Diseases that are induced by modern medical procedures are referred to as

A. iatrogenic infections

B. exogenous infections

C. endogenous infections

D. subacute infections

E. opportunistic infections

A

In early spring 2009, the COC reported dozen cases of novel H1N1 influenza ("swine flu") in the United States. By the summer, the number of confirmed cases was reported as over 40,000. The pattern novel H1N1 cases in the US represents a(n) ____ disease.

A. sporadic

B. opportunistic

C. endemic

D. pandemic

E. epidemic

E

Aerosols may be involved in ____ transmission of pathogens.

A. direct

B. droplet

C. vector

D. fecal-oral

E. waterborne

B

Which of the following is the correct sequence of a disease process?

A. prodromal period, convalescence, incubation, illness, decline

B. convalescence, incubation, prodromal period, illness, decline

C. illness, convalescence, incubation, prodromal period, decline

D. incubation, prodromal period, illness, decline, convalescence

E. incubation, convalescence, prodromal period, illness, decline

D

Which of the following combinations of pathogen and virulence factor is correct?

A. Neisseria gonorrheae and endotoxin

B. Staphylococcus aureus and neurotoxin

C. Streptococcus pyogenes and protein M

D. Escherichia coli and cytotoxin

E. Gram-positive bacteria and lipid A

C

Which of the following situations might cause normal microbiota to become opportunistic pathogens?

A. growth of microbes on the surface of intact skin

B. growth of Lactobacillus on the surface of the teeth

C. growth of microorganisms on the excreted cellular wastes and dead cells in the large intestine

D. presence of Entamoeba in the lumen of the sigmoid colon

E. treatment of a cancer patient with radiation

E

Pathogen

B

Transient microbiota

F

Opportunistic microorganisms

G

Resident microbiota

A

Mutualism

H

Commensalism

C

Parasitism

D

Axenic environment

I

Microbial antagonism

E

Reservoir

J

______ interfere with the nerve function of the host.

Neurotoxins

______ are toxins that affect the lining of the gastrointestinal tract.

Enterotoxins

Staphylococcus bacteria are commonly present in the human nasal cavity but rarely cause disease of the upper respiratory system. This situation is an example of ______?

commensalism

The bacterium that causes cholera is capable of living independently in freshwater. As a consequence, cholera epidemics primarily involve ______ reservoirs.

nonliving

In 2% of pregnancies, pathogens cross the ______ and infect the embryo or fetus.

placenta

The ______ route is not a portal route of entry of a pathogen per se, but rather a way of circumventing the usual portals.

parenteral

Koch's postulates can be applied to every infectious disease to identify its causative pathogen.

T/F

False

A common cold is an example of a chronic disease.

T/F

False

Fomites cause disease by direct contact.

T/F

False

All diseases go through the stages know as incubation period, prodromal period, and illness.

T/F

False

Normal microbiota may cause disease if they are introduced into an unusual site in the boby.

T/F

True

An infection always leads to disease.

T/F

False

Which of the following are phagocytic cells found in the epidermis?

A. microglia

B. dendritic cells

C. wandering macrophages

D. neutrophils

E. natural killer lymphocytes

B

Which of the following is NOT one of the signs of inflammation?

A. odor

B. redness (rubor)

C. swelling (humor)

D. pain (dolar)

E. heat (calor)

A

Which of the following contributes to protecting the eyes from microbial invasion?

A. A mucus layer traps and removes microbes.

B. Tears contain lysozyme and salt.

C. Tears mechanically flush particles from the eyes.

D. Tears contain lysozyme and salt and mechanically flush particles from the eyes.

E. Tears and mucus combine to trap microbes and remove them.

D

MACs are

A. the end result of only the alternative complement system.

B. the initial trigger for the alternative complement system.

C. the initial trigger for the lectin complement system.

D. the end result of both the classical and alternative complement systems

E. the initial trigger for the classical complement system.

D

Which of the following pairs is MISMATCHED?

A. macrophages - lymph nodes

B. alveolar macrophage - lungs

C. dendritic cells - epidermis

D. microglial cells - spleen

E. microglial cells - brain

D

Which of the following leukocytes have granules in their cytoplasm that stain blue with methylene blue?

A. lymphocytes

B. monocytes

C. eosinophils

D. basophils

E. neutrophils

D

Which of the following is(are) activities of neutrophils?

A. formation of neutrophil extracellular traps and phagocytosis.

B. formation of neutrophil extracellular traps.

C. phagocytosis

D. enzyme production that leads to the formation of nitric oxide.

E. formation of neutrophil extracellular traps, phagocytosis, and production of nitric oxide.

E

Which of the following cells does NOT have the ability to release histamine?

A. damaged body cells

B. basophils

C. mast cells

D. platelets

E. macrophages

E

How does aspiring act to decrease the symptoms of inflammation?

A. It blocks the release of histamine.

B. It acts as an antiprostaglandin.

C. It interferes with the action of interferons.

D. It is an antitoxoid for most microbial toxins.

E. It prevents complement activation.

B

The residual body is

A. a type of granule in a granulocyte

B. the remains of a phagosome after digestion

C. a dead phagocyte

D. the union of a phagosome with lysosomes

E. the attachment of a phagosome to the surface of a pathogen

B

Sweat glands produce _____, which destroys the cell wall of bacteria by cleaving the bonds between the sugar subunits present in the wall.

lysozome

The process know as _____ allows neutrophils and eosinophils to squeeze between the cells lining the capillaries to attack invading microbes.

diapedesis

The redness and heat of acute inflammation are caused in part by the production of _____ during the formation of blood clots.

bradykinin

A chemical reaction in which the product of each reaction becomes the enzyme that catalyzes the next reaction is known as a(n) _____ reaction.

cascade

Neutriphils use their own _____ in the formation of NETs to trap bacteria.

DNA

Chemotaxis

E

Opsonization

J

Diapedesis

A

Margination

B

Eosinophils

I

Macrophages

C

TRLs

H

Natural killer lymphocytes

F

First line of defense

D

Complement cascade

G

The resident microbiota have no role in defense against pathogen invasion.

T/F

False

The alternative pathway for complement activation is more effective than the classical pathway.

T/F

False

Neutrophils can kill bacteria by nonphagocytic mechanisms.

T/F

True

Adaptive immunity is sometimes also called acquired immunity. Which of the following statements provides a basis for the alternative name?

A. To become activated, lymphocytes require exposure to the antigenic determinant for which they are specific.

B. Lymphocytes of the adaptive immune system are highly specific for a single antigenic determinant.

C. Activated lymphocytes may persist for years in the body.

D. Lymphocytes reactive to normal body components are removed.

E. Activated lymphocytes produce daughter cells that are identical in specificity and function

A

The designation "B" for B lymphocytes comes from

A. the sequence in which these lymphocytes where discovered.

B. the ability of these cells to provide immunity through bodily fluid

C. the bone marrow where these cells are produced.

D. the bursa of Fabricius in birds where these cells were first identified.

E. the fact that these cells produce antibodies.

D

Which of the following statements concerning the chemical structure of an antibody is FALSE?

A. The stem and arm are connected by a hinge.

B. Antibodies are formed of four polypeptide chains.

C. Antibodies have two long peptide chains know as light chains.

D. Antibodies have two short peptide chains know as light chains.

E. The heavy and light chains are connected by hydrogen bonds

E

The Fc portion of an antibody is formed by

A. one light chain and one heavy chain.

B. the upper portions of the heavy chains.

C. the lower portions of the heavy chains.

D. the lower portions of the light chains.

E. the upper portions of the light chains.

C

Secretory IgA antibodies are unique because they

A. they are Y-shaped molecules.

B. they are present in lymph nodes.

C. they are present in the plasma.

D. are connected with J chains and short polypeptides to form dimers.

E. they have unique light chains.

D

Under normal situations the lymphocytes do NOT develop an immune response against autoantigens because

A. antibodies produced against autoantigens are destroyed.

B. they never have binding sites that are complimentary to autoantigens.

C. lymphocytes that bind to autoantigens undergo apoptosis.

D. they identify cells with autoantigens as belonging to the body and do not attack them.

E. antibodies prevent them from binding to the body's own cells.

C

Class II MHC (major histocompatibility antigens) are only found on

A. cytoplasmic membranes of nucleated cells.

B. the skin.

C. professional antigen-presenting cells.

D. muscle.

E. red blood cells.

C

Which of the following recognizes and binds to MHC II antigens and helps stabilize the binding of antigenic determinants to T cell receptors?

A. CCR3

B. CCR5

C. CD26

D. CD4

E. MHC I

D

The perforin-granzyme pathway involves

A. the production of fever, which kills the pathogen.

B. binding CD95L to infected cells, which eventually leads to cell apoptosis

C. the production of antibodies toward the invading pathogen.

D. the synthesis of special cell-killing proteins that act on infected or abnormal cells.

E. presenting the foreign antigen to B cells.

D

The immunological synapse refers to the

A. interaction between lymphocytes and foreign antigens to produce memory cells.

B. interaction of the many cytokines produced by different immunological cells.

C. binding of a monocyte or macrophage to the antigen so that it can act as an antigen-presenting cell.

D. activation of a B cell to become a plasma cell.

E. interaction between a T cell and an antigen-presenting cell to produce a specialized contact area for communication between these cells.

E

A sick child may have influenza or RSV. These virus infections have different treatment options, so the physician requests antibody titer tests. The results are as follows: anti-influenza antibodies are primarily IgM, and anti-RSV antibodies are all IgA and IgG. Which of the following is the most appropriate interpretation?

A. The child has neither influenza nor RSV.

B. The child currently has influenza and has previously been exposed to RSV.

C. The child has a current RSV infection and was previously exposed to influenza.

D. The results do not provide sufficient data to draw a conclusion.

E. The child has concurrent influenza and RSV infections.

B

Which of the following statements about T lymphocytes is FALSE?

A. T lymphocytes directly attack antigens and produce the cell-mediated immune response.

B. T lymphocytes have TCRs that recognize antigen only if it is bound to MHC.

C. T lymphocytes are called such because they mature in the thymus.

D. There are fewer types of T cell receptors than B cell receptors, and therefore the T lymphocyte cannot react with as many types of antigens.

E. There are three types of T lymphocytes.

D

The variable regions from the light and heavy chains of an antibody combine to form _____.

antigen-binding sites

TCRs only recognize antigens presented by APC; therefore, _____ molecules ultimately determine which epitopes elicit an immune response.

MHC

An APC presents antigen to an unactivated T lymphocyte on an MHC I molecule and secretes IL-12 at the same time. As a result, the T lymphocyte differentiates into a(n) _____ lymphocyte.

Th1

A humoral immune response occurs when an APC binds to a(n) _____ and releases IL-1.

Th2 Lymphocytes

Gamma interferon (INF-y)

I

Interleukins

D

Interferons

B

Growth factors

F

Chemokines

G

IgG

C

IgM

A

IgE

E

IgA

H

Interleukin 4 (IL-4)

J

Molecules with a molecular mass less than 5000 daltons can become antigens when they bind to carrier molecules.

T/F

True

A single B lymphocyte can recognize multiple antigenic determinants.

T/F

False

During an infection with Listeria, an intracellular parasite, APCs will present antigen on MHC II molecules.

T/F

False

When a T cell's CD95L binds on a target cell, antibodies are formed.

T/F

False

Variolation was first used

A. to spread smallpox throughout the Native American populations.

B. to treat individuals exposed to hepatitis.

C. to protect individuals against the plaque during the Middle Ages.

D. for research purposes in the 20th century.

E. to immunize the Chinese against smallpox.

E

Almost a century after Edward Jenner introduced successful vaccination, Louis Pasteur developed vaccine(s) against

A. influenza

B. anthrax

C. rabies

D. anthrax and rabies

E. human cholera

D

Pathogens may be attenuated for use in vaccines by

A. genetic manipulation coupled with treatment with formaldehyde.

B. treatment with formaldehyde.

C. genetic manipulation.

D. raiding the pathogen for several generations in tissue culture cells.

E. genetic manipulation and/or raising the pathogen for several generations in tissue culture cells.

E

An adjuvant is a substance that

A. delays the action of the vaccine.

B. is a piece of a microbe that is representative of the entire microorganism.

C. is used to decrease the inflammatory reaction to a vaccine.

D. increases the effective antigenicity of a pathogen.

E. is used to inactivate a microbe in a vaccine.

D

Which of the following substances is commonly used to inactivate microbes?

A. aluminum phosphate

B. formaldehyde

C. aluminum

D. saponin

E. mineral oil

B

An infectious disease researcher isolates the pathogen responsible for an emerging disease. The microbe is grown in the lab for many generations. A preparation of the laboratory grown microbe is treated with ionizing radiation and then tested for its potential as a vaccine. What type of vaccine is this?

A. toxoid vaccine
B. subunit vaccine
C. inactivated whole
D. attenuated vaccine
E. combination vaccine

C

A person who has been exposed to rabies received both HRIG (human rabies immunoglobulin) injected near the bite site and the rabies vaccine. What does this strategy represent?

A. passive immunotherapy

B. active immunization combined with passive immunotherapy

C. viral hemagglutination inhibition

D. passive immunotherapy combined with viral hemagglutination inhibition

E. active immunization

B

Hydridomas are produced by

A. fusing plasma cells with myeloma cells

B. repeated culture of a pathogen until it loses it virulence

C. combining two virus-infected cells

D. combining two bacterial infected cells

E. combining a viral infected cell with a bacterial infected cell

A

Viral neutralization testing is based on the fact that

A. antibodies have different molecular weights

B. antibodies to certain microbes can be given a fluorescent label

C. viruses introduced into appropriate cell cultures have a cytopathic effect

D. antibodies can be produced against the toxin of a pathogen

E. the gene for a pathogen's antigen can be isolated and introduced into a host cell by way of a plasmid

C

A woman uses a home pregnancy test kit that tests for hCG hormone in urine. She knows this is a type of antibody assay from the kit brochure. Antibodies reacting with the hormone produce two lines on the test strip what specific type of immunoassay does this represent?

A. an Ouchterlony test

B. a complement fixation test

C. a neutralization assay

D. an ELISA

E. an immunochromatographic assay

E

The complement fixation test uses red blood cells as the target for complement activation. Test serum containing antibodies is combined with a known amount of antigen in a tube, and then the RBC's and antibodies against the RBC's are added. A positive result for the complement fixation test would be

A. loss of color in the tube.

B. a fluorescent precipitate.

C. a cloudy solution in the tube.

D. a solution that is clear due to precipitation of RBCs.

E. a line of precipitate near the bottom of the tub.

C

Raising viruses for numerous generations can produce a(n) _____ form of the virus.

attenuated

Immunization with _____ vaccines results in primarily an antibody-mediated immune response.

inactivated

Modern vaccine technology can involve inserting the DNA encoding the pathogen's antigen(s) into a(n) _____ and injecting it into an individual.

plasmid vector

The fusion of antibody-producing plasma cells with cancerous cells produces _____ the divide continuously.

hybridomas

The Ouchterlony test is a(n) _____ test.

double immunodiffusion

Tetanus

E

Bacterial pneumonia

D

Tuberculosis

A

Anthrax

B

Cervical cancer

C

HIV

E

Coccidiodes immitis

B

Influenza

D

Rabies

A

Hanavirus

C

For some bacterial diseases such as tetanus, it is more effective to produce an immune response against the bacterial toxin than against the bacteria.

T/F

True

The process of reducing the virulence of a microbe in known as attenuation.

T/F

True

Because attenuated live vaccines contain viruses that are less virulent, many booster vaccines must be given to produce an effective immune response.

T/F

False

Complement fixation is a more sensitive test than agglutination.

T/F

True

Which of the following is NOT considered a hypersensitivity reaction?

A. breaking into hives after eating strawberries

B. immune system attack on the thyroid gland

C. a rash caused by poison ivy

D. itchy eyes and a runny nose in a dusty environment

E. dermatitis at the site of a metal watchband

B

Which of the following allergic reactions is the result of type IV (delayed) hypersensitivity?

A. dermatitis in response to latex gloves

B. runny nose triggered by pollen

C. sensitivity to pet dander

D. breathing difficulties after exposure to mold spores

E. skin irritation after wearing wool

A

Which of the following is an example of type I hypersensitivity reaction?

A. destruction of RBCs after an incompatible blood transfusion

B. watery eyes after exposure to animal dander

C. farmer's lung

D. the tuberculin response

E. deposition of immune complexes in the kidney

B

How can type I allergic reactions be diagnosed?

A. by mixing antigens and antibodies with red blood cells

B. by encouraging the patient to visit rural areas during pollen season

C. by taking a biopsy from the kidney to detect the deposition of immune complexes

D. by injecting very small quantities of suspected allergens under the skin of the forearm

E. by injecting a protein solution from Mycobacterium tuberculosis under the skin.

D

Haptens

A. are small molecules that become antigenic only when they bind to red blood cells or platelets.

B. trigger type III hypersensitivity reactions.

C. are the antigenic substances involved in transplant rejection.

D. are large protein molecule that can trigger immune responses.

E. do not react with antibodies, but instead with T cells.

A

A young woman comes into the clinic complaining of itchy reddish skin and swelling on her arms and legs. She had not been in any parks or wooded areas recently, but she had been shopping. A blood sample reveals elevated levels of granulocytes. What treatment is the physician likely to prescribe at this point?

A. cyclophosphamide

B. interferon

C. methotrexate

D. cortiscosteroids

E. antihistamines

E

Which of the would test positive for the tuberculin response?

A. someone who has previously been injected subcutaneously with tuberculin

B. someone who has been immunized with the tuberculosis vaccine or previously been injected subcutaneously with tuberculin

C. someone who has been immunized with the tuberculosis vaccine or has previously had tuberculosis

D. someone who has been immunized with the tuberculosis vaccine

E. someone who has previously had tuberculosis

C

A child has a history of repeated severe infections and frequently has recurring infections with the same bacterial pathogen. A blood sample shows some lymphopenia and serological tests are negative. Based on this info, which of the following is the best diagnosis for this child?

A. DiGeorge syndrome

B. severe combined immune deficiency (SCID)

C. hemolytic disease of the newborn

D. systemic lupus erythematosus (SLE)

E. Bruton-type agammaglobinemia

E

Multiple sclerosis is

A. the development of neurological disease due to the deposition of immune complexes in nerves.

B. an autoimmune disease in which antibodies attack the myelin sheath of neurons.

C. a type of allergy to myelin.

D. the formation of antibodies against transplanted tissue.

E. a genetic birth defect of the nervous system.

B

Which of the following statements concerning allografts is correct?

A. They are the rarest type of transplants.

B. They use tissues from privileged areas and are associated with extensive hypersensitivity reactions.

C. They are impossible to perform because the antigens between donor and recipient are so different.

D. They induce strong IV hypersensitivity reactions and must be treated with immunosuppresive drugs.

E. They are the best type of transplants because they are not associated with rejection.

D

_____ is a type III hypersensitivity reaction that results when B cells produce autoantibodies that damage the cartilage in the joints.

Rheumatoid arthritis

The _____ released in an immediate hypersensitivity reaction leads to the destruction of nearby cells and the activation of the complement system.

proteases

A graft that is from one identical twin to another is a(n) _____.

isograft

Graves' disease is an autoimmune disease that affects the _____.

thyroid gland

Failure of the thymus to develop results in _____.

DiGeorge syndrome

DiGeorge synodrome

G

Isografts

C

Allografts

B

Xenografts

I

Privileged site grafts

D

Type I diabetes

A

Anaphylactic shock

F

Transfussion reactions

H

Rheumatoid arthritis

E

Allergic contact dermatitis

J

The uterus is a privileged sire that prevents allograft rejection.

T/F

False

Children with Bruton-type agammaglobulinemia are highly susceptible to dangerous bacterial infections.

T/F

True

Systemic lupus erythematosus (SLE) is a disease resulting from loss of suppression of humoral immunity.

T/F

True

If an Rh-positive women marries an Rh-negative man, their children are at risk for hemolytic disease of the newborn.

T/F

False

Certain sites in the body are considered privileged sites because grafts from these areas are not likely to be rejected.

T/F

True