Multiple Choice Questions: A. B. C. D

Chapter 18 - The Immune System
Chapter 18
The Immune System

Multiple Choice Questions

1. The immune system

A. Must recognize the identity of a foreign cell or substance in order to inactivate it
B. Must recognize a foreign cell or substance as foreign in order to inactivate it
C. Can recognize and destroy "self" cells that have been changed or damaged
D. Both must recognize the identity of a foreign cell or substance in order to inactivate it and
can recognize and destroy "self" cells that have been changed or damaged are correct
E. Both must recognize a foreign cell or substance as foreign in order to inactivate it and can
recognize and destroy "self" cells that have been changed or damaged are correct
Bloom's Level: 1. Remember

Section 18 Introduction
Topic: Lymphatic System and Immunity

2. Which of the following statements about viruses is not correct? Viruses

A. Consist of a nucleic acid surrounded by a carbohydrate shell
B. Require a host cell in order to reproduce themselves
C. May reside in a host cell for years without killing it
D. May cause a host cell to become cancerous
E. May have genetic information in the form of RNA


3. The killing of virus-infected or cancerous cells by the immune system is called

A. Immune oversight
B. Immune surveillance
C. Tissue immunity
D. Phagocytosis
E. Hemostasis


18-1
18-2
4. Regarding the immune system cells,

A. Plasma cells are derived from B cells
B. Macrophages are derived from basophils
C. Monocytes have functions similar to the functions of macrophages but are found in
different compartments of the body
D. Both plasma cells are derived from B cells and monocytes have functions similar to the
functions of macrophages but are found in different compartments of the body are correct
E. Both macrophages are derived from basophils and monocytes have functions similar to the
functions of macrophages but are found in different compartments of the body are correct

Section 18.01

5. Which of the following statements about the immune system is true?
A. All cells with important immune-system functions originate in the bone marrow or are
derived from precursors or immature cells that originated in bone marrow
B. Natural killer cells have functions similar to macrophages but are found in different
compartments of the body
C. Mast cells are derived from monocytes
D. Plasma cells are derived from T lymphocytes
E. Macrophages are derived from neutrophils

Section 18.01

6. Which of the following statements regarding the chemical mediators of inflammatory

responses is not true?
A. They may be secreted by cells residing in the area of injury
B. They may be secreted by cells that enter the affected area
C. They may be generated by enzymatic cleavage of proteins in plasma
D. They are all peptides
E. They may be chemotaxins
Bloom's Level: 2. Understand

Section 18.02

18-3
7. After initial entry of bacteria into a cut in the skin, vasodilation of local blood vessels and
increased capillary permeability occur. These phenomena are
A. Part of the specific immune response
B. Accompanied by chemotaxis of B lymphocytes
C. Initiated by antibody activation of complement
D. Components of the inflammatory response
E. Both part of the specific immune response and initiated by antibody activation of
complement are correct

Section 18.02

8. Chemotaxis
A. Refers to the chemical attraction of phagocytes to the site of inflammation
B. Is important only for nonspecific immune responses
C. Is important only for specific immune responses
D. Both refers to the chemical attraction of phagocytes to the site of inflammation and is
important only for nonspecific immune responses are correct
E. Both refers to the chemical attraction of phagocytes to the site of inflammation and is
important only for specific immune responses are correct

Section 18.02

9. Chemotaxis
A. Refers to the chemical attraction of erythrocytes to the site of inflammation
B. Brings neutrophils and monocytes to the scene of microbial invasion or injury
C. Activates macrophages
D. Both refers to the chemical attraction of erythrocytes to the site of inflammation and brings
neutrophils and monocytes to the scene of microbial invasion or injury are correct
E. Both brings neutrophils and monocytes to the scene of microbial invasion or injury and
activates macrophages are correct

Section 18.02

18-4
10. Which of the following statements regarding phagocytes and phagocytosis is true?

A. Macrophages, monocytes, and mast cells are phagocytes
B. Contact of phagocytes with microbes stimulates the phagocytes to release chemicals that
stimulate the inflammatory response
C. Phagocytosis is stimulated by the presence of proteins called rhodopsins
D. Both macrophages, monocytes, and mast cells are phagocytes and contact of phagocytes
with microbes stimulates the phagocytes to release chemicals that stimulate the inflammatory
response are true
E. All of the choices are true

Section 18.02

11. Which of the following statements regarding phagocytosis is true?

A. Macrophages are the only phagocytes in the tissues
B. The microbe engulfed by the phagocyte is killed by lysosomal enzymes and hydrogen
peroxide
C. Phagocytosis is controlled by a negative feedback mechanism whereby phagocytes release
chemicals that inhibit further phagocytosis
D. The microbe engulfed by the phagocyte is killed by the membrane attack complex (MAC)
E. None of these statements are true

Section 18.02

12. Cells in the immune system that can phagocytose or endocytose antigen include
macrophages
A. And NK cells
B. Neutrophils, and B cells
C. And cytotoxic T cells
D. And neutrophils
E. Only

Section 18.02

18-5
13. Which of the following statements regarding complement is true?

A. Complement refers to a protein that is present in blood in an inactive form
B. Activated complement can form a membrane attack complex, which causes lysis of
microbes
C. Activated complement stimulates cells to secrete chemicals that cause vasoconstriction
D. Both complement refers to a protein that is present in blood in an inactive form and
activated complement can form a membrane attack complex, which causes lysis of microbes
are true

Section 18.02

14. Which of the following statements regarding complement is true?

A. It is activated by binding to a receptor on an antibody molecule
B. It is activated by contact with collagen on the surface of microbes
C. Activated complement proteins can function as opsonins
D. Both it is activated by binding to a receptor on an antibody molecule and it is activated by
contact with collagen on the surface of microbes are true
E. Both it is activated by binding to a receptor on an antibody molecule and activated
complement proteins can function as opsonins are true

Section 18.02

15. Complement
A. Is the name of a specific family of proteins that interact in a defined, complex sequence
B. Is secreted by lymphocytes
C. Enhances antibody activity
D. Both is the name of a specific family of proteins that interact in a defined, complex
sequence and enhances antibody activity are correct
E. All of the choices are correct

Section 18.02

18-6
16. Which of the following statements regarding the activation of complement is true?

A. Complement is activated only as a result of nonspecific immune responses
B. Complement is activated only as a result of specific immune responses
C. Complement is activated as a result of both nonspecific and specific immune responses,
but the activation by specific immune responses is more robust
D. Complement is activated as a result of both nonspecific and specific immune responses,
but the activation by nonspecific immune responses is more robust
E. None of the choices are true

Section 18.02

17. Kinins are
A. Part of the complement family
B. Vasodilators
C. Chemotaxins
D. Part of the complement family and vasodilators
E. Vasodilators and chemotaxins

Section 18.02

18. Interferon
A. Is a family of protein mediators
B. Interferes with viral replication in cells
C. Enters cells and directly affects their protein-assembly functions
D. Both is a family of protein mediators and interferes with viral replication in cells are
correct

Section 18.02

18-7
19. Which of the following statements regarding the lymphoid organs is not true?
A. The primary lymphoid organs are the bone marrow and thymus
B. The thymus secretes hormones
C. Large numbers of macrophages and lymphocytes are found in the lymph nodes and spleen
D. The tonsils act as a first line of defense against microbes in food
E. Once a lymphocyte reaches a peripheral lymphoid organ, it remains there for its lifetime

Section 18.03

20. Which if the following statements regarding major histocompatibility proteins (MHCs) is

true?
A. Class I MHCs are found on all nucleated cells in the body
B. Class II MHCs are found on macrophages and B cells
C. Cytotoxic T cells require class II MHCs to recognize foreign antigens
D. Both class I MHCs are found on all nucleated cells in the body and class II MHCs are
found on macrophages and B cells are true

Section 18.03

21. Helper T cells
A. Are activated by antigen presented with MHC II proteins
B. Secrete interferon-gamma when activated
C. Secrete perforin when activated
D. Both are activated by antigen presented with MHC II proteins and secrete interferon-
gamma when activated are correct

Section 18.03

18-8
22. Cytotoxic T cells
A. Secrete perforin, which kills bacteria and viruses by perforating the membrane or coat that
surrounds them
B. Are activated by interleukin 1
C. Require Class I MHC proteins to recognize foreign antigens
D. Both secrete perforin, which kills bacteria and viruses by perforating the membrane or coat
that surrounds them and are activated by interleukin 1 are correct
E. Both are activated by interleukin 1 and require Class I MHC proteins to recognize foreign
antigens are correct

Section 18.03

23. Which of the following statements regarding the secretions of immune system cells is
true?
A. Interleukin 2 is an autocrine secreted by helper T cells
B. Interleukin 2 is a paracrine secreted by helper T cells
C. Interleukin 1 is a cytokine
D. Both interleukin 2 is an autocrine secreted by helper T cells and interleukin 1 is a cytokine
are true

Section 18.03

24. Which of the following statements regarding the secretions of immune system cells is
true?
A. Interleukin 2 is an autocrine secreted by cytotoxic T cells
B. Interleukin 1 is a paracrine secreted by macrophages and B lymphocytes
C. Interleukin 1 is an autocrine secreted by helper T cells
D. Both interleukin 2 is an autocrine secreted by cytotoxic T cells and interleukin 1 is a
paracrine secreted by macrophages and B lymphocytes are true

Section 18.03

18-9
18-10
25. Natural killer cells

A. Are activated by IL-2 and interferon-gamma
B. Have no MHC restriction
C. Can bind to the Fc portion of antibodies bound to antigen
D. Both are activated by IL-2 and interferon-gamma and can bind to the Fc portion of
antibodies bound to antigen are correct

Section 18.03

26. Activated macrophages
A. Are activated by interferon-gamma
B. Preferentially kill abnormal body cells
C. Secrete tumor necrosis factor
D. Both are activated by interferon-gamma and preferentially kill abnormal body cells are
correct

Section 18.03

27. Antibodies are
A. Secreted by helper T cells
B. Cytokines
C. Immunoglobulins
D. Composed of two polypeptide chains - a heavy chain and a light chain
E. Cytokines and immunoglobulins

Section 18.03

18-11
28. Antibodies
A. Are secreted by plasma cells
B. Protect against viruses by binding to them and presenting them to phagocytes
C. Protect against viruses by binding to them and neutralizing them
D. Activate complement
E. Are described by all of these choices

Section 18.03

29. When an antigen is bound to an antibody, it binds to

A. The heavy immunoglobulin chain only
B. The light immunoglobulin chain only
C. A specific antigen-binding site formed by heavy and light chains
D. A hypervariable region of immunoglobulin DNA
E. Gamma immunoglobulin only

Section 18.03

30. Compared to undifferentiated B cells,

A. Plasma cells are more effective antigen-presenting cells
B. Plasma cells have increased amounts of granular endoplasmic reticulum
C. Memory cells respond faster to antigen
D. Both plasma cells are more effective antigen-presenting cells and memory cells respond
faster to antigen are correct
E. Both plasma cells have increased amounts of granular endoplasmic reticulum and memory
cells respond faster to antigen are correct

Section 18.03

18-12
31. Binding of IgG or IgM to an antigen

A. Activates the complement system by the classical complement pathway
B. Facilitates production of MAC
C. Stimulates phagocytosis by enabling phagocytes to be bound to the antigen
D. Is an example of allosteric protein modulation
E. Is described by all of these choices

Section 18.03

32. Systemic responses to infection

A. Are mediated by cytokines such as IL-1 and tumor necrosis factor
B. Include resetting the body's "thermostat," so that body temperature is maintained lower
than normal
C. Include secretion of iron and zinc into the blood by the liver
D. Both are mediated by cytokines such as IL-1 and tumor necrosis factor and include
resetting the body's "thermostat," so that body temperature is maintained lower than normal
are correct
E. Both are mediated by cytokines such as IL-1 and tumor necrosis factor and include
secretion of iron and zinc into the blood by the liver are correct

Section 18.04

33. Which of the following is not a systemic effect of IL-1 and other cytokines in response to
infection or tissue injury?
A. Increased plasma levels of amino acids
B. Increased secretion of colony-stimulating factors
C. Decreased appetite
D. Secretion of acute-phase proteins by the liver
E. Stimulation of helper T cells

Section 18.04

18-13
34. AIDS is
A. Caused by a retrovirus
B. Caused by a virus that contains RNA
C. Transmitted by intimate contact with infected blood, sexual intercourse with an infected
partner, or by an infected mother to her fetus or breast-fed infant
D. Both caused by a retrovirus and transmitted by intimate contact with infected blood, sexual
intercourse with an infected partner, or by an infected mother to her fetus or breast-fed infant
are correct

Section 18.05

35. Graft rejection
A. Occurs primarily because donor macrophages recognize the host tissue as foreign
B. Can be combated by drugs that inhibit lymphocyte proliferation
C. Can be combated by drugs that inhibit cytokine secretion
D. Both occurs primarily because donor macrophages recognize the host tissue as foreign and
can be combated by drugs that inhibit lymphocyte proliferation are correct
E. Both can be combated by drugs that inhibit lymphocyte proliferation and can be combated
by drugs that inhibit cytokine secretion are correct

Section 18.06

36. A subject with type O blood has

A. Erythrocytes carrying type A antigen
B. Erythrocytes carrying type B antigen
C. Antibodies to type A and type B antigen in his/her plasma
D. Erythrocytes carrying type A antigen and erythrocytes carrying type B antigen
E. None of these things

Section 18.06

18-14
37. Which of the following statements regarding blood-type incompatibilities between a

mother and her fetus is true?
A. An Rh-negative fetus may be at risk if its mother is Rh-positive
B. An Rh-positive fetus may be at risk if its mother is Rh-negative
C. A fetus with type B blood may be at risk if its mother has type O blood
D. Both an Rh-negative fetus may be at risk if its mother is Rh-positive and a fetus with type
B blood may be at risk if its mother has type O blood are true
E. Both an Rh-positive fetus may be at risk if its mother is Rh-negative and a fetus with type
B blood may be at risk if its mother has type O blood are true
Bloom's Level: 3. Apply

Section 18.06

38. Allergic reactions are the result of

A. Inappropriate responses by the immune system to stimuli that are not antigens
B. Mast cells and IgE activity
C. Parasite infestation
D. Mast cells and IgE activity and parasite infestation

Section 18.06

39. Autoimmune diseases
A. Include multiple sclerosis and AIDS
B. Can be treated by drugs that suppress the immune system
C. Are diseases in which the immune system is damaged by microbes that kill leukocytes
D. Both include multiple sclerosis and AIDS and can be treated by drugs that suppress the
immune system are correct
E. Both include multiple sclerosis and AIDS and are diseases in which the immune system is
damaged by microbes that kill leukocytes are correct

Section 18.06

18-15
40. Individuals who have been infected by the Human Immunodeficiency Virus (HIV)
A. May show no signs or symptoms of the disease
B. Generally are diagnosed by detection of anti-HIV antibodies from their blood
C. Succumb to the disease in a relatively brief period of time after infection due to massive
loss and failure to replace T lymphocytes
D. Both may show no signs or symptoms of the disease and generally are diagnosed by
detection of anti-HIV antibodies from their blood are correct
E. Both generally are diagnosed by detection of anti-HIV antibodies from their blood and
succumb to the disease in a relatively brief period of time after infection due to massive loss
and failure to replace T lymphocytes

Section 18.05

41. Each of the following are typically associated with the transmission of HIV/AIDS,
except:
A. Unprotected sexual intercourse with an infected partner
B. Through kissing or contact with items contaminated by the saliva of an infected individual
C. Transmission from an infected mother to her fetus across the placenta during pregnancy or
delivery
D. Transfer via breast milk during nursing
E. Transfer of contaminated blood or blood products from one person to another

Section 18.05

42. The rationale behind the drugs used to treat HIV/AIDS, is to reduce the number of viruses
present in the body to infect otherwise healthy cells, by all of the following methods, except:
A. Inhibition of the reverse transcriptase enzyme
B. Interference with the processes involved in expression of viral nucleic acid by the host cell
C. Blocking an alpha protease enzyme associated with the assembly of the virus
D. Chemical agents directed at interruption of mitosis in host cells for the virus
E. Blocking the attachment and fusion of the HIV viruses with T lymphocyte host cells

Section 18.05

18-16
18-17
True / False Questions

43. Immune surveillance refers to the search for and destruction of bacteria in the blood.
FALSE


44. The body's first line of defense against invasion by microbes is a physical and chemical
barrier.
TRUE

Section 18.02

45. The local response to injury in the body is called infection.

FALSE

Section 18.02

46. Histamine is a mediator of inflammatory responses that is generated by enzymatic

cleavage of a plasma precursor.
FALSE

Section 18.02

18-18
47. A consequence of inflammation is increased capillary filtration and edema, which causes
swelling and pain.
TRUE

Section 18.02

48. A chemical that causes binding of a phagocyte to a microbe is called a chemotaxin.

FALSE

Section 18.02

49. A phagocyte can kill a microbe only after phagocytosis.

FALSE

Section 18.02

50. Specific immune responses differ from nonspecific ones in that the former are mediated
by lymphocytes.
TRUE

Section 18.03

51. Bone marrow and thymus are the primary sites of lymphocyte maturation.
TRUE

Section 18.03

18-19
18-20
52. B and T cells are preprogrammed to recognize specific antigens.

TRUE

Section 18.03

53. The two broad categories of specific immune responses are antibody-mediated and
humoral.
FALSE

Section 18.03

54. In cell-mediated immune responses, immune cells directly kill antigen-bearing cells.
TRUE

Section 18.03

55. Cytotoxic T cells kill body cells by phagocytosis.

FALSE

Section 18.03

56. Helper T cells bind to antigen complexed with class II MHC proteins, while cytotoxic T
cells bind to antigen complexed with class I MHC proteins.
TRUE

Section 18.03

18-21
18-22
57. Helper T cells are important only for cell-mediated immune responses.

FALSE

Section 18.03

58. Unlike cytotoxic T cells, natural killer cells do not require antigen to be complexed with
class I MHC proteins in order to bind to the antigen.
TRUE

Section 18.03

59. A person who receives a vaccine made from killed virus particles will, if the vaccination is
successful, acquire passive immunity against that virus.
FALSE

Section 18.03

60. The primary difference between active and passive immunity is accounted for by the
presence of memory cells in the former.
TRUE

Section 18.03

61. HIV preferentially attacks cytotoxic T cells.

FALSE

Section 18.05

18-23
18-24
62. Cyclosporin may be useful for treating autoimmune disorders.

TRUE

Section 18.06

63. A person with type B blood can generally accept a transfusion of type AB blood.
FALSE

Section 18.06

64. People lacking Rh factor have natural antibodies to it.

FALSE

Section 18.06

65. Passive immunization of an Rh-negative woman with anti-Rh factor antibodies within a

few hours of giving birth to an Rh-positive baby is helpful in preventing erythroblastosis
fetalis in a subsequent pregnancy.
TRUE

Section 18.06

66. The skin constitutes a good barrier for foreign chemicals that are nonpolar.
FALSE

Section 18.02

18-25
18-26
67. A patient with AIDS would be likely to react to an infection with a greater elevation of
plasma cortisol than a person without the disease.
FALSE

Section 18.05

68. Treatment of individuals with HIV infection focuses upon early detection by interfering
with the processes involved in replication and assembly of the virus by T lymphocytes, rather
than attacking infected host cells directly.
TRUE

Section 18.05

69. The appearance of the signs and symptoms of AIDS in an HIV infected individual
generally appear after the virus has had enough time to replicate within host tissue cells and to
cause death and destruction of cells critical to mounting a normal immune response.
TRUE

Section 18.05

18-27

Multiple Choice Questions: A. B. C. D

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Chapter 18 - The Immune System

Multiple Choice Questions

1. The immune system

Bloom's Level: 1. Remember

2. Which of the following statements about viruses is not correct? Viruses

Bloom's Level: 1. Remember

3. The killing of virus-infected or cancerous cells by the immune system is called

Bloom's Level: 1. Remember

4. Regarding the immune system cells,

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

6. Which of the following statements regarding the chemical mediators of inflammatory

Bloom's Level: 2. Understand

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

10. Which of the following statements regarding phagocytes and phagocytosis is true?

Bloom's Level: 2. Understand

11. Which of the following statements regarding phagocytosis is true?

Bloom's Level: 2. Understand

Bloom's Level: 1. Remember

13. Which of the following statements regarding complement is true?

Bloom's Level: 2. Understand

14. Which of the following statements regarding complement is true?

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

16. Which of the following statements regarding the activation of complement is true?

Bloom's Level: 2. Understand

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

Bloom's Level: 2. Understand

20. Which if the following statements regarding major histocompatibility proteins (MHCs) is

Bloom's Level: 2. Understand

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

25. Natural killer cells

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

29. When an antigen is bound to an antibody, it binds to

Bloom's Level: 1. Remember

30. Compared to undifferentiated B cells,

Bloom's Level: 2. Understand

31. Binding of IgG or IgM to an antigen

Bloom's Level: 1. Remember

32. Systemic responses to infection

Bloom's Level: 1. Remember

Bloom's Level: 2. Understand

Bloom's Level: 2. Understand

Bloom's Level: 2. Understand

36. A subject with type O blood has

Bloom's Level: 2. Understand

37. Which of the following statements regarding blood-type incompatibilities between a

Bloom's Level: 3. Apply

38. Allergic reactions are the result of

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

Bloom's Level: 1. Remember

Bloom's Level: 2. Understand

Bloom's Level: 2. Understand