1.

The composition of lymph is most similar to

A) blood

B) serum

C) cytosol

D) interstitial fluid

Answer : D
Feedback: Lymph is interstitial fluid that has entered a lymphatic vessel.

2.The cisterna chyli is

A) the point at which lymph is returned to venous blood

B) a dilation at the beginning of the thoracic duct

C) the embryonic thymus gland

D) the array of lacteals associated with the small intestine

Answer: B
Feedback: The cisterna chyli is found at the junction of several inferior lymphatic trunks to form the thoracic duct. It located
posterior to the duodenum of the stomach.

3. Which of the following .ly lists the structures according to the sequence of fluid flow?

A) lymphatic capillaries, interstitial spaces, blood capillaries, lymphatic vessels, lymphatic ducts,
subclavian veins
B) blood capillaries, lymphatic vessels, interstitial spaces, lymphatic capillaries, lymphatic ducts,
subclavian veins
C) blood capillaries, interstitial spaces, lymphatic capillaries, lympatic ducts, lymphatic vessels,
subclavian veins
D) blood capillaries, interstitial spaces, lymphatic capillaries, lymphatic vessels, lymphatic ducts,
subclavian veins
Answer: D
Feedback: Fluid moves from blood plasma into the interstitial space, which is drained by small lymphatic capillaries that fuse
to form lymphatic vessels. The vessels fuse to form ducts and trunks which finally join the veins to return the fluid to the
blood plasma.

4. One known function of the cells of the thymus is to

A) produce and secrete thymic hormones

B) produce and secrete antibodies

C) act as antigen-presenting cells

D) produce and secrete interleukin-1

Answer: A
Feedback: The primary role of the thymus is the selection and maturation of T-lymphocytes. Thymosin is a thymic hormone
that promotes T-cell maturation.
5. The thoracic lymphatic duct empties into the

A) right lymphatic duct

B) cisterna chyli

C) left subclavian vein

D) ventricles of the brain

Answer: C
Feedback: The thoracic duct receives lymph from the entire lower half of the body, the left side of the thorax and the left
arm. It joins the left subclavian vein at its junction with the left internal jugular vein.

6. The structure of a lymphatic vessel is most similar to that of

A) an artery

B) an arteriole

C) a vein

D) a capillary

Answer: C
Feedback: Lymphatic vessels have internal valves like the veins.

7. The two collecting ducts that drain the lymphatic trunks are the

A) thoracic duct and right lymphatic duct

B) lumbar duct and left lymphatic duct

C) intestinal duct and left intercostal duct

D) bronchomediastinal duct and subclavian duct

Answer: A
Feedback: The right lymphatic duct drains the right side of the thorax and the right arm. The thoracic duct receives lymph
from the entire lower half of the body, the left side of the thorax and the left arm.

8. The formation of lymph increases as a result of

A) increasing osmotic pressure in blood capillaries

B) increasing osmotic pressure in tissue fluid

C) decreasing volume of tissue fluid

D) decreasing protein concentration in tissue fluid

Answer: B
Feedback: Increasing osmotic pressure in interstitial fluid would draw more fluid from the capillaries. The extra fluid in the
tissue space would then be drained into the lymphatic system.

9. The lymph nodes of the axillary region receive lymph mainly from the

A) scalp and face

B) arm and mammary gland

C) thoracic viscera

D) abdominal viscera

Answer: B
Feedback:  The axillary region is the armpit, and the vessels there are perfectly positioned to receive lymph from the arms
and mammary glands.

10. Lymph differs from plasma in that

A) lymph contains more protein than plasma

B) plasma contains more protein than lymph

C) lymph contains white blood cells, whereas plasma does not

D) lymph and plasma are essentially the same

Answer: B
Feedback: The majority of plasma proteins, like albumin and fibrinogen, do not leave the blood during filtration.

11. Lymph nodes occur in groups throughout the body except in the

A) lungs

B) central nervous system

C) mesentery

D) inguinal connective tissues

Answer: B
Feedback: The central nervous system has its own circulatory fluid (CSF) and "clean-up cells" (the microglia). It is structurally
isolated from most body functions, and is therefore not likely to become contaminated.

12. If lymphatic tissue is removed from an axillary region, the arm on that side is likely to

A) have a deficient blood supply

B) have an excessive blood supply

C) become edematous

D) lose tissue fluid

Answer: C
Feedback: Loss of lymphatic tissue would impair the drainage of interstitial fluid from the tissues. The accumulation of fluid
in the tissues is called edema.

13. Tissue fluid is _____ and lymph is _______.

A) forced out of lymph vessels; absorbed into lymph vessels

B) forced out of blood plasma; absorbed into blood capillaries

C) generally rich in proteins; rich in proteins and foreign particles

 D) forced out of blood plasma and generally lacking in proteins; absorbed into lymph capillaries and
rich in proteins and foreign particles
Answer: D
Feedback: The majority of plasma proteins, like albumin and fibrinogen, do not leave the blood during filtration. The tissue
fluid is generally lacking such proteins.

14. The structure of a lymph node can be described as

A) being divided into compartments that contain masses of lymphocytes and macrophages

B) afferent vessels circulating lymph into the node on its convex surface

C) efferent vessels circulating lymph out of the node at its hilus

D) all of the above

Answer: D
Feedback: Afferent means "into". Efferent means "leaving".

15. Which of the following is not a function of the spleen?

A) site of stem cell maturation into T and B cells

B) destruction of blood-borne pathogens by macrophages

C) removal of worn-out blood cells and platelets by macrophages

D) storage of platelets

Answer: A
Feedback: T-cells are matured in the thymus. B-cells are matured in the red bone marrow.

16. The ability of T-lymphocytes to recognize self from non-self antigens is developed in the

A) plasma cells

B) spleen

C) thymus

D) liver

Answer: C
Feedback: The "T" stands for "thymus-derived".

17. Which person most likely has the largest thymus gland?

A) a third trimester fetus

B) a two-year-old

C) a 12-year-old

D) a 25-year-old

Answer: B
Feedback: The thymus increases in size through the first year after birth, then maintains its relative size until adulthood.

18. The spleen is much like a lymph node except that the spleen
A) does not store lymphocytes

B) filters lymph

C) filters blood

D) does not contain phagocytes

Answer: C
Feedback: The spleen filters out old, weak red blood cells and serves as a blood reservoir for the cardiovascular system.

19. Which of the following is not a function of lymph nodes?

A) production of lymphocytes

B) production of plasma proteins

C) filtration of cellular debris

D) filtration of foreign particles

Answer: B
Feedback: The plasma proteins are produced by the liver and the lymphocytes.

20. The spleen can be described as

A) a bilobed organ located in the mediastinum

B) resembling a large lymph node

C) functioning to produce T-lymphocytes

D) functioning to produce B-lymphocytes

Answer: B
Feedback: In addition to lympatic tissue, the spleen contains red pulp for storing and filtering blood. This extra tissue
increases its size.

21. People that are confined to bed for long periods of time often develop edema because

A) their blood pressure becomes elevated, forcing more fluid into interstitial spaces as blood
hydrostatic pressure rises
B) lack of motor activity leads to reduced sympathetic stimulation to lympathic vessels, so
lymph tends to pool
C) without skeletal muscle contraction to force lymph through lymphatic vessels, fluid tends to
accumulate in the interstitial spaces
D) reduced vasomotor tone allows proteins to leak from plasma, and water follows the osmotic
gradient
Answer: C
Feedback: With no pumping organ to provide circulatory pressure, the lymphatic system is dependent upon the action of
skeletal muscles and their own internal valves to move lymph through the system.

22. The functions of the lymphatic system do not include

A) returning interstitial fluid to the bloodstream

B) removing proteins from the interstitial spaces

C) transporting hormones to intestinal smooth muscle

D) transporting the products of lipid digestion from the intestine to the liver

Answer: C
Feedback: Hormone transport is accomplished via the bloodstream and interstitial fluids. Lymph would not provide any fluid
supply to the intestinal smooth muscle.

23. Foreign particles that are injected into the skin are likely to enter the lymphatic system

A) rapidly

B) slowly

C) not at all, because lymphatic valves prevent this

D) not at all, because the skin lacks lymphatic capillaries

Answer: A
Feedback: Because the skin is the most vulnerable surface to being contaminated by microorganisms, it is well supplied with
lymphatic capillaries.

24. A lysozyme is

A) an enzyme found in body fluids that flow over epithelial surfaces to destroy certain bacteria

B) a type of antibody that makes a cell more recognizable to a phagocyte

C) a cytokine produced by helper T-cells

D) one of the self-antigens on the surface of antigen-presenting cells

Answer: A
Feedback: The suffix "zyme" denotes enzyme. The prefix "lys" means "to rupture". Lysozyme is an enzyme that makes
bacterial cells rupture, thereby killing them.

25. Which of the following would most likely increase a person's risk of invasion by pathogenic
microbes?
A) increased urine flow

B) loss of epidermal tissue

C) increased action of cilia

D) increased intestinal motility

Answer: B
Feedback: The thickness and dryness of the epidermis provide an excellent barrier to invasion by microbes. Loss of the
epidermis creates an much greater risk of infection.

26. The function of interferons is to

A) break down bacterial cell walls

B) fragment bacterial DNA

C) opsonize microbes
D) prevent viral replication

Answer: D
Feedback: Interferons are produced and released by cells infected with a virus. The interferons makes neighboring cells
more resistant to viral invasion.

27. Which of the following is a nonspecific mechanism of resistance?

A) activation of the complement via the alternative pathway

B) binding of an allergen to IgE molecules on mast cells

C) a delayed hypersensitivity response to poison ivy

D) cloning of B-cells in response to a measles vaccine

Answer: A
Feedback: The alternative pathway to complement formation is initiated by foreign substances. The proteins of the
complement increase vascular permability, stimulate inflammation, activate enzymes, lyse cells, and attract phagocytes and
other leukocytes to the area of contamination.

28. The cells that are primarily responsible for immunity are

A) lymphocytes and macrophages

B) neutrophils and lymphocytes

C) monocytes and macrophages

D) lymphocytes and eosinophils

Answer: A
Feedback: The macrophages present foreign antigens to the T- and B-lymphocytes who, when activated, attack the antigen
bearing cells.

29. Which of the following is an example of a specific body defense mechanism?

A) phagocytosis

B) inflammation

C) fever

D) antibody production

Answer: D
Feedback: Phagocytosis, inflammation and fever are produced in response to a wide variety of foreign invaders. Antibodies
are very specific, and each is produced only in response to a particular pathogen.

30. Antibodies are

A) plasma cells

B) B-lymphocytes

C) T-lymphocytes

D) gamma globulin proteins

Answer: D
Feedback: The antibodies are immunoglobulins produced by a type of B-lymphocyte called a plasma cell.

31. The process of coating a microbe with antibodies to make it more susceptible to phagocytosis
is
A) chemotaxis

B) opsonization

C) cloning

D) anergy

Answer: B
Feedback: Opsonization makes bacteria more susceptible to phagocytosis.

32. The antibodies involved in allergic reactions

A) are called allergens

B) are secreted by mast cells

C) belong to the IgE group

D) are produced by T-lymphocytes

Answer: C
Feedback: The IgE group of antibodies promotes in the inflammation commonly seen in allergic reaction.

33. A hapten is

A) a small substance that becomes antigenic when it binds to tissue proteins

B) the heavy chain of an immunoglobulin molecule

C) the antigen binding site of an immunoglobulin molecule

D) the part of a lymphoid organ where antigens are processed

Answer: A
Feedback: Haptens are typically small proteins that do not stimulate an immune response unless they are
associated with particular tissue proteins. The presence or absence of these tissue proteins is what determines whether or
not a person will be allergic to the hapten.

34. All of the following would have MHC-1 antigens except

A) neurons

B) lymphocytes

C) macrophages

D) erythrocytes

Answer: D
Feedback: MHC-1 antigens are found on nucleated cells. Erythrocytes do not have a nucleus.

35. Which of the following possess Class II MHC antigens?

A) antigen-presenting cells
B) erythrocytes

C) cardiac muscle cells

D) simple columnar epithlial cells in the digestive tract

Answer: A
Feedback: The Class II MHC antigens are used to display processed antigens. They are found on the surface of antigen-
presenting cells.

36. T-cells and B-cells are

A) phagocytes

B) antibodies

C) lymphocytes

D) part of the complement

Answer: C
Feedback: "T-cells" and "B-cells" are the shorthand terminology for "thymus-derived lymphocytes" and "bone marrow-
derived lymphocytes".

37. Which of the following is an example of a specific immune response?

A) release of histamine from damaged cells

B) adherence of a macrophage to a microbe

C) release of interferon from virus-infected cells

D) opsonization of an antigen by IgG molecules

Answer: D
Feedback: Each immunoglobulin works only against a specific antigen.

38. The immunoglobulin class of an antibody molecule is determined by the

A) structure of the L chains

B) structure of the variable region

C) structure of the constant region of the H chains

D) function of the molecule

Answer: C
Feedback: Each of the five classes of antibodies is characterized by a certain base structure, called the constant region.

39. The antigen-binding site of an antibody molecule is contained in the

A) hinge region

B) disulfide bonds

C) constant region of the L chains

D) variable regions of the H and L chains

Answer: D
Feedback: The variable region determines antigen specificity.

40. The most abundant type of immunoglobulin is

A) IgA

B) IgE

C) IgG

D) IgD

Answer: C
Feedback: Immunoglobulins G, also called the gamma globulins, are the result of adaptive immunity.

41. Following a primary immune response, plasma cells give rise to

A) T-cells

B) memory cells

C) natural killer cells

D) haptens

Answer: B
Feedback: Plasma cells are B-cells that actively produce antibodies. Memory cells are B-cells that are retained in the plasma
after the initial infection is conquered, and are quickly converted to active plasma cells in subsequent infections.

42. In an autoimmune disease, the immune response is directed toward

A) foreign antigens

B) self-antigens

C) antibodies

D) viruses

Answer: B
Feedback: "Auto" means "within self". For some reason, the immune system begins to attack cells bearing self-antigens,
causing tissue damage and organ malfunction in the process.

43. An antigen is ______, whereas an antibody is_______.

A) a foreign substance such as a protein or polysaccharide to which lymphocytes respond; a

globular protein that reacts with antigens to eliminate them
B) an immunoglobulin that is produced by lymph nodes in response to bacteria; a foreign
protein that enters the body and causes an immune reaction
C) a hapten molecule that is quite complicated in shape; an enzyme that is produced by the
thymus gland to neutralize antigens
D) produced by T-cells; produced by B-cells

Answer: A
Feedback: Antigens are markers on the surface of all cells. In response to the antigens found on non-self cells, the B-cells
produce antibodies - special proteins designed to eliminate the source of the antigens.
44. Which of the following antibody mechanisms is .ly described?

A) chemotaxis - activated enzymes attract neutrophils and macrophages into the region where
there are antigens
B) opsonization - activated enzymes altering cell membranes so that they are more susceptible
to phagocytosis
C) lysis - activated enzymes digest the membranes of foreign cells so that they rupture

D) all of the above

Answer: D
Feedback: Antibodies may enhance chemotaxis, cause opsonization, or cause lysis of foreign cells.

45. An antigen is a foreign substance that causes _______, whereas an allergen is a foreign
substance that causes _________.
A) the activation of the complement; the formation of large numbers of T-lymphocytes

B) immunity to develop; a loss of immunity

C) the release of histamine; the formation of plasma cells

D) the formation of antibodies; a hypersensitivity reaction

Answer: D
Feedback: Allergens are non-self substances that are typically incapable of harming the body, and which normally do not
produce an immune response. In certain individuals, allergens bind with tissue proteins and stimulate an exaggerated
immune response, which may cause such severe inflammation as to cause death.

46. A primary immune response is ________, and a secondary immune response is ________.

A) very important; of less importance

B) the primary source of immunity; a back-up form of immunity in case the primary response
fails
C) production of antibodies after the body's initial exposure to an antigen; the rapid production
of large quantities of antibodies after subsequent exposure to the antigen
D) activation of the complement; production of antibodies

Answer: C
Feedback: The primary immune response typically produces significant quantities of antibodies within 5 - 10 days after
exposure to an antigen. In subsequent exposures, memory cells retained from the primary immune response are able to
produce antibodies within a day or two, usually in time to prevent a second infection. This is called the secondary immune
response.

47. In cell-mediated immunity, the antigen is destroyed by

A) killer T-cells

B) mast cells

C) B-cells

D) antibodies

Answer: A
Feedback: The T-cells are the primary weapon in cell-mediated immunity
48. Proteins known as CD4 and CD8 are

A) attachment proteins on the surfaces of helper-T and cytotoxic T-cells

B) different protein chains seen in IgG and IgM antibodies

C) proteins on microbes that identify them as foreign

D) the proteins that antigen-presenting cells display along with foreign antigens

Answer: A
Feedback: CD4 and CD8 are important in the activation of T-cells by macrophages. CD4 proteins are found on helper-T cells.
CD8 proteins are found on the surface of cytotoxic T-cells.

49. In specific immunity, competent T-cells are activated by

A) plasma cells

B) complement

C) antibodies

D) interleukin-1

Answer: D
Feedback: The interleukins are responsible for activating both T-cells and B-cells.

50. Cytotoxic T-cells recognize antigens combined with

A) interleukin-1

B) CD8

C) MHC-I antigens

D) MHC-II antigens

Answer: C
Feedback: Cytotoxic T-cells respond to antigens bound to MHC-I antigens. Helper-T cells respond to antigens bound to
MHC-II antigens.

51. T-lymphocytes are responsible for

A) programming macrophages

B) producing antibodies

C) cell-mediated immunity

D) humoral immunity

Answer: C
Feedback: T-cells directly attack antigen-bearing cells. B-cells produce antibodies to destroy the antigen-bearing cells, a
process called humoral immunity.

52. Cytotoxic T-cells destroy their target cells by releasing a substance that affects

A) cell membranes
B) lysosomes

C) ribosomes

D) DNA molecules

Answer: A
Feedback: Cytotoxic T-cells produce chemicals cause perforins onto their targets cells, causing the target's membrane to
rupture.

53. B-cells proliferate and differentiate into plasma cells in the

A) liver

B) bloodstream

C) lymph nodes

D) red pulp of the spleen

Answer: C
Feedback: Once the immune system becomes competent, the cells migrate to the lymph nodes and the white pulp of the
spleen where they proliferate and differentiate.

54. Immunoglobulins that circulate in the interstitial spaces and the bloodstream that attach to
mast cells and basophils to initiate an inflammatory response are
A) IgA

B) IgM

C) IgG

D) IgE

Answer: D
Feedback: IgE is indirectly responsible for the itching and swelling associated with allergic reactions.

55. A vaccine produces its effects by

A) directly attacking the antigens and neutralizing them

B) opsonization

C) stimulating a primary immune response

D) causing cell lysis

Answer: C
Feedback: A vaccine utilizes a form of a pathogenic antigen to simulate infection by that pathogen. The immune system
produces a primary immune response, which should provide protection against future infection by that specific antigen-
bearing pathogen.

56. Giving a patient an intravenous injection of immunoglobulin should

A) temporarily protect them from a specific disease via passively acquired immunity

B) cause them to produce antibodies to a pathogen

C) protect them for several years

D) trigger activation of memory B-cells that make antibodies

Answer: A
Feedback: Gamma globulin injections are given when rapid immunity is required because of exposure to an antigen to
which one is not immune, or in cases where stimulation of an immune response could prove harmful, as during pregnancy.

57. The type of resistance that is acquired as a result of developing and recovering from a disease
is
A) naturally acquired active immunity

B) artificially acquired active immunity

C) artificially acquired passive immunity

D) naturally acquired passive immunity

Answer: A
Feedback: Active immunity develops as the body is stimulated to produce antibodies against a pathogen. Passive immunity
is achieved by receiving ready-made antibodies. Either type of immunity can be achieved naturally (via disease or
vaccination) or passively (via gamma globlin injection or breast milk).

58. Injections of gamma globulin are sometimes given to provide

A) naturally acquired active immunity

B) artificially acquired active immunity

C) artificially acquired passive immunity

D) naturally acquired passive immunity

Answer: A
Feedback: Active immunity develops as the body is stimulated to produce antibodies against a pathogen. Passive immunity
is achieved by receiving ready-made antibodies. Either type of immunity can be achieved naturally (via disease or
vaccination) or passively (via gamma globlin injection or breast milk).

59. Which of the following cells is most affected as an individual ages?

A) B-cells

B) cytotoxic T-cells

C) helper T-cells

D) macrophages

Answer: C
Feedback: As helper T-cells fail to respond to the presence of antigens, the immune response is impaired.

60. After which age are declines in the immune system most evident?

A) 20

B) 40

C) 60

D) 80
Answer: C
Feedback: After age 60, the immune system is harder to stimulate and slower to produce responses.
61. Which of these statements about the lymphatic system is (ar true?
A. In the spleen, reticular cells form a blood-splenic barrier.
B. The thymus is an important filter for lymphatic fluid.
C. The tonsils are areas of diffuse lymphatic tissue that increase in size with age.
D. The spleen filters blood, removing microorganisms and other foreign substances.
E. All of these are true
Answer: D
Feedback: . Answer: There is no blood barrier in the spleen.
62. The tonsils that are referred to as "the tonsils" are the
A. lingual tonsils.
B. palatine tonsils.
C. pyloric tonsils.
D. pharyngeal tonsils.
E. splenic tonsils.
Answer: B
Feedback: . Answer: Although there are three tonsil groups (palatine, pharyngeal, and lingual), "the tonsils" commonly
refers to just the palatine tonsils.
63. Which of these is NOT a location for aggregations of lymph nodes?
A. axillary (armpit) region
B. cervical region
C. inguinal (groin) region
D. around the heart
E. around the intestines
Answer: D
Feedback: . Answer: Of the choices, only the heart is not a location for aggregation of lymph nodes.
64. Lymph nodes
A. contain red and white pulp.
B. have germinal centers where lymphocytes divide.
C. filter the blood.
D. are attached to blood vessels.
E. pump lymph toward the heart.
Answer: B
Feedback: . Answer: The lymph nodes do not have a pumping function; they function primarily in the filtering of the lymph.
65. Lymphatic organs
A. contain many neutrophils.
B. may filter blood or lymph.
C. contain dense collagen fibers.
D. include the pancreas and adrenal glands.
E. all of these
Answer: B
Feedback: . Answer: Only choice B is .; lymphatic organs may filter blood or lymph.
66. The spleen
A. has white pulp that is associated with the venous supply.
B. has red pulp that is associated with the arterial supply.
C. filters lymph and puts it back in the blood.
D. acts as a blood reservoir.
E. destroys worn-out lymphocytes.
Answer: D
Feedback: . Answer: The spleen destroys defective and worn-out erythrocytes, detects and removes foreign substances in
the blood, and functions as a blood reservoir.
67. The thymus
A. decreases in size in older adults.
 B. produces neutrophils that move to other tissues.
C. responds to foreign substances in the blood.
D. produces a hormone called lymphopathin.
E. all of these
Answer: A
Feedback: . Answer: Only choice A is .; the thymus decreases in size in older adults.
68. With innate immunity,
A. each time the body is exposed to a substance, the response is the same.
B. specificity and memory are involved.
C. the body may become immune to a disease.
D. antibodies may be produced.
E. all of these
Answer: A
Feedback: . Answer: Only choice A is .; IN innate immunity, each time the body is exposed to a substance, the response is
the same.
69. Which of the following is a protective chemical that lyses cells, found on the surface of cells and in tears and saliva?
A. complement
B. interferon
C. lysozyme
D. mucus
E. sebum
Answer: C
Feedback: . Answer: Lysozyme is the protective chemical that lyses cells and is found on the surface of cells and in tears and
saliva. Sebum is an oily, white substance rich in lipids that is produced by sebaceous glands. It provides protection at the
level of skin from some bacteria.
70. A(n) __________ is a group of 20 proteins activated by a series of reactions, in which one activated chemical then
activates another; and promotes inflammation, phagocytosis, and cell lysis.
A. complement
B. interferon
C. lysozyme
D. mucus
E. sebum
Answer: A
Feedback: . Answer: Complement is a group of 20 proteins activated by a series of reactions, in which one activated
chemical then activates another; promotes inflammation, phagocytosis, and cell lysis. Sebum is an oily, white substance rich
in lipids that is produced by sebaceous glands. It provides protection at the level of skin from some bacteria.
71. Which of the following is a protein that interferes with virus production, and is produced by most cells in response to a
viral infection?
A. complement
B. interferon
C. lysozyme
D. mucus
E. sebum
Answer: B
Feedback: . Answer: Interferons are proteins that are produced by virally infected cells, which provide neighboring cells
with a stimulus to produce antiviral proteins and therefore prevent the spread of the viral infection. Sebum is an oily, white
substance rich in lipids that is produced by sebaceous glands. It provides protection at the level of skin from some bacteria.
72. Which of these chemical mediators does NOT promote inflammation?
A. complement
B. histamines
C. leukotrienes
D. interferon
E. prostaglandins
Answer: D
Feedback: . Answer: Of the chemical mediators listed, only interferon does not promote inflammation. Interferon is
produced by virally infected cells, and functions to interfere with virus production in neighboring cells.
73. The most important phagocytes are
A. lymphocytes and basophils.
B. basophils and mast cells.
C. neutrophils and basophils.
D. neutrophils and macrophages.
E. macrophages and lymphocytes.
Answer: D
Feedback: . Answer: The most important phagocytes are the neutrophils and macrophages.
74. Neutrophils
A. seldom leave the blood.
B. are usually the last cells to enter infected tissue.
C. enlarge to become macrophages.
D. often die after a single phagocytic episode.
E. all of these
Answer: D
Feedback: . Answer: Only choice D is .; neutrophils often die after a single phagocytic episode.
75. Dust cells, microglia, and Kupffer cells are examples of
A. basophils.
B. eosinophils.
C. lymphocytes.
D. macrophages.
E. neutrophils.
Answer: D
Feedback: . Answer: Dust cells, microglia, and Kupffer cells are all examples of macrophages.
76. Natural killer cells
A. are a type of macrophage.
B. exhibit no memory response.
C. recognize cells infected by a specific virus.
D. are produced in the thymus.
E. all of these
Answer: B
Feedback: . Answer: Only choice B is .; natural killer cells exhibit no memory response, they are part of innate immunity.
77. Which cells release enzymes that break down chemical mediators released by other cells?
A. basophils
B. eosinophils
C. lymphocytes
D. macrophages
E. neutrophils
Answer: B
Feedback: . Answer: Eosinophils release enzymes that are able to break down chemical mediators released by other cells.
The enzymes released by eosinophils can break down the histamine that is released by basophils and mast cells during an
inflammatory response.
78. In addition to the symptoms of local inflammation, systemic inflammation results in the
A. production of large numbers of neutrophils from red bone marrow.
B. production of pyrogens.
C. loss of large amounts of fluid from the blood.
D. all of these
Answer: D
Feedback: . Answer: System inflammation can cause the production of large numbers of neutrophils from red bone marrow,
production of pyrogens, and the loss of large amounts of fluid from the blood.
79. Which of these results occur in response to the release of chemical mediators?
A. vasodilation
 B. chemotactic attraction of phagocytes
C. increased vascular permeability
D. redness and swelling
E. all of these
Answer: E
Feedback: . Answer: Vasodilation, chemotactic attraction of phagocytes, increased vascular permeability, and redness and
swelling, can all result in response to the release of chemical mediators.
80. Substances that stimulate adaptive immunity are called
A. antibodies.
B. antigens.
C. pyrogens.
D. chemical mediators.
E. phagocytes.
Answer: B
Feedback: . Answer: Antigens are substances that stimulate adaptive immunity. Phagocytes are cells, including neutrophils
and macrophages, which carry out phagocytosis.
81. Which of these is an example of a self-antigen?
A. bacterial antigen
B. viral antigen
C. pollen antigen
D. food antigen
E. tumor antigen
Answer: E
Feedback: . Answer: A tumor antigen would be an example of a self-antigen, a molecule produced by the body that
stimulates an adaptive immune response.
82. Antibodies
A. prevent antigens from binding together.
B. promote phagocytosis.
C. inhibit inflammation.
D. block complement activation.
E. prevent breakdown of foreign antigens.
Answer: B
Feedback: . Answer: Antibodies facilitate the breakdown of antigens.
83. An antibody molecule
A. has three polypeptide chains.
B. has both heavy and light chains.
C. has a variable region that can bind to complement.
D. has a constant region that binds to antigens.
E. is the same thing as an MHC molecule.
Answer: B
Feedback: . Answer: Antibodies are not MHC molecules. MHC molecules are glycoproteins that are found of the surface of
cells that can bind with foreign and self-antigens.
84. Which antibody accounts for 80-85% of serum antibodies, can cross the placenta, and is responsible for Rh reactions?
A. IgA
B. IgD
C. IgE
D. IgG
E. IgM
Answer: D
Feedback: . Answer: IgG accounts for 80-85% of serum antibodies, can cross the placenta, and is responsible for Rh
reactions.
85. T cells
A. are processed in the thymus.
B. are responsible for antibody-mediated immunity.
 C. originate in the spleen.
D. produce antibodies when activated.
Answer: A
Feedback: . Answer: B cells produce antibodies when activated.
86. The activation of B cells
A. occurs in the process of innate immunity.
B. results in the production of cytotoxic cells.
C. results in the production of antibodies.
D. occurs when macrophages release cytokines.
E. all of these
Answer: C
Feedback: . Answer: Only choice C is .; the activation of B cells results in the production of antibodies.
87. B cells
A. are stimulated by helper T cells.
B. are produced in the thymus.
C. release cytokines.
D. cause cell lysis.
E. all of these
Answer: A
Feedback: . Answer: Only choice A is .; B cells are stimulated by helper T cells.
88. The activation of T cells can result in
A. lysis of virus-infected cells.
B. production of memory T cells.
C. production of lymphokines.
D. delayed hypersensitivity reactions.
E. all of these
Answer: E
Feedback: . Answer: The activation of T cells can result in the lysis of virus-infected cells, the production of memory T cells,
the production of lymphokines, and delayed hypersensitivity reactions.
89. Given these events that are part of helper T cell activation:
1. interleukin-1 released by macrophage (costimulation)
2. antigen processed by macrophage
3. helper T cell binds to macrophage
4. helper T cell releases interleukin-2 and divides
5. antigen displayed on MHC molecule
Arrange the events in the order that they occur as an antigen is recognized and a helper T cell is activated.
A. 1,4,2,5,3
B. 2,5,3,1,4,
C. 3,1,4,2,5
D. 4,2,5,3,1
E. 5,3,1,4,2
Answer: B
Feedback: . Answer: The order of events occurring in helper T cell activation is: 2,5,3,1,4.
90. MHC molecules are
A. cell-surface glycoproteins that display antigens.
B. proteins found in the mitochondria of a cell.
C. areas of a macrophage that produce interleukin.
D. specific regions of a given antigen that activate a lymphocyte.
E. chemicals produced by helper T cells.
Answer: A
Feedback: . Answer: MHC molecules are cell-surface glycoproteins that display antigens.
91. MHC class II molecules
A. are found on all cells.
B. are found on antigen-presenting cells.
 C. usually display self-antigens.
D. cannot combine with other antigens.
E. both a and c
Answer: B
Feedback: . Answer: Only choice B is .; MHC class II molecules are found on antigen-presenting cells.
92. __________ are responsible for the secondary antibody response.
A. Memory B cells
B. Plasma B cells
C. Helper T cells
D. Natural killer cells
Answer: A
Feedback: . Answer: Memory B cells are responsible for the secondary antibody response. The memory B cells are
stimulated to quickly divide, producing plasma cells that then produce a large amount of antibodies, when the immune
system is exposed to an antigen that it has already produced a primary response to.
93. As the result of a bee sting, Joe B. Hive had an immediate severe reaction, and nearly died. This reaction was caused by
A. B cells.
B. T cells.
C. natural killer cells.
D. macrophages.
E. neutrophils.
Answer: A
Feedback: . Answer: The immediate hypersensitivity reaction was caused by antibodies produced by B cells reacting with
allergens from the bee sting. This could cause a severe reaction, like anaphylaxis, within minutes.
94. The antigen-presenting cells that are required for the activation of B cells are
A. B cells.
B. macrophages.
C. dendritic cells.
D. monocytes.
E. mast cells.
Answer: A
Feedback: . Answer: B cells are the antigen-presenting cells that are required for the activation of B cells. They present
processed antigen to helper T cells that then produce interleukins that stimulate the B cell to divide and produce antibodies.
95. Interleukins and CD4, B7, and CD28 proteins are all involved in
A. innate immunity.
B. costimulation of helper T cells.
C. suppressing B cell or T cell activity.
D. inflammation.
E. production of T cells in the spleen.
Answer: B
Feedback: . Answer: Interleukins and CD4, B7, and CD28 proteins are all involved in costimulation of helper T cells.
96 .B cells are involved in
A. only adaptive immunity.
B. only innate immunity.
C. both adaptive and innate immunity.
Answer: A
Feedback: . Answer: B cells are involved in only adaptive immunity.
97. Neutrophils are involved in
A. only adaptive immunity.
B. only innate immunity.
C. both adaptive and innate immunity.
Answer: C
Feedback: . Answer: Neutrophils are involved in only innate immunity.
98. Complement is involved in
A. only adaptive immunity.
 B. only innate immunity.
C. both adaptive and innate immunity
Answer: C
Feedback: . Answer: Complement is involved in both adaptive and innate immunity.
99. A vaccination is a way of acquiring
A. passive natural immunity.
B. active natural immunity.
C. active artificial immunity.
D. passive artificial immunity.
Answer: C
Feedback: . Answer: A vaccination is a way of acquiring active artificial immunity, where an antigen is deliberately
introduced into an individual to stimulate the immune system.
100 Antiserum is used to produce
A. active natural immunity.
B. active artificial immunity.
C. passive natural immunity.
D. passive artificial immunity.
Answer: D
Feedback: . Answer: Antiserum is used to produce passive artificial immunity. The antiserum consists of prepared antibodies
that are injected into an individual needing immunity.
101. The lymphatic system
A) removes excess fluid from tissues.
B) absorbs fats from the digestive tract.
C) defends the body against microorganisms and other foreign substances.
D) all of the above.
Answer: D
102. Lymphatic capillaries
A) have a basement membrane.
B) are less permeable than blood capillaries.
C) prevent backflow of lymph into the tissues.
D) all of the above.
Answer: C
103. Lymph is moved through lymphatic vessels because of
A) contraction of surrounding skeletal muscles.
B) contraction of the heart.
C) pressure changes in the blood vessels.
D) flapping of the lymphatic valves.
E) pumping by lymph nodes.
Answer: A
104. Which of the following statements is true?
A) Lymphatic vessels do not have valves.
B) Lymphatic vessels empty into lymph nodes.
C) Lymph from the right-lower limb passes into the right jugular or subclavian vein.
D) Lymph from the jugular and subclavian trunks empties into the cisterna chyli.
E) All of the above.
Answer: B
105. The tonsils
A) consist of three groups of lymphatic nodules.
B) are located in the nasal cavity.
C) are located in the oral cavity.
D) increase in size in adults.
E) all of the above.
Answer: A
106. Lymph nodes
A) filter lymph.
B) are where lymphocytes divide and increase in number.
C) contain a network of reticular fibers.
D) contain lymphatic sinuses.
E) all of the above.
Answer: E
107. Which of these statements about the spleen is not .?
A) The spleen has white pulp associated with the arteries.
B) The spleen has red pulp associated with the veins.
C) The spleen destroys defective red blood cells.
D) The spleen is surrounded by trabeculae located outside the capsule.
E) The spleen is a limited reservoir for blood.
Answer: D
108. The thymus
A) increases in size in adults.
B) produces macrophages that move to other lymphatic tissue.
C) responds to foreign substances in the blood.
D) has a blood-thymic barrier.
E) all of the above.
Answer: D
109. Which of these is an example of innate immunity?
A) Tears and saliva wash away microorganisms.
B) Basophils release histamine and leukotrienes.
C) Neutrophils phagocytize a microorganism.
D) The complement cascade is activated.
E) All of the above.
Answer: E
110. Neutrophils
A) enlarge to become macrophages.
B) account for most of the dead cells in pus.
C) are usually the last cell type to enter infected tissues.
D) are usually located in lymphatic and blood sinuses.
Answer: B
111. Macrophages
A) are large phagocytic cells that outlive neutrophils.
B) develop from mast cells.
C) often die after a single phagocytic event.
D) have the same function as eosinophils.
E) all of the above.
Answer: A
112. Which of these cells is the most important in the release of histamine, which promotes inflammation?
A) monocyte
B) macrophage
C) eosinophil
D) mast cell
E) natural killer cell
Answer: D
113. Which of these conditions does not occur during the inflammatory response?
A) histamine and other chemical mediators are released
B) chemotaxis of phagocytes
C) fibrinogen enters tissues from the blood
D) vasoconstriction of blood vessels
E) increased permeability of blood vessels
Answer: D
114. Which of these is a symptom of systemic inflammation?
A) large numbers of neutrophils are produced and released
B) pyrogens stimulate fever production
C) greatly increased vascular permeability
D) shock
E) all of the above
Answer: E
115. Antigens
A) are foreign substances introduced into the body.
B) are molecules produced by the body.
C) stimulate an adaptive immune system response.
D) all of the above.
Answer: D
116. B cells
A) are processed in the thymus.
B) originate in red bone marrow.
C) once released into the blood, remain in the blood.
D) are responsible for cell-mediated immunity.
E) all of the above.
Answer: B
117. MHC molecules
A) are glycoproteins.
B) attach to the plasma membrane.
C) have a variable region that can bind to foreign and self-antigens.
D) may form an MHC/antigen complex that activates T cells.
E) all of the above.
Answer: E
118. Antigen-presenting cells can
A) take in foreign antigens.
B) process antigens.
C) use MHC class II molecules to display the antigens.
D) stimulate other immune system cells.
E) all of the above.
Answer: E
119. Which of these participates in costimulation?
A) cytokines
B) complement
C) antibodies
D) histamine
E) natural killer cells
Answer: A
120. Helper T cells
A) respond to antigens from macrophages.
B) respond to cytokines from macrophages.
C) stimulate B cells with cytokines.
D) all of the above.
Answer: D
121. The most important function of tolerance is to
A) increase lymphocyte activity.
B) increase complement activation.
C) prevent the immune system from responding to self-antigens.
D) prevent excessive immune system response to foreign antigens.
E) process antigens.
Answer: C
122. Variable amino acid sequences on the arms of the antibody molecule
A) make the antibody specific for a given antigen.
B) enable the antibody to activate complement.
C) enable the antibody to attach to basophils and mast cells.
D) are part of the constant region.
E) all of the above.
Answer: A
123. Antibodies
A) prevent antigens from binding together.
B) promote phagocytosis.
C) inhibit inflammation.
D) block complement activation.
E) block the function of opsonins.
Answer: B
124. The secondary antibody response
A) is slower than the primary response.
B) produces fewer antibodies than the primary response.
C) prevents disease symptoms from occurring.
D) occurs because of cytotoxic T cells.
Answer: C
125. The type of lymphocyte that is responsible for the secondary antibody response is the
A) memory B cell.
B) B cell.
C) T cell.
D) helper T cell.
Answer: A
126. The largest percentage of antibodies in the blood are
A) IgA.
B) IgD.
C) IgE.
D) IgG.
E) IgM.
Answer: D
127. Antibody-mediated immunity
A) works best against intracellular antigens.
B) is involved in tumor control.
C) cannot be transferred from one person to another person.
D) is responsible for immediate hypersensitivity reactions.
Answer: D
128. The activation of cytotoxic T cells can result in the
A) lysis of virus-infected cells.
B) production of cytokines.
C) production of memory T cells.
D) all of the above.
Answer: D
129. Cytokines
A) promote inflammation.
B) activate macrophages.
C) kill target cells by causing them to lyse.
D) all of the above.
Answer: D
130. Delayed hypersensitivity is
A) caused by activation of B cells.
B) a result of antibodies reacting with an allergen.
C) mediated by T cells.
D) caused by natural killer cells.
E) caused by interferon.
Answer: C