(Test Bank) Clinical Immunology and Serology

Stevens, 4

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Test Bank

4th Edition

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Test Bank for Clinical Immunology and Serology, The downloadable file consists of 174 pages, and the total size of the file is 1.33 MB. Purchase now only for highly discounted price.

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Clinical Immunology and Serology 4th Edition Stevens Test Bank Chapter 1. Introduction to Immunity and the Immune System Multiple Choice 1. Eosinophils are involved in the immune response against: A. viruses. B. intracellular bacteria. C. parasites that cannot be phagocytized. D. extracellular bacteria. ANS: C 2. Which of the following are components of both innate and adaptive immune responses? A. Immunoglobulins B. T helper cells C. Macrophages D. B cells ANS: C 3. The process by which leukocytes are attracted to a specific area by chemical messengers is called: A. diapedesis. B. degranulation. C. chemotaxis. D. opsonization. ANS: C 4. Which of the following is a characteristic of natural killer cells? A. They mature in the thymus. B. They are smaller than B and T cells. C. They are a type of lymphocyte. D. They are part of the adaptive immune system. ANS: C 5. Which of the following best describes diapedesis? A. Movement toward increasing concentrations of a cytokine B. Attachment of immunoglobulin to target cells C. Movement through blood vessel walls as cells exit the circulation D. Engulfment of target cells ANS: C 6. The most effective phagocytic and antigen -presenting cell is the: A. neutrophil. B. monocyte. C. dendritic cell. D. macrophage. ANS: C 7. Which of the following is characteristic of natural immunity? A. It involves memory. B. T lymphocytes play a major role. C. It involves specificity. D. Mechanisms are always present and fully functional. ANS: D 8. All of the following cells are considered part of natural immunity EXCEPT: A. eosinophils. B. B lymphocytes. C. monocytes. D. neutrophils. ANS: B 9. Where does the specific immune response to a foreign antigen mainly occur? A. Lymph nodes B. Blood C. Bone marrow D. Skin ANS: A 10. Which white cell in the peripheral blood migrates into tissue to become a macrophage? A. Eosinophil B. Basophil C. Neutrophil D. Monocyte ANS: D 11. A white blood cell that is 16 to 18 micrometers in diameter, has a horseshoe -shaped nucleus, and is capable of phagocytosis is a: A. neutrophil. B. eosinophil. C. basophil. D. monocyte. ANS: D 12. Pasteur's discovery that older bacterial cultures would not cause disease in chickens but would protect them from subsequent infection with more virulent strains is an example of: A. attenuated vaccine. B. natural immunity. C. passive immunity. D. cross -immunity. ANS: A 13. Antibodies are secreted by: A. plasma cells. B. B cells. C. T cells. D. dendritic cells. ANS: A 14. Which of the following is characteristic of mucosal -associated lymphoid tissue? A. It is one of the primary lymphoid organs. B. It clears pathogens from the bloodstream. C. It includes the tonsils and the appendix. D. It includes the liver and spleen. ANS: C 15. Acquired (adaptive) immunity can be characterized as: A. nonspecifically activated. B. immediately responsive. C. neutrophil dependent. D. involving memory. ANS: D 16. Which of the following is NOT a characteristic of neutrophils? A. Congregate in the marginating pool in blood vessels B. Capable of diapedesis C. Granules that become bright orange with Wright stain D. Segmented nucleus ANS: C 17. The function of NK cells is to: A. produce antibody. B. phagocytize bacteria. C. present antigen to T cells. D. kill target cells such as tumor and virally infected cells. ANS: D 18. All of the following are involved in adaptive immunity EXCEPT: A. memory. B. lymphocytes. C. specificity. D. neutrophils. ANS: D 19. Which of the following is NOT a characteristic of a lymph node? A. Filters interstitial fluid draining from tissues B. Colonized with T and B cells C. Between 1 and 25 mm in size D. Considered a primary or central lymphoid organ ANS: D 20. All of the following are considered part of natural immunity EXCEPT: A. eosinophils. B. lymphocytes. C. acute -phase reactants. D. neutrophils. ANS: B 21. Macrophages that migrate to the liver are called: A. alveolar macrophages. B. histiocytes. C. microglial cells. D. Kupffer cells. ANS: D 22. Innate immunity can be characterized as: A. specific. B. slow to respond. C. dependent upon neutrophils and macrophages. D. involving memory. ANS: C 23. The ability to resist infection through normally present body functions best characterizes: A. autoimmunity. B. natural immunity. C. acquired immunity. D. alloimmunity. ANS: B 24. Which type of cell has a diameter between 10 and 15 micrometers, has a multi -lobed nucleus, and usually comprises more than 50% of circulating leukocytes? A. Neutrophil B. Lymphocyte C. Basophil D. Monocyte ANS: A 25. Which of the following is NOT a component or charact eristic of natural (innate) immunity? A. Repeated exposure to a pathogen does not change the response. B. The response involves acute -phase reactants. C. The response involves phagocytosis. D. The response involves antibodies. ANS: D 26. T cells are mainly concentrated in which region of the lymph nodes? A. Primary follicles B. Secondary follicles C. Paracortex D. Medulla ANS: C 27. A primary site of antigen trapping and presentation to immune cells is the: A. spleen. B. thymus. C. bone marrow. D. brain. ANS: A 28. Hematopoietic stem cells are located in the: A. lymph nodes. B. spleen. C. bone marrow. D. thymus. ANS: C 29. Which of the following is NOT a characteristic or function of the spleen? A. Removes old red blood cells from the circulation B. Filters infectious agents and foreign matter from the blood C. Less than 25 mm in size D. Is considered a secondary lymphoid organ ANS: C 30. T cells mature in the: A. bone marrow. B. thymus. C. lymph nodes. D. spleen. ANS: B 31. Primary lymphoid organs include which of the following? A. Spleen B. Tonsils C. Thymus D. Lymph nodes ANS: C 32. B cells that are actively responding to antigen can be found in the: A. peripheral blood. B. primary follicles. C. germinal centers. D. bone marrow. ANS: C 33. Contact with antigen and activatTioEn SofTBBcAelNlsKnSorEmLalLlyEoRcc.urCsOinMthe: A. peripheral blood. B. connective tissue. C. thymus. D. lymph nodes. ANS: D 34. Which best describes lymph nodes? A. They line the interior of small blood vessels. B. They are concentrated where appendages join the thorax of the body. C. They are approximately 12 cm in size. D. They are considered primary or central lymphoid organs. ANS: B 35. Which of the following is a characteristic of opsonins? A. They are carbohydrates that stimulate T cells. B. They are molecules that coat bacteria, making them more susceptible to phagocytosis. C. They are expressed on the surface of neutrophils. D. They are produced by NK cells. ANS: B 36. “Cluster of differentiation” refers to: A. a category of cell surface proteins used to identi fy cell types. B. aggregates of differentiating stem cells. C. groups of antigens that identify a cell as foreign. D. the cells that congregate in germinal centers. ANS: A 37. All of the following are commonly found within non-lymphoid tissues EXCEPT: A. B cells. B. macrophages. C. mast cells. D. dendritic cells. ANS: A Matching Match each scientist with the appropriate immunological discovery. A. Elie Metchnikoff B. Edward Jenner C. Emil Von Behring D. Almoth Wright 38. Vaccination 39. Opsonization 40. Humoral immunity 41. Phagocytosis 38. B 39. D 40. C 41. A . Chapter 2. Nature of Antigens and the Major Histocompatibility Complex Multiple Choice 1. An antigenic determinant is also called: A. an immunogen. B. an epitope. C. an antibody. D. a polysaccharide. ANS: B 2. Which of the following would be the most effective immunogen? A. One that is genetically foreign and has a single epitope B. One with a molecular weight of less than 10,000 Da C. One with multiple epitopes with many specificities D. One with multiple epitopes with a single repeated specificity ANS: C 3. A 50-kDa protein from a bacterial cell that has numerous different epitopes would be called: A. a hapten but not an antigen. B. a hapten and an antigen. C. an antigen but not an immunogen. D. an immunogen and an antigen. ANS: D 4. Which of the following molecules is the best immunogen? A. Protein B. Polysaccharide C. Nucleic acid D. Lipid ANS: A 5. Which of the following is a low-molecular -weight molecule that has one binding site for an antibody? A. Antigen B. Hapten C. Immunogen D. Adjuvant ANS: B 6. Which of the following is NOT a characteristic shared by class I and class II MHC molecules? A. Expressed co-dominantly B. Involved in antigen recognition C. Members of the immunoglobulin superfamily D. Expressed constitutively on all nucleated cells ANS: D 7. Antigen recognition by CD4-positive T cells requires: A. class I MHC molecules. B. class II MHC molecules. C. class III MHC molecules. D. no MHC molecules. ANS: B 8. Class II molecules bind to what kind of peptides? A. Native peptides B. Processed exogenous C. Processed endogenous D! Any of the above ANS: B 9. Each class II MHC molecule has specificity for: A. any endogenous peptide. B. related peptides that share a similar peptide sequence. C. one very specific peptide sequence. D. native, conformational epitopes. ANS: B 10. MHC molecules containing beta-2-microglobulin: A. contain alpha and beta transmembrane polypeptides. B. participate in the activation of CD4 T cells. C. are determined by MHC -A, MHC -B, and MHC -C genes. D. are determined by MHC -DR genes. ANS: C 11. The purpose of the invariant chain is to block the peptide -binding site of: A. antibody molecules. B. class II MHC molecules. C. class I MHC molecules. D. T-cell receptors. ANS: B 12. Which of the following is a characteristic of MHC -DR, MHC -DP, and MHC -DQ molecules? A. Antigen receptors on all lymphocytes B. Antigen receptors on T lymphocytes C. Surface alloantigens on liver and kidney cells D. Expressed co -dominantly (maternal and paternal) ANS: D 13. A processed antigen first encounters and binds to MHC class II molecules in the: A. nucleus. B. endoplasmic reticulum. C. endosomal compartment. D. membrane surface. ANS: C 14. A processed antigen first encounters and binds to class I MHC molecules in the: A. nucleus. B. endoplasmic reticulum. C. endosomal compartment. D. membrane surface. ANS: B 15. Endogenous peptides binding to MHC -A, MHC -B, or MHC -C molecules on the surface of hepatocytes are critical for the response by: A. B lymphocytes. B. T helper cells. C. cytotoxic T cells. D. macrophages. ANS: C 16. Which of the following is likely to be the most immunogenic? A. A lipid with a molecular weight of 50,000 Da B. A polysaccharide with a molecular weight of 40,000 Da C. A protein with a molecular weight of 45,000 Da D. A nucleic acid with a molecular weight of 60,000 Da ANS: C 17. Antigens found in different species that trigger a similar antibody response are called: A. heterophile antigens. B. haptens. C. alloantigens. D. autoantigens. ANS: A 18. The term “human leukocyte antigen” is synonymous with: A. allele. B. haplotype. C. major histocompatibility complex. D. chromosome. ANS: C 19. The ability to respond to antigen depends on which of the following factors? A. Age B. Proper nutrition C. Genetic predisposition D! All of the above ANS: D 20. A macromolecule that is capable of eliciting an immune response in an immunocompetent host is called: A. an antigen. B. an antibody. C. a hapten. D. an acute -phase reactant. ANS: A 21. A bacterial antigen to which the human immune system responds would be classified as: A. an autoantigen. B. an alloantigen. C. a heteroantigen. D. a holoantigen. ANS: C 22. Which option best describes a finding of Landsteiner's study of haptens? A. Similar haptens trigger the same antibody response. B. Spatial configuration is recognized by antibody. C. Small chemical changes to a hapten do not affect antibody response. D. A hapten can react with many different antibodies. ANS: B 23. Naturally occurring anti-A and anti-B antibodies are thought to be the result of exposure to which of the followi ng? A. Heterophile antigens B. Haptens C. Alloantigens D. Autoantigens ANS: A 24. A substance that is too small to stimulate antibody production by itself unless it is attached to a larger carrier molecule is called: A. an autoantigen. B. a cross -reacting antigen. C. a hapten. D. an alloantigen. ANS: C 25. A determinant site on an antigen that is produced by the folding of the primary chain is known as a: A. conformational epitope. B. linear epitope. C. hapten. D. monovalent epitope. ANS: A 26. If a person has a reaction to poison ivy, this is caused by: A. a hapten complexing with a tissue protein. B. a heterophile antigen. C. a T-independent antigen. D. exposure to an adjuvant. ANS: A 27. Aluminum salt in the hepatitis vaccine functions as: A. a hapten. B. an adjuvant. C. an immunogen. D. a carrier. ANS: B 28. In antigen processing, the functiTonEoSf TtraBnAspNorKteSrsEaLssLocEiaRte.dCwOithMantigen-processing proteins is to: A. help digest large proteins. B. bind to MHC class II molecules in the endoplasmic reticulum. C. transport digested proteins to MHC class I molecules. D. recognize and digest exogenous protein. ANS: C 29. A substance used to enhance antibody formation is called: A. a hapten. B. an adjuvant. C. an immunogen. D. a carrier. ANS: B 30. MHC class I antigens are recognized by which of the following cells? A. CD4+ T cells B. CD8+ T cells C. B cells D. Macrophages ANS: B 31. Characteristics of MHC class II molecules include which of the following? A. Interact with CD8+ T cells B. Have an alpha chain and beta-2 microglobulin C. Have alpha and beta chains of approximately equal size D. Combine with antigen made inside the cell ANS: C 32. If a mother is MHC A3A14/B5B15/Cw3Cw4 and her child is A3A9/B5B27/Cw4Cw7, which of the following men is the most likely candidate for the father? A. A5A9/B5B27/Cw3Cw7 B. A9A11/B15B21/Cw1Cw4 C. A4A15/B2B27/Cw1Cw5 D. A5A9/B17B27/Cw3Cw5 ANS: A 33. Which option best describes MHTCEcSlaTssBIAanNtiKgeSnEs?LLER.COM A. They are recognized by helper T cells. B. They are found on all nucleated cells. C. They combine with exogenous antigen. D. They are coded for on chromosome 9. ANS: B 34. The antigens that bind MHC class II antigens are first “processed” by: A. the proteasome. B. the endoplasmic reticulum. C. transporters associated with antigen processing. D. enzymes in the endosome. ANS: D 35. Characteristics of heterophile antigens include which of the following? A. Found in unrelated plants or animals but cross -react with the same antibody B. One's own self-antigens C. Any antigens used for immunization D! All of the above ANS: A 36. Which of the following must be matched between donor and recipient as closely as possible to avoid rejection of a tissue transplant? A. Haptens B. MHC molecules C. Transporters associated with antigen processing D. Beta-2 microglobulins ANS: B 37. All of the following are characteristics of a strong immunogen EXCEPT: A. it is a large molecule. B. it is foreign to the host. C. it is a repeating polymer. D. it is protein in nature. ANS: C 38. MHC class I protein is found on: A. red blood cells. B. all nucleated cells. C. B cells and macrophages only. D. stem cells only. ANS: B 39. The inheritance of certain MHC antigens can result in which of the following? A. Increased resistance to certain infectious organisms B. Predisposition to particular autoimmune diseases C. Diminished immune responses to particular antigens D! All of the above ANS: D 40. T cells are capable of recognizing: A. conformational epitopes. B. native (nondegraded) peptides. C. degraded peptides. D. haptens. ANS: C Chapter 3. Innate Immunity 1. Which of the following is an acute -phase protein? A. Serum amyloid A B. Streptolysin O C. Cardiolipin D. Reagin ANS: A 2. Which of the following is directly used in oxidative killing of target cells? A. Hydrogen peroxide B. Lysozyme C. Defensin D. TNF -alpha ANS: A 3. Serum proteins that increase in concentration within 24 to 48 hours of the onset of infection or injury are called: A. reagins. B. immunoglobulins. C. complement proteins. D. acute -phase proteins. ANS: D 4. Which of the following can be measured as an indicator of inflammation? A. Body temperature B. Number of circulating leukocytes C. Erythrocyte sedimentation rate D! All of these ANS: D 5. Macrophages use all of the following to kill bacteria EXCEPT: A. hydrogen peroxide. B. perforin. C. hydroxyl radical. D. lysozyme. ANS: B 6. Which is a characteristic of circulating neutrophils? A. Kill cells with granzymes B. Membranes express antigen -specific receptors C. Membranes express pathogen -recognition receptors D. Activated by alpha -1 antitrypsin ANS: C 7. Acute -phase reactants are elevated in a patient’s serum. What does this result, on its own, indicate about the patient? A. Inflammation of an unknown cause is present. B. The patient has a leukemia but not a lymphoma. C. The patient has a bacterial infection. D. There is a parasitic infection and not a viral infection. ANS: A 8. The phagosome of a macropha ge TisEaSmTemBbArNanKe-SboEuLndLvEeRsi.cleCtOhaMt contains: A. enzymes. B. reactive oxygen intermediates. C. ingested pathogens. D. perforin and granzymes. ANS: C 9. Oxidative killing involves which of the following? A. Perforin and granzymes B. Activation of complement C. Direct cytokine -mediated killing D. The hexose monophosphate shunt ANS: D 10. Macrophages recognize target cells using which of the following? A. MHC class I molecules B. Toll-like receptors C. Antigen -specific receptors D. Killer cell inhibitory receptors ANS: B 11. Which of the following occurs during the oxidative burst? A. A decrease in oxygen consumption B. Pseudopodia extending around a particle C. The release of granules from a cell D. Increased release of carbon dioxide ANS: B 12. Which of the following is part of the external defense system? A. Ceruloplasmin B. Skin C. Neutrophils D. Complement ANS: B 13. What is the major function of C-reactive protein? A. Opsonization B. Binding hemoglobin C. Causing vasodilation D. Promoting clot formation ANS: A 14. Which acute -phase reactant is an important clotting factor? A. Haptoglobin B. Ceruloplasmin C. Fibrinogen D. Alpha -2 macroglobulin ANS: C 15. Which substance best inactivates bacterial proteins? A. Nicotinamide adenine dinucleotide phosphate B. Oxygen C. Hypochlorite D. Lactic acid ANS: C 16. All of the following are characteristic of acute -phase reactants EXCEPT: A. they are constituents that increase rapidly in response to infection. B. they are used to diagnose a specific disease. C. they enhance phagocytosis. D. they limit destruction of host tissue. ANS: B 17. What is the function of the acute -phase protein haptoglobin? A. Acts as an opsonin B. Forms clots C. Binds hemoglobin D. Acts as a chemotaxin ANS: C 18. All of the following occur during the process of inflammation EXCEPT: A. increased capillary permeability. B. migration of basophils away fromTtEisSsuTe.BANKSELLER.COM C. increase in blood flow. D. swelling and pain. ANS: B 19. The defense mechanism carried out by natural killer cells involves: A. recognition of a specific antigen. B. MHC class II –mediated killing. C. perforin - and granzyme -mediated killing. D. phagocytosis. ANS: C 20. The internal defense system includes which of the following? A. Cilia B. Mucous membranes C. Acute -phase reactants D. Acidity of the skin ANS: C 21. All of the following are part of the process of phagocytosis EXCEPT: A. formation of a phagosome. B. creation of hypochlorite radicals. C. diapedesis. D. fusion of lysosome with phagosome. ANS: C 22. Which enzyme is part of the external defense system? A. Lysozyme B. Elastase C. Myeloperoxidase D. Superoxide dismutase ANS: A 23. All of the following are considered acute -phase reactants EXCEPT: A. fibrinogen. B. complement. C. C-reactive protein. D. TNF -alpha. ANS: D 24. Which is a characteristic of resident bacteria (microbiota) in the gastrointes tinal tract? A. Develop when a person has an immunodeficiency B. Consist of a single species that is tolerated by the host C. Supplant pathogenic bacteria D. Cause gastrointestinal disease ANS: C 25. Which of the following binds to CD16 on the surface of natural killer cells? A. MHC class I B. Fc of IgG C. T-cell receptor D. Antigenic peptide ANS: B 26. Natural killer cells recognize and kill abnormal host cells that are: A. opsonized with IgE. B. lacking expression of MHC class I. C. expressing MHC class I. D. presenting antigen bound to MHC class II. ANS: B 27. Granzymes activate which of the following in a target cell? A. Phagocytosis B. Apoptosis C. Cytokine secretion D. Complement activation ANS: B 28. The killing mechanism of natural killer cells is regulated by: A! inhibitory receptors. B! activating receptors. C! both inhibitory and activating receptors. D! none of the above. ANS: C 29. Inappropri ately administered antibiotic therapy can sometimes cause disease, most often by: A. eliminating normal protective flora. B. altering local pH. C. being toxic to host tissues. D. depressing adaptive immune responses. ANS: A 30. Toll-like receptors bind to: A. cytokines. B. the Fc portion of IgG. C. acute -phase proteins. D. pathogen -associated molecular patterns. ANS: D 31. Which of the following have the highest concentrations of Toll-like receptors? A. B-cells B. Monocytes C. Natural killer cells D. T cells ANS: B 32. Patients with chronic granulomatous disease have neutrophils that cannot kill bacteria because they: A. cannot phagocytize bacteria. B. do not have granules containing antibacterial enzymes. C. cannot produce superoxide. D. cannot migrate to the site of infection. ANS: C 33. Which enzyme protects host cells rather than destroying invading cells? A. Alpha -1 antitrypsin B. Lysozyme C. Granzyme D. Myeloperoxidase ANS: A 34. Although antibodies are generally regarded as part of the adaptive immune system, they can enhance the function of which innate process(es)? A! Phagocytosis (via opsonization) B! Natural killer cell cytotoxicity C! Both phagocytosis (via opsonization) and natural killer cell cytotoxicity D! None of the above ANS: C 35. Toll-like receptors and C-type lectin receptors are examples of: A. pathogen -recognition receptors. B. antigen receptors. C. Fc receptors. D. killer inhibitory receptors. ANS: A 36. After a macrophage phagocytizes, kills, and digests a microbe: A. all of the microbial debris is expelled by exocytosis. B. some microbial peptides are bound by MHC class II. C. some microbial peptides are bound by Fc. D. all of the microbial peptides are broken down into amino acids that are recycled by the macrophage into new proteins. ANS: B 37. C-reactive protein, complement components, and antibodies are all: A. acute -phase reactants. B. enzymes. C. pathogen -recognition receptors. D. opsonins. ANS: D 38. Proteins that form channels in target cell membranes are called: A. perforins. B. granzymes. C. opsonins. D. pentraxins. ANS: A 39. For diapedesis to occur: A. CD16 receptors must be bound. B. microbes must be phagocytized. C. endothelial cells must contract. D. NADPH must be activated. ANS: C 40. Oxygen -independent bacterial killing in the phagolysosome involves: A. hypochlorite. B. pH-activated defensins. C. opsonins. D. pentraxins. ANS: B Chapter 4. Adaptive Immunity Multiple Choice 1. T cells that respond against self -antigens are inactivated by: A. binding to immunoglobulin. B. intermediate -strength binding to self MHC. C. apoptosis. D. positive selection. ANS: C 2. A cell that can recall previous contact with a particular antigen so that subsequent exposure leads to a more rapid and more effective immune response than the first encounter is which type of cell? A. Memory lymphocyte B. Effector lymphocyte C. Plasma cell D. Stem cell ANS: A 3. Immunoglobulin gene rearrangements occur in which stage of B-cell development? A. Pro-B cell B. Pre-B cell C. Immature B cell D. Mature B cell ANS: A 4. The purpose of negative selection of B cells is to: A. eliminate B cells that don't express mu. B. prevent activation of B cells in the bone marrow. C. direct more B cells to become plasma cells. D. eliminate B cells that are specific for self-antigens. ANS: D 5. When IgM on the surface of an immature B cell binds to a self -antigen, which of the following processes can occur? A. Class switching B. Affinity maturation