module 4 (20 &21)

Which lymphoid organ(s) appear(s) before the others?

thymus

Lymphangitis is caused by ______.

an infection

Lymphedema may be treated by all EXCEPT which of the following?

bed rest to allow enhanced blood flow and therefore healing of the affected area

Hypoalbuminemia is a medical condition in which blood plasma levels of albumin are abnormally low. One reason for this disorder is an increased movement of blood plasma albumin into the interstitial space through leaky capillaries. How would this condition affect the volume of lymph that’s produced?

in would inc volume

Which of the following distinguishes lymphatic vessels from veins?

permiable of the walls

What is the main function of the lymphatic system?

The lymphatic system returns leaked fluid and plasma proteins that escape from the bloodstream to the blood.

Which of the following mechanisms is NOT used to propel lymph through lymphatic vessels?

small heart like pumps

Adjacent cells in lymphatic capillaries overlap each other loosely. What is the unique structural modification that increases their permeability?

minivaluves

Which of the following promotes closure of the minivalves associated with lymph capillaries?

increasing pressure inside the lyph cap

Which of the following is a characteristic of lymphangitis?

inflamed and painful

Lymph from the right leg ultimately is delivered to which duct in the thoracic region?

thoracic duct

Lymph from what regions of the body is drained into the right lymphatic duct?

the right upper limb, the right side of the head, and the thorax

What is the name of the enlarged sac to which the lumbar trunks and the intestinal trunk return lymph?

cisterna

The thoracic duct runs parallel and close to all of the following EXCEPT the __________.

iliac artieries

Where are the three large clusters of superficial lymph nodes?

the cervical, inguinal, and axillary regions

Which of the following vessels delivers lymph into the junction of the internal jugular vein and the subclavian vein?

thoracic duct

Which of the following is NOT a function of the lymphatic system?

to participate in gas exchange at capillaries

Which statement describes the origin of lymph fluid?

Lymph is excess fluid formed from plasma that accumulates in the tissues as interstitial fluid.

Lymphatic collecting vessels originate in which of the following areas?

capillary beds

Which of the following statements is true regarding veins versus lymphatic collecting vessels?

Veins have fewer internal valves than lymphatic vessels.

Once collected, lymph ultimately drains into __________.

venous circulation

Which of the following is NOT a part of the lymphatic system?

blood vessles

what is the function of the mini-valves in lymph capillaries?

increase perm

Which lymphoid organ is primarily active during the early years of life?

B

Which of these lymphoid organs is part of a collection of tissues called the mucosa-associated lymphoid tissues (MALT) and removes pathogens entering the pharynx (throat)?

A

Which lymphoid organ extracts aged and defective blood cells and platelets from the blood in addition to storing some of the breakdown products for later reuse?

C

Which of these lymphoid organs is the thymus?

B

Which of these lymphoid organs destroys bacteria before it can breach the intestinal wall and generates "memory" lymphocytes for long-term memory?

D

Which of these lymphatic organs is organized with trabeculae and compartments containing white pulp and red pulp?

C

Which lymph cells produce antibodies?

plasma

Which of the following lymphoid tissues/organs do(es) NOT contain reticular connective tissue?

thymus

Which of the following lymphoid cells trap antigens and transport them to lymph nodes?

dendritic

Which of the following is NOT a secondary lymph organ?

thymus

Which lymphoid organ(s) serve(s) as the site where B lymphocytes become immunocompetent B cells?

red bone marrow

Within buboes, bacteria are directly attacked by ______.

macro

The filtration of lymph and activation of the immune system are the two basic functions of the __________

lyph nodes

Which of the following is an INACCURATE statement regarding lymph nodes?

Immune system cells are only located in the cortex.

What region of the lymph node contains follicles filled with dividing B cells?

cortex

Which of the following is a role of lymph nodes?

they filter lymph

Lymph arrives at the lymph nodes via afferent lymphatic vessels.

true

Where in the lymph node is a dendritic cell most likely associated with a B or T lymphocyte?

cortex

After surgical removal of the spleen (i.e., a splenectomy), some other organs take over most of its functions. Which of the following spleen functions in the adult can not be performed by bone marrow?

removal of aged

Which part of the spleen is the site of immune function?

white pulp

What vessel serves as the source of the spleen’s blood supply from the aorta?

ceilac trunk

Which lymphoid organ(s) serve(s) in immune surveillance and blood cell recycling?

speen

What anatomical area(s) is/are protected by the tubal tonsils?

the passage from the pharynx to the middle ear

Tonsillar crypts are invaginations deep into the interior of the tonsil. What structure(s), found in most other lymphoid organs, is/are missing from the tonsil that allows for the presence of these cry

capsule

Which tonsil is located in the posterior wall of the nasopharynx and is referred to as the adenoids if it is enlarged?

pharyngeal tonsil

Which of the following lymph organs is NOT matched with its function?

peyers patch

The __________ tonsils are also called the adenoids.

pharengeal

Peyer’s patches are mucosa-associated lymph tissue located in the __________.

wall of small inestine

Of the following lymphoid organs, which is/are structurally simplest and lack(s) a complete capsule?

tonsils

Which of the following organs or locations do(es) NOT contain MALT (mucosa-associated lymphoid tissue)?

mesentery of small inetsine

Where are Peyer’s patches located?

distal portion of the small intestines

Besides lymph nodes, where would you expect to find proliferating (dividing) B cells?

spleen

The thymus functions strictly in maturation of B cells.

fasle

Which of the following is NOT a chemical barrier that helps prevent infections?

ph of blood

Which of the following provides a first line of defense against pathogens?

intact skin and mucous mebranes

Treatment of an abscess often requires that it be surgically drained because ______.

the wall of the abscess prevents neutrophils from entering the pus and attacking the pathogens

Which letter represents the formation of a phagolysosome resulting from the fusion of a lysosome with the phagocytic vesicle?

C

With what does our immune system coat pathogens to facilitate their capture and accelerate phagocytosis?

opsonins

What type of immune system cell performs the most phagocytosis in the body?

macrophages

Four (or five) cardinal signs indicate inflammation. What specific sign of inflammation is the result of exudate in the tissue spaces?

edmea (swelling)

Which of the following inflammatory chemicals is/are released by mast cells?

histamine

Which of the following is NOT one of the effects produced by the release of inflammatory chemicals?

vasconstiction

When do neutrophils enter the blood from the red bone marrow in response to leukocytosis-inducing factors?

during leukocytosis

What characterizes the chemotaxis phase of phagocyte mobilization?

Neutrophils and other WBCs migrate up the gradient of chemotactic agents to the site of injury.

What characterizes the diapedesis phase of phagocyte mobilization?

Neutrophils flatten to squeeze between the endothelial cells of the capillary walls.

What protein can be released by infected cells to help protect cells that have not yet been infected?

interferom

How do interferons protect against viral infection in healthy cells?

Interferons block viral reproduction in healthy cells through the production of antiviral proteins.

What is/are the specific target(s) of interferons?

the membrane receptors on healthy cells

Which type of chemical induces fever?

pyrogens

Which cells secrete histamines that trigger inflammatory pathways?

mast cells

Which of the following chemicals do NOT directly trigger inflammation?

antibodies

Discharge is one of the cardinal signs of inflammation.

fasle

Which of the following phases involves white blood cells leaving capillaries?

diapedsis

Which of the following is an effect of complement activation?

opsonization

Which antimicrobial protein triggers inflammation?

histamine

Adaptive defenses require us to use what molecules that can identify whether a cell is a self or nonself cell?

antibodeis

Haptens have immunogenicity but not reactivity.

fasle

Which of the areas seen the figure must be occupied by T lymphocytes, at least for a while, but is NOT required for the production of B lymphocytes?

the thymus

How does a lymphocyte exhibit immunocompetence?

by being able to recognize their one specific antigen

Proliferation of lymphocytes occurs immediately after __________.

activation

Which of the following are antigen-presenting cells (APC)?

B cells

Which of the following cells engulf antigens and present fragments of them on their own surfaces for recognition?

dendreitic cells

Binding of an eosinophil to an antibody-coated parasitic worm involves binding of the antibody’s stem region to a(n) ______.

plasma membrane protein on the eosinophil’s surface

Plasma cell neoplasms are disorders in which abnormal plasma (myeloma) cells form tumors in bone or soft tissues. These altered cells may produce a large quantity of M protein, an immunoglobulin fragment with no protective qualities. What effect would M protein have upon blood?

increased viscocity

The antivenom used to treat venomous snake bites is an antibody produced in an animal such as a horse. Suppose these antibodies are injected into a patient who has been bitten by a venomous snake–how would you classify the resulting humoral immunity?

passive, artifical

Which of the following should produce naturally acquired, active immunity?

recovering from chicken pox

Which of the following best illustrates artificially acquired active humoral immunity?

vaccined

What part of the antibody’s structure determines its class?

constant C region

How many sites on this antibody molecule have potential to bind to a non-self molecule?

2

In certain classes of antibody, the monomeric versions join to form dimers. What portions of the molecules adhere to each other to form these dimers?

the stem regions

Which of the following occurs when antibodies block specific sites on viruses or bacterial exotoxins?

neutralzation

What class of antibody acts to clump red blood cells because of a transfusion of mismatched blood?

immunoglobin M

Which mechanism(s) of antibody action result(s) in cell lysis?

complement fixation and activation

Which of the following are properly matched?

IgG: most abundant antibody

Which of the following statements regarding the primary versus the secondary immune response is true?

A primary response results when naive lymphocytes are activated, while a secondary response is a result of activating memory cells.

Vaccines provide what type of immunity?

artifical active

Why are children given vaccinations?

so that they will develop antibodies against various diseases

Which of the following statements does NOT describe the adaptive immune response?

it occurs immidealty

Health workers working with diphtheria commonly receive a serum with antibodies against the pathogen. What type of immunity would this be?

passive artifical immunity

What type of cell is the precursor to the helper T cell?

CD4

Where does most exogenous antigen presentation take place?

IN THE LYMPHOID TISSUES AND ORGANS

Which of the following activate CD8 cells?

antigen fragments on class 1 MHC protiens

What type of T cell can directly attack and kill other cells, such as virus-infected cells?

cytotxic T cells

Which of these mechanisms do cytotoxic T (TC) cells use to destroy a target–that is, deliver a lethal hit?

perforation of the mebrane

Which type of T cell will recognize antigens associated with an organ transplant?

cytotoxic Tq

Activated CD8 cells become __________.

cytotoxic T cells

Which of the following are NOT appropriately matched?

helper T cells: destroy infected cells

T cells achieve self-tolerance in the __________.

thymus

What occurs if a T cell binds to an antigen and the T cell does NOT receive a co-stimulatory signal?

the T cell centers a state of emergency

Which lymphocytes act as the bridge between the cellular and humoral responses?

helper t CELLS

Which class of tissue graft is the LEAST likely to be accepted by a patient’s body?

xenograft

Which of the following is/are the most specific internal defense against disease?

T cells

A class I MHC protein presents an antigen. What type of cell is likely presenting and to what type of cell would it be presented?

Any nucleated cell would be presented to a CD8 cell.

What types of antigen do T cells NOT recognize?

self antigens

Which of the following are NOT correctly matched?

immediate hypersensitivity: allergic

The lymphatic system protects the body by removing foreign material such as bacteria from the lymphatic stream.

true

Lymph is __________.

excess tissue fluid that has leaked out of capillaries

Collecting lymphatic vessels have three tunics and are equipped with valves like veins.

true

__________, which serve as filters for the lymphatic system, occur at various points along the lymphatic vessels.

lyph nodes

The immune response is a systemic response that occurs when the body recognizes a substance as foreign and acts to destroy or neutralize it.

true

__________ differentiate in the thymus.

T cells

T cells mediate __________ immunity because they destroy cells infected with viruses and certain bacteria and parasites.

cellular

Antibodies are produced by plasma cells in response to antigens and are found in all body secretions.

true

Antibodies that have only one structural unit (monomer) consist of __________ protein chains, connected by disulfide bonds.

4

The lymphatic system consists of lymphatic vessels, lymphatic tissue, lymph nodes, and lymphoid organs such as ________.

spleen and thymus

The functions of the lymph system include all of the following except ________.

removing worn out erythrocytes from the system

The right lymphatic duct drains ________.

the right side of the head and thorax, and the right upper extremity

Select the mechanism below that is not involved in the flow of lymph through the lymphatic vessels.

pumping action of the heart

Antigens that can provoke an immune response include ________.

foreign proteins, polysaccharides, and small molecules, called haptens that link to our own body proteins

These cells recognize antigens and initiate the immune response.

lymphocytes

B cells provide this kind of immunity.

humoral

Germinal centers in the cortex of lymph nodes contain primarily ________.

B cells

This medullary region of the lymph node contains primarily ________.

macrophages

The ________ pulp is responsible for the immune functions of the spleen.

white

In the tonsils, these structures trap bacteria and other foreign material.

crypts

What is not true about antibodies?

they are cells

Lymph from the right leg ultimately is delivered to which duct in the thoracic region?

thoracic duct

The thoracic duct runs parallel and close to all of the following EXCEPT the __________.

iliac arteries

The filtration of lymph and activation of the immune system are the two basic functions of the __________.

lymph nodes

Which of these lymphoid organs is part of a collection of tissues called the mucosa-associated lymphoid tissues (MALT) and removes pathogens entering the pharynx (throat)?

A

Which of these lymphoid organs destroys bacteria before it can breach the intestinal wall and generates "memory" lymphocytes for long-term memory?

D

What vessel serves as the source of the spleen’s blood supply from the aorta?

celiac trunk

Where is the spleen located?

in the left side of the abdominal cavity just beneath the diaphragm and curled around the anterior aspect of the stomach

What part of the antibody’s structure determines its class?

constant region

Lymph vessels resemble these vessels of the systemic circulation.

veins

Although all of the organs below can raise an immune response, only this one filters the lymph.

lymph nodes

Lymph in the cisterna chyli differs in composition from lymph in the general lymphatic stream in that it contains more ________.

fat

The function of B cells in the immune response is ________.

to produce plasma cells that make antibodies

The property of immunological memory is ________.

the ability to recognize and mount an attack on an antigen that was previously encountered

What causes the flow of lymph to slow within lymph nodes?

there are more afferent vessels than efferent vessels

Antibodies ________.

are proteins composed of heavy chains and light chains

The ________ receives lymph from the left half of the body and part of the right side as well.

thoracic duct

In the Ouchterlony test, where will a precipitin line form when bovine serum albumin is mixed with the antibodies for horse albumin, bovine albumin, and swine albumin?

between the wells for bovine albumin and antibodies for bovine albumin

In the Ouchterlony test, if an unknown antigen contains only swine serum albumin, how many precipitin lines will form between it and the wells of antibodies for horse, bovine, and swine albumin?

1

This region of an antibody forms the antigen-binding site that binds a specific antigenic determinant of an antigen.

variable portion of heavy and light chains

Antibodies are produced by _______.

plasma cells

The fluid portion of the blood with the clotting factors removed is called _______.

serum

The form of Chlamydia that divides inside the host cell is the _______.

reticulate body

The direct fluorescent antibody test for Chlamydia uses fluorescently labeled _______.

antibody to detect antigen in the patient sample

The washing steps are necessary to _______.

reduce any nonspecific binding that may occur

A positive result with the negative control would _______.

be a "false positive" and invalidate the results

How many patient samples were positive for Chlamydia?

one

In the Ouchterlony technique, a precipitin line forms where _______.

the ratio of antigen and antibodies is optimal

When two antigens have NO epitopes in common, their precipitin lines form _______.

an X

What is the medium for diffusion in the Ouchterlony technique?

agar

The antibodies used in this activity have been produced in _______.

goats

Antigens with epitopes in common _______.

can have partial identity and can be identical

Which of the following describes the identity seen between human serum albumin and bovine serum albumin?

partial identity

Which type of identity would you expect to see between human serum albumin and sheep serum albumin?

partial identity

Which of the following describes the precipitin line formation between wells 2 and 3?

an arc

In the direct ELISA, _______.

both primary and secondary antibodies bind to the antigen

Within a class of antibodies, the _______.

constant region has the same sequence of amino acids

In the indirect ELISA, _______.

the secondary antibody binds to the constant region of the primary antibody

In both the direct and indirect ELISA, the substance that changes from colorless to colored in a positive result is the _______.

substrate

Which patient(s) tested positive for HIV?

patient C

Possible reasons for an indeterminate test include _______.

all of the above

What result(s) would you expect if you had forgotten to add the developing buffer?

a "false negative" for the positive control and all of the patient samples would read negative

Why might a patient infected with HIV initially test negative with the indirect ELISA?

The patient has not yet undergone seroconversion.

After the proteins are separated by electrophoresis, the _______.

nitrocellulose membrane is treated with antibodies

Western blotting _______.

is a serological technique

Which of the following is true?

The ELISA is easier to perform and less expensive than the Western blot.

The proteins separated on the nitrocellulose in this activity are _______.

HIV antigens

In this activity, _______________ was used to detect a positive result.

an indirect ELISA

The sample(s) from which of the following tested positive for reverse transcriptase?

THE POSITIVE CONTROL

While passing through a village on safari you notice a man with legs of drastically different sizes. What is the most likely reason for the increased size of the swollen leg?

The man has elephantiasis, which is caused by parasitic worms that get in the lymph system and reproduce to levels that block the vessels. The swelling is due to edema.

Why might lymphedema occur as a complication after a radical mastectomy, in which lymph nodes have been removed?

Anything that prevents the normal return of lymph to the blood results in severe localized edema.

Antibodies mostly act against extracellular targets in body fluids and are therefore considered part of the humoral branch of adaptive immunity.

true

When the lymphatic structures of a limb are blocked due to tumors, the result is ________.

severe localized edema distal to the blockage of that limb

Lymphocytes reside temporarily in lymphoid tissue, then move to other parts of the body.

true

Which of the following is NOT a function of lymph nodes?

produce lymph fluid and cerebrospinal fluid

There are more efferent lymphatic vessels leaving a lymph node than there are afferent vessels entering a lymph node.

false

Which of the following statements is FALSE regarding the spleen?

Red pulp is where immune functions take place.

Antibodies that act against a particular foreign substance are released by ________.

plasma celss

Mucosa-associated lymphoid tissues include all of the following EXCEPT ________.

islets of langerhans

Lymphoid tissue that appears as a swelling of the mucosa in the oral cavity is called a(n) ________.

tonsil

Which of the following statements regarding the thymus is FALSE?

it has follicles similar to those in the spleen

The blood testis barrier is to newly formed sperm cells as the blood thymus barrier is to ________.

T lymphoctye

The thymus is most active during ________.

childhood

An advantage of innate immunity is ________.

its barriers that prevent pathogens from entering into the body

Which of the following is not a role of activated complement?

prevention of immediate hypersensitivity

All but one of the following occur during the inflammatory response. Select the example below that does not describe the process of inflammation.

Vasoconstriction will prevent excessive blood loss due to injury.

Fever is often a beneficial immune response because it can speed the activities of leucocytes.

true

When the white blood cell count is depressed, the classic signs of infection such as redness, local heat, and swelling are not manifested. In this case, should the nurse avoid administering aspirin?

Yes, aspirin should be avoided because aspirin would disguise a fever that would indicate infection.

Activated T cells and macrophages release ________ to mobilize immune cells and attract other leukocytes into the area.

cytokines

A physician orders Tylenol for a temperature greater than 101 degrees F. The patient’s temperature is 100.4 F. What is the rationale for not medicating a fever of 100.4 F?

A mild or moderate fever results in the liver and spleen sequestering iron and zinc. Bacteria need large amounts of zinc and iron to multiply, thus this action limits the pathogens ability to multiply.

The directional movement of cells in response to chemicals is called chemotaxis

true

Soluble proteins secreted by plasma cells are called antibodies.

true

Which of the following best describes the qualities of most antigens?

macromolecules that are foreign to the host

Which of the following statements is a false or incorrect statement?

After becoming immunocompetent, the naive T cells and B cells are exported to the bone marrow where the encounters with antigens occur.

A vaccine is effective because ________.

the secondary response of the adaptive immunity is faster and more efficient the primary response

Select the correct statement about active and passive immunity.

Active and passive humoral immunity are both mechanisms of adaptive immunity that use antibodies.

B-lymphocytes are categorized as part of the adaptive branch of the immune system for all of the following reason but one. Which of the following is not one of the reasons B-lymphocytes are considered part of the adaptive immunity?

They are a first line of defense that can begin killing pathogens immediately.

Helper T cells ________.

function in the adaptive immune system activation

Select the correct statement about immunodeficiency.

The causative agent in acquired immune deficiency syndrome (AIDS) is a virus that recognizes CD4 proteins.

A 36-year-old man enters the hospital in an extremely debilitated condition. He has purple-brown skin lesions (a symptom of Kaposi’s sarcoma) and a persistent cough. A physical examination reveals swollen lymph nodes, and laboratory tests find a very low lymphocyte count. Information taken during the personal history reveals that he has multiple sex partners with whom he frequently engages in unprotected sex. What is likely to be the man’s problem and what is his prognosis?

He is probably suffering from AIDS. His outlook is poor once the disease has progressed to this advanced stage. There is no cure, and drug therapy has had limited short-term success.

Allergens differ from antigens because ________.

allergens produce an abnormally large immune response to what is an otherwise harmless particle