Click card # to mark/un-mark cardmark allun-mark all # Front Side Back Side

Using Figure 21.1, match the following: 1) Heavy chain. Answer: B 2) Light chain. Answer: D 1 3) Variable region. Answer: C 4) Constant region. Answer: E 5) Antigenbinding site. Answer: A

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Back Side Using Figure 21.2, match the following: 6) Area where B cells become immunocompet ent. Answer: C 7) Area where T cells become immunocompet ent. Answer: B 8) Area where activated immunocompet ent B and T cells recirculate. Answer: E 9) Area seeded by immunocompet ent B and T cells. Answer: D 10) Area where antigen challenge and clonal selection are most likely to occur. Answer: D 11) First line of defense. D

Match the following: 3 A) Inflammatory response and skin and mucous membranes B) Immune response C) Inflammatory response D) Intact skin and mucous membranes

12) Second line of defense. C 13) Third line of defense. B 14) Innate defense system. A

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Back Side 15) Adaptive defense system. B 16) Small proteins secreted by virus-containing cells. Answer: A 17) Major innate mechanism that mediates destruction of foreign substances in the body. Answer:C 18) Stimulate the proliferation of other lymphocytes. Answer: D 19) Dampen the activity of both T cells and B cells. Answer:B 20) Present the double activation signal to T cell Answer: E 21) Main antibody of both primary and secondary immune response. Answer: A 22) Protects mucosal

Match the following: A) Interferon B) Regulatory T cells 4 C) Complement D) Helper T cells E) APCs

Match the following: A) IgG 5 B) IgD C) IgE D) IgA E) IgM

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Back Side barriers. Answer: D 23) Involved in allergies. Answer: C 24) Along with IgM, this is a B cell receptor. Answer: B 25) Activates complement. Answer: E

Multiple-Choice Questions 1) Which of the following is characteristic of antibodies? A) carbohydrate structure B) composed of heavy and light polypeptide chains C) three binding sites per antibody monomer D) incapable of being transferred from one person to another 2) Which of the following is associated with passive immunity? A) exposure to an antigen B) infusion of weakened viruses C) passage of IgG antibodies from a pregnant mother to her fetus D) booster shot of vaccine 3) Which of the following is not a type of T cell? A) cytotoxic B) antigenic C) helper D) regulatory 4) B lymphocytes develop immunocompetence in the ________. A) thymus B) spleen C) bone marrow D) lymph nodes 5) Which of the following is not a function of the inflammatory response? A) prevents the spread of the injurious agent to nearby tissue B) replaces injured tissues with connective tissue C) disposes of cellular debris and pathogens D) sets the stage for repair processes 6) The redness and heat of an inflamed area are due to a local hyperemia caused by ________. A) vasodilation B) vasoconstriction

Answer: B

Answer: C

Answer: B

Answer: C

1 0

Answer: B

1 1

Answer: A

Front Side C) phagocyte mobilization D) production of complement and interferon 7) The antibody molecule is held together by ________ bonds. A) disulfide B) hydrogen C) amino acid D) sodium 8) In clonal selection of B cells, which substance is responsible for determining which cells will eventually become cloned? A) antigen B) interferon C) antibody D) complement 9) Which of the following statements regarding NK cells is a false or incorrect statement? A) NK cells are a type of neutrophil. B) NK cells are present in the blood, spleen, lymph nodes, and red bone marrow. C) NK cells attack cells that display abnormal MHC antigens. D) NK cells attack cancer cells and virus-infected body cells. 10) The process whereby neutrophils and other white blood cells are attracted to an inflammatory site is called ________. A) diapedesis B) chemotaxis C) margination D) phagocytosis 11) Small molecules that bind with self-proteins to produce antigenic substances are called ________. A) haptens B) antibodies C) ions D) reagins 12) Which of the following is the correct sequence of events in phagocytosis? A) adherence, digestion, killing, ingestion, chemotaxis B) chemotaxis, ingestion, digestion, adherence, killing C) chemotaxis, adherence, ingestion, digestion, killing D) ingestion, adherence, chemotaxis, digestion, killing 13) The only T cells that can directly attack and kill other cells are the ________. A) regulatory cells B) helper cells C) cytotoxic cells D) plasma cells 14) Which of the following does not respond to cell-mediated immunity? A) intracellular pathogens that reside within host cells B) some cancer cells

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1 2

Answer: A

1 3

Answer: A

1 4

Answer: A

1 5

Answer: B

1 6

Answer: A

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Answer: C

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Answer: C

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Answer: D

Front Side C) foreign tissue transplants D) pathogens in the CNS 15) ________ predominate at the sites of chronic infections. A) Basophils B) Eosinophils C) Macrophages D) B cells 16) Interferons ________. A) are virus-specific, so that an interferon produced against one virus could not protect cells against another virus B) act by increasing the rate of cell division C) interfere with viral replication within cells D) are routinely used in nasal sprays for the common cold 17) ________ determine(s) what specific foreign substances our adaptive immune system will be able to recognize and resist. A) The type of antigen B) Memory cell production C) Enzymes present at the time of the invasion D) Our genes 18) Regulatory T cells ________. A) release cytokines that increase the activity of cytotoxic T cells and activated B cells B) decrease their activity as antigenic stimulus decreases C) may function in preventing autoimmune reactions D) are the most thoroughly understood T cells 19) Select the correct definition about tissue grafts. A) Isografts are between identical twins. B) Allografts are between different species. C) Xenografts are between individuals of the same species. D) Autografts are between two genetically identical individuals. 20) Which of the statements below does not describe antigens? A) Antigens exhibit immunogenicity and reactivity. B) Antigens only come from microbes. C) The parts of antigen molecules that initiate immune responses are called epitopes or antigenic determinants. D) Antigens can include proteins, nucleic acids, lipoproteins, glycoproteins, and certain large polysaccharides. 21) ________ are released by activated T cells and macrophages to mobilize immune cells and attract other leukocytes into the area. A) Cytokines B) Perforins C) Interleukin 1 proteins D) Interleukin 2 proteins 22) Which of the following is a part of the second line of defense against microorganisms? A) keratin B) cilia

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2 0

Answer: C

2 1

Answer: C

2 2

Answer: D

2 3

Answer: C

2 4

Answer: A

2 5

Answer: B

2 6

Answer: A

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Answer: D

Front Side C) gastric juice D) phagocytes 23) Which of the following is characteristic of complete antigens? A) small molecules B) reactivity with an antibody C) contain many repeating chemical units D) inhibit production of antibodies 24) B cells respond to the initial antigen challenge by ________. A) reducing its size B) immediately producing antigen-specific antibodies C) forming of a large number of cells that are unlike the original B cell D) producing progeny cells that include plasma cells and memory cells 25) Graft rejection may be caused by ________. A) using a xenograft B) use of immunosuppressive drugs C) treatment with antilymphocyte serum D) total body irradiation 26) Cancer cells and virus-infected body cells can be killed before activation of adaptive immunity by ________. A) natural killer cells B) T lymphocytes C) B lymphocytes D) pinocytosis 27) Complement proteins and antibodies coat a microorganism and provide binding sites, enabling macrophages and neutrophils to phagocytize the organism. This phenomenon is termed ________. A) diapedesis B) agglutination C) opsonization D) chemotaxis 28) Which of the following is not characteristic of the adaptive immune system? A) It is antigen-specific. B) It is systemic. C) It has memory. D) It is specific for a given organ. 29) Monoclonal antibodies are used for the diagnosis of all of the following except ________. A) juvenile diabetes B) hepatitis C) rabies D) pregnancy 30) Which of the following would be classified as a delayed hypersensitivity reaction? A) immune complex hypersensitivity B) anaphylaxis C) cytotoxic hypersensitivity

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2 8

Answer: B

2 9

Answer: D

3 0

Answer: A

3 1

Answer: A

3 2

Answer: C

3 3

Answer: D

3 4

Answer: A

3 5

Answer: D

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D) allergic contact dermatitis 31) Innate immune system defenses include ________. A) B cells B) T cells Answer: D C) plasma cells D) phagocytosis 32) Which of the following statements is incorrect or false? A) Haptens lack immunogenicity unless attached to protein carriers. B) Class 1 MHC molecules are built into the plasma membranes of all body cells. Answer: C C) Class II MHC molecules appear only on the surface of antigenpresenting cells, thymic cells, and T cells that have been activated by exposure to antigens. D) MHC proteins are the cells identity markers. 33) Phagocyte mobilization involves ________. A) diapedesis, during which cells line up against the capillary wall B) margination, which is the process of white cell movement through the Answer: C walls of capillaries into injured tissues C) mainly neutrophil and macrophage migration into inflamed areas D) monocytes as the most active phagocyte 34) Fever ________. A) is a higher-than-normal body temperature that is always dangerous B) decreases the metabolic rate of the body to conserve energy C) production is regulated by chemicals that reset the body's thermostat Answer: C to a higher setting D) causes the liver to release large amounts of iron, which seems to inhibit bacterial replication 35) Immunocompetence ________. A) occurs in one specific organ of the adaptive immune system B) is the ability of individual cells to recognize a specific antigen by binding to it Answer: B C) prevents intercellular communication so that only specific cell types respond to the invader D) requires exposure to an antigen 36) Select the correct statement about the prevention of immune attack on "self." A) The development of tolerance is specific to B cells only. B) Neutrophils capable of binding to self-antigens are chemically Answer: D inactivated. C) Tolerance to self is due to the action of foreign antigens that inactivate the immune response to one's own tissues. D) Tolerance is developed during fetal life. 37) Select the correct statement about active and passive immunity. A) Immunological memory is established by passive immunization. B) A vaccination is an example of the introduction of passive immunity Answer: D into the body. C) The antibodies utilized in active immunity are acquired from another

Front Side organism. D) Active and passive humoral immunity are both mechanisms of adaptive immunity that use antibodies. 38) Cytotoxic T cells ________. A) are the only T cells that can directly attack and kill other cells B) require the double recognition signal of I MHC plus II MHC on the target cell in order to function C) function mainly to stimulate the proliferation of other T cell populations D) self-destruct once the antigen has been neutralized 39) Helper T cells ________. A) bind tightly to target cells and release a lymphotoxin called perforin B) often function to decrease the immune response C) release B7 proteins D) function in the adaptive immune system activation 40) Select the correct statement about immunodeficiency. A) Severe combined immunodeficiency (SCID) disease is an acquired condition. B) The causative agent in acquired immune deficiency syndrome (AIDS) is a virus that recognizes CD4 proteins. C) Hodgkin's disease is a hereditary immunodeficiency found in children. D) The most common form of immunodeficiency is graft-versus-host (GVH) disease. 41) Which of the following is true of immediate hypersensitivities? A) They are also called type IV hypersensitivities. B) They are are adaptive immune responses to disease organisms. C) They include allergic contact dermatitis. D) They involve IgE antibodies and the release of histamine from mast cells and basophils. 42) Delayed hypersensitivities ________. A) are mediated by B cells B) include allergic contact dermatitis C) include anaphylactic shock, a systemic vasodilation that results in inadequate blood delivery to all tissues D) do not involve T cells 43) Natural killer (NK) cells ________. A) are also called cytotoxic T cells B) are a type of phagocyte C) are cells of the adaptive immune system D) can kill cancer cells before the immune system is activated 44) Select the correct statement about antigens. A) "Self-antigens" is another name for incomplete antigens. B) The largest type of antigen is called a hapten. C) Only small antigens exhibit reactivity. D) One antigen may have many different antigenic determinants and may therefore cause the formation of more than one antibody. 45) Clonal selection of B cells ________.

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4 3

Answer: A

4 4

Answer: D

4 5

Answer: B

4 6

Answer: D

4 7

Answer: B

4 8

Answer: D

4 9

Answer: D

Answer: B

# Front Side 0 A) occurs during fetal development B) results in the formation of plasma cells C) cannot occur in the presence of antigens D) only occurs in the secondary immune response 46) The primary immune response ________. A) occurs more rapidly and is stronger than the secondary response 5 B) occurs when memory cells are stimulated 1 C) is another name for immunological memory D) has a lag period while B cells proliferate and differentiate into plasma cells 47) Select the correct statement about the function of antibodies. A) Antibodies may directly destroy "invaders." B) Neutralization is the process by which antibodies cause invading cells 5 to clump together. 2 C) Complement fixation is the main mechanism by which antibodies provide protection. D) The most potent agglutinating agent is IgG. 48) Which of the following cells is the most critical cell in immunity? A) B cell 5 B) helper T cell 3 C) cytotoxic T cell D) APC 49) Which of the following is not an autoimmune disease? A) multiple sclerosis 5 B) type II diabetes 4 C) systemic lupus erythematosus D) glomerulonephritis 50) Which of the following is not a mechanism for the development of autoimmune disorders? A) exposure of previously "hidden" self-antigens to the adaptive immune system 5 B) a second exposure to an allergen 5 C) mutation followed by the appearance of membrane proteins not previously present D) cross-reaction of antibodies formed against foreign antigens with selfantigens 51) Select the correct statement about complement. A) An adaptive immune mechanism is often involved in directing complement to its target. B) Complement can be activated through three pathways: classical, 5 secondary, and alternate. 6 C) The membrane attack complex consists of complement proteins C3a through C5. D) Complement proteins C1 through C9 act exclusively in the classical pathway. 5 52) Which of the following is true about the number of binding sites per 7 functional antibody unit?

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Answer: D

Answer: C

Answer: B

Answer: B

Answer: B

Answer: A

Answer: D

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6 1

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Front Side A) IgD contains 4 binding sites. B) IgA contains 6 binding sites. C) IgG contains 6 binding sites. D) IgM contains 10 binding sites. 53) Antibody functions include all of the following except ________. A) binding and inactivating chemical toxins released by bacteria or other microorganisms B) cross-linking cell-bound antigens on red blood cells when blood types are properly matched C) linking soluble antigens together so that they fall out of solution D) targeting foreign cells so that complement proteins can cause cellular lysis 54) Which statement is true about T cells? A) They usually directly recognize antigens, which then activates a subpopulation of killer cells. B) Their proliferation is enhanced by interleukins 1 and 2. C) Once activated, they cannot secrete cytokines. D) They will develop into cytotoxic T cells if antigen is complexed with class II MHC proteins. 55) Toll-like receptors (TLRs) trigger the release of ________ to attract white blood cells to the scene. A) cytokines B) histamine C) prostaglandins D) complement 56) Which of the following is not a method by which antibodies work? A) neutralizing antigen B) activating cytokines C) enhancing phagocytosis D) agglutinating and precipitating antigen 57) What is the role of interferon in defense against disease? A) protects cells that have not yet been infected by viruses B) protects cells that have not yet been infected by bacteria C) activates the complement mechanism D) activates the inflammatory process 58) Which of the following statements is a false or incorrect statement? A) The lymphoid organs where lymphocytes become immunocompetent are called primary lymph organs. All other lymphoid organs are referred to as secondary lymphoid organs. B) It is our genes, not antigens, that determine what specific foreign substances our immune system will be able to recognize and resist. C) After becoming immunocompetent, the naive T cells and B cells are exported to the bone marrow where the encounters with antigens occur. D) T cells and B cells become fully immunocompetent when they bind with recognized antigens. Fill-in-the-Blank/Short Answer Questions

Back Side

Answer: B

Answer: B

Answer: A

Answer: B

Answer: A

Answer: C

Answer: Xenografts

Front Side Back Side 1) ________ are grafts taken from another animal species. 6 2) Pure antibody preparations specific for a single antigenic determinant Answer: 5 are called ________ antibodies. monoclonal 6 Answer: 3) ________ is the most common type of immediate hypersensitivity. 6 Allergy 6 4) ________ cells can lyse and kill cancer cells and virus-infected body Answer: Natural 7 cells before the immune system is activated. killer 5) ________ is a dangerous condition where the cytokines are released 6 Answer: Septic unchecked, making the capillaries very leaky and thus depleting blood 8 shock or Sepsis fluids. 6 Answer: 6) Harmful or disease-causing microorganisms are called ________. 9 pathogens 7) ________ refers to a group of at least 20 plasma proteins that normally 7 Answer: circulate in an inactive state and are a major mechanism for destroying 0 Complement foreign substances in the body. 7 8) The antibody that becomes bound to mast cells and basophils and Answer: IgE 1 causes the cells to release histamine and other chemicals is ________. 7 9) A(n) ________ is a cell hybrid formed from the fusion of tumor cells Answer: 2 and B lymphocytes. hybridoma 7 10) ________ cells are the only T lymphocytes that can directly attack Answer: 3 and kill other cells. Cytotoxic T Answer: 7 11) ________ is an autoimmune disease that severely impairs renal Glomerulonephr 4 function. itis Answer: Innate body defenses to disease include surface membrane barriers, such as the skin and mucous membranes, as the first line of 7 defense. Not 12) List and briefly discuss innate body defenses to disease. 5 only do the skin and mucous membranes act as a physical barrier to microorganisms , but they also secrete chemicals such as saliva, sebum, mucus,

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7 13) What are monoclonal antibodies? How are they produced, and what 6 are some of their clinical uses?

Back Side and HCl that kill microorganisms . Innate cellular defenses include the use of phagocytes and natural killer cells. Inflammation occurs in response to injury. The inflammation response includes vasodilation, increased vascular permeability, and phagocyte mobilization. Antimicrobial substances such as interferon and complement are also produced as innate defenses by the body. Answer: Monoclonal antibodies are pure antibody preparations that exhibit specificity for a single antigenic determinant. They are produced from the progeny of a single B cell hybridoma "clone," prepared by injecting a specific antigen

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7 14) What is the antigen challenge, and where does it usually take place? 7

7 15) Why are regulatory T cells important to the immune process? 8

Back Side into a lab animal and then harvesting sensitized B cells from its spleen. The cells are mixed with myeloma cells and incubated, and the resulting hybridoma cells (B cells fused with myeloma cells) produce the monoclonal antibody. They are used for the diagnosis of pregnancy, certain sexually transmitted diseases, hepatitis, rabies, and for other purposes. Answer: The antigen challenge is the first encounter between an immunocompet ent lymphocyte and an invading antigen. It usually takes place in the spleen or a lymph node, but may happen in any lymphoid tissue. Answer: They are vital in the final stopping of an immune response after the antigen is

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16) What is the most likely type of hypersensitivity associated with an 7 agonizingly itchy case of poison ivy, appearance of hives after eating 9 shellfish, or a positive TB test?

8 17) Children born without a thymus must be kept in a germ-free 0 environment if they are to survive. Explain why this is necessary.

8 18) What are the signs of inflammation, and how does inflammation 1 serve as a protective function?

Back Side inactivated. They may also help prevent autoimmune reactions. Answer: The hypersensitivity associated with poison ivy is delayed hypersensitivity allergic contact dermatitis. The hypersensitivity associated with hives is a local anaphylactic reaction. The hypersensitivity associated with a positive TB test is delayed hypersensitivity. Answer: If the thymus fails to develop, the T cells will not mature and become immunocompet ent. If T cell function is disrupted, there is no resistance to disease. Answer: The four signs of inflammation are swelling, redness, heat, and pain. The signs are caused by local vasodilation and increased capillary permeability. This is of

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Back Side benefit because the process helps to dilute harmful substances that may be present; brings in large quantities of oxygen, nutrients, and cells necessary for the repair process; and allows the entry of clotting proteins. Pain helps immobilize the injury. Answer: Multiple sclerosis, myasthenia gravis, Graves' disease, juvenile 19) Name four autoimmune diseases. (type I) diabetes, systemic lupus erythematosus, glomerulonephri tis, rheumatoid arthritis. Answer: 1) Appearance of new selfproteins in the circulation that have not 20) What are two general mechanisms by which autoimmune diseases previously been could arise? exposed to the immune system. 2) An immune response to foreign antigens resembling selfantigens. 21) Elderly people tend to develop cancer more frequently than younger Answer: As one people. Give an explanation for this observation that relates to immune ages, the

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8 5

8 6

Back Side function. efficiency of the immune system begins to decline. This may allow cancer to become established more easily. Answer: The inoculations are required to try to prevent epidemics of these microbiological infections. The inoculations are of great benefit in preventing 22) Why do schools require inoculations for childhood diseases such as the diseases mumps, measles, and whooping cough? Why are the inoculations of because the value? vaccines cause immunity to the pathogens by stimulating both the formation of protective antibodies and the establishment of immunological memory against future infection Answer: The wound has become infected, probably with bacteria. The 23) Tom gets a cut on his hand. After several days he notes swelling, initial pain, heat, and redness. Upon opening the wound to relieve the pressure, symptoms the presence of pus is noted. What has happened to the wound? indicate acute inflammation. Pus indicates the presence of dead or dying neutrophils,

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Back Side broken-down tissue cells, and living and dead pathogens. Answer: The effects are short lived; it does not trigger 24) What are some of the drawbacks of passive humoral immunity? memory cell production; and your body degrades the antibodies. Answer: He is probably suffering from Clinical Questions AIDS. His outlook is poor 1) A 36-year-old man enters the hospital in an extremely debilitated once the disease condition. He has purple-brown skin lesions (a symptom of Kaposi's has progressed sarcoma) and a persistent cough. A physical examination reveals swollen to this advanced lymph nodes, and laboratory tests find a very low lymphocyte count. stage. There is Information taken during the personal history reveals that he has multiple no cure and sex partners with whom he frequently engages in unprotected sex. What drug therapy has is likely to be the man's problem and what is his outlook? had limited short-term success. Answer: The ABO and other blood group antigens of the donor and recipient must be determined. Next, donor and recipient tissues are matched as 2) A young girl requires a liver transplant due to failure of her liver to closely as function. What is required for her to have a good prognosis and why? possible. Following surgery she must receive immunosuppres sive therapy to keep her body from rejecting the new liver as foreign tissue.

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3) A woman comes into the hospital emergency room complaining that 9 she is having problems swallowing and her neck is swelling. She was 0 involved in an automobile accident a couple days ago but only bruised her neck. What could be the problem?

4) Max is bitten by a rattlesnake while on a camping trip. His friends 9 immediately apply ice packs to the bitten area to slow the spread of the 1 protein-based toxin; they then rush him to an emergency facility. What treatment would be given and why?

Back Side Answer: The woman is suffering from Hashimoto's thyroiditis. The automobile accident injured the thyroid gland and released thyroidglobulin into the bloodstream. The immune system has mounted an attack on the thyroid gland. Answer: Max could be given an immune serum to the rattlesnake venom, thereby conferring passive immunity. The reason for passive immunization is that the venom could kill the person before active immunity could be established. The passive immunity would last until the "borrowed" antibodies naturally degraded in the body. No immunological memory would be established because B cells

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Back Side are not activated. Answer: A mild or moderate fever is an adaptive response that seems to benefit the body. Bacteria need large amounts 5) A physician orders Tylenol for a temperature greater than 101 degrees of zinc and iron F. The patient's temperature is 100.4 F. Explain the rationale for not to multiply. medicating a fever of 100.4 F. During fever, the liver and spleen sequester these nutrients, making them less available, which helps to reduce the bacterial population. Answer: The primary defect in patients with AIDS is depletion of helper T cells, and therefore 6) Nursing care of a patient with acquired immune deficiency syndrome the cell(AIDS) includes monitoring of T lymphocyte counts. Explain why. mediated response. This immunodeficien cy makes the patient more susceptible to infection and unusual cancers. Answer: Therapeutic management 7) After receiving penicillin intravenously, a 32-year-old male patient has includes speed an anaphylactic reaction. The nurse understands that therapeutic in recognition of management includes what critical items? signs and symptoms of an anaphylactic reaction because

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8) When the white blood cell count is depressed, the classic signs of 9 infection such as redness, heat, and swelling are not manifested. In this 5 case, the nurse should avoid administering aspirin. Explain why. If you have any questions or notice any mistakes, 9 Please message me. I will try to reply within 48 hours. 6 Thank you for taking the time to view my notecards!

Back Side death can occur within minutes. Maintaining an open airway is critical, because the bronchioles constrict, making it difficult to breathe. Answer: Aspirin would disguise a fever that would indicate infection. Good luck in your class!