1. Which action is a purpose of the inflammatory process? a. To provide specific responses toward antigens b. To lyse cell membranes of microorganisms c. T

                1.            Which action is a purpose of the inflammatory process?

a.            To provide specific responses toward antigens

b.            To lyse cell membranes of microorganisms

c.             To prevent infection of the injured tissue

d.            To create immunity against subsequent tissue injury

If the epithelial barrier is damaged, then a highly efficient local and systemic response (inflammation)is mobilized to limit the extent of damage, to protect against infection, and to initiate the repair of damaged tissue. The other options do not accurately identify a purpose of the inflammatory process.

                2.            How do surfactant proteins A through D provide innate resistance?

a.            Initiate the complement cascade.            c.             Secrete mucus.

b.            Promote phagocytosis. d.            Synthesize lysosomes.

The lung produces and secretes a family of glycoproteins, collectins,which includes surfactant proteins A through D and mannose-binding lectin. Collectin binding facilitates macrophages to recognize the microorganism, enhancing macrophage attachment, phagocytosis, and killing. The other options do not accurately identify how surfactant proteins provide innate resistance.

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                3.            Which secretion is a first line of defense against pathogen invasion that involves antibacterial and antifungal fatty acids, as well as lactic acid?

a.            Optic tears          c.             Sweat gland perspiration

b.            Oral saliva            d.            Sebaceous gland sebum

Sebaceous glands in the skin secrete sebum that is made up of antibacterial and antifungal fatty acids and lactic acid that provide the first-line barrier against pathogen invasion.

                4.            Which bacterium grows in the intestines after prolonged antibiotic therapy?

a.            Lactobacillus       c.             Clostridium difficile

b.            Candida albicans               d.            Helicobacter pylori

                5.            What causes the edema that occurs during the inflammatory process?

a.            Vasodilation of blood vessels     c.             Endothelial cell contraction

b.            Increased capillary permeability                d.            Emigration of neutrophils

The increased flow and capillary permeability result in a leakage of plasma from the vessels, causing swelling (edema) in the surrounding tissue and is solely responsible for inflammation-induced edema.

                6.            What process causes heat and redness to occur during the inflammatory process?

a.            Vasodilation of blood vessels     c.             Decreased capillary permeability

b.            Platelet aggregation       d.            Endothelial cell contraction

The increased blood flow as a result of vasodilation and increasing concentration of red cells at the site of inflammation cause locally increased warmth and redness. The other options do not accurately identify the process that results in inflammatory redness and heat.

                7.            Activation of the classical pathway begins with:

a.            Viruses c.             Mast cells

b.            Antigen-antibody complexes     d.            Macrophages

                8.            What plasma protein system forms a fibrinous meshwork at an inflamed site?

a.            Complement     c.             Kinin

b.            Coagulation        d.            Fibrinolysis

                9.            Which component of the plasma protein system tags pathogenic microorganisms for destruction by neutrophils and macrophages?

a.            Complement cascade    c.             Kinin system

b.            Coagulation system        d.            Immune system

C3b (a component of the complement cascade) adheres to the surface of a pathogenic microorganism and serves as an efficient opsonin. Opsoninsare molecules that tag microorganisms for destruction by cells of the inflammatory system, primarily neutrophils and macrophages. The other options do not accurately identify a component capable of tagging pathogenic microorganisms.

                10.          What is the vascular effect of histamine released from mast cells?

a.            Platelet adhesion             c.             Vasodilation

b.            Initiation of the clotting cascade                d.            Increased endothelial adhesiveness

C2b affects smooth muscle, causing vasodilation and increased vascular permeability. C3a, C5a, and, to a limited extent, C4a are anaphylatoxins; that is, they induce rapid mast cell degranulation(i.e., release of granular contents) and the release of histamine, causing vasodilation and increased capillarypermeability. The other options do not accurately describe the vascular effect of histamine released from mast cells?

                11.          What is an outcome of the complement cascade?

a.            Activation of the clotting cascade

b.            Prevention of the spread of infection to adjacent tissues

c.             Inactivation of chemical mediators such as histamine

d.            Lysis of bacterial cell membranes

The complement cascade can be activated by at least three different means, and its products have four functions: (1) anaphylatoxic activity, resulting in mast cell degranulation, (2) leukocyte chemotaxis, (3) opsonization, and (4) cell lysis. The other options do not accurately describe an outcome of the complement cascade.

                12.          The function of opsonization related to the complement cascade is to:

a.            Tag of pathogenic microorganisms for destruction by neutrophils and macrophages.

b.            Process pathogenic microorganisms so that activated lymphocytes can be created for acquired immunity.

c.             Destroy glycoprotein cell membranes of pathogenic microorganisms.

d.            Promote anaphylatoxic activity, resulting in mast cell degranulation.

                13.          In the coagulation (clotting) cascade, the intrinsic and the extrinsic pathways converge at which factor?

a.            XII           c.             X

b.            VII          d.            V

                14.          Which chemical interacts among all plasma protein systems by degrading blood clots, activating complement, and activating the Hageman factor?

a.            Kallikrein              c.             Bradykinin

b.            Histamine            d.            Plasmin

                15.          The chemotactic factor affects the inflammatory process by:

a.            Causing vasodilation around the inflamed area

b.            Stimulating smooth muscle contraction in the inflamed area

c.             Directing leukocytes to the inflamed area

d.            Producing edema around the inflamed area

                16.          What affect does the process of histamine binding to the histamine-2 (H2) receptor have on inflammation?

a.            Inhibition             c.             Acceleration

b.            Activation            d.            Termination

                17.          Frequently when H1 and H2 receptors are located on the same cells, they act in what fashion?

a.            Synergistically    c.             Antagonistically

b.            Additively            d.            Agonistically

                18.          Some older adults have impaired inflammation and wound healing because of which problem?

a.            Circulatory system cannot adequately perfuse tissues.

b.            Complement and chemotaxis are deficient.

c.             Underlying chronic illness(es) exists.

d.            Number of mast cells is insufficient.

                19.          Which chemical mediator derived from mast cells retracts endothelial cells to increase vascular permeability and to cause leukocyte adhesion to endothelial cells?

a.            Leukotrienes     c.             Platelet-activating factor

b.            Prostaglandin E d.            Bradykinin

                20.          What is the inflammatory effect of nitric oxide (NO)?

a.            Increases capillary permeability, and causes pain.

b.            Increases neutrophil chemotaxis and platelet aggregation.

c.             Causes smooth muscle contraction and fever.

d.            Decreases mast cell function, and decreases platelet aggregation.

                21.          What is the correct sequence in phagocytosis?

a.            Engulfment, recognition, fusion, destruction

b.            Fusion, engulfment, recognition, destruction

c.             Recognition, engulfment, fusion, destruction

d.            Engulfment, fusion, recognition, destruction

                22.          When considering white blood cell differentials, acute inflammatory reactions are related to elevations of which leukocyte?

a.            Monocytes         c.             Neutrophils

b.            Eosinophils         d.            Basophils

                23.          In the later stages of an inflammatory response, which phagocytic cell is predominant?

a.            Neutrophils        c.             Chemokines

b.            Monocytes         d.            Eosinophils

                24.          In regulating vascular mediators released from mast cells, the role of eosinophils is to release:

a.            Arylsulfatase B, which stimulates the formation of B lymphocytes

b.            Histaminase, which limits the effects of histamine during acute inflammation

c.             Lysosomal enzymes, which activate mast cell degranulation during acute inflammation

d.            Immunoglobulin E, which defends the body against parasites

                25.          What is the role of a natural killer (NK) cells?

a.            Initiation of the complement cascade

b.            Elimination of malignant cells

c.             Binding tightly to antigens

d.            Proliferation after immunization with antigen

                26.          Which cytokine is produced and released from virally infected host cells?

a.            IL-1         c.             TNF-

b.            IL-10      d.            IFN-

                27.          IFN- is secreted from which cells?

a.            Virally infected cells        c.             Macrophages

b.            Bacterial infected cells   d.            Mast cells

                28.          Which manifestation of inflammation is systemic?

a.            Formation of exudates  c.             Redness and heat

b.            Fever and leukocytosis  d.            Pain and edema

                29.          The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by:

a.            Endogenous pyrogens   c.             Antigen-antibody complexes

b.            Bacterial endotoxin         d.            Exogenous pyrogens

                30.          What occurs during the process of repair after tissue damage?

a.            Nonfunctioning scar tissue replaces destroyed tissue.

b.            Regeneration occurs; the original tissue is replaced.

c.             Resolution occurs; tissue is regenerated.

d.            Epithelialization replaces destroyed tissue.

                31.          The role of fibroblasts during the reconstructive phase of wound healing is to:

a.            Generate new capillaries from vascular endothelial cells around the wound.

b.            Establish connections between neighboring cells and contract their fibers.

c.             Synthesize and secrete collagen and the connective tissue proteins.

d.            Provide enzymes that débride the wound bed of dead cells.

                32.          A keloid is the result of which dysfunctional wound healing response?

a.            Epithelialization                c.             Collagen matrix assembly

b.            Contraction        d.            Maturation

                33.          Which solution is best to use when cleaning a wound that is healing by epithelialization?

a.            Normal saline    c.             Hydrogen peroxide

b.            Povidone-iodine              d.            Dakin solution

                34.          Many neonates have a transient depressed inflammatory response as a result of which condition?

a.            The circulatory system is too immature to perfuse tissues adequately.

b.            Complement and chemotaxis are deficient.

c.             Mast cells are lacking.

d.            The respiratory system is too immature to deliver oxygen to tissues.

                35.          During phagocytosis, what is occurring during the step referred to as opsonization?

a.            Phagocytes recognize and adhere to the bacteria.

b.            Microorganisms are ingested.

c.             Microorganisms are killed and digested.

d.            An intracellular phagocytic vacuole is formed.

                36.          Fusion is the step in phagocytosis during which:

a.            Microorganisms are killed and digested.

b.            An intracellular phagocytic vacuole is formed.

c.             Lysosomal granules enter the phagocyte.

d.            Microorganisms are ingested.

                37.          During the process of endocytosis, the phagosome step results in:

a.            Microorganisms are ingested.

b.            Microorganisms are killed and digested.

c.             Phagocytes recognize and adhere to bacteria.

d.            An intracellular phagocytic vacuole is formed.

                38.          When cellular damage occurs and regeneration is minor with no significant complications, the process of returning the cells to preinjury function is referred to as:

a.            Restoration        c.             Regrowth

b.            Resolution          d.            Replacement

                39.          Newborns often have deficiencies in collectin-like proteins, making them more susceptible to what type of infection?

a.            Cardiac c.             Respiratory

b.            Urinary d.            Gastrointestinal

                40.          Which cell is the body’s primary defense against parasite invasion?

a.            Eosinophil           c.             T lymphocytes

b.            Neutrophils        d.            B lymphocytes

MULTIPLE RESPONSE

                41.          Which chemical mediators induce pain during an inflammatory response? (Select all that apply.)

a.            Prostaglandins

b.            Leukotrienes

c.             Tryptase

d.            Phospholipase

e.            Bradykinin

                42.          Sebaceous glands protect the body from infection by secreting: (Select all that apply.)

a.            Antibacterial fatty acids

b.            Antifungal fatty acids

c.             Ascorbic acid

d.            Lactic acid

e.            Hydrochloric acid

                43.          Which body fluid has the ability to attack the cell walls of gram-positive bacteria? (Select all that apply.)

a.            Perspiration

b.            Semen

c.             Tears

d.            Saliva

e.            Urine

                44.          The main function of NK cells includes: (Select all that apply.)

a.            Recognizing virus-infected cells

b.            Eliminating virus-infected cells

c.             Recognizing bacteria-infected cells

d.            Eliminating bacteria-infected cells

e.            Eliminating previously identified cancer cells

                45.          Normal bacterial flora found in the intestines produce vitamin K to assist in the absorption of which of the following? (Select all that apply.)

a.            Calcium

b.            Fatty acids

c.             Large polysaccharides

d.            Iron

e.            Magnesium

                46.          An individual’s acquired immunity is dependent on the function of which cells? (Select all that apply.)

a.            Tlymphocytes

b.            B lymphocytes

c.             Macrophages

d.            Opsonins

e.            Neutrophils

                47.          An example of a pathogen capable of surviving and even multiplying inside a macrophage is known as: (Select all that apply.)

a.            Mycobacterium tuberculosis (tuberculosis)

b.            Mycobacterium leprae(leprosy)

c.             Salmonella typhi(typhoid fever)

d.            Clostridium difficile

e.            Brucellaabortus(brucellosis)

                48.          An older adult is particularly susceptible to infections of which body parts? (Select all that apply.)

a.            Lungs

b.            Skin

c.             Liver

d.            Eyes

e.            Bladder