Development of Digestive Enzymes: From Transcription to Release, Exams of Health sciences

Download Development of Digestive Enzymes: From Transcription to Release and more Exams Health sciences in PDF only on Docsity! 1 501 Study Guides NURS 501 Advanced Physiology and Pathophysiology,Rated A+. Chapter 1: Cellular Biology Study Guide 1. Which statement best describes the cellular function of metabolic absorption? a. Cells can produce proteins. c. Cells can take in and use nutrients. b. Cells can secrete digestive enzymes. d. Cells can synthesize fats. 2. Most of a cell’s genetic information, including RNA and DNA, is contained in the: a. Mitochondria c. Nucleolus b. Ribosome d. Lysosome 3. Which component of the cell produces hydrogen peroxide (H2 O2 ) by using oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction? a. Lysosomes c. Ribosomes b. Peroxisomes d. Oxyhydrosomes 4. Which cell component is capable of cellular autodigestion when it is released during cell injury? a. Ribosome c. Smooth endoplasmic reticulum b. Golgi complex d. Lysosomes 5. What is the sequence of steps in the development of a digestive enzyme by the pancreas cells from the initial transcription to the release from the cell? a. The enzyme is transcribed from DNA by RNA in the nucleus, proceeds to the ribosome for synthesis, and is transported in a secretory vesicle to the cell membrane. b. The enzyme is transcribed from RNA by DNA in the nucleus, proceeds to the lysosome for synthesis, and is transported in an encapsulated membrane to the cell membrane. c. The enzyme is transcribed by the mitochondria in the nucleus, proceeds to the ribosome for synthesis, and is transported in a cytoskeleton to the cell membrane. d. The enzyme is transcribed from DNA by RNA in the nucleus, proceeds to the Golgi complex for synthesis, and is transported in cytosol to the cell membrane. 1 6. During which phase of the cell cycle is DNA synthesized? a. G1 b. S c. G2 d. M 7. What organic compound facilitates transportation across cell membranes by acting as receptors, transport channels for electrolytes, and enzymes to drive active 1 a. Protein channel (gap junction) b. Plasma membrane-bound signaling molecules (involving receptors) c. Hormone secretion such as neurotransmitters d. Chemical messengers such as ligands 16. When a second message is necessary for extracellular communication to be activated, it is provided by which one? a. Guanosine triphosphate (GTP) c. Adenosine triphosphate (ATP) b. Adenosine monophosphate (AMP) d. Guanosine diphosphate (GDP) 17. Under anaerobic conditions, what process provides energy for the cell? A.. Oxidative phosphorylation B.. Lactolysis C. Glycolysis D. Passive transport 18. What is the mechanism by which the energy produced from carbohydrates, proteins, and lipids is transferred to adenosine triphosphate (ATP)? a. Anaerobic glycolysis c. Oxidative phosphorylation b. Oxidative cellular metabolism d. Tricarboxylic acid phosphorylation 19. Passive transport is best described with which statement? a. Being driven by osmosis, hydrostatic pressure, and diffusion. b. Involving receptors that can bind with substances being transported. c. Being capable of transporting macromolecules. d. Requiring energy generated by the cell 20. Active transport occurs across which type of membranes? a. Membranes that have a higher concentration of the solute on the outside of the cell b. Membranes that are semipermeable to water and small electrically uncharged molecules c. Membranes that have receptors that are capable of binding with the substances to be transported d. Membranes that have a cell membrane that is hydrophobic rather than hydrophilic 21. Which method of transport uses transmembrane proteins with receptors with a high degree of specificity for the substance being transported? a. Active c. Transmembranous b. Mediated d. Passive 22. The movement of fluid across the arterial end of capillary membranes into the interstitial 1 fluid surrounding the capillary is an example of which fluid movement process? 1 a. Hydrostatic pressure c. Diffusion b. Osmosis d. Active transport 23. Why is osmolality preferred over osmolarity as the measurement of osmotic activity in the clinical assessment of individuals? a. Plasma contains sodium and chloride, which influence the volume of solution. b. Volume affects perfusion more than the weight of solutes. c. More of the weight of plasma is influenced by solutes, such as protein and glucose, rather than by water. d. Osmotic activity depends on the concentration of solutes present in plasma, such as proteins and glucose. 24. A patient who has diarrhea receives a 3% saline solution intravenously to replace the sodium and chloride lost in the stool. What effect will this fluid replacement have on cells? a. Become hydrated c. Shrink b. Swell or burst d. Divide 25. The transport of glucose from the blood to the cell is accomplished by which process? a. Active-mediated transport (active transport) b. Active diffusion c. Passive osmosis d. Passive-mediated transport (facilitated diffusion) 26. Potassium and sodium are transported across plasma membranes by: a. Passive electrolyte channels b. Coupled channels c. Adenosine triphosphatase (ATPase) enzyme d. Diffusion 27. What occurs during exocytosis? a. Macromolecules can be secreted across eukaryotic cell membranes. b. All substances are secreted into the cellular matrix. c. No repairs in the plasma membrane can take place. d. Solute molecules flow freely into and out of the cell. 28. Why is it possible for potassium to diffuse easily into and out of cells? a. Potassium has a greater concentration in the intracellular fluid (ICF). b. Sodium has a greater concentration in the extracellular fluid (ECF). c. The resting plasma membrane is more permeable to potassium. d. An 1 Phagocytosis focuses on solute molecules. 1 36. A muscle cell possesses which specialized function? a. Movement c. Secretion b. Conductivity d. Respiration 37. When a mucous gland cell creates a new substance from previously absorbed material, this process is known as which specialized cellular function? a. Excretion c. Reproduction b. Metabolic absorption d. Secretion 38. All cells are capable of what process? a. Excretion c. Metabolic absorption b. Movement d. Continuous division Multiple Response Identify one or more choices that best complete the statement or answer the question. 39. What are the major chemical components of the cell membranes? (Select all that apply.) a. Lipids. b. Sodium ions c. Carbohydrates d. DNA e. Proteins 40. Which cells lose their ability to replicate and divide? (Select all that apply.) a. Intestines b. Nerves c. Skin d. Lens of the eye e. Skeletal muscle 41. Which statements are true concerning the process of facilitated diffusion? (Select all that apply). a. Facilitated diffusion is also referred to as passive mediated transport. b. This process expends no metabolic energy. c. Moving solute molecules through cellular membranes are involved in this process. d. Movement up a concentration gradient is necessary. e. Facilitated diffusion is the primary means for water transport. 42. Passive transport is dependent on: (Select all that apply.) a. Semipermeable barrier membrane b. The process of osmosis c. Diffusion as a driving force d. A living host e. Hydrostatic pressure 1 43. What is the primary function of proteins? (Select all that apply.) a. Proteins are binding units. b. Proteins are transport channels. c. Proteins are ribonucleoproteins. d. Proteins provide cell surface markers. e. Proteins are chemical reaction catalysts. Matching Match the structure with its function. Answers may be used more than once. A. Endoplasmic reticulum B. Ribosome C. Secretory vesicle D. Lysosomes 44. Packages and transports proteins. Endoplasmic reticulum, Ribosome 45. Fuses with the plasma membrane to release contents from the cell. Secretory Vesicle 46. Synthesizes and transports lipids. Endoplasmic reticulum 47. Provides energy to digest proteins into amino acids. Lysosomes Match the structure with its function. Answers may be used more than once. A. Passive-mediated transport B. Active-mediated transport C. Osmosis 48. Movement of water Osmosis 49. Protein carrier Passive-mediated transport & Active- mediated transport 50. Facilitated diffusion Passive-mediated transport Thought Questions 1 cell responses to common neurotransmitters and steroids, which are first messenger molecules to cAMP second messenger pathway. 1 -Second messengers are intracellular signaling molecules released by the cell in response to exposure to extracellular signaling molecules—the first messengers. First messengers are extracellular factors, often hormones or neurotransmitters, such as epinephrine, growth hormone, and serotonin. -AC Pathway. The AC pathway begins with an outside signal, such as a hormone, that binds to a receptor on a cell surface. The receptor then activates a G-protein by causing a change from GDP to GTP. The alpha piece of Gs, when activated, tells the AC to begin changing ATP to Cyclic adenosine monophosphate (cAMP, cyclic AMP, or 3',5'- cyclic adenosine monophosphate) . -cAMP is a second messenger important in many biological processes. cAMP is a derivative of adenosine triphosphate (ATP) and used for intracellular signal transduction in many different organisms, conveying the cAMP-dependent pathway for the activation of specific proteins. 1 Chapter 2: Altered Cellular & Tissue Study Guide Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Which type of cell adaptation occurs when normal columnar ciliated epithelial cells of the bronchial lining have been replaced by stratified squamous epithelial cells? a. Hyperplasia c. Dysplasia b. Metaplasia d. Anaplasia 2. The loss of adenosine triphosphate (ATP) during ischemia causes cells to: a. Shrink because of the influx of calcium (Ca). b. Shrink because of the influx of potassium (KCL). c. Swell because of the influx of sodium chloride (NaCl). d. Swell because of the influx of nitric oxide (NO). 3. The mammary glands enlarge during pregnancy primarily as a consequence of hormonal: a. Atrophy c. Hyperplasia c. Anaplasia d. Dysplasia 4. Free radicals play a major role in the initiation and progression of which diseases? a. Cardiovascular diseases such as hypertension and ischemic heart disease b. Renal diseases such as acute tubular necrosis and glomerulonephritis c. Gastrointestinal diseases such as peptic ulcer disease and Crohn disease d. Muscular disease such as muscular dystrophy and fibromyalgia 5. Free radicals cause cell damage by: a. Stealing the cell’s oxygen to stabilize the electron, thus causing hypoxia b. Stimulating the release of lysosomal enzymes that digest the cell membranes c. Transferring one of its charged, stabilized atoms to the cell membrane, which causes lysis d. Giving up an electron, which causes injury to the chemical bonds of the cell membrane 6. What is a consequence of plasma membrane damage to the mitochondria? a. Enzymatic digestion halts DNA synthesis. b. Influx of calcium ions halts ATP production. c. Edema from an influx in sodium causes a reduction in ATP production. d. Potassium shifts out of the mitochondria, which destroys the infrastructure. 7. What is a consequence of leakage of lysosomal enzymes during chemical injury? 1 15. What physiologic change occurs during heat exhaustion? 1 a. Hemoconcentration occurs because of the loss of salt and water. b. Cramping of voluntary muscles occurs as a result of salt loss. c. Thermoregulation fails because of high core temperatures. d. Subcutaneous layers are damaged because of high core temperatures. 16. In hypoxic injury, sodium enters the cell and causes swelling because: a. The cell membrane permeability increases for sodium during periods of hypoxia. b. ATP is insufficient to maintain the pump that keeps sodium out of the cell. c. The lactic acid produced by the hypoxia binds with sodium in the cell. d. Sodium cannot be transported to the cell membrane during hypoxia. 17. What is the most common site of lipid accumulation? a. Coronary arteries c. Liver b. Kidneys d. Subcutaneous tissue 18. What mechanisms occur in the liver cells as a result of lipid accumulation? a. Accumulation of lipids that obstruct the common bile duct, preventing flow of bile from the liver to the gallbladder b. Increased synthesis of triglycerides from fatty acids and decreased synthesis of apoproteins c. Increased binding of lipids with apoproteins to form lipoproteins d. Increased conversion of fatty acids to phospholipids 19. Hemoprotein accumulations are a result of the excessive storage of: a. Iron, which is transferred from the cells to the bloodstream b. Hemoglobin, which is transferred from the bloodstream to the cells c. Albumin, which is transferred from the cells to the bloodstream d. Amino acids, which are transferred from the cells to the bloodstream 20. Hemosiderosis is a condition that results in the excess of what substance being stored as hemosiderin in cells of many organs and tissues? a. Hemoglobin c. Iron b. Ferritin d. Transferrin 21. What is the cause of free calcium in the cytosol that damages cell membranes by uncontrolled enzyme activation? a. Activation of endonuclease interferes with the binding of calcium to protein. b. Activation of phospholipases, to which calcium normally binds, degrades the proteins. c. An influx of phosphate ions competes with calcium for binding to proteins. d. Depletion of ATP normally pumps calcium from the cell. 22. What two types of hearing loss are associated with noise? a. Acoustic trauma and noise-induced c. High frequency and acoustic trauma b. High frequency and low frequency d. Noise-induced and low frequency 23. What type of necrosis results from ischemia of neurons and glial cells? 1 a. Coagulative c. Caseous 1 d. Oxygen is not available to bind with sodium to maintain it outside of the cell. 32. In decompression sickness, emboli are formed by bubbles of: a. Oxygen b. Nitrogen c. Carbon monoxide d. Hydrogen 33. Which is an effect of ionizing radiation exposure? a. Respiratory distress b.Sun intolerance c. DNA aberrations d. Death 34. What is an example of compensatory hyperplasia? a. Hepatic cells increase cell division after part of the liver is excised. b. Skeletal muscle cells atrophy as a result of paralysis. c. The heart muscle enlarges as a result of hypertension. d. The size of the uterus increases during pregnancy. 35. It is true that nondividing cells are: a. Found in gastrointestinal lining c. Incapable of synthesizing DNA b. Affected by hyperplasia d. Affected by only hypertrophy 36.Dysplasia refers to a(n): a. Abnormal increase in the number of a specific cell type b. True adaptive process at the cellular level c. Modification in the shape of a specific cell type d. Lack of oxygen at the cellular level 37.Current research has determined that chemical-induced cellular injury: a. Affects the permeability of the plasma membrane. b. Is often the result of the damage caused by reactive free radicals. c. Is rarely influenced by lipid peroxidation. d. Seldom involves the cell’s organelles. Multiple Response Identify one or more choices that best complete the statement or answer the question. 38. Which organs are affected by lead consumption? (Select all that apply.) a. Bones b. Muscles 1 c. Pancreas 1 d. Nerves e. Eyes 39. What effect does fetal alcohol syndrome have on newborns? (Select all that apply.) a. Failure of alveoli to open b. Cognitive impairment c. Incompetent semilunar values d. Esophageal stricture e. Facial anomalies 40. What organs are affected by the type of necrosis that results from either severe ischemia or chemical injury? (Select all that apply.) a. Lungs b. Brain c. Kidneys d. Muscles e. Heart 41. It is true that melanin is: (Select all that apply.) a. Rarely found in epithelial cells b. Found in cells called keratinocytes, which are present in the retina c. A factor in the prevention of certain types of cancer d. Most influential in managing the effects of short-term sunlight exposure e. Accumulated in specific cells found in the skin 42. Examples of adaptive cellular responses include: (Select all that apply.) a. Atrophy b. Dysplasia c. Hypertrophy d. Hyperplasia e. Metaplasia 43. Blunt force injuries would include a: (Select all that apply.) a. Bruise to the upper arm, resulting from a fall b. Simple tibia fracture sustained in a skiing accident c. Cut on the finger while slicing vegetables for a salad d. Spleen laceration caused by a punch during a physical fight e. Small caliber gunshot wound to the foot while target shooting 1 result of decreases in workload, pressure, use, nerve stimulation) 2.) Hypertrophy: increase in size of cells and size of infected organ. Cells of the 1 heart and kidneys are prone to enlargement. Increased size in associated with an increase in accumulation of protein in cellular components (plasma membrane, ER, mitochondria) and NOT with an increase in cellular fluid. can be physiologic or pathologic- caused by specific hormone stimulation or increased functional demand. Two types of signals- a. mechanical signals- stretch b. trophic signals- growth factors, hormones, and vasoactive agents. Ex. Kidney is removed, other kidney is larger. Physiologic- NORMAL, Pathologic- BAD. Pathologic example- hypertension. 3.) Hyperplasia: increase in number of cells resulting from an increased rate of cellular division. As a response to injury, occurs when injury has been severe and prolonged long enough to cause cell death. Hyperplasia and hypertrophy go hand in hand If cells can synthesize DNA. Two types of physiologic- compensatory (adaptative mechanism that causes cells to regenerate) Ex. Compensatory hyperplasia is the callus (thickening) of the skin as a result of hyperplasia of epidermal cells in response to a mechanical stimulus. Removing part of liver leads remaining cells to regenerate for loss and hormonal (in estrogen dependent organs such as uterus and breast. Pregnancy occurs- uterus enlarges. Pathological- abnormal proliferation of normal cells, usually in response to excessive hormonal stimulation or growth. Ex. Hyperplasia of endometrium= excessive menstrual bleeding. 4.) Dysplasia: abnormal changes in size, shape, and organization of mature cells. Not a true adaptive process but related to hyperplasia- called atypical hyperplasia. Does not indicate cancer and may not progress to cancer. 5.) Metaplasia: reversible replacement of 1 mature cell type by another, sometimes less differentiated cell type. Develop from a reprogramming of stem cells that exist on most epithelia or of undifferentiated mesenchymal cells present in connective tissue. EX cigarette smoke replaces cells. Bronchial tubes are normal ciliated epithelial cells replaced with stratified squamous epithelial cells. Bronchial metaplasia can be reversed if the inducing stimulus, usually cigarettes, is removed. With prolonged exposure to the inducing stimulus, dysplasia and cancerous transformation can occur Chapter 3: Fluids, Electrolytes, and Acid- Base Balance Study Guide Multiple Choice Identify the choice that best completes the statement or answers the question 1 1. Infants are most susceptible to significant losses in the total body water because of an infant’s: 1 9. Secretion of antidiuretic hormone (ADH) and the perception of thirst are stimulated by a(n): a. Decrease in serum sodium b. Increase in plasma osmolality c. Increase in glomerular filtration rate d. Decrease in osmoreceptor stimulation 10. Thirst activates osmoreceptors by an increase in which blood plasma? a. Antidiuretic hormone b. Aldosterone c. Hydrostatic pressure d. Osmotic pressure 11. It is true that natriuretic peptides: a. Decrease blood pressure and increase sodium and water excretion b. Increase blood pressure and decrease sodium and water excretion c. Increase heart rate and decrease potassium excretion d. Decrease heart rate and increase potassium excretion 12. When changes in total body water are accompanied by proportional changes in electrolytes, what type of alternation occurs? a. Isotonic b. Hypertonic c. Hypotonic d. Normotonic 13. Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced? a. Angiotensin I b. Angiotensin II c. Aldosterone d. Renin 14. What mechanism can cause hypernatremia? a. Syndrome of inappropriate antiduretic hormone b. Hypersecretion of aldosterone c. Brief bouts of vomiting or diarrhea d. Excessive diuretic therapy 15. What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma in hypernatremia? a. High sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink b. High sodium in the brain cells pulls water out of the blood vessels into the brain cells, causing them to swell c. High sodium in the blood vessels pulls potassium out of the brain cells, which slows the synapses in the brain d. High sodium in the blood vessels draw chloride into the brain cells followed by water, causing the brain cells to swell 1 16. Vomiting-induced metabolic alkalosis, resulting in the loss of chloride, causes: a. Retained sodium to bind with the chloride 1 b. Hydrogen to move into the cell and exchange with potassium to maintain cation Balance c. Retention of bicarbonate to maintain the anion balance d. Hypoventilation to compensate for the metabolic alkalosis 17. The pathophysiologic process of edema is related to which mechanism? a. Sodium depletion b. Decreased capillary hydrostatic pressure c. Increased plasma oncotic pressure d. Lymphatic obstruction 18. Insulin is used to treat hyperkalemia because it: a. Stimulates sodium to be removed from the cell in exchange for potassium b. Binds to potassium to remove it through the kidneys c. Transports potassium from the blood to the cell along with glucose d. Breaks down the chemical components of potassium, causing it to be no longer effective 19. A major determinant of the resting membrane potential necessary for the transmission of nerve impulses is the ratio between: a. Intracellular and extracellular Na+ b. Intracellular and extracellular K+ c. Intracellular Na+ and extracellular K+ d. Intracellular K+ and extracellular Na+ 20. During acidosis, the body compensates for the increase in serum hydrogen ions by shifting the hydrogen ions int to the cell in exchange for which electrolyte? a. Oxygen b. Sodium c. Potassium d. Magnesium 21. Causes of hyperkalemia include: a. Hyperparathyroidism and malnutrition b. Vomiting and diarrhea c. Renal failure and Addison disease d. Hyperaldosteronism and Cushing disease 22. In hyperkalemia, what change occurs to the cells’ resting membrane potential? a. Hypopolarization b. Hyperexcitability c. Depolarization d. Repolarization 23. The calcium and phosphate balance is influenced by which three substances? a. Parathyroid hormone, vasopressin, and vitamin D b. Parathyroid hormone, calcitonin, and vitamin D c. Thyroid hormone, vasopressin, and vitamin A d. Thyroid hormone, calcitonin, vitamin A 1 b. Inflammation resulting from an immune response 1 c. Blockage within the lymphatic channel system d. Sodium and water retention 33. The existence of hyperkalemia is likely to result in which changes to a person’s electrocardiogram (ECG)? a. Flattened U waves b. Peaked T waves c. Depressed ST segments d. Peaked P waves Multiple Response Identify one or more choices that best complete the statement or answer the question. 34. Which groups are at risk for fluid imbalance? (Select all that apply.) a. Women b. Infants c. Men d. Obese persons e. Older adults 35. Dehydration can cause which result? (Select all that apply.) a. Moist mucous membranes b. Weak pulses c. Tachycardia d. Polyuria e. Weight loss 36. Causes of hypocalcemia include: (Select all that apply.) a. Repeated blood administration b. Pancreatitis c. Decreased reabsorption of calcium d. Hyperparathyroidism e. Kidney stones 37. The electrolyte imbalance called hyponatremia exhibits which clinical manifestations? (Select all that apply.) a. Headache b. Seizures c. Paranoia d. Confusion e. Lethargy 38. The electrolyte imbalance hypercalcemia exhibits which clinical manifestations? (Select all that apply.) a. Diarrhea b. Calcium based kidney stones 1 c. ECG showing narrow T waves d. Lethargy 1 2. Describe the three types of alterations in sodium, chloride and water imbalance (isotonic, hypertonic and hypotonic alterations) Isotonic: (isoosmolar) Gain or loss of extracellular fluid (ECF) resulting in a concentrated equivalent to a 0.9% sodium chloride solution (normal saline); no shrinkage or swelling of the cell. Hypertonic: (hyperosmolar) Imbalance that results in an ECF concentration >0.9% salt solution; that is, water loss or solute gain; cells shrink in a hypertonic fluid. Hypotonic: (hypoosmolar) Imbalance that results in an ECF <0.9% salt solution; that is, water gain or solute loss; cells swell in a hypotonic fluid. 3. Describe the manifestations of alterations in potassium, calcium, phosphate and magnesium balance. Potassium: Hypokalemia • Decreased neuromuscular excitability • Skeletal muscle weakness • Smooth muscle atony • Cardiac dysrhythmias Calcium: Hyperkalemia • U wave on electrocardiogram (ECG) • Increased intake • Shift of K+ from ICF to ECF • Decreased renal excretion • Hypoxia • Acidosis • Insulin deficiency • Cell trauma • Digitalis overdose Hypocalcemia • Increased neuromuscular excitability (partial depolarization) • Muscle spasms • Chvostek and Trousseau signs • Convulsions • Tetany Hypercalcemia • Decreased neuromuscular excitability • Weakness • Kidney stones • Constipation • Heart block Phosphate: Hypophosphatemia • Diminished release of oxygen • osteomalacia (soft bones) 1 • muscle weakness • bleeding disorders (platelet impairment) 1 • leukocyte alterations • rickets Hyperphosphatemia • Same as hypocalcemia with possible calcification of soft tissue Magnesium: Hypomagnesemia • From malabsorption • Associated with hypocalcemia and hypokalemia • Neuromuscular irritability • Tetany, convulsions • Increased reflexes • From renal failure Hypermagnesemia • Skeletal muscle depression • Muscle weakness • Hypotension • Respiratory depression • Bradycardia Chapter 7: Innate Immunity Study Guide Multiple Choice Identify the choice that best completes the statement or answers the question. Chapter 7 Multiple Choice Identify the choice that best completes the statement or answers the question. 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 2. How do surfactant proteins A through D provide innate resistance? a. Initiate the complement cascade. 1 d. Immune system 1 10. What is the vascular effect of histamine released from mast cells? a. Platelet adhesion b. Initiation of the clotting cascade c. Vasodilation d. Increased endothelial adhesiveness 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 12. What is the function of opsonization related to the complement cascade? a. To tag pathogenic microorganisms for destruction by neutrophils and macrophages b. To process pathogenic microorganisms so that activated lymphocytes can be created for acquired immunity c. To destroy glycoprotein cell membranes of pathogenic microorganisms d. To 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 b.VII c.X d.V 14. Which chemical interacts among all plasma protein systems by degrading blood clots, activating complement, and activating the Hageman factor? a. Kallikrein b. Histamine c. Bradykinin d. Plasmin 15. How does the chemotactic factor affect the inflammatory process? a. By causing vasodilation around the inflamed area b. By stimulating smooth muscle contraction in the inflamed area c. By directing leukocytes to the inflamed area d. By producing edema around the inflamed area 16. What effect does the process of histamine binding to the histamine-2 (H2) receptor have on inflammation? a. Inhibition 1 b. Activation 1 a. Neutrophils b. Monocytes c. Chemokines d. Eosinophils 24. In regulating vascular mediators released from mast cells, the role of eosinophils is to release what? 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 a 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 b. IL-10 c. TNF- d. IFN- 27. Which manifestation of inflammation is systemic? a. Formation of exudates b. Fever and leukocytosis c. Redness and heat d. Pain and edema 28. The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by what? a. Endogenous pyrogens b. Bacterial endotoxin c. Antigen-antibody complexes d. Exogenous pyrogens 29. 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. 1 30. What is the role of fibroblasts during the reconstructive phase of wound healing? 1 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. 31. A keloid is the result of which dysfunctional wound healing response? a. Epithelialization b. Contraction c. Collagen matrix assembly d. Maturation 32. A student is preparing to irrigate a patient’s wound and gathers supplies, including hydrogen peroxide. What response by the health care professional is best? a. Help the student gather the rest of the supplies. b. Instruct the student to dilute the hydrogen peroxide. c. Tell the student to get some normal saline instead. d. Ask the patient if pain medication is needed first. 33. 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. 34. 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. 35. Fusion is the step of phagocytosis during which what happens? a. Microorganisms are killed and digested. b. An intracellular phagocytic vacuole is formed. c. Lysosomal granules enter the phagocyte. d. Microorganisms are ingested. 36. What does the phagosome step result in during the process of endocytosis? a. Microorganisms are ingested. b. Microorganisms are killed and digested. c. Phagocytes recognize and adhere to bacteria. d. An intracellular phagocytic vacuole is formed. 1 d. Saliva 1 e. Urine 43. What do the main functions of NK cells include? (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 44. An individual’s acquired immunity is dependent on the function of which cells? (Select all that apply.) a. T lymphocytes b. B lymphocytes c. Macrophages d. Opsonins e. Neutrophils 45. Examples of pathogens capable of surviving and even multiplying inside a macrophage include what? (Select all that apply.) a. Mycobacterium tuberculosis (tuberculosis) b. Mycobacterium leprae (leprosy) c. Salmonella typhi (typhoid fever) d. Clostridium difficile e. Brucella abortus (brucellosis) 46. 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 Chapter 8: Adaptive Immunity Study Guide Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Which primary characteristic is unique for the immune response? a. The immune response is similar each time it is activated. 1 b. The immune response is specific to the antigen that initiates it. 1 a. Are antigen-presenting molecules 1 b. Bind antigens to antibodies c. Secrete interleukins during the immune process d. Are capable of activating cytotoxic T lymphocytes 10. Where are antibodies produced? a. Helper T lymphocytes b. Thymus gland c. Plasma cells d. Bone marrow 11. Which immunoglobulin is present in blood, saliva, breast milk, and respiratory secretions? a. IgA b. IgE c. IgG d. IgM 12. Which antibody initially indicates a typical primary immune response? a. IgG b. IgM c. IgA d. IgE 13. An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody? a. IgG b. IgM 1 c. IgA 1 b. 24 hours 1 c. 3 days d. 6 days 23. Vaccinations are able to provide protection against certain microorganisms because of what? a. Strong response from IgM b. Level of protection provided by IgG c. Memory cells for IgE d. Rapid response from IgA 24. The healthcare professional working with older adults teaches general infection- prevention measures as a priority for this age group due to which change in lymphocyte function? a. Increased production of antibodies against self-antigens b. Decreased number of circulating T cells c. Decreased production of autoantibodies d. Increased production of helper T cells 25. How do antibodies protect the host from bacterial toxins? a. Lysing the cell membrane of the toxins b. Binding to the toxins to neutralize their biologic effects c. Inhibiting the synthesis of DNA proteins needed for growth d. Interfering with the DNA enzyme needed for replication 26. Which T cell controls or limits the immune response to protect the host’s own tissues against an autoimmune response? a. Cytotoxic T cells b. Th1 cells 1 c. Th2 cells 1 35. Which is an example of a bacterial toxin that has been inactivated but still retains its immunogenicity to protect the person? (Select all that apply.) a. Poliomyelitis b. Measles c. Tetanus d. Gonorrhea e. Diphtheria 36. Which statements are true concerning the humoral immune response? (Select all that apply.) a. The humoral immune response is divided into major and minor phases. b. The response has IgG and IgM produced during each of its phrases. c. It has a greater presence of IgG than IgM in one of its phases. d. The humoral immune response is produced in reaction to the presence of an antigen. e. Phases differ in their response time as a result of the effect of memory cells. 37. CD4 is a characteristic surface marker and a result of which of these? (Select all that apply.) a. Activity in the primary lymphoid organs b. Process of cellular differentiation c. Alterations to T cells d. Changes to B cells 1 e. Clonal selection 38. What are the necessary components of an adaptive immune response? (Select all that apply.) a. Antigen b. Gamma IgG c. Lymphocyte surface receptors d. Crystalline fragment e. Antibody Chapter 9 Alteration in Immunity and Inflammation Multiple Choice Identify the choice that best completes the statement or answers the question. 1. How is hypersensitivity best defined? a. A disturbance in the immunologic tolerance of self-antigens b. An immunologic reaction of one person to the tissue of another person c. An altered immunologic response to an antigen that results in disease d. An undetectable immune response in the presence of antigens 1 2. What is a hypersensitivity reaction that produces an allergic response called? a. Hemolytic shock b. Anaphylaxis c. Necrotizing vasculitis d. Systemic erythematosus 3. The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins? a. IgE b. IgG c. IgM d. T cells 4. What are blood transfusion reactions an example of? a. Autoimmunity b. Alloimmunity c. Homoimmunity d. Hypersensitivity 5. During an IgE-mediated hypersensitivity reaction, which leukocyte is activated? a. Neutrophils b. Monocytes c. Eosinophils d. T lymphocytes 6. During an IgE-mediated hypersensitivity reaction, what causes bronchospasm? a. Bronchial edema caused by the chemotactic factor of anaphylaxis 1 a. Complement-mediated cell lysis b. Phagocytosis by macrophages c. Phagocytosis in the spleen d. Natural killer cells 11. When antibodies are formed against red blood cell antigens of the Rh system, how are the blood cells destroyed? a. Complement-mediated cell lysis b. Phagocytosis by macrophages c. Phagocytosis in the spleen d. Neutrophil granules and toxic oxygen products 12. When soluble antigens from infectious agents enter circulation, what is tissue damage a result of? a. Complement-mediated cell lysis b. Phagocytosis by macrophages c. Phagocytosis in the spleen d. Neutrophil granules and toxic oxygen products 13. How are target cells destroyed in a type II hypersensitivity reaction? a. Tissue damage from mast cell degranulation b. Antigen-antibody complexes deposited in vessel walls c. Cytotoxic T lymphocytes attack the cell directly. d. Natural killer cells 14. Graves disease (hyperthyroidism) is an example of which type II hypersensitivity reaction? 1 a. Modulation 1 b. Antibody-dependent cell-mediated cytotoxicity c. Neutrophil-mediated damage d. Complement-mediated lysis 15. Type III hypersensitivity reactions are a result of which of these? a. Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues c. Tc cells or lymphokine-producing Th1 cells directly attacking and destroying cellular targets d. Antibodies binding to the antigen on the cell surface 16. A type IV hypersensitivity reaction causes which result? a. Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues c. Lymphokine-producing Th1 cells directly attacking and destroying cellular targets d. Antibodies binding to the antigen on the cell surface 17. In a type III hypersensitivity reaction, the harmful effects after the immune complexes that are deposited in tissues are a result of what? a. Cytotoxic T cells b. Natural killer cells c. Complement activation d. Degranulation of mast cells 1 c. Systemic lupus erythematosus 1 d. Myasthenia gravis 22. A patient asks the healthcare professional why tissue damage occurs in acute rejection after organ transplantation. What response by the professional is best? a. Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T cells directly attack the endothelial cells of the transplanted tissue. b. Circulating immune complexes are deposited in the endothelial cells of transplanted tissue, where the complement cascade lyses tissue. c. Receptors on natural killer cells recognize antigens on the cell surface of transplanted tissue, which releases lysosomal enzymes that destroy tissue. d. Antibodies coat the surface of transplanted tissue to which mast cells bind and liberate preformed chemical mediators that destroy tissue. 23. Which blood cell carries the carbohydrate antigens for blood type? a. Platelets b. Neutrophils c. Lymphocytes d. Erythrocytes 24. A person with type O blood needs a blood transfusion. What blood type does the healthcare professional prepare to administer to the patient? a. A b. B c. AB d. O 25. Which class of immunoglobulins forms isohemagglutinins? a. IgA 1 b. IgE 1 c. Natural killer cells d. Neutrophils 30. Urticaria is a manifestation of a which type of hypersensitivity reaction? a. IV b. III c. II d. I 31. What is Graves disease a result of? a. Increased levels of circulating immunoglobulins b. The infiltration of the thyroid with T lymphocytes c. Autoantibodies binding to thyroid-stimulating hormone (TSH)-receptor sites d. Exposure to acetylates in substances such as rubber 32. Raynaud phenomenon is an example of which type of hypersensitivity? a. IV b. III c. II d. I 33. Which statement is true concerning an atopic individual? a. They tend to produce less IgE. b. They tend to produce more Fc receptors. c. They tend to attract very few mast cells. d. They tend to produce very high levels of IgM. 1 34. Which statement is true regarding immunodeficiency? a. Immunodeficiency is generally not present in other family members. b. Immunodeficiency is never acquired; rather, it is congenital. c. Immunodeficiency is almost immediately symptomatic. d. Immunodeficiency is a result of a postnatal mutation. 35. A person with type O blood is considered to be the universal blood donor because type O blood contains which of these? a. No antigens b. No antibodies c. Both A and B antigens d. Both A and B antibodies 36. Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction? a. I b. II c. III d. IV 37. A pregnant woman has Graves disease. What test/s does the healthcare professional advise the woman about? a. Frequent tests of the newborn’s muscular strength and movement. b. Blood test for hyperthyroidism c. Monthly OB checkups for fetal anomalies or pregnancy loss d. Serum complete blood count including platelet count Multiple Response 1 Identify one or more choices that best complete the statement or answer the question. 1 e. Acute rejection is a response against unmatched human leukocyte antigens (HLAs). Thought Questions 1. Briefly compare and contrast the four different types of hypersensitivity reactions. Be able to discuss the mediators and responses to the mediators; provide an example of each reaction. Type 1: IgE-Mediated Mediated by antigen-specific IgE and the products of tissue mast Cells -Histamine (most potent mediator) acts on H1 and H2 receptors - acts on H1 receptors 1. Contracts bronchial smooth muscles à bronchial constriction 2. Increases vascular permeability à edema 3. Vasodilation à increases blood flow into affected areas -acts on H2 receptors 1. increases gatic acid secretion and a decrease of histamine released from mast cells and basophils -Mast cells initiate synthesis of bioactive lipid-derived mediators such as leukotrienes, platelet-activating factor (PAF), and prostaglandins à each released much more slowly than histamine and can mediate, yet more prolonged, clinical symptoms such as recruiting inflammatory cells (eg. Neutrophils, eosinophils), promoting vascular permeability and edema, inducing bronchoconstriction or rhinitis, and inducing further release of histamine form mast cells Example: seasonal allergic rhinitis Type 2: Tissue Specific Antibody binds to antigen on cell surface Mediator – antibody binding to tissue-specific antigens or antigens that have attached to particular tissues 1. Cell can be destroyed by antibody (IgG or IgM) and activation of complement cascade through classical pathways 2. Antibody cause cell destruction through 1 phagocytosis by macrophages. IG and also C3b of the complement system are opsonins that bind to receptors 1 Chapter 10: Infection 1. What is a significant cause of morbidity and mortality worldwide? a. Starvation b. Traumatic injury c. Cardiovascular disease d. Infectious disease 2. What is the first stage in the infectious process? a. Invasion b. Colonization c. Spread d. Multiplication 3. Which type of microorganism reproduces on the skin? a. Viruses b. Bacteria and fungi c. Protozoa and Rickettsiae d. Mycoplasma 4. Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms? a. Bacteria b. Fungi c. Viruses d. Yeasts