Chapter 20: Lymphatic System and Immunity

118) ________ will develop when the immune response mistakenly targets normal body cells and tissues. A) Autoimmune disorders B) Acquired immune deficiency syndrome C) Immunosuppression D) Anaphylaxis E) Allergies

A) Autoimmune disorders

6) Lymphatic vessels are located in almost all portions of the body except the A) CNS. B) periphery. C) renal arteries. D) groin. E) throat.

A) CNS.

98) Immunoglobulins that are primarily found in glandular secretions such as mucus, saliva, and tears are A) IgA. B) IgD. C) IgE. D) IgG. E) IgM.

A) IgA.

53) The cells that perform immunological surveillance are the ________ cells. A) NK B) plasma C) B D) helper T E) suppressor T

A) NK

20) ________ are large lymphoid nodules that are located in the walls of the pharynx. A) Tonsils B) Peyer's patches C) Lymph nodes D) Immune complexes E) Spleens

A) Tonsils

111) In opsonization, A) a pathogen is coated by proteins to facilitate its destruction by neutrophils and macrophages. B) the cell wall of a pathogen is breached, leading to death of the cell. C) MHC II glycoproteins display a fragment of an alien cell. D) antigens bind to antibodies to become antigen-antibody complexes. E) antibodies tie many antigens together.

A) a pathogen is coated by proteins to facilitate its destruction by neutrophils and macrophages.

35) All of the following are true of the thymus gland except that it A) activates B cells. B) reaches its greatest relative size before puberty. C) involutes after puberty. D) produces T cells. E) lies in the anterior mediastinum.

A) activates B cells.

75) Which of the following concerning Class I MHC proteins is false? A) bind complement B) allow the body to differentiate its own antigens from foreign antigens C) function in antigen presentation D) display abnormal peptides on the plasma membrane E) are found on all nucleated cells

A) bind complement

52) The attraction or repulsion of certain cells to chemicals in their environment is called A) chemotaxis. B) diapedesis. C) phagocytosis. D) apoptosis. E) immune surveillance.

A) chemotaxis.

32) Identify the region labeled "5." A) germinal center B) subscapular space C) medullary sinus D) trabeculae E) deep cortex

A) germinal center

114) Destruction of antigens or cell lysis can be caused by all of the following except A) helper T cells. B) cytotoxic T cells. C) antibody actions. D) macrophages. E) complement system.

A) helper T cells.

108) When large numbers of antibodies encounter their antigenic targets, they interact to form a three-dimensional structure known as a(n) A) immune complex. B) antigen-presenting cell. C) antigenic determinant site. D) major histocompatibility complex. E) antigen-antibody complex.

A) immune complex.

43) The white pulp of the spleen is populated by A) lymphocytes. B) trabeculae. C) arteries. D) veins. E) fibrous connective tissue.

A) lymphocytes.

69) Immunity that results from exposure to an antigen in the environment is called ________ immunity. A) naturally acquired active B) naturally acquired passive C) passive D) auto E) innate

A) naturally acquired active

92) B cells prepare for activation by presenting an antigen bound to Class II MHC proteins in a process called A) sensitization. B) apoptosis. C) opsonization. D) differentiation. E) customization.

A) sensitization.

11) The merging of ________ forms the right lymphatic duct. A) the right jugular, right subclavian, and right bronchomediastinal trunks B) the left jugular, right subclavian, and right bronchomediastinal trunks C) two great vessels D) the thoracic and mediastinal ducts E) superior and inferior lymphatic ducts

A) the right jugular, right subclavian, and right bronchomediastinal trunks

13) Lymph draining from your right shoulder flows into A) the right lymphatic duct. B) the thoracic duct.

A) the right lymphatic duct.

78) The cells responsible for antibody-mediated immunity are the ________ cells. A) NK B) B C) helper T D) cytotoxic T E) suppressor T

B) B

91) T cells release cytokines to stimulate the activation of A) APCs. B) B cells. C) antibodies. D) immunoglobulins. E) plasma cells.

B) B cells.

87) When an antigen is bound to a Class II MHC protein, it can activate a(n) ________ cell. A) plasma B) CD4 T C) NK D) suppressor T E) cytotoxic T

B) CD4 T

96) Immunoglobulins that are found on the surface of B cells and may activate antibody production are A) IgA. B) IgD. C) IgE. D) IgG. E) IgM.

B) IgD.

79) Adaptive immunity is the result of the actions of A) NK cells. B) T and B cells. C) mast cells. D) antigen-antibody complexes. E) interferons.

B) T and B cells.

25) The cell that dominates the deep cortical region of a lymph node is the ________ cell. A) B B) T helper C) plasma D) cytotoxic T E) NK

B) T helper

73) ________ exists when the immune system does not respond to a particular antigen. A) Versatility B) Tolerance C) Specificity D) Allergy E) Hypersensitivity

B) Tolerance

54) What is perforin? A) a type of antibody synthesized by B cells B) a protein produced by NK cells C) a type of interferon D) a toxin expressed by some pathogens that is capable of damaging healthy cells E) a destructive enzyme secreted by sebaceous glands

B) a protein produced by NK cells

7) Lymphatic vessels commonly occur in association with A) hyaline cartilage. B) blood vessels. C) adipose tissue. D) sensory nerve endings. E) both hyaline cartilage and adipose tissue.

B) blood vessels.

64) Histamine increases blood flow and vascular permeability. This would account for all of the following changes that occur during inflammation except A) redness of the inflamed tissue. B) chemotaxis of phagocytes. C) heat of the inflamed tissue. D) movement of defense proteins and cells into the interstitial space. E) swelling of the inflamed tissue.

B) chemotaxis of phagocytes.

86) Helper T cells do all of the following except A) activate sensitized B cells by costimulation. B) destroy target cells using perforins. C) enhance cell-mediated immunity. D) secrete cytokines to stimulate production of plasma cells. E) enhance antibody-mediated immunity.

B) destroy target cells using perforins.

51) The movement of phagocytes through the capillary wall is called A) chemotaxis. B) diapedesis. C) phagocytosis. D) apoptosis. E) involution.

B) diapedesis.

44) Which class of leukocytes is particularly abundant in the red pulp of the spleen? A) T lymphocytes B) free and fixed macrophages C) B lymphocytes D) neutrophils E) red blood cells

B) free and fixed macrophages

50) Various types of macrophages are derived from A) lymphocytes. B) monocytes. C) neutrophils. D) eosinophils. E) basophils.

B) monocytes.

70) Immunity that results from antibodies that pass the placenta from mother to fetus is called ________ immunity. A) naturally acquired active B) naturally acquired passive C) passive D) auto E) innate

B) naturally acquired passive

59) The process by which the surface of a microorganism is covered with antibodies and complement, rendering it more likely to be phagocytized, is called A) neutralization. B) opsonization. C) agglutination. D) antigen presentation. E) sensitization.

B) opsonization.

88) The cells responsible for producing antibody molecules are ________ cells. A) NK B) plasma C) helper T D) thymus E) liver

B) plasma

63) In response to tissue damage and infection, circulating proteins called pyrogens A) cause inflammation. B) produce a fever. C) activate complement. D) opsonize pathogens. E) activate antibodies.

B) produce a fever.

10) The thoracic duct drains lymph from all of the following regions except the A) left breast. B) right breast. C) left arm and shoulder. D) pelvic viscera. E) left side of the neck.

B) right breast.

40) The lobules of the thymus are divided by partitions called A) fissures. B) septa. C) hilum. D) trabeculae. E) sutures.

B) septa.

67) Defense of the body against a particular pathogen is provided by A) nonspecific immunity. B) specific immunity. C) immunological surveillance. D) skin defenses. E) fever.

B) specific immunity.

1) The lymphatic system is composed of all of the following except A) the appendix. B) the venae cavae. C) the spleen. D) red bone marrow. E) lymph.

B) the venae cavae.

9) Most of the lymph returns to the venous circulation by way of the A) right lymphatic duct. B) thoracic duct. C) cisterna chyli. D) hepatic portal vein. E) dural sinus.

B) thoracic duct.

38) The thymus produces several complementary hormones called A) catecholamines. B) thymosins. C) immunoglobulins. D) desmosomes. E) interferons.

B) thymosins.

17) T is to ________ as B is to ________. A) top; bottom B) thymus-dependent; bone marrow-derived C) thyroid; bowel D) non-thymus-dependent; bottom E) None of the answers is correct.

B) thymus-dependent; bone marrow-derived

105) The site on an antibody that is specifically tailored to fit a specific antigen is called the A) constant segment. B) variable segment. C) hapten. D) heavy chain. E) bond.

B) variable segment.

55) Interferons are released by some macrophages and lymphocytes, but also by cells carrying what pathogen? A) parasites B) viruses C) bacteria D) prions E) spirochetes

B) viruses

26) Lymph nodes range in diameter from A) 1 nm to 10 nm. B) 1 inch to 2 inches. C) 1 mm to 25 mm. D) 1 cm to 25 cm. E) 1 cm to 1 inch.

C) 1 mm to 25 mm.

33) Identify the area where dividing lymphocytes are found. A) 2 B) 4 C) 5 D) 1 E) 3

C) 5

29) Identify the dominant cell type in the area labeled "2." A) monocytes B) T lymphocytes C) B cells D) NK cells E) erythrocytes

C) B cells

95) Immunoglobulins that attach to and sensitize mast cells and basophils are A) IgA. B) IgD. C) IgE. D) IgG. E) IgM.

C) IgE.

27) ________ are connective tissues dominated by lymphocytes. A) Dendritic cells B) Afferent lymphatics C) Lymphoid tissues D) Palatine tonsils E) None of the answers is correct.

C) Lymphoid tissues

21) ________ are clusters of lymphoid nodules deep to the epithelial lining of the small intestine. A) Tonsils B) Adenoids C) Peyer's patches D) Immune complexes E) Lymph glands

C) Peyer's patches

37) If the thymus shrank and stopped functioning properly, we would expect to see an immediate decrease in the number of A) B lymphocytes. B) NK cells. C) T cells. D) neutrophils. E) NK cells and T cells.

C) T cells.

23) Lymphoid organs differ from lymphoid tissues in what way? A) They contain T lymphocytes and lymphoid tissues do not. B) They are found in the digestive tract and lymphoid tissues are found in the thorax. C) They are surrounded by a fibrous capsule and lymphoid tissues are not. D) They cannot produce antibodies, whereas lymphoid tissues can. E) None of the answers is correct.

C) They are surrounded by a fibrous capsule and lymphoid tissues are not.

109) The process by which antibodies bind to the antigen on the surface of cells, forming large immune complexes, is called A) neutralization. B) opsonization. C) agglutination. D) antigen presentation. E) sensitization.

C) agglutination.

112) Inappropriate or excessive immune responses to antigens are A) immunodeficiency diseases. B) autoimmune diseases. C) allergies. D) the result of stress. E) signs of a weak system.

C) allergies.

57) The classic pathway of complement activation begins when the complement protein binds to A) the cell wall of bacteria. B) the plasma membrane of bacteria. C) an antibody attached to an antigen. D) a cell surface antigen. E) a plasma protein.

C) an antibody attached to an antigen.

102) An antibody binds to an antigen at a specific area called the A) constant segment. B) light chain. C) antigen binding site. D) hapten. E) antigen-antibody complex.

C) antigen binding site.

2) The primary function of the lymphatic system is A) circulation of nutrients. B) the transport of hormones. C) defending the body against both environmental hazards and internal threats. D) the production and distribution of plasma proteins. E) both the transport of hormones and the production and distribution of plasma proteins.

C) defending the body against both environmental hazards and internal threats.

115) Autoantibodies are A) produced by activated T cells. B) produced during an allergic reaction. C) directed against the body's own antigens. D) the first step in immunological competence. E) important in tissue rejection reactions.

C) directed against the body's own antigens.

89) Cells that help regulate the antibody-mediated immune response are ________ cells. A) B B) plasma C) helper T D) cytotoxic T E) NK

C) helper T

90) B cells are primarily activated by the activities of A) antigens. B) antibodies. C) helper T cells. D) macrophages. E) plasma cells.

C) helper T cells.

56) The effects of activating the complement system include all of the following except A) destruction of target cell plasma membranes. B) stimulation of inflammation. C) inhibition of the immune response. D) enhanced phagocytosis. E) histamine release.

C) inhibition of the immune response.

110) Which of the following is not a method in which antibodies work with features of innate immunity to destroy a pathogen? A) neutralization B) agglutination C) initiate allergic reaction D) complement activation E) phagocyte attraction

C) initiate allergic reaction

117) Infection with the HIV virus occurs through A) sharing eating utensils. B) airborne droplets from coughs and sneezes. C) intimate contact with an infected person's body fluids. D) casual contact with an infected individual. E) sharing clothes with an infected individual.

C) intimate contact with an infected person's body fluids.

101) All of the following are true of the primary response to antigen exposure except that A) it depends on antigen triggering the appropriate B cell. B) it requires B cell differentiation into plasma cells. C) it is delayed by the memory cell stage. D) circulating antibodies undergo a gradual, sustained rise. E) it peaks 1 to 2 weeks after the initial exposure.

C) it is delayed by the memory cell stage.

62) An inflammatory response is triggered when A) red blood cells release pyrogens. B) T cells release interferon. C) mast cells release histamine and heparin. D) neutrophils phagocytize bacteria. E) blood flow to an area increases.

C) mast cells release histamine and heparin.

72) In an experimental situation, a rabbit is exposed to a viral antigen to which it makes antibodies. These antibodies are then purified and injected into a human with the same viral disease. This is an example of A) innate immunity. B) active immunization. C) passive immunity. D) natural immunity. E) alloimmunity.

C) passive immunity.

15) Lymphocytes A) are all actively phagocytic. B) destroy red blood cells. C) respond to antigens. D) are primarily found in red bone marrow. E) decrease in number during infection.

C) respond to antigens.

34) Leslie has a bad sore throat, and the lymph glands in her neck are swollen. This would indicate that A) the focus of the infection is the lymph glands. B) lymph is not flowing through these lymph glands. C) the affected lymph glands contain an increased number of lymphocytes. D) the lymph gland is actively producing phagocytes. E) the lymph gland has increased its secretion of thymosin.

C) the affected lymph glands contain an increased number of lymphocytes.

104) A test to measure the antibody level of a blood sample is called a(n) A) primary response. B) secondary response. C) titer. D) anaphylaxis test. E) major histocompatibility complex.

C) titer.

31) Identify the structures labeled "4." A) lymphatic vessels B) medullae C) trabeculae D) dendritic cells E) venules

C) trabeculae

41) Areas of the spleen that contain large aggregations of lymphocytes are known as A) Peyerȇs patches. B) adenoids. C) white pulp. D) red pulp. E) lymph nodes.

C) white pulp.

24) The medullary sinus of a lymph node contains ________ lymphocytes and plasma cells. A) cytotoxic T B) immature T C) NK D) B E) helper T

D) B

94) Immunoglobulins that are most abundant and are responsible for resistance against many viruses, bacteria, and bacterial toxins are A) IgA. B) IgD. C) IgE. D) IgG. E) IgM.

D) IgG.

8) Which of the following statements regarding lymph is false? A) Lymph derived from interstitial fluid. B) Lymphatic vessels have valves to direct fluid flow. C) Lymphatic capillaries have larger diameters than blood capillaries. D) Lacteals are prominent lymphatic vessels in the respiratory system. E) Lymphatic capillaries have little or no basement membrane.

D) Lacteals are prominent lymphatic vessels in the respiratory system.

85) ________ cells enable the immune system to respond quickly and robustly if the same antigen is encountered a second time. A) IgM B) Suppressor C) Dendritic D) Memory E) Plasma

D) Memory

80) The cells directly responsible for cell-mediated immunity are the ________ cells. A) B B) plasma C) NK D) T E) interferon

D) T

83) Cytotoxic T cells attack target cells by doing what? A) secreting a strong acid B) secreting organic solvent C) secreting free radicals D) activating genes that trigger apoptosis E) secreting mutant proteins

D) activating genes that trigger apoptosis

30) Identify the structure labeled "3." A) efferent lymphatic B) hilum C) outer cortex D) afferent lymphatic E) medulla

D) afferent lymphatic

113) An allergen circulating in the bloodstream affects mast cells throughout the body, dropping blood pressure to dangerously low levels. This response is termed A) allergy. B) hypersensitivity. C) allergic rhinitis. D) anaphylactic shock. E) asthma.

D) anaphylactic shock.

5) Compared to blood capillaries, lymph capillaries exhibit all of the following except that they A) have no basement membrane. B) are larger in diameter. C) have walls of endothelial cells that overlap like shingles. D) are smaller in diameter. E) are frequently irregular in shape.

D) are smaller in diameter.

47) Each of the following is a physical barrier to infection except A) body hair. B) epithelium. C) secretions. D) complement. E) basement membranes.

D) complement.

81) Lymphocytes that destroy foreign cells or virus-infected cells are ________ cells. A) B B) plasma C) helper T D) cytotoxic T E) suppressor T

D) cytotoxic T

93) The various classes of immunoglobulins are differentiated on the basis of their A) asymmetry. B) antigen specificity. C) light-chain variable segments. D) heavy-chain constant segments. E) both light-chain variable segments and heavy-chain constant segments.

D) heavy-chain constant segments.

116) The human immunodeficiency virus (HIV), which causes the disease known as AIDS, selectively infects ________ cells. A) B B) plasma C) cytotoxic T D) helper T E) suppressor T

D) helper T

39) After puberty, the thymus gradually shrinks and becomes more fibrous, in a process called A) atrophy. B) diminishment. C) necrosis. D) involution. E) conversion.

D) involution.

65) A sample of John's blood shows a high level of pyrogens. This would indicate that John A) is feeling achy. B) is producing T lymphocytes. C) has a sore throat. D) is running a fever. E) has swollen lymph nodes.

D) is running a fever.

76) Class II MHC molecules are found only on which of the following? A) all body cells with a nucleus B) red blood cells C) granulocytes and microphages D) lymphocytes and antigen-presenting cells E) liver cells and macrophages in the spleen

D) lymphocytes and antigen-presenting cells

107) Antibodies may bind to superficial sites on bacteria or other toxins, making the toxin incapable of attaching itself to a cell. This mechanism is known as A) opsonization. B) agglutination. C) phagocytosis. D) neutralization. E) costimulation.

D) neutralization.

99) During a primary response to antigen exposure, all of the following occur except A) the antigen must activate appropriate B cells. B) B cells may take time to develop into plasma cells and memory cells. C) antibody levels do not peak until 1 to 2 weeks after the initial exposure. D) neutrophils invade the surrounding areas, releasing chemotactic substances. E) the first immunoglobulins to appear in circulation are of the IgM type.

D) neutrophils invade the surrounding areas, releasing chemotactic substances.

49) The first line of cellular defense against pathogens are the A) T cells. B) B cells. C) NK cells. D) phagocytes. E) plasma cells.

D) phagocytes.

74) The role of antigen-presenting cells in immunity is to do all of the following except A) activate T cells. B) display antigen fragments. C) process antigens. D) phagocytosis. E) activate B cells.

D) phagocytosis.

42) The largest single collection of lymphoid tissue in the adult body is located in the A) liver. B) thymus. C) tonsils. D) spleen. E) lymph nodes.

D) spleen.

82) Regulatory T cells act to A) inhibit T and B cell activities. B) erase memory T cells. C) limit antigen proliferation. D) suppress antigens. E) produce antibodies involved in autoimmunity.

D) suppress antigens.

103) A crime scene investigator found that a biological fluid sample contains a large amount of IgA-type antibody. This fluid is probably A) blood. B) lymph. C) serum. D) tears. E) interstitial.

D) tears.

16) Lymphocyte production does not occur in A) bone marrow. B) thymus tissue. C) peripheral lymphoid tissues. D) the liver. E) the spleen.

D) the liver.

14) All of the following are true of lymphocytes except that A) they spend most of their time in lymphoid tissue. B) they have relatively long life spans. C) they have one nucleus. D) they are granulocytes. E) some produce antibodies.

D) they are granulocytes.

36) Stem cells that will form T cells develop in the A) bone marrow. B) liver. C) spleen. D) thymus. E) kidneys.

D) thymus.

45) The body's nonspecific defenses include all of the following except A) the skin. B) complement. C) interferon. D) inflammation. E) B and T cells.

E) B and T cells.

84) ________ cells provide cell-mediated immunity. A) Memory B B) Cytotoxic T C) Suppressor T D) Helper T E) CD8 T

E) CD8 T

97) Immunoglobulins, formed of five subunits, which are the first antibodies to be produced in response to infection are A) IgA. B) IgD. C) IgE. D) IgG. E) IgM.

E) IgM.

19) Which of these statements about lymph flow in a node is false? A) Lymph enters in an afferent lymphatic vessel. B) Lymph first enters the subcapsular space. C) Lymph flows past dendritic cells. D) The efferent lymphatic vessel exits at the hilum. E) The afferent lymphatic vessel enters at the hilum.

E) The afferent lymphatic vessel enters at the hilum.

106) The binding of an antigen to an antibody can result from all of the following except A) neutralization of the antigen. B) agglutination or precipitation. C) complement activation. D) opsonization. E) activate T cells.

E) activate T cells.

46) Nonspecific defenses would not include A) phagocytic cells. B) physical barriers. C) inflammation. D) interferons. E) antibodies.

E) antibodies.

18) A substance that provokes an immune response is called a(n) A) thymosin. B) complement. C) chemotoxin. D) irritant. E) antigen.

E) antigen.

77) Before specific defenses are activated, most antigens must A) infect cells. B) be processed by a phagocyte. C) either infect cells or be processed by a phagocyte. D) depolarize the lymphocyte. E) bind to the DNA of the lymphocyte

E) bind to the DNA of the lymphocyte

48) Examples of physical barriers against pathogens include all of the following except A) sebaceous glands. B) mucus. C) epithelia. D) epidermal layers. E) blood.

E) blood.

71) In passive immunity, the A) immune system attacks normal body cells. B) body is deliberately exposed to an antigen. C) body receives antibodies produced by other humans. D) body receives antibodies produced by an animal. E) body receives antibodies produced by other humans or the body receives antibodies produced by an animal.

E) body receives antibodies produced by other humans or the body receives antibodies produced by an animal.

12) The thoracic duct originates from an expanded chamber called the A) lymph node. B) azygos. C) hilum. D) bronchomediastinal trunk. E) cisterna chyli.

E) cisterna chyli.

60) Inflammation produces all of the localized effects except A) increased swelling. B) increased redness. C) increased heat. D) increased pain. E) decreased blood flow.

E) decreased blood flow.

28) Identify the structure labeled "1." A) venule B) lymphatic nodule C) trabecula D) afferent lymphatic E) efferent lymphatic

E) efferent lymphatic

61) Fever is the maintenance of body temperature higher than A) 37.2°C. B) 99°F. C) 98.6°F. D) either 37.2°C or 98.6°F. E) either 37.2°C or 99°F.

E) either 37.2°C or 99°F.

3) The lymphocytes are most important in A) helping maintain normal blood volume. B) transporting gases to and away from lymph nodes. C) eliminating variations in the composition of interstitial fluid. D) transporting lipids from the digestive tract. E) fighting infection.

E) fighting infection.

68) Immunity that is genetically determined and present at birth is called ________ immunity. A) active B) maternal C) passive D) auto E) innate

E) innate

66) Characteristics of specific defenses include all of the following except A) versatility. B) tolerance. C) memory. D) specificity. E) intrinsic.

E) intrinsic.

58) Plasma contains ________ proteins that form the complement system. A) 1-3 B) 5 C) fewer than 10 D) 18-25 E) more than 30

E) more than 30

22) Lymph nodes do all of the following except A) produce antibodies. B) monitor the contents of lymph. C) remove debris and pathogens from the lymph. D) detect pathogens. E) remove excess nutrients from the lymph.

E) remove excess nutrients from the lymph.

4) Lymphocytes are produced and stored in all of the following except A) the thymus. B) lymphoid nodules. C) lymph node organs. D) the spleen. E) the brain.

E) the brain.

100) All of the following are true of the secondary response to antigen exposure except that it A) depends on memory B cells. B) results in much higher antibody titers than in the primary response. C) results in much quicker rise in antibody titers. D) produces more IgG antibodies. E) weakens quickly because memory B cells only survive for a year or two.

E) weakens quickly because memory B cells only survive for a year or two.