Innate Defenses: Inflammation

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Module 3 Exam

If the surface barriers such as the skin or mucus membranes are breached, the second line of defense in innate immunity is the:

A) lymph node.
B) lymphocyte response.
C) inflammatory response.
D) memory cells.

C) inflammatory response.

If the surface barriers are breached, the body's second line of defense is the inflammatory response. Inflammation is considered part of the innate immune response.

hich of the following statements about the skin's role as barrier to infectious microorganisms is false?

A) The melanocytes, which are the pigment-producing cells, have the capacity to ingest microorganisms.
B) Body surface temperatures are cooler than required for optimal bacterial growth.
C) Tight junctions between epithelial cells prevent microorganisms from entering the body.
D) Microorganisms get sloughed off with dead skin.

A) The melanocytes, which are the pigment-producing cells, have the capacity to ingest microorganisms.

There are dendritic cells in the skin that play a role in activating immune and allergic responses; however, the pigment cells of the skin do not play a role in body defense.

The first vascular response in inflammation is:

A) vasoconstriction.
B) vasodilation.
C) increased vascular permeability.
D) decreased vascular permeability.

A) vasoconstriction.

The first response during inflammation is vasoconstriction, which limits bleeding at the site of tissue injury.

What is the purpose of vasodilation and increased vascular permeability during inflammation?

A) To bring white blood cells to the area of injury
B) To transport inflammatory chemicals to the area of injury
C) To dilute toxins
D) All of the above

D) All of the above

The purpose of vasodilation and increased vascular permeability is to dilute toxins and bring white blood cells and chemicals to the area of injury.

The alternative pathway of the complement system is activated by:

A) histamine.
B) antigen-antibody complexes.
C) bacteria.
D) bleeding.

C) bacteria.

The alternative pathway of the complement system is activated by the presence of bacterial cell wall polysaccharides (endotoxin).

Functions of the clotting cascade during inflammation include which of the following?

A) Keeps bacteria close to the inflammatory cells
B) Helps stop bleeding
C) Prevents the spread of infection
D) All of the above

D) All of the above

The clotting cascade keeps bacteria close to the phagocytes, helps stop any bleeding, and prevents the spread of infection or inflammation.

Activation of the clotting system results in the production of:

A) platelets.
B) Hageman factor.
C) platelet-activating factor.
D) fibrin.

D) fibrin.

The clotting system involves activation of a series of clotting factors, resulting in the production of fibrin.

he first cell to react to tissue injury is the:

A) macrophage.
B) mast cell.
C) fibroblast.
D) neutrophil.

B) mast cell.

An inflammatory response to tissue injury is typically initiated by mast cells.

Which of the following stimuli are known to induce mast cell degranulation?

A) Thermal injury
B) The presence of toxins
C) Immunologic tissue injury
D) All of the above

D) All of the above

Any form of cell damage, immunologic injury, or the presence of toxic substances will stimulate mast cells to degranulate.

Which of the following chemicals of inflammation are produced by mast cells from arachidonic acids in the cell membrane after degranulation?

A) Platelet-activating factor
B) Histamine and chemotactic cytokines
C) Leukotrienes and prostaglandins
D) Complement proteins

C) Leukotrienes and prostaglandins

Leukotrienes and prostaglandins, also known as arachidonic acid metabolites, are synthesized by the mast cell after degranulation.

During degranulation the mast cells release chemotactic cytokines that perform which of the following functions?

A) Vasodilation and increased vascular permeability
B) Attraction of neutrophils and eosinophils
C) Activation of the complement cascade
D) Opsonization of bacteria

B) Attraction of neutrophils and eosinophils

Chemotactic cytokines play an important role in inflammation by attracting phagocytes to the site of tissue injury.

In the respiratory system, the release of leukotrienes during an inflammatory response induces:

A) bronchoconstriction.
B) bronchodilation.
C) coughing.
D) free radical formation.

A) bronchoconstriction.

Leukotrienes stimulate bronchial smooth contraction that results in bronchoconstriction. Leukotrienes play an important role in asthma.

The process of a phagocyte squeezing through retracted endothelial cells to enter into the tissues is called:

A) fusion.
B) diapedesis.
C) phagocytosis.
D) margination.

B) diapedesis.

The process of diapedesis is how phagocytes gain entry to the infected or inflamed tissues.

Prior to engulfment of a bacterium during phagocytosis, which of the following events must occur?

A) Release of lysosomal enzymes
B) Fusion
C) Recognition and adherence
D) Formation of a phagolysosome

C) Recognition and adherence

Recognition of the opsonized bacteria and adherence of the bacteria to the phagocyte cell membrane occurs prior to engulfment.

Which of the following cells is responsible for prolonging the inflammatory response and are present at the site of chronic bacterial infections?

A) Neutrophils
B) Eosinophils
C) Macrophages
D) Lymphocytes

C) Macrophages

Macrophages can persist in infected tissues for weeks, months, or even longer.

A monocyte is a circulating white blood cell that transforms into which of the following cells once it enters the tissue during an inflammatory response?

A) Neutrophil
B) Macrophage
C) Mast cell
D) Fibroblast

B) Macrophage

Monocytes must mature into macrophages once they enter the tissues to become active phagocytes.

Which white blood cell plays an important role in inhibiting the inflammatory response?

A) Neutrophil
B) Mast cell
C) Eosinophil
D) Basophil

C) Eosinophil

Eosinophils inhibit inflammation by releasing chemicals that control the vascular effects of histamine.

Under normal conditions, which cell accounts for the greatest percentage of the white blood cell count differential?

A) Neutrophils (PMNs)
B) Monocytes
C) Bands
D) Lymphocytes

A) Neutrophils (PMNs)

Neutrophils (PMNs) account for 55% of the white blood cell count differential.

Which of the following cytokines is an antiinflammatory chemical?

A) IL-1
B) IL-6
C) IL-10
D) TNF-alpha

C) IL-10

The release of IL-10 inhibits inflammation.

ll of the following chemicals will induce a fever during inflammation except:

A) TNF-alpha.
B) IL-1.
C) histamine.
D) prostaglandin E2.

C) histamine.

TNF-alpha, IL-1, and prostaglandin E2 all induce fever by stimulating the hypothalamus. Histamine is not involved in the fever response.

Which of the following inflammatory chemicals are blocked by nonsteroidal antiinflammatory drugs such as ibuprofen?

A) Histamine
B) Prostaglandins
C) Leukotrienes
D) All of the above

B) Prostaglandins

Nonsteroidal antiinflammatory drugs block prostaglandins by inhibiting the cyclooxygenase (COX) 1 and 2 pathway.

Which of the following inflammatory chemicals are responsible for inducing pain during inflammation?

A) Bradykinin and prostaglandins
B) Histamine and chemotactic cytokines
C) Lymphokines
D) Nitrous oxide and platelet-activating factor

A) Bradykinin and prostaglandins

Bradykinin produced through the kinin system and prostaglandins released by the mast cell induce pain during inflammation.

Cells defend against viral invasion through the production and secretion of:

A) histamine.
B) interferon.
C) growth factors.
D) prostaglandins.

B) interferon.

After a host cell is infected by a virus, it releases interferon to signal neighboring cells to boost their viral defenses.

Which of the following molecules are opsonins?

A) Histamine and serotonin
B) Endotoxin and exotoxin
C) Bacteria and parasites
D) Antibodies and complement proteins

D) Antibodies and complement proteins

Antibodies and complement proteins opsonize bacteria and parasites by attaching to the cell membrane.

Opsonization promotes the process of:

A) phagocytosis.
B) vasodilation.
C) increased vascular permeability.
D) clotting.

A) phagocytosis.

Opsonization involves attaching complement proteins or antibodies to a foreign cell's plasma membrane to make it easier for phagocytes to ingest bacteria.

Manifestation of local inflammation includes:

A) edema.
B) pallor.
C) bruising.
D) necrosis.

A) edema.

Increased capillary permeability and the resulting exudation of plasma into the tissue during inflammation results in edema formation.

Warmth and redness of the skin are indicators of inflammation. Which of the following processes is responsible for this clinical manifestation?

A) Increased vascular permeability
B) Phagocytosis
C) Vasoconstriction
D) Vasodilation

D) Vasodilation

Vasodilation increases blood flow to inflamed tissues and is manifested by warmth and redness (blood is warm and red).

Which of the following types of exudate is characterized by the movement of watery fluid, containing few cells and little protein, into the tissues?

A) Fibrinous
B) Serous
C) Purulent
D) Hemorrhagic

B) Serous

A serous exudate is primarily composed of water without the accumulation of cells or proteins.

Which of the following exudates would be present in highest concentration at the site of a persistent bacterial infection?

A) Fibrinous
B) Serous
C) Hemorrhagic
D) Purulent

D) Purulent

Purulent or suppurative exudates contain many leukocytes, which form pus in the exudate of chronically infected tissue.

One systemic manifestation of the acute inflammatory response is fever, which is induced by several mediators, including:

A) histamine.
B) interferon.
C) interleukin 1.
D) nitrous oxide.

C) interleukin 1.

Fever during inflammation is induced by IL-1, IL-6, TNF-alpha, and PGE2.

Which of the following characteristics concerning the acute phase reactant C-reactive protein is (are) true?

A) Produced by the liver
B) Plasma indicator of inflammation
C) Significant risk factor for heart disease
D) All of the above

D) All of the above

Acute-phase reactants such as C-reactive protein are plasma proteins produced by the liver. The presence of these molecules in the plasma is a marker of inflammation and is a known risk factor in the development of coronary heart disease.

Which of the following is a characteristic feature of chronic inflammation?

A) Granuloma formation
B) Bleeding
C) Neutrophilia
D) All of the above

A) Granuloma formation

A granuloma that consists of a wall of macrophages (epithelioid cells) surrounding the inflamed area is characteristic of chronic inflammation.

The first line of defense against pathogens is the:

A) skin and mucous membranes.
B) inflammatory response.
C) primary immune response.
D) hypersensitivity response.

A) skin and mucous membranes.

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