A naive lymphocyte first recognizes its
specific antigen and begins adaptive immune
activation. Where does this recognition phase occur?
A.
Primary lymphoid organs
B. Secondary lymphoid organs
C.
Peripheral infected tissue
D. Bone marrow sinusoids
B. Secondary lymphoid organs
What are three secondary lymphoid organs?
____ ____, ____, ____
Lymph nodes, spleen, MALT
Which organs are classified as primary lymphoid organs?
____ ____
____
Bone marrow
thymus
A patient has impaired lymphoid follicle formation.
Which immune structures would most directly share this
abnormality?
A. Primary lymphoid organs
B. All lymphatic
vessels
C. Secondary lymphoid organs
D. All inflamed tissues
C. Secondary lymphoid organs
The common anatomical structure shared by secondary lymphoid organs is which of the following?
_____ _____
Lymphoid follicles
Lymphoid follicles begin as loose networks of which cell type?
_____ _____ _____
Follicular dendritic cells
Early lymphoid follicles form in regions especially rich in which lymphocyte population?
B cells
Follicular dendritic cells are already present by which developmental period?
Second trimester
Which cell type displays antigen primarily to B cells?
____ ____ ____
Follicular dendritic cells
Which cell type presents antigen primarily to T cells?
____ ____ ____
Conventional dendritic APCs
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delete
Follicular dendritic cells can also bind immune complexes using receptors for which antibody region?
____ region
Fc region
A follicular dendritic cell attracts and activates B cells, leading to intense B-cell proliferation. Over time, this active follicle becomes what?
______ ______
Germinal center
Before adaptive immunity responds effectively to infection, which system must first detect danger?
______ system
Innate system
B cells proliferating in germinal centers become fragile. Which cells rescue them from apoptosis?
Helper T cells
Which secondary lymphoid organ lacks high endothelial venules?
Spleen
High endothelial venules serve primarily as a
doorway for which cells?
A. Neutrophils and
eosinophils
B. B and T cells
C. Monocytes and
basophils
D. Plasma cells and platelets
B. B and T cells
High endothelial venules allow lymphocytes to enter secondary
lymphoid organs from which compartment?
A. Blood
B. Bone
marrow
C. Germinal centers
D. Efferent lymph
A. Blood
High endothelial venules are regions within
which vessel type?
A. Arteriole
B.
Capillary
C. Venule
D. Lymphatic duct
C. Venule
In a lymph node, high endothelial venules are located in which region?
Paracortex
In a lymph node, B cells mainly accumulate in which area?
Cortex
In a lymph node, T cells mainly accumulate in which area?
Paracortex
Conventional dendritic cells mainly accumulate in which lymph-node region?
Paracortex
Follicular dendritic cells are mainly located in which lymph-node region?
Cortex
Lymph-node sinus walls are carpeted with which immune cells?
Macrophages
Movement of immune cells within secondary lymphoid
organs is coordinated by which signal type?
A. Chemokines
B. Antibodies
C. Perforins
D. Integrins only
A. Chemokines
Chemokines are best described as which type of cytokine?
A.
Apoptotic cytokines
B. Chemoattractive cytokines
C.
Cytotoxic cytokines
D. Complement-fixing cytokines
B. Chemoattractive cytokines
Follicular dendritic cells produce which
chemokine to attract naive B cells?
A. CCR7
B. ICOSL
C. CXCR5
D. CXCL13
D. CXCL13
After a B cell finds its cognate antigen, what
happens to its CXCL13 receptor expression?
A.
It increases sharply
B. It remains unchanged
C. It
downregulates
D. It switches to CD28
C. It downregulates
After recognizing cognate antigen, an
activated B cell upregulates which
chemokine receptor?
A. CXCL13
B.
CCR7
C. ICOSL
D. B7
B. CCR7
CCR7 expression helps activated B cells
migrate toward which region?
A. Medullary sinus
B. Thymic cortex
C. Blood-red pulp border
D.
Cortex-paracortex border
D. Cortex-paracortex border
The cortex-paracortex border is important because it allows meeting
between which cells?
A. B cells and T cells
B. NK cells
and neutrophils
C. Macrophages and eosinophils
D. Plasma
cells and platelets
A. B cells and T cells
Activated helper T cells downregulate signals keeping them in which region?
Paracortex
Activated helper T cells upregulate which receptor to meet activated
B cells?
A. CCR7
B. CXCL13
C. CXCR5
D. ICOSL
C. CXCR5
CXCR5 expression helps helper T cells congregate with activated B
cells at which site?
A. Medullary cord
B. Follicle
border
C. Splenic red pulp
D. Efferent lymphatic
B. Follicle border
B cells require help from activated helper T cells. Activated helper
T cells also require help from which cells?
A. Activated B
cells
B. Resting macrophages
C. Naive neutrophils
D.
Medullary thymocytes
A. Activated B cells
The reciprocal help between activated B cells and activated Th cells
occurs through what mechanism?
A. Cell-cell contact
B.
Antibody secretion only
C. Complement lysis
D. Cytokine
diffusion only
A. Cell-cell contact
Which B-cell surface protein binds
CD28 on helper T cells?
A.
CCR7
B. ICOSL
C. B7
D. CXCL13
C. B7
Which B-cell surface protein binds
ICOS on helper T cells?
A.
B7
B. ICOSL
C. CCR7
D. CXCR5
B. ICOSL
Which helper T-cell protein binds
B7 on the activated B-cell surface?
A. ICOS
B. CD28
C. CCR7
D. CXCR5
B. CD28
Which helper T-cell protein binds
ICOSL on the activated B-cell
surface?
A. CD28
B. CXCL13
C. CCR7
D. ICOS
D. ICOS
A patient has impaired complement deposition on
antigen. Which FDC function would be most directly reduced?
A.
Binding opsonized antigen
B. Producing IL-2
C. Presenting
peptide to T cells
D. Activating thymic selection
A. Binding opsonized antigen
Which statement best captures secondary lymphoid organ function?
They support _____ _____
They support antigen recognition
At the follicle border, an activated Th cell directly helps an
activated B cell through which ligand-receptor pair?
A.
ICOSL–ICOS
B. B7–CD28
C. CD40L–CD40
D. CXCL13–CXCR5
C. CD40L–CD40
During the B-cell/Th-cell “dance,” which molecule is provided by the helper T cell?
CD40L
During the B-cell/Th-cell “dance,” which molecule is found on the B-cell surface and binds CD40L?
CD40
Activated B cells provide which material to
help helper T cells mature?
A. IL-17, IL-21,
IL-23
B. Antigen, B7, ICOSL
C. CD40L, IL-2, FasL
D.
Perforin, granzyme, IFN-gamma
B. Antigen, B7, ICOSL
A helper T cell becomes fully mature at the follicular border after
contact with an activated B cell. What is it now called?
A. Th0
cell
B. Treg cell
C. Tfh cell
D. CTL cell
C. Tfh cell
Follicular helper T cells are licensed to
rescue which fragile cell
population?
A. Germinal-center B cells
B. Naive
T cells
C. Marginal-zone macrophages
D. Follicular
dendritic cells
A. Germinal-center B cells
A germinal-center B cell receives Tfh help and avoids apoptosis. Which later processes can Tfh cells support?
____ ____ and ____
Class switching and hypermutation
Somatic hypermutation takes place in the ____ ____ of the germinal center
dark zone
During affinity maturation, B cells with higher-affinity receptors
gain an advantage by doing what?
A. Secreting more IL-12
B. Plucking more antigen
C. Blocking CD40 signaling
D.
Losing class II MHC
B. Plucking more antigen
Higher-affinity B cells present more antigen to Tfh cells using which molecule?
Class II MHC
In germinal centers, greater antigen presentation by high-affinity B cells causes what outcome?
More Tfh help
Somatic hypermutation selects higher-affinity B cells because these cells receive more help from which cells?
Tfh cells
A killer T cell recognizes cognate antigen presented by dendritic cells in a lymph node. Where does activation occur?
Paracortex
A lymph node draining an infected wound becomes enlarged. Which process contributes most directly?
_____ proliferation
Lymphocyte proliferation
In infected draining lymph nodes, medullary sinuses may become clogged by which cells?
_____
Macrophages
Peyer patches are examples of which lymphoid
tissue?
A. Thymic tissue
B. Red pulp
C. Bone
marrow
D. MALT
D. MALT
Unlike lymph nodes, Peyer patches
lack which structure?
A. Outgoing lymphatics
B.
Incoming lymphatics
C. Germinal centers
D. B-cell follicles
B. Incoming lymphatics
Peyer patches are topped by which
specialized epithelial cells?
A. Goblet
cells
B. Paneth cells
C. Enteroendocrine cells
D. M cells
D. M cells
M cells over Peyer patches are not coated with which structures?
____ and ____
Mucus and villi
M cells sample material from which location?
____ ____
Intestinal lumen
M cells transport sampled intestinal material into which site?
____ ____
Underlying tissues
The spleen primarily functions as what type of filter?
A. Blood
filter
B. Lymph filter
C. Mucus filter
D. Airway filter
A. Blood filter
Approximately what fraction of cardiac output enters the
spleen?
A. 1%
B. 20%
C. 5%
D. 50%
C. 5%
The spleen screens circulating blood approximately every how
long?
A. 5 minutes
B. 30 minutes
C. 6 hours
D.
1 day
B. 30 minutes
Compared with lymph nodes and Peyer patches,
the spleen is less selective because everything
enters from where?
A. Blood
B. Lymph
C. Mucus
D. Thymus
A. Blood
Which organs are selective about where B/T cells and antigens enter?
_____ _____ and _____ _____
Lymph nodes and Peyer patches
In the spleen, T cells are temporarily retained in which region?
_____
PALS
In the spleen, B cells are found between which structures?
_____ and _____ _____
PALS and marginal sinuses
The periarteriolar lymphocyte sheath mainly
retains which cells?
A. T cells
B. B cells
C. Plasma
cells
D. Macrophages
A. T cells
The spleen lacks lymphatics
to transport dendritic cells from tissues. How does
it compensate?
A. Uses thymic epithelial cells
B. Uses
incoming M cells
C. Uses circulating neutrophils
D. Uses
resident dendritic cells
D. Uses resident dendritic cells
In the spleen, resident dendritic cells take up antigens from invaders located where?
Blood
Which organ is a main site where B cells can activate without Th-cell assistance?
Spleen
B cells that can activate without Th-cell help in the spleen are
called what?
A. Germinal-center B cells
B. Naive
follicular B cells
C. Plasma memory cells
D. Marginal-zone
B cells
D. Marginal-zone B cells
Marginal-zone B cells are stationed where they contact blood entering
the spleen. Where is this?
A. Marginal sinuses
B. Red pulp
cords
C. Splenic capsule
D. Central arteriole wall
A. Marginal sinuses
Secondary lymphoid organs are strategically positioned to intercept
which threat?
A. Self-reactive thymocytes
B. Aging
erythrocytes only
C. Invaders entering the body
D. Bone
marrow precursors
C. Invaders entering the body
Secondary lymphoid organs provide environments that mobilize weapons
appropriate to what?
A. Thymocyte selection stage
B.
Likely invading organisms
C. Red-cell deformability
D.
Platelet activation status
B. Likely invading organisms
The most important function of secondary lymphoid
organs is bringing together which
cells?
A. Platelets and erythrocytes
B. Mast cells and
basophils
C. Fibroblasts and osteoblasts
D. Lymphocytes
and APCs
D. Lymphocytes and APCs
Bringing lymphocytes and APCs
together increases the probability of
activating which immune system?
A. Adaptive immune system
B. Complement system
C. Coagulation system
D. Innate
barrier system
A. Adaptive immune system
The process of B and T cells moving to specific locations is called
what?
A. Chemotactic drift
B. Lymphocyte trafficking
C. Germinal rescue
D. Antigen plucking
B. Lymphocyte trafficking
Virgin and experienced lymphocytes differ mainly in which
feature?
A. Nuclear membrane number
B. Immunoglobulin
shape
C. Traffic patterns
D. Ribosomal density
C. Traffic patterns
Virgin T cells use which molecule to enter lymph nodes through HEVs?
L-selectin
L-selectin on virgin T cells binds which
ligand on lymph-node HEVs?
A. MadCAM-1
B.
ICOS
C. CD40
D. GlyCAM-1
D. GlyCAM-1
Virgin T cells use which integrin
to enter Peyer patches and intestinal lymph nodes?
A. CD28
B. α4β7
C. CXCL13
D. CD40L
B. α4β7
α4β7 on virgin T cells binds which ligand on intestinal HEVs?
A. GlyCAM-1
B. Fas receptor
C. MadCAM-1
D. ICOSL
C. MadCAM-1
Virgin T cells circulate through blood and lymph, spending about how long per loop?
1 day
If a virgin T cell does not find cognate
antigen, it dies after approximately how
long?
A. 1 day
B. 30 minutes
C. 1 year
D. 6 weeks
D. 6 weeks
A virgin T cell failing to find cognate antigen eventually dies by what mechanism?
Apoptosis
Experienced T cells that have found cognate
antigen have their travel passports become
what?
A. Expanded
B. Deleted
C.
Randomized
D. Restricted
D. Restricted
Experienced T cells express adhesion molecules based on what
location?
A. Where they activated
B. Where they die
C. Where they circulate randomly
D. Where antibodies bind
A. Where they activated
A T cell activated in a Peyer patch will increase which adhesion
molecule?
A. GlyCAM-1
B. CD40
C. α4β7
D. B7
C. α4β7
Increased α4β7 on Peyer-patch-activated T
cells helps them do what?
A. Return to mucosal
sites
B. Enter thymic cortex
C. Bind splenic red
pulp
D. Block dendritic migration
A. Return to mucosal sites
Experienced T cells also carry “combat passports” that help them
enter what sites?
A. Primary lymphoid organs
B. Sites of
infection
C. Bone marrow niches
D. Thymic medulla
B. Sites of infection
Experienced mucosa-activated T cells express which integrin?
A.
α4β7
B. MadCAM-1
C. L-selectin
D. αEβ7
D. αEβ7
αEβ7 helps experienced mucosal T cells enter which tissue
environment?
A. Inflamed mucosa
B. Splenic capsule
C. Thymic cortex
D. Bone marrow
A. Inflamed mucosa
A defect in CD40L expression on activated Th cells would most
directly impair which interaction?
A. B-cell CD40
activation
B. HEV entry into nodes
C. Antigen plucking by
FDCs
D. M-cell sampling
A. B-cell CD40 activation
A B cell fails to provide B7 and ICOSL to a helper T cell. Which
process is most directly impaired?
A. CTL granzyme release
B. Helper T-cell maturation
C. M-cell antigen transport
D.
Splenic blood screening
B. Helper T-cell maturation
A high-affinity B cell outcompetes low-affinity B cells in a germinal
center. Which mechanism best explains this?
A. Less antigen
presentation
B. Better antigen plucking
C. Loss of class
II MHC
D. Reduced Tfh contact
B. Better antigen plucking
A patient’s draining lymph node is swollen after cellulitis. Which
combined mechanism best explains the swelling?
A. Lymphocyte
loss, neutrophil apoptosis
B. Platelet trapping, RBC
hemolysis
C. Lymphocyte growth, macrophage clogging
D.
Fibrosis, thymocyte expansion
A. Lymphocyte loss, neutrophil apoptosis
A virgin T cell enters intestinal lymphoid
tissue. Which receptor-ligand pair is most likely used?
A. CD40L–CD40
B. L-selectin–GlyCAM-1
C.
α4β7–MadCAM-1
D. ICOS–ICOSL
C. α4β7–MadCAM-1
A virgin T cell enters a nonintestinal lymph
node through HEVs. Which pair is most
relevant?
A. αEβ7–mucosal ligand
B. α4β7–MadCAM-1
C.
ICOS–ICOSL
D. L-selectin–GlyCAM-1
D. L-selectin–GlyCAM-1
Structures (in order) from arteriole to venulue as lymph passes a lymph node?
(Medullary Sinus, Cortex, Paracortex, Marginal Sinus)
Marginal Sinus -> Cortex -> Paracortex -> Medullary Sinus
The subcapuslar sinus of a lymph node contains what two cells?
macrophage
dendritic cell
delete
delete
Where in the spleen does blood first enters and contains resident dendritic cells?
____ ____
Marginal Sinuses
____ bacteria can directly activate B-cells without T-cell help.
Encapsulated
Peyer’s Patches specialize in turning out Th Cells that secrete ____ cytokine types and B-Cells that secrete ____.
Th2
IgA
If you are invaded by bacteria, the lymph node will produce _____ cytokine types and B-Cells that secrete _____.
Th1
IgG