Chapter 16 Innate Immunity: Nonspecific Defenses of the Host My Nursing Test Banks

Microbiology: An Introduction, 12e, (Tortora)

Chapter 16   Innate Immunity: Nonspecific Defenses of the Host

16.1   Multiple-Choice Questions

1) Innate immunity

A) is slower than adaptive immunity in responding to pathogens.

B) is nonspecific and present at birth.

C) involves a memory component.

D) involves T cells and B cells.

E) provides increased susceptibility to disease.

Answer:  B

Section:  16.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.1

2) All of the following protect the skin and mucous membranes from infection EXCEPT

A) multiple layers of cells.

B) tears.

C) saliva.

D) HCl.

E) the ciliary escalator.

Answer:  D

Section:  16.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.3

3) The function of the ciliary escalator is to

A) propel inhaled dust and microorganisms toward the mouth, away from the lower respiratory tract.

B) remove microorganisms from the gastrointestinal tract.

C) remove microorganisms from the lower respiratory tract.

D) trap microorganisms in mucus in the upper respiratory tract.

E) trap inhaled dust and microorganisms in mucus and propel it away from the lower respiratory tract.

Answer:  E

Section:  16.2

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  16.3

Global Outcome:  2

4) Which of the following exhibits the highest phagocytic activity?

A) eosinophils

B) erythrocytes

C) macrophages

D) basophils

E) neutrophils

Answer:  C

Section:  16.5

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  16.6

5) TLRs attach to all of the following EXCEPT

A) AMPs.

B) flagellin.

C) LPS.

D) PAMPs.

E) peptidoglycan.

Answer:  A

Section:  16.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  16.2

6) A differential cell count is used to determine each of the following EXCEPT

A) the total number of white blood cells.

B) the numbers of each type of white blood cell.

C) the number of red blood cells.

D) leukocytosis.

E) leukopenia.

Answer:  C

Section:  16.5

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.7

7) The complement protein cascade is the same for the classical pathway, alternative pathway, and lectin pathway after the point in the cascade where the activation of ________ takes place.

A) C1

B) C2

C) C3

D) C5

E) C6

Answer:  C

Section:  16.10a

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.17

Global Outcome:  2

8) All of the following increase blood vessel permeability EXCEPT

A) kinins.

B) prostaglandins.

C) lysozymes.

D) histamine.

E) leukotrienes.

Answer:  C

Section:  16.8

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.13

9) A child falls and suffers a deep cut on her leg. The cut went through her skin and she is bleeding. Which of the following defense mechanisms will participate in eliminating contaminating microbes?

A) mucociliary escalator

B) normal skin flora

C) phagocytosis in the inflammatory response

D) acidic skin secretions

E) lysozyme

Answer:  C

Section:  16.8

Blooms Taxonomy:  Analysis

Learning Outcome:  16.14

Global Outcome:  2

10) Margination refers to

A) the adherence of phagocytes to microorganisms.

B) the chemotactic response of phagocytes.

C) adherence of phagocytes to the lining of blood vessels.

D) dilation of blood vessels.

E) the movement of phagocytes through walls of blood vessels.

Answer:  C

Section:  16.8

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.14

11) Which of the following statements is TRUE?

A) All three types of interferons have the same effect on the body.

B) Alpha interferon promotes phagocytosis.

C) Gamma interferon causes bactericidal activity by macrophages.

D) Alpha interferon acts against specific viruses.

E) Beta interferon attacks invading viruses.

Answer:  C

Section:  16.10a

Blooms Taxonomy:  Analysis

ASMcue Outcome:  3.4

Learning Outcome:  16.20

12) Which of the following is found normally in serum?

A) complement

B) interferon

C) histamine

D) leukocytosis-promoting factor

E) TLRs

Answer:  A

Section:  16.10a

Blooms Taxonomy:  Analysis

Learning Outcome:  16.16

13) Each of the following is an effect of complement activation EXCEPT

A) interference with viral replication.

B) bacterial cell lysis.

C) opsonization.

D) increased phagocytic activity.

E) increased blood vessel permeability.

Answer:  A

Section:  16.10a

Blooms Taxonomy:  Analysis

Learning Outcome:  16.18

14) Which of the following is an effect of opsonization?

A) increased adherence of phagocytes to microorganisms

B) increased margination of phagocytes

C) increased diapedesis of phagocytes

D) inflammation

E) cytolysis

Answer:  A

Section:  16.7

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.10

15) Normal microbiota provide protection from infection in each of the following ways EXCEPT

A) they produce antibacterial chemicals.

B) they compete with pathogens for nutrients.

C) they make the chemical environment unsuitable for nonresident bacteria.

D) they produce lysozyme.

E) they change the pH of the environment.

Answer:  D

Section:  16.4

Blooms Taxonomy:  Analysis

ASMcue Outcome:  5.4

Learning Outcome:  16.5

Global Outcome:  2

16) Each of the following provides protection from phagocytic digestion EXCEPT

A) M protein.

B) capsules.

C) formation of phagolysosomes.

D) leukocidins.

E) biofilms.

Answer:  C

Section:  16.7

Blooms Taxonomy:  Analysis

ASMcue Outcome:  2.3

Learning Outcome:  16.11

17) The antimicrobial effects of AMPs include all of the following EXCEPT

A) inhibition of cell wall synthesis.

B) lysis of bacterial cells.

C) destruction of nucleic acids.

D) pore formation in bacterial membranes.

E) inhibition of phagocytosis.

Answer:  E

Section:  16.10a

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  16.22

18) The swelling associated with inflammation decreases when the fluid

A) returns to the blood.

B) goes into lymph capillaries.

C) is excreted in urine.

D) is lost as perspiration.

E) is transported into macrophages.

Answer:  B

Section:  16.8

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.12

19) Which of the following statements about fixed macrophages is FALSE?

A) They are found in certain tissues and organs.

B) They develop from neutrophils.

C) They are cells of the mononuclear phagocytic system.

D) They are mature monocytes.

E) They gather at sites of infection.

Answer:  B

Section:  16.5

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.6

20) Phagocytes utilize all of the following to optimize interaction with (getting to and getting hold of) microorganisms EXCEPT

A) trapping a bacterium against a rough surface.

B) opsonization.

C) chemotaxis.

D) lysozyme.

E) complement.

Answer:  D

Section:  16.7

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  16.9

Global Outcome:  2

21) All of the following are effects of histamine EXCEPT

A) vasodilation.

B) fever.

C) swelling.

D) redness.

E) pain.

Answer:  B

Section:  16.8

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.13

22) All of the following are effects of histamine EXCEPT

A) destruction of an injurious agent.

B) removal of an injurious agent.

C) isolation of an injurious agent.

D) repair of damaged tissue.

E) production of antibodies.

Answer:  E

Section:  16.8

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.13

23) A chill is a sign that

A) body temperature is falling.

B) body temperature is rising.

C) body temperature is not changing.

D) the metabolic rate is decreasing.

E) blood vessels are dilating.

Answer:  B

Section:  16.9

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.15

24) Which of the following statements is TRUE?

A) There are at least thirty complement proteins.

B) All of the complement proteins are constantly active in serum.

C) Factors B, D, and P cause cytolysis.

D) Complement activity is antigen-specific.

E) Complement increases after immunization.

Answer:  A

Section:  16.10a

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.16

25) Which of the following is mismatched?

A) diapedesis movement of leukocytes between capillary walls cells out of blood and into tissue

B) chemotaxis chemical degradation inside a phagolysosome

C) abcess a cavity created by tissue damage and filled with pus

D) pus tissue debris and dead phagocytes in a white or yellow fluid

E) scab dried blood clot over injured tissue

Answer:  B

Section:  16.8

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.14

26) All of the following are part of the mechanism of action of alpha and beta interferons EXCEPT

A) they bind to the surface of uninfected cells.

B) they are effective for long periods.

C) they initiate manufacture of antiviral proteins.

D) they disrupt stages of viral multiplication.

E) they initiate transcription.

Answer:  B

Section:  16.10a

Blooms Taxonomy:  Analysis

ASMcue Outcome:  3.4

Learning Outcome:  16.20

27) The alternative pathway for complement activation is initiated by

A) lipid-carbohydrate complexes and C3.

B) C5-C9.

C) antigen-antibody reactions.

D) factors released from phagocytes.

E) factors released from damaged tissues.

Answer:  A

Section:  16.10a

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  16.17

28) The classical pathway for complement activation is initiated by

A) lipid-carbohydrate complexes and C3.

B) C5-C9.

C) antigen-antibody reactions.

D) factors released from phagocytes.

E) factors released from damaged tissues.

Answer:  C

Section:  16.10a

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  3.4

Learning Outcome:  16.17

29) Activation of C3a results in

A) acute inflammation.

B) increased blood vessel permeability.

C) opsonization.

D) attraction of phagocytes.

E) cell lysis.

Answer:  A

Section:  16.10a

Blooms Taxonomy:  Analysis

Learning Outcome:  16.16

30) Neutrophils with defective lysosomes are unable to

A) undergo chemotaxis.

B) migrate.

C) produce toxic oxygen products.

D) attach to microorganisms and other foreign material.

E) engulf microorganisms and other foreign material.

Answer:  C

Section:  16.7

Blooms Taxonomy:  Analysis

Learning Outcome:  16.10

Global Outcome:  2

31) Innate immunity includes all of the following EXCEPT

A) phagocytosis.

B) inflammation.

C) production of antibody.

D) production of interferon.

E) activation of complement.

Answer:  C

Section:  16.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.1

32) After ingesting a pathogen, lysosomal enzymes produce all of the following EXCEPT

A) complement.

B) O2-.

C) H2O2.

D) OH.

E) HOCl.

Answer:  A

Section:  16.7

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  16.10

33) Activation of C5-C9 results in

A) activation of C3.

B) fixation of complement.

C) lysis of microbial cells.

D) phagocytosis.

E) inflammation.

Answer:  C

Section:  16.10a

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.18

34) All of the following are true regarding NK cells EXCEPT

A) they are a type of lymphocyte.

B) they are found in tissues of the lymphatic system.

C) they have the ability to kill infected body cells and some tumor cells.

D) they destroy infected body cells by phagocytosis.

E) they release toxic substances that cause cell lysis or apoptosis.

Answer:  D

Section:  16.5

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.6

35) Which of the following is involved in resistance to parasitic helminths?

A) basophils

B) eosinophils

C) lymphocytes

D) monocytes

E) neutrophils

Answer:  B

Section:  16.5

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.6

36) Macrophages arise from which of the following?

A) basophils

B) eosinophils

C) lymphocytes

D) monocytes

E) neutrophils

Answer:  D

Section:  16.5

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.6

37) All of the following pertain to fever EXCEPT that it

A) accelerates microbial growth by increasing iron absorption from the digestive tract.

B) stimulates T lymphocyte activity.

C) is caused by interleukin-1 and TNF-alpha coming into contact with the hypothalamus.

D) intensifies the effect of antiviral interferons.

E) can be initiated by specific types of pathogens.

Answer:  A

Section:  16.9

Blooms Taxonomy:  Analysis

Learning Outcome:  16.15

Global Outcome:  2

38) All of the following are iron-binding proteins found in humans EXCEPT

A) lactoferrin.

B) transferrin.

C) hemoglobin.

D) siderophorin.

E) ferritin.

Answer:  D

Section:  16.10a

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.21

39) All of the following occur during inflammation. What is the first step?

A) diapedesis

B) margination

C) phagocyte migration

D) repair

E) vasodilation

Answer:  E

Section:  16.8

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.13

40) The lectin pathway for complement action is initiated by

A) mannose on host membranes.

B) mannose on the surface of microbes.

C) lectins of the microbe.

D) gram-negative cell walls.

E) gram-positive cell walls.

Answer:  B

Section:  16.10a

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.17

41) All of the following are components of the inflammatory process EXCEPT

A) dilation of blood vessels.

B) release of histamines and prostaglandins.

C) chemotaxis.

D) diapedesis.

E) antibody synthesis.

Answer:  E

Section:  16.8

Blooms Taxonomy:  Analysis

Learning Outcome:  16.12

42) Several inherited deficiencies in the complement system occur in humans. Which of the following would be the MOST severe?

A) deficiency of C3

B) deficiency of C5

C) deficiency of C6

D) deficiency of C7

E) deficiency of C8

Answer:  A

Section:  16.10a

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.17

Global Outcome:  2

43) Which of the following statements about the classical pathway of complement activation is FALSE?

A) C1 is the first protein activated in the classical pathway.

B) The C1 protein complex is initiated by antigen-antibody complexes.

C) C3 is not involved in the classical pathway.

D) Cleaved fragments of some of the proteins act to increase inflammation.

E) C3b causes opsonization.

Answer:  C

Section:  16.10a

Blooms Taxonomy:  Analysis

Learning Outcome:  16.17

44) Lysozyme and the antibiotic penicillin have similar mechanisms of action in that they both cause damage to the bacterial

A) cell membrane.

B) capsule.

C) cell wall.

D) DNA.

E) ribosomes.

Answer:  C

Section:  16.7

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  2.2

Learning Outcome:  16.10

Global Outcome:  7

45) Which non-specific defense mechanism is mismatched with its associated body structure or body fluid?

A) lysozyme tears and saliva

B) mucociliary escalator intestines

C) very acidic pH stomach

D) keratin and tightly packed cells skin

E) cerumen and sebum ear

Answer:  B

Section:  16.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.3

16.2   True/False Questions

1) The dermis is composed of connective tissue and serves the primary purpose of providing direct protection from the external environment.

Answer:  FALSE

Section:  16.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.3

Global Outcome:  7

2) Microorganisms that are members of the normal microbiota are also known to cause disease.

Answer:  TRUE

Section:  16.4

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  16.5

Global Outcome:  7

3) Maturation of stem cells into mature blood cells occurs in the red bone marrow.

Answer:  TRUE

Section:  16.5

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.6

4) The inflammatory response can only be triggered by an infection.

Answer:  FALSE

Section:  16.8

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.12

Global Outcome:  2

5) Histamine and kinins cause increased blood flow and capillary permeability.

Answer:  TRUE

Section:  16.8

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.13

6) Aspirin alleviates pain, inflammation, and fever by inhibiting prostaglandins.

Answer:  TRUE

Section:  16.8

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.13

7) Complement proteins in their intact and unactivated form act as opsonins by binding to microorganisms and promoting phagocytosis.

Answer:  FALSE

Section:  16.10a

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.18

8) Digestion of microorganisms occurs in phagosomes.

Answer:  FALSE

Section:  16.7

Blooms Taxonomy:  Knowledge

Learning Outcome:  16.10

Global Outcome:  7

9) An example of a TLR would be peptidoglycan found in the cell wall of gram-positive bacteria.

Answer:  FALSE

Section:  16.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  16.2

10) Ingestion of certain lactic acid bacteria (LABs) has been shown to be beneficial for function and health of the intestinal tract.

Answer:  TRUE

Section:  16.4

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  16.5

Global Outcome:  7

16.3   Essay Questions

1) Explain how each of the following avoids being killed by phagocytes.

a. Streptococcus pneumoniae

b. Mycobacterium tuberculosis

c. Streptococcus pyogenes

d. Shigella dysenteriae

Section:  16.7

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  2.3

Learning Outcome:  16.11

Global Outcome:  8

2) The complement system is extremely important in the innate defense response. It can be said that this system is a cascade system. Explain this statement.

Section:  16.10a

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  3.4

Learning Outcome:  16.17

Global Outcome:  8

3) Describe the nonspecific antimicrobial effects of mucus, lysozyme, and low pH. For each of these substances, list where they are found in the body and how they function in fighting pathogens.

Section:  16.3

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  3.4

Learning Outcome:  16.4

Global Outcome:  8

4) Describe and differentiate between the three pathways of activating complement.

Section:  16.10a

Blooms Taxonomy:  Synthesis

ASMcue Outcome:  3.4

Learning Outcome:  16.17

Global Outcome:  8

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