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adv. patho > exam 2 practice questions > Flashcards

exam 2 practice questions Flashcards

1
Q

Which action is a purpose of the inflammatory process?

a. To provide specific responses toward antigens
b. To lyse cell membranes of microorganisms
c. To prevent infection of the injured tissue
d. To create immunity against subsequent tissue injury

A

c. To prevent infection of the injured tissue

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2
Q

How do surfactant proteins A through D provide innate resistance?

a. Initiate the complement cascade.
b. Promote phagocytosis.
c. Secrete mucus.
d. Synthesize lysosomes.

A

b. Promote phagocytosis.

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3
Q

Which secretion is a first line of defense against pathogen invasion that involves antibacterial
and antifungal fatty acids, as well as lactic acid?
a. Optic tears
b. Oral saliva
c. Sweat gland perspiration
d. Sebaceous gland sebum

A

d. Sebaceous gland sebum

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4
Q

Which bacterium grows in the intestines after prolonged antibiotic therapy?

a. Lactobacillus
b. Candida albicans
c. Clostridium difficile
d. Helicobacter pylori

A

c. Clostridium difficile

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5
Q

What causes the edema that occurs during the inflammatory process?

a. Vasodilation of blood vessels
b. Increased capillary permeability
c. Endothelial cell expansion
d. Emigration of neutrophils

A

b. Increased capillary permeability

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6
Q

What process causes heat and redness to occur during the inflammatory process?

a. Vasodilation of blood vessels
b. Platelet aggregation
c. Decreased capillary permeability
d. Endothelial cell contraction

A

a. Vasodilation of blood vessels

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7
Q

What does activation of the classical pathway begin with?

a. Viruses
b. Antigen-antibody complexes
c. Mast cells
d. Macrophages

A

b. Antigen-antibody complexes

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8
Q

What plasma protein system forms a fibrinous meshwork at an inflamed site?

a. Complement
b. Coagulation
c. Kinin
d. Fibrinolysis

A

b. Coagulation

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9
Q 
Which component of the plasma protein system tags pathogenic microorganisms for destruction 
by neutrophils and macrophages?
a. Complement cascade
b. Coagulation system
c. Kinin system
d. Immune system
A

a. Complement cascade

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10
Q

What is the vascular effect of histamine released from mast cells?

a. Platelet adhesion
b. Initiation of the clotting cascade
c. Vasodilation
d. Increased endothelial adhesiveness

A

c. Vasodilation

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11
Q

What is an outcome of the complement cascade?

a. Activation of the clotting cascade
b. Prevention of the spread of infection to adjacent tissues
c. Inactivation of chemical mediators such as histamine
d. Lysis of bacterial cell membranes

A

d. Lysis of bacterial cell membranes

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12
Q

What is the function of opsonization related to the complement cascade?

a. To tag pathogenic microorganisms for destruction by neutrophils and macrophages
b. To process pathogenic microorganisms so that activated lymphocytes can be
created for acquired immunity
c. To destroy glycoprotein cell membranes of pathogenic microorganisms
d. To promote anaphylatoxic activity, resulting in mast cell degranulation

A

a. To tag pathogenic microorganisms for destruction by neutrophils and macrophages

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13
Q 
In the coagulation (clotting) cascade, the intrinsic and the extrinsic pathways converge at which 
factor?
a. XII
b. VII
c. X
d. V
A

c. X

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14
Q

Which chemical interacts among all plasma protein systems by degrading blood clots, activating
complement, and activating the Hageman factor?
a. Kallikrein
b. Histamine
c. Bradykinin
d. Plasmin

A

d. Plasmin

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15
Q

How does the chemotactic factor affect the inflammatory process?

a. By causing vasodilation around the inflamed area
b. By stimulating smooth muscle contraction in the inflamed area
c. By directing leukocytes to the inflamed area
d. By producing edema around the inflamed area

A

c. By directing leukocytes to the inflamed area

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16
Q 
What effect does the process of histamine binding to the histamine-2 (H2) receptor have on 
inflammation?
a. Inhibition
b. Activation
c. Acceleration
d. Termination
A

a. Inhibition

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17
Q

Frequently when H1 and H2 receptors are located on the same cells, they act in what fashion?

a. Synergistically
b. Additively
c. Antagonistically
d. Agonistically

A

c. Antagonistically

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18
Q

. Some older adults have impaired inflammation and wound healing because of which problem?

a. Circulatory system cannot adequately perfuse tissues.
b. Complement and chemotaxis are deficient.
c. Underlying chronic illness(es) exists.
d. Number of mast cells is insufficient.

A

c. Underlying chronic illness(es) exists.

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19
Q

Which chemical mediator derived from mast cells retracts endothelial cells to increase vascular
permeability and to cause leukocyte adhesion to endothelial cells?
a. Chemokines
b. Prostaglandin E
c. Platelet-activating factor
d. Bradykini

A

c. Platelet-activating factor

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20
Q

What is the inflammatory effect of nitric oxide (NO)?

a. Increases capillary permeability, and causes pain
b. Increases neutrophil chemotaxis and platelet aggregation
c. Causes smooth muscle contraction and fever
d. Decreases mast cell function, and decreases platelet aggregation

A

d. Decreases mast cell function, and decreases platelet aggregation

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21
Q

What is the correct sequence in phagocytosis?

a. Engulfment, recognition, fusion, destruction
b. Fusion, engulfment, recognition, destruction
c. Recognition, engulfment, fusion, destruction
d. Engulfment, fusion, recognition, destruction

A

c. Recognition, engulfment, fusion, destruction

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22
Q 
When considering white blood cell differentials, acute inflammatory reactions are related to 
elevations of which leukocyte?
a. Monocytes
b. Eosinophils
c. Neutrophils
d. Basophils
A

c. Neutrophils

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23
Q

In the later stages of an inflammatory response, which phagocytic cell is predominant?

a. Neutrophils
b. Monocytes
c. Chemokines
d. Eosinophils

A

b. Monocytes

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24
Q

In regulating vascular mediators released from mast cells, the role of eosinophils is to release
what?
a. Arylsulfatase B, which stimulates the formation of B lymphocytes
b. Histaminase, which limits the effects of histamine during acute inflammation
c. Lysosomal enzymes, which activate mast cell degranulation during acute
inflammation
d. Immunoglobulin E, which defends the body against parasites

A

b. Histaminase, which limits the effects of histamine during acute inflammation

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25
Q

What is a role of a natural killer (NK) cells?

a. Initiation of the complement cascade
b. Elimination of malignant cells
c. Binding tightly to antigens
d. Proliferation after immunization with antigen

A

b. Elimination of malignant cells

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26
Q

Which cytokine is produced and released from virally infected host cells?

a. IL-1
b. IL-10
c. TNF-A
d. IFN-A

A

d. IFN-A

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27
Q

Which manifestation of inflammation is systemic?

a. Formation of exudates
b. Fever and leukocytosis
c. Redness and heat
d. Pain and edema

A

b. Fever and leukocytosis

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28
Q 
The acute inflammatory response is characterized by fever that is produced by the hypothalamus 
being affected by what?
a. Endogenous pyrogens
b. Bacterial endotoxin
c. Antigen-antibody complexes
d. Exogenous pyrogens
A

a. Endogenous pyrogens

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29
Q

What occurs during the process of repair after tissue damage?

a. Nonfunctioning scar tissue replaces destroyed tissue.
b. Regeneration occurs; the original tissue is replaced.
c. Resolution occurs; tissue is regenerated.
d. Epithelialization replaces destroyed tissue.

A

a. Nonfunctioning scar tissue replaces destroyed tissue

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30
Q

What is the role of fibroblasts during the reconstructive phase of wound healing?

a. Generate new capillaries from vascular endothelial cells around the wound.
b. Establish connections between neighboring cells and contract their fibers.
c. Synthesize and secrete collagen and the connective tissue proteins.
d. Provide enzymes that débride the wound bed of dead cells.

A

c. Synthesize and secrete collagen and the connective tissue proteins

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31
Q

A keloid is the result of which dysfunctional wound healing response?

a. Epithelialization
b. Contraction
c. Collagen matrix assembly
d. Maturation

A

c. Collagen matrix assembly

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32
Q

A student is preparing to irrigate a patient’s wound and gathers supplies, including hydrogen peroxide. What response by the health care professional is best?

a. Help the student gather the rest of the supplies.
b. Instruct the student to dilute the hydrogen peroxide.
c. Tell the student to get some normal saline instead.
d. Ask the patient if pain medication is needed first.

A

c. Tell the student to get some normal saline instead.

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33
Q

Many neonates have a transient depressed inflammatory response as a result of which condition?

a. The circulatory system is too immature to perfuse tissues adequately.
b. Complement and chemotaxis are deficient.
c. Mast cells are lacking.
d. The respiratory system is too immature to deliver oxygen to tissues

A

b. Complement and chemotaxis are deficient

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34
Q

During phagocytosis, what is occurring during the step referred to as opsonization?

a. Phagocytes recognize and adhere to the bacteria.
b. Microorganisms are ingested.
c. Microorganisms are killed and digested.
d. An intracellular phagocytic vacuole is formed.

A

a. Phagocytes recognize and adhere to the bacteria.

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35
Q

Fusion is the step of phagocytosis during which what happens?

a. Microorganisms are killed and digested.
b. An intracellular phagocytic vacuole is formed.
c. Lysosomal granules enter the phagocyte.
d. Microorganisms are ingested.

A

c. Lysosomal granules enter the phagocyte

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36
Q

What does the phagosome step result in during the process of endocytosis?

a. Microorganisms are ingested.
b. Microorganisms are killed and digested.
c. Phagocytes recognize and adhere to bacteria.
d. An intracellular phagocytic vacuole is formed.

A

d. An intracellular phagocytic vacuole is formed.

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37
Q

When cellular damage occurs and regeneration is minor with no significant complications, what
is the process of returning the cells to preinjury function referred to as?
a. Restoration
b. Resolution
c. Regrowth
d. Replacement

A

b. Resolution

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38
Q 
Newborns often have deficiencies in collectin-like proteins, making them more susceptible to 
what type of infection?
a. Cardiac
b. Urinary
c. Respiratory
d. Gastrointestinal
A

c. Respiratory

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39
Q

Which cell is the body’s primary defense against parasite invasion?

a. Eosinophil
b. Neutrophils
c. T lymphocytes
d. B lymphocytes

A

a. Eosinophil

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40
Q

Which chemical mediators induce pain during an inflammatory response? (Select all that apply.)

a. Prostaglandins
b. Leukotrienes
c. Tryptase
d. Phospholipase
e. Bradykinin

A

a. Prostaglandins

e. Bradykinin

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41
Q

What do sebaceous glands secrete in order to protect the body from infection? (Select all that

apply. )
a. Antibacterial fatty acids
b. Antifungal fatty acids
c. Ascorbic acid
d. Lactic acid
e. Hydrochloric acid

A

a. Antibacterial fatty acids
b. Antifungal fatty acids
d. Lactic acid

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42
Q 
Which body fluids have the ability to attack the cell walls of gram-positive bacteria? (Select all 
that apply.)
a. Perspiration
b. Semen
c. Tears
d. Saliva
e. Urine
A

a. Perspiration
c. Tears
d. Saliva

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43
Q

What do the main functions of NK cells include? (Select all that apply.)

a. Recognizing virus-infected cells
b. Eliminating virus-infected cells
c. Recognizing bacteria-infected cells
d. Eliminating bacteria-infected cells
e. Eliminating previously identified cancer cells

A

a. Recognizing virus-infected cells
b. Eliminating virus-infected cells
e. Eliminating previously identified cancer cells

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44
Q

An individual’s acquired immunity is dependent on the function of which cells? (Select all that

apply. )
a. T lymphocytes
b. B lymphocytes
c. Macrophages
d. Opsonins
e. Neutrophils

A

a. T lymphocytes
b. B lymphocytes
c. Macrophages

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45
Q

Examples of pathogens capable of surviving and even multiplying inside a macrophage include what? (Select all that apply.)

a. Mycobacterium tuberculosis (tuberculosis)
b. Mycobacterium leprae (leprosy)
c. Salmonella typhi (typhoid fever)
d. Clostridium difficile
e. Brucella abortus (brucellosis)

A

a. Mycobacterium tuberculosis (tuberculosis)
b. Mycobacterium leprae (leprosy)
c. Salmonella typhi (typhoid fever)
e. Brucella abortus (brucellosis)

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46
Q

An older adult is particularly susceptible to infections of which body parts? (Select all that

apply. )
a. Lungs
b. Skin
c. Liver
d. Eyes
e. Bladder

A

a. Lungs
b. Skin
e. Bladder

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47
Q

Which primary characteristic is unique for the immune response?

a. The immune response is similar each time it is activated.
b. The immune response is specific to the antigen that initiates it.
c. The response to a specific pathogen is short term.
d. The response is innate, rather than acquired.

A

b. The immune response is specific to the antigen that initiates it

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48
Q

In which structure does B lymphocytes mature and undergo changes that commit them to becoming B cells?

a. Thymus gland
b. Regional lymph nodes
c. Bone marrow
d. Spleen

A

c. Bone marrow

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49
Q

What is the term for the process during which lymphoid stem cells migrate and change into either immunocompetent T cells or immunocompetent B cells?

a. Clonal diversity
b. Clonal differentiation
c. Clonal selection
d. Clonal competence

A

a. Clonal diversity

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50
Q

Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen?

a. Passive-acquired immunity
b. Active-acquired immunity
c. Passive-innate immunity
d. Active-innate immunity

A

b. Active-acquired immunity

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51
Q

What type of immunity is produced when an immunoglobulin crosses the placenta?

a. Passive-acquired immunity
b. Active-acquired immunity
c. Passive-innate immunity
d. Active-innate immunity

A

a. Passive-acquired immunity

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52
Q

The portion of the antigen that is configured for recognition and binding is referred to as what type of determinant?

a. Immunotope
b. Paratope
c. Epitope
d. Antigenitope

A

c. Epitope

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53
Q

Which characteristic is the most important determinant of immunogenicity when considering the antigen?

a. Size
b. Foreignness
c. Complexity
d. Quantity

A

b. Foreignness

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54
Q

A student asks why some vaccinations are given orally and some are given by injection. What response by the professor is best?

a. Different routes allow the speed of onset of the antigen to be varied, with the intravenous route being the fastest.
b. Some individuals appear to be unable to respond to an antigen by a specific route, thus requiring the availability of different routes for the same antigen.
c. Antigen-presenting cells are highly specialized and thus require stimulation by different routes.
d. Each route stimulates a different lymphocyte-containing tissue, resulting in different types of cellular and humoral immunity

A

d. Each route stimulates a different lymphocyte-containing tissue, resulting in different types of cellular and humoral immunity

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55
Q

The functions of the major histocompatibility complex (MHC) and CD1 molecules are alike because both do what?

a. Are antigen-presenting molecules
b. Bind antigens to antibodies
c. Secrete interleukins during the immune process
d. Are capable of activating cytotoxic T lymphocytes

A

a. Are antigen-presenting molecules

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56
Q

Where are antibodies produced?

a. Helper T lymphocytes
b. Thymus gland
c. Plasma cells
d. Bone marrow

A

c. Plasma cells

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57
Q

Which immunoglobulin is present in blood, saliva, breast milk, and respiratory secretions?

a. IgA
b. IgE
c. IgG
d. IgM

A

a. IgA

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58
Q

Which antibody initially indicates a typical primary immune response?

a. IgG
b. IgM
c. IgA
d. IgE

A

b. IgM

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59
Q

An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody?

a. IgG
b. IgM
c. IgA
d. IgE

A

c. IgA

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60
Q

How does the B-cell receptor (BCR) complex function?

a. Communicating information about the antigen to the helper T cell
b. Secreting chemical signals to communicate between cells
c. Releasing histamine and other vasoactive substances
d. Communicating information about the antigen to the cell nucleus

A

d. Communicating information about the antigen to the cell nucleus

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61
Q

The generation of clonal diversity occurs primarily during which phase of life?

a. Fetal
b. Neonatal
c. Infancy
d. Puberty

A

a. Fetal

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62
Q

A student is confused about the process of the generation of clonal diversity. What description by
the professor is best?
a. It involves antigens that select those lymphocytes with compatible receptors.
b. It allows the differentiation of cells into antibody-secreting plasma cells or mature
Peyer patches.
c. It takes place in the primary (central) lymphoid organs.
d. It causes antigens to expand and diversify their populations.

A

c. It takes place in the primary (central) lymphoid organs.

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63
Q

Which is an example of an endogenous antigen?

a. Yeast
b. Cancer cells
c. Bacteria
d. Fungus

A

b. Cancer cells

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64
Q

Which cytokine is needed for the maturation of a functional helper T cell?

a. IL-1
b. IL-2
c. IL-4
d. IL-12

A

b. IL-2

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65
Q

Th2 cells produce IL-4 and suppress which cells?

a. B lymphocytes
b. Cytotoxic T lymphocytes
c. Th1 cells
d. Memory T lymphocytes

A

c. Th1 cells

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66
Q

Which statement is believed to be true concerning Th1 cells?

a. Th1 cells are induced by antigens derived from allergens.
b. They are induced by antigens derived from cancer cells.
c. Th1 cells produce IL-4, IL-5, IL-6, and IL-13.
d. They assist in the development of humoral immunity.

A

b. They are induced by antigens derived from cancer cells.

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67
Q

Which statement is believed to be true concerning Th2 cells?

a. Th2 cells are induced by antigens derived from allergens.
b. They are induced by antigens derived from cancer cells.
c. Th2 cells produce IL-2, TNF-ß, and IFN-.
d. They assist in the development of cell-mediated immunity.

A

a. Th2 cells are induced by antigens derived from allergens

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68
Q

When a person is exposed to most antigens, antibodies can be usually detected in their circulation within what timeframe?

a. 12 hours
b. 24 hours
c. 3 days
d. 6 days

A

d. 6 days

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69
Q

Vaccinations are able to provide protection against certain microorganisms because of what?

a. Strong response from IgM
b. Level of protection provided by IgG
c. Memory cells for IgE
d. Rapid response from IgA

A

b. Level of protection provided by IgG

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70
Q

The healthcare professional working with older adults teaches general infection-prevention measures as a priority for this age group due to which change in lymphocyte function?

a. Increased production of antibodies against self-antigens
b. Decreased number of circulating T cells
c. Decreased production of autoantibodies
d. Increased production of helper T cells

A

a. Increased production of antibodies against self-antigens

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71
Q

How do antibodies protect the host from bacterial toxins?

a. Lysing the cell membrane of the toxins
b. Binding to the toxins to neutralize their biologic effects
c. Inhibiting the synthesis of DNA proteins needed for growth
d. Interfering with the DNA enzyme needed for replication

A

b. Binding to the toxins to neutralize their biologic effects

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72
Q

Which T cell controls or limits the immune response to protect the host’s own tissues against an autoimmune response?

a. Cytotoxic T cells
b. Th1 cells
c. Th2 cells
d. Regulatory T (Treg) cells

A

d. Regulatory T (Treg) cells

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73
Q

Evaluation of umbilical cord blood can confirm that which immunoglobulin level is near adult levels?

a. IgA
b. IgG
c. IgM
d. IgE

A

b. IgG

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74
Q

Which statement is true concerning IgM?

a. IgM is the first antibody produced during the initial response to an antigen.
b. IgM mediates many common allergic responses.
c. IgM is the most abundant class of immunoglobulins.
d. IgM is capable of crossing the human placenta.

A

a. IgM is the first antibody produced during the initial response to an antigen.

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75
Q

Which cell has the ability to recognize antigens presented by the MHC class I molecules?

a. T cytotoxic
b. CD 4
c. CD 8
d. T helper

A

c. CD 8

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76
Q

Which cell has a role in developing cell-mediated immunity?

a. Th1
b. CD4
c. CD8
d. Th2

A

a. Th1

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77
Q

A student asks the healthcare professional how the aging process of the T-cell activity affects older adults. What response by the professional is best?

a. Poor heat regulation abilities
b. Increased risk for bone fractures
c. Tendency to develop various infections
d. Likelihood of experiencing benign skin lesions

A

c. Tendency to develop various infections

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78
Q

Which statement is true regarding maternal antibodies provided to the neonate?

a. The antibodies enter into the fetal circulation by means of active transport.
b. The antibodies are transferred to the fetus via the lymphatic system.
c. The antibodies are directly related to the mother’s nutritional intake.
d. The antibodies reach protective levels after approximately 6 months of age.

A

a. The antibodies enter into the fetal circulation by means of active transport.

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79
Q

Antibodies that are associated with mucosal immune system, such as immunoglobulins, function to prevent which type of infections?

a. Infections that attack the respiratory system
b. Infections that tend to be chronic in nature
c. Infections likely to be resistant to antibiotics
d. Infections that focus on epithelial surfaces of the body

A

d. Infections that focus on epithelial surfaces of the body

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80
Q

Cytokines are vital to a cell’s ability to do which function?

a. Excrete
b. Reproduce
c. Metabolize
d. Communicate

A

d. Communicate

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81
Q

Which is an example of a bacterial toxin that has been inactivated but still retains its immunogenicity to protect the person? (Select all that apply.)

a. Poliomyelitis
b. Measles
c. Tetanus
d. Gonorrhea
e. Diphtheria

A

c. Tetanus

e. Diphtheria

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82
Q

Which statements are true concerning the humoral immune response? (Select all that apply.)

a. The humoral immune response is divided into major and minor phases.
b. The response has IgG and IgM produced during each of its phrases.
c. It has a greater presence of IgG than IgM in one of its phases.
d. The humoral immune response is produced in reaction to the presence of an
antigen.
e. Phases differ in their response time as a result of the effect of memory cells.

A

b. The response has IgG and IgM produced during each of its phrases.
c. It has a greater presence of IgG than IgM in one of its phases.
d. The humoral immune response is produced in reaction to the presence of an
antigen.
e. Phases differ in their response time as a result of the effect of memory cells

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83
Q

CD4 is a characteristic surface marker and a result of which of these? (Select all that apply.)

a. Activity in the primary lymphoid organs
b. Process of cellular differentiation
c. Alterations to T cells
d. Changes to B cells
e. Clonal selection

A

a. Activity in the primary lymphoid organs
b. Process of cellular differentiation
c. Alterations to T cells
d. Changes to B cells

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84
Q

What are the necessary components of an adaptive immune response? (Select all that apply.)

a. Antigen
b. Gamma IgG
c. Lymphocyte surface receptors
d. Crystalline fragment
e. Antibody

A

a. Antigen
c. Lymphocyte surface receptors
e. Antibody

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85
Q

How is hypersensitivity best defined?

a. A disturbance in the immunologic tolerance of self-antigens
b. An immunologic reaction of one person to the tissue of another person
c. An altered immunologic response to an antigen that results in disease
d. An undetectable immune response in the presence of antigens

A

c. An altered immunologic response to an antigen that results in disease

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86
Q

What is a hypersensitivity reaction that produces an allergic response called?

a. Hemolytic shock
b. Anaphylaxis
c. Necrotizing vasculitis
d. Systemic erythematosus

A

b. Anaphylaxis

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87
Q 
The common hay fever allergy is expressed through a reaction that is mediated by which class of 
immunoglobulins?
a. IgE
b. IgG
c. IgM
d. T cells
A

a. IgE

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88
Q

What are blood transfusion reactions an example of?

a. Autoimmunity
b. Alloimmunity
c. Homoimmunity
d. Hypersensitivity

A

b. Alloimmunity

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89
Q

During an IgE-mediated hypersensitivity reaction, which leukocyte is activated?

a. Neutrophils
b. Monocytes
c. Eosinophils
d. T lymphocytes

A

c. Eosinophils

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90
Q

During an IgE-mediated hypersensitivity reaction, what causes bronchospasm?

a. Bronchial edema caused by the chemotactic factor of anaphylaxis
b. Bronchial edema caused by binding of the cytotropic antibody
c. Smooth muscle contraction caused by histamine bound to H1 receptors
d. Smooth muscle contraction caused by histamine bound to H2 receptors

A

c. Smooth muscle contraction caused by histamine bound to H1 receptors

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91
Q

A patient is having an IgE-mediated hypersensitivity reaction. What action by the healthcare professional is best?

a. Give the patient an antihistamine.
b. Prepare to give the patient a blood transfusion.
c. Ask the patient is he/she is having pain at the site.
d. Apply warm, moist heat to the affected area.

A

a. Give the patient an antihistamine

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92
Q

What characteristic do atopic individuals have that make them genetically predisposed to develop allergies?

a. Greater quantities of histamine
b. More histamine receptors
c. Greater quantities of IgE
d. A deficiency in epinephrine

A

c. Greater quantities of IgE

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93
Q

A student asks about the mechanism that results in type II hypersensitivity reactions. What description by the professor is best?
a. Antibodies coat mast cells by binding to receptors that signal its degranulation,
followed by a discharge of preformed mediators.
b. Antibodies bind to soluble antigens that were released into body fluids, and the
immune complexes are then deposited in the tissues.
c. Cytotoxic T lymphocytes or lymphokine-producing helper T 1 cells directly attack
and destroy cellular targets.
d. Antibodies bind to the antigens on the cell surface.

A

d. Antibodies bind to the antigens on the cell surface.

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94
Q

When mismatched blood is administered causing an ABO incompatibility, how are the erythrocytes destroyed?

a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Phagocytosis in the spleen
d. Natural killer cells

A

a. Complement-mediated cell lysis

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95
Q

When antibodies are formed against red blood cell antigens of the Rh system, how are the blood cells destroyed?

a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Phagocytosis in the spleen
d. Neutrophil granules and toxic oxygen products

A

c. Phagocytosis in the spleen

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96
Q

When soluble antigens from infectious agents enter circulation, what is tissue damage a result of?

a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Phagocytosis in the spleen
d. Neutrophil granules and toxic oxygen products

A

d. Neutrophil granules and toxic oxygen products

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97
Q

How are target cells destroyed in a type II hypersensitivity reaction?

a. Tissue damage from mast cell degranulation
b. Antigen-antibody complexes deposited in vessel walls
c. Cytotoxic T lymphocytes attack the cell directly.
d. Natural killer cells

A

d. Natural killer cells

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98
Q

Graves disease (hyperthyroidism) is an example of which type II hypersensitivity reaction?

a. Modulation
b. Antibody-dependent cell-mediated cytotoxicity
c. Neutrophil-mediated damage
d. Complement-mediated lysis

A

a. Modulation

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99
Q

Type III hypersensitivity reactions are a result of which of these?

a. Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators
b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues
c. Tc cells or lymphokine-producing Th1 cells directly attacking and destroying cellular targets
d. Antibodies binding to the antigen on the cell surface

A

b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues

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100
Q

A type IV hypersensitivity reaction causes which result?

a. Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators
b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues
c. Lymphokine-producing Th1 cells directly attacking and destroying cellular targets
d. Antibodies binding to the antigen on the cell surface

A

c. Lymphokine-producing Th1 cells directly attacking and destroying cellular targets

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101
Q

In a type III hypersensitivity reaction, the harmful effects after the immune complexes that are deposited in tissues are a result of what?

a. Cytotoxic T cells
b. Natural killer cells
c. Complement activation
d. Degranulation of mast cells

A

c. Complement activation

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102
Q

A healthcare professional is teaching a patient about Raynaud phenomenon and instructs the patient to avoid cold. What is the best explanation of how cold impacts the manifestations of this disease?

a. Immune complexes that are deposited in capillary beds, blocking circulation
b. Mast cells that are bound to specific endothelial receptors, causing them to
degranulate and creating a localized inflammatory reaction that occludes capillary
circulation
c. Cytotoxic T cells that attack and destroy the capillaries so that they are unable to
perfuse local tissues
d. Antibodies that detect the capillaries as foreign protein and destroy them using
lysosomal enzymes and toxic oxygen species

A

a. Immune complexes that are deposited in capillary beds, blocking circulation

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103
Q

Deficiencies in which element can produce depression of both B- and T-cell function?

a. Iron
b. Zinc
c. Iodine
d. Magnesium

A

b. Zinc

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104
Q

An Rh-negative woman gave birth to an Rh-positive baby. When discussing Rho[D] immunoglobulin with her, what information should the healthcare professional provide?

a. It provides protection against infection from poor immunity in the baby.
b. It prevents alloimmunity and hemolytic anemia of the newborn.
c. It provides necessary antibodies in case the mother doesn’t breastfeed.
d. It causes the intestinal tract of the newborn to produce antibodies

A

b. It prevents alloimmunity and hemolytic anemia of the newborn

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105
Q

Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host DNA is the cause of which disease?

a. Hemolytic anemia
b. Pernicious anemia
c. Systemic lupus erythematosus
d. Myasthenia gravis

A

c. Systemic lupus erythematosus

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106
Q

A patient asks the healthcare professional why tissue damage occurs in acute rejection after organ transplantation. What response by the professional is best?

a. Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T cells directly attack the endothelial cells of the transplanted tissue.
b. Circulating immune complexes are deposited in the endothelial cells of transplanted tissue, where the complement cascade lyses tissue.
c. Receptors on natural killer cells recognize antigens on the cell surface of transplanted tissue, which releases lysosomal enzymes that destroy tissue.

d. Antibodies coat the surface of transplanted tissue to which mast cells bind and
liberate preformed chemical mediators that destroy tissue.

A

a. Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T cells directly attack the endothelial cells of the transplanted tissue.

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107
Q

Which blood cell carries the carbohydrate antigens for blood type?

a. Platelets
b. Neutrophils
c. Lymphocytes
d. Erythrocytes

A

d. Erythrocytes

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108
Q

A person with type O blood needs a blood transfusion. What blood type does the healthcare
professional prepare to administer to the patient?
a. A
b. B
c. AB
d. O

A

d. O

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109
Q

Which class of immunoglobulins forms isohemagglutinins?

a. IgA
b. IgE
c. IgG
d. IgM

A

d. IgM

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110
Q

Which component of the immune system is deficient in individuals with infections caused by viruses, fungi, or yeast?

a. Natural killer cells
b. Macrophages
c. B cells
d. T cells

A

d. T cells

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111
Q

A child in the clinic has an absence of a parathyroid gland, structural heart defects, and a shortened structure of the upper lip. What immune dysfunction does the healthcare professional suspect?

a. Partial-to-complete absence of T-cell immunity
b. X-linked recessive microcephaly
c. An autoimmune disease like systemic lupus erythematosus
d. Adenosine deaminase deficiency

A

a. Partial-to-complete absence of T-cell immunity

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112
Q 
How many months does it take for the newborn to be sufficiently protected by antibodies 
produced by its own B cells?
a. 1 to 2
b. 4 to 5
c. 6 to 8
d. 10 to 12
A

c. 6 to 8

113
Q

Considering the effects of nutritional deficiencies on the immune system, severe deficits in
calories and protein lead to deficiencies in the formation of which immune cells?

a. B cells
b. T cells
c. Natural killer cells
d. Neutrophils

A

b. T cells

114
Q

Urticaria is a manifestation of a which type of hypersensitivity reaction?

a. IV
b. III
c. II
d. I

A

d. I

115
Q

What is Graves disease a result of?

a. Increased levels of circulating immunoglobulins
b. The infiltration of the thyroid with T lymphocytes
c. Autoantibodies binding to thyroid-stimulating hormone (TSH)-receptor sites
d. Exposure to acetylates in substances such as rubber

A

c. Autoantibodies binding to thyroid-stimulating hormone (TSH)-receptor sites

116
Q

Raynaud phenomenon is an example of which type of hypersensitivity?

a. IV
b. III
c. II
d. I

A

b. III

117
Q

Which statement is true concerning an atopic individual?

a. They tend to produce less IgE.
b. They tend to produce more Fc receptors.
c. They tend to attract very few mast cells.
d. They tend to produce very high levels of IgM.

A

b. They tend to produce more Fc receptors.

118
Q

Which statement is true regarding immunodeficiency?

a. Immunodeficiency is generally not present in other family members.
b. Immunodeficiency is never acquired; rather, it is congenital.
c. Immunodeficiency is almost immediately symptomatic.
d. Immunodeficiency is a result of a postnatal mutation.

A

a. Immunodeficiency is generally not present in other family members.

119
Q

A person with type O blood is considered to be the universal blood donor because type O blood contains which of these?

a. No antigens
b. No antibodies
c. Both A and B antigens
d. Both A and B antibodies

A

a. No antigens

120
Q

Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?

a. I
b. II
c. III
d. IV

A

a. I

121
Q

A pregnant woman has Graves disease. What test/s does the healthcare professional advise the woman about?

a. Frequent tests of the newborn’s muscular strength and movement.
b. Blood test for hyperthyroidism
c. Monthly OB checkups for fetal anomalies or pregnancy loss
d. Serum complete blood count including platelet count

A

b. Blood test for hyperthyroidism

122
Q

When a tuberculin skin test is positive, the hard center and erythema surrounding the induration are a result of which of these? (Select all that apply.)

a. Histamine
b. T lymphocytes
c. Immune complexes
d. Products of complement
e. Macrophages

A

b. T lymphocytes

e. Macrophages

123
Q

Exposure to which of these could result in a type IV hypersensitivity reaction? (Select all that apply.)

a. Poison ivy
b. Neomycin
c. Dairy products
d. Nickel
e. Detergents

A

a. Poison ivy
b. Neomycin
d. Nickel
e. Detergents

124
Q

Which disorders are considered autoimmune? (Select all that apply.)

a. Crohn disease
b. Addison disease
c. Rheumatoid arthritis
d. Systemic lupus erythematosus
e. Type 2 diabetes

A

a. Crohn disease
b. Addison disease
c. Rheumatoid arthritis
d. Systemic lupus erythematosus

125
Q

Which statements best define acute rejection? (Select all that apply.)
a. Acute rejection is a cell-mediated immune response.
b. Acute rejection is usually a type III rejection.
c. Immunosuppressive drugs delay or lessen the intensity of an acute rejection.
d. Acute rejection is associated with the body’s response to an organ transplant.
e. Acute rejection is a response against unmatched human leukocyte antigens
(HLAs).

A

a. Acute rejection is a cell-mediated immune response.
c. Immunosuppressive drugs delay or lessen the intensity of an acute rejection.
d. Acute rejection is associated with the body’s response to an organ transplant.

e. Acute rejection is a response against unmatched human leukocyte antigens
(HLAs).

126
Q

What is a significant cause of morbidity and mortality worldwide?

a. Starvation
b. Traumatic injury
c. Cardiovascular disease
d. Infectious disease

A

d. Infectious disease

127
Q

What is the first stage in the infectious process?

a. Invasion
b. Colonization
c. Spread
d. Multiplication

A

b. Colonization

128
Q

Which type of microorganism reproduces on the skin?

a. Viruses
b. Bacteria and fungi
c. Protozoa and Rickettsiae
d. Mycoplasma

A

b. Bacteria and fungi

129
Q

Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms?

a. Bacteria
b. Fungi
c. Viruses
d. Yeasts

A

a. Bacteria

130
Q

Once they have penetrated the first line of defense, which microorganisms do natural killer (NK) cells actively attack?

a. Bacteria
b. Fungi
c. Viruses
d. Mycoplasma

A

c. Viruses

131
Q

A student asks the healthcare professional to describe exotoxins. Which statement by the professional is best?

a. Exotoxins are contained in cell walls of gram-negative bacteria.
b. Exotoxins are released during the lysis of bacteria.
c. Exotoxins are able to initiate the complement and coagulation cascades.
d. Exotoxins are released during bacterial growth.

A

d. Exotoxins are released during bacterial growth.

132
Q

A healthcare professional student is learning about fungal infections. What information should the student use to help another student understand?

a. Fungal infections occur only on skin, hair, and nails.
b. Phagocytes and T lymphocytes control fungal infections.
c. Fungal infections release endotoxins.
d. Vaccines prevent fungal infections.

A

b. Phagocytes and T lymphocytes control fungal infections.

133
Q

Cytokines are thought to cause fevers by stimulating the synthesis of which chemical mediator?

a. Leukotriene
b. Histamine
c. Prostaglandin
d. Bradykinin

A

c. Prostaglandin

134
Q

Considering the hypothalamus, what is a fever produced by?

a. Endogenous pyrogens acting directly on the hypothalamus
b. Exogenous pyrogens acting directly on the hypothalamus
c. Immune complexes acting indirectly on the hypothalamus
d. Cytokines acting indirectly on the hypothalamus

A

a. Endogenous pyrogens acting directly on the hypothalamus

135
Q

A healthcare professional is conducting community education on vaccinations. Which statement about vaccines does the professional include in the presentation?

a. Most bacterial vaccines contain attenuated organisms.
b. Most viral vaccines are made by using dead organisms.
c. Vaccines require booster injections to maintain life-long protection.
d. Vaccines provide effective protection against most infections.

A

c. Vaccines require booster injections to maintain life-long protection

136
Q

What are vaccines against viruses created from?

a. Killed organisms or extracts of antigens
b. Live organisms weakened to produce antigens
c. Purified toxins that have been chemically detoxified
d. Recombinant pathogenic protein

A

b. Live organisms weakened to produce antigens

137
Q

What does the student learn about HIV?

a. HIV only infects T-helper (Th) cells.
b. HIV is a retrovirus.
c. HIV carries genetic information in its DNA.
d. HIV has five identified strains

A

b. HIV is a retrovirus.

138
Q

What is the role of reverse transcriptase in HIV infection?

a. Reverse transcriptase converts single-stranded DNA into double-stranded DNA.
b. It is needed to produce integrase.
c. It transports the RNA into the cell nucleus.
d. It converts RNA into double-stranded DNA.

A

d. It converts RNA into double-stranded DNA.

139
Q

After sexual transmission of HIV, how soon can lab results detect the infection?

a. 1 to 2 days
b. 4 to 10 days
c. 4 to 8 weeks
d. 2 to 4 months

A

b. 4 to 10 days

140
Q
  1. Which cells are primary targets for HIV?

a. CD4+Th cells only
b. CD4+Th cells, macrophages, and dendritic cells
c. CD8-positive cytotoxic T (Tc) cells and plasma cells
d. CD8-positive Tc cells only

A

b. CD4+Th cells, macrophages, and dendritic cells

141
Q

.What area in the body may act as a reservoir in which HIV can be relatively protected from antiviral drugs?

a. Central nervous system
b. Bone marrow
c. Thymus gland
d. Lungs

A

a. Central nervous system

142
Q

What is the final stage of the infectious process?

a. Colonization
b. Invasion
c. Multiplication
d. Spread

A

d. Spread

143
Q

How is toxigenicity defined?
a. The ability of the pathogen to invade and multiply in the host
b. The pathogen’s ability to produce disease by the production of a soluble toxin
c. The ability of an agent to produce disease
d. The potency of a pathogen measured in terms of the number of microorganisms
required to kill the host

A

b. The pathogen’s ability to produce disease by the production of a soluble toxin

144
Q

What is the ability of the pathogen to invade and multiply in the host referred to as?

a. Infectivity
b. Toxigenicity
c. Pathogenicity
d. Virulence

A

a. Infectivity

145
Q

Some bacterial surface proteins bind with the crystalline fragment (Fc) portion of an antibody to
do what?

a. Hide in cells to avoid triggering an immune response
b. Form self-protecting toxins
c. Make staining possible for microscopic observation
d. Produce a protective “self” protein

A

d. Produce a protective “self” protein

146
Q

Which organism is a common sexually transmitted bacterial infection?

a. Staphylococcus aureus
b. Clostridium perfringens
c. Helicobacter pylori
d. Treponema pallidum

A

d. Treponema pallidum

147
Q

Which disease is an example of a rickettsial infection?

a. Cholera
b. Candida
c. Sleeping sickness
d. Rocky Mountain spotted fever

A

d. Rocky Mountain spotted fever

148
Q

Which secretions transmit HIV? (Select all that apply.)

a. Semen
b. Urine
c. Saliva
d. Breast milk
e. Sweat

A

a. Semen

d. Breast milk

149
Q

Which infections are fungal? (Select all that apply.)

a. Ringworm
b. Candida
c. Cholera
d. Athlete’s foot
e. Aspergillus

A

a. Ringworm
b. Candida
d. Athlete’s foot
e. Aspergillus

150
Q

Which statements are true regarding the development of HIV symptoms? (Select all that apply.)

a. Symptoms generally appear in the clinical latency stage.
b. Symptoms are generally observable within 5 years of the initial infection.
c. T cells levels, particularly those of memory T cells, progressively decrease.
d. Untreated infected individuals may remain asymptomatic for up to10 years.
e. Secondary lymphoid organs experience damage and resulting malfunction.

A

c. T cells levels, particularly those of memory T cells, progressively decrease.
d. Untreated infected individuals may remain asymptomatic for up to 10 years.
e. Secondary lymphoid organs experience damage and resulting malfunction.

151
Q

Which statements are true regarding endotoxins? (Select all that apply.)

a. Endotoxins are lipopolysaccharides.
b. Endotoxins are located in the walls of bacteria.
c. Endotoxins are created during the process of lysis.
d. Endotoxins are found in gram-negative microorganisms.
e. Endotoxins are released during the destruction of its host.

A

a. Endotoxins are lipopolysaccharides.
b. Endotoxins are located in the walls of bacteria.
d. Endotoxins are found in gram-negative microorganisms.
e. Endotoxins are released during the destruction of its host.

152
Q

Which statements are true regarding viruses? (Select all that apply.)

a. Viruses are very complex microorganisms.
b. Viruses are referred to as eukaryotes.
c. Viruses are capable of producing messenger RNA (mRNA).
d. Viruses penetrate plasma membranes via endocytosis.
e. Viruses are capable of uncoating cytoplasmic nucleocapsid.

A

c. Viruses are capable of producing messenger RNA (mRNA).
d. Viruses penetrate plasma membranes via endocytosis.
e. Viruses are capable of uncoating cytoplasmic nucleocapsid.

153
Q

Which of these play a role in the control of fungal infections? (Select all that apply.)

a. Cytokines
b. Macrophages
c. Natural killer cells
d. Neutrophils
e. T lymphocytes

A

a. Cytokines
b. Macrophages
d. Neutrophils
e. T lymphocytes

154
Q

Which are complications of AIDS? (Select all that apply.)

a. Kaposi sarcoma
b. Helicobacter pylori
c. Cytomegalovirus retinitis
d. Herpes simplex infection
e. Legionella pneumophila

A

a. Kaposi sarcoma
c. Cytomegalovirus retinitis
d. Herpes simplex infection

155
Q 
Exhaustion occurs if stress continues when which stage of the general adaptation syndrome is not
successful?
a. Flight or fight
b. Alarm
c. Adaptation
d. Arousal
A

c. Adaptation

156
Q

Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?

a. Adrenal cortex
b. Hypothalamus
c. Anterior pituitary
d. Limbic system

A

b. Hypothalamus

157
Q

During an anticipatory response to stress, what is the reaction from the limbic system stimulated by?

a. The retronucleus of the anterior pituitary
b. The anterior nucleus of the hippocampus
c. The paraventricular nucleus of the hypothalamus
d. The prefrontal nucleus of the amygdala

A

c. The paraventricular nucleus of the hypothalamus

158
Q

Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?

a. Norepinephrine
b. Epinephrine
c. Cortisol
d. Adrenocorticotropic hormone (ACTH)

A

a. Norepinephrine

159
Q

Perceived stress elicits an emotional, anticipatory response that begins where?

a. Prefrontal cortex
b. Anterior pituitary
c. Limbic system
d. Hypothalamus

A

c. Limbic system

160
Q

A student asks the healthcare professional how immunity is decreased by stress. The professional
responds that during a stress response, the helper T (Th) 1 response is suppressed by which hormone?

a. ACTH
b. Cortisol
c. Prolactin
d. Growth hormone

A

b. Cortisol

161
Q

Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of what?

a. Epinephrine and aldosterone
b. Norepinephrine and cortisol
c. Epinephrine and norepinephrine
d. Acetylcholine and cortisol

A

c. Epinephrine and norepinephrine

162
Q

A severely stressed patient has cold, clammy skin. The healthcare professional quizzes the student about this effect. The student correctly answers that this effect is directly from which action?

a. Epinephrine dilating blood vessels leading to the vital organs
b. Norepinephrine constricting blood vessels in the skin
c. Dilating the airways to increased oxygenation of the tissues
d. Dysfunctional temperature regulation from cortisol secretion

A

b. Norepinephrine constricting blood vessels in the skin

163
Q

Released stress-induced cortisol results in the stimulation of gluconeogenesis by affecting which
structure?

a. Adrenal cortex
b. Pancreas
c. Liver
d. Anterior pituitary

A

c. Liver

164
Q

What effect of increased secretions of epinephrine, glucagon, and growth hormone would the healthcare professional assess for?

a. Hyperglycemia
b. Hypertension
c. Bronchodilation
d. Pupil dilation

A

a. Hyperglycemia

165
Q

severely stressed patient has hypoglycemia each time the patient’s blood glucose is checked. The healthcare professional should order laboratory tests to measure which hormone in the patient’s blood?

a. Epinephrine
b. Norepinephrine
c. Cortisol
d. Growth hormone

A

c. Cortisol

166
Q

What effect do androgens have on lymphocytes?

a. Suppression of B-cell responses and enhancement of T-cell responses
b. Suppression of T-cell responses and enhancement of B-cell responses
c. Suppression of B- and T-cell responses
d. Enhancement of B- and T-cell responses

A

c. Suppression of B- and T-cell responses

167
Q

The action of which hormone helps explain increases in affective anxiety and eating disorders, mood cycles, and vulnerability to autoimmune and inflammatory diseases in women as a result of stimulation of the CRH gene promoter and central norepinephrine system?

a. Progesterone
b. Cortisol
c. Estrogen
d. Prolactin

A

c. Estrogen

168
Q

Which statement is true concerning the differences between stress-induced hormonal alterations of men and women?

a. After injury, women produce more proinflammatory cytokines than men, a profile
that is associated with poor outcomes.
b. Androgens appear to induce a greater degree of immune cell apoptosis after injury,
creating greater immunosuppression in injured men than in injured women.
c. Psychologic stress associated with some types of competition decreases both
testosterone and cortisol, especially in athletes older than 45 years of age.
d. After stressful stimuli, estrogen is increased in women, but testosterone is
decreased in men

A

b. Androgens appear to induce a greater degree of immune cell apoptosis after injury, creating greater immunosuppression in injured men than in injured women.

169
Q

A patient perceives living in a state of chronic stress. What will diagnostic blood work ordered by the healthcare professional likely demonstrate?

a. Decreased Th lymphocytes
b. Increased erythrocytes
c. Decreased Tc cells
d. Increased platelets

A

c. Decreased Tc cells

170
Q

What are the signs that a patient is in the adaptive stage of the general adaptation syndrome?

a. He or she begins to experience elevated heart and respiratory rates.
b. He or she finds it difficult to concentrate on a solution for the stress.
c. The patient perceives his or her only options are to run away or fight back.
d. The patient has exceeded his or her ability to cope with the current situation.

A

c. The patient perceives his or her only options are to run away or fight back.

171
Q

What is the most influential factor in whether a person will experience a stress reaction?

a. General state of physical health
b. Spiritual belief system
c. Intellectual abilities
d. Ability to cope

A

d. Ability to cope

172
Q

A reduction in an individual’s number of natural killer (NK) cells appears to correlate with an increased risk for the development of what?

a. Depression
b. Type 1 diabetes
c. Obsessive compulsive disorder (OCD)
d. Gastroesophageal reflux disorder (GERD)

A

a. Depression

173
Q

The effect epinephrine has on the immune system during the stress response is to increase which cells? (Select all that apply.)

a. NK cells
b. Immunoglobulins
c. Cytokines
d. T cells
e. Th cells

A

a. NK cells

d. T cells

174
Q

The increased production of proinflammatory cytokines is associated with which considerations?
(Select all that apply.)

a. Chronic respiratory dysfunction
b. Elevated anxiety levels
c. Immune disorders
d. Age and gender
e. Dementia

A

b. Elevated anxiety levels

c. Immune disorders

175
Q

Which statements are true regarding lymphocytes? (Select all that apply.)

a. Lymphocytes are involved in the production of the human growth hormone.
b. Elevated catecholamine levels influence lymphocytes.
c. Lymphocytes are synthesized in the anterior pituitary gland.
d. Lymphocytes have receptors for the hormone prolactin.
e. Lymphocytes produce endorphins in large amounts

A

a. Lymphocytes are involved in the production of the human growth hormone.
b. Elevated catecholamine levels influence lymphocytes.
d. Lymphocytes have receptors for the hormone prolactin.

176
Q

Which cytokines initiate the production of corticotropin-releasing hormone (CRH)? (Select all
that apply.)

a. IL-1
b. IL-6
c. TNF-ß
d. IFN
e. IL-12

A

a. IL-1

b. IL-6

177
Q

If the surface barriers of innate immunity, such as the skin or mucous membranes are breached, the second line of defense in innate immunity is (are) the:

lymph node
lymphocyte response
inflammatory response
memory cells

A

inflammatory response

178
Q

Which of the following statements about the skin’s role as barrier to infectious microorganisms is false?

The melanocytes, which are the pigment-producing cells, have the capacity to ingest microorganisms.

Body surface temperatures are cooler than required for optimal bacterial growth

Tight junctions between epithelial cells prevent microorganisms from entering the body

Microorganisms get sloughed off with dead skin.

A

The melanocytes, which are the pigment-producing cells, have the capacity to ingest microorganisms.

179
Q

The first vascular response in inflammation is:

brief vasoconstriction
brief vasodilation
increased vascular permeability
decreased vascular permeability

A

brief vasoconstriction

180
Q

What is the purpose of vasodilation and increased vascular permeability during inflammation?

To bring white blood cells to the area of injury

To transport inflammatory chemicals to the area of injury

To dilute toxins

All of the above

A

All of the above

181
Q

The components of the complement and kinin system are:

antibodies
white blood cells.
growth factors
plasma proteins.

A

plasma proteins

182
Q

Activated complement proteins C3a and C5a may act as:

opsonins
membrane attack complexes
anaphylatoxins.
vasoconstrictive agents

A

anaphylatoxins.

183
Q

The alternative pathway of the complement system is activated by:

histamine
antigen-antibody complexes
bacteria.
bleeding

A

bacteria.

184
Q

Functions of the clotting cascade during inflammation include which of the following?

Keeps microorganisms close to the neutrophils and macrophages

Helps stop bleeding

Prevents the spread of infection

All of the above

A

All of the above

185
Q

The end product of the clotting cascade is:

platelets
Hageman factor
platelet-activating factor
fibrin

A

fibrin

186
Q

Which of the following inflammatory chemicals is capable of impacting all three plasma protein systems?

Hageman factor (factor XII)

IL-2

Factor X

Fibrin

A

Hageman factor (factor XII)

187
Q

What is the role of plasmin in the inflammatory response?

It inhibits the complement system
It directly stimulates mast cell degranulation.
It stimulates proliferation of fibrocytes
It controls clotting by breaking down fibrin.

A

It controls clotting by breaking down fibrin.

188
Q

What role do toll-like receptors (TLRs) play in inflammation?

TLRs recognize the cellular debris associated with tissue damage

TLRs increase cellular resistance and lymphocyte response to invasion

TLRs allow bacteria to avoid phagocytosis

TLRs do all of the above

A

TLRs increase cellular resistance and lymphocyte response to invasion

189
Q

The first cell to react to tissue injury is the:

macrophage
mast cell
fibroblast
neutrophil

A

mast cell.

190
Q

Which of the following stimuli are known to induce mast cell degranulation?

Thermal injury
The presence of toxins
Immunologic tissue injury
All of the above

A

All of the above

191
Q

Which of the following chemicals of inflammation are produced by mast cells from arachidonic acids in the cell membrane after degranulation?

Platelet-activating factor
Histamine and chemotactic cytokines
Leukotrienes and prostaglandins
Complement proteins

A

Leukotrienes and prostaglandins

192
Q

During degranulation the mast cells release chemotactic cytokines that perform which of the following functions?

Vasodilation and increased vascular permeability
Attraction of neutrophils and eosinophils
Activation of the complement cascade
Opsonization of bacteria

A

Attraction of neutrophils and eosinophils

193
Q

What is the function of H2 receptors for histamine on white blood cells?

Activate neutrophils and macrophages
Stimulate degranulation
Inhibit inflammation
Stimulate the immune response

A

Inhibit inflammation

194
Q

In the respiratory system, the release of leukotrienes during an inflammatory response induces:

bronchoconstriction
bronchodilation
coughing.
free radical formation

A

bronchoconstriction

195
Q

The process of a phagocyte squeezing through retracted endothelial cells to enter into the tissues is called:

fusion
diapedesis
phagocytosis
margination.

A

diapedesis

196
Q

Prior to engulfment of a bacterium during phagocytosis, which of the following events must occur?

Release of lysosomal enzyme
Fusion
Recognition and adherence
Formation of a phagolysosome

A

Recognition and adherence

197
Q

Which of the following substances are used by phagocytes to destroy engulfed bacteria?

Hydrolytic enzymes
Lactic acid
Oxygen radicals
All of the above

A

All of the above

198
Q

Which of the following cells is responsible for prolonging the inflammatory response and are present at the site of chronic bacterial infections?

Neutrophils
Eosinophils
Macrophages
Lymphocytes

A

Macrophages

199
Q

How long does it take neutrophils to arrive at the site of inflammation?

1 to 2 hours
6 to 12 hours
24 to 48 hours
At least 48 hours

A

6 to 12 hours

200
Q

In addition to phagocytosis, which of the following functions are also performed by macrophages?

stimulating healing and blood vessel growth
Destroying circulating antibodies
Inhibiting inflammation
promotion of blood clotting and calcium up-take

A

stimulating healing and blood vessel growth

201
Q

A monocyte is a circulating white blood cell that transforms into which of the following cells once it enters the tissue during an inflammatory response?

Neutrophil
Macrophage
Mast cell
Fibroblast

A

Macrophage

202
Q

In order for macrophages to be effective phagocytes, they must be activated by lymphokines produced by:

neutrophils
plasma cells
mast cells.
T helper cells

A

T helper cells

203
Q

Which white blood cell plays an important role in inhibiting the inflammatory response?

Neutrophil
Mast cell
Eosinophil
Basophil

A

Eosinophil

204
Q

Under normal conditions, which cells account for the greatest percentage of the white blood cell count differential?

Neutrophils (PMNs)
Monocytes
Bands
Lymphocytes

A

Neutrophils (PMNs)

205
Q

A differential rise in which white blood cell is typically seen with viral infections?

Neutrophils
Eosinophils
Monocytes
Lymphocytes

A

Lymphocytes

206
Q

All of the following chemicals will induce a fever during inflammation except:

TNF-alpha
IL-1
histamine
prostaglandin E2.

A

histamine

207
Q

Which of the following inflammatory chemicals is blocked by nonsteroidal anti-inflammatory drugs such as ibuprofen

Histamine
Prostaglandins
Leukotrienes
All of the above

A

Prostaglandins

208
Q

Which of the following inflammatory chemicals are responsible for inducing pain during inflammation?

bradykinin and prostaglandins
Histamine and chemotactic cytokines
Lymphokines
Nitrous oxide and platelet-activating factor

A

bradykinin and prostaglandins

209
Q

Cells defend against viral invasion through the production and secretion of:

histamine.
interferon
growth factors
prostaglandins

A

interferon.

210
Q

Which of the following molecules are opsonins?

Histamine and serotonin
Endotoxin and exotoxin
Bacteria and parasites
Antibodies and complement proteins

A

Antibodies and complement proteins

211
Q

Opsonization promotes the process of:

phagocytosis
vasodilation
increased vascular permeability
clotting

A

phagocytosis

212
Q

Prostaglandins differ from histamine in which of the following ways?

Site of production
Duration of effect
Vascular effect
All of the above

A

Duration of effect

213
Q

One systemic manifestation of the acute inflammatory response is fever, which is induced by several mediators, including:

histamine
interferon
interleukin 1.
nitrous oxide

A

interleukin 1.

214
Q

Which of the following constitute the third line of human defense mechanisms?

Mast cells and macrophages
Complement and kinins
Activated lymphocytes and antibodies
lymphocytes and antibodies

A

lymphocytes and antibodies

215
Q

In contrast with the inflammatory response, the immune response:

is more effective at fighting microorganisms
is faster
recognizes specific invaders
has no memory

A

recognizes specific invaders.

216
Q

The primary cell of immunity is the:

mast cell
macrophage
neutrophil
lymphocyte

A

lymphocyte

217
Q

Humoral immunity is generated through the process of:

direct cell lysis.
stimulating an inflammatory response
producing antibodies
secreting toxic molecules

A

producing antibodies

218
Q

The generation of clonal diversity is:

the reaction of a lymphocyte to a specific antigen

the development of natural immunity.

the ability of the population of lymphocytes to recognize any antigenic molecule.

the circulation of lymphocytes through the spleen

A

the ability of the population of lymphocytes to recognize any antigenic molecule.

219
Q

Which of the following statements best describes the process of clonal selection?

An antigen directly activates B- and T-cell clones

Lymphocytes that can recognize and react to a specific antigen proliferate

A single lymphocyte develops the ability to recognize multiple antigens

A B lymphocyte is selected to become a T cytotoxic cell.

A

Lymphocytes that can recognize and react to a specific antigen proliferate

220
Q

Molecules that are capable of inducing an immune response are called:

lymphocytes
haptens
antigens
antibodies

A

antigens

221
Q

Immune cells distinguish “self” from “non-self” by recognizing:

cellular RNA
major histocompatibility antigens
different types of phospholipids in a cell’s membrane
“non-self” enzymes secreted by foreign cells

A

major histocompatibility antigens

222
Q

The Fc portion of the antibody:

is responsible for binding to specific antigen

is responsible for creating the hinge region of the antibody

consists of light chains

interacts with inflammatory cells.

A

interacts with inflammatory cells.

223
Q

Which cell stimulates both the cell-mediated and humoral immune responses?

Plasma cell
Cytotoxic T cell
B lymphocyte
Helper T cell

A

Helper T cell

224
Q

Which cytokine is produced by macrophages to stimulate the immune response?

Colony-stimulating factor
Tumor necrosis factor
Interleukin 1
Interleukin 2

A

Interleukin 1

225
Q

CD4 receptors that bind to the surface of macrophages and B cells are found on:

helper T cells.
cytotoxic T cells
plasma cells.
the human immunodeficiency virus (HIV)

A

helper T cells.

226
Q

Th1 cells stimulate the proliferation and differentiation of:

cytotoxic T cells
B cells.
eosinophils.
regulatory T cells

A

cytotoxic T cells

227
Q

Blocking the Th2 cell response would:

block the entire immune response
decrease macrophages.
decrease antibody production.
decrease Tc cell response

A

decrease antibody production.

228
Q

Which process confers long-lasting immunity against a specific antigen?

Production of memory cells
Activation of macrophages
Activation of cytotoxic T cells
Activation of the inflammatory response

A

Production of memory cells

229
Q

The predominant antibody of a typical secondary immune response is:

IgG
IgM
IgE
IgA

A

IgG

230
Q

If a person is exposed to antigen X and is later exposed to antigen X again, which of the following immune responses will occur?

Primary
Secondary
Determinant
Immunosuppressive

A

Secondary

231
Q

Which of the following is not a function of antibodies?

Neutralizing bacterial toxins
Preventing viruses from entering tissue cells
Direct cell killing through the release of toxic chemicals
Opsonizing foreign antigen

A

Direct cell killing through the release of toxic chemicals

232
Q

How do natural killer (NK) cells differ from cytotoxic T cells (Tc)

NK cells lack antigen-specificity and can target any infected or malignant cell

NK cells are phagocytic

NK cells can opsonize bacteria and viruses

NK cells release toxins that kill the target cell.

A

NK cells lack antigen-specificity and can target any infected or malignant cell

233
Q

What is the function of regulatory T cells (Treg)?

They prevent lymphocytes from attacking self-antigen.

They suppress the inflammatory response

They enhance the activity of antigen-presenting cells

They are involved in the development of passive immunity

A

They enhance the activity of antigen-presenting cells

234
Q

syndrome of inappropriate diuretic hormone (SIADH) results in excessive:

renal retention of sodium and water.
renal retention of sodium without water retention.
renal retention of water without sodium retention.
renal excretion of water without sodium retention.

A

renal retention of water without sodium retention.

235
Q

Neurological symptoms of SIADH are related to:

hypotension and cellular dehydration.
decreased serum sodium concentrations.
increased serum osmolarity.
hypokalemia.

A

decreased serum sodium concentrations

236
Q

Which of the following is a serious complication of SIADH?

Permanent neurological damage
Renal failure
Myocardial infarction
Panhypopituitarism

A

Permanent neurological damage

237
Q

Damage to the posterior pituitary caused by a cerebrovascular accident (stroke) results in _____ diabetes insipidus (DI).

vascular
nephrogenic
psychogenic
neurogenic

A

neurogenic

238
Q

Classic symptoms of diabetes insipidus (DI) include all of the following except:

hypertension.
dehydration.
low urine osmolarity.
thirst.

A

hypertension

239
Q

When evaluating the kidney function of an individual with diabetes insipidus (DI), the nurse would observe:

high volume urine output.
high urine osmolarity.
blood in the urine.
protein in the urine.

A

high volume urine output.

240
Q

In adults, the most serious consequence of panhypopituitarism is the loss of:

growth hormone.
luteinizing hormone (LH).
adrenocorticotropic hormone (ACTH).
thyroid-stimulating hormone (TSH).

A

adrenocorticotropic hormone (ACTH).

241
Q

Acromegaly is caused by increased secretion of:

prolactin.
growth hormone.
insulin.
glucocorticoids.

A

growth hormone.

242
Q

Prolactinomas (pituitary tumors that secrete prolactin) cause which of the following problems in women?

Heavy menstrual periods
Dysmenorrhea
Breast milk production without pregnancy
Hair loss

A

Breast milk production without pregnancy

243
Q

A clinician would suspect thyrotoxicosis if a patient presented with which of the following symptoms?

Confusion and gait disturbances
Weight loss and enlarged thyroid gland
Slow tendon reflexes and muscle stiffness
Peripheral edema and dry skin

A

Weight loss and enlarged thyroid gland

244
Q

Graves disease is characterized by:

ectopic secretion of thyroid hormone by a tumor.

excessive production of circulating thyroid-stimulating immunoglobulin.

autoimmune destruction of the thyroid gland.

injury to the pituitary, resulting in decreased thyroid-stimulating hormone secretion

A

excessive production of circulating thyroid-stimulating immunoglobulin.

245
Q

Graves disease is an example of a:

type I hypersensitivity.
type II hypersensitivity.
type III hypersensitivity.
type IV hypersensitivity.

A

type II hypersensitivity.

246
Q

In Graves disease, accumulation of edema in the orbit can lead to:

optic nerve damage.
eye muscle palsies.
exophthalmos.
all of the above.

A

all of the above.

247
Q

What is the cause of exophthalmos in Graves disease?

Decreased blood flow to the eye
Degenerative changes in the muscle and orbital edema
High levels of TSH causing retinal toxicity
Optic nerve damage

A

Degenerative changes in the muscle and orbital edema

248
Q

The level of thyroid-stimulating hormone (TSH) in Graves disease is:

low.
high.
normal.
variable.

A

low.

249
Q

The physiologic stress of illness or surgery can induce a severe response in individuals who have unrecognized and untreated thyrotoxicosis. The pathophysiology of thyroid storm, also known as thyrotoxic crisis, involves:

hypotension and bradycardia leading to shock.

pulmonary edema and bronchoconstriction leading to respiratory arrest.

hypercoagulability and formation of deep vein thromboses leading to pulmonary emboli.

fever and tachycardia leading to high-output heart failure.

A

fever and tachycardia leading to high-output heart failure.

250
Q

An endocrinologist orders a series of lab tests to assess thyroid function. Low levels of thyroid hormone (T3 and T4) and high levels of thyroid-stimulating hormone (TSH) are indicative of:

primary hypothyroidism.
secondary hypothyroidism.
primary hyperthyroidism.
secondary hyperthyroidism.

A

primary hypothyroidism.

251
Q

If left untreated, congenital hypothyroidism results in:

hyperactivity and attention deficit disorder.
increased risk of childhood thyroid cancer.
mental retardation and stunted growth.
liver, kidney, and pancreas failure.

A

mental retardation and stunted growth.

252
Q

Signs and symptoms of hypothyroidism include all of the following except:

weight gain.
diarrhea.
myxedema.
lethargy.

A

diarrhea

253
Q

The most common cause of primary hypothyroidism in adults is:

bacterial infection of the thyroid gland.
viral infection of the thyroid gland.
congenital hypothyroidism.
autoimmune thyroiditis.

A

autoimmune thyroiditis.

254
Q

Which of the following thyroid disorders can be caused by exposure of the thyroid gland to ionizing radiation?

Graves disease
Hashimoto thyroiditis
Thyroid cancer
Subacute thyroiditis

A

Thyroid cancer

255
Q

Causes of myxedema coma include:

untreated hypothyroidism.
subclinical hyperthyroidism.
thyroid storm.
a reaction to abnormally high levels of thyroid autoantibodies

A

untreated hypothyroidism.

256
Q

Thyroid carcinoma usually presents with the following thyroid tissue changes:

small nodules.
elevated T3 and T4.
large, diffuse goiter.
thyroid gland atrophy.

A

small nodules.

257
Q

Chronic hyperparathyroidism will lead to all of the following conditions except:

osteopenia.
renal calculi (stones).
weight loss.
pathologic bone fractures.

A

weight loss.

258
Q

Which of the following disorders can cause secondary hyperparathyroidism?

Chronic renal failure
Primary hyperparathyroidism
A pituitary tumor
Graves disease

A

Chronic renal failure

259
Q

The most common cause of hypoparathyroidism is:

hypothalamic inactivity.
pituitary hyposecretion.
parathyroid adenoma.
parathyroid gland injury or removal.

A

parathyroid gland injury or removal.

260
Q

One problem associated with untreated hypoparathyroidism is:

osteoporosis.
metabolic acidosis.
insulin resistance.
muscle spasms.

A

muscle spasms.

261
Q

The pathophysiology of type 1 diabetes mellitus (DM) involves:

autoimmune destruction of pancreatic beta cells.
production of antibodies against insulin.
type IV hypersensitivity against pancreatic islet cells.
all of the above.

A

all of the above.

262
Q

A new diagnosis of type 1 DM is based on:

random serum glucose levels
fasting plasma glucose levels and glycosylated hemoglobin (A1c).
genetic testing.
the presence of symptoms only.

A

fasting plasma glucose levels and glycosylated hemoglobin (A1c).

263
Q

Hyperglycemia and lipid abnormalities in type 2 DM are a result of:

production of inactive insulin.
glucagon deficiency.
insulin resistance.
glycogen excess.

A

insulin resistance.

264
Q

Signs and symptoms common to both type 1 and type 2 diabetes mellitus (DM) include all of the following except:

polyphagia.
weight loss.
polydipsia.
polyuria.

A

weight loss.

265
Q

Signs and symptoms that a person with type 1 diabetes has administered too much insulin include:

Kussmaul respirations and acetone breath.
dizziness and confusion.
abdominal cramping and nausea.
pain at the site of injection.

A

dizziness and confusion.

266
Q

Gestational diabetes can occur:

during fetal development.
in early childhood.
during pregnancy.
in older adults.

A

during pregnancy.

267
Q

The purpose of monitoring glycosylated hemoglobin levels in persons with diabetes is to:

check for hyperlipidemia.
detect acute complications of diabetes.
monitor long-term serum glucose control.
measure fasting glucose levels.

A

monitor long-term serum glucose control.

268
Q

The symptom of polyuria in diabetes mellitus (DM) is caused by:

a reduced AHD response caused by insulin deficiency.
the loss of protein across the glomerular membrane.
the production of ketones.
increased glucose in the urine.

A

increased glucose in the urine.

269
Q

What effect does the presence of advanced glycosylation end products (AGEs) have in diabetes?

Increased ketone formation
Tissue injury
Dawn phenomenon
Reduction of chronic complications

A

Tissue injury

270
Q

The development of an acute metabolic acidosis from insulin deficiency is due to which of the following processes?

Protein catabolism with ammonia release
Anaerobic metabolism of glucose
Fatty acid metabolism with ketone production
Renal failure

A

Fatty acid metabolism with ketone production

271
Q

Alterations in lipid and protein metabolism lead to chronic complications of DM through which of the following processes?

Activation of protein kinase C
Induction of the polyol pathway
Glycosylation
All of the above

A

All of the above

272
Q

Chronic complications of DM include which of the following?

Peripheral neuropathies
End-stage renal disease
Coronary artery disease
All of the above

A

All of the above

273
Q

Cushing disease may be caused by:

autoimmune destruction of the adrenal cortex.
ectopic production of ACTH from a lung tumor.
excessive production of cortisol from a tumor in the adrenal cortex.
excessive production of aldosterone from a tumor in the adrenal cortex.

A

ectopic production of ACTH from a lung tumor.

274
Q

Which of the following alterations would you expect to find in a patient with untreated Cushing disease or syndrome?

Weight loss
Pale skin
Truncal obesity
Peripheral edema

A

Truncal obesity

275
Q

Which of the following problems arises from primary hyperaldosteronism?

Hypertension
Hyperglycemia
Hyperkalemia
Hyponatremia

A

Hypertension

276
Q

Metabolic abnormalities in Addison disease include all of the following except:

hyperkalemia.
hyponatremia.
hypoglycemia.
hypercalcemia.

A

hypercalcemia.

277
Q

The most common cause of Addison disease is:

adrenal cancer.’
autoimmune injury to the adrenal cortex.
viral infection of the pituitary gland.
bacterial infection of the adrenal medulla.

A

autoimmune injury to the adrenal cortex.

278
Q

Mental status changes in people with Addison disease are caused by:

hypoglycemia.
insulin resistance.
CNS ischemia.
encephalopathy.

A

hypoglycemia.

279
Q

Hypersecretion of androgens from an adrenal tumor in female children causes virilization, which is:

the early development of female sex characteristics.
the development of male sex characteristics.
a form of hypercortisolism.
sterility.

A

the development of male sex characteristics.

adv. patho (10 decks)

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