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Advanced Pathophysiology > Chapter 2: Immunity > Flashcards

Chapter 2: Immunity Flashcards

1
Q
  1. Innate immunity, also called natural or native immunity, consists of mechanisms that respond specifically to:
    A) self-cells.
    B) microbes.
    C) antibodies.
    D) inflammation.
A

B). microbes

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2
Q
  1. Adaptive immune responses, also called acquired or specific immunity, are composed of and their products.
    A) granulocytes
    B) lymphocytes
    C) epithelial cells
    D) Toll-like receptors
A

B). lymphocytes

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3
Q
  1. The effector cells of the immune system have the primary function of:
    A) activating phagocytic cells.
    B) eliminating the antigens.
    C) processing antigen into epitopes.
    D) controlling the immune response.
A

B). eliminating the antigens

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4
Q
  1. Activation of lymphocytes is dependent upon the and of the antigens by macrophages.
    A) memory; clustering
    B) capture; destruction
    C) recognition; grouping
    D) processing; presentation
A

D: processing; presentation

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5
Q
  1. Major histocompatibility complex (MHC) molecules, with human leukocyte antigens (HLAs), are markers on all nucleated cells and have an important role in:
    A) identifying blood types.
    B) cell membrane transport.
    C) suppressing viral replication.
    D) avoiding transplant rejections.
A

D) avoiding transplant rejections

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6
Q
  1. Dendritic cells, found in skin tissues and lymphoid tissues, are important for:
    A) initiation of adaptive immunity.
    B) deep-tissue phagocytosis.
    C) disposal of dead cells.
    D) delaying inflammation.
A

A). initiation of adaptive immunity

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7
Q
  1. Once T helper cells are activated, they secrete that activate and regulate nearly all of the other cells of the immune system.
    A) complement proteins
    B) cytokines
    C) leukotrienes
    D) bradykinins
A

B) cytokines

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8
Q
  1. The first circulating immunoglobulin to appear in response to a new antigen is:
    A) IgG.
    B) IgM.
    C) IgA.
    D) IgD.
A

B). IgM

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9
Q
  1. The effector function of activated members of the complement system includes all of the following EXCEPT:
    A) chemotaxis.
    B) opsonization.
    C) pathogen lysis.
    D) phagocytosis.
A

D) phagocytosis

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10
Q

10 During the latent period before antibodies are detected in the humoral
. immune response, B cells differentiate into cells.
A) plasma
B) cytotoxic
C) stem
D) helper

A

A). plasma

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11
Q

11 Which of the following would participate in the innate immune response to
. an infectious microorganism?
A) T lymphocytes
B) Antibodies
C) B lymphocytes
D) Neutrophils

A

D). Neutrophils

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12
Q

12 A patient has recently received a pneumococcal vaccine and the patients B
. cells are consequently producing antibodies. Which of the following cells may enhance this production of antibodies?
A) Helper T cells
B) Regulatory T cells
C) Cytotoxic T cells
D) Natural killer cells

A

A). Helper T cells

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13
Q

13 A childs thymus gland is fully formed and proportionately larger than an
. adults. Which of the following processes that contribute to immunity takes place in the thymus gland?
A) Differentiation of B cells
B) Production of natural killer (NK) cells
C) Proliferation of T cells
D) Filtration of antigens from the blood

A

B) Production of natural killer cells

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14
Q

14 A patients exposure to an antibiotic-resistant microorganism while in the
. hospital has initiated an immune response, a process that is mediated and regulated by cytokines. Which of the following statements is true of cytokines?
A) They are stored in the peripheral lymphoid tissues until required.
B) They have a long half-life that contributes to an ongoing immune response.
C) They are normally released at cell-to-cell interfaces, binding to specific receptors.
D) They are capable of performing phagocytosis in the response to viral invasion.

A

C). They are normally released at cell-to-cell interfaces, binding to specific receptors

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15
Q

15 The entrance of a microbe into an individuals vascular space has initiated
opsonization. Which of the following processes is involved in opsonization?
A) Stimulation of B cells by helper T cells
B) Coating of a microbe to aid phagocyte recognition
C) Release of proteins that stimulate cell production by the bone marrow
D) Lysis of intracellular microbes by cytotoxic T cells

A

B). coating of a microbe to aid phagocyte recognition

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16
Q

16 Bacteria on a sliver in a boys finger have initiated an adaptive immune
response. The boys lymphocytes and antibodies recognize immunologically active sites on the bacterial surfaces known as:
A) Toll-like receptors.
B) opsonins.
C) chemokines.
D) epitopes.

A

D) epitopes

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17
Q

17 Histocompatability molecules are of primary importance to which of the
. following aspects of immunity?
A) Induction of T-cell immunity
B) T-cell maturation
C) NK cell activation
D) Phagocytosis by neutrophils

A

A). induction of t-cell immunity

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18
Q

18 Prior to leaving on a backpacking trip to Southeast Asia, a college student has received a tetanus booster shot. This immunization confers protection by way of what immune process?
A) Secondary humoral response
B) Cell-mediated immune response
C) Primary humoral response
D) Innate immunity

A

A). secondary humoral response

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19
Q

19 A patients cell-mediated immune response has resulted in the release of regulator T cells. These cells will perform which of the following roles?
A) Suppressing the immune response to limit proliferation of potentially harmful lymphocytes
B) Presenting antigens to B cells to facilitate the production of antibodies
C) Differentiating into subpopulations of helper T cells
D) Destroying target cells by releasing cytolytic enzymes and other toxins

A

A) suppressing the immune response to limit proliferation of potentially harmful lymphocytes

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20
Q

20 A 1-day-old infant was exposed to an infectious microorganism prior to discharge home from the hospital, but was able to effect a sufficient immune response in the hours and days following exposure. This immune response may have been due to the presence of which of the following immunoglobulins from the infants mother?
A) IgA
B) IgG
C) IgM
D) IgD

A

B). IgG

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21
Q

Two types of Stem Cells in bone marrow

A

hematopoetic, mesenchymal

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22
Q

two types of cells that hematopoietic stem cells give rise to

A

lymphoid, myeloid

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23
Q

which of the following is not an innate immune cell
helper T cell
Basophil
Mast Cell
Macrophage

A

Helper T cell

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24
Q

Type of cell produced in bone marrow, matures in thymus

A

T cell

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25
Q

Erythroblastosis Fetalis is an example of what type of hypersensitivity
I, II, III, or IV

A

II (remember mom and baby = 2)
results from destruction of antigens on target cells or tissues

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26
Q

_________response occurs after first line barriers are penetrated within the immune system

A

inflammatory

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27
Q

Skin and mucous membranes are second line barriers in the immune system (true or false?)

A

false

28
Q

The vascular inflammatory response is primarily _____ cell driven

A

mast

29
Q

T-cell mediated responses act to destroy the antigen

A

true

30
Q

What type of hypersensitivity is associated with autoimmune disorders?
I, II, III, or IV

A

III (remember SLE = 3)
caused by accumulation of circulating antigen/antibody complexes

31
Q

What type of immunity is gained by receiving antibodies?
natural
passive acquired
artificial
serum sickness

A

passive acquired

32
Q

_________ must be presented to the cell receptor for recognition by T-cells.
antibodies
antigens
apc cells
b cells

A

antigens

33
Q

_________ tolerance occurs in secondary lymph tissue, such as the spleen

A

peripheral

34
Q

Gram positive bacteria are associated with B-lactamase (true or false)

A

false

35
Q

________ mediated responses produce antibodies against the antigen

A

b cell

36
Q

An infected person can only infect another person during the acute phase of an infection (true or false)

A

false

37
Q

Which type of hypersensitivity can result in anaphylaxis and produces IgE
I, II, III, or IV

A

I
T cells activated by allergens, bind to mast cells. Produces IgE antibodies instead of IgA/G/M, makes mast cells sensitive to allergen

38
Q

__________ tolerance occurs in primary lymph tissue, such as the thymus and bone marrow

A

central

39
Q

What type of hypersensitivity is associated with transplant rejection and contact dermatitis from poison ivy?
I, II, III, or IV

A

IV
delayed processing of the antigen by macrophages - results in severe tissue injury

40
Q

chronic inflammatory disease that can affect connective tissue, known for butterfly (malar) rash

A

Systemic Lupus Erythematous

41
Q

One of the most common forms of immunodeficiency is caused by viral illnesses (true or false)

A

true

42
Q

Most HIV treatments are aimed at treating only the receptors on the surface of a CD4 helper cell (true or false)

A

false

43
Q

HIV stages

A

Acute retroviral syndrome (initial flu like symptoms)
chronic/clinical latency (asymptomatic)
AIDS. (CD4 < 200 or opportunistic infection)

44
Q
  1. The mediators involved in type I hypersensitivity allergic responses are released from:
    A) mast cells.
    B) plasma cells.
    C) monocytes.
    D) arachidonic acid.
A

A) mast cells.

45
Q
  1. A genetically determined hypersensitivity to common environmental allergens causes reactions, such as:
    A) atopic; urticaria.
    B) autoimmune; diarrhea.
    C) IgM-mediated; infections.
    D) delayed; poison ivy rash:
A

A) atopic; urticaria.

46
Q
  1. Mismatched blood transfusion reaction with hemolysis of blood cells is an example of type II, mediated hypersensitivity reaction.
    A) T-cell
    B) antibody
    C) leukotriene
    D) complement
A

B) antibody

47
Q
  1. Type III hypersensitivity immune responses can be harmful when immune complex deposits in tissue activate that can directly damage area tissues.
    A) inflammation
    B) autoantibodies
    C) cytotoxic cells
    D) immunoglobulins
A

A) inflammation

48
Q
  1. The mechanism by which humans recognize self-cells from non-self (antigens)-cells is .
    A) autoimmunity
    B) self-tolerance
    C) non-self anergy
    D) immunocompatibility
A

B) self-tolerance

49
Q
  1. Organ rejection is a complication of organ transplantation caused by recipient immune cells:
    A) destroying the host T cells.
    B) attack on the donor cells.
    C) combining with grafts HLA.
    D) being recognized as foreign.
A

B) attack on the donor cells.

50
Q
  1. The leading cause of death for people with HIV is opportunistic
    .
    A) leukemia
    B) tuberculosis
    C) pneumonia
    D) toxoplasmosis
A

B) tuberculosis

51
Q
  1. Wasting syndrome, an AIDS-defining illness, is characterized by involuntary weight loss of at least 10% of baseline body weight in the presence of:
    A) diarrhea.
    B) hypermetabolism.
    C) weakness and fever.
    D) glucose intolerance.
A

A) diarrhea.

52
Q
  1. The window period of HIV infection refers to the period of time between infection and:
    A) transmission.
    B) seroconversion.
    C) initial symptoms.
    D) antibody screening.
A

B) seroconversion.

HIV seroconversion is the period when the body’s immune system responds to HIV by producing antibodies, and when these antibodies can be detected in the blood:

53
Q

10 HIV-positive persons that display manifestations of laboratory category 3 or
. clinical category C are considered to have:
A) zero viral load.
B) seroconversion.
C) complete remission.
D) AIDS-defining illnesses.

A

D) AIDS-defining illnesses.

54
Q

11 Contact with poison ivy has resulted in intense pruritus, erythema, and
. weeping on a patients forearm. Which of the following processes resulted in the patients signs and symptoms?
A) IgE-mediated mast cell degranulation
B) Formation of antigen-antibody complexes
C) Cytokine release by sensitized T cells
D) Formation of antibodies against cell surface antigens

A

C) Cytokine release by sensitized T cells

55
Q

12 A patient with a long history of hay fever has recently begun a series of
immunotherapy (allergy shots). How will this treatment potentially achieve a therapeutic effect?
A) By blocking cytokine release from sensitized mast cells
B) By preventing mast cells from becoming sensitized
C) By causing T cells to be sequestered in the thymus for longer periods
D) By stimulating production of IgG to combine with antigens

A

D) By stimulating production of IgG to combine with antigens

56
Q

13 A patient with a diagnosis of cirrhosis has experienced an acute rejection of a donor liver. Which of the following cells is central to the rejection of the patients transplanted organ?
A) Natural killer cells
B) Mast cells
C) T cells
D) Neutrophils

A

C) T cells

57
Q

14 A patient with a diagnosis of aplastic anemia has undergone allogenic bone marrow transplantation. Which of the following signs and symptoms would most clearly suggest the existence of graft-versus-host disease (GVHD)?
A) Shortness of breath, audible crackles, and decreasing PaO2
B) Presence of a pruritic rash that has begun to slough off
C) Development of metabolic acidosis
D) Diaphoresis, fever, and anxiety

A

B) Presence of a pruritic rash that has begun to slough off

58
Q

15 A patient has developed pericarditis after developing acute
. glomerulonephritis, a development that may be attributable to the presence of similar epitopes on group A, b-hemolytic streptococci and the antigens in the patients heart tissue. Which of the following has most likely accounted for this patients autoimmune response?
A) Breakdown of T-cell anergy
B) Release of sequestered antigens
C) Superantigens
D) Molecular mimicry

A

D) Molecular mimicry

59
Q

16 A 70-year-old female patient has had her mobility and independence
. significantly reduced by rheumatoid arthritis. Which of the following processes likely contributed to the development of her health problem?
A) Delayed-type hypersensitivity (DTH) reaction
B) Proliferation of cytotoxic T cells
C) Failure of normal self-tolerance
D) Deletion of autoreactive B cells

A

C) Failure of normal self-tolerance

60
Q

17 Which of the following would constitute a normal assessment finding in a
. neonate?
A) Minimal or absent levels of IgA and IgM
B) Absence of plasma cells in the lymph nodes and spleen
C) Undetectable levels of all immunoglobulins
D) Absence of mature B cells with normal T-cell levels and function

A

A) Minimal or absent levels of IgA and IgM

61
Q

18 A patient was diagnosed as HIV positive several years ago. Which of the
. following blood tests is most clinically useful for determining the stage and severity of her disease?
A) Plasma levels
B) CD4+ cell counts
C) Viral load
D) White blood cell count with differential

A

B) CD4+ cell counts

62
Q

19 A patient has been admitted to the hospital for the treatment of HIV
. infection, which has recently progressed to overt AIDS. Which of the following nursing actions should the nurse prioritize when providing care for this patient?
A) Frequent neurologic vital signs and thorough skin care
B) Hemodynamic monitoring and physical therapy
C) Careful monitoring of fluid balance and neurologic status
D) Astute infection control and respiratory assessments

A

D) Astute infection control and respiratory assessments

63
Q

20 Shortly after being diagnosed with HIV, a patient has begun highly active
. antiretroviral therapy (HAART). What is the primary goal of the patients drug regimen?
A) To limit the latent period of HIV
B) To slow the progression of the disease
C) To minimize opportunities for transmission
D) To prevent seroconversion

A

B) To slow the progression of the disease

64
Q

Example of disorder leading to primary immunodeficiency

A

DiGeorge Syndrome - chromosome 22 defect; born without thymus = no T cell maturation

65
Q

What enzyme allows an HIV virus to mature? (Become infectious)

A

Protease

66
Q

Difference between PrEP and PEP

A

P EP
Stands for post-exposure prophylaxis, and is taken after a possible exposure to HIV to prevent infection. PEP is an emergency treatment that must be started within 72 hours of exposure and taken for 28 days. PEP is not recommended for people who are frequently exposed to HIV.

PrEP
Stands for pre-exposure prophylaxis, and is taken to prevent HIV infection before exposure. It can be taken as a daily pill or a shot every two months. PrEP is for people who are at risk of getting HIV, such as those who have had unprotected sex or shared needles

67
Q

What is the effect of prostaglandins

A

Vasodilation, increase blood flow, increase vascular permeability

Advanced Pathophysiology (8 decks)

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