Chapter 22 - Lymph System & Immunity

1. The lymphatic system is involved in

A. fat absorption from the digestive tract.

B. transporting lymph from the intestines to the liver.

C. maintenance of pH in the tissues.

D. production of erythrocytes.

E. protein metabolism.

A. fat absorption from the digestive tract.

2. The lymphatic system plays a role in maintaining fluid balance within the body by

A. adding lymph to GI tract secretions.

B. returning interstitial fluid to the plasma.

C. transporting lymph from tissues to the liver.

D. carrying excess fluid to the kidneys to be excreted.

E. actively absorbing fluid from the blood.

B. returning interstitial fluid to the plasma.

3. Lacteals are

A. a type of lymphocyte.

B. a nonspecific defense.

C. lymphatic vessels in the lining of the small intestine.

D. the sinuses inside a lymph node.

E. germinal centers.

C. lymphatic vessels in the lining of the small intestine.

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

A. Defending from infection caused by microorganisms and other foreign substances.

B. Aiding in erythropoiesis of red blood cells.

C. Maintaining fluid balance by returning excess interstitial fluid to the blood.

D. Absorbing and transporting lipids from the digestive tract.

B. Aiding in erythropoiesis of red blood cells.

5. What is the purpose of lacteals?

A. Drain blood from the spleen.

B. Absorb fluid from capillary beds.

C. Absorb lipids from the digestive tract.

D. Absorb solutes from interstitial spaces.

C. Absorb lipids from the digestive tract.

6. Lymph containing a high lipid content is called

A. chyle.

B. chyme.

C. lacteal.

D. interstitial fluid.

A. chyle.

7. The lymphatic system differs from the cardiovascular system in that

A. the lymphatic system only carries fluid away from tissues.

B. the lymphatic vessels have their own "pump" to assist flow.

C. lymph capillaries do not contain any fluid.

D. lymph capillaries allow free movement of fluid in and out of the capillaries.

E. lymph circulates fluids and cardiovascular does not.

A. the lymphatic system only carries fluid away from tissues.

8. Lymph capillaries are found in the

A. epidermis.

B. cornea.

C. bone marrow.

D. central nervous system.

E. dermis.

E. dermis.

9. Structurally, lymph vessels are most similar to

A. veins.

B. arteries.

C. arterioles.

D. capillaries.

E. venules.

A. veins.

10. How do lymphatic capillaries differ form blood capillaries?

A. Lymphatic capillaries do not have a basement membrane.

B. Simple squamous epithelial cells of lymphatics overlap with loose attachments.

C. Lymphatic capillaries are more permeable than blood capillaries.

D. Lymphatic capillary epithelium act as one-way valves preventing movement of fluid back into interstitial spaces.

E. All of the choices are ways lymphatic capillaries differ from blood capillaries.

E. All of the choices are ways lymphatic capillaries differ from blood capillaries.

11. What structural feature of lymphatic vessels is responsible to forward movement of lymph?

A. over-lapping endothelial cells

B. valves

C. no basement membrane

D. thin walls

B. valves

12. Lymph movement is assisted by

A. contraction of skeletal muscle.

B. contraction of smooth muscle in lymph vessel.

C. pressure changes in the thorax during respiration.

D. compression of lymphatic vessels.

E. All of these choices are correct.

E. All of these choices are correct.

13. A woman has her right breast and right axillary lymph nodes removed. Which of the following might occur?

A. Cisterna chyli flow increases.

B. The thoracic duct would be severed.

C. Right lymphatic duct drainage decreases causing edema in the right arm.

D. Lymph drainage would be affected in her left arm.

E. Lymph drainage would be affected in both legs.

C. Right lymphatic duct drainage decreases causing edema in the right arm.

14. The right lymphatic duct drains lymph from the

A. abdomen.

B. upper part of the body.

C. right arm, right chest, and right side of head.

D. right side of the body.

E. left arm, left chest, and left side of head.

C. right arm, right chest, and right side of head.

15. The thoracic duct drains lymph into the

A. left subclavian vein.

B. right subclavian vein.

C. right internal jugular vein.

D. left brachiocephalic vein.

E. left subclavian artery.

A. left subclavian vein.

16. Which of the following organs does NOT contain lymphatic tissue?

A. liver

B. spleen

C. lingual tonsils

D. thymus

E. pharyngeal tonsils.

A. liver

17. Lymphatic tissue contains an interlaced network of reticular fibers that functions to

A. produce lymphocytes.

B. produce capsules around lymph nodes.

C. attack microorganisms.

D. line the walls of lymphatic vessels.

E. trap microorganisms.

E. trap microorganisms.

18. Nonencapsulated lymphatic tissue called MALT includes all of the following except:

A. tonsils.

B. Peyer patches.

C. lymph nodes.

D. diffuse lymphatic tissue.

C. lymph nodes.

19. Peyer patches are lymphatic nodules found in the

A. lymph nodes.

B. spleen and tonsils.

C. appendix and tonsils.

D. small intestine and appendix.

D. small intestine and appendix.

20. Lymph nodules are

A. small, bean-shaped structures.

B. the site of erythrocyte production.

C. located in the loose connective tissue of the digestive system.

D. composed of an outer cortex and inner medulla.

E. connected together in a series.

C. located in the loose connective tissue of the digestive system.

21. Adenoids are enlarged

A. lingual tonsils.

B. pharyngeal tonsils.

C. palatine tonsils.

D. cervical lymph nodes.

E. axillary lymph nodes.

B. pharyngeal tonsils.

22. Tonsils

A. increase in size in adults.

B. are located in both the oral and abdominal cavities.

C. provide protection against bacteria entering the oral and nasal cavities.

D. contain red pulp and white pulp.

E. are not functional in children.

C. provide protection against bacteria entering the oral and nasal cavities.

23. The palatine tonsils

A. interfere with breathing when enlarged.

B. are located at the junction of the oral cavity and pharynx.

C. are located superior to the palate.

D. are really lymph nodes in disguise.

E. are located in the nasopharynx

B. are located at the junction of the oral cavity and pharynx.

24. Bean-shaped lymphatic organs found along lymphatic vessels are called

A. lymph nodes.

B. medullary cords.

C. cisterna chyli.

D. trabeculae.

E. lymph nodules.

A. lymph nodes.

25. Lymph nodes are surrounded by a dense connective tissue called

A. cortex.

B. capsule.

C. reticulum.

D. trabeculum.

E. basement membrane.

B. capsule.

26. Bacteria and debris are actively removed from the lymph by _____ in the sinuses of lymph nodes.

A. trabecular cells

B. germinal cells

C. macrophages.

D. lymphocytes

E. plasma cells

C. macrophages.

27. Germinal centers are the sites of

A. increased blood flow to the lymph nodes.

B. fluid production.

C. increased flow of lymph from infected tissues.

D. entrance of lymph into lymph nodes.

E. proliferation of lymphocytes in the lymph nodes.

E. proliferation of lymphocytes in the lymph nodes.

28. Lymph exits a lymph node via the

A. efferent lymphatic vessels.

B. afferent lymphatic vessels.

C. cortical sinuses.

D. trabeculae.

E. lymphatic duct.

A. efferent lymphatic vessels.

29. The only structures that filter lymph is/are the

A. tonsils.

B. spleen.

C. lymph nodes.

D. thymus.

C. lymph nodes.

30. The spleen

A. filters damaged red blood cells from the blood.

B. changes undifferentiated lymphocytes into competent lymphocytes.

C. is necessary for life. It can't be removed without causing death.

D. produces several different hormones with unknown function.

E. has additional digestive functions.

A. filters damaged red blood cells from the blood.

31. Which of the following statements concerning the spleen is true?

A. Splenic arteries enter the organ at the periarterial sheath.

B. The spleen can act as a blood reservoir.

C. The white pulp is associated with the venous supply.

D. The red pulp has trabeculae.

E. Humans can not survive without a spleen.

B. The spleen can act as a blood reservoir.

32. The white pulp of the spleen

A. contains lymphocytes that can stimulate an immune response.

B. filters lymph as it flows through the spleen.

C. destroys defective red blood cells.

D. stimulates immune responses, filter lymph, and destroys defective red blood cells.

A. contains lymphocytes that can stimulate an immune response

33. Which of the following statements accurately describes the thymus gland?

A. The thymus gland lacks a capsule.

B. The thymus gland contains many reticular fibers.

C. The thymus gland is larger in infants than in adults.

D. Lymphocytes are found only in the medulla of the thymus gland.

E. The thymus increases in size with aging.

C. The thymus gland is larger in infants than in adults.

34. What is the function of thymosin?

A. destroys damaged red blood cells

B. destroys damaged white blood cells

C. activates lymphocytes in lymph nodes

D. maturation of T-cells

D. maturation of T-cells

35. When innate immunity is activated,

A. each exposure is very specific.

B. previous exposures are remembered.

C. each exposure produces the same response.

D. each exposure increases the strength of the immune response.

E. the second exposure does not produce a response.

C. each exposure produces the same response.

36. Which of the following is true of adaptive immunity?

A. It is present at birth.

B. Previous encounters with the foreign substance does not change the response.

C. The second response is faster and stronger than the first response.

D. Responses are general, not specific.

C. The second response is faster and stronger than the first response.

37. Which of the following is NOT a characteristic of adaptive immunity?

A. It has memory.

B. You are born with it.

C. It has specificity.

D. Acquired throughout your lifetime.

B. You are born with it.

38. Which of the following characteristics is/are most consistent with adaptive immunity?

A. constant response to each exposure

B. specificity

C. memory

D. increased response to second and subsequent exposures

E. specificity, memory and increased response to second and subsequent exposures

E. specificity, memory and increased response to second and subsequent exposures

39. Which of the following would be classified as an innate physical barrier?

A. activation of complement

B. phagocytosis of invading organisms

C. washing action of tears and saliva

D. inflammation

E. release of histamine

C. washing action of tears and saliva

40. Complement proteins

A. can form holes in the plasma membrane of target cells.

B. are on the surface of macrophages.

C. are hormones found in the blood.

D. may cause the release of interferon.

E. do not attract neutrophils, monocytes, macrophages, or eosinophils.

A. can form holes in the plasma membrane of target cells.

41. Which of the following most accurately describes how foreign substances can activate complement?

A. Antibodies can bind to foreign antigens and activate complement through the classical pathway.

B. Foreign substances can bind to spontaneously activated C3 and stabilize it.

C. Foreign proteins bind to C1 and activate it.

D. Foreign proteins are phagocytized by macrophages and directly activate complement.

E. Antibodies can bind to foreign antigens and activate complement through the classical pathway and foreign substances can bind to spontaneously activated C3 and stabilize it.

E. Antibodies can bind to foreign antigens and activate complement through the classical pathway and foreign substances can bind to spontaneously activated C3 and stabilize it.

42. Which of the following is NOT a mechanism of complement action?

A. produces cytokines

B. opsonization

C. attracts other immune cells to the site of infection

D. forms a MAC that leads to cell lysis

A. produces cytokines

43. A surface chemical that prevents microbial growth is

A. histamine.

B. leukotriene.

C. sebum.

D. kinin.

E. interferon.

C. sebum.

44. A protein that helps to protect the body against viral infections is

A. complement.

B. interferon.

C. lysozyme.

D. histamine.

E. kinin.

B. interferon

45. Interferon

A. directly attacks viruses.

B. protects cells that have been invaded by viruses.

C. increases vascular permeability.

D. is not produced by most cells.

E. is a protein that interferes with virus production and infection.

E. is a protein that interferes with virus production and infection.

46. Interferon production is stimulated by

A. a viral infection.

B. the complement cascade.

C. antigen-presenting cells.

D. degranulation of basophils.

E. inflammation.

A. a viral infection.

47. The movement of leukocytes to the source of certain chemicals is called

A. chemotaxis.

B. opsonization.

C. chemoreception.

D. phagocytosis.

E. hemolysis.

A. chemotaxis

48. Lysozyme is

A. an enzyme found in body fluids that destroys certain bacteria.

B. a type of antibody that attracts a phagocyte.

C. a cytokine produced by T cells.

D. an antigen.

E. a bacteria.

A. an enzyme found in body fluids that destroys certain bacteria.

49. The two major types of phagocytic cells are

A. neutrophils and monocytes.

B. neutrophils and macrophages.

C. monocytes and macrophages.

D. lymphocytes and monocytes.

E. eosinophils and T cells.

B. neutrophils and macrophages.

50. Which of the following statements concerning neutrophils and macrophages is false?

A. They both exhibit chemotaxis.

B. They both move by amoeboid motion.

C. Both are capable of phagocytosis.

D. Both release histamine when activated.

E. Both can squeeze between cells.

D. Both release histamine when activated.

51. Macrophages

A. are derived from basophils.

B. reduce the inflammatory response.

C. are responsible for most phagocytic activity in the late stages of an infection.

D. produce cytokines that aid in the destruction of antigens.

E. are the first at the site of infection.

C. are responsible for most phagocytic activity in the late stages of an infection.

52. Histamine and leukotrienes are released from

A. basophils and mast cells.

B. eosinophils and basophils.

C. neutrophils and lymphocytes.

D. macrophages and microphages.

E. phagocytes.

A. basophils and mast cells.

53. In a patient experiencing an allergic reaction, which of the following immune cells will greatly increase in number?

A. mast cells

B. eosinophils

C. monocytes

D. neutrophils

E. basophils

B. eosinophils

54. Which of the following is usually the first cell type to leave the blood and enter infected tissues?

A. eosinophil

B. lymphocyte

C. monocyte

D. natural killer cell

E. neutrophil

E. neutrophil

55. Natural Killer (NK) cells

A. a type of macrophage.

B. are a type of plasma cell.

C. secrete enzymes that kill tumor or virus-infected cells.

D. are derived from B cells.

E. promote inflammation.

C. secrete enzymes that kill tumor or virus-infected cells.

56. The inflammatory response

A. prevents the spread of an infection.

B. stimulates erythrocytes to leave the blood.

C. delays healing of damaged tissues.

D. depresses immunity.

E. is harmful and should be immediately reversed.

A. prevents the spread of an infection.

57. The redness and heat seen in an inflamed area are the result of

A. vasoconstriction.

B. increased blood flow to the area.

C. phagocyte mobilization.

D. production of interferon.

E. a reddish substance released by erythrocytes.

B. increased blood flow to the area.

58. During the inflammatory response,

A. vasoconstriction occurs.

B. chemical mediators are released.

C. vascular permeability is decreased.

D. neutrophil production is depressed.

E. blood flow is reduced.

B. chemical mediators are released.

59. The key signs of inflammation include all of the following EXCEPT

A. jaundice.

B. pain.

C. swelling.

D. redness.

E. heat.

A. jaundice.

60. Which of the following substances causes increased capillary permeability, chemotaxis, and vasodilation?

A. histamine

B. protaglandins

C. leukotrienes

D. complement

E. cytokines

A. histamine

61. In systemic inflammation, pyrogens

A. decrease phagocytosis.

B. decrease vasodilation.

C. increase neutrophil production.

D. stimulate fever production.

E. are chemotaxic factors.

D. stimulate fever production.

62. Circulatory changes that occur in inflammation include

A. increased viscosity of the blood.

B. decreased vascular permeability.

C. increased vascular permeability.

D. decreased blood flow to the area.

E. vasoconstriction.

C. increased vascular permeability.

63. Adaptive immunity is stimulated by

A. antigens.

B. histamines.

C. antibodies.

D. complement.

E. plasma proteins.

A. antigens.

64. Transplanted tissues and organs that contain _________ _________ are rejected by the body.

A. self-antigens

B. foreign antigens

C. foreign antibodies

D. self-antibodies

E. plasma proteins

B. foreign antigens

65. ____ are part of cell-mediated immunity while ____ are part of antibody-mediated immunity.

A. B cells, NK cells

B. Antibodies, antigens

C. T cells, B cells

D. Macrophages, antibodies

E. Neutrophils, monocytes

C. T cells, B cells

66. A small molecule that can cause an allergic reaction is a/an

A. T cell.

B. B cell.

C. antibody.

D. hapten.

D. hapten

67. ______ determines which B-cell is cloned in an antibody-mediated response.

A. The antibody

B. The antigen

C. A macrophage

D. Complement

E. A neutrophil

B. The antigen

68. Which of the following is a subpopulation of T cells?

A. cytotoxic

B. antigenic

C. cytokinetic

D. basophilic

E. antitoxic

A. cytotoxic

69. T cells are divided into two primary groups, effector and regulatory. Which of the following are regulatory T cells?

A. helper T cells

B. cytotoxic T cells

C. chemotaxic T cells

D. delayed hypersensitivity T cells

E. assistant T cells

A. helper T cells

70. The effects of cell-mediated immunity are the result of activities of

A. B cells.

B. cytotoxic T cells.

C. macrophages.

D. dendritic cells.

E. helper T cells.

B. cytotoxic T cells.

71. The thymus is where ____ mature and become functional immune cells.

A. pre-T cells

B. pre-B cells

C. macrophages

D. null cells

E. C cells.

A. pre-T cells

72. The process of eliminating those lymphocytes that react or respond against self-antigens is called

A. phagocytosis.

B. inflammation.

C. negative selection.

D. activation of complement.

E. natural selection.

C. negative selection.

73. Positive selection of lymphocytes refers to the

A. processing of an antigen by a macrophage.

B. proliferation of natural killer cells.

C. production of antigen-specific antibodies.

D. survival of pre-B and pre-T cells that are capable of an immune response.

E. replication of memory cells.

D. survival of pre-B and pre-T cells that are capable of an immune response.

74. Primary lymphatic organs include the

A. tonsils and spleen.

B. thymus and lymph nodes.

C. red bone marrow and thymus.

D. red bone marrow and lymph nodes.

C. red bone marrow and thymus.

75. Which of the following is NOT a secondary lymphatic organ?

A. spleen

B. lymph node

C. lymphatic nodule

D. thymus gland

D. thymus gland

76. What areas of an antigen are recognized by lymphocytes so that they can respond?

A. major histocompatibility complexes

B. antigenic determinants

C. T-cell receptors

D. epitopes

E. Both antigenic determinants and epitopes are correct.

E. Both antigenic determinants and epitopes are correct.

77. The MHC (major histocompatibility complex) class molecules

A. are only found on B cells.

B. are found in the nucleus of cells.

C. allow the immune system to respond to antigens inside cells.

D. are lipoproteins on cell surfaces.

E. do not attach to plasma membranes.

C. allow the immune system to respond to antigens inside cells.

78. Different T-cell receptors can respond to different antigens because of different

A. variable regions in the structure of the receptors.

B. epitopes in the receptor's structure.

C. selection processes.

D. complement binding sites in the receptors.

E. antigenic determinants.

A. variable regions in the structure of the receptors.

79. Lymphocyte activation can occur in several ways. However, in all cases

A. lymphocytes must recognize an antigen.

B. helper T cells are activated first and they then stimulate other cells.

C. antigen-presenting cells process the antigen and present it to the lymphocytes.

D. cytokines released by the antigen stimulate the lymphocyte response.

E. antigens must be able to recognize the lymphocytes.

A. lymphocytes must recognize an antigen.

80. The MHC class I antigen complex displays a foreign antigen on the cell surface. This prompts the immune system to destroy

A. B cell clones.

B. extracellular antigens.

C. the displaying cell.

D. mature red blood cells.

E. the virus inside the cell, but not the cell.

C. the displaying cell.

81. MHC class II molecules are found on

A. neutrophils, monocytes, and macrophages.

B. dendritic cells, B cells, and helper T cells.

C. monocytes, helper T cells, and neutrophils.

D. B cells, macrophages, and dendritic cells.

E. B cells, C cells and D cells.

D. B cells, macrophages, and dendritic cells.

82. Cells that process antigen and present antigens to other immune cells are called

A. plasma cells.

B. antigen-presenting cells.

C. B receptor cells.

D. T suppressor cells.

E. antibodies.

B. antigen-presenting cells.

83. Frequently, several different signals or molecules are needed in order to produce an immune response by a B cell or T cell. The second signal in this process is called

A. opsonization.

B. copresentation.

C. complement activation.

D. antigen processing.

E. costimulation.

E. costimulation.

84. Which of the following cytokines is mismatched?

A. perforin - makes a hole in target cell membranes

B. alpha interferon - prevents viral replication

C. lymphotoxin - costimulator of T cells

D. interleukin 4 - plays a role in allergic reactions

E. TNF - activates macrophages and promotes fever

C. lymphotoxin - costimulator of T cells

85. T helper cells possess a glycoprotein called CD4. This molecule binds to

A. MHC class I molecules.

B. MHC class II molecules.

C. MHC-CD8 antigens.

D. MHC-CD28 antigens.

E. Interleukin-1 receptor.

B. MHC class II molecules.

86. Which of the following might occur after a helper T cell is presented with a processed antigen and costimulated?

A. Helper T cells destroy the presenting cell.

B. Helper T cells produce antibodies.

C. Helper T cells release interleukins that stimulate B cells to clone.

D. Helper T cells stop division.

E. Helper T cells lyse.

C. Helper T cells release interleukins that stimulate B cells to clone.

87. Lymphocyte proliferation begins by increasing the number of

A. macrophages.

B. B cells.

C. T suppressor cells.

D. helper T cells.

E. cytotoxic T cells.

D. helper T cells.

88. Once cytotoxic T cells are produced, which of the following is (are) consistent with their ability to attack intracellular viruses?

A. Most nucleated cells process antigens through the MHC class I mechanisms.

B. Viral antigens are processed by the MHC class I mechanism and are presented to the cell surface.

C. Cytotoxic T cells bind to MHC class I processed antigens.

D. Cytotoxic T cells bound to the MHC class I processed antigens release lymphokines.

E. All of these choices are correct.

E. All of these choices are correct.

89. Tolerance is a state of

A. hypersensitivity.

B. transplant rejection.

C. unresponsiveness to antigens.

D. responding to self-antigens.

E. non-recognition of antigens.

C. unresponsiveness to antigens

90. Tolerance to antigens is induced by

A. blocking costimulation.

B. stimulating interleukin 2 production.

C. preventing suppressor T cell proliferation.

D. promoting the release of cytokines.

E. stimulating helper T cell division.

A. blocking costimulation.

91. Antibodies are produced by

A. T effector cells stimulated by T helper cells.

B. T helper cells stimulated by various cytokines.

C. B cells that differentiate to form plasma cells.

D. natural killer cells as they lyse cancer cells.

E. the red bone marrow.

C. B cells that differentiate to form plasma cells.

92. Antibodies

A. play a large role in cell-mediated immunity.

B. are produced by both T and B cells.

C. are composed of four light and four heavy polypeptide chains.

D. are not specific, but act generally.

E. have a variable region that binds to a specific antigenic determinant.

E. have a variable region that binds to a specific antigenic determinant.

93. The immunoglobulin that is often the first antibody produced in response to an antigen is

A. IgD.

B. IgA.

C. IgM.

D. IgE.

E. IgG.

C. IgM.

94. Antibodies

A. activate antigens.

B. may initiate inflammation and enhance phagocytosis.

C. are proteins produced by T helper cells.

D. are needed for costimulation.

E. have memory.

B. may initiate inflammation and enhance phagocytosis.

95. Which of the following is correctly matched?

A. IgA - found in saliva and tears

B. IgD - can cross the placenta

C. IgG - first to challenge the antigen

D. IgM - antigen-binding receptor on B cells

E. IgE - transfusion reactions

A. IgA - found in saliva and tears

96. Antibodies secreted in breast milk

A. are IgG antibodies.

B. are IgA antibodies.

C. provide natural active adaptive immunity.

D. include the cytokine interleukin 2.

E. promote inflammation.

B. are IgA antibodies.

97. As a result of opsonization,

A. holes are produced in target cell membranes.

B. organ transplant rejection occurs.

C. antigens are more susceptible to phagocytosis.

D. antigens clump together.

E. inflammation, chemotaxis, and lysis occur.

C. antigens are more susceptible to phagocytosis.

98. B-cells

A. are a subset of T cells.

B. when activated become plasma cells and produce antibodies.

C. are responsible for forming all the body's memory cells.

D. suppress the activity of T cells.

E. mature in the thymus.

B. when activated become plasma cells and produce antibodies.

99. Several days after an initial contact with an antigen, antibody blood levels increases. This is a

A. primer response.

B. primary response.

C. precipitating response.

D. principle response.

E. cascade response

B. primary response.

100. The secondary or memory response

A. occurs after the primary response has activated NK cells.

B. provides better protection than the primary response.

C. is less effective in antibody production.

D. produces different antibodies than those produced in the primary immune response.

E. does not protect the body after the first exposure.

B. provides better protection than the primary response.