CH 16, 17, and 14 exam review

okaylets hope i pass

1) Innate immunity
A) is slower than adaptive immunity in responding to pathogens.
B) is nonspecific and present at birth.
C) involves a memory component.
D) involves T cells and B cells.
E) provides increased susceptibility to disease.

is nonspecific and present at birth.

2) All of the following protect the skin and mucous membranes from infection EXCEPT
A) multiple layers of cells.
B) tears.
C) saliva.
D) HCl.
E) the "ciliary escalator."

HCI.

3) The function of the "ciliary escalator" is to
A) propel inhaled dust and microorganisms toward the throat.
B) remove microorganisms from the gastrointestinal tract.
C) remove microorganisms from the lower respiratory tract.
D) remove microorganisms from the upper respiratory tract.
E) trap inhaled dust and microorganisms in mucous and propel it away from the lower respiratory tract.

trap inhaled dust and microorganisms in mucous and propel it away from the lower respiratory tract.

4) Which of the following exhibits the highest phagocytic activity?
A) neutrophils
B) erythrocytes
C) macrophages
D) basophils
E) eosinophils

macrophages

5) TLRs attach to all of the following EXCEPT
A) AMPs.
B) flagellin.
C) LPS.
D) PAMPs.
E) peptidoglycan.

AMPs

6) A differential cell count is used to determine each of the following EXCEPT
A) the total number of white blood cells.
B) the numbers of each type of white blood cell.
C) the number of red blood cells.
D) leukocytosis.
E) leukopenia.

the number of red blood cells.

7) The complement protein cascade is the same for the classical pathway, alternative pathway, and lectin pathway beginning with the activation of
A) C1.
B) C2.
C) C3.
D) C5.
E) C6.

C3.

8) All of the following increase blood vessel permeability EXCEPT
A) kinins.
B) prostaglandins.
C) lysozymes.
D) histamine.
E) leukotrienes.

lysozymes.

9) A child falls and suffers a deep cut on her leg. The cut went through her skin and she is bleeding. Which of the following defense mechanisms will participate in eliminating contaminating microbes?
A) mucociliary escalator
B) normal skin flora
C) phagocytosis in the inflammatory response
D) acidic skin secretions
E) lysozyme

phagocytosis in the inflammatory response

10) Margination refers to
A) the adherence of phagocytes to microorganisms.
B) the chemotactic response of phagocytes.
C) adherence of phagocytes to the lining of blood vessels.
D) dilation of blood vessels.
E) the movement of phagocytes through walls of blood vessels.

adherence of phagocytes to the lining of blood vessels

11) Which of the following statements is TRUE?
A) All three types of interferons have the same effect on the body.
B) Alpha interferon promotes phagocytosis.
C) Gamma interferon causes bactericidal activity by macrophages.
D) Alpha interferon acts against specific viruses.
E) Beta interferon attacks invading viruses.

Gamma interferon causes bactericidal activity by macrophages.

12) Which of the following is found normally in serum?
A) complement
B) interferon
C) histamine
D) leukocytosis-promoting factor
E) TLRs

complement

13) Each of the following is an effect of complement activation EXCEPT
A) interference with viral replication.
B) bacterial cell lysis.
C) opsonization.
D) increased phagocytic activity.
E) increased blood vessel permeability.

interference with viral replication.

14) Which of the following is an effect of opsonization?
A) increased adherence of phagocytes to microorganisms
B) increased margination of phagocytes
C) increased diapedesis of phagocytes
D) inflammation
E) cytolysis

Increased adherence of phagocytes to microorganisms

15) Normal microbiota provide protection from infection in each of the following ways EXCEPT
A) they produce antibacterial chemicals.
B) they compete with pathogens for nutrients.
C) they make the chemical environment unsuitable for nonresident bacteria.
D) they produce lysozyme.
E) they change the pH of the environment.

They produce lysozymes.

16) Each of the following provides protection from phagocytic digestion EXCEPT
A) M protein.
B) capsules.
C) formation of phagolysosomes.
D) leukocidins.
E) biofilms.

formation of phagolysosomes.

17) The antimicrobial effects of AMPs include all of the following EXCEPT
A) inhibition of cell wall synthesis.
B) lysis of bacterial cells.
C) destruction of nucleic acids.
D) pore formation in bacterial membranes.
E) inhibition of phagocytosis.

inhibition of phagocytosis.

18) The swelling associated with inflammation decreases when the fluid
A) returns to the blood.
B) goes into lymph capillaries.
C) is excreted in urine.
D) is lost as perspiration.
E) is transported into macrophages.

goes into lymph capillaries.

19) Which of the following statements about fixed macrophages is FALSE?
A) They are found in certain tissues and organs.
B) They develop from neutrophils.
C) They are cells of the mononuclear phagocytic system.
D) They are mature monocytes.
E) They gather at sites of infection.

They develop from neutrophils.

20) Phagocytes utilize all of the following to optimize interaction with microorganisms EXCEPT
A) trapping a bacterium against a rough surface.
B) opsonization.
C) chemotaxis.
D) lysozyme.
E) complement.

lysozyme.

21) All of the following are affects of histamine EXCEPT
A) vasodilation.
B) fever.
C) swelling.
D) redness.
E) pain.

fever.

22) All of the following are effects of histamine EXCEPT
A) destruction of an injurious agent.
B) removal of an injurious agent.
C) isolation of an injurious agent.
D) repair of damaged tissue.
E) production of antibodies.

production of antibodies.

23) A chill is a sign that
A) body temperature is falling.
B) body temperature is rising.
C) body temperature is not changing.
D) the metabolic rate is decreasing.
E) blood vessels are dilating.

body temperature is rising.

24) Which of the following statements is TRUE?
A) There are at least thirty complement proteins.
B) All of the complement proteins are constantly active in serum.
C) Factors B, D, and P cause cytolysis.
D) Complement activity is antigen-specific.
E) Complement increases after immunization.

There are at least thirty complement proteins.

25) Which of the following is mismatched?
A) diapedesis — movement of leukocytes between capillary walls cells out of blood and into tissue
B) chemotaxis — chemical degradation inside a phagolysosome
C) abcess — a cavity created by tissue damage and filled with pus
D) pus — tissue debris and dead phagocytes in a white or yellow fluid
E) scab — dried blood clot over injured tissue

chemotaxis - chemical degradation inside a phagolysosome

26) All of the following are part of the mechanism of action of alpha and beta interferons EXCEPT
A) they bind to the surface of uninfected cells.
B) they are effective for long periods.
C) they initiate manufacture of antiviral proteins.
D) they disrupt stages of viral multiplication.
E) they initiate transcription.

they are effective for long periods.

27) The alternative pathway for complement activation is initiated by
A) lipid-carbohydrate complexes and C3.
B) C5C9.
C) antigenantibody reactions.
D) factors released from phagocytes.
E) factors released from damaged tissues.

lipid-carbohydrate complexes and C3.

28) The classical pathway for complement activation is initiated by
A) lipid-carbohydrate complexes and C3.
B) C5C9.
C) antigenantibody reactions.
D) factors released from phagocytes.
E) factors released from damaged tissues.

antigenantibody reactions.

29) Activation of C3a results in
A) acute inflammation.
B) increased blood vessel permeability.
C) opsonization.
D) attraction of phagocytes.
E) cell lysis.

acute inflammation.

30) Neutrophils with defective lysosomes are unable to
A) undergo chemotaxis.
B) migrate.
C) produce toxic oxygen products.
D) attach to microorganisms and other foreign material.
E) engulf microorganisms and other foreign material.

produce toxic oxygen products.

31) Innate immunity includes all of the following EXCEPT
A) phagocytosis.
B) inflammation.
C) production of antibody.
D) production of interferon.
E) activation of complement.

production of antibody.

32) After ingesting a pathogen, lysosomal enzymes produce all of the following EXCEPT
A) complement.
B) O2-.
C) H2O2.
D) OH∙.
E) HOCl.

complement.

33) Activation of C5C9 results in
A) activation of C3.
B) fixation of complement.
C) lysis of microbial cells.
D) phagocytosis.
E) inflammation.

lysis of microbial cells.

34) All of the following are true regarding NK cells EXCEPT
A) they are a type of lymphocyte.
B) they are found in tissues of the lymphatic system.
C) they have the ability to kill infected body cells and some tumor cells.
D) they destroy infected body cells by phagocytosis.
E) they release toxic substances that cause cell lysis or apoptosis.

they destroy infected body cells by phagocytosis.

35) Which of the following is involved in resistance to parasitic helminths?
A) basophils
B) eosinophils
C) lymphocytes
D) monocytes
E) neutrophils

eosinophils

36) Macrophages arise from which of the following?
A) basophils
B) eosinophils
C) lymphocytes
D) monocytes
E) neutrophils

monocytes

37) All of the following pertain to fever EXCEPT that it
A) accelerates microbial growth by increasing iron absorption from the digestive tract.
B) stimulates T lymphocyte activity.
C) is caused by interleukin-1 and TNF-alpha coming into contact with the hypothalamus.
D) intensifies the effect of antiviral interferons.
E) can be initiated by specific types of pathogens.

accelerates microbial growth by increasing iron absorption from the digestive tract.

38) All of the following are iron-binding proteins found in humans EXCEPT
A) lactoferrin.
B) transferrin.
C) hemoglobin.
D) siderophorin.
E) ferritin.

siderophorin.

39) All of the following occur during inflammation. What is the first step?
A) diapedesis
B) margination
C) phagocyte migration
D) repair
E) vasodilation

vasodilation

40) The lectin pathway for complement action is initiated by
A) mannose on host membranes.
B) mannose on the surface of microbes.
C) lectins of the microbe.
D) gram-negative cell walls.
E) gram-positive cell walls.

mannose on the surface of microbes.

41) All of the following are components of the inflammatory process EXCEPT
A) dilation of blood vessels.
B) release of histamines and prostaglandins.
C) chemotaxis.
D) diapedesis.
E) antibody synthesis.

diapedesis.

42) Several inherited deficiencies in the complement system occur in humans. Which of the following would be the MOST severe?
A) deficiency of C3
B) deficiency of C5
C) deficiency of C6
D) deficiency of C7
E) deficiency of C8

deficiency of C3

43) Which of the following statements about the classical pathway of complement activation is FALSE?
A) C1 is the first protein activated in the classical pathway.
B) The C1 protein complex is initiated by antigenantibody complexes.
C) C3 is not involved in the classical pathway.
D) Cleaved fragments of some of the proteins act to increase inflammation.
E) C3b causes opsonization.

C3 is not involved in the classical pathway.

44) Lysozyme and the antibiotic penicillin have similar mechanisms of action in that they both cause damage to the bacterial
A) cell membrane.
B) capsule.
C) cell wall.
D) DNA.
E) ribosomes.

cell wall.

45) Which non-specific defense mechanism is mismatched with its associated body structure or body fluid?
A) lysozyme — tears and saliva
B) mucociliary escalator — intestines
C) very acidic pH— stomach
D) keratin and tightly packed cells — skin
E) cerumen and sebum — ear

mucociliary escalator - intestines

1) The dermis is composed of connective tissue and provides protection from the external environment.

False

2) Microorganisms that are members of the normal microbiota are also known to cause disease.

True

3) Maturation of stem cells into mature blood cells occurs in the red bone marrow.

True

4) The inflammatory response can only be triggered by an infection.

False

5) Histamine and kinins cause increased blood flow and capillary permeability.

True

6) Aspirin alleviates pain, inflammation, and fever by inhibiting prostaglandins.

True

7) Complement proteins act as opsonins by binding to microorganisms and promoting phagocytosis.

False

8) Digestion of microorganisms occurs in phagosomes.

False

9) An example of a TLR would be peptidoglycan found in the cell wall of gram-positive bacteria.

True

10) Ingestion of certain lactic acid bacteria (LABs) has been shown to be beneficial for function and health of the intestinal tract.

True

1) A commensal bacterium
A) does not receive any benefit from its host.
B) is beneficial to its host.
C) may also be an opportunistic pathogen.
D) does not infect its host.
E) is beneficial to, and does not infect, its host.

may also be an opportunistic pathogen.

2) Which of the following statements is TRUE?
A) At least one member must not benefit in a symbiotic relationship.
B) Members of a symbiotic relationship cannot live without each other.
C) A parasite is not in symbiosis with its host.
D) Symbiosis refers to different organisms living together and benefiting from each other.
E) At least one member must benefit in a symbiotic relationship.

At least one member must benefit in a symbiotic relationship.

3) A nosocomial infection is
A) always present, but is inapparent at the time of hospitalization.
B) acquired during the course of hospitalization.
C) always caused by medical personnel.
D) only a result of surgery.
E) always caused by pathogenic bacteria.

acquired during the course of hospitalization.

4) The major significance of Robert Koch's work is that
A) microorganisms are present in a diseased animal.
B) diseases can be transmitted from one animal to another.
C) microorganisms can be cultured.
D) microorganisms cause disease.
E) microorganisms are the result of disease.

microorganisms cause disease.

5) Which of the following is NOT a verified exception in the use of Koch's postulates?
A) Some diseases have poorly defined etiologies.
B) Some pathogens can cause several disease conditions.
C) Some human diseases have no other known animal host.
D) Some diseases are not caused by microbes.
E) Some diseases are noncommunicable.

Some diseasess are noncommunicable.

6. Which of the following diseases is NOT spread by droplet infection?

A) botulism B) tuberculosis C) measles D) the common cold E) diphtheria

botulism

7) Biological transmission differs from mechanical transmission in that biological transmission
A) requires an arthropod.
B) involves fomites.
C) involves specific diseases.
D) requires direct contact.
E) works only with noncommunicable diseases.

involves specific diseases.

8) Which of the following definitions is INCORRECT?
A) endemic: a disease that is constantly present in a population
B) epidemic: a disease that is endemic across the world
C) pandemic: a disease that affects a large number of people in the world in a short time
D) sporadic: a disease that affects a population occasionally
E) incidence: number of new cases of a disease

epidemic: a disease that is endemic across the world

9) Focal infections initially start out as
A) sepsis.
B) bacteremia.
C) local infections.
D) septicemia.
E) systemic infections.

local infections.

10) The rise in herd immunity amongst a population can directly attributed to
A) increased use of antibiotics.
B) improved handwashing.
C) vaccinations.
D) antibiotic-resistant microorganisms.
E) None of the answers is correct.

vaccinations.

11) Koch observed Bacillus anthracis multiplying in the blood of cattle. What is this condition called?
A) bacteremia
B) focal infection
C) local infection
D) septicemia
E) systemic infection

septicemia

12) Which one of the following does NOT contribute to the incidence of nosocomial infections?
A) antibiotic resistance
B) lapse in aseptic techniques
C) gram-negative cell walls
D) lack of handwashing
E) lack of insect control

gram-negative cell walls

13) Transient microbiota differ from normal microbiota in that transient microbiota
A) cause diseases.
B) are found in a certain location on the host.
C) are always acquired by direct contact.
D) are present for a relatively short time.
E) never cause disease.

are present for a relatively short time.

14) Which of the following statements about nosocomial infections is FALSE?
A) They occur in compromised patients.
B) They may be caused by opportunists.
C) They may be caused by drug-resistant bacteria.
D) They may be caused by normal microbiota.
E) The patient was infected before hospitalization.

The patient was infected before hospitalization.

15) One effect of washing regularly with antibacterial agents is the removal of normal microbiota. This can result in
A) body odor.
B) fewer diseases.
C) increased susceptibility to disease.
D) normal microbiota returning immediately.
E) no bacterial growth because washing removes their food source.

increased susceptibility to disease.

16) Which of the following is NOT a reservoir of infection?
A) a sick person
B) a healthy person
C) a sick animal
D) a hospital
E) None of the answers is correct; all of these can be reservoirs of infection.

None of the answers is correct; all of these can be reservoirs of infection.

17) Which of the following is NOT a communicable diseases?
A) malaria
B) AIDS
C) tuberculosis
D) tetanus
E) typhoid fever

tetanus

18) Which of the following is a fomite?
A) water
B) droplets from a sneeze
C) pus
D) insects
E) a hypodermic needle

a hypodermic needle

19) Which of the following statements about biological transmission is FALSE?
A) The pathogen reproduces in the vector.
B) The pathogen may enter the host in the vector's feces.
C) Houseflies are an important vector.
D) The pathogen may be injected by the bite of the vector.
E) The pathogen may require the vector as a host.

Houseflies are an important vector.

20) Which of the following definitions is INCORRECT?
A) acute: a short-lasting primary infection
B) inapparent: infection characteristic of a carrier state
C) chronic: a disease that develops slowly and lasts for months
D) primary infection: an initial illness
E) secondary infection: a long-lasting illness

secondary infection: a long-lasting illness

21) Symptoms of disease differ from signs of disease in that symptoms
A) are changes felt by the patient.
B) are changes observed by the physician.
C) are specific for a particular disease.
D) always occur as part of a syndrome.
E) None of the answers is correct.

are changes felt by the patient.

22) The science that deals with when diseases occur and how they are transmitted is called
A) ecology.
B) epidemiology.
C) communicable disease.
D) morbidity and mortality.
E) public health.

epidemiology.

Figure 14.1



23) Figure 14.1 shows the incidence of influenza during a typical year. Which letter on the graph indicates the endemic level?
A) a
B) b
C) c
D) d
E) The answer cannot be determined based on the information provided.

d

24) Emergence of infectious diseases can be attributed to all of the following EXCEPT
A) antibiotic resistance.
B) climatic changes.
C) new strains of previously known agents.
D) ease of travel.
E) None of the answers is correct; the emergence of infectious diseases can be attributed to all of these.

None of the answers is correct; the emergence of infectious diseases can be attributed to all of these.

25) Which of the following pairs is mismatched?
A) malaria vector
B) salmonellosis vehicle transmission
C) syphilis direct contact
D) influenza droplet infection
E) None of the pairs is mismatched.

None of the pairs is mismatched.

26) Which of the following can contribute to postoperative infections?
A) using syringes more than once
B) normal microbiota on the operating room staff
C) errors in aseptic technique
D) antibiotic resistance
E) All of the answers are correct.

All of the answers are correct.

Figure 14.2



27) In Figure 14.2, when is the prevalence the highest?
A) July
B) January
C) February
D) March
E) The answer cannot be determined based on the information provided.

February

28) A cold transmitted by a facial tissue is an example of
A) direct contact.
B) droplet transmission.
C) fomite.
D) vector.
E) vehicle transmission.

vehicle transmission.

29) A researcher has performed a prospective study on the disease tetanus. To which specific kind of epidemiological study is this referring?
A) analytical
B) case control
C) descriptive
D) experimental
E) prodromal

descriptive

30) The CDC is located in
A) Atlanta, GA.
B) Washington, DC.
C) New York City, NY.
D) Las Angeles, CA.
E) Chicago, IL.

Atlanta, GA.

31) A disease in which the causative agent remains inactive for a time before producing symptoms is referred to as
A) subacute.
B) subclinical.
C) latent.
D) zoonotic.
E) acute.

latent.

32) A needlestick is an example of
A) direct contact.
B) droplet transmission.
C) fomite.
D) vector.
E) vehicle transmission.

fomite.

33) Which of the following is NOT a predisposing factor of disease?
A) lifestyle
B) genetic background
C) climate
D) occupation
E) None of the answers are correct; all of these are predisposing factors of disease.

None of the answers are correct; all of these are predisposing factors of disease.

34) In which of the following diseases can gender be considered a viable predisposing factor?
A) urinary tract infections
B) pneumonia
C) salmonellosis
D) tetanus
E) anthrax

urinary tract infections

35) In which of the following patterns of disease does the patient experience no signs or symptoms?
A) prodromal
B) decline
C) convalescence
D) incubation
E) incubation and convalescence

incubation and convalescence

Situation 14.1
During a six-month period, 239 cases of pneumonia occurred in a town of 300 people. A clinical case was defined as fever ≥39°C lasting \>2 days with three or more symptoms (i.e., chills, sweats, severe headache, cough, aching muscles/joints, fatigue, or feeling ill). A laboratory-confirmed case was defined as a positive result for antibodies against Coxiella burnetii. Before the outbreak, 2000 sheep were kept northwest of the town. Of the 20 sheep tested from the flock, 15 were positive for C. burnetii antibodies. Wind blew from the northwest, and rainfall was 0.5 cm compared with 7 to 10 cm during each of the previous three years.

36) Situation 14.1 is an example of
A) human reservoirs.
B) a zoonosis.
C) a nonliving reservoir.
D) a vector.
E) a focal infection.

a zoonosis.

37) The etiologic agent of the disease in Situation 14.1 is
A) sheep.
B) soil.
C) Coxiella burnetii.
D) pneumonia.
E) wind.

Coxiella burnetii.

38) The method of transmission of the disease in Situation 14.1 was
A) direct contact.
B) droplet.
C) indirect contact.
D) vector-borne.
E) vehicle.

vehicle.

39) Which of the following is NOT an example of microbial antagonism?
A) acid production by bacteria
B) bacteriocin production
C) bacteria occupying host receptors
D) bacteria causing disease
E) bacteria producing vitamin K

bacteria causing disease

40) The yeast Candida albicans does not normally cause disease because of
A) symbiotic bacteria.
B) antagonistic bacteria.
C) parasitic bacteria.
D) commensal bacteria.
E) other fungi.

antagonistic bacteria.

41) If a prodromal period exists for a certain disease, it should occur prior to
A) incubation.
B) illness.
C) decline.
D) convalescence.

illness.

42) Which one of the following is NOT a zoonosis?
A) cat-scratch disease
B) Hantavirus pulmonary syndrome
C) rabies
D) tapeworm
E) None of the answers is correct; all of these are zoonoses.

None of the answers is correct; all of these are zoonoses.

43) Pseudomonas bacteria colonized the bile duct of a patient following his liver transplant surgery. This is an example of a
A) communicable disease.
B) latent infection.
C) nosocomial infection.
D) sporadic disease.
E) None of the answers is correct.

nosocomial infection.

Figure 14.3



44) The graph in Figure 14.3 shows the incidence of polio in the United States. The period between 1945 and 1955 indicates a(n)
A) endemic level.
B) epidemic level.
C) sporadic infection.
D) communicable disease.
E) pandemic.

epidemic level.

45) Which of the following statements is FALSE?
A) Antimicrobial therapy for hemodialysis-associated infections increases antibiotic resistance.
B) S. aureus is differentiated from other mannitol+ cocci by the coagulase test.
C) The M in MRSA stands for mannitol.
D) The USA100 strain accounts for most hospital-acquired MRSA.
E) The USA300 strain accounts for most community-acquired MRSA.

The M in MRSA stands for mannitol..