b.EBV-VCA(IgM)
c.EBV-VCA(IgG)
d.Heterophile

Answer 12

b.EBV-VCA(IgM)

Question 13

13.The Epstein-Barr virus infects which of the following cells?
a.Helper T lymphocytes
b.Cytotoxic T lymphocytes
c.B lymphocytes
d.NK cells

Answer 13

c.B lymphocytes

Question 14

14. What is the most frequent cause of a heterophile (Monospot) negative mononucleosis-like syndrome?
    a.HIV
    b.CMV
    c.Hepatitis C
    d. Toxoplasma gondii

Answer 14

b.CMV

Question 15

15. In which of the following conditions are reactive lym-phocytes found?
    a. Infectious mononucleosis
    b.CMV infection
    c.Rubella
    d.All of the above

Answer 15

d.All of the above

Question 16

16.Absolute lymphocytosis is best described as:

a. Greater than 70% lymphocytes on differential
b.Presence of nucleoli in lymphocytes
c. Monoclonal population of lymphocytes
d. Greater than 4.0x10° lymphocytes per liter in an adult

Answer 16

d. Greater than 4.0x10° lymphocytes per liter in an adult

Question 17

17.Which of the following features are seen in reactive lym-phocytes?
a.Low N:C ratio
b.Blue cytoplasm
c.Indented cytoplasmic borders
d. All of the above

Answer 17

d. All of the above

Question 18

18. Which of the following clinical manifestations would be unexpected in infectious mononucleosis?

a.Skin rash
b.Sore throat
c. Fatigue
d. Fever

Answer 18

a.Skin rash

Question 19

19.Which of the following features best differentiates malignant lymphomas from infectious mononucleosis?
a.Clonality
b.Monotony
c.Pattern of lymphadenopathy
d.All of the above

Answer 19

d.All of the above

Question 20

20. Which of the following viral agents causes infectious mononucleosis?
    a.Heterophile virus
    b.Human herpes-6 virus
    c.EBV
    d.HIV

Answer 20

c.EBV