Chapter 01: Highlights of the Innate and Adaptive Immune Systems
Turgeon: Evolve Resources for Immunology & Serology in Laboratory Medicine, 7th Edition

MULTIPLE CHOICE

	1.	The “father” of immunology is generally considered to be
a.	Koch.	
b.	Pasteur.	
c.	Gram.	
d.	Salk.	

ANS:	B
Louis Pasteur is generally considered to be the “father of immunology.”

DIF:	Cognitive Level: I	

	2.	An early form of immunization was practiced by the
a.	Romans.	
b.	Greeks.	
c.	Chinese.	
d.	Native Americans.	

ANS:	C
Beginning about 1000 AD, the Chinese practiced a form of immunization by inhaling dried powders derived from the crusts of smallpox lesions.

DIF:	Cognitive Level: I	

	3.	A specific function of the immune system is to
a.	recognize self from nonself.	
b.	defend the body against nonself.	
c.	amplify specific functions.	
d.	Both A and B.	

ANS:	D
The function of the immune system is to recognize self from nonself and defend the body against nonself. Such a system is necessary for survival. The immune system also has nonspecific effector mechanisms that usually amplify the specific functions. Nonspecific components of the immune system include mononuclear phagocytes, polymorphonuclear leukocytes, and soluble factors (e.g., complement).

DIF:	Cognitive Level: I	

	4.	An undesirable consequence of immunity is
a.	natural resistance.	
b.	acquired resistance to infectious diseases.	
c.	an autoimmune disorder.	
d.	recovery from infectious disease.	

ANS:	C
The desirable consequences of immunity include natural resistance, recovery, and acquired resistance to infectious diseases. A deficiency or dysfunction of the immune system can cause many disorders. Undesirable consequences of immunity include allergy, rejection of a transplanted organ, or an autoimmune disorder.

DIF:	Cognitive Level: I	

	5.	The immune system has various distinctive characteristics except;
a.	specificity.	
b.	memory.	
c.	mobility.	
d.	noncooperation among different cells.	

ANS:	D
The immune system is composed of a large, complex set of widely distributed elements, with the distinctive characteristics of specificity, memory, mobility, replicability, and cooperation among different cells or cellular products. Specificity and memory are characteristics of lymphocytes in the immune system. Nonspecific elements of the immune system demonstrate mobility. In addition, specific and nonspecific cellular components of the immune system can replicate. Cooperation is required for optimal functioning, and interaction involves specific cellular elements, cell products, and nonlymphoid elements.

DIF:	Cognitive Level: I	

	6.	Hematopoiesis occurs in the yolk sac during the
a.	immediate hours after conception	
b.	second month of gestation.	
c.	second trimester of gestation.	
d.	periods of severe anemia in children.	

ANS:	A
The sites of blood cell development, or hematopoiesis, follow a definite sequence in the embryo and fetus. Hematopoiesis occurs in the yolk sac during the second month of gestation.

DIF:	Cognitive Level: II	

	7.	The sequence of blood cell development in the embryo and fetus is
a.	yolk sac, liver-spleen, bone marrow.	
b.	yolk sac, bone marrow, liver/spleen.	
c.	liver-spleen, yolk sac, bone marrow.	
d.	bone marrow, liver-spleen, yolk sac.	

ANS:	A
The first blood cells are primitive red blood cells (erythroblasts; RBCs) formed in the islets of the yolk sac during the first 2 to 8 weeks of life. Gradually, the liver and spleen replace the yolk sac as the sites of blood cell development. By the second month of gestation, the liver becomes the major site of hematopoiesis, and granular types of leukocytes have made their initial appearance. The liver and spleen predominate from about 2 to 5 months of fetal life. In the fourth month of gestation, bone marrow begins to produce blood cells. After the fifth fetal month, bone marrow begins to assume its ultimate role as the primary site of hematopoiesis.

DIF:	Cognitive Level: II	

	8.	The primary function of mature neutrophils is
a.	to reduce inflammation.	
b.	to lyse parasites in the circulatory system.	
c.	antigen recognition.	
d.	phagocytosis.	

ANS:	D
Various phagocytic cells continually circulate throughout the blood, lymph, gastrointestinal system, and respiratory tract. When trauma occurs, the neutrophils arrive at the site of injury and can be found in the initial exudate in less than 1 hour. Monocytes are slower in moving to the inflammatory site. Macrophages resident in the tissues of the body are already in place to deal with an intruding agent. Additional macrophages from the bone marrow and other tissues can be released in severe infections.

DIF:	Cognitive Level: II	

	9.	Primary granules, or azurophilic granules, in neutrophils contain
a.	lysozyme.	
b.	myeloperoxidase.	
c.	lactoferrin.	
d.	Both A and B.	

ANS:	D
Granules in the phagocyte cytosol contain degradatory enzymes of three types
1.   Primary, or azurophilic, granules containing enzymes (e.g., lysozyme, myeloperoxidase)
2.   Secondary, or specific, granules containing substances such as lactoferrin.
3.   Tertiary granules containing substances such as caspases

DIF:	Cognitive Level: I	

	10.	The origin of a condition when eosinophils are increased in the circulating blood is associated with:
a.	fungus	
b.	parasitic amoeba	
c.	allergic reactions	
d.	bacteria	

ANS:	C
An increase in eosinophils is associated with a wide variety of conditions, but especially with allergic reactions, drug reactions, certain skin disorders, parasitic infestations, collagen vascular diseases, Hodgkin disease, and myeloproliferative diseases.
A functional property related to the membrane receptors of the eosinophil is the cell’s ability to interact with the larval stages of some helminth parasites and damage them by oxidative mechanisms. Certain proteins released from eosinophilic granules damage antibody-coated Schistosoma parasites and may account for damage to endothelial cells in hypereosinophilic syndromes.

DIF:	Cognitive Level: I	

	11.	A basophil degranulates in a(n)
a.	inflammatory reaction.	
b.	immediate (acute) hypersensitivity reaction.	
c.	chronic tissue rejection.	
d.	Both A and B.	

ANS:	B
Basophils have high concentrations of heparin and histamine in their granules. If events are triggered by antigens from pollen, food, drugs, or insect venom, the result is an immediate hypersensitivity reaction.

DIF:	Cognitive Level: II	

	12.	Mononuclear cells are effective phagocytic cells against
a.	staphylococci.	
b.	streptococci.	
c.	Mycobacterium tuberculosis.	
d.	pneumonia.	

ANS:	C
Mononuclear cells are particularly effective as phagocytic cells because of the large amounts of lipase in their cytoplasm. Lipase is able to attack bacteria with a lipid capsule, such as Mycobacterium tuberculosis.

DIF:	Cognitive Level: I	

	13.	Macrophages
a.	process antigens.	
b.	physically present biologically modified antigens to lymphocytes.	
c.	secrete a lymphocyte-activating factor (IL-1) as a result of proper MHC recognition.	
d.	All of the above.	

ANS:	D
The phagocytic property of the macrophage is particularly important in the processing of antigens as part of the immune response. Macrophages are believed to process antigens and physically present this biochemically modified and more reactive form of antigen to lymphocytes (particularly T helper cells) as an initial step in the immune response.

DIF:	Cognitive Level: II	

	14.	Cell-mediated immunity is moderated by
a.	B lymphocytes.	
b.	T lymphocytes.	
c.	monocytes-macrophages.	
d.	Both B and C.	

ANS:	D
Cell-mediated immunity is moderated by the link between T lymphocytes and phagocytic cells (i.e., monocytes-macrophages).

DIF:	Cognitive Level: I	

	15.	B lymphocytes respond to
a.	antigens presented on the surface of an antigen-presenting cell.	
b.	antigens on microorganisms or other living cells.	
c.	native antigenic determinants of appropriate fit.	
d.	antigens floating in body fluids.	

ANS:	C
The B type of lymphocyte can probably respond to a native antigenic determinant of the appropriate “fit.”

DIF:	Cognitive Level: I	

	16.	T lymphocytes respond to
a.	antigens presented on the surface of an antigen-presenting cell.	
b.	antigens on microorganisms or other living cells.	
c.	native antigenic determinants of appropriate fit.	
d.	antigens floating in body fluids.	

ANS:	A
The T type of lymphocyte responds to antigens presented by other cells in the context of major histocompatibility complex (MHC) proteins.

DIF:	Cognitive Level: I	

	17.	Cytokines
a.	are produced by various cells of the immune system including lymphocytes, monocytes, macrophages.	
b.	act on various elements of the immune system.	
c.	are molecular structures.	
d.	All of the above.	

ANS:	D
Lymphocytes are immunologically active through various types of direct cell-to-cell contact and by the production of soluble factors. Nonspecific soluble factors are made by, or act on, various elements of the immune system. These molecules are collectively called cytokines.

DIF:	Cognitive Level: I	

	18.	Another name for Toll-like receptors is
a.	genome.	
b.	pathogen-associated molecular patterns (PAMPs).	
c.	pattern-recognition receptors.	
d.	complement.	

ANS:	C
The number of genes encoded in an organism is called its genome. The innate immune response may not be able to recognize every possible antigen, but rather may focus on a few large groups of microorganisms, called pathogen-associated molecular patterns (PAMPs). The receptors of the innate immune system that recognize these PAMPs are called pattern recognition receptors (e.g., Toll-like receptors).

DIF:	Cognitive Level: I	

	19.	The innate immune system is
a.	the most ancient form of host defense.	
b.	divided into two components, each with a different function.	
c.	mediated by germline-encoded receptors.	
d.	Both A and C.	

ANS:	D
The innate immune system is an ancient form of host defense that appeared before the adaptive immune system. Some form of innate immunity probably exists in all multicellular organisms. Innate immune recognition is mediated by germline-encoded receptors, which means that the specificity of each receptor is genetically predetermined. Germline-encoded receptors evolved by natural selection to have defined specificities for infectious microorganisms.

DIF:	Cognitive Level: II	

	20.	Mechanisms of innate immunity
a.	are activated immediately after infection.	
b.	quickly begin to control multiplication.	
c.	are organized around T and B lymphocytes.	
d.	Both A and B.	

ANS:	D
Mechanisms of innate immunity (e.g., phagocytes) and the alternate complement pathways are activated immediately after infection and quickly begin to control the multiplication of infecting microorganisms.

DIF:	Cognitive Level: II	

	21.	A specific component of the adaptive immune system formed in response to antigenic stimulation is
a.	complement.	
b.	immunoglobulin.	
c.	increased secretion of mucus.	
d.	enhanced phagocytosis.	

ANS:	B
If specific antibodies have been formed to antigenic stimulation, they are available to protect the body against foreign substances. The recognition of foreign substances and subsequent production of antibodies to these substances defines immunity.

DIF:	Cognitive Level: I	

	22.	Acquired immunity can result from
a.	vaccination by injection of an antigen.	
b.	contracting a disease.	
c.	genetic inheritance.	
d.	Both A and B.	

ANS:	D
Antibody-mediated immunity to infection can be acquired if the antibodies are formed by the host or if they are received from another source; these two types of acquired immunity are called active immunity and passive immunity, respectively.

DIF:	Cognitive Level: I	

	23.	A child who contracts a contagious disease from an older sibling could develop a form of immunity against the disease due to the mechanism of:
a.	natural active	
b.	artificial active	
c.	natural passive	
d.	artificial passive	

ANS:	A
Active immunity can be acquired by natural exposure in response to an infection or natural series of infections, or through intentional injection of an antigen.

DIF:	Cognitive Level: II	

	24.	Preschool children who are vaccinated against specific microorganisms would be expected to develop a form of immunity against those microorganisms due to the immune mechanism of:
a.	natural active	
b.	artificial active	
c.	natural passive	
d.	artificial passive	

ANS:	B
Vaccination is an effective artificial method of stimulating antibody production and memory (acquired resistance) without contracting the disease.

DIF:	Cognitive Level: I	

	25.	Artificial passive immunity is achieved by
a.	vaccination.	
b.	contracting a disease.	
c.	infusion or injection of preformed specific antibody.	
d.	transfer in vivo.	

ANS:	C
Artificial passive immunity is achieved by infusion of serum or plasma containing high concentrations of antibody or lymphocytes from an actively immunized individual. Passive immunity via preformed antibodies in serum provides immediate, temporary antibody protection against microorganisms (e.g., hepatitis A) by administering preformed antibodies.

DIF:	Cognitive Level: I	

	26.	In the first line of nonspecific body defense, intact skin, is cut with a piece of glass contaminated with Staphylococcus aureus, which cellular component of the immune system quickly responds?
a.	T lymphocytes	
b.	B lymphocytes	
c.	Neutrophils	
d.	Platelets	

ANS:	C
The neutrophilic leukocyte, particularly the polymorphonuclear neutrophil (PMN) type, provides an effective host defense against bacterial and fungal infections.

DIF:	Cognitive Level: II