Exam 1: Dr. Pruett Chapter 1

Question 1

In 1849, what were recommended treatments for tetanus? (9)

Answer 1

Bleeding
Mercury to cause vigorous vomiting
Purgatives to cause clearance of colon
Tobacco enema until signs of nicotine poisoning
Tonics
Ardent spirits
Nutriment
Cannabis
Opium

Question 2

What was medicine based on?

Answer 2

Logic or anecdotal evidence by authorities

Question 3

What was the rationale for bleeding, purgatives, and emetics?

Answer 3

There was something bad in the body causing illness so “flushing” was needed

Question 4

What is the gold standard for evidence based medicine?

Answer 4

Double blind clinical trial

Question 5

What happens in a double blind clinical trial?

Answer 5

Neither the doctor nor the patient know if they received the experimental drug or other therapy or an inert placebo. At the end of the day, the results are decoded and analyzed

Question 6

What is the null hypothesis in a double blind clinical trial?

Answer 6

The treatment has no effect

Question 7

If statistical analysis reveals that there is less than a 5% chance that the difference between groups could be explained by natural variations, what happens?

Answer 7

The null hypothesis can be rejected and the drug can be regarded as having some effect

Question 8

What is an example of a drug that has never been tested? How have they studied its efficacy?

Answer 8

Aspirin

It is compared to other drugs

Question 9

What animals is the innate system present in?

Answer 9

All

Question 10

How often is the innate system ready?

Answer 10

At all times

Question 11

What kind of response does the innate system have?

Answer 11

Rapidly deployed, early-phase response

Question 12

What does the innate system involve?

Answer 12

Germline encoded receptors that can recognize the presence of microbes or damage

Question 13

How were receptors selected in the innate immune system?

Answer 13

Over evolution

Question 14

What does the innate system recognize?

Answer 14

Broad groups of related microbes or other threats

Question 15

Is the innate system triggered by self antigens alone?

Answer 15

Rarely

Question 16

What is the innate immune response regulated by?

Answer 16

A variety of cells and molecules that are effective against a wide range of microbes

Question 17

Is the efficiency of the innate system improved with repeated exposure?

Answer 17

No

Question 18

What animals is the adaptive system present in?

Answer 18

Only vertebrates

Question 19

What does the adaptive system require?

Answer 19

Selection of lymphocytes

Question 20

What kind of response does the adaptive system have?

Answer 20

Delayed late-phase response

Question 21

What does the adaptive system involve?

Answer 21

Gene rearrangement of receptors that are highly specific

Question 22

When are receptors selected in the adaptive system?

Answer 22

In individual animals during maturation

Question 23

What does the adaptive system recognize?

Answer 23

Specific single molecules

Question 24

Does the adaptive system react to self antigens?

Answer 24

It may

Question 25

What is the adaptive system response mediated by?

Answer 25

Antigen-specific lymphocytes that are effective against a particular antigen

Question 26

How is efficiency improved in the adaptive system?

Answer 26

With repeated exposure to a given antigen (memory)

Question 27

What are examples of extracellular innate effectors?

Answer 27

Complement activation Phagocytosis by phagocytes Extracellular killing

Question 28

What is an example of intracellular innate effectors?

Answer 28

NK cell cytotoxicity

Question 29

What are examples of extracellular adaptive effectors?

Answer 29

B cells Helper T cells Antibodies (humoral)

Question 30

What are examples of intracellular adaptive effectors?

Answer 30

Cytotoxic T cells Macrophage Helper T cells

Question 31

What is the secondary immune response like?

Answer 31

It is faster and longer

Question 32

What happens when an antibody binds to bacterial toxins?

Answer 32

It goes through neutralization and then ingestion by a macrophage

Question 33

What happens when an antibody binds to bacteria in extracellular space?

Answer 33

It goes through opsonization and then ingestion and lysis

Question 34

What happens when an antibody binds to bacteria in plasma?

Answer 34

It goes through complement activation and then either opsoniziation to ingestion and lysis or straight into ingestion and lysis

Question 35

What do interleukins do?

Answer 35

Deliver messages between leukocytes

Question 36

What are the primary lymphoid organs?

Answer 36

Bone marrow | Thymus

Question 37

What does the bone marrow do?

Answer 37

Produces the precursors of all cells of the innate and acquired immune systems in mammals as well as RBCs and platelets

Question 38

What happens in the thymus?

Answer 38

Pre-T cells migrate from the bone marrow to the thymus and mature in the thymus to functions T-lymphocytes

Question 39

What are the secondary lymphoid organs locations of?

Answer 39

Microbial clearance and acquired immune response initiation

Question 40

What are the secondary lymphoid organs?

Answer 40

Lymph nodes Spleen Gut associated lymphoid tissue Bronchial associated lymphoid tissues

Question 41

What is the spleen an alternative site for?

Answer 41

Hematopoiesis

Question 42

What happens with 90% of T cells?

Answer 42

The recognize self too strongly in thymic education and are killed

Question 43

Why are the primary and secondary lymphoid organs in birds and fish different?

Answer 43

They do not have bone marrow hematopoietic function

Question 44

Do lymphocytes enter through afferent lymphatic vessels?

Answer 44

No

Question 45

Where do lymphocytes enter?

Answer 45

After arterioles become venules, lymphocytes enter through them and then use receptor-mediated active transport

Question 46

Where can lymphocytes exit through?

Answer 46

Efferent lymphatic vessels

Question 47

What does a germinal center indicate?

Answer 47

Active immune response in that location

Question 48

What is the immediate source of lymphocytes?

Answer 48

Blood

Question 49

What does the heart indirectly drive?

Answer 49

Efferent circulation

Question 50

What are T cells needed to do?

Answer 50

Activate the acquire immune response of B cells

Question 51

What does a ruptured spleen lead to?

Answer 51

Blood loss

Question 52

How does antigen enter the spleen?

Answer 52

Via blood, not lymphatics

Question 53

What does the spleen consist of?

Answer 53

Red pulp and white pulp

Question 54

What does red pulp consist of?

Answer 54

RBCs and stem cells

Question 55

What is the center of white pulp?

Answer 55

A central arteriole

Question 56

What happens to someone without a spleen?

Answer 56

They are prone to infection

Question 57

What is the primary function of the spleen?

Answer 57

Provide an immune response/blood filter

Question 58

What is the main regulator of the immune system?

Answer 58

Clearance of the stimulus

Question 59

The adaptive system can't always kill microbes alone. What does the system do in the case that it cannot?

Answer 59

It activate the innate system to a higher degree to help remove the microbe

Question 60

Know and understand chart on page 15

Answer 60

Know and understand chart on page 15

Question 61

What percentage of microbes in the GI tract are unknown?

Answer 61

60%

Question 62

What is the innate barrier in the reproductive tract?

Answer 62

Low pH

Question 63

What are the innate barriers in the intestinal tract?

Answer 63

``` Rapid change in pH Lysozyme Defensins Hydrolases Bile acids Peristalsis Mucus ```

Question 64

What are the innate barriers in the skin?

Answer 64

Keratinized barrier Desquamation Fatty acids Dessication

Question 65

What is the innate barrier in the urinary tract?

Answer 65

Unidirectional flushing

Question 66

What are the innate barriers in the mammary gland?

Answer 66

``` Keratin plug Flushing Complement Lysozyme Lactoferrin Lactoperoxidase ```

Question 67

What are the innate barriers in the cornea and conjunctiva?

Answer 67

Physical flushing | Lysozyme in lacrimal secretions

Question 68

What are the innate barriers in the trachea/bronchi?

Answer 68

Mucus Cilia-mediated clearance Cough

Question 69

What is the innate barrier in the upper respiratory tract?

Answer 69

Trapping and removal of particulates in mucus

Question 70

How and why does the ciliated epithelium of the respiratory tract lining move?

Answer 70

Moves in a rhythmic motion by nerve cells to keep mucus moving up