Immune and Lymphatic Systems

1. All of the following organs actively FIGHT pathogens EXCEPT:

a. Cervical lymph nodes
b. Tonsils
c. Spleen
d. Thymus
e. Axillary lymph nodes

2. T lymphocytes gain immunocompetence within the:

a. Bone marrow
b. Thyroid
c. Spleen
d. Bursa of Fabricius
e. None of the above

3. ________ secrete antibodies.

a. Helper T cells
b. Killer T cells
c. Natural killer cells
d. Viruses
e. None of the above

4. All nucleated cells bear __________ proteins on their surface.

a. MHC 1
b. MHC 2
c. MHC 3
d. MHC 4
e. Foreign

5. Which of the following is TRUE?

a. Neutrophils are typically the first WBCs to arrive at a site of infection.
b. Macrophages contain lysosomes which contain digestive enzymes.
c. Eosinophils help defend against parasitic worms.
d. Natural killer cells attack and kill virus infected cells.
e. All of the above

6. Which of the following is NOT a sign of inflammation?

a. Pallor
b. Redness
c. Loss of function
d. Swelling
e. Heat

7. Which of the following is NOT associated with inflammation?

a. Redness
b. Swelling
c. Decreased capillary permeability
d. Vasodilation
e. Pain

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 Immune and Lymphatic Systems

8. The ANP virus has infected a cell. Fragments of viral proteins will be displayed on the surface of the cell
by its ________ proteins and will activate a __________ .
a. MHC2 – Plasma cell
b. MHC1 – Plasma cell
c. MHC1 – Cytotoxic T cell
d. MHC2 – Cytotoxic T cell
e. Interferon – retroviral cell

9. Which of the following is NOT a class of antibodies?

a. IgA
b. IgB
c. IgD
d. IgE
e. IgG

10. Which of the following are functions of the lymphatic system?

1. Removal of excess fluid from tissues
2. Absorption of fat from the digestive tract
3. Defending the body against pathogenic organisms
a. 1, 2, and 3
b. 1 and 3
c. 1 and 2
d. 2 and 3

11. Lymph is moved through lymphatic vessels because of:

a. Skeletal muscle contraction
b. Ventricular contraction
c. Flapping of the lymphatic valves
d. Pumping by the smooth muscle of the lymphatic capillaries

12. Which of the following does NOT empty into the thoracic duct?
a. Lymph from the right leg
b. Intestinal trunk
c. Left jugular trunk
d. Right subclavian trunk

13. As lymph flows through a lymph node, which of the following would it go through LAST?
a. Medullary sinus
b. Subcapsular sinus
c. Afferent lymphatic vessel
d. Cortical sinus

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 Immune and Lymphatic Systems

14. All of the following are functions of the spleen EXCEPT:

a. Production of complement proteins
b. Removal of old RBCs from the blood
c. Storage of blood platelets
d. Fetal RBC production

15. Which of the following is TRUE?

a. Tonsils are entirely surrounded by a connective tissue capsule.
b. Tonsils contain crypts which can help trap pathogens.
c. The palatine tonsil is superior to the pharyngeal tonsil.
d. The lingual tonsils are often referred to as the adenoids

16. Most of the body's mucosa-associated lymphatic tissue can be found in the ________ tract and the
___________ tract.
a. Respiratory and digestive
b. Respiratory and reproductive
c. Gastrointestinal and urinary
d. Reproductive and urinary

17. Which of the following cells produces the fibers that form the structural framework of most lymphatic
organs?
a. Reticular cells
b. Mononuclear fibrocytes
c. Binuclear fibrocytes
d. Macrophages

18. Lymphoid follicles are usually found in all of the following EXCEPT the:
a. Distal small intestine
b. Appendix
c. Lymph node cortex
d. Tonsils
e. All of the above contain lymphoid follicles!

19. Which of the following is TRUE of lymphatic capillaries?

a. They empty into lymphatic collecting vessels.
b. They're practically impermeable to fluid and proteins.
c. They are abundant in teeth and bone.
d. They receive blood directly from venules.

20. There are typically _________ afferent lymphatic vessels entering a lymph node than there are efferent
lymphatic vessels leaving a lymph node. This causes the flow of lymph to ________ as it passes through
the lymph node.
a. More - slow down
b. More - speed up
c. Fewer - slow down
d. Fewer - speed up

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 Immune and Lymphatic Systems

21. Both a B lymphocyte and a Helper T cell respond to antigen Q. Thus, they will probably have a similar
receptor on their surface that can bind to antigen Q.
a. The statement is TRUE.
b. The statement is FALSE

22. The IgM antibody exists as pentamer. This basically means that it consists of 5 antibodies joined together.
Thus the IgM pentamer could bind to how many antigens?
a. 200
b. 10
c. 15
d. 5
e. 20

23. What type of lymphocyte is responsible for antibody-mediated immunity?

a. B lymphocyte
b. Killer T lymphocyte
c. Macrophages
d. Antigen-presenting cells

24. Which of the following is TRUE of neutrophils?

a. They enlarge to become macrophages.
b. They account for most of the dead cells in pus.
c. They're usually the last immune cells to enter infected tissues.
d. They're considered part of the adaptive immune system.

25. The thymus of a young experimental animal was removed. There were no immediate effects, but after 1
year several changes were apparent. Which of the following is the LEAST likely result of the removal of
the thymus?
a. Increased antibody production
b. Decreased Helper T cell count
c. Decreased Cytotoxic T cell count
d. Increased likelihood of acquiring viral infections

26. Complement proteins do which of the following:

1. Activate mast cells
2. Act as chemotactants
3. Form membrane attack complexes
4. Opsonization
a. 1, 2, 3, and 4
b. 1, 2, and 4
c. 1, 2, and 3
d. 2 and 4

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 Immune and Lymphatic Systems

27. Which of the following is NOT a lymphoid organ?

a. Spleen
b. Inguinal lymph node
c. Cervical lymph node
d. Thyroid
e. Palatine tonsil

28. Which of the following is closest to the diaphragm?

a. Lingual tonsil
b. Spleen
c. Peyer's patches
d. Right lymphatic duct

29. Select the TRUE statement.

a. Lymphatic capillaries are involved in the absorption of digested sugars
b. Lymphatic vessels typically have very few valves
c. Compared to blood, lymph has a higher density of red blood cells
d. The expansion and recoil of arteries assists in causing lymph flow
e. Macrophages are NOT an example of lymphoid cells

30. Nonspecific immunity includes all of the following EXCEPT:

a. Lysozyme
b. Neutrophils
c. Interferon
d. Antibodies released by B lymphocytes
e. Complement

31. Which of the following does NOT refer to a tonsil?

a. Palatine
b. Pharyngeal
c. Uvula
d. Lingual
e. Adenoids

Use the following answer choices for the next 10 items.

a. B lymphocyte
b. T lymphocyte
c. B and T lymphocytes
d. Neither B nor T lymphocytes

32. Immune cells that gain immunocompetence in the bone marrow

33. Immune cells that can mature in a mediastinal lymphoid organ more prominent in the fetus than in the
adult

34. They can turn into cells that secrete IgA

35. They can turn into cells that secrete IgM

36. They’re part of the specific immune system

37. An example of these cells is the Langerhans cells of the epidermis

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 Immune and Lymphatic Systems

38. They can release perforins and lymphotoxins

39. They contain a nucleus

40. They mediate humoral immunity

41. They mediate cellular immunity

42. Suppose Joey was exposed to antigen X for the first time, and 2 days later his blood serum contained 2 x
6
10 anti-X antibodies per milliliter. Six months later, Joey is again exposed to antigen X. 2 days after the
6
second exposure, you would expect his serum anti-X antibody concentration to be ____________ 2 x 10
per milliliter.
a. Exactly
b. Greater than
c. Less than

43. In response to B lymphocyte activation, the number of circulating plasma B cells will
__________________ and the number of circulating memory B cells will __________________
a. Increase – Increase
b. Increase – Decrease
c. Decrease – Decrease
d. Decrease – Increase
e. None of the above

44. MHC proteins:

a. Are involved in marking body cells as being “self”
b. Can be found on virtually all cells (Type I)
c. Can be found on antigen-presenting cells (Type II)
d. All of the above
e. None of the above

45. Which of the following associations is CORRECT?

a. Injection of an attenuated pathogen – Artificial active immunity
b. Antibody excretion in breast milk – Natural passive immunity
c. Injection of antibody-containing sera – Artificial passive immunity
d. Generation of memory cells against live pathogens – Natural active immunity
e. All of the above are correct

46. Which of the following is INCORRECT?

a. IgA is a dimer often found in the same secretions as lysozyme
b. IgG can be involved in hemolytic disease of the newborn
c. IgM and IgG can activate complement
d. IgD can be found acting as a receptor protein on the B cell plasma membrane
e. None of the above

47. Which of the following is NOT an autoimmune disease?

a. Multiple sclerosis
b. Myasthenia gravis
c. Type I (insulin dependent) diabetes
d. Rheumatoid arthritis
e. Botulism

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 Immune and Lymphatic Systems

48. Which of the following is NOT a function of complement?

f. Tagging antigen-antibody complexes for phagocytosis
g. Inducing inflammation via glucose release from neutrophils
h. Inducing lysis of pathogenic cells
i. Inducing histamine release from mast cells and basophils
j. None of the above

49. Which of the following would you expect to have the most well developed rough endoplasmic reticulum?
k. Memory B lymphocyte
l. Memory T lymphocyte
m. Plasma T lymphocyte
n. Plasma B lymphocyte
o. Immuno-incompetent B lymphocyte

50. The lymphatic system:

I. Plays no role in nutrient transport
II. Returns interstitial fluid to the vascular system
III. Plays an active role in immune defense

a. I, II, and III are TRUE

b. Only I and II are TRUE
c. Only II and III are TRUE
d. Only I and III are TRUE
e. I, II, and III are all FALSE

51. Which of the following cells could be found in a lymphoid organ?

a. B lymphocytes
b. T lymphocytes
c. Plasma cells
d. Macrophages
e. All of the above

52. Which of the following is TRUE of lymph nodes?

a. There are an average of 35 lymph nodes in the human body
b. Lymph nodes are not surrounded by a connective tissue capsule
c. Lymph nodes are the only lymphoid organs with afferent and efferent lymphatic vessels
d. The number of living microorganisms in an efferent lymphatic vessel is always greater than the number of
living microorganisms in an afferent lymphatic vessel
e. None of the above

53. The spleen:

a. Is the only lymphoid organ in the abdominal cavity
b. Is involved in mineral storage and red blood cell destruction
c. Is served by the splenic artery, which is a branch of inferior mesenteric artery
d. Contains primarily white pulp which is involved in red blood cell synthesis
e. Is the smallest of the lymphoid organs

54. Surgical excision of the thymus would be most detrimental to a(n):

a. 18yo male
b. 18yo female
c. 34yo male
d. 65yo male
e. 2yo male

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 Immune and Lymphatic Systems

55. Which of the following is TRUE of the tonsils?

a. The smallest tonsils are the pterygoid tonsils
b. The lingual tonsils are located in the posterior wall of the nasopharynx
c. The pharyngeal tonsils are referred to as the adenoids
d. The palatine tonsils are the least often infected
e. None of the above

56. Which of the following would deal with an extracellular pathogen in the lymph?
a. B cells and natural killer cells
b. B cells and antibodies
c. Killer T cells only
d. Macrophages only
e. Helper T cells only

57. Which of the following is TRUE?

a. Natural killer cells primarily deal with extracellular non-viral pathogens.
b. Interferons are released from cells that are infected by bacteria.
c. Most phagocytes are derived from lymphocytes
d. The high pH of sweat is detrimental to bacteria
e. None of the above

58. Which of the following is NOT a function of activated complement?

a. Opsonization
b. Costimulation of helper B cells
c. Stimulation of histamine release by basophils
d. Formation of a membrane attack complex
e. Causing lysis of bacterial cells

59. Which of the following is NOT TRUE of fever?

a. It affects mineral storage by the liver or spleen
b. Is caused by pyrogens that act on the hypothalamus
c. Can be caused by increased interleukin-1 release
d. Causes the individual’s metabolic rate to decrease
e. 2 of the above

60. Which of the following is NOT a function of antibodies?

a. Agglutination of cells bearing foreign antigens
b. Production of cytotoxic chemicals such as lymphotoxins and capillary lysozyme
c. Opsonization
d. Activation of complement
e. Neutralization of toxins

61. Assume you found a significant number of an antibody type within an individual’s saliva. You would
expect each of the antibody molecules to be able to bind to ______ antigens.
a. 12
b. 4
c. 16
d. 8
6
e. 3 x 10

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 Immune and Lymphatic Systems

62. Put the following items in correct sequential order.

1. B cell binds and endocytoses its specific antigen
2. B cells differentiate into plasma and memory B cells
3. Helper T cell releases cytokines that activate the B cell
4. Plasma antibody levels rise
5. B cell presents the antigen/MHCII complex

a. 1,4,5,3,2
b. 1,5,3,2,4
c. 1,3,2,5,4
d. 1,5,2,3,4
e. 1,3,5,2,4

63. Anti-A and anti-B antibodies do not attack fetal red blood cells because:
a. IgG antibodies activate complement
b. IgM molecules are physically large pentamer structures
c. Antibodies are not produced during pregnancy
d. IgG antibodies cannot cross the placenta
e. Both A and D are correct

64. Which of the following associations is INCORRECT?

a. Helper T cells – regulate cell-mediated immunity
b. Killer T cells – destroy virus-infected cells
c. Red blood cells – contain hemoglobin and display MHC class I receptors
d. Killer T cells – destroy cancer cells
e. Plasma cells – secrete proteins

65. Julio just caught the dreaded Akoloko virus. Since Chester has already had the Akoloko virus, he offers to
donate some of his memory T cells to Julio to help combat the disease.
a. This idea would work because the memory cells would mount a swift campaign against the virus
since they’ve been exposed to it before
b. This would work and is an example of natural active immunity
c. This would not work because there are no such thing as memory T cells
d. This would not work because Julio would consider Chester’s T cells as foreign
e. Both A and B are correct

66. Fever
a. Can be caused by the release of anti-pyretic chemicals from reticular monocytes
b. Causes a decrease in the body’s metabolic rate by increasing anaphylaxis
c. Causes the liver and spleen to sequester minerals that are necessary for bacterial growth
d. Is caused by a resetting of the body’s “thermostat” which is the located in the ventromedial nucleus of the
thalamus
e. None of the above

67. Interferons:
a. Are nucleic acids released by virally infected cells
b. Are considered part of the specific immune system because they are released in response to viral infection
c. Cause cells to produce a molecule that interferes with viral protein synthesis
d. Are released by an infected cell so that all viruses within it will be destroyed
e. None of the above

68. Complement:
a. When activated will cause a decrease in histamine secretion from basophils and mast cells

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 Immune and Lymphatic Systems

b. When activated can cause bacterial lysis

c. Can only be activated by antigen-antibody complexes
d. All of the above
e. None of the above

69. Chemicals released in response to tissue injury can:

i. Increase the number of circulating white blood cells
ii. Cause local vasodilation
iii. Act as chemotactic factors that attract neutrophils to the site of injury

a. I, II, and III are correct

b. Only I and II are correct
c. Only I and III are correct
d. Only II and III are correct
e. Only II is correct

70. Natural killer cells:

a. Are an integral component of the body’s specific immune defense against viruses
b. Release chemicals that increase the rate of bacterial fission
c. Can be considered fixed macrophages
d. Lack nuclei
e. Release perforins

71. Which of the following is INCORRECT?

a. Neutrophils are capable of phagocytosis
b. A phagosome is cellular organelle that contains high concentrations of digestive enzymes
c. Pseudopods are used to envelop a bacterium during phagocytosis
d. Langerhans cells are found within keratinized stratified squamous epithelium and are free macrophages
e. Kupffer cells of the liver are an example of fixed macrophages

72. Which of the following does NOT help provide protection from pathogens?
a. The acidity of the stomach interior
b. Proteases found within the lumen of the stomach
c. Commensal bacteria found within the gut
d. Lysozyme
e. The high pH of sweat

73. Which of the following is NOT TRUE?

a. The palatine tonsils are found in the posterior oral cavity
b. The lingual tonsils are found on the tongue
c. The pharyngeal tonsils are found in the posterior wall of the nasopharynx
d. The pharyngeal tonsils are referred to as the adenoids when they are inflamed
e. None of the above

74. The thymus:

a. Secretes hormones that promote the maturation of B lymphocytes
b. Functions predominantly in fighting antigens
c. Is not present in an infant
d. Is superior to the diaphragm and often contains adipose tissue in adults
e. None of the above

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 Immune and Lymphatic Systems

75. The spleen:

a. Functions mainly in the removal/destruction of aged or defective red blood cells
b. Cannot be considered a lymphoid organ since it does not filter lymph
c. Is located within the left anterior portion of the thoracic cavity
d. Consists primarily of white pulp which contains a few small islands of red pulp
e. Both A and D are correct

76. Which of the following is CORRECT?

a. The thymus and the thyroid are both lymphoid organs
b. Lymph nodes are the only lymphoid organs that contain lymphocytes
c. All lymphoid organs contain both efferent and afferent lymphatic vessels
d. Peyer’s patches are found within the distal small intestine
e. None of the above

77. Which of the following is TRUE of lymph nodes?

a. They contain more efferent than afferent lymphatic vessels
b. They are surrounded by a capsule made of fibrous epithelial tissue
c. They contain mostly T lymphocytes in their superficial cortex
d. They function as filters of lymph
e. More than one of the above is TRUE

78. Which of the following is TRUE of lymph nodes?

a. There are less than 50 of them in the average adult
b. None are found in the inguinal region
c. They do NOT contain macrophages
d. Their stroma contains reticular fibers
e. None of the above

79. Plasma cells:

a. Are NOT found in lymphoid organs
b. Secrete histamine only
c. Secrete heparin and histamine
d. Secrete antibodies
e. None of the above

80. Lymph is returned to the vascular system:

a. At the azygos vein only
b. At the superior vena cava and the azygos vein
c. At the junction of the subclavian artery and internal jugular artery
d. Only when the body is in a horizontal position
e. None of the above

81. Which of the following is TRUE of lymphatic capillaries?

a. They are not found in bone, teeth, or the small intestine
b. They can assist in nutrient transport
c. They are relatively impermeable to water
d. They are open on both ends
e. None of the above

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 Immune and Lymphatic Systems

82. Which of the following is TRUE of antigens?

a. They are secreted by plasma cells
b. They only react with B lymphocytes
c. They cause the production of non-specific antibodies, i.e., antibodies that can bond up to 1000
different types of antigens
d. All of the above
e. None of the above

83. Which of the following is TRUE?

a. Antigen challenge occurs primarily in the spleen and the liver
b. During clonal selection, more plasma cells are produced than memory cells
c. Langerhans cells and macrophages are both examples of antigen-presenting cells
d. Naïve B cells gain immunocompetence in the thymus
e. 2 of the above are TRUE

84. A decrease in the body’s Helper T cell count would:

I. Not impair clonal selection of B lymphocytes
II. Decrease the body’s ability to fight viral infections
III. Increase the body’s ability to produce activated T8 cells

a. I, II, and III are all correct

b. Only I and II are correct
c. Only II is correct
d. Only I is correct
e. Only II and III are correct

85. Immunity:
a. Can be the result of a bacterial or viral infection
b. Can be a result of IgA antibodies passed to an infant via breast milk
c. Can be due to vaccination
d. All of the above
e. 2 of the above

86. Which of the following is INCORRECTLY matched?

st
a. IgM  1 antibody class typically released by plasma cells
b. IgD  binds to mast cells and basophils and causes histamine release
c. IgG  able to activate complement
d. IgA  found in saliva and tears
e. None of the above

87. Antibodies can cause:

IV. Neutralization of bacterial exotoxins
V. Precipitation of intracellular antigens
VI. Histamine release and a ensuing decrease in inflammation
VII. Agglutination of cell bound antigens

a. I, II, III, and IV are all correct

b. Only I, III, and IV are correct
c. Only II, III, and IV are correct
d. Only I and II are correct
e. Only I and IV are correct

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 Immune and Lymphatic Systems

88. T cells:
a. Primarily respond to free antigens floating in plasma or lymph
b. Can target cancerous cells and cells of transplanted tissue
c. Can react to exogenous but not endogenous antigens
d. All of the above
e. None of the above

89. The presence of a virus inside an intestinal epithelial cell would most likely be detected by:
a. A T8 cell interacting with a class I MHC protein and an attached fragment of viral protein
b. A T8 cell interacting with a class II MHC protein and an exogenous antigen
c. A T4 cell interacting with a class I MHC protein and an attached fragment of viral protein
d. A T4 cell interacting with a class II MHC protein and an endogenous antigen
e. None of the above

90. Which of the following is INCORRECT?

a. T helper cells promote B and T cell proliferation as well as the recruitment of neutrophils and
macrophages
b. T killer cells release perforins which can cause cell lysis
c. Antigen binding is the only event that must occur for T cells to be activated
d. T suppressor cells increase the activity of cytotoxic T cells and natural killer cells
e. None of the above

91. Proteins on the surface of mitral valve cells resemble proteins on the surface of the bacterium
staphylococcus aureus. This:
a. Is beneficial because it will help increase the body’s anti-bacterial defenses
b. Can result in the production of antibodies that target mitral valve cells
c. Is an example of cell-mediated immunity
d. Is an example of passive artificial humoral immunity
e. None of the above

92. The lymphatic system is composed of all of the following EXCEPT:

a. Lymphatic vessels
b. Thyroid gland
c. Spleen
d. Lymph nodes
e. Lymph

93. The majority of the lymph returns to the venous circulation by way of:
a. Right lymphatic duct
b. Thoracic duct
c. Cisterna chyli
d. Dural sinus
e. None of the above

94. ___________ are clusters of lymphatic nodules located beneath the epithelial lining of the small intestine.
a. Tonsils
b. Adenoids
c. Immune complexes
d. Peyer’s patches
e. Red pulp

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 Immune and Lymphatic Systems

95. All of the various macrophages are derived from:

a. Lymphocytes
b. Monocytes
c. Neutrophils
d. Eosinophils
e. Basophils

96. The cells responsible for the production of circulating antibodies are the:
a. T lymphocytes
b. NK cells
c. Plasma cells
d. Mast cells
e. None of the above

97. Stem cells that will form both B lymphocytes and Natural Killer cells are found primarily in the:
a. Liver
b. Spleen
c. Thymus
d. Adrenals
e. Bone marrow

98. The cell that dominates in the cortical region of a lymph node is the:
a. B lymphocyte
b. T lymphocyte
c. Plasma cell
d. NK cell
e. Nodule cell

99. Which of the following is NOT an effect of activation of the complement system?
a. Enhancement of phagocytosis
b. Increased release of histamine by basophils
c. Formation of a membrane attack complex
d. Opsonization
e. None of the above

100. Histamine increases blood flow and vascular permeability. This would account for all of the following
changes that occur during inflammation EXCEPT:
a. Redness of the inflamed tissue
b. Increased number of phagocytes being attracted to the tissue
c. Heat of the inflamed tissue
d. Increased formation of interstitial fluid at the site of injury
e. Both A and C

101. A sample of Ralph’s blood shows a high concentration of pyrogens. This would indicate that Ralph:
a. Has hypotension
b. Is producing T lymphocytes
c. Has a sore throat
d. Is running a fever
e. Has swollen lymph nodes

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 Immune and Lymphatic Systems

102. Lymphatic capillaries are:

a. More permeable than blood capillaries
b. Less permeable than blood capillaries
c. Equally permeable to blood capillaries
d. Completely impermeable

103. When lymphatic vessels are blocked due to tumors, the result is:
a. Shrinkage of tissues distal to the blockage due to inadequate delivery of lymph
b. Severe localized edema distal to the blockage
c. Increased pressure in the lymphatics proximal to the blockage
d. Abnormally high lymph drainage from the distal region
e. Severe localized edema proximal to the blockage

104. Functions of the spleen include all of the following EXCEPT:

a. Removal of old or defective RBCs from the blood
b. Trapping bacteria within epithelia lined crypts
c. Storage of blood platelets
d. Storage of iron
e. 2 of the above

105. Functions of the lymphatic system include:

a. Transport of excess tissue fluid to the blood vascular system
b. Transport of red blood cells to the blood vascular system
c. Maintenance of blood pressure within the venous circulation
d. Excretion of excess dietary fat
e. None of the above

106. The tonsils located at the base of the tongue are the:
a. Pharyngeal tonsils
b. Adenoids
c. Palatine tonsils
d. Labial tonsils
e. None of the above

107. Which of the following is NOT a normal component of lymph?

a. Water
b. Plasma proteins
c. Ions
d. Red blood cells
e. Leukocytes

108. The process whereby neutrophils and other white blood cells are attracted to an inflammatory site is
called:
a. Margination
b. Chemotaxis
c. Diapedesis
d. Chemotaxis
e. Phagocytosis

109. Cancer cells may be destroyed without any action of the specific immune system.
a. The above statement is TRUE
b. The above statement is FALSE

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 Immune and Lymphatic Systems

110. The fact that living bacteria populate our skin:

a. Is always detrimental to homeostasis
b. Helps prevent infection as our resident bacteria compete with pathogenic bacteria
c. Proves that the low pH of the stomach is bacteriostatic
d. Proves that the high pH of the stomach is bacteriostatic
e. None of the above

111. Interferons:
a. Are virus specific, such that an interferon produced against one virus could not protect cells against another
virus
b. Act by increasing the rate of cell division
c. Interfere within intracellular viral multiplication
d. Cannot be considered part of the immune system since they do not provide protection from bacteria
e. None of the above

112. Saliva and lacrimal fluid both contain:

a. Lysosomes, bactericidal organelles
b. Peroxisomes, bactericidal organelles
c. Lysozyme, a bactericidal enzyme
d. Peroxizyme, a bactericidal enzyme
e. Both A and B are correct

113. Which of the following plays NO ROLE in phagocytosis?

a. Pseudopods
b. Monocytes
c. Phagosomes
d. Phagolysosomes
e. None of the above

114. Certain complement molecules called C3b coat the surface of a bacterium and roughen its surface,
enabling macrophages and neutrophils to phagocytize the organism. This phenomenon would most likely
be termed:
a. Autolysis
b. Catalysis
c. Antibody-mediated phagocytosis
d. Opsonization
e. Both A and C are correct

115. Lymphatic capillaries do NOT play a role in nutrient absorption and delivery.
a. The above statement is TRUE
b. The above statement is FALSE

116. Damaged tissues release vasodilators as well as chemicals that induce leukopenia.
a. The above statement is TRUE
b. The above statement is FALSE

117. Fever:
a. Is a higher than normal body temperature that is always dangerous
b. Decreases the body’s metabolic rate so as to conserve energy
c. Is caused by the resetting of the body’s hypothalamic thermostat
d. Causes the liver to release copious amounts of iron, which inhibits bacterial reproduction and enzyme
synthesis
e. Is a higher than normal body temperature that is never dangerous

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 Immune and Lymphatic Systems

118. Immunity that results from antibodies that pass the placenta from mother to fetus is
called__________________ immunity.
a. Active
b. Natural passive
c. Artificial passive
d. Auto
e. Inconsequential

119. Suppressor T cells act to:

a. Suppress antigens.
b. Limit the degree of memory in memory T cells.
c. Limit antigen proliferation.
d. Depress the responses of other T cells and B cells.
e. Produce antibodies involved in autoimmunity

120. Immunoglobulins that attach to mast cells and basophils and are involved in allergic reactions are:
a. IgA.
b. IgD.
c. IgE.
d. IgG.
e. IgM

121. Immunoglobulins that are found on the surface of B cells and may play a role in regulation of the humoral
immune response are:
a. IgA.
b. IgD.
c. IgE.
d. IgG.
e. IgM

122. The binding of an antigen to an antibody can result in:

a. Neutralization of the antigen.
b. Agglutination or precipitation.
c. Complement activation and opsonization.
d. A and B only.
e. All of the above

123. When an antigen is bound to a Class I MHC molecule, it can stimulate a:

a. B cell
b. Plasma cell
c. Helper T cell
d. Cytotoxic T cell
e. NK cell

124. Helper T cells do all of the following EXCEPT:

a. Promote B-cell division, plasma cell maturation, and antibody production.
b. Encode the antigenic genetic information for use during future exposures to the antigen.
c. Stimulate T-cell divisions that produce memory T cells and accelerate maturation of cytotoxic T
cells.
d. Attract and stimulate the activity of NK cells.
e. Enhance nonspecific defenses.

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 Immune and Lymphatic Systems

125. The following are steps in the cell-mediated immune response.

1. Several cycles of mitosis occur

2. Antigen is engulfed and presented by a macrophage
3. Cytotoxic T cells migrate to focus of infection
4. Differentiated T cells with specific receptors recognize the antigen
5. Cytotoxic T cells release perforin and/or lymphotoxin

The correct sequence for these steps is:

a. 4, 1, 5, 3, 2
b. 2, 4, 1, 5, 3,
c. 1, 2, 4, 5, 3,
d. 3, 2, 4, 1, 5,
e. 3, 4, 5, 1, 2

126. The only antibodies that normally cross the placenta are:
a. IgA.
b. IgD.
c. IgE.
d. IgG.
e. IgM

127. In an experimental situation, a virus is injected into a rabbit and the rabbit is allowed to make antibodies
for the viral antigen. These antibodies are then removed from the rabbit plasma and injected into a
human to help deal with the same viral disease. This would be an example of:
a. Innate immunity.
b. Active immunization.
c. Passive immunization.
d. Natural immunity.
e. Autoimmunity.

128. A decrease in which population of lymphocytes would impair all aspects of an immune response?
a. Cytotoxic T cells
b. Helper T cells
c. Suppressor T cells
d. B cells
e. Plasma cells

129. A fluid sample contains a large amount of IgA type antibody. This fluid is probably:
a. Blood.
b. Lymph
c. Serum
d. Tears.
e. Intracellular.

130. Which of the following is characteristic of antibodies?

a. Carbohydrate structure
b. Composed of heavy and light polypeptide chains
c. 3 antigen binding sites per antibody monomer
d. Incapable of being transferred from one individual to another
e. Both C and D are correct

18
 Immune and Lymphatic Systems

131. In clonal selection of B cells, which of the following is responsible for determining which cells eventually
become cloned?
a. Antigen
b. Lymphocyte
c. Antibody
d. Macrophage
e. IgA

132. The only T cell population that can directly attack and kill other cells are the:
a. Suppressor cells
b. Helper cells
c. CD4 cells
d. Cytotoxic cells
e. Plasma cells

133. Helper T cells:

a. Bind tightly to target cells and release perforins as well as tumor necrosis factor
b. Often function to decrease the immune response
c. Perform one function only; they release B234 proteins
d. Are often involved in clonal selection of B lymphocytes
e. 3 of the above are correct

134. The primary immune response:

a. Occurs more rapidly and is stronger than the secondary immune response
b. Occurs only when memory cells are stimulated
c. Is another name for immunological memory
d. Has a lag period where B cells proliferate and differentiate into plasma cells
e. None of the above

135. Which of the following is TRUE?

a. There are more erythrocytes found in lymph vessels than in blood vessels
b. Lymphatic capillaries are typically less permeable than blood capillaries
c. Most lymphatic capillaries are found in bone tissue and nervous tissue
d. Lymphatic capillaries called lacteals may contain digested fats
e. Lymphatic vessels resemble veins but they lack valves

136. Which of the following is TRUE?

a. Lymph drains into the vascular system at the right atrium
b. Lymph from the left leg will eventually enter the thoracic duct
c. Lymph from the right leg will eventually enter the right lymphatic duct
d. Lymphatic vessels lack epithelial tissue and muscle tissue
e. More than one of the above

137. Which of the following associations is INCORRECT?

a. B lymphocytes – differentiate into plasma cells
b. T lymphocytes – can kill virus-infected cells
c. Macrophages – contain MHC class II proteins
d. Reticular cells – produce reticular fibers
e. None of the above

19
 Immune and Lymphatic Systems

138. Lymphoid tissue:

a. Is often found beneath mucous membranes
b. Is a tissue that lacks cells
c. Is NOT found within the digestive tract
d. Usually functions to promote bacterial and viral replication
e. 2 of the above

139. Lymph nodes:

a. Are only found in the cervical, inguinal, and axillary regions
b. Are NOT surrounded by a connective tissue capsule
c. Have a cortex that will contain B lymphocytes
d. Typically have more efferent lymph vessels than afferent lymph vessels
e. All of the above

140. The spleen:

i. Is superior to all of the external intercostals
ii. Plays a role in RBC recycling
iii. Stores platelets and iron

a. i, ii, and iii

b. i and ii
c. i and iii
d. ii and iii
e. ii only

141. A lack of a functioning thymus:

a. Would prevent B cell production
b. Would prevent B cell maturation
c. Would have a detrimental effect on the humoral immune system
d. Would affect T cell production, but would not affect T cell maturation
e. All of the above

142. Which of the following is TRUE of the tonsils?

a. All are superior to the soft palate
b. None are superior to the oropharynx
c. The lingual tonsil is the largest and the most often infected
d. Tonsils contain follicles overlain by epithelial crypts
e. 2 of the above

143. Which of the following makes skin an excellent barrier to pathogens?

a. Presence of sweat
b. Presence of sebum
c. Presence of keratin
d. The fact that it is multi-layered
e. All of the above

144. Which of the following is NOT TRUE?

a. Secretions such as saliva contain lysozyme, an anti-bacterial chemical
b. The stomach’s low pH helps destroy pathogens
c. Interferon is produced by certain virus-infected cells
d. Macrophages in the liver and in the skin are derived from monocytes
e. Natural killer cells destroy virus-infected cells as part of the specific immune response

20
 Immune and Lymphatic Systems

145. Which of the following is NOT TRUE of the complement system?

a. Complement proteins are produced by the liver
b. Inactive complement proteins are always found in the plasma
c. Activated complement proteins bind to bacteria and thus decrease the likelihood of them being
phagocytosed
d. Activated complement can cause cell lysis
e. Activated complement can cause an increase in local histamine release

146. Which of the following is involved in natural passive immunity?

a. Vaccination
b. Injection of human antibodies into an individual
c. Injection of rabbit antibodies into an individual
d. Excretion of antibodies into breast milk
e. Producing memory cells in response to infection with a live virus

147. The specificity of T and B lymphocytes is determined by:

a. Their surface receptors
b. Their nuclear receptors
c. Their mitochondria
d. All of the above
e. 2 of the above

148. Class I MHC proteins:

a. Are found on all blood cells
b. Display protein fragments on a cell’s surface
c. Are only involved in bacterial infections
d. Are not found on macrophages
e. Are recognized primarily by Helper T cells

149. In order for a naïve T cell to be activated:

a. It must be immunocompetent
b. It must recognize a specific antigen
c. It must recognize an MHC protein
d. It must be “costimulated”
e. All of the above

150. Killer T cells:

I. Are produced in red bone marrow
II. Destroy virus-infected cells
III. Destroy cancerous cells

a. I and II only
b. I and III only
c. II only
d. I, II, and III
e. II and III only

151. Which of the following is NOT TRUE of Helper T cells?

a. They play a role in B cell activation
b. They can stimulate neutrophils
c. They can stimulate natural killer cells
d. They are destroyed by the HIV virus
e. All of the above are TRUE

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 Immune and Lymphatic Systems

152. Antibodies:
a. Are produced by plasma cells and helper T cells
b. Are nonspecific
c. Contain a single antigen binding site
d. Can neutralize bacterial toxins
e. 2 of the above

153. Antibodies can cause:

a. Agglutination by linking cellular antigens
b. Precipitation by linking soluble antigens
c. Lysis by activating complement which can then form a membrane attack complex
d. All of the above
e. 2 of the above

154. In a disorder known as congenital thymic aplasia, the thymus fails to develop. Which of the following
would be the most likely consequence of this disorder?
a. An elevated number of mature helper T cells in the body.
b. A lack of functioning immunocompetent T lymphocytes
c. An inability to regulate stroke volume in response to changes in blood pressure.
d. An enhanced ability to fight infection.
e. An elevated number of lymph nodes in the lumen of the proximal esophagus.

155. Which of the following signs of inflammation are primarily caused by increased local blood flow and
increased local capillary permeability?
a. Redness
b. Heat
c. Swelling
d. All of the above
e. Only 2 of the above

156. Which of the following is a normal constituent of plasma, lymph, and interstitial fluid?
1. Water
2. Proteins
3. Red blood cells

a. 1, 2, and 3
b. 1 only
c. 2 only
d. 1 and 2
e. 1 and 3

157. Which of the following would you expect to be present in greatest amounts in the mucus of the
respiratory tract?
a. Lymph nodes
b. IgA antibodies
c. Red blood cells
d. IgD antibodies
e. Immunoincompetent T lymphocytes

22
 Immune and Lymphatic Systems

th
158. Below is a graph showing John Doe’s immune response to antigen Q on March 7 , 1999.

Plasma antibody
concentration

Time (days)

Which of the following graphs most likely represents John Doe’s response to antigen Q on
st
December 1 , 1998, when he was exposed to the antigen for the first time?

B
A

C D

159. Activated complement:

a. Enhances phagocytosis.
b. Promotes lysis of bacterial cells.
c. Stimulates basophils and mast cells to release histamine.
d. Acts as an opsonin.
e. All of the above

160. The only antibody that could attack the Rh complexes on fetal red blood cells is the:
a. IgG antibody
b. IgA antibody
c. IgE antibody
d. IgM antibody
e. IgD antibody

161. The Human Immunodeficiency Virus destroys Helper T cells. This will:

23
 Immune and Lymphatic Systems

1. Increase the efficiency of the body’s cell-mediated immune response.

2. Decrease the efficiency of the body’s humoral immune response.
3. Have no effect on the nonspecific immune response.

a. 1, 2, and 3
b. 1 only
c. 2 only
d. 1 and 3
e. 2 and 3

162. Which of the following associations is CORRECT?

a. Injection of a weakened pathogen – Artificial active immunity
b. Antibody excretion in breast milk – Natural passive immunity
c. Injection of antibody-containing sera – Artificial passive immunity
d. Generation of memory cells against live pathogens – Natural active immunity
e. All of the above are correct

163. __________ released from basophils and mast cells causes ___________.
a. Histamine; vasoconstriction
b. Histamine; vasodilation
c. Nitrous oxide; vasodilation
d. Prostaglandin; vasoconstriction
e. Leukocytosis-inducing factor; hyperemia

164. Which of the following are NOT part of the nonspecific immune system?
a. Complement and interferon
b. Skin and mucous membranes
c. Fixed macrophages and lysozyme
d. IgA and IgG
e. Natural killer cells and fever

165. Which of the following is TRUE?

a. Killer T cells can destroy virus-infected cells by releasing perforins.
b. Substances that can provoke an immune response are called kinins.
c. Antibodies are produced primarily by Suppressor T cells.
d. Class I MHC proteins are found only on antigen-presenting cells.
e. Class I MHC proteins are found on red and white blood cells.

166. A cell that has been infected with a virus will:

a. Release antibodies.
b. Display viral protein fragments along with a MHC I protein
c. Display viral protein fragments along with a MHC II protein
d. Always release lysozyme and complement proteins
e. None of the above

167. When the body fails to differentiate between self and foreign antigens:
a. Acquired immunodeficiency is the result.
b. It is because the body lacks T cells.
c. Autoimmune disease results
d. It is because the body contains too many neutrophils.
e. The body’s nucleated cells will stop all protein production.

168. The manner in which an antigen-antibody complex is eliminated is determined by the particular:

24
 Immune and Lymphatic Systems

a. Binding sites on the antibody’s variable regions

b. Binding sites on the antibody’s constant regions
c. Binding sites on the antigen’s variable regions
d. Binding sites on the antigen’s constant regions

169. Lymph normally would NOT contain:

a. Proteins
b. WBCs
c. Water
d. RBCs
e. Bacteria

170. Which of the following is NOT TRUE?

a. There are no “lymphatic arteries”
b. Lymphatic capillaries are more permeable than blood capillaries
c. Lymphatic capillaries and blood capillaries are found in bone and teeth.
d. Lymphatic capillaries called lacteals are involved in fat absorption.
e. Lymphatic vessels contain valves.

171. Which of the following is TRUE?

a. Lymphatic vessels pass through lymph nodes.
b. There are only 2 lymphatic ducts.
c. The thoracic duct begins as the cisterna chyli
d. Blockage of the right lymphatic duct could cause the right arm to swell.
e. All of the above

172. An inability to move lymph could result in edema.

a. The above statement is TRUE
b. The above statement is FALSE

173. Which of the following is TRUE?

a. Plasma cells secrete antibodies
b. Dendritic cells assist in activating the immune response
c. Diffuse lymphatic tissue is rare in the mucous lining of the digestive tract
d. All of the above
e. 2 of the above

174. Which of the following is NOT a lymphoid organ?

a. Thymus
b. Thyroid
c. Pancreas
d. Lymph node
e. 2 of the above

175. Which of the following is NOT TRUE?

a. There are 100’s of lymph nodes within the body.
b. Each lymph node is surrounded by a dense connective tissue capsule.
c. Reticular fibers help support lymphocytes and macrophages within a lymph node.
d. The lymph node cortex primarily contains B lymphocytes
e. There are fewer afferent lymphatic vessels than efferent lymphatic vessels

176. Which of the tonsils is the most superior?

25
 Immune and Lymphatic Systems

a. Palatine
b. Labial
c. Pharyngeal
d. Lingual
e. Choroidal

177. Peyer’s patches are found in the:

a. Proximal stomach
b. Distal small intestine
c. Liver
d. Pancreas
e. Rectum

178. Which of the following is TRUE of the tonsils?

a. The most superior are the palatine tonsils.
b. The lingual tonsils are often referred to as the adenoids.
c. Tonsils are totally covered by a connective tissue capsule.
d. The structure of tonsils facilitates exposure to bacteria for the purpose of building immunological memory.
e. 2 of the above.

179. Which of the following is TRUE of the thymus?

a. Surgical removal of the thymus from a 3 month old child could affect B lymphocyte development, but NOT T
lymphocyte development.
b. An adult thymus will contain more adipocytes than the thymus of a 13yr old.
c. The thymus is the only lymphoid organ that directly fights pathogens.
d. The thymus is located anterior to the sternum and inferior to the diaphragm.
e. The thymus is the only example of diffuse lymphatic tissue in the thoracic cavity.

180. Which of the following is TRUE of the spleen?

a. The spleen is located in the lower right hand quadrant of the abdominal cavity.
b. The spleen consists primarily of white pulp, which functions in RBC recycling.
c. The spleen is the only lymphoid organ that entirely lacks white blood cells.
d. If the spleen is surgically removed, many of its blood cleansing functions can be taken over by the liver.
e. The spleen is the only lymphoid organ that contains both afferent and efferent lymphatic vessels.

181. The majority of the body’s lymph drains from the:

a. Right lymphatic duct into the right subclavian vein
b. Left lymphatic duct into the left subclavian artery
c. Thoracic duct into the right subclavian vein
d. Cisterna chyli into the abdominal vena cava
e. Right lymphatic duct into the thoracic duct

182. Which of the following cells is correctly matched with its function?
a. Macrophages – perform phagocytosis
b. Plasma cells – secrete antibodies
c. Reticular cells – activate the immune system in response to infection
d. All of the above
e. Two of the above

183. Which of the following is NOT a lymphoid organ?

26
 Immune and Lymphatic Systems

a. Thyroid
b. Thymus
c. Pancreas
d. Palatine tonsil
e. 2 of the above

184. Which of the following is TRUE?

a. Inflammation is a specific immune response.
b. Saliva contains antibacterial chemicals.
c. The CNS lacks phagocytic cells.
d. A phagosome is an organelle that contains digestive enzymes and is found in all cells.
e. Complement proteins are primarily made by the red bone marrow.

185. Which of the following is TRUE?

a. Activated complement can cause bacterial cell lysis.
b. An inflamed area appears red because of decreased local blood flow.
c. During a fever, the liver and spleen release prodigious amounts of zinc into the plasma.
d. T lymphocytes are made in the thymus but they mature in the red bone marrow.
e. 2 of the above

186. Which of the following could play a role in destroying a foreign antigen in the plasma?
I. Antibodies
II. Immunoglobulins
III. Plasma cells
IV. Helper T cells

a. I, II, III, and IV

b. I, II, and III only
c. I, III, and IV only
d. I, II, and IV only
e. I and III only

187. Which of the following is most related to artificial active immunity?

a. Transfer of IgG antibodies from mother to fetus across the placenta.
b. Production of memory lymphocytes in response to an infection with the bacterium,
Streptococcus mutans.
c. Transfer of IgA antibodies from mother to infant via breast milk.
d. Production of memory lymphocytes in response to the Variola virus, which was deliberately
injected into the body.
e. None of the above are related to active artificial immunity.

188. Which of the following is NOT TRUE of antibodies?

a. They are synthesized by plasma cells.
b. They are involved in humoral immunity.
c. They are shaped like the letter Y.
d. They are specific for antigens.
e. There are four major classes.

189. If a virus invaded a muscle cell, that muscle cell would:

27
 Immune and Lymphatic Systems

a. Display fragments of viral proteins on its MHC I protein.

b. Display fragments of viral proteins on its MHC II protein.
c. Begin making viral proteins and nucleic acids (e.g., DNA, RNA).
d. Release activated complement.
e. Both A and C are correct.

190. Which of the following is NOT TRUE?

a. Sebum is bactericidal.
b. Free macrophages are derived from monocytes.
c. A lysozyme is an organelle that contains digestive enzymes.
d. Pathogens are disease-causing organisms.
e. Keratin is resistant to bacterial enzymes.

191. Which of the following cells destroys body cells that have been infected by a virus?
a. Monocytes
b. Natural killer cells
c. B lymphocytes
d. Eosinophils
e. Alveolar macrophages

192. Interferon:
a. Is produced by cells in response to high plasma levels of pyrogens.
b. Is made only by the cells of the thymus.
c. Actively kills bacteria and viruses.
d. Helps to prevent viral replication.
e. None of the above.

193. Which of the following is NOT a possible result of activated complement?

a. Formation of a membrane attack complex.
b. Lysis of bacterial cells.
c. Opsonization.
d. Inflammation.
e. All of the above are possible results of complement activation.

194. Serious chronic inflammation may result in the formation of:

a. Pyrogens
b. Pus
c. Mucus
d. Cilia
e. Interferon

195. Which of the following does NOT occur during a fever?

a. WBC function is increased.
b. Bacterial metabolism is impaired.
c. Plasma zinc levels rise.
d. Plasma iron levels fall.
e. Body temperature rises.

196. Which of the following common signs of inflammation could be caused by increased local blood flow?

28
 Immune and Lymphatic Systems

a. Pain
b. Swelling
c. Heat
d. Redness
e. All of the above

197. Which of the following is TRUE?

a. Palatine tonsils are located on the anterior edge of the nasal cavity.
b. The lingual tonsils contain no lymphocytes at all.
c. The pharyngeal tonsils are sometimes referred to as the adenoids.
d. The spleen is the largest lymphoid organ in the thoracic cavity.
e. The thymus is the site of B lymphocyte production and maturation.

198. The major function of the ____________ is blood “cleansing.”

a. Thymus
b. Spleen
c. Peyer’s patches
d. Lymph nodes
e. Cortex

199. Which of the following is NOT TRUE?

a. The majority of the spleen is composed of white pulp, lymphocytes suspended on reticular fibers.
b. The cortex of a lymph node is packed with lymphoid follicles.
c. Large superficial clusters of lymph nodes are found in the axillary, cervical, and inguinal regions.
d. Lymphoid organs are characterized by a connective tissue capsule.
e. Diffuse lymphatic tissue is prominent within mucous membranes.

200. The cells that produce the connective tissue framework of most lymphoid organs are the
______________.
a. Endothelial cells
b. Fibrocytes
c. Histiocytes
d. Reticular cells
e. None of the above

201. The specialized lymphatic capillaries found in the intestinal villi are known as:
a. Entrails
b. Lymphoids
c. Lacteals
d. Thymosins
e. None of the above

202. Which of the following is TRUE?

a. Lymphatic capillaries are present in both teeth and bone.
b. Blood capillaries are more permeable than lymphatic capillaries.
c. There are fewer valves found in arteries than found in lymphatic vessels.
d. Lymph from the right leg will empty into the right subclavian vein.
e. Lymph from the left leg will empty into the right subclavian vein.

203. Which of the following is TRUE?

29
 Immune and Lymphatic Systems

a. There are usually more proteins in lymph than in plasma.

b. Lymphatic capillaries in the kidneys are known as lacteals.
c. The thoracic duct will receive lymph that was formed in the right kidney.
d. Lymph empties into the vascular system near the beginning of the subclavian arteries.
e. Differentiated T lymphocytes are referred to as plasma cells.

204. Which of the following is TRUE?

a. Reticular cells are an example of an antibody-secreting leukocyte.
b. Diffuse lymphatic tissue is prominent within mucous membranes.
c. Lymphoid follicles are usually surrounded by a connective tissue capsule.
d. Several regions of the body lack lymph nodes, including the axillary, cervical, and lumbar areas.
e. There are typically more efferent lymphatic vessels than afferent lymphatic vessels associated
with a lymph node.

205. Which of the following is TRUE?

a. The spleen is located on the left side of the abdominal cavity just superior to the diaphragm.
b. The primary function of the spleen is erythropoiesis.
c. The majority of the spleen consists of white pulp.
d. Surgical removal of the thymus would be more detrimental to a 35yo than to a 5yo.
e. The pharyngeal tonsils are found in the posterior nasopharynx.

206. Which of the following is TRUE?

a. Activated complement proteins are involved in opsonization.
b. Sweat and sebum typically promote bacterial reproduction.
c. Phagocytosis is only performed by macrophages.
d. Interferon acts to inhibit cellular production of viral proteins.
e. More than one of the above

207. Which of the following is TRUE?

a. The body’s “thermostat” is located in the frontal lobe of the cerebrum.
b. A rise in body temperature would accelerate bacterial metabolism.
c. The passage of antibodies from mother to fetus is an example of natural active immunity.
d. Injection of antibodies is an example of artificial active immunity.
e. None of the above

208. Which of the following is TRUE?

a. T lymphocytes acquire immunocompetence in the thymus.
b. All T lymphocytes will display the same surface receptors.
c. All nucleated cells contain class II MHC proteins on their surface.
d. Helper T cells are also referred to as CD8 cells.
e. More than one of the above.

209. Which of the following is TRUE?

a. Killer T cells release perforins to kill infected cells.
b. Helper T cells release cytokines that can affect the activity of other immune cells.
c. Each antibody typically contains 2 antigen binding sites.
d. IgA antibodies are often found in bodily secretions.
e. All of the above

210. Lymphatic capillaries:

30
 Immune and Lymphatic Systems

a. Are less permeable than blood capillaries.

b. Are found primarily in bone and teeth.
c. Play a role in fat absorption in the intestines.
d. Contain 33% fewer RBCs compared to blood capillaries.

211. Which of the following is TRUE?

a. Lymphatic vessels lack valves.
b. An increase in skeletal muscle activity will increase lymph flow.
c. The thoracic duct drains both the right arm and the right leg.
d. The thoracic duct drains both the right and left arms.
e. The right lymphatic duct begins as an enlarged sac called the cisterna chyli.

212. Which of the following is an INCORRECT match?

a. Reticular cells  produce reticular fibers
b. Dendritic cells  help activate the immune response
c. B lymphocytes  differentiate into plasma cells
d. Natural killer cells  secrete antibodies
e. Macrophages  contain lysosomes

213. Lymph nodes:

a. Typically have more efferent than afferent lymphatic vessels.
b. Contain reticular cells and lymphocytes and function to cleanse lymph.
c. Are only found in the inguinal, cervical, and axillary regions.
d. Are shaped like a biconcave disk.
e. Have a cortex and medulla but lack a connective tissue capsule.

214. The spleen:

a. Typically performs erythropoiesis in adults.
b. Is involved in T lymphocyte maturation.
c. Is located just deep to the stomach and superior to the diaphragm.
d. Removes old and defective RBCs from the blood stream.
e. All of the above.

215. The adult thymus:

a. Is more active than the infant thymus.
b. Contains adipocytes and fibrous connective tissue.
c. Directly removes pathogens from the lymphatic circulation.
d. Has both afferent and efferent lymphatic vessels.
e. Is an avascular tissue.

216. Which of the following is the most SUPERIOR?

a. Pharyngeal tonsil
b. Peyer’s patch
c. Axillary lymph nodes
d. Palatine tonsil
e. Thymus

217. The spleen is found on the _________ side of the abdominal cavity just __________ to the stomach.
a. Right – medial
b. Right – lateral
c. Left – medial
d. Left – lateral
218. Which of the following is TRUE of the tonsils?

31
 Immune and Lymphatic Systems

a. The pharyngeal tonsil is the most inferior.

b. The palatine tonsils are found just under the tongue.
c. Tonsils are characterized by the presence of crypts.
d. Tonsils usually do not contain any lymphocytes.
e. Tonsils are fully encapsulated by connective tissue.

219. Large lymphoid follicles found in the ______________ are known as Peyer’s patches.
a. Proximal colon
b. Distal small intestine
c. Stomach
d. Appendix
e. Rectum

220. Mycobacterium bovis is a weakened, non-pathogenic form of the bacterium that causes tuberculosis.
Upon injection, macrophages engulf and destroy them and use the resulting debris to prime the acquired
immune system. The macrophages would display the pieces of digested bacteria on their:
a. MHC I proteins
b. MHC II proteins
c. MHC III proteins
d. Antigen receptors
e. Golgi apparatus

221. Which of the following cells is responsible for the production of the fibrous framework of most lymphatic
organs?
a. Dendritic cells
b. Lymphocytes
c. Monocytes
d. Reticular cells
e. Hemocytoblasts

222. Which of the following would NOT be drained by the thoracic duct?
a. Right lumbar trunk
b. Left bronchomediastinal trunk
c. Lymph from the right leg
d. Right jugular trunk
e. Intestinal trunks

223. Which of the following is NOT a function of the lymphatic system?

a. Immune defense
b. Return of interstitial fluid to the bloodstream
c. Return of leaked plasma proteins to the bloodstream.
d. Absorption of dietary fat in the small intestine
e. All of the above ARE functions of the lymphatic system

224. Antibodies are produced by _____________.

a. Dendritic cells
b. Memory B cell
c. Killer T cells
d. Plasma cells
e. Macrophages

225. The primary function of the spleen is:

32
 Immune and Lymphatic Systems

a. Blood pressure and volume regulation

b. Filtering of damaged and old erythrocytes from the bloodstream.
c. Production of platelets and granulocytes
d. Storage of iron, zinc, and mercury.
Production of epinephrine

226. Which of the following help skin function as an effective pathogen barrier?
I. Sebum
II. Sweat
III. Keratin
IV. Stratified epithelium

a. I, II, III, and IV

b. I, II, and III only
c. I, II, and IV only
d. I and II only
e. IV only

227. Which of the following is NOT TRUE?

a. Lysozyme is an antibacterial chemical found in saliva and tears.
b. Alveolar macrophages are descended from monocytes.
c. Cilia line portions of the respiratory tract.
d. Inflammation is typical of a nonspecific immune response.
e. All of the above are TRUE.

228. Binding of _____________ to bacteria can _______________ the likelihood of phagocytosis.

a. Antibodies: decrease
b. Antigens: decrease
c. Antigens: increase
d. Complement proteins: increase
e. Complement proteins: decrease

229. Interferons:
a. Are released by virus infected cells
b. Stimulate cells to produce antiviral proteins
c. Are an example of activated complement proteins
d. All of the above
e. 2 of the above

230. Which of the following is TRUE?

a. Complement proteins are produced by plasma cells.
b. Activated complement proteins can cause increased histamine levels.
c. The heat and redness characteristic of inflammation are usually due to local ischemia.
d. Inflammatory chemicals usually cause a decrease in plasma WBC levels.
e. None of the above

231. Lymphatic collecting vessels are linked to lymphatic ducts by:

a. Lymphatic capillaries
b. Lacteals
c. Lymphatic trunks
d. Lymphatic arteries
e. Anastomoses

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 Immune and Lymphatic Systems

232. Cells of the innate branch of the immune system that target virus-infected cells and cancerous cells are
the:
a. Killer T cells
b. Helper T cells
c. Antigen-presenting cells
d. Natural killer cells
e. Plasma cells

233. Which of the matches is INCORRECT?

a. Lysozyme – secreted in saliva
b. Lysosome – contains lysozyme
c. Complement proteins – form membrane attack complexes
d. CD4 cells – Killer T cells
e. All of the above ARE CORRECT.

234. The transfer of plasma antibodies from mother to infant via breast milk is an example of what type of
immunity?
a. Natural active
b. Natural passive
c. Artificial active
d. Artificial passive
e. None of the above

235. Which of the following is NOT an attribute of skin that helps it act as a barrier to pathogens?
a. Stratification
b. Keratin
c. Cilia
d. Sweat
e. Sebum

236. The majority of cells produced in response to the clonal selection of a B lymphocyte are:
a. Memory B cells
b. Plasma cells
c. Dendritic cells
d. CD8 cells
e. CD4 cells

237. Which of the following is NOT caused by activated complement proteins?

a. Bacterial cell lysis
b. Stimulation of mast cells
c. Stimulation of basophils
d. Opsonization
e. All of the above ARE caused by activated complement proteins

238. Nonspecific immunity includes all of the following EXCEPT:

a. Immunoglobulins
b. Complement
c. Interferons
d. Neutrophils
e. 2 of the above

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 Immune and Lymphatic Systems

239. Put the following in the correct order for lymph flow:
1. Subcapsular sinus
2. Afferent lymphatic vessel
3. Cortical sinus
4. Efferent lymphatic vessel
5. Medullary sinus

a. 1,2,3,4,5
b. 2,1,3,5,4
c. 2,3,5,1,4
d. 3,2,5,1,4
e. None of the above are correct

240. Which of the following is the most SUPERIOR?

a. Lingual tonsil
b. Thymus
c. Right lymphatic duct
d. Pharyngeal tonsil
e. Peyer’s patches

241. Mr. Reich was infected with Clostridium difficile. In response, his adaptive immune system produced
antibodies. This type of immunity is…
a. Natural but not active
b. Passive but not natural
c. Active but not artificial
d. Active and passive
e. Artificial but not passive

242. Which of the following would contain the greatest concentration of digestive enzymes?
a. Phagosome
b. Opsonin
c. Lysosome
d. Interferon
e. Complement

243. Which of the following is/are true of dendritic cells?

a. They are capable of phagocytosis
b. They present antigens to T lymphocytes
c. They contain MHC 1 proteins
d. They contain MHC 2 proteins
e. All of the above

244. The linking of soluble antigens by antibodies is known as:

a. Agglutination
b. Self lysis
c. Neutralization
d. Aggrandization
e. Precipitation

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 Immune and Lymphatic Systems

245. Which of the following is NOT an antibody class?

a. IgE
b. IgD
c. IgF
d. IgA
e. IgG

246. Alexander Fleming made a serendipitous discovery. One day when he was suffering from a cold, he
sneezed on a bacterial culture of Micrococcus lysodeikticus. Following his usual routine of leaving his
bacterial cultures lying about, 10 days later he observed that the bacteria near his own nasal mucus had
dissolved. The best explanation for this is that:
a. His mucus contained large quantities of lysozyme
b. His mucus had a low osmotic pressure
c. His mucus contained B lymphocytes that had recently matured in the thymus
d. His mucus lacked T lymphocytes
e. His mucus contained a large quantity of natural killer cells

247. Which of the following organs contains these structures:

- Connective tissue capsule
- Afferent lymphatic vessels
- B lymphocytes
- T lymphocytes
a. Spleen
b. Lymph node
c. Thymus
d. Pharyngeal tonsil
e. Appendix

248. Swelling of the _______________ could make it difficult to breathe through the nose.
a. Peyer’s patch
b. Lingual tonsils
c. Pharyngeal tonsil
d. Inguinal lymph nodes
e. Palatine tonsils

249. Which of the following is NOT TRUE?

a. The lag period is longer during the secondary immune response than during the primary immune
response.
b. Tonsils contain crypts that “trap” pathogens, which can result in the destruction of the pathogen
and the production of memory cells.
c. Peyer’s patches are found in the distal small intestine.
d. Serious chronic inflammation can result in formation of pus.
e. The primary function of the spleen is red blood cell removal/recycling.

250. Which of the following is an example of natural passive immunity?

a. Getting sick with monkey pox.
b. Getting vaccinated for monkey pox.
c. Getting an injection of antibodies from a passive nurse
d. Transfer of antibodies from maternal blood to fetal blood
e. Transfer of Helper T cells from maternal blood to fetal blood.

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 Immune and Lymphatic Systems

251. Which of the following is TRUE?

a. Lymphatic capillaries are less permeable than blood capillaries.
b. Lymphatic vessels structurally resemble muscular arteries.
c. Natural killer cells destroy virus-infected cells.
d. Lacteals are specialized lymphatic capillaries that help absorb proteins in the large intestine.
e. The 2 regions with the greatest concentration of lymphatic capillaries are the bones of the skull and the spinal
cord.

252. Which of the following is TRUE?

a. Lymph in the left leg is ultimately drained by the thoracic duct.
b. Lymph in the right leg is ultimately drained by the thoracic duct.
c. Most mucous membranes are underlain by diffuse lymphatic tissue.
d. The appendix contains lymphoid follicles.
e. All of the above

253. Which of the following is TRUE of a lymph node?

a. It contains more afferent than efferent lymphatic vessels.
b. It is surrounded by a connective tissue capsule.
c. It contains an indentation known as a hilus.
d. It contains follicles in its cortex.
e. All of the above

Use the following answer choices for the next 5 items.

a. Spleen
b. Thymus
c. Tonsils
d. All of the above
e. None of the above

254. Red blood cell graveyard.

255. Contains afferent lymphatic vessels.
256. Forms a ring around the pharynx.
257. Site of T lymphocyte maturation.
258. Site of B lymphocyte maturation.

Use the following answer choices for the next 28 items:

a. Increase
b. Decrease
c. Stay the same

259. As the diameter of the right lymphatic duct decreases due to the presence of a growing tumor, the
circumference of the right arm will most likely:

260. Interleukin-1 is a pyrogen. Thus it will cause body temperature to:

261. Killing the normal bacterial population of the reproductive tract would cause the likelihood of acquiring an
infection there to:

262. The agglutination of bacterial cells by antibodies will cause the likelihood of them being swallowed by a
macrophage to:

263. In the secondary response to an antigen, the duration of the lag time will:

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 Immune and Lymphatic Systems

264. A lack of functioning regulatory T cells would cause the likelihood of acquiring an autoimmune condition to:

265. The binding of a bacterium by complement proteins will cause the likelihood of it getting engulfed by a
macrophage to:

266. Histamine causes blood vessel resistance to:

267. Regulatory T cells cause the activity of Cytotoxic T cells to:

268. Stimulation by interferon will cause a cell’s likelihood of being killed by a virus to:

269. Opsonization causes the likelihood of phagocytosis to:

270. A lack of functioning cilia will cause the likelihood of acquiring a respiratory infection to:

271. As bacterial release of pyretic chemicals increases, core body temperature will:

272. As plasma [interferon] increases, the number of newly synthesized viruses should:

273. During inflammation, local blood flow will:

274. The binding of an antibody to a bacterium will cause the probability of that bacterium being phagocytosed to:

275. During a fever, you would expect plasma levels of zinc to:

276. In Kartagener’s syndrome, cilia do not function. This would cause the likelihood of acquiring a respiratory
infection to:

277. Interferon causes a cell’s protein production capability to:

278. At a site of inflammation, local WBC count will:

279. Precipitation of soluble antigens cause the likelihood of their being phagocytosed to:

280. During inflammation capillary permeability will:

281. Pyrogens cause body temperature to:

282. If a cell is stimulated by interferon, the likelihood of that cell being “hijacked” by a virus will:

283. In response to an acute bacterial infection, one would expect the blood neutrophil count to:

284. An inability to produce functioning leukocytes would cause one’s susceptibility to infection to:

285. As lymph flows from an afferent lymphatic vessel to an efferent lymphatic vessel, you would expect the
number of pathogens within it to:

286. If the left lumbar trunk was blocked by a mass of parasites, the size of the left leg would:

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 Immune and Lymphatic Systems

In each of the next 28 items two quantities are given. If quantity A is the larger of the two then choose A as your
answer. If quantity B is the larger of the two then choose B as your answer. If the two quantities are equal then
choose C as your answer.

287. a. Average number of proteins in 5ml of blood

b. Average number of proteins in 5ml of lymph

288. a. Percentage of the body drained by the right lymphatic duct

b. Percentage of the body drained by the thoracic duct

289. a. Number of antigens that can bind to a typical IgM antibody

b. Number of antigens that can bind to a typical IgD antibody

290. a. Number of pathogens in the average efferent lymphatic vessel

b. Number of pathogens in the average afferent lymphatic vessel

291. a. Volume of lymph carried by the thoracic duct

b. Volume of lymph carried by the right lymphatic duct

292. a. Specificity of a memory Killer T cell

b. Specificity of a natural killer cell

293. a. Number of body cells displaying class I MHC proteins

b. Number of body cells displaying class II MHC proteins

294. a. Amount of IgG antibodies produced in the first week of the primary response to
an antigen
b. Amount IgG antibodies made in the first week of the secondary response to the same
antigen

295. a. Number of memory cells made during natural passive immunity

b. Number of memory cells made during artificial active immunity

296. a. Ability of IgM antibodies to cause agglutination

b. Ability of IgD antibodies to cause agglutination

297. a. Number of primary lymphoid organs in the human body

b. Number of secondary lymphoid organs in the human body

298. a. Typical number of B lymphocytes in blood

b. Typical number of T lymphocytes in blood

299. a. Lag time in the primary immune response to antigen X

b. Lag time in the secondary immune response to antigen X

300. a. Number of memory cells produced in response to injection of an attenuated pathogen

b. Number of memory cells produced in response to injection of antibodies

301. a. Number of antibody classes

b. 4

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 Immune and Lymphatic Systems

302. a. Number of antigen-binding sites on a typical IgM pentamer

b. Number of antigen-binding sites on a typical IgA dimer

303. a. Ability of IgE antibodies to cross the placenta

b. Ability of IgG antibodies to cross the placenta

304. a. Typical number of afferent lymphatic vessels going to a lymph node

b. Typical number of efferent lymphatic vessels leaving from a lymph node

Change ONE TERM in each of the next 6 false statements so that they become true.

305. The palatine tonsils are located in the posterior wall of the nasopharynx and are sometimes referred to as the
adenoids.

306. The passage of maternal antibodies to the infant via breast milk is an example of natural active immunity.

307. The secondary response to an antigen is generally much slower than the primary response to an antigen.

308. Human B lymphocytes are produced in the red bone marrow and gain immunocompetence in the bursa of
Fabricius.

309. Peyer’s patches are lymph nodes found within the wall of the distal small intestine.

310. Complement proteins are made by the spleen and when activated can form a membrane attack complex that
can cause bacterial cells to lyse.

The next 12 items are TRUE/FALSE

311. Lacteals are specialized lymphatic capillaries found within the villi of the intestinal mucosa

312. The thoracic duct empties directly into the azygos vein

313. Large lymphatic vessels have 3 tunics and contain smooth muscle

314. The expansion/recoil of arteries with each ventricular contraction plays no role in lymph movement

315. An autoimmune disease is an inappropriate and excessive process to an otherwise harmless

environmental antigen

316. Each IgA antibody will contain identical antigen binding sites but different constant regions.

317. Killer T cells display the CD8 protein

318. T cells that respond to self-antigens are removed in the bone marrow

319. IgE antibodies are associated with heparin releasing cells

320. Natural killer cells and cytotoxic T cells can both release perforins

321. A deficiency of suppressor T cells could increase the likelihood of an autoimmune disease

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 Immune and Lymphatic Systems

322. Because it targets and destroys T helper cells, the human immunodeficiency virus has little impact on
humoral immunity

The next 8 items are Fill in the Blanks.

323. The organ that acts as the site of T lymphocyte maturation is the ______________________
and it’s found in the _____________________________________.

324. _________________________________ are chemicals that act on the body’s thermostat (which is located in
the _________________________________) and cause body temperature to rise.

325. Mucosa-associated lymphatic tissue is primarily found in the _____________________________ tract and the
_____________________ tract.

326. _____________________________________ will contain both MHC1 and MHC2 proteins on their surface.

327. __________________________________________________ can be considered to be “in charge” of the cell-

mediated immune response.

328. Each antibody is shaped like a ______________________________________________ and has

________________________________________ antigen binding sites.

329. A microbe that has been engulfed by a phagocyte will typically be destroyed by
___________________________ in the phagocyte’s ___________________________.

330. Antibodies are produced by _______________________________________________ cells.

The next 22 items are Short Answers .

331. Identify the organ where T lymphocytes mature.

332. Name the 3 main tonsils.

333. Identify the cell that could be considered in charge of the cell mediated immune response.

334. Identify a cell that contains MHC2 proteins on its surface.

335. Identify the location and function of lacteals.

336. Name a region of the body that contains prominent superficial lymph nodes.

337. Identify the clusters of lymphatic nodules in the distal small intestine.

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 Immune and Lymphatic Systems

338. Name 2 functions of activated complement proteins.

339. Identify 2 functions of antibodies.

340. Name each of the lymphatic trunks that drain the following areas:
a. Arm

b. Leg

c. Head

d. Lung

341. Explain why it would be advantageous for a virus to prevent its host cell from making MHC1 proteins.

342. Very briefly explain why inflammation is a good thing.

343. Very briefly explain the function of interferons.

344. Compare the primary and secondary immune response in terms of lag period, rate of antibody production,
and quantity of antibodies produced.

342. Injection of a dead virus will create immunity. Explain how this occurs. Include the roles played by
macrophages, T Helper cells, and B cells in your discussion.

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 Immune and Lymphatic Systems

343. Label the following parts of the lymph node (just write the letter and draw an arrow to the correct
structure/location):
a. Trabeculae
b. Hilum
c. Capsule
d. Afferent vessel
e. Efferent vessel
f. Subcapsular sinus
g. Cortex
h. Medulla
i. Lymph follicle
j. Lymphatic valve

343. Theresa was born with a defective heart and was lucky enough to receive a new heart from a girl who was
killed in a tragic skydiving accident. In conjunction with the heart transplant, Theresa received an “anti-
lymphocyte serum” that contained antibodies against her own lymphocytes. The new heart worked great, but
unfortunately Theresa died soon after the transplant because of a massive bacterial infection. Explain in great
detail why the anti-lymphocyte serum was necessary and how it related to her fatal infection.

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 Immune and Lymphatic Systems

344. Mrs. Jackson, a 59-year-old woman, has undergone a left radical masectomy (removal of the left breast and
left axillary lymph nodes and vessels). Her left arm is severely swollen and painful, and she is unable to raise it
more tan shoulder height. Explain her signs and symptoms. Can she expect to have relief from these
symptoms in time? How so?

345. Some people with a deficit of IgA exhibit recurrent respiratory tract infections. Explain these symptoms.

346. Explain the underlying mechanisms responsible for the cardinal signs of acute inflammation:

Heat
Pain
Redness
Swelling

347. Why is an injection into the skin like an injection into the lymphatic system?

348. Some parents keep their preschoolers away from other children to prevent them from catching illnesses. How
might these well-meaning parents actually be harming their children?

349. Explain why xenografts are usually rejected by the patients.

350. Explain why young babies and the elderly often have compromised immune systems?

351. The HIV virus attacks and destroys helper T-cells (CD 4) in the human body. Explain exactly how this would
compromise the immune system. Will the HIV virus kill someone and if not what do they die from?

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 Immune and Lymphatic Systems

352. Trace the path that a molecule of water would follow as it traveled from a lymphatic capillary in the left side of
the head of a fetus to the fetal aorta.
- Name every lymphatic vessel, blood vessel, heart chamber, foramen, and valve that it would pass.
- Note that some items have been partially completed for you.
- Note that some items have been totally completed for you.
- Do not abbreviate anything except R for right and L for left.

Lymphatic capillary

Lymphatic collecting vessel

_______________________________ __________________________________________________Trunk

__________________________________________________________________________________Duct

__________________________________________________________________________________Vein

__________________________________________________________________________________Vein

______________________________________________________________________________________


__________________________________Atrium  ______________________________________
 
____________________________________Valve __________________________________________
 
_________________________________________ _________________ _____________________Valve
 
___________________ __________________Valve ___________________________________________
 
__________________________________________ Aortic semilunar Valve

____________________________________ __________

____________________________

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