Immune System Responses and Inflammation, Exams of Pathophysiology

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SCI 225

PATHOPHYSIOLOGY

Week 3 : Inflammation and

Immunity

CONTENT REVIEW EXAM

1. Which of the following cytokines is primarily responsible for the promotion of inflammation? a) Interleukin-1 (IL-1) b) Interleukin-10 (IL-10) c) Interferon-gamma (IFN-γ) d) Tumor necrosis factor-alpha (TNF-α) Correct Answer : d) Tumor necrosis factor-alpha (TNF-α) Rationale: TNF-α is a pro-inflammatory cytokine that plays a critical role in the inflammatory response.
2. What is the main function of neutrophils during the inflammation process? a) Antibody production b) Phagocytosis of pathogens c) Secretion of histamine d) Activation of T cells Correct Answer : b) Phagocytosis of pathogens Rationale: Neutrophils are the first responders to sites of inflammation and are primarily involved in the phagocytosis of pathogens.

3. What does the term 'antigenic variability' refer to in the context of pathogens? a) The ability of a pathogen to evade the immune system by changing its antigens b) The variation in immune response among different individuals c) The process of mutation in the host's immune system d) The increase in pathogen load during an infection Correct Answer : a) The ability of a pathogen to evade the immune system by changing its antigens Rationale: Antigenic variability allows pathogens to escape detection and elimination by the immune system.
4. In which stage of the inflammatory response does the release of inflammatory mediators typically peak? a) Resolution b) Exudation c) Recruitment d) Initiation Correct Answer : c) Recruitment Rationale: During the recruitment stage, various mediators are released from damaged tissues and immune cells, facilitating an inflammatory response.

5. Which immune response is primarily responsible for memory after an infection? a) Innate immunity b) Adaptive immunity c) Inflammatory response d) Autoimmunity Correct Answer : b) Adaptive immunity Rationale: The adaptive immune system is responsible for developing immunological memory, allowing for more rapid responses to previously encountered pathogens.

Fill-in-the-Blank Questions

6. The cardinal signs of inflammation include redness, heat, swelling, pain, and __________. Correct Answer : loss of function Rationale: Loss of function is recognized as a key aspect of the inflammatory process, alongside the four classical signs.
7. T cells mature in the __________ gland, where they specialize in cellular immune responses.

Correct Answer : thymus Rationale: The thymus is the primary site for the maturation of T lymphocytes, which are crucial for adaptive immunity.

8. The process by which white blood cells move toward the site of inflammation in response to previously released inflammatory mediators is called __________. Correct Answer : chemotaxis Rationale: Chemotaxis is the directed movement of cells towards higher concentrations of chemotactic agents at the inflammation site.
9. The term __________ refers to an exaggerated immune response that can lead to tissue damage. Correct Answer : hypersensitivity Rationale: Hypersensitivity reactions occur when the immune system overreacts to a harmless substance, resulting in tissue injury.
10. Inflammation can be classified as acute or chronic, with chronic inflammation being characterized by __________. Correct Answer : persistence of inflammatory cells over time Rationale: Chronic inflammation is sustained over a longer period and features ongoing inflammation, tissue damage, and healing.

True/False Questions

11. True or False: Macrophages are involved in both the innate and adaptive immunity. Correct Answer : True Rationale: Macrophages play a role in the innate immune response by phagocytosing pathogens and in the adaptive immune response by presenting antigens to T cells.
12. True or False: The primary function of B cells is to produce antibodies against pathogens. Correct Answer : True Rationale: B cells are responsible for the production of antibodies that can neutralize pathogens.
13. True or False: Fever is considered an adaptive response of the body during inflammation. Correct Answer : False Rationale: Fever is primarily a physiological response of the innate immune system, although it can assist the adaptive immune response.

14. True or False: The complement system is only involved in the adaptive immune response. Correct Answer : False Rationale: The complement system is part of the innate immunity and can enhance both innate and adaptive immune responses.
15. True or False: Interleukins are a type of antibody that helps in fighting infections. Correct Answer : False Rationale: Interleukins are cytokines that mediate communication between immune cells, while antibodies are produced by B cells to target specific pathogens.

Multiple Response Questions

16. Select all cytokines that are considered pro-inflammatory. a) IL- 6 b) IL- 1 c) IL- 10 d) TNF-α Correct Answer s: a) IL-6, b) IL-1, d) TNF-α

Rationale: IL-6, IL-1, and TNF-α are all known pro- inflammatory cytokines that promote inflammation.

17. Which of the following are hallmarks of chronic inflammation? a) Tissue repair b) Formation of granulomas c) Presence of neutrophils d) Fibrosis Correct Answer s: b) Formation of granulomas, d) Fibrosis Rationale: Granuloma formation and fibrosis are characteristic features of chronic inflammation, whereas neutrophils are more typical of acute inflammation.
18. Select all the pathways through which the complement system can be activated. a) Classical pathway b) Alternative pathway c) Membrane attack pathway d) Lectin pathway Correct Answer s: a) Classical pathway, b) Alternative pathway, d) Lectin pathway

Rationale: The complement system can be activated via the classical, alternative, and lectin pathways but not the membrane attack pathway, which is an effect of the complement cascade.

19. Which immune cells are primarily involved in the adaptive immune response? Select all that apply. a) Macrophages b) T lymphocytes c) B lymphocytes d) Neutrophils Correct Answer s: b) T lymphocytes, c) B lymphocytes Rationale: T and B lymphocytes are the main players in the adaptive immune response, while macrophages and neutrophils are part of the innate response.
20. Select all the factors that can lead to the activation of the innate immune response. a) Pathogen-associated molecular patterns (PAMPs) b) Damage-associated molecular patterns (DAMPs) c) Allergens d) Autoantigens Correct Answer s: a) Pathogen-associated molecular patterns (PAMPs), b) Damage-associated molecular patterns (DAMPs)

Rationale: PAMPs and DAMPs can trigger the innate immune response, whereas allergens and autoantigens typically initiate adaptive responses.

Additional Questions

21. Identify the cells that are primarily responsible for the recognition of foreign antigens in the adaptive immune system: a) Natural Killer Cells b) T lymphocytes c) B lymphocytes d) Neutrophils Correct Answer : b) T lymphocytes Rationale: T lymphocytes play a critical role in recognizing antigens presented by antigen-presenting cells.
22. Fill in the blank: The __________ immune response typically takes longer to mount compared to the innate immune response. Correct Answer : adaptive Rationale: The adaptive immune response takes time to develop due to the need for antigen processing and clonal selection.

23. True or False: All cytokines have a pro-inflammatory effect. Correct Answer : False Rationale: While many cytokines promote inflammation, others, such as IL-10, have anti-inflammatory effects.
24. Multiple response: Which of the following diseases are characterized as autoimmune disorders? Select all that apply. a) Rheumatoid arthritis b) Type 1 diabetes c) Hypertension d) Systemic lupus erythematosus (SLE) Correct Answer s: a) Rheumatoid arthritis, b) Type 1 diabetes, d) Systemic lupus erythematosus (SLE) Rationale: Both rheumatoid arthritis and SLE are autoimmune disorders; Type 1 diabetes is also autoimmune. Hypertension is primarily a cardiovascular issue.
25. Fill in the blank: Inflammation can result in the production of __________ that acts as a chemical mediator to induce vasodilation. Correct Answer : nitric oxide

Rationale: Nitric oxide is produced during inflammation and helps induce vasodilation to increase blood flow to the affected area.

Concluding Questions

26. Multiple choice: Which of the following cells is primarily involved in the elimination of virus-infected cells? a) T helper cells b) Natural Killer (NK) cells c) B cells d) Dendritic cells Correct Answer : b) Natural Killer (NK) cells Rationale: NK cells are part of the innate immune system and are specifically involved in the destruction of virus-infected cells.
27. True or False: Dendritic cells are essential for the activation of naive T lymphocytes. Correct Answer : True Rationale: Dendritic cells process and present antigens effectively, thus playing a crucial role in activating naive T cells.

28. Fill in the blank: The __________ pathway of complement activation is started by the binding of antibodies to an antigen. Correct Answer : classical Rationale: The classical pathway is activated when antibodies bind to specific antigens on pathogens.
29. Select all the following that are considered signs/symptoms of systemic inflammation: a) Fever b) Fatigue c) Increased heart rate d) Localized swelling Correct Answer s: a) Fever, b) Fatigue, c) Increased heart rate Rationale: Fever, fatigue, and increased heart rate are systemic indicators; localized swelling represents a localized inflammatory response. Multiple Choice: Which of the following cells is primarily responsible for the acute inflammatory response? A) Neutrophils B) Macrophages C) Lymphocytes

D) Eosinophils Correct Answer : A) Neutrophils Rationale: Neutrophils are typically the first responders to sites of acute inflammation, playing a crucial role in the initial defense against pathogens. Fill-in-the-Blank: The __ pathway is activated by the presence of pathogens and leads to the production of antibodies. Correct Answer : humoral immune Rationale: The humoral immune response involves the activation of B cells and the production of antibodies in response to pathogens. True/False: The release of histamine during an inflammatory response causes vasoconstriction. Correct Answer : False Rationale: Histamine causes vasodilation, increasing blood flow to the affected area during inflammation. Multiple Response: Which of the following are characteristics of chronic inflammation? (Select all that apply) A) Presence of lymphocytes B) Short duration

C) Tissue destruction D) Formation of granulomas Correct Answer s: A, C, D Rationale: Chronic inflammation is characterized by the presence of lymphocytes, ongoing tissue destruction, and the formation of granulomas. Multiple Choice: Which cytokine is primarily involved in the regulation of immune responses and inflammation? A) Interleukin- 1 B) Tumor Necrosis Factor-alpha (TNF-α) C) Interleukin- 6 D) All of the above Correct Answer : D) All of the above Rationale: All the mentioned cytokines play significant roles in modulating immune responses and inflammation. Fill-in-the-Blank: The process by which white blood cells migrate to the site of inflammation is called __. Correct Answer : chemotaxis Rationale: Chemotaxis refers to the movement of cells towards the site of inflammation in response to chemical signals.

True/False: Antigen-presenting cells (APCs) are responsible for initiating the adaptive immune response by presenting antigens to T cells. Correct Answer : True Rationale: APCs, such as dendritic cells and macrophages, play a critical role in activating T cells by presenting antigens. Multiple Choice: What type of immunity is characterized by the body’s ability to recognize and remember specific pathogens? A) Innate immunity B) Adaptive immunity C) Passive immunity D) Local immunity Correct Answer : B) Adaptive immunity Rationale: Adaptive immunity involves the recognition and memory of specific pathogens, allowing for a stronger response upon re-exposure. Multiple Response: Which of the following are components of the innate immune system? (Select all that apply) A) Skin B) B cells

C) Phagocytes D) Complement system Correct Answer s: A, C, D Rationale: Skin, phagocytes, and the complement system are all part of the innate immune system, providing immediate defense against pathogens. Fill-in-the-Blank: The __ response is characterized by redness, heat, swelling, and pain due to inflammation. Correct Answer : inflammatory Rationale: The inflammatory response leads to these classic signs due to increased blood flow and vascular permeability. True/False: Memory T cells are responsible for the immediate response to previously encountered antigens. Correct Answer : True Rationale: Memory T cells enable a faster and more efficient immune response upon subsequent exposures to the same antigen. Multiple Choice: Which of the following best describes autoimmunity? A) The immune system attacks foreign pathogens B) The immune system is unable to respond to pathogens

C) The immune system attacks the body’s own cells D) The immune system cannot differentiate between viruses and bacteria Correct Answer : C) The immune system attacks the body’s own cells Rationale: Autoimmunity occurs when the immune system mistakenly targets and attacks the body's own tissues. Multiple Response: Which factors can lead to the development of chronic inflammation? (Select all that apply) A) Persistent infection B) Autoimmune diseases C) Allergic reactions D) Acute injury Correct Answer s: A, B, C Rationale: Persistent infection, autoimmune diseases, and allergic reactions can all contribute to the development of chronic inflammation. Fill-in-the-Blank: The main function of __ is to neutralize or destroy pathogens through phagocytosis. Correct Answer : macrophages

Rationale: Macrophages are key players in the immune system, responsible for engulfing and digesting pathogens. True/False: The complement system enhances the ability of antibodies and phagocytes to clear pathogens from an organism. Correct Answer : True Rationale: The complement system plays a supportive role in immune responses by promoting opsonization and inflammation. Multiple Choice: Which of the following is NOT a characteristic of innate immunity? A) Rapid response B) Specificity to pathogens C) No memory formation D) First line of defense Correct Answer : B) Specificity to pathogens Rationale: Innate immunity is not pathogen-specific; it provides a generalized defense. Multiple Response: Which of the following are signs of systemic inflammation? (Select all that apply) A) Fever

B) Localized redness C) Increased white blood cell count D) Fatigue Correct Answer s: A, C, D Rationale: Fever, increased white blood cell count, and fatigue are systemic signs of inflammation, while localized redness is not systemic. Fill-in-the-Blank: The activation of the __ pathway leads to the formation of membrane attack complexes that lyse pathogens. Correct Answer : classical complement Rationale: The classical complement pathway is triggered by antibodies and leads to the formation of complexes that can lyse pathogens. True/False: Cytokines play a role in regulating the inflammatory response and coordinating the activities of immune cells. Correct Answer : True Rationale: Cytokines are crucial for cell signaling in the immune response, helping to regulate inflammation and coordinate immune cell activities. Multiple Choice: Which of the following is a primary function of T helper cells?

A) Killing infected cells B) Producing antibodies C) Activating B cells and other immune cells D) Directly attacking pathogens Correct Answer : C) Activating B cells and other immune cells Rationale: T helper cells are essential for activating B cells and orchestrating the overall immune response.

1. Multiple Choice: Which cytokine is primarily responsible for the fever response during inflammation? a) Interleukin-1 (IL-1) b) Tumor Necrosis Factor (TNF) c) Interleukin-6 (IL-6) d) Interferon-gamma (IFN-γ) Answer : c) Interleukin-6 (IL-6) Rationale: IL-6 is a cytokine that plays a significant role in the fever response and acute phase reaction during inflammation.
2. Fill-in-the-Blank: The process by which leukocytes exit the capillaries and enter the tissue is known as __________.

Answer : Diapedesis Rationale: Diapedesis is the process of white blood cells moving out of the circulatory system and towards the site of tissue damage or infection.

3. True/False: The complement system is part of the innate immune response and can be activated without the presence of antibodies. Answer : True Rationale: The complement system is a component of the innate immune system that can be activated through several pathways, not all of which require antibodies.
4. Multiple Response: Select all the correct statements about natural killer (NK) cells: a) They are a type of lymphocyte. b) They require antigen presentation to become activated. c) They can induce apoptosis in virally infected cells. d) They have memory cells similar to T and B lymphocytes. Answer s: a) and c) Rationale: NK cells are a type of lymphocyte that can induce apoptosis in virally infected cells without the need for antigen presentation, and they do not have memory cells.

5. Multiple Choice: What is the primary function of neutrophils during the acute inflammatory response? a) Antibody production b) Phagocytosis of pathogens c) Release of histamine d) Activation of T cells Answer : b) Phagocytosis of pathogens Rationale: Neutrophils are primarily responsible for the phagocytosis and destruction of pathogens at the site of inflammation.
6. Fill-in-the-Blank: The specific type of acquired immunity that is mediated by B cells is known as __________ immunity. Answer : Humoral Rationale: Humoral immunity is the aspect of immunity that is mediated by macromolecules found in extracellular fluids such as secreted antibodies, complement proteins, and certain antimicrobial peptides.
7. True/False: Macrophages are the first type of cell to respond to a site of inflammation. Answer : False Rationale: Neutrophils are typically the first cells to arrive at the site of inflammation, followed by macrophages.

8. Multiple Response: Which of the following are characteristics of chronic inflammation? a) Infiltration of neutrophils b) Presence of lymphocytes and macrophages c) Tissue destruction d) Immediate resolution of the inflammatory response Answer s: b) and c) Rationale: Chronic inflammation is characterized by the presence of lymphocytes and macrophages, ongoing tissue destruction, and does not resolve immediately.
9. Multiple Choice: During an inflammatory response, which molecule is responsible for increasing vascular permeability and vasodilation? a) Bradykinin b) Prostaglandins c) Leukotrienes d) C-reactive protein Answer : a) Bradykinin Rationale: Bradykinin is a peptide that causes blood vessels to dilate (vasodilation) and become more permeable (increased vascular permeability) during the inflammatory process.

10. Fill-in-the-Blank: The term used to describe the accumulation of fluid in tissues, leading to swelling, during inflammation is __________. Answer : Edema Rationale: Edema is the medical term for swelling caused by excess fluid trapped in the body's tissues, commonly occurring during inflammation.
11. True/False: Adaptive immunity is antigen-specific and has memory, which allows for a faster response upon re-exposure to the same antigen. Answer : True Rationale: Adaptive immunity is characterized by its ability to recognize specific antigens and remember previous encounters, leading to a quicker and more robust response upon subsequent exposures.
12. Multiple Response: Select all the correct statements regarding the role of mast cells in inflammation: a) They release histamine, which contributes to itching and increased mucus production. b) They are primarily found in the central nervous system. c) They can directly kill pathogens without assistance from other immune cells.