Test 1 (1-9)

37. What is the difference between the terms "infection" and "inflammation"?

"Infection" refers to an invasion of tissues by an organism "Inflammation" refers to a bodily response to either infection or injury or an antibody-antigen interaction.

42. Name three common but generally less serious sexually transmitted diseases.

(any three of the following) anal and genital warts, condylomas, papilloma virus, vaginitis, Gardnerella, Trichomonas vaginalis, scabies, crabs, hepatitis, intestinal infections

40. __________ are bands of fibrous tissue that bind adjacent tissues together.

Adhesions

39. Identify and briefly describe the three groups of animal parasites.

1. Protozoa, which are simple, one-celled organisms 2. Metazoa, which are more complex multicellular structures 3. Arthropods, which are small insects

38. Name four major factors known to induce congenital malformations.

1. Chromosomal abnormalities 2. Abnormalities of individual genes 3. Intrauterine injury to the embryo or fetus by drugs, radiation, maternal infection, or other harmful environmental factors 4. Environmental factors acting on a genetically predisposed embryo

46. What are two major differences between spermatogenesis and oogenesis?

1. Four spermatozoa are produced from each precursor cell in spermatogenesis, but only one ovum is formed from each precursor cell in oogenesis. 2. Spermatogenesis occurs continually and is carried through to completion in about 2 months, meaning that there is always "fresh" sperm. In contrast, the oocytes are all formed before birth and remain in a prolonged prophase of the first meiotic division from fetal life until they are ovulated.

44. Name three factors that may predispose an individual to autoimmune diseases.

1. Genetics 2. Gender 3. Previous infection

42. What are the four types of hypersensitivity? Give an example for each.

1. Immediate hypersensitivity. Localized response: hay fever, food allergy; systemic response: bee sting, penicillin anaphylaxis 2. Cytotoxic hypersensitivity reactions. Blood transfusion reactions, Rh hemolytic disease, autoimmune hemolytic anemia 3. Immune complex disease. Some types of glomerulonephritis; lupus erythematosus; rheumatoid arthritis 4. Delayed (cell-mediated) hypersensitivity. Tuberculosis; fungus and parasitic infections; contact dermatitis

41. What are the three principal means of controlling spread of communicable diseases?

1. Immunization 2. Identification, isolation, and treatment of infected persons 3. Control of means of indirect transmission (spraying for insects, cleaning contaminated water or food, etc.)

39. What are three conditions that may result in Down syndrome?

1. Nondisjunction during gametogenesis, leading to the formation of an abnormal gamete containing an extra chromosome 21 2. An extra chromosome 21, acquired as part of a translocation chromosome 3. Nondisjunction occurring in the zygote.

45. Identify and briefly explain the four stages of mitosis.

1. Prophase: Each chromosome thickens and shortens. The centrioles migrate to opposite poles of the cell and form the mitotic spindle. Some of these spindle fibers attach to the chromatids. The nuclear membrane breaks down toward the end of prophase. 2. Metaphase: The chromosomes line up in the center of the cell. The chromatids are partially separated but still remain joined at the centromere. 3. Anaphase: The chromatids separate to form individual chromosomes, which are pulled to opposite poles of the cell by the spindle fibers. 4. Telephase: The nuclear membrane of the two daughter cells reform, and the cytoplasm divides, forming two daughter cells, each an exact duplicate of the parent cell.

43. Name three undesirable effects of cell-mediated and humoral immune responses.

1. They may be directed against the individual's own cells or tissue components, leading to autoimmune diseases. 2. They are responsible for the rejection of transplanted organs. 3. They lead to Rh hemolytic disease in newborn infants.

50. Explain why an individual will accept a graft from his or her own body or an identical twin but not from another person.

A graft from another person contains HLA antigens foreign to the recipient that the recipient's immune system recognizes and destroys, otherwise known as tissue rejection.

47. What is the difference between a viral infection and a viral disease?

A viral infection can occur without causing any symptoms or signs of injury to the infected cell(s). A viral disease occurs when an infection does cause injury and active symptoms in the host.

41. Identify the following pathogenic bacteria as either gram-positive (+) or gram-negative (-). A. Staphylococci B. Campylobacter C. Listeria D. Borrelia burgdorferi E. Yersinia F. Salmonella G. Gonococci H. Clostridia I. Shigella J. Streptococci

A. + Staphylococci B. - Campylobacter C. + Listeria D. + Borrelia burgdorferi E. - Yersinia F. - Salmonella G. - Gonococci H. + Clostridia I. - Shigella J. + Streptococci

2. What is a sex chromatin body? A. An inactivated X chromosome that appears as a dense mass of chromatin applied to the nuclear membrane of a nondividing cell B. A mass of mitotic spindle fibers that became entangled during mitosis C. A remnant of the nucleolus D. An abnormal chromosome that is unable to function during mitosis

A. An inactivated X chromosome that appears as a dense mass of chromatin applied to the nuclear membrane of a nondividing cell

24. The fundamental structure of a virus consists essentially of a core containing a single nucleic acid enclosed within a protein coat. What is the outer protein coat called? A. Capsid B. Virion C. Elementary body D. Mosaic

A. Capsid

3. Which of the following substances can suppress the inflammatory reaction? A. Corticosteroid hormones B. Antibodies C. Monocytes D. Lymphokines produced by T lymphocytes

A. Corticosteroid hormones

8. Which of the following are systemic effects from an inflammatory response? A. Elevated temperature B. Redness and swelling C. Blisters D. Pus

A. Elevated temperature

6. Which of the following is a highly infectious fungus that often causes an acute pulmonary infection if fungus spores are inhaled? A. Histoplasma capsulatum B. Candida albicans C. Pneumocystis carinii D. Toxoplasma gondii E. Cryptosporidium parvum

A. Histoplasma capsulatum

11. Autoimmune diseases are caused by __________. A. authoantibodies B. non-self-antigens C. self-antigens D. none of the above

A. authoantibodies

7. Which of the following is NOT characteristic of a pulmonary infection caused by a pathogenic fungus? A. Human-to-human transmission B. The fungi that cause pulmonary infections grow in the soil C. Inhalation of the fungus that often causes an acute pulmonary infection D. May lead to severe progressive pulmonary disease in immunocompromised persons

A. Human-to-human transmission

2. John Jones was exposed to a person who was ill with an infectious disease, and John received an injection of globulin to provide protection against the infectious agent to which he was exposed. What is the class of antibody in the gamma globulin that provides the protection? A. IgG B. IgA C. IgM D. IgD E. IgE

A. IgG

7. Which of the following diseases or conditions is caused by the bite of an infected insect? A. Malaria B. Cryptosporidiosis C. Toxoplasmosis D. Pinworm infestation E. Trichinosis

A. Malaria

9. Which of the following conditions is NOT an indication for amniocentesis? A. Maternal age younger than 35 years B. Previous infant born with Down syndrome or other chromosomal abnormality C. Known translocation chromosome carrier or other chromosome abnormality in either parent D. Risk of fetal genetic disease that can be detected by fetal cell biochemical or DNA analysis E. Maternal blood tests (triple screen) indicating increased risk of fetal abnormality

A. Maternal age younger than 35 years

20. __________ are sausage-shaped organelles that have small amounts of DNA that contain genes necessary for the synthesis of energy-generating proteins. A. Mitochondria B. Chromosomes C. Cells D. Gonads

A. Mitochondria

4. What is the antibody-producing cell that plays an important role in protecting us from infection? A. Plasma cell B. T lymphocyte C. Monocyte D. Neutrophil

A. Plasma cell

6. An important and serious infection in AIDS patients is a pneumonia caused by a small parasite that grows within pulmonary alveoli, called A. Pneumocystis carinii B. Chlamydia C. Toxoplasma D. The EB virus

A. Pneumocystis carinii

6. Most of the lymphocytes in the circulation would be classified as what? A. T lymphocytes B. B lymphocytes C. Neither T nor B lymphocytes (natural killer cells, also called NK cells) D. Macrophages E. Mast cells

A. T lymphocytes

17. A patient has a bacterial infection, and a sensitivity test performed on the organism responsible for the infection reveals that the organism is sensitive to tetracycline. What does that indicate? A. The organism probably can be inhibited by a concentration of antibiotic that can be achieved by the usual therapeutic dose of tetracycline when administered to the patient. B. The organism probably cannot be inhibited by the usual therapeutic dose of tetracycline when administered to the patient. C. The infection may be quite serious, and the patient probably should have more than one antibiotic administered. D. The antibiotic will cure the infection.

A. The organism probably can be inhibited by a concentration of antibiotic that can be achieved by the usual therapeutic dose of tetracycline when administered to the patient.

15. The mechanism by which penicillin, cephalosporins, and other beta-lactarn ring antibiotics act against bacteria is A. They prevent the synthesis of the bacterial cell wall by inactivating the bacterial enzymes that make the cell wall. B. They disrupt the function of the bacterial cell membrane. C. They attach to ribosomes of the bacterial cell so that the bacterium cannot make needed proteins. D. They compete with compounds that the bacterium needs in order to grow and divide, thereby inhibiting or stopping the growth of the bacteria.

A. They prevent the synthesis of the bacterial cell wall by inactivating the bacterial enzymes that make the cell wall.

5. Which protozoal infection may result from eating incompletely cooked meat contaminated by a parasite? A. Toxoplasmosis B. Cryptosporidiosis C. Histoplasmosis D. Giardiasis

A. Toxoplasmosis

8. The constricted area at which chromatids remain joined during metaphase is the __________. A. centromere B. centriole C. cytoplasm D. nuclear membrane

A. centromere

17. A __________ gene expresses itself in either the heterozygous or the homozygous state. A. dominant B. recessive C. sex-linked D. hemizygous

A. dominant

4. Bacterial infection of heart valves (bacterial endocarditis) is usually caused by: A. group A beta streptococci. B. group B beta streptococci. C. staphylococcus aureus. D. hemophilus influenzae. E. alpha streptococci (viridans streptococci).

A. group A beta streptococci.

18. The most selective antimicrobial activity (toxic to bacteria but little or no effect on human cells) would be exhibited by a drug that: A. inhibits cell wall synthesis. B. inhibits protein synthesis. C. injures the plasma membrane. D. inhibits nucleic acid synthesis.

A. inhibits cell wall synthesis.

14. Cytokines that act by interfering with the multiplication of viruses within cells are __________. A. interferon B. interleukins C. monokines D. tumor necrosis factors

A. interferon

13. A __________ is an arrangement of chromosomes from a single cell arrangement in pairs in descending order according to size of the chromosomes and the positions of the centromeres. A. karyotype B. allele C. polar body D. chromatid

A. karyotype

11. The parasites that cause malaria in humans begin their development within the __________. A. liver B. red blood cells C. lungs D. stomach

A. liver

10. Cells that most commonly active during chronic infections are: A. lymphocytes, monocytes, and plasma cells. B. polymorphonuclear leukocytes, monocytes, and mast cells. C. complement and bradykinins. D. None of the above.

A. lymphocytes, monocytes, and plasma cells.

13. Absence of a chromosome is called a __________. A. monosomy B. trisomy C. double chromosome D. translocation

A. monosomy

7. Failure of chromosome separation during meiosis is called __________. A. nondisjunction B. translocation C. monosomy D. trisomy

A. nondisjunction

16. An antimicrobial drug that acts by competitive inhibition acts by: A. resembling important compounds required for growth by the bacteria. B. inhibiting cell wall synthesis. C. inhibiting cell membrane function. D. inhibiting metabolic functions.

A. resembling important compounds required for growth by the bacteria.

14. Babesia microtis is usually transmitted to humans from: A. small rodents. B. cats, dogs, and other pets. C. insects. D. none of the above.

A. small rodents.

20. Lupus erythematosus is a common connective-tissue disease that is most frequently seen in __________. A. young women B. young men C. older women D. older men

A. young women

46. Compare and contrast drug category A versus category X.

A: no risk to fetus, as demonstrated in well-controlled studies in humans X: Absolutely contraindicated in pregnancy, with severe risk to fetus outweighing any possible benefits to mother

48. Explain the largest outbreak of cryptosporidiosis in Milwaukee in 1993.

About 400,000 people were infected from a municipal water supply as a result of oocyst contamination of the pool water by infected persons using the pool. Oocysts on the perianal skin of these infected people were released while swimming and infected other individuals.

48. Compare and contrast acid-fast versus gram negative bacteria.

Acid-fast bacteria has a waxy capsule that is difficult to stain using gram staining but can be stained using concentrated dyes. Once stained, unlike most bacteria, these organisms resist decolorization with the dilute acid and/or ethanol-based solvents (example: Mycobacterium tuberculosis, leprae, and avium complex). Gram-negative bacteria decolorize by the acetone-ethanol decolorizing solvent and take in the red counterstain, basic fuchsin.

44. Compare and contrast acute versus chronic inflammation

Acute inflammation is characterized by the proliferation of polymorphonuclear cells. Monocytes, macrophages, lymphocytes, and plasma cells predominate in chronic inflammation, which is a relatively quiet and smoldering process characterized by the body's attempt to heal itself.

52. Explain vaginal infection in a young woman following a full course of antibiotics.

Alteration of the normal bacterial flora of the vagina following an intensive therapy with broad-spectrum antibiotics. The predominance of the normal bacteria usually holds the fungi in check; once normal bacteria are eliminated, proliferation of fungi will result in disease.

47. Describe the process of inflammation.

Attraction of leukocytes to site of injury and adhesion to endothelial lining of small blood vessels; capillary dilatation; increased capillary permeability; leakage of plasma from dilated and permeable vessels, resulting in swelling and irritation of sensory nerve endings

46. Describe precautions that pregnant women should follow to avoid contacting toxoplasmosis during pregnancy.

Avoid contact with infected cats that excrete Toxoplasma oocysts in their feces by having another person empty the cat litter box; do not permit indoor cats to go outdoors; do not allow outdoor cats or stray cats indoors; do not feed cats with raw meat products.

4. A middle-aged man has a communicable disease caused by a virus that is excreted in the feces. Which of the following measures could be least effective or ineffective in limiting the spread of the infection? A. Isolation of the infected individual B. Administration of penicillin or similar antibacterial antibiotic C. Sanitary disposal of feces D. Thorough washing of hands after direct contact with the patient

B. Administration of penicillin or similar antibacterial antibiotic

5. Which of the following statements about pathogenic microorganisms is NOT true? A. The ability to cause disease depends on the virulence of the organism and the integrity of the body's immune defenses. B. Adrenal corticosteroids facilitate destruction of organisms and promote recovery. C. They usually incite an inflammatory response at the site of invasion. D. The ability to respond to a pathogen is in part genetically determined.

B. Adrenal corticosteroids facilitate destruction of organisms and promote recovery.

11. What does the ending -itis indicate when it is affixed to the name of an organ or tissue (e.g., hepatitis)? A. Pain is present in that tissue or organ. B. An infection or an inflammatory process is occurring in that tissue or organ. C. The tissue or organ has sustained serious and irreversible damage. D. An abscess is present in the tissue or organ.

B. An infection or an inflammatory process is occurring in that tissue or organ.

8. The most commonly encountered parasitic worm is the __________. A. pinworm (Enterobius vermicularis) B. Ascaris lumbricoides C. Trichinella spiralis D. Sarcoptes scabiei

B. Ascaris lumbricoides

13. __________ are tick-borne protozoal parasites that can cause malaria-like illness. A. Plasmodia B. Babesiae C. Cryptosporidia D. None of the above

B. Babesiae

3. Pregnant women susceptible to toxoplasma infection should avoid contact with which of the following? A. Mosquitoes B. Cat feces C. Raw sewage D. Ticks

B. Cat feces

20. The gene responsible for the fragile X syndrome is __________. A. FRMP B. FMR1 C. FXS1 D. FRM1

B. FMR1

6. What usually causes Down syndrome? A. Maternal infection during early pregnancy B. Fertilization of an ovum containing an abnormal number of chromosomes C. An interaction of hereditary and environmental factors D. An abnormal gene transmitted by Mendelian inheritance

B. Fertilization of an ovum containing an abnormal number of chromosomes

10. __________ are mature germ cells. A. Gonads B. Gametes C. Spermatids D. Granulosa cells

B. Gametes

4. Which of the following is most likely to lead to congenital malformation or developmental disturbances in the developing fetus? A. Penicillin tablets (ampicillin, which is a FDA category A drug) given to a mother to treat a urinary tract infection during pregnancy B. Heavy alcohol consumption during pregnancy C. Overeating, leading to excessive maternal weight gain in pregnancy D. A high-carbohydrate diet

B. Heavy alcohol consumption during pregnancy

9. __________ immunity is associated with the production of antibodies that can combine and eliminate the foreign material. A. Acquired B. Humoral C. Cell-mediated D. Hypersensitive

B. Humoral

2. Neisseria gonorrhoeae (the gonococcus) can infect many tissues. Which of the following infections is NOT caused by the gonococcus? A. Infection of the urethral mucosa (urethritis) B. Infection of the bladder mucosa (cystitis) C. Throat infections (pharyngitis) D. Infections of the rectal mucosa (proctitis) E. Infections of the mucosa of the uterine cervix (cervicitis)

B. Infection of the bladder mucosa (cystitis)

8. Which of the following statements regarding herpes infection of the genital tract is INCORRECT? A. A sexually transmitted disease B. Initial attack confers permanent immunity C. Infected woman may transmit herpes infection to infant during childbirth D. Can be transmitted to a sexual partner even though active lesions are not present in the genital tract

B. Initial attack confers permanent immunity

3. An infection that spreads from its original site to involve the regional lymph nodes is called what? A. An abscess B. Lymphadenitis C. Cellulitis D. Lymphangitis

B. Lymphadenitis

9. These are chemical agents that are released when tissue is damaged, promoting an inflammatory response. A. Exudate B. Mediators of inflammation C. Mononuclear cells D. Vasodilators

B. Mediators of inflammation

10. All of the following statements about chromosomal mosaicism are correct EXCEPT: A. The affected person has more than one population of chromosomally distinct cells. B. Mosaicism results from chromosome nondisjunction occurring in the ovum before fertilization. C. Mosaicism results from chromosome nondisjunction during a mitotic division of the fertilized ovum (zygote). D. Persons with mosaic Down syndrome often have less disability than those in whom all the cells contain an extra chromosome 21. E. Mosaicism may occur in association with other chromosomal abnormalities as well as Down syndrome.

B. Mosaicism results from chromosome nondisjunction occurring in the ovum before fertilization.

25. Which of the following statements regarding streptococci is INCORRECT? A. The organisms are classified based on the carbohydrate antigens present in their cell walls and on the type of hemolysis produced by the organism growing on a blood agar plate. B. Most alpha hemolytic streptococci are very pathogenic. C. Group A beta streptococci may cause serious respiratory tract infections such as streptococcal pharyngitis, and such infections may be followed by rheumatic fever. D. Group B beta streptococci may colonize the genital tract of pregnant women and may lead to an infection in the infant caused by the streptococcus acquired by the infant during delivery.

B. Most alpha hemolytic streptococci are very pathogenic.

2. To which of the following groups does an acid-fast bacillus belong? A. Spirochetes B. Mycobacteria C. Gram-negative aerobic bacilli and cocci D. Anaerobic gram-negative rods E. None of the above

B. Mycobacteria

3. What is the main application of amniocentesis? A. Prenatal detection of genetic abnormalities in the fetus B. Prenatal detection of chromosome abnormalities in a fetus carried by a woman over age 35 C. Prenatal detection of congenital abnormalities caused by intrauterine injury or by drugs ingested by the mother during pregnancy D. Prenatal detection of fetal abnormalities caused by maternal alcohol abuse during pregnancy

B. Prenatal detection of chromosome abnormalities in a fetus carried by a woman over age 35

7. The enzyme reverse transcriptase possessed by HIV catalyzes the conversion of: A. DNA to RNA. B. RNA to DNA. C. protein to DNA. D. RNA to protein. E. RNA to ribosomes.

B. RNA to DNA.

11. __________ is a highly communicable and devastating viral disease that has been completely eliminated throughout the world by means of widespread immunization. A. Genital chlamydial infection B. Smallpox C. Chickenpox D. German measles E. Hepatitis A

B. Smallpox

5. Which of the following statements regarding mitosis is correct? A. It is a specialized type of cell division that occurs only in eggs and sperm. B. Spindle fibers pull chromatids apart. C. Genetic material on homologous chromosomes intermixes during cell division. D. Chromosomes of daughter cells (resulting from cell division) are genetically different from the parent cell (precursor cell).

B. Spindle fibers pull chromatids apart.

12. The presence of an extra chromosome in a cell is called a __________. A. monosomy B. trisomy C. double chromosome D. translocation

B. trisomy

46. Give two examples of mediators from blood plasma and their actions.

Bradykinin is a vasodilator. Complement is activated by antigen-antibody reaction, leading to cell destruction.

5. A mother has given birth to an infant with cytomegalic inclusion disease; what does this indicate? A. The infant is likely to have an abnormal chromosome karyotype. B. The mother has been previously infected with the cytomegalovirus (CMV), and the infection became activated during the pregnancy, or the mother acquired a CMV infection during her pregnancy. C. There is no risk of fetal injury or malformation, because the mother cannot transmit CMV to the fetus. D. The virus may have caused genetic abnormalities in the fetal chromosomes, which can be identified by laboratory tests.

B. The mother has been previously infected with the cytomegalovirus (CMV), and the infection became activated during the pregnancy, or the mother acquired a CMV infection during her pregnancy.

5. A 25-year-old male was exposed to HIV virus by heterosexual intercourse and now has anti-HIV antibody. What does the positive antibody test indicate? A. The person infected has eliminated the virus and is now immune to the virus. B. The person has been infected and can infect other persons. C. The person has been infected, but the presence of anti-HIV antibody will prevent the infection from progressing and causing AIDS. D. The person has been infected; however, the infection is probably mild, and he is unlikely to infect other persons by heterosexual intercourse.

B. The person has been infected and can infect other persons.

4. Which of the following conditions may result from contact with cat feces? A. Cryptosporidiosis B. Toxoplasmosis C. Malaria D. Pinworm infestation E. Tapeworm infestation

B. Toxoplasmosis

17. A common abnormality in females, __________ syndrome results from an absence of one X chromosome. A. triple X B. Turner's C. Klinefelter's D. Down

B. Turner's

14. Chromosome deletion occurs when: A. homologous chromosomes in germ cells fail to separate. B. a chromosome breaks during meiosis and the broken piece is lost from the cell. C. pieces of chromosomes are exchanged between two nonhomologous chromosomes. D. None of the above.

B. a chromosome breaks during meiosis and the broken piece is lost from the cell.

16. Reciprocal translocation occurs when: A. homologous chromosomes in germ cells fail to separate. B. a chromosome breaks during meiosis and the broken piece is lost from the cell. C. pieces of chromosomes are exchanged between two nonhomologous chromosomes. D. none of the above

B. a chromosome breaks during meiosis and the broken piece is lost from the cell.

19. The fibrous connective tissue that forms the framework of all tissues in the body is __________. A. cellulose B. collagen C. antigen D. muscle

B. collagen

21. A __________ is a set of HLA genes on one chromosome. A. karyotype B. haplotype C. plasmid D. polar body

B. haplotype

17. The desirable effect of the immune system, in which foreign antigens are eliminated, is called __________. A. hypersensitivity B. immunity C. anaphylaxis D. suppression

B. immunity

9. One complication of mumps infection in adult males is __________. A. skin rash B. inflammation of testicle (orchitis) C. inflammation of urethra D. conjunctivitis

B. inflammation of testicle (orchitis)

19. The main symptom of pinworm infestation is: A. severe diarrhea. B. intense anal and perianal itching. C. fever. D. dizziness.

B. intense anal and perianal itching.

15. Cytokines that send regulatory signals between cells of the immune system are __________. A. interferon B. interleukins C. monokines D. tumor necrosis factors

B. interleukins

19. Most cases of lobar pneumonia are caused by: A. staphylococcus aureus. B. pneumococcus (streptococcus pneumoniae). C. hemophilus influenzae. D. group A beta streptococci.

B. pneumococcus (streptococcus pneumoniae).

16. A __________ gene is one that produces an effect only in the homozygous state. A. dominant B. recessive C. sex-linked D. hemizygous

B. recessive

21. The usual source of Staphylococcus aureus in those who carry this organism and act as a potential source of this organism for wound infections is: A. intestinal tract. B. skin and/or nose. C. throat. D. urinary tract.

B. skin and/or nose.

15. The __________ plays an important role in controlling Babesiae infection because its blood filtration function eliminates many of the parasites as blood flows through it. A. heart B. spleen C. stomach D. liver

B. spleen

15. An individual is heterozygous for a gene if: A. both alleles are the same. B. the alleles are different. C. no alleles are present. D. none of the above.

B. the alleles are different.

12. A woman requested an HIV test, and the test was positive. This indicates that: A. the patient has been infected with HIV but cannot be infectious to other persons because she does not have AIDS. B. the patient has been infected with HIV; her blood, vaginal secretions, and, if she becomes pregnant, breast milk can infect other persons. C. The patient has AIDS. D. The patient can prevent progression of HIV infection by refraining from sexual activity and eating a well-balanced diet.

B. the patient has been infected with HIV; her blood, vaginal secretions, and, if she becomes pregnant, breast milk can infect other persons.

40. Match the organism with the disease or condition. ___ Brucella ___ Borrelia ___ Ehrlichia ___ Babesia ___ Yersinia A. A malaria-like parasite transmitted by ticks B. A febrile illness transmitted to people from unpasteurized milk or tissues of infected animals C. Causes a febrile illness with a skin rash D. Causes bubonic plague E. A tick-transmitted rickettsia-like agent that infects white blood cells

B___ Brucella C___ Borrelia E___ Ehrlichia A___ Babesia D___ Yersinia

28. Match the terms below with the correct definition ___ Serous exudate ___ Purulent exudate ___ Fibrinous exudates ___ Pus ___ Hemorrhagic exudate A. An exudate composed largely of inflammatory cells B. An exudate composed of fluid containing little protein C. An exudate containing red blood cells, indicating the rupture of capillaries due to inflammation D. An exudate rich in the blood protein fibrinogen E. A yellowish exudate composed of inflammatory cells

B___ Serous exudate A___ Purulent exudate D___ Fibrinous exudates E___ Pus C___ Hemorrhagic exudate

45. Give 3 examples of types of schistosomiasis infestations.

Blood fluke: Schistosoma japonicum ; portal venous system and its tributaries Bladder fluke: Schistosoma hematobium; urinary bladder Skin: swimmer's itch from the skin penetration of the cercaria Others affect the liver and intestinal tract

45. Compare and contrast amniocentesis versus chorionic villi sampling.

Both are used to obtain fetal cells for evaluation; the fetal cells are grown in the lab by tissue culture techniques and later used to determine the karyotype of cells. The karyotype wil help determine abnormalities in chromosomal number or structure. Analysis of the fetal DNA will help determine presence of genetic diseases. Amniocentesis examines amnionic fluid obtained anytime between the 14th to 18th week of pregnancy. Chorionic villi sampling examines fetal cells obtained without extracting amnionic fluid during the 8th to 10th week of pregnancy; it involves less risk, with results obtained earlier, but is more technically difficult to perform and may lead to spontaneous abortion and limb deformities.

46. Compare and contrast: gonorrheal versus Chlamydial infections

Both give the same clinical picture with involvement of the mucous membranes of the vagina, cervix, uterus, and fallopian tubes resulting in the upward migration of infection and scarring of the tubes leading to ectopic pregnancy and sterility. Because Chlamydial infections lead to same signs and symptoms and type of inflammation as gonorrhea of the urethra, it is referred to as nongonoccocal urethritis (NGU) in males.

32. What are bradykinins? What triggers the formation of bradykinins?

Bradykinins are blood plasma mediators that form in the presence of a protein concerned with blood coagulation that is activated by tissue injury.

12. About __________ million people die of malaria each year. A. 100 B. 10 C. 1 D. 0.5

C. 1

6. Which of the following statements regarding histocompatibility (HLA) antigens is INCORRECT? A. The HLA system consists of four separate but closely linked gene loci with any one of many possible allelic genes at each locus. B. A set of HLA genes on one chromosome, which is transmitted as a unit, is called a haplotype. C. A mother may transmit both of her HLA haplotypes to her child. D. Certain HLA types predispose to specific diseases.

C. A mother may transmit both of her HLA haplotypes to her child.

18. Which of the following describes an atopic person? A. An individual with a low T-cell count B. An individual with a disease of the immune system C. An individual who is prone to having allergies D. None of the above

C. An individual who is prone to having allergies

3. Which of the following statements relating to herpes infection of the genital tract is correct? A. The initial attack confers permanent immunity to subsequent infection. B. The herpes virus damages the immune system and predisposes to opportunistic infections. C. An infected woman may transmit the virus to her sexual partner even though she does not have the demonstrable herpetic lesions in her genital tract. D. Inclusion bodies are almost never demonstrated in herpes infected cells.

C. An infected woman may transmit the virus to her sexual partner even though she does not have the demonstrable herpetic lesions in her genital tract.

13. What happens when the vasodilator histamine is released by the mast cells? A. The inflammatory process is ended. B. Blood platelets adhere to collagen fragments and begin the healing process. C. Blood vessels expand and become more permeable. D. Blood vessels constrict and become less permeable.

C. Blood vessels expand and become more permeable.

10. ________ immunity is characterized by the formation of a population of lymphocytes that can attack and destroy the foreign material. A. Acquired B. Humoral C. Cell-mediated D. Hypersensitive

C. Cell-mediated

12. The daughter cells that are discarded during oogenesis are called __________. A. granulosa cells B. follicular cells C. polar bodies D. secondary oocytes

C. polar bodies

2. Which of the following statements regarding Down syndrome is INCORRECT? A. The affected fetus can be detected before birth by means of amniocentesis. B. The affected child is mentally retarded and usually has a characteristic physical appearance. C. Cells from an affected child reveal an extra sex chromatin body (Barr body) attached to the nuclear membrane of the cells. D. Chromosome karyotype of affected child usually reveals trisomy of chromosome 21.

C. Cells from an affected child reveal an extra sex chromatin body (Barr body) attached to the nuclear membrane of the cells.

13. In nonimmune children, the varicella-zoster virus usually manifests itself as what? A. Measles B. Mumps C. Chickenpox D. Cold sore

C. Chickenpox

12. __________ are chemical messengers that take part in any function of the immune system. A. Lymphokines B. Monokines C. Cytokines D. Interleukins

C. Cytokines

3. __________ are the parts of the DNA chains that code for specific proteins. A. Introns B. Genomes C. Exons D. Chromosomes

C. Exons

9. __________ are thick, fleshy, short worms that have suckers for the attachment to the host. A. Roundworms B. Tapeworms C. Flukes D. none of the above

C. Flukes

17. __________ inhabits the duodenum and upper jejunum, and causes intestinal inflammation manifested by crampy abdominal pain, distention, and watery diarrhea. A. Malaria B. Babesiosis C. Giardiasis D. Amebiasis

C. Giardiasis

7. Which of the following is not a stage of mitosis? A. Prophase B. Metaphase C. Haplophase D. Anaphase

C. Haplophase

21. __________ is caused by a deficiency of protein called antihemophilic globulin, which is required for normal blood coagulation. A. Sickle cell anemia B. Tay-Sachs disease C. Hemophilia D. Hemochromatosis

C. Hemophilia

1. Which of the following statement is INCORRECT? A. Gonococci may infect the rectal mucosa and pharynx as well as the genital tract. B. A male infected with HIV may transmit the infection to his female partner by sexual intercourse. C. Infants born to HIV-infected mothers do not become infected with HIV because they have acquired a passive immunity from their mothers. D. Most HIV-positive persons may eventually develop manifestations of acquired immune deficiency syndrome (AIDS).

C. Infants born to HIV-infected mothers do not become infected with HIV because they have acquired a passive immunity from their mothers.

8. Which of the following statements does NOT apply to autoimmune diseases? A. Due to an autoantibody directed against an individual's own cells or tissue components B. Often treated by drugs that suppress the inflammatory reaction C. Inflammation usually responds to penicillin or other bacterial antibiotics. D. May result from autoantibodies formed against foreign antigens that cross-react with components in similar antigens possessed by the subject's own tissues

C. Inflammation usually responds to penicillin or other bacterial antibiotics.

12. Injury and infection by a pathogenic organism can cause inflammation. What else can cause an inflammatory response? A. Administration of corticosteroid hormones B. Excess lysosomes in the cells C. Interaction of antibodies and antigens D. No other causes exist

C. Interaction of antibodies and antigens

23. Which of the following statements regarding Legionnaire's disease is correct? A. It is a virus infection. B. It is usually spread by direct person-to-person contact. C. It causes a pulmonary infection. D. The infectious agent is usually transmitted by ticks.

C. It causes a pulmonary infection.

18. __________ syndrome occurs in males when there is an extra X chromosome. A. Triple X B. Turner's C. Klinefelter's D. XYY

C. Klinefelter's

3. Which of the following statements is INCORRECT? A. Gas gangrene is caused by various species of Clostridia. B. Mycoplasma may cause a pulmonary infection (mycoplasmal pneumonia). C. Legionella pneumophila is highly infectious and can be transmitted easily from person to person. D. Clostridium perfringens may cause gastroenteritis as well as gas gangrene.

C. Legionella pneumophila is highly infectious and can be transmitted easily from person to person.

14. Bacteria are identified and classified by various methods. Which of the following is NOT a method for classifying and identifying bacteria? A. The shape of the bacterium (coccus, rod, or spiral) B. Gram stain reaction C. Lymphokine production D. Metabolic and cultural characteristics

C. Lymphokine production

2. Many parasites are transmitted by contaminated food or water or by contact with infected animals. Which of the following parasitic diseases is NOT transmitted in this manner? A. Toxoplasmosis B. Giardiasis C. Malaria D. Cryptosporidiosis

C. Malaria

7. The most important cell in the acute inflammatory response is an actively phagocytic cell called the __________. A. mononuclear cell B. monocyte C. polymorphonuclear leukocyte D. macrophage

C. polymorphonuclear leukocyte

1. Which of the following statements regarding cryptosporidiosis is INCORRECT? A. Infection may be acquired from drinking water contaminated with parasite cysts. B. Parasites are present in the intestinal tracts of cattle and many farm animals, and infectious cysts are excreted in their feces. C. Parasite cysts are quite fragile and do not normally survive outside of the intestinal tract of infected persons. D. Infection may be acquired from swimming in a swimming pool in which the pool water has been contaminated by parasite cysts from the perianal skin of infected persons with diarrhea who have also been swimming in the pool. E. Infection causes an acute self-limited diarrhea in immunocompetent persons, but may cause chronic life-threatening diarrhea in immunocompromised persons.

C. Parasite cysts are quite fragile and do not normally survive outside of the intestinal tract of infected persons.

12. Infections with viruses cause various clinical manifestations. Which of the following is NOT a manifestation of a virus infection? A. The virus damages or destroys infected cells. B. Formation of inclusion bodies in infected cells C. Production of endotoxins D. The virus causes proliferation of infected cells. E. The virus infects cells but causes only an asymptomatic (latent) infection.

C. Production of endotoxins

9. Which of the following statements applying to AIDS is INCORRECT? A. The infected individual forms HIV antibodies. B. The virus attacks helper (T4) lymphocytes. C. Prompt treatment with appropriate antiviral drugs can destroy the virus and prevent progression of the disease. D. There is a high incidence of the infection in male homosexuals and intravenous drug abusers.

C. Prompt treatment with appropriate antiviral drugs can destroy the virus and prevent progression of the disease.

20. __________ is caused by a small parasite that burrows in the superficial layers of the skin, where it lays eggs that hatch in a few days. This causes intense itchiness. A. Lice B. "Swimmer's itch" C. Scabies D. All of the above

C. Scabies

1. Some persons may develop bloody diarrhea with hemolytic anemia and kidney failure from eating incompletely cooked hamburgers. Which organism is responsible for the illness? A. Salmonella B. Shigella C. Toxin-producing E. coli D. Pathogenic clostridium

C. Toxin-producing E. coli

6. Which of the following worm infestations may result from eating incompletely cooked meat contaminated by a parasite? A. Malaria B. Giardiasis C. Trichinosis D. Pinworm infestation

C. Trichinosis

10. Which of the following statements about AIDS is INCORRECT? A. High incidence in male homosexuals B. Eventually fatal as a result of opportunistic infections or malignant tumors C. Usually responds to corticosteroids, which stimulate the immune system D. May be contracted by transfusion of blood containing HIV virus

C. Usually responds to corticosteroids, which stimulate the immune system

11. A (An) __________ disease is one that is present at birth. A. x-linked B. autosomal C. congenital D. genetically transmitted

C. congenital

1. The major hazard of a rubella infection affecting a young woman is: A. meningitis. B. hepatitis. C. congenital malformations in the fetus if a susceptible pregnant woman acquires the infection in the first trimester. D. chronic rubella infection, leading to immune-deficiency state.

C. congenital malformations in the fetus if a susceptible pregnant woman acquires the infection in the first trimester.

1. The sum total of all the genes contained in a cell's chromosomes is called its __________. A. gene product B. sum C. genome D. intron

C. genome

19. Males are called __________ for genes carried on the X chromosome because they only possess one X chromosome. A. homozygous B. heterozygous C. hemizygous D. none of the above

C. hemizygous

10. Coccidioidomycosis is generally an acute, self-limited respiratory infection that subsides without treatment, but a more serious, chronic progressive form is often encountered in: A. teenagers. B. young male adults. C. immunocompromised persons. D. middle-aged females.

C. immunocompromised persons.

14. Each gene occupies a specific site on the chromosome, called a(n) __________. A. karyotype B. polar body C. locus D. allele

C. locus

20. Botulinum toxin causes: A. abdominal pain. B. vomiting. C. paralysis. D. diarrhea.

C. paralysis.

18. Genes carried on sex chromosomes are called __________ genes. A. dominant B. recessive C. sex-linked D. hemizygous

C. sex-linked

9. The pairing of homologous chromosomes in meiosis is called a __________. A. crossover B. gamete C. synapse D. chromatid

C. synapse

15. A misplaced chromosome or part of a chromosome attached to another chromosome is called a __________. A. trisomy B. monosomy C. translocation D. zygote

C. translocation

36. Match the class of drugs for HIV treatment to the method by which they act on the virus. __ Nucleoside reverse transcriptase inhibitors __ Protease inhibitors __ Entry inhibitors __ Nonnucleoside reverse transcriptase inhibitors A. Blocks the enzyme that cuts the viral protein into segments to form infectious virus particles B. Prevents the virus from entering a cell C. Interrupts the formation of viral DNA by substituting a nucleoside analog for a normal nucleoside used by the virus to construct DNA D. Binds directly to reverse transcriptase and blocks DNA polymerase

C__ Nucleoside reverse transcriptase inhibitors A__ Protease inhibitors B__ Entry inhibitors D__ Nonnucleoside reverse transcriptase inhibitors

42. Match the virus with the disease or condition it causes. ___ Herpes simplex 2 ___ Epstein-Barr virus ___ Human immunodeficiency virus ___ Hantavirus ___ Papilloma virus ___ Varicella-zoster virus ___ Herpes simplex 1 A. Chicken pox, shingles B. Acute respiratory illness C. Genital herpes D. AIDS E. Warts, condylomas F. Cold sores G. Infectious mononucleosis

C___ Herpes simplex 2 G___ Epstein-Barr virus D___ Human immunodeficiency virus B___ Hantavirus E___ Papilloma virus A___ Varicella-zoster virus F___ Herpes simplex 1

21. The phrases below describe properties or functions of various immunoglobins. Match the immunoglobin with its properties or functions. ___ The "allergy antibody" ___ The first antibody formed in response to antigenic stimulation ___ The antibody secreted on mucosal surfaces ___ The antibody present in highest concentration after antigenic stimulation A. IgM B. IgG C. IgE D. IgA

C___ The "allergy antibody" A___ The first antibody formed in response to antigenic stimulation D___ The antibody secreted on mucosal surfaces B___ The antibody present in highest concentration after antigenic stimulation

45. Compare and contrast humoral versus cellular immunity.

Cellular immunity: immunity associated with formation of sensitized lymphocytes; major defense against viruses, fungi, parasites, some bacteria, and in transplant rejection Humoral immunity: immunity associated with formation of antibodies that can combine with and eliminate an antigen; major defense against bacteria and bacterial toxins

47. Give three examples of strategies for controlling indirect transmission of communicable diseases.

Chlorination of water supplies to prevent transmission via contaminated water; establishing effective sewage treatment facilities; training of food handlers; standards for monitoring the manufacture and distribution of commercially prepared foods

50. Explain why inflammation can become chronic.

Chronic inflammation represents a stalemate or balance between the body's attempt to heal itself in the presence of continuing inflammation.

41. Describe the role of complement in immune responses.

Complement functions along with the immune system to destroy or inactivate all types of foreign antigens. It can be activated in two ways: the classical pathway or the alternative pathway. Some functions of complements include acting as mediators of inflammation, coating the surface of invading bacteria, and generating an attack complex, which punches holes in the target's cell membrane, destroying it.

40. What are the two types of effector T cells? What does each type do?

Cytotoxic T cells attack and destroy body cells infected with viruses or intracellular bacteria. They can also attach cancer cells. Delayed hypersensitivity cells respond to foreign antigens processed by macrophages or similar cells by accumulating at the site of the antigenic material, where they secrete a variety of lymphokines that attract macrophages, activate them, and stimulate them to secrete additional cytokines.

11. The cells that form a single layer and surround oocytes during oogenesis are called __________. A. follicular cells B. granulosa cells C. primary follicles D. A and B

D. A and B

7. Which of the following is an immunoglobin E (IgE)-mediated hypersensitivity reaction? A. A transfusion reaction resulting from an infusion of incompatible blood into a person who has pre-existing antibodies directed against the transfused cells B. Organ or tissue damage resulting from deposition of antigen-antibody complexes in the organs or tissues of an affected person C. An area of swelling and tenderness in the skin after an intradermal injection of protein material derived from the tubercle bacillus D. A penicillin reaction characterized by fall in blood pressure and respiratory distress after an injection of penicillin in a person who has become sensitized to penicillin as a result of a previous penicillin injection

D. A penicillin reaction characterized by fall in blood pressure and respiratory distress after an injection of penicillin in a person who has become sensitized to penicillin as a result of a previous penicillin injection

6. A young man is struck on the cheek by a baseball and sustains an injury in which the skin is not broken and the cheekbone is not fractured. He develops an acute inflammation in the injured area. Which of the following is NOT part of the acute inflammatory process? A. Leakage of fluid through permeable capillaries into the connective tissue of the cheek B. Congestion of tissues caused by dilation of capillaries C. Accumulation of leukocytes in the injured area D. Accumulation of plasma cells and formation of immunoglobulins

D. Accumulation of plasma cells and formation of immunoglobulins

4. Which of the following statements regarding antibody molecules is INCORRECT? A. An antibody molecule is composed of four polypeptide chains and is shaped somewhat like a fork. B. The "tines of the fork" (Fab ends of the molecule) combine with the antigen. C. The "handle of the fork" (Fc end of the molecule) determines the properties of the molecule, such as the ability to activate complement. D. All antibodies are secreted as groups (clusters) of five individual antibody molecules that are joined together to form large molecules called macroglobulins. E. There are five different classes of antibodies: IgG, IgA, IgM, IgD, and IgE.

D. All antibodies are secreted as groups (clusters) of five individual antibody molecules that are joined together to form large molecules called macroglobulins.

18. Which of the following is a group of metazoal parasites? A. Roundworms B. Tapeworms C. Flukes D. All of the above

D. All of the above

16. __________ is an infection of the intestinal tract by a pathogenic ameba. A. Malaria B. Babesiosis C. Giardiasis D. Amebiasis

D. Amebiasis

4. Which of the following statements is INCORRECT? A. Chromosomes normally exist in pairs called homologous chromosomes. B. A dominant gene is expressed in the homozygous or heterozygous state. C. Genes exist in pairs that are located at corresponding sites (loci) in homologous chromosomes. D. An X-linked gene occurs only in females.

D. An X-linked gene occurs only in females.

1. One method the body uses to destroy bacteria is by forming a membrane attack complex that produces perforations in the walls of bacterial cells and enveloped viruses, thereby causing their destruction. What is the substance producing the membrane attack complex? A. Interferon B. Lymphokines produced by T lymphocytes C. Gamma globulin produced by B lymphocytes D. Complement

D. Complement

11. Which of the following statements regarding varicella-zoster virus (VZV) is INCORRECT? A. VZV causes chickenpox. B. VZV may infect sensory ganglia in the nervous system. C. Reactivation of VZV in nervous system ganglia may cause shingles (herpes zoster). D. Contact with skin vesicles of persons with shingles may cause shingles in persons who have not been previously exposed to VZV. E. A vaccine is available to immunize susceptible persons against VZV.

D. Contact with skin vesicles of persons with shingles may cause shingles in persons who have not been previously exposed to VZV.

8. Which is NOT one of the common agents that causes opportunistic infections in AIDS patients? A. Pneumocystis carinii B. Cytomegalovirus C. Mycobacterium avium-intracellulare D. Corynebacterium diphtheriae E. Toxoplasma gondii

D. Corynebacterium diphtheriae

2. Which of the following is not a mediator of inflammation? A. Prostaglandins B. Histamine C. Bradykinins D. Gamma globulin antibodies E. Products of complement activation

D. Gamma globulin antibodies

22. __________ is characterized by excessive absorption of iron, which accumulates within the body and disrupts organ functions. A. Sickle cell anemia B. Tay-Sachs disease C. Hemophilia D. Hemochromatosis

D. Hemochromatosis

16. __________ are antibodies produced by plasma cells. A. Immune-response genes B. Interleukins C. Interferons D. Immunoglobulins

D. Immunoglobulins

5. Which of the following is an antiviral substance produced by virus-infected cells? A. Acyclovir B. AZT C. Immunoglobin (antibodies) D. Interferon E. Histamine

D. Interferon

22. Borrelia burgdorferi causes: A. relapsing fever. B. syphilis. C. pertussis. D. Lyme disease. E. inflammation of the urethra.

D. Lyme disease.

5. Which of the following statement regarding antigens and antibodies is INCORRECT? A. An antigen is a substance that can induce formation of an antibody in a person whose own cells and tissues lack the antigen. B. An antibody is a globulin made by plasma cells (which are derived from B lymphocytes). C. Normally our own immune system will not produce antibodies that are directed against antigens present in our own cells and tissues. D. Most antibodies are produced by either helper T lymphocytes (T4 cells) or suppressor T lymphocytes (T8 cells) when they are stimulated by a foreign antigen.

D. Most antibodies are produced by either helper T lymphocytes (T4 cells) or suppressor T lymphocytes (T8 cells) when they are stimulated by a foreign antigen.

27. Which of the following statements regarding the organism causing anthrax (Bacillus anthracis) is INCORRECT? A. The organism is a gram-positive spore-forming aerobic bacillus. B. The organism can be used as a bioterrorism/germ warfare agent. C. Inhalation of anthrax spores may cause a severe pulmonary infection. D. Pulmonary anthrax caused by inhalation of anthrax spores can be prevented by a short (1- to 2-week) course of antibiotics because the organism is sensitive to antibiotics.

D. Pulmonary anthrax caused by inhalation of anthrax spores can be prevented by a short (1- to 2-week) course of antibiotics because the organism is sensitive to antibiotics.

1. A patient has a swollen ear caused by a bacterial infection. Which of the following is not a feature of the inflammatory process? A. Leakage of fluid through permeable capillaries into the loose connective tissue of the ear B. Congestion of tissues because of dilation of capillaries C. Redness of skin because of increased blood flow through the inflamed tissues D. Reduced blood flow to tissues because of vasoconstriction of capillaries in the area of inflammation

D. Reduced blood flow to tissues because of vasoconstriction of capillaries in the area of inflammation

8. Which of the following statements about the fragile X syndrome is INCORRECT? A. It causes mental deficiency. B. It affects a gene on the X chromosome. C. It is characterized by an excessive number of cytosine-guanine-guanine triplet-repeating sequences that disrupt gene function. D. There is no relationship between the number of triplet repeats and the severity of the mental deficiency. E. The diagnosis is made by DNA analysis of cells from the affected person.

D. There is no relationship between the number of triplet repeats and the severity of the mental deficiency.

26. Which of the following is NOT a characteristic used to classify bacteria? A. Biochemical and cultural characteristics B. Shape C. Antigenic structure D. Virulence

D. Virulence

19. __________ syndrome occurs in males when there is an extra Y chromosome. A. triple X B. Turner's C. Klinefelter's D. XYY

D. XYY

22. The technology that paved the way for advances in DNA technology is referred to as __________. A. recombinant DNA technology B. genetic engineering C. gene splicing D. all of the above.

D. all of the above.

10. An animal on or within which a parasite lives is called the __________. A. master animal B. arthropod C. parasitic home D. host

D. host

14. The term virulence refers to __________. A. a disease caused by a viral pathogen B. a disease likely to be fatal to its host C. an organism that causes disease in humans D. the ease with which a pathogenic organism can overcome host defenses

D. the ease with which a pathogenic organism can overcome host defenses

13. Cytokines that can destroy foreign or abnormal cells are called __________. A. interferon B. interleukin C. monokine D. tumor necrosis factor

D. tumor necrosis factor

43. What is the preferred diagnostic method for fragile X mental retardation?

DNA analysis

37. Match the sexually transmitted diseases listed below with their principal symptoms. __ Gonorrhea __ Syphilis __ Herpes __ Chlamydia __ HIV infection A. Inflammation of the cervix and urethra; women often have vaginal discharge, men may have frequent urination and a burning sensation on urination B. Chancre in the external genitals or in the genital tract, followed by rash, fever, enlarged lymph nodes, and ulcers on the mucous membranes of oral cavity and genital tract C. Virus present in blood or lymph tissue is visible upon testing, but patient shows no overt symptoms and may be asymptomatic for an extended time after initial infection D. Inflammation of the cervix, urethra, pharynx, and rectum; in women, profuse vaginal discharge, and in men, pain on urination are common symptoms E. Patient may be asymptomatic but occasionally has ulcers and vesicles on the genitals and in the genital tract, sometimes with enlarged or tender lymph nodes in the groin

D__ Gonorrhea B__ Syphilis E__ Herpes A__ Chlamydia C__ HIV infection

29. Match the disease name to the correct description. ___ Appendicitis ___ Pneumonitis ___ Septicemia ___ Cellulitis ___ Lymphangitis ___ Colitis A. Inflammation of the colon B. Inflammation of the lung C. An acute spreading infection at any site D. Inflammation of the appendix E. An infection that spreads into the lymphatic channels F. An infection that spreads into the bloodstream

D___ Appendicitis B___ Pneumonitis F___ Septicemia C___ Cellulitis E___ Lymphangitis A___ Colitis

22. Match the term with its definition. ___ Cell-mediated immunity ___ Humoral immunity ___ Complement ___ Interferon ___ Immunoglobin A. Activated by antigen-antibody interaction B. An antiviral substance C. A property of B lymphocytes D. A property of T lymphocytes E. An antibody protein

D___ Cell-mediated immunity C___ Humoral immunity A___ Complement B___ Interferon E___ Immunoglobin

49. Explain why Type 1 herpes virus may cause genital infections.

Engaging in oral-genital sexual practices with an increase in cases over the years

51. Explain susceptibility to fungi of low pathogenicity.

Disturbance in the normal flora and impaired immunologic process

41. Maria owns a cat and is pregnant with her first child. Her doctor determined that she is susceptible to toxoplasma. What should she do to avoid being infected with the parasite?

Do not eat incompletely cooked meat. Wash hands after handling cats, especially before eating. Have someone else empty the litter box daily. Do not let indoor cats go outside. Do not let outdoor cats inside. Do not feed cats raw meat products.

23. Match the cell with its function or activity. ___ Macrophage ___ Antigenic determinant (epitope) ___ MHC complex ___ Cytotoxic T cell ___ Helper T lymphocyte A. Regulates immune response B. A small fragment of an antigen to which the immune system responds C. Destroys abnormal or infected body cells D. A group of unique self-antigens on body cells E. Antigen processing cell

E___ Macrophage B___ Antigenic determinant (epitope) D___ MHC complex C___ Cytotoxic T cell E___ Helper T lymphocyte

49. Explain the relationship between the number of triplet repeats and the severity of the mental deficiency.

Excessive number of CGG repeats blocks the function of the gene such that no gene product is produced, which then interferes with the formation and function of synapses within the nervous system, causing mental retardation.

14. A syphilitic chancre may persist indefinitely unless the patient is treated with antibiotics.

FALSE

17. A positive HIV antibody test indicates immunity to HIV.

FALSE

17. Monocytes and macrophages rush to the area of cell injury at the beginning of an acute inflammation, but are not active in chronic inflammation.

FALSE

20. A pathogenic organism with low virulence does not produce disease in humans.

FALSE

21. Ingested pinworm eggs mature in the intestines, invade the bloodstream, and are carried throughout the body.

FALSE

22. Complement is activated only by the antigen-antibody interaction.

FALSE

22. Tapeworms inhabit the rectum and migrate out the anus to lay their eggs.

FALSE

23. Mediators of inflammation are biologically active compounds present in the cells or blood plasma.

FALSE

24. A pregnant woman with phenylketonuria does not need to adhere to a phenylalanine-restricted diet because the high concentration of phenylalanine in the woman's blood does not harm the fetus.

FALSE

24. Among young persons ages 13 to 19 years old, most HIV infections occur in males.

FALSE

24. Human beings normally have 22 pairs of autosomes and 2 pairs of sex chromosomes.

FALSE

25. A natural killer cell is an antibody-producing plasma cell.

FALSE

25. An increased concentration of alpha fetoprotein in maternal blood or amnionic fluid suggests that the fetus has Down syndrome.

FALSE

25. Inflammation always subsides when the harmful agent that caused it is eliminated.

FALSE

25. Mature Ascaris worms frequently migrate out the anus and lay their eggs on the perianal skin.

FALSE

26. All inflammation results in scar formation.

FALSE

26. Most infants with Down syndrome are born to mothers who are carriers of a chromosome 21, which is attached to another chromosome (translocation carrier).

FALSE

26. Trichinella spiralis organisms live in the soil, and people become infected by contact with infected soil.

FALSE

27. A newborn infant born to an HIV-infected mother may be breastfed because the virus cannot be transmitted by breast milk.

FALSE

27. A patient with an autoimmune disease usually has an impaired cell-mediated immunity.

FALSE

27. A serous exudate contains a high concentration of protein.

FALSE

28. The crab louse (Pediculosis pubis) commonly infests the scalp hair of children and may be spread by sharing combs or hats, which transmit the lice from child to child.

FALSE

28. The sex chromatin body (Barr body) represents an inactivated X chromosome and is only encountered in persons having two X chromosomes and lacking a Y chromosome.

FALSE

29. An X-linked gene occurs in only females.

FALSE

29. Consumption of alcoholic beverages in pregnancy does not harm the fetus if the amount of alcohol consumed does not exceed 1 pint of liquor per day.

FALSE

29. HIV is found in equal amounts in blood, semen, urine, saliva, and perspiration.

FALSE

29. The main function of lymphocytes is phagocytosis of bacteria and other invading microorganisms.

FALSE

30. A structurally abnormal chromosome is called an autosome.

FALSE

30. An active immunity is generated in a newborn infant when maternal antibodies are transferred across the placenta from the mother's blood into the fetal circulation.

FALSE

30. Animal parasites are capable of free-living existence.

FALSE

30. Treatment with highly active antiretroviral therapy should only be used in patients whose CD4+ count is low and whose viral load is high.

FALSE

30. Tumor necrosis factors are so named because they can only destroy tumor cells.

FALSE

31. A translocation is an abnormal mitosis.

FALSE

31. The human genome consists of about 3 billion pairs of DNA bases, and most of the DNA on chromosomes consists of genes that regulate cell structure and functions.

FALSE

32. Nondisjunction occurs when homologous chromosomes in germ cells separate from one another in either the first or the second meiotic division.

FALSE

32. Pregnant women with HIV infection are better protected against opportunistic infections because the immune system is heightened during pregnancy.

FALSE

32. The Human Genome Project has identified all the genes on the human chromosomes and has also determined the function of each gene that has been identified.

FALSE

33. A communicable disease is defined as any disease that can pass directly from one person to another.

FALSE

33. Anaphylaxis is not life threatening.

FALSE

33. The presence of one or more extra X chromosomes adversely affects female development.

FALSE

34. An individual can accept a tissue graft from another person.

FALSE

34. Trichinosis is transmitted via skin penetration of larval forms of the round worm Trichinella spiralis.

FALSE

35. E. coli O157:H7 is not very pathogenic but may at times cause a mild gastritis.

FALSE

35. Introns code for specific proteins.

FALSE

35. The most common autosomal trisomy seen in newborn infants is that of chromosome 13, which causes Down syndrome.

FALSE

36. Ascariasis or Ascaris infestation is diagnosed using a scotch tape swab method.

FALSE

36. Cigarettes and alcoholic beverages do not harm the fetus.

FALSE

36. SLE is a type of a delayed hypersensitivity reaction.

FALSE

37. All mature somatic cells are able to divide through mitosis.

FALSE

37. If a mother tolerates a drug well, her fetus will, too.

FALSE

37. The growth of viruses is inhibited by the proper use of antibiotics.

FALSE

38. Anti-parasitic drugs are available to treat cryptosporidiosis.

FALSE

38. In the first meiotic division, the chromosomes of the daughter cells are exact duplicates of those in the parent cell.

FALSE

39. Antiviral antibodies can combine with viruses within the cells, preventing the infection from spreading from cell to cell.

FALSE

39. SLE is a connective tissue disease that equally affects men and women.

FALSE

40. The process of spermatogenesis takes about 4 months, and sperm are being produced continually.

FALSE

41. During each reproductive cycle, several oocytes begin to mature, all of which are ovulated.

FALSE

42. Any one chromosome can carry multiple alleles at a given locus.

FALSE

43. Gene imprinting changes the basic structure of the gene and the way the gene is expressed in the offspring.

FALSE

50. Describe the Lyon hypothesis.

Female cells function as though they contained only genetic material from one X chromosome instead of two. The reason for this is the inactivation of one of the X chromosomes following the first week of embryonic development. This inactivation of one of the X chromosomes occurs randomly.

39. __________ is an exudate made up of fibrinogen

Fibrinous exudate

33. How are adhesions formed?

Fibrinous exudates involving two adjacent surfaces may cause those surfaces to stick together, eventually forming a band of fibrous tissue that is the basis of the adhesion.

48. Describe the process of scar formation.

Fibrous tissue that replaces normal tissue following large areas of tissue injury and damage

28. Penicillin destroys microorganisms by blocking synthesis of the bacterial cell wall.

TRUE

47. Give three examples of autoimmune diseases, including their clinical manifestations and pathogenesis.

Glomerulonephritis: antibodies form against basement membrane; some cases from deposition of antigen-antibody complexes in the glomerular basement membrane resulting in inflammation of renal glomeruli SLE: formation of antinuclear antibodies causing widespread organ damage to the joints, kidneys, heart muscle, blood vessels resulting in systemic disease such as joint pain, skin rash Hashimoto's thyroiditis: antibodies to thyroid gland cause injury and inflammation of the thyroid, resulting in hypothyroidism

50. Explain the mode of transmission of toxoplasmosis.

Handling infected cat litter or ingestion of raw or partially cooked contaminated meat

48. Explain the process of inheritance of haplotypes from parents to children.

Haplotype is a set of HLA genes on one chromosome that is transmitted as a unit; each person has two haplotypes, each consisting of four HLA genes for a total of eight HLA proteins. This happens because chromosomes come in pairs. Unless two individuals are identical twins, there is a very remote chance for both to have the same HLA proteins. Each person receives one of two possible haplotypes from each parent. As such, each child has only one haplotype that is common with each parent and will have only one out of four possible combinations of haplotypes.

35. Name the four characteristic signs of localized inflammation.

Heat, redness, swelling, pain

42. What diseases may result from Entamoeba histolytica infestation?

Mucosal ulcers of the colon, hepatic amebic abscess, amebic hepatitis

39. Of the following diseases—gonorrhea, syphilis, herpes, Chlamydia, and HIV infection—which two can be suppressed but not cured? What mode of transmission is common to these diseases that is less common or not applicable to the others?

Herpes and HIV Mother-to-infant transmission

49. Give two diseases caused by highly pathogenic fungi, their etiologic agents, and organs affected.

Histoplasmosis: Histoplasma capsulatum causes histoplasmosis via inhalation of dust containing fungal spores. Coccidioidomycosis: Coccidiodes immitis causes coccidioidomycosis, an acute pulmonary infection, or may also cause a chronic and severe systemic disease. Transmission is via inhalation of fungal spores.

46. Compare and contrast hypersensitivity versus immunity.

Hypersensitivity: increased responsiveness or abnormal reaction to a foreign material such as an allergic or transfusion reaction Immunity: resistance to disease provided by the body's defense system

38. __________ is a nonspecific response to an injurious agent.

Inflammation

41. How is cryptosporidiosis transmitted to human hosts?

Ingestion of Cryptosporidia oocysts in contaminated swimming pools and unfiltered municipal water supplies and by fecal-oral transmission as in households and daycare facilities

43. What are the ways in which people are infected with toxoplasmosis?

Ingestion of raw or partially cooked contaminated meat or by contact with infected cat feces with oocysts

47. Explain the process of HLA types and disease susceptibility.

Inheritance of certain HLA antigen types predisposes to specific diseases such as HLA-B27 and spondyloarthropthies. Although this type is found in only 4% of the population, it is present in 90% of those affected with spondyloarthropathy, indicating an increased propensity to develop the disease.

44. How do antimicrobial substances interfere with the bacterial cell?

Inhibiting cell-wall synthesis, inhibiting cell-membrane function, inhibiting metabolic functions, competitive inhibition

40. Name three forms of malignant tumors common in AIDS patients.

Kaposi's sarcoma, B lymphocyte tumors, cancer of oral cavity, cancer of rectum

43. What are required to effectively control communicable diseases

Knowledge of disease etiology and its method of transmission

43. Compare and contrast lymphangitis versus lymphadenitis

Lymphangitis: inflammation of lymph vessels draining the site of an infection Lymphadenitis: inflammation of lymph nodes draining the site of an infection

31. What is the role of lysosomal enzymes in the inflammatory process?

Lysosomes contain potent enzymes that allow them to digest bacteria or foreign matter brought into cell cytoplasm by phagocytosis. Destruction of neutrophils and monocytes during the inflammatory reaction can cause lysosomal enzymes to be released and create additional tissue injury, which in turn generates further inflammatory response.

44. Compare and contrast mode of transmission of pinworm infection versus Ascariasis.

Malaria comes from a mosquito bite that infests the red blood cells; the disease is characterized by alternating fever and chills and anemia. Babesiosis is caused by Babesia microti from a deer tick bite, results in the same clinical picture as malaria with invasion and damage to red blood cells resulting in fever, chills, and anemia. Most individuals develop mild disease and recover but those who had a splenectomy may develop a more severe form of the disease.

40. Name four protozoal infections found in humans.

Malaria, babesiosis, amebic dysentery, genital tract trichomonad infections, giardiasis, toxoplasmosis, cryptosporidiosis, pneumocystis pneumonia

30. What are the sources of chemical mediators of inflammation?

Mast cells and blood plasma

45. Give two examples of cell mediators of inflammation and their actions.

Mast cells have granules that contain histamine, which acts as a vasodilator, increasing vascular permeability. Blood platelets contain histamine and serotonin that are released when platelets adhere to collagen fibers. Prostaglandins are derived from fatty acids and sustain inflammatory response. Leukotrienes are synthesized from arachidonic acid and increase bronchial constriction, attract neutrophils, and increase vascular permeability.

34. Name three cell-derived mediators of inflammation.

Mast cells, prostaglandins, leukotrienes

44. Name two disadvantages of chorionic villi sampling

More technically difficult to perform; may lead to spontaneous abortion and limb deformities

38. Two of the most common opportunistic infections affecting patients with AIDS are __________ and __________.

Pneumocystis carinii infection (or pneumocystic pneumonia) and Mycobacterium avium-intracellulare (or Mycobacterium avium complex)

44. What are the three stages of syphilis and their main clinical manifestations?

Primary syphilis: chancre formation Secondary syphilis: clinical picture of a systemic infection such as fever, lymphadenopathy, skin rash, and shallow ulcers on mucous membranes of the oral cavity and genital tract Tertiary syphilis: chronic inflammation of cardiovascular and nervous systems such as scarring of aortic valve; degeneration of fiber tracts in the spinal cord; mental deterioration; paralysis

45. Compare and contrast: primary versus tertiary syphilis in terms of infectivity

Primary syphilis: chancre remains infectious as the fluid is teeming with spirochetes Tertiary syphilis: no longer infectious as organisms are very few and confined to internal organs where they cause irreparable damage

36. Name five outcomes of inflammation.

Resolution, repair, areas of destruction replaced by scar tissue, mediators intensify inflammatory process, mediators generate more mediators

49. Explain the danger of toxoplasmosis in pregnancy.

Risk of infecting the fetus, resulting in congenital malformations such as severe brain and eye injuries, microcephaly, and hydrocephalus

40. Some infections acquired by a pregnant woman may injure the developing fetus. Name three infectious agents that are known causes of congenital malformations.

Rubella (the virus of German measles), cytomegalovirus (the virus of cytomegalic inclusion disease), and toxoplasma gondii (the protozoan parasite)

48. Describe the process of SLE and the underlying pathogenesis of hypersensitivity.

SLE is a type of an immune complex hypersensitivity reaction in which antigen-autoantibody (antinucleoprotein antibodies) immune complexes are formed and circulate in the body and deposited in various organs and tissues such as the joints, glomeruli, heart, and blood vessels. Complement is activated that generates and inflammatory response, causing tissue damage.

46. Name the four principal shapes of bacteria.

Spherical, rod, spiral, corkscrew

13. A mother with herpetic lesions in her genital tract at the time of delivery may infect her infant during vaginal delivery.

TRUE

15. A chlamydial infection of the uterine cervix can be detected by laboratory tests that detect the chlamydia or chlamydial antigens in cervical secretions.

TRUE

15. Interaction of antigen and antibody activates a series of blood proteins called complement, and products of complement activation function as mediators of inflammation.

TRUE

16. Chlamydial infections and gonococcal infections infect the female genital tract and may spread to infect the fallopian tube.

TRUE

16. Extensive destruction of tissue resulting from inflammation is often followed by scarring that may impair the function of the tissue in which the scarring has occurred.

TRUE

18. Some genital chlamydial infections in women may be associated with few or no symptoms.

TRUE

18. The inflammatory reaction is the same no matter what kind of injury is present, because the injury itself does not directly cause the reaction.

TRUE

19. Gonococci may infect the rectal mucosa and cause a rectal inflammation.

TRUE

19. The ability of the body's defenses to fight off a pathogenic organism depends on both the virulence of the organisms and the resistance of the infected person.

TRUE

20. Gonococci may gain access to the blood stream, causing infections of heart valves, joints, and other tissues.

TRUE

21. Persons with HIV or AIDS have an increased susceptibility to both tuberculosis and histoplasmosis.

TRUE

21. Resolution occurs when an inflammation is mild and the tissue returns to normal without any need for repair.

TRUE

22. Candida infections are common in people with HIV.

TRUE

23. Ascaris lumbricoides is a large round worm that inhabits the small intestine.

TRUE

23. Chromosomes exist in pairs called homologous chromosomes.

TRUE

23. Currently, about 24% of all AIDS cases occur in heterosexual drug abusers.

TRUE

23. Most persons with Turner's syndrome have only a single X chromosome (45, X).

TRUE

24. A dendritic cell is an antigen-processing cell with long cytoplasmic processes.

TRUE

24. Mature Ascaris worms may migrate into the appendix, biliary ducts, or other parts of the gastrointestinal tract.

TRUE

24. The release of mediators from any source can trigger not only inflammation, but also the release of other mediators.

TRUE

25. Antiretroviral drugs like zidovudine (ZDV), when given to a pregnant HIV-infected mother, significantly reduce the risk of mother-to-infant HIV transmission.

TRUE

25. Certain HLA types appear to predispose to specific diseases.

TRUE

26. A newborn infant born to an HIV-infected mother is also treated with the antiretroviral drug ZDV for several weeks after delivery.

TRUE

26. Genes exist in pairs and the members of each pair are located at corresponding sites (gene loci) on homologous chromosomes.

TRUE

26. Plasma cells make antibodies.

TRUE

27. "Swimmer's itch" is an itchy skin inflammation (dermatitis) caused by swimming in water contaminated by bird or animal schistosomes.

TRUE

27. A neural tube defect (anencephaly or spina bifida) can usually be identified in an affected fetus by mean of an ultrasound examination performed at about 16 weeks gestation.

TRUE

27. An individual is homozygous for a gene if the genes at corresponding loci on homologous chromosomes are the same and heterozygous for the gene if the genes are different.

TRUE

28. A dominant gene expresses itself in either the homozygous or heterozygous state.

TRUE

28. Delivery of an HIV-infected mother by cesarean section reduces the risk of mother-to-infant HIV transmission.

TRUE

28. Humoral immunity is a property of B lymphocytes that become transformed into plasma cells and produce antibodies directed against the foreign antigen that caused the immune response.

TRUE

29. A sensitivity test report indicating that a bacterium is resistant to an antibiotic indicates that the antibiotic is unlikely to be effective against the bacterium.

TRUE

29. The larval form of Trichinella spiralis becomes encysted in the muscles of infected people or animals.

TRUE

30. A female carrying a defective X-linked gene may not manifest any clinical abnormalities related to the defective gene.

TRUE

31. Combinations of two nucleoside inhibitors and a protease inhibitor can effectively reduce HIV in the circulation to undetectable levels, but cannot eliminate it from the body.

TRUE

31. The immune defenses of the host are activated as viruses that invade cells produce new antigens and the body recognizes the antigens as foreign.

TRUE

31. The infectious form of toxoplasma gondii that is found in cat feces is called an oocyst.

TRUE

31. The precursor cells of the lymphocytes are formed initially in the bone marrow.

TRUE

32. Immune-response genes control the immune response by regulating T-cell and B-cell proliferation.

TRUE

32. Ooscysts can be removed from municipal water supplies only by filtration.

TRUE

32. Our normal bacterial flora (in oral cavity, vagina, etc.) help protect us from infections by inhibiting potentially pathogenic microorganisms that attempt to grow in regions of our body occupied by our normal flora.

TRUE

33. Minor variations in the sequence of the nucleotides within the same genes of different individuals (gene polymorphism) may lead to differences in the way the genes are expressed.

TRUE

33. Tapeworms sometimes grow to a length of several feet.

TRUE

33. The incubation period is the interval of time between entrance of pathogenic microorganism into the body and appearance of disease symptoms.

TRUE

34. A gene inherited from a female parent does not always have the same effect as the identical gene inherited from the male parent.

TRUE

34. Cytopathogenic effect is cell injury with necrosis and degeneration of infected cells caused by certain viruses.

TRUE

34. Epidemics occur when there are large numbers of people affected by a certain disease.

TRUE

34. Most embryos lacking an X chromosome are aborted spontaneously.

TRUE

35. A scotch tape swab is used to diagnose pinworm infestation.

TRUE

35. Lupus erythematosus is characterized by widespread damage to fibrous connective tissue in the skin, articular tissues, heart, serous membranes, and kidneys.

TRUE

35. People who are asymptomatic but with a high viral load of HIV should be treated even if their CD4+ count is normal.

TRUE

36. Administration of an antibiotic may alter the patient's normal bacterial flora of the oral cavity, genital tract, and gastrointestinal tract and may predispose the patient to an infection with an antibiotic-resistant microorganism.

TRUE

36. Genetic sex is determined by the composition of X and Y chromosomes.

TRUE

37. Cryptosporidiosis in immunocompromised individuals can result in severe, life-threatening diarrhea.

TRUE

37. Many patients with SLE die of renal failure from renal glomerular injury.

TRUE

38. Autoantibodies in SLE can cause hemolytic anemia, leukopenia, and thrombocytopenia.

TRUE

38. Some antiviral drugs act by blocking DNA synthesis or by producing abnormal, nonfunctional DNA.

TRUE

39. Gametogenesis is the process by which gametes are formed.

TRUE

44. Transmission of abnormal mitochondrial DNA from parents to child is almost always from the mother.

TRUE

42. What are three methods a doctor might use to identify congenital abnormalities in the fetus?

Tests on maternal blood; examination of amniotic fluid; examination of fetal cells; utrasound examination of the fetus

47. Give 3 examples of drugs harmful in pregnancy and the resulting conditions or abnormality.

Thalidomide: used in the 1960s to treat nausea and vomiting; can cause malformation of the upper or lower limbs Heroin, methadone, and cocaine: congenital malformations in fetus with development of narcotic withdrawal symptoms a few days following delivery Tetracycline: yellowish discoloration of the enamel

45. What do antibiotic sensitivity tests measure?

The ability of an antibiotic to inhibit the growth of an organism isolated from a patient

49. Explain why resolution of severe inflammation may result in compromise of organ function

The body's natural response is the formation of scar tissue that replaces normal tissue following large areas of tissue injury and damage. Fibrous connective tissue that makes up scar tissue is paler, thicker than surrounding tissue, with limited function.

48. Describe the process of translocation in Down syndrome.

The extra chromosome 21 is attached to another chromosome such as chromosome 14. Actual total number of chromosomes is not increased but the resulting chromosome is a composite of both 21 and 14. The affected person has genetic material equivalent to 47 chromosomes. This may result from an accident in the germ cells of one parent during gametogenesis or one of the parents is carrier of the abnormal chromosome, in which case parent carrier has only 45 chromosomes, resulting from the fusion of chromosome 21 with another chromosome

47. Explain why Phthirus pubis infestation may be considered a sexually transmitted infection.

The organism lives in genital and anal hairs, causing intense itching, and organisms may be transmitted during sexual contact.

49. Describe the process of a Mantoux or tuberculin skin test.

The test is based on the presence or absence of delayed hypersensitivity reaction to proteins of the TB bacilli. Previous exposure or infection will lead to an inflammatory reaction at site of injection. Prior exposure has led to the development of a cell-mediated immunity and associated hypersensitivity to tubercle bacilli.

48. Describe the process of sterility from gonorrheal and Chlamydial infections.

The upward spread of the infection to the fallopian tubes may cause an acute inflammation and abscess that can cause scarring and sterility.

43. What are four adverse effects of antibiotics?

Toxicity, hypersensitivity, alteration of normal bacterial flora, development of resistant strains of bacteria

50. Describe the process of antibiotic resistance.

Two ways in which an organism becomes resistant to an antibiotic: spontaneous mutation that conveys resistance or by acquiring a plasmid that contains resistance genes from another bacterium.

50. Explain why use of condoms (male or female) during sexual contact with a partner with known herpes infection but without visible vulvar lesions is recommended.

Virus is continually shed periodically and can infect sexual partner despite absence of active lesions.

50. Explain more pronounced progressive mental deficiency in successive generations of fragile X syndrome.

When a women transmits the fragile X mental retardation gene (FMR1), the number of CGG repeats in the transmitted X chromosome is amplified during oogenesis, and her gametes contain more repeats than she has in her own somatic cells.

42. The inflammation of lymph vessels that drain the site of an infection is called __________.

lymphangitis

49. Give two examples of current applications of DNA technology.

prenatal diagnosis of genetic diseases by identifying abnormal genes and gene products in fetal cells. Development of important biologic products such as insulin and growth hormone; increasing the understanding for gene structure and function

41: The ability of an organism to cause disease is known as __________.

virulence

44. Identify and briefly explain the five parts of a patient's clinical history.

1. The history of the patient's current illness provides details concerning the severity, time of onset, and character of the patient's symptoms. 2. The past medical history provides details of the patient's general health and previous illnesses. 3. The family history provided information about the health of the patient's parents and other family members. 4. The social history deals with the patient's occupation, habits, alcohol and tobacco consumption, and similar data. 5. The review of symptoms inquires as to the presence of symptoms other than those disclosed in the history of the present illness.

45. A successful screening program should fulfill what three requirements?

1. A significant number of persons must be at risk for the disease in the group being screened. 2. A relatively inexpensive noninvasive test must be available to screen for the disease that does not yield an excessively high number of false-positive or false-negative results. 3. Early identification and treatment of the disease will favorably influence the health or welfare of the person with the disease.

48. Give four examples of various diagnostic applications of a PET scan

1. Biochemical functions within the brain - strokes, brain tumors, Alzheimer's disease, Parkinson's disease, and hereditary disease of the nervous system 2. Evaluate changes in blood flow and metabolism in heart muscle following a heart attack 3. Distinguish a benign from a malignant tumor 4. Identify metastatic sites by demonstrating increased glucose uptake within tumor deposits

11. Which of the following statements regarding identification of inherited disease in newborn infants by screening tests is INCORRECT? A. Screening is unlikely to be useful because most inherited diseases do not respond to treatment. B. Long-term harmful effects of inherited diseases can often be prevented by early treatment. C. Identification of a hereditary disease in a newborn may allow parents to make an informed decision regarding future pregnancies, based on the nature of the inherited disease and its prognosis.

A. Screening is unlikely to be useful because most inherited diseases do not respond to treatment.

4. The normal osmolarity of blood and body fluids is 300 mOsm/L. A person with severe diabetes and a greatly elevated blood glucose has a blood osmolarity of 370 mOsm/L. Which of the following events will result from the increased osmolarity? A. Water shifts by osmosis from the cells into the extracellular fluid (ECF). B. No water shifts will occur between the cells and the extracellular fluids as a result of the higher osmolarity of the subject's blood and body fluids. C. Water shifts by osmosis from the extracellular fluid into the cells. D. Equal amounts of water move from the cells into the ECF and from the ECF into the cells, and thus, there is no net change in the water content of either the cells or the ECF.

A. Water shifts by osmosis from the cells into the extracellular fluid (ECF).

10. A computed tomographic (CT) scan is a type of: A. X-ray procedure. B. ultrasound procedure. C. radioisotope procedure. D. procedure that measures the electrical activity of body tissues.

A. X-ray procedure.

15. A disease that causes the affected individual no discomfort or disability is a(n) ________ disease. A. asymptomatic B. chronic C. inflammatory D. neoplastic

A. asymptomatic

17. The function of lysosomes is to: A. break down particles or worn-out cellular components. B. convert food materials into energy. C. produce digestive enzymes and antibody proteins. D. aid in cell division.

A. break down particles or worn-out cellular components.

21. A(n) ________ is the determination of the nature and cause of a patient's illness by a physician or other health practitioner. A. diagnosis B. prognosis C. etiology D. treatment

A. diagnosis

7. A physician examines a patient and determines that the patient has an infection of the throat caused by a pathogenic streptococcus. The physician's evaluation is called a/an __________. A. diagnosis B. prognosis C. etiology D. pathology

A. diagnosis

13. Dysplasia of epithelial cells sometimes results from which of the following? A. Excessive sodium intake B. Chronic irritation or inflammation C. Increased enzyme synthesis D. Apoptosis

B. Chronic irritation or inflammation

24. ________ tests detect the presence of disease-producing organisms in urine, blood, and feces. A. Clearance B. Pulmonary function C. Microbiologic D. Serologic

C. Microbiologic

19. Diabetes is an example of a ________ disease. A. congenital B. degenerative C. metabolic D. neoplastic

C. metabolic

12. An injured cell may commonly show which of the following changes? A. Sodium and water diffuse into the cell, causing it to swell and sometimes to rupture. B. Fat droplets accumulate within the cytoplasm. C. Cell death, occasionally leading to necrosis. D. All of the above. E. None of the above.

D. All of the above.

2. Which of the following processes is not involved in the movements of materials in and out of the cell? A. Diffusion B. Osmosis C. Pinocytosis D. Filtration

D. Filtration

17. ________ diseases are the result of developmental disturbances. A. Congenital B. Inflammatory C. Degenerative D. Metabolic

D. Metabolic

11. Which of the terms below does not describe a method by which cells adapt to changing conditions? A. Hypertrophy B. Hyperplasia C. Increased enzyme synthesis D. Necrosis

D. Necrosis

20. ________ diseases are characterized by abnormal cell growth that leads to the formation of various types of benign and malignant tumors. A. Congenital B. Degenerative C. Metabolic D. Neoplastic

D. Neoplastic

5. The activities of the cell are directed by which cell structure? A. Cytoplasm B. Organelles C. Cell membranes D. Nucleus

D. Nucleus

Which of the following tests does not measure the electrical impulses associated with various body functions and activities? A. Electromyogram (EMG) B. Electroencephalogram (EEG) C. Electrocardiogram (EKG) D. Radioisotope studies that measure cardiac function

D. Radioisotope studies that measure cardiac function

25. ________ tests detect and measure the presence of antibodies as an indication of response to infectious agents. A. Clearance B. Pulmonary function C. Microbiologic D. Serologic

D. Serologic

A disease in which the principal manifestation is an abnormal growth of cells leading to formation of tumors is called a __________ disease. A. congenital B. degenerative C. metabolic D. neoplastic

D. neoplastic

13. A disease associated with structural changes is called a(n) ________ disease. A. chronic B. hereditary C. functional D. organic

D. organic

31. Match each term with its definition: ___ Collagen fibers ___ Elastic fibers ___ Reticulin fibers ___ Matrix A. Fibers that stretch readily and return to their former shape B. An extracellular material into which various fibers are embedded C. Thin, delicate fibers that form in a fine meshwork to support organs such as the liver D. Long, flexible fibers that are strong but do not stretch

D___ Collagen fibers A___ Elastic fibers C___ Reticulin fibers B___ Matrix

41. List the three ways that oxygen, nutrients, and waste products cross the cell membrane.

Diffusion and osmosis; active transport; phagocytosis and pinocytosis

19. During contraction of a muscle fiber, actin filaments slide outward and lengthen the fiber.

FALSE

20. Nerve tissue is composed entirely of cells called neuroglia.

FALSE

25. Cell death normally does not occur unless there has been an injury to the cell.

FALSE

27. An organic disease is one in which no morphologic abnormalities can be identified even though body functions may be profoundly disturbed.

FALSE

27. The trophoblast is the part of the fertilized ovum that eventually grows into an embryo.

FALSE

43. Differentiate hyperplasia from hypertrophy.

Hyperplasia: increase in cell size with an increase in cell number Hypertrophy: increase in cell size without an increase in cell number

49. Describe underlying principle in magnetic resonance imaging (MRI).

Images produced depend on the response of hydrogen protons contained within water molecules when they are placed in a strong magnetic field

46. Define and give an example of hypertrophic change.

Increase in cell size without an increase in cell number; hypertrophy of the heart in chronic hypertension

21. During DNA synthesis, the chemical structure of the bases means that adenine always pairs with thymine and guanine always pairs with cytosine.

TRUE

22. Phagocytosis is a method by which cells ingest particles that are too large to cross through the cell membrane by other means.

TRUE

23. All necrotic cells are dead, but not all dead cells are necrotic.

TRUE

24. Neoplasia is a term for dysplastic cells that undergo malignant transformation.

TRUE

26. A gross examination involves examining diseased tissue with the naked eye.

TRUE

26. Specific types of cells often can be identified by examining structures called intermediate filaments in the cytoskeleton.

TRUE

28. Parenchyma is the total mass of functional tissue.

TRUE

29. A disease of unknown etiology is one for which the cause is not yet known.

TRUE

46. Compare and contrast black and white images on an X-ray film.

Tissues of low density transmit most of the X-rays and would appear black, while tissues of high density, such as bone, absorb most of the rays and would appear white on the film.

39. Name the four major tissue groups.

Epithelium, connective and supporting tissues, muscle tissue, and nerve tissue.

28. Symptoms are objective manifestations produced by a disease.

FALSE

30. Various supporting tissues such as cartilage and bone are derived from the endoderm.

FALSE

31. Hemophilia is an example of a degenerative disease.

FALSE

35. Prescribing antibiotics to a patient with an ear infection is an example of symptomatic treatment.

FALSE

36. Treatment of late-stage disease is just as effective as treatment at an earlier stage of the disease.

FALSE

38. A urine test is an example of an invasive procedure.

FALSE

40. A cystoscope is an instrument used to examine the rectum and the sigmoid colon.

FALSE

36. List three possible causes of cell aging.

Genetic pre-programming (inherent property of the cell) decreased activity or efficiency of enzyme systems damage to cellular DNA, RNA, and organelles.

50. Explain increased enzyme synthesis in chronic alcoholism.

Increased elimination, metabolism, or detoxification of drugs or chemicals by increased synthesis of enzymes in the SER occurs in alcoholism; a person is much more able to metabolize alcohol as the body's response to chronic exposure to alcohol.

37. What are the three different types of protein tubules and filaments in the cell cytoskeleton? What are the principal functions of these structures?

Microtubules, microfilaments, and intermediate filaments; they form the structural framework of the cell and are responsible for cell movements.

45. Compare and contrast phagocytosis versus pinocytosis.

Phagocytosis is the ingestion of particles too large to pass across the cell membrane. Pinocytosis is the ingestion of fluid.

35. What is apoptosis? What happens in the body when apoptosis mechanisms cease to function properly?

Pre-determined or programmed cell death. If apoptosis mechanisms cease to function properly, cells may continue to proliferate and accumulate in organs or tissues, causing diseases or tumors.

18. Endocrine glands discharge their secretions directly into the bloodstream, while secretions from exocrine glands discharge through ducts.

TRUE

29. Stroma is the supporting framework of an organ

TRUE

30. A pathogen is any microorganism that can cause disease.

TRUE

32. The primary abnormality in degenerative diseases is the degeneration of various parts of the body.

TRUE

33. The goal of traditional medicine is to cure or ameliorate disease.

TRUE

34. In a differential diagnosis the practitioner considers a number of diseases that are characterized by the patient's symptoms.

TRUE

37. Generally, there is no point in screening for a disease if no treatment is available.

TRUE

39. An endoscopy is an examination of the interior of the body by means of various types of rigid or flexible tubular instruments that are named according to the part of the body they are designed to examine.

TRUE

41. An arteriogram is a procedure that uses contrast material to study the flow of blood in large arteries and to identify areas of narrowing or obstruction.

TRUE

42. The histologic examination of a small sample of tissue removed from the affected tissue or organ is called a biopsy.

TRUE

43. Generally, there is no point in screening for a disease if no treatment is available to arrest the progression of the disease.

TRUE

47. Describe the process and direction of movement of water in severe uncontrolled diabetes.

The high glucose concentration increases the ECF osmolarity, and water moves by osmosis from the cells into the extracellular fluid.

49. Explain why a liver exposed to chronic injury as in hepatitis or alcoholism becomes swollen.

The liver becomes swollen because of fatty liver change or an increased accumulation of fat droplets in the cytoplasm due to the impairment of enzyme systems that metabolize fat. This is an initial reaction to injury. If the offending organism is not eliminated, the liver eventually undergoes scarring or cirrhosis as a result of chronic inflammatory process.

48. Explain the direction of water movement in renal failure.

Water is not excreted by the kidneys, and the excess water dilutes the ECF, resulting in a lower osmolarity. Therefore, water moves from the ECF into the cells, causing the cells to swell.

14. Choose the response that correctly identifies which components are true or false in the following statement: Fat stored in adipose tissue functions as (1) stored energy, (2) padding and insulation, and (3) support for internal organs and bones. A. 1 and 2 are true, but not 3 B. 1 and 3 are true, but not 2 C. 2 and 3 are true, but not 1 D. 1, 2, and 3 are all true

A. 1 and 2 are true, but not 3

10. Choose the answer below that best completes the sentence: DNA is composed of __________ base chemicals called __________. A. 4; adenine, thymine, guanine, cytosine B. 3; nucleotide, deoxyribose, base C. 2: chromosomes, proteins D. None of the above.

A. 4; adenine, thymine, guanine, cytosine

1. Which of the following statements is correct? A. Mesothelium is a type of flat (squamous) epithelium lining the pleural cavity and external (pleural) surface of the lung. B. Epithelium consists of small groups of cells dispersed in a large amount of extracellular material called matrix. C. Cartilage is a type of modified epithelium. D. Endothelium is a type of stratified squamous epithelium.

A. Mesothelium is a type of flat (squamous) epithelium lining the pleural cavity and external (pleural) surface of the lung.

40. Name four types of connective and supporting tissue.

Any four of the following: loose fibrous tissue, dense fibrous tissue, elastic tissue, reticular tissue, adipose tissue, cartilage, bone, hematopoietic tissue, lymphatic tissue, subcutaneous tissue, ligaments, tendons, blood vessel wall membranes, bronchi walls, trachea, supporting framework of organs

8. Which of the following tests measures the electrical activity of the heart? A. EEG B. ECG C. Radioisotope (radionuclide) studies D. EMG

B. ECG

3. Which of the following statements is incorrect? A. The nucleus directs the metabolic functions of the cell. B. Organelles are small chromosome fragments. C. Migration of water molecules across the semipermeable membrane from a more dilute to a more concentrated solution is called osmosis. D. The rough endoplasmic reticulum contains ribosomes attached to its membrane that synthesize protein molecules.

B. Organelles are small chromosome fragments.

16. ________ refers to the manner by which a disease develops. A. Etiology B. Pathogenesis C. Social history D. Diagnosis

B. Pathogenesis

23. ________ tests measure the rate at which air moves in and out of the lungs. A. Clearance B. Pulmonary function C. Microbiologic D. Serologic

B. Pulmonary function

22. ________ treatment makes the patient more comfortable by alleviating symptoms but does not influence the course of the underlying disease. A. Specific B. Symptomatic C. Asymptomatic D. Initial

B. Symptomatic

5. A young woman has a skin rash that is caused by an allergic reaction to an antibiotic. This patient's condition would be classified as: A. an infectious disease. B. an inflammation. C. a fungus. D. a neoplastic disease.

B. an inflammation.

12. Examining diseased tissue with a microscope is called a ________ examination. A. gross B. histological C. physical D. metabolic

B. histological

18. Sore throat and pneumonia are examples of ________ diseases. A. congenital B. inflammatory C. degenerative D. metabolic

B. inflammatory

7. Mitochondria, endoplasmic reticulum, Golgi apparatus, lysosomes, and centrioles are all examples of __________. A. cell membranes B. organelles C. enzymes D. None of the above

B. organelles

6. A physician's opinion concerning the eventual outcome of a disease in a patient is called a/an __________. A. diagnosis B. prognosis C. etiology D. pathology

B. prognosis

34. Match the terms below to the correct definitions. ___ Metaplasia ___ Hypertrophy ___ Atrophy ___ Neoplasia ___ Hyperplasia ___ Apoptosis ___ Necrosis ___ Dysplasia A. Programmed cell death B. A change from one type of cell to another type better able to tolerate adverse conditions C. Disturbed or abnormal development and maturation of cells D. Structural changes occurring in dead cells E. Reduction in the size of cells in response to less favorable conditions F. An increase in the size of a tissue or organ due to an increased number of cells G. An increase in the size of individual cells H. Development of a mass of abnormal cells called a tumor

B___ Metaplasia G___ Hypertrophy E___ Atrophy H___ Neoplasia F___ Hyperplasia A___ Apoptosis D___ Necrosis C___ Dysplasia

50. Explain why tissues with high water content can give a sharper resolution using MRI.

Body tissues with a high water content are a rich source of protons capable of excitation. The intensity of the signals produced is related to the varying water content of body tissues and to the strength and duration of the radiofrequency pulse.

A governmental agency proposes a pilot program to screen a population for a disease by means of a blood test. The characteristics of the disease and the screening test are listed. Which of these indicate that the proposed screening is not likely to be worthwhile? A. The disease occurs with some frequency (1 per 1000 persons screened). B. The disease progresses slowly in affected persons. C. No specific method of treatment is currently available. D. The test can detect the disease in its early stage and is relatively inexpensive. E. The test is quite specific, as it produces few false-positive and false-negative results.

C. No specific method of treatment is currently available.

9. How many types of muscle tissue exist in the body, and what are they called? A. Four: cardiac, skeletal, smooth, and striated. B. Two: smooth and striated. C. Three: smooth, striated, and cardiac. D. One: all muscle tissue is the same.

C. Three: smooth, striated, and cardiac.

9. __________ is a test based on echoes produced in tissues by high-frequency sound waves. A. EEG B. ECG C. Ultrasound examination D. Magnetic resonance imaging (MRI) examination

C. Ultrasound examination

8. Choose the answer below that best completes following statement: An organ is __________. A. an object within the abdominal cavity that processes food, water, and air. B. a complex structure that evolves from a single cell. C. a group of different tissues integrated to perform a specific function. D. a collection of similar cells that have an identical function.

C. a group of different tissues integrated to perform a specific function.

16. An organ system is composed of: A. three distinct layers called germ layers. B. connective and supporting tissues. C. a group of organs organized to perform complementary functions. D. muscle and nerve tissues.

C. a group of organs organized to perform complementary functions.

6. Enzymes that use oxidation to convert food materials into energy are found in sausage-shaped structures called __________. A. endoplasmic reticulum B. ribosomes C. mitochondria D. Golgi apparatus

C. mitochondria

15. The cells in nerve tissue that are responsible for transmitting nerve impulses are called __________. A. astrocytes B. microglia C. neurons D. oligodendroglia

C. neurons

14. A ________ diagnoses and classifies diseases while a ________ cares for patients. A. clinician; pathologist B. clinician; health practitioner C. pathologist; clinician D. pathologist; physiologist

C. pathologist; clinician

47. Compare and contrast an MRI and CT scan.

CT: • produces images of the body in cross section by rotating an X-ray tube around the patient at various levels • patient is exposed to radiation and uses ionizing radiation to reconstruct the data into an image that reproduces the patient's anatomy as a cross-section picture • images appear white (dense tissues) and dark (less dense tissues) as in an x-ray with sharper images produced for tissues separated by planes of fat (low density) MRI: • produces computer-constructed images using a device that consists of a strong magnet; the images depend on the response of hydrogen protons contained within water molecules when they are placed in a strong magnetic field • does not expose patients to radiation

32. Match each term below with the type of cells, functions, or organs that are derived from it: ___ Ectoderm ___ Inner cell mass ___ Entoderm ___ Mesoderm A. Tissues used for support, motion, circulation, urination, generation B. Tissues that form inner layers of the body and linings of organs C. Tissues that form the external covering of the body and organs that contact the external environment D. The collection of cells that gives rise to the distinct germ layers

C___ Ectoderm D___ Inner cell mass B___ Entoderm A___ Mesoderm

33. Match each term with its role in the genetic code. ___ Messenger RNA ___ Transfer RNA ___ Chromosome ___ Nucleotide A. Picks up required amino acids from the cytoplasm and transfers them to the ribosomes for assembly B. Basic structural unit of DNA consisting of a phosphate group linked to a five-carbon sugar C. Carries instructions from the nucleus to the ribosomes in the cytoplasm D. Contains a series of messages called the genetic code that regulates cell functions

C___ Messenger RNA A___ Transfer RNA D___ Chromosome B___ Nucleotide

A patient has a chronic cough, fever, and purulent sputum, and a lung infection (pneumonia) is suspected. Which of the following diagnostic procedures is least likely to provide useful information? A. White blood cell count and differential count B. Chest X-ray C. Culture of sputum for disease-producing organisms D. Urinalysis

D. Urinalysis

38. What are the two types of nucleic acid combined with protein found in the nucleus of the cell? Where does each type of nucleic acid occur within the cell?

Deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). DNA is found in the chromosomes. RNA is found in the nucleoli.

44. Compare and contrast diffusion versus osmosis.

Diffusion is the passage of dissolved particles or solute from a more concentrated to a more dilute solution. Osmosis is the movement of water molecules from a dilute to a more concentrated solution.

42. Differentiate dysplasia from metaplasia.

Dysplasia: abnormal maturation of cells, resulting in varied cell shape and size Metaplasia: change from one cell type to another