Chapter 22: The Lymphatic System and Immunity (Martini)

 Lymphocytes provide an adaptive or specific defense known as the  

A) phagocytic response.  

B) adaptive defense.  

C) immune response.  

D) lymphocytic response.  

E) inflammation of tissues

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C

The primary function of the lymphatic system is  

A) circulation of nutrients.  

B) the transport of hormones.  

C) defending the body against both environmental hazards and internal threats. 

D) the production and distribution of plasma proteins.  

E) circulation of dissolved gases. 

C

The lymphatic system does all of the following, **except** that it  

A) helps maintain normal blood volume.  

B) transports gases to and away from lymph nodes.  

C) eliminates variations in the composition of interstitial fluid.  

D) transports lipids from the digestive tract.  

E) fights infection

B

The lymphatic system is composed of all of the following, **except**  

A) lymphatic vessels.  

B) the venae cavae.  

C) the spleen.  

D) lymph nodes.  

E) lymph.  

B

Compared to blood capillaries, lymph capillaries exhibit all of the following, **except** that they  

A) have no basement membrane.  

B) are larger in diameter.  

C) have walls of endothelial cells that overlap like shingles.  

D) are smaller in diameter.  

E) are frequently irregular in shape

D

Lymph nodes do all of the following, **except** that they  

A) produce antibodies.  

B) monitor the contents of lymph.  

C) remove debris and pathogens from the lymph.  

D) accumulate cancer cells.  

E) remove excess nutrients from the lymph.

E

All of the following are true of the thymus gland, **except** that it  

A) activates B cells.  

B) reaches its greatest relative size during the second year of life.  

C) involutes after puberty.  

D) produces T cells.  

E) lies in the anterior mediastinum

A

In general, lymphocytes  

A) spend most of their time in lymphatic tissue.  

B) have relatively short life spans.  

C) have two nuclei.  

D) are produced and mature only in red bone marrow.  

E) spend most of their time circulating in the blood

A

Most of the lymph returns to the venous circulation by way of the  

A) right lymphatic duct.  

B) thoracic duct.  

C) cisterna chyli.  

D) hepatic portal vein.  

E) dural sinus.  

B

 The thoracic duct drains lymph from all of the following regions, **except** the  

A) left breast.  

B) right breast.  

C) left arm and shoulder.  

D) pelvic viscera.  

E) left side of neck.  

B

The cells directly responsible for cellular immunity are the ________ cells.  

A) B  

B) plasma  

C) helper T  

D) cytotoxic T  

E) suppressor T

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D

The cells responsible for humoral immunity are the ________ cells.  

A) NK  

B) B  

C) helper T  

D) cytotoxic T  

E) suppressor T 

B

The medullary cords of a lymph node contain ________ lymphocytes and plasma cells.  

A) cytotoxic T  

B) medullary  

C) NK  

D) B  

E) cordal  

D

Lymphocytes that destroy foreign cells or virus-infected cells are ________ cells.  

A) B  

B) plasma  

C) helper T  

D) cytotoxic T  

E) suppressor T  

D

Lymphocytes  

A) are actively phagocytic.  

B) destroy red blood cells.  

C) respond to antigens.  

D) are primarily found in red bone marrow. 

E) decrease in number during infection.

C

Lymphocytes may be found in which of the following tissues or organs?

A) tonsils  

B) spleen  

C) lymph nodes  

D) thymus  

E) All of the answers are correct.

E

 ________ are large lymphatic nodules that are located in the walls of the pharynx.  

A) Tonsils  

B) Peyer patches  

C) Lymph nodes  

D) Immune complexes  

E) Spleens  

A

 ________ are clusters of lymphatic nodules deep to the epithelial lining of the small intestine.  

A) Tonsils  

B) Adenoids  

C) Peyer patches  

D) Immune complexes  

E) Lymph glands  

C

The term *lymphadenopathy* refers to  

A) a congenital lack of lymph nodes.  

B) a chronic or excessive enlargement of lymph nodes.  

C) accumulations of lymph in the tissue space.  

D) the lack of lymphocytes in peripheral circulation.  

E) increased numbers of circulating lymphocytes.

B

The cells responsible for the production of circulating immunoglobulins are ________ cells.  

A) NK  

B) plasma  

C) helper T  

D) thymus  

E) liver  

B

Stem cells that will form B cells or NK cells are found only in the  

A) bone marrow.  

B) liver.  

C) spleen.  

D) thymus.  

E) kidneys.  

A

 Areas of the spleen that contain large aggregations of lymphocytes are known as  

A) Peyer patches.  

B) adenoids.  

C) white pulp.  

D) red pulp.  

E) lymph nodes.

C

Which class of leukocytes is particularly abundant in the *red pulp* of the spleen?

A) T lymphocytes.  

B) free and fixed macrophages.  

C) B lymphocytes.  

D) neutrophils.  

E) red blood cells.

B

Lymphatic organs differ from lymphatic tissues in what way?  

A) They contain T lymphocytes and lymphatic tissues do not.  

B) They are found in the digestive tract and lymphatic tissues are found in the thorax.  

C) They are surrounded by a fibrous capsule and lymphatic tissues are not.  

D) They cannot produce antibodies, whereas lymphatic tissues can.  

E) They occur throughout the body except in the head.

C

The *white pulp* of the spleen is populated by 

A) lymphocytes.  

B) trabeculae.  

C) arteries.  

D) veins.  

E) fibrous connective tissue.

A

Lymphocytes are produced and stored in all of the following, **except**  

A) the thymus.  

B) lymphatic nodules.  

C) lymph node organs.  

D) the spleen.   

E) the brain.  

E

Lymphatic capillaries are known for  

A) being the starting point of the lymphatic circulation.  

B) being the smallest lymphatic vessels.  

C) having larger diameters and looser walls than blood capillaries.  

D) shingle-like endothelial cells.  

E) All of the answers are correct.

E

Lymphatic vessels commonly occur in association with  

A) hyaline cartilage.  

B) blood vessels.  

C) adipose tissue.  

D) sensory nerve endings.  

E) both blood vessels and adipose tissue.

B

The merging of ________ forms the right lymphatic duct.  

A) the right jugular, right subclavian, and right bronchomediastinal trunks  

B) the left jugular, right subclavian, and right bronchomediastinal trunks  

C) two great vessels  

D) the thoracic and mediastinal ducts 

E) superior and inferior lymphatic ducts

A

 T is to ________ as B is to ________.  

A) top; bottom  

B) thymus-dependent; bone marrow-derived  

C) thyroid; bowel

D) non-thymus-dependent; bottom  

E) trabeculae; bursa  

B

Lymphocyte production involves  

A) bone marrow.  

B) thymus tissue.  

C) peripheral lymphatic tissues.  

D) stem cells.

E) All of the answers are correct. 

D

Dividing lymphocytes can be found in the ________ of the lymphatic nodule.  

A) sinus

B) germinal center  

C) cortex  

D) capsule  

E) stromba  

B

Lymph nodes range in diameter from  

A) 1 nm to 10 nm.  

B) 1 inch to 2 inches.  

C) 1 mm to 25 mm.  

D) 1 cm to 25 cm.  

E) 1 cm to 1 inch.

C

Lymphatic vessels are located in almost all portions of the body, **except** the  

A) CNS.  

B) periphery.  

C) renal arteries.  

D) groin.  

E) throat.  

A

Which of these statements about lymph flow in a node is **false**?  

A) Lymph enters in an afferent lymphatic.  

B) Lymph first enters the subcapsular space. 

C) Lymph flows past dendritic cells.  

D) The efferent lymphatic exits at the hilum.  

E) The afferent lymphatics enters at the hilum

E

Stem cells that can form all types of lymphocytes are concentrated in the  

A) circulation.  

B) thymus.  

C) red marrow.  

D) spleen.  

E) yellow marrow.

C

Lymphatic tissue is found in the greatest quantity in  

A) the adult spleen.  

B) the adult thymus.  

C) bone marrow.  

D) the tonsils.  

E) Peyer patches.

A

If the thymus shrank and stopped making thymosins, we would expect to see an immediate decrease in the number of  

A) B lymphocytes.  

B) NK cells.  

C) T cells.  

D) neutrophils.  

E) red blood cells.

C

The cell that dominates the deep cortical region of a lymph node is the ________ cell.  

A) B  

B) T  

C) plasma  

D) nodule  

E) NK  

B

Innate defenses include  

A) phagocytic cells.  

B) physical barriers.  

C) inflammation.  

D) interferons.  

E) All of the answers are correct.

E

Examples of physical barriers against pathogens include  

A) sebaceous glands.  

B) mucus.  

C) epithelia.  

D) epidermal layers.  

E) All of the answers are correct.

E

The body's innate defenses include all of the following, **except**  

A) the skin.  

B) complement.  

C) interferon.  

D) inflammation.  

E) antibodies.  

E

 Each of the following is a physical barrier to infection, **except** 

A) body hair.  

B) epithelium.  

C) secretions.  

D) complement.  

E) basement membranes.

D

An inflammatory response is triggered when  

A) red blood cells release pyrogens.  

B) T cells release interferon.  

C) mast cells release histamine and heparin.  

D) neutrophils phagocytize bacteria.  

E) blood flow to an area increases. 

C

The release of endogenous pyrogen (or interleukin-1) by active macrophages would  

A) cause inflammation.  

B) produce a fever.  

C) activate complement.  

D) opsonize pathogens.  

E) activate antibodies.

B

 Microphages include  

A) monocytes.  

B) Kupffer cells.  

C) neutrophils.  

D) eosinophils.  

E) both neutrophils and eosinophils.

E

Various types of macrophages are derived from  

A) lymphocytes.  

B) monocytes.  

C) neutrophils.  

D) eosinophils.  

E) basophils.  

B

Plasma contains ________ special complement proteins that form the complement system.  

A) 3  

B) 5  

C) 7  

D) 9  

E) 11  

E

Inflammation produces localized  

A) swelling.  

B) redness.  

C) heat.  

D) pain.  

E) All of the answers are correct.

E

Histamine increases blood flow and vascular permeability. This would account for all of the following changes that occur during inflammation, **except**  

A) redness of the inflamed tissue.  

B) chemotaxis of phagocytes.  

C) heat of the inflamed tissue.  

D) movement of defense proteins and cells into the interstitial space.  

E) swelling of the inflamed tissue.  

B

Fever is the maintenance of body temperature greater than  

A) 105°F.  

B) 99°F.  

C) 98.6°F.  

D) 102°F.  

E) 99.5°F.  

B

Leslie has a bad sore throat and the lymph nodes in her neck are swollen. This would indicate that  

A) the focus of the infection is the lymph nodes.    

B) lymph is not flowing through these lymph nodes.    

C) the affected lymph nodes contain an increased number of lymphocytes.  

D) the lymph node is actively producing phagocytes.  

E) the lymph node has increased its secretion of thymosin.

C

 A sample of John's blood shows a high level of pyrogens. This would indicate that John  

A) is feeling achy.  

B) is producing T lymphocytes.  

C) has a sore throat.  

D) is running a fever.  

E) has swollen lymph nodes

D

The effects of activating the complement system include all of the following, **except**  

A) destruction of target cell plasma membranes.  

B) stimulation of inflammation.  

C) inhibition of the immune response.  

D) opsonization.  

E) chemotaxis.  

C

The classic pathway of complement activation begins when the protein C1 binds to  

A) the cell wall of bacteria.  

B) the plasma membrane of bacteria.  

C) an antibody attached to an antigen.  

D) a cell surface antigen.  

E) a plasma protein.  

C

Immunity that is genetically determined and present at birth is called ________ immunity.  

A) active  

B) natural passive  

C) passive  

D) auto  

E) innate  

E

The cells that perform immunological surveillance are the ________ cells.  

A) NK  

B) plasma  

C) B  

D) helper T  

E) suppressor T

A

Cytotoxic T cells can attack target cells with which of these chemical weapons?

A) secrete strong acid

B) secrete organic solvent 

C) secrete free radicals

D) secrete a cytokine that triggers apoptosis

E) secrete mutant proteins

D

Adaptive defenses depend on the activities of  

A) monocytes.  

B) leukocytes.  

C) agranulocytes.  

D) erythrocytes.  

E) lymphocytes. 

E

Characteristics of adaptive defenses include  

A) versatility.  

B) tolerance.  

C) memory.  

D) specificity.  

E) All of the answers are correct.

E

Defense of the body against a particular pathogen is provided by  

A) innate immunity.  

B) adaptive immunity.  

C) immunological surveillance.  

D) skin defenses.  

E) fever.  

B

The first line of cellular defense against pathogens are the  

A) T cells.  

B) B cells.  

C) NK cells.  

D) phagocytes.  

E) plasma cells.

D

Immunity that results from exposure to an antigen in the environment is called ________ immunity.  

A) naturally acquired active 

B) natural passive  

C) passive  

D) auto  

E) innate  

A

Immunity that results from antibodies that pass through the placenta from mother to fetus is called ________ immunity.  

A) active  

B) naturally acquired passive  

C) passive  

D) auto  

E) innate  

B

 In passive immunization, the  

A) immune system attacks normal body cells.  

B) body is deliberately exposed to an antigen.  

C) body receives antibodies produced by other humans.  

D) body receives antibodies produced by an animal.  

E) body receives antibodies produced by other humans or by an animal.

E

The following are steps in the cell-mediated immune response.


1. Several cycles of mitosis occur.
2. Antigen is engulfed and presented by a macrophage.
3. Cytotoxic T cells migrate to focus of infection.
4. T cells with specific receptors recognize the antigen.
5. T cells differentiate into cytotoxic T cells or T memory cells.
6. Cytotoxic T cells release perforin and/or lymphotoxin.

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The correct sequence for these steps is

A) 4, 1, 5, 3, 6, 2.

B) 2, 4, 1, 5, 3, 6.

C) 1, 2, 4, 5, 3, 6.

D) 3, 2, 4, 1, 5, 6.

E) 3, 6, 4, 5, 1, 2.

B

During a primary humoral response to antigens all of the following occur, **except**  

A) B cells may differentiate into plasma cells immediately.  

B) B cells may undergo several rounds of mitosis before producing plasma cells and memory cells.  

C) antibody levels do not peak until 1 to 2 weeks after the initial exposure.  

D) neutrophils invade the surrounding areas, releasing chemotactic substances.  

E) the first immunoglobulins to appear in circulation are of the IgM type. 

D

 In an experimental situation, a rabbit is exposed to a viral antigen to which it makes antibodies. These antibodies are then purified and injected into a human with the same viral disease. This is an example of  

A) innate immunity.  

B) active immunization.  

C) passive immunization.  

D) natural immunity.  

E) alloimmunity.  

C

All of the following are true of the secondary response of humoral immunity, **except** that it  

A) depends on memory B cells.  

B) results in much higher antibody titers than in the primary response.  

C) results in much quicker rise in antibody titers.

D) produces more effective antibodies.  

E) weakens quickly because memory B cells only survive for a year or two

E

All of the following are true of the primary response of humoral immunity, **except** that

A) it depends on antigen triggering the appropriate B cell.

B) it requires B cell differentiation into plasma cells.  

C) it is delayed by the memory cell stage.  

D) circulating antibodies undergo a gradual, sustained rise. 

E) it peaks 1 to 2 weeks after the initial exposure.

C

 Hormones of the immune system include all of the following, **except**  

A) interleukins.  

B) interferons.  

C) natriuretic factor.  

D) thymosins.  

E) tumor necrosis factor.

C

Interleukins do all of the following, **except**  

A) increase T-cell sensitivity to antigens exposed on macrophage membranes.  

B) stimulate B-cell activity, plasma cell formation, and antibody production.  

C) stimulate inflammation.  

D) elevate body temperature.  

E) stimulate collagen synthesis.

E

Cells that help regulate the immune response are ________ cells.  

A) B  

B) plasma  

C) helper T  

D) cytotoxic T  

E) NK  

C

Suppressor T cells act to  

A) suppress antigens.  

B) erase memory T cells.  

C) limit antigen proliferation.  

D) inhibit T and B cell activities.  

E) produce antibodies involved in autoimmunity.

D

Which of the following statements about MHC proteins is **not** true? 

A) bind complement  

B) allow the body to differentiate its own cells from foreign cells  

C) function in antigen presentation 

D) fall into two major classes  

E) are found on all nucleated cells

A

When an antigen is bound to a Class I MHC molecule, it can stimulate a ________ cell.  

A) B  

B) plasma  

C) helper T  

D) cytotoxic T  

E) NK  

D

Class II MHC molecules are found only on which of the following?  

A) all body cells with a nucleus  

B) red blood cells  

C) granulocytes and microphages  

D) lymphocytes and antigen-presenting cells  

E) liver cells and macrophages in the spleen

D

When an antigen is bound to a Class II MHC protein, it can activate a ________ cell.  

A) plasma  

B) helper T  

C) NK  

D) suppressor T  

E) cytotoxic T  

B

Helper T cells do all of the following, **except**  

A) trigger B-cell division, plasma cell maturation, and antibody production.  

B) provide a rapid response to a future exposure to the antigen.  

C) enhance production of memory and cytotoxic T cells.  

D) attract macrophages to the affected area.  

E) enhance nonspecific defenses. 

B

 Stem cells that will form T cells develop in the  

A) bone marrow.  

B) liver.  

C) spleen.  

D) thymus. 

E) kidneys.  

D

T cells and B cells can be activated only by  

A) pathogens.  

B) interleukins, interferons, and colony-stimulating factors.  

C) cells infected with viruses, bacteria, or cancer cells.  

D) exposure to a specific antigen at a specific site in a plasma membrane.  

E) disease-causing agents.  

D

 Class II MHC proteins are present in the plasma membrane only 

A) when plasma cells are releasing antibodies.  

B) in antigen-presenting cells and lymphocytes.  

C) when cytotoxic T cells are inhibited.  

D) when NK cells are activated.  

E) during infections.  

B

 If the disulfide bonds in IgG were broken, how many protein chains would be set free?

A) 2

B) 4

C) 6

D) 8

E) dozens

B

The various classes of immunoglobulins are differentiated on the basis of their  

A) asymmetry.  

B) antigen specificity.  

C) light-chain variable segments.  

D) heavy-chain constant segments.  

E) reactivity.  

D

Immunoglobulins that are most abundant and are responsible for resistance against many viruses, bacteria, and bacterial toxins are  

A) IgA.  

B) IgD.  

C) IgE.  

D) IgG.  

E) IgM.  

D

Immunoglobulins that attach to and sensitize mast cells and basophils are  

A) IgA.  

B) IgD.  

C) IgE.  

D) IgG.  

E) IgM.

C

Immunoglobulins that are found on the surface of B cells and may activate antibody production are  

A) IgA.  

B) IgD.  

C) IgE.  

D) IgG.  

E) IgM. 

B

Immunoglobulins, formed of five subunits, that are the first antibodies to be produced in response to infection, are  

A) IgA.  

B) IgD.  

C) IgE.  

D) IgG.  

E) IgM. 

E

Immunoglobulins that are primarily found in glandular secretions such as saliva and tears are  

A) IgA.  

B) IgD.  

C) IgE.  

D) IgG.  

E) IgM.

A

The binding of an antibody to an antigen can result in  

A) neutralization of the antigen.  

B) agglutination or precipitation.  

C) complement activation and opsonization.  

D) inflammation.  

E) All of the answers are correct.

D

In order for a lymphocyte to respond to an antigen, the antigen must  

A) be phagocytized by the lymphocyte.  

B) enter the cytoplasm of the lymphocyte.  

C) bind to the DNA of the lymphocyte.  

D) bind to specific receptors on the lymphocyte surface.  

E) depolarize the lymphocyte. 

D

The role of antigen-presenting cells in immunity is to  

A) activate T cells.

B) display antigen fragments. 

C) process antigens.  

D) bind antigens to glycoproteins. 

E) All of the answers are correct. 

E

 B cells are primarily activated by the activities of  

A) antigens.  

B) antibodies.  

C) helper T cells.  

D) macrophages.  

E) plasma cells.

C

In IgG, the antigen binding site is formed by

A) the variable segment of the light chain. 

B) the variable segment of the heavy chain.

C) the constant segment of the heavy chain.

D) the variable segments of both the light and heavy chains.

E) the ionized segment of the light chain and the isotropic segment of the heavy chain.

D

 ________ is the class of antibody first secreted in response to a new antigen.  

A) IgG  

B) IgE  

C) IgD  

D) IgM  

E) IgA  

D

Which of these is **not** a property of an IgG heavy chain?

A) has one constant segment

B) has one variable segment

C) binds one light chain

D) binds antigen at both ends

E) binds complement in the constant region

D

Each IgG has ________ binding sites for attachment to antigenic determinants.

A) 1 

B) 2

C) 4

D) up to 8

E) as many as a 1000

B

During a primary immune response, the  

A) IgM titer is initially higher than the IgG titer.  

B) IgG titer is initially higher than the IgM titer.  

C) IgM titer and the IgG titer rise in parallel

A

In a routine examination, some blood is taken and analyzed. The results show a high IgM titer for the mumps virus but a low IgG anti-mumps titer. This would indicate the person  

A) has just recovered from mumps.  

B) was recently infected with mumps.  

C) is allergic to mumps.  

D) is immune to mumps.  

E) is relying on passive immunity.

B

A crime scene investigator found that a biological fluid sample contains a large amount of IgA-type antibody. This fluid is probably  

A) blood.  

B) lymph.  

C) serum.  

D) tears.  

E) interstitial.  

D