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# Chapter 13 Exercises

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## Review Questions for Chapter 13

### Multiple Choice

1) Which of the following best describes the innate nonspecific immune system?

1. a targeted and highly specific response to a single pathogen or molecule
2. a generalized and nonspecific set of defenses against a class or group of pathogens
3. a set of barrier mechanisms that adapts to specific pathogens after repeated exposure
4. the production of antibody molecules against pathogens

2) Which of the following constantly sheds dead cells along with any microbes that may be attached to those cells?

1. epidermis
2. dermis
3. hypodermis
4. mucous membrane

3) Which of the following uses a particularly dense suite of tight junctions to prevent microbes from entering the underlying tissue?

1. the mucociliary escalator
2. the epidermis
3. the blood-brain barrier
4. the urethra

4) Which of the following serve as chemical signals between cells and stimulate a wide range of nonspecific defenses?

1. cytokines
2. antimicrobial peptides
3. complement proteins
4. antibodies

5) Bacteriocins and defensins are types of which of the following?

1. leukotrienes
2. cytokines
3. inflammation-eliciting mediators
4. antimicrobial peptides

6) Which of the following chemical mediators is secreted onto the surface of the skin?

1. cerumen
2. sebum
3. gastric acid
4. prostaglandin

7) Identify the complement activation pathway that is triggered by the binding of an acute-phase protein to a pathogen.

1. classical
2. alternate
3. lectin
4. cathelicidin

8) Histamine, leukotrienes, prostaglandins, and bradykinin are examples of which of the following?

1. chemical mediators primarily found in the digestive system
2. chemical mediators that promote inflammation
3. antimicrobial peptides found on the skin
4. complement proteins that form MACs

9) White blood cells are also referred to as which of the following?

1. platelets
2. erythrocytes
3. leukocytes
4. megakaryocytes

10) Hematopoiesis occurs in which of the following?

1. liver
2. bone marrow
3. kidneys
4. central nervous system

11) Granulocytes are which type of cell?

1. lymphocyte
2. erythrocyte
3. megakaryocyte
4. leukocyte

12) PAMPs would be found on the surface of which of the following?

1. pathogen
2. phagocyte
3. skin cell
4. blood vessel wall

13) ________ on phagocytes bind to PAMPs on bacteria, which triggers the uptake and destruction of the bacterial pathogens?

1. PRRs
2. AMPs
3. PAMPs
4. PMNs

14) Which of the following best characterizes the mode of pathogen recognition for opsonin-dependent phagocytosis?

1. Opsonins produced by a pathogen attract phagocytes through chemotaxis.
2. A PAMP on the pathogen’s surface is recognized by a phagocyte’s toll-like receptors.
3. A pathogen is first coated with a molecule such as a complement protein, which allows it to be recognized by phagocytes.
4. A pathogen is coated with a molecule such as a complement protein that immediately lyses the cell.

15) Which refers to swelling as a result of inflammation?

1. erythema
2. edema
3. granuloma
4. vasodilation

16) Which type of inflammation occurs at the site of an injury or infection?

1. acute
2. chronic
3. endogenous
4. exogenous

### Fill-in-the-Blanks

17) The muscular contraction of the intestines that results in movement of material through the digestive tract is called ________.

18) ______ are the hair-like appendages of cells lining parts of the respiratory tract that sweep debris away from the lungs.

19) Secretions that bathe and moisten the interior of the intestines are produced by _______ cells.

20) ________ are antimicrobial peptides produced by members of the normal microbiota.

21) ________ is the fluid portion of a blood sample that has been drawn in the presence of an anticoagulant compound.

22) The process by which cells are drawn or attracted to an area by a microbe invader is known as ________.

23) Platelets are also called ________.

24) The cell in the bone marrow that gives rise to all other blood cell types is the ________.

25) PMNs are another name for ________.

26) Kupffer cells residing in the liver are a type of ________.

27) _____________ are similar to basophils, but reside in tissues rather than circulating in the blood.

28) ________, also known as diapedesis, refers to the exit from the bloodstream of neutrophils and other circulating leukocytes.

29) Toll-like receptors are examples of ________.

30) A(n) ________ is a walled-off area of infected tissue that exhibits chronic inflammation.

31) The ________ is the part of the body responsible for regulating body temperature.

32) Heat and redness, or ________, occur when the small blood vessels in an inflamed area dilate (open up), bringing more blood much closer to the surface of the skin.

### Short Answers

33) Differentiate a physical barrier from a mechanical removal mechanism and give an example of each.

34) Identify some ways that pathogens can breach the physical barriers of the innate immune system.

35) Differentiate the main activation methods of the classic, alternative, and lectin complement cascades.

36) What are the four protective outcomes of complement activation?

37) Explain the difference between plasma and the formed elements of the blood.

38) List three ways that a neutrophil can destroy an infectious bacterium.

39) Briefly summarize the events leading up to and including the process of transendothelial migration.

40) Differentiate exogenous and endogenous pyrogens, and provide an example of each.

### Critical Thinking

41) Neutrophils can sometimes kill human cells along with pathogens when they release the toxic contents of their granules into the surrounding tissue. Likewise, natural killer cells target human cells for destruction. Explain why it is advantageous for the immune system to have cells that can kill human cells as well as pathogens.

42) In a blood smear taken from a healthy patient, which type of leukocyte would you expect to observe in the highest numbers?

43) If a gram-negative bacterial infection reaches the bloodstream, large quantities of LPS can be released into the blood, resulting in a syndrome called septic shock. Death due to septic shock is a real danger. The overwhelming immune and inflammatory responses that occur with septic shock can cause a perilous drop in blood pressure; intravascular blood clotting; development of thrombi and emboli that block blood vessels, leading to tissue death; failure of multiple organs; and death of the patient. Identify and characterize two to three therapies that might be useful in stopping the dangerous events and outcomes of septic shock once it has begun, given what you have learned about inflammation and innate immunity in this chapter.

44) In Lubeck, Germany, in 1930, a group of 251 infants was accidentally administered a tainted vaccine for tuberculosis that contained live Mycobacterium tuberculosis. This vaccine was administered orally, directly exposing the infants to the deadly bacterium. Many of these infants contracted tuberculosis, and some died. However, 44 of the infants never contracted tuberculosis. Based on your knowledge of the innate immune system, what innate defenses might have inhibited M. tuberculosis enough to prevent these infants from contracting the disease?

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