Pathophysiology Chapter 07 – Innate Immunity: Inflammation and Wound Healing

Chapter 07: Innate Immunity: Inflammation and Wound Healing

MULTIPLE CHOICE

 

1. Which action is a purpose of the inflammatory process?

a. To provide specific responses toward antigens

b. To lyse cell membranes of microorganisms

c. To prevent infection of the injured tissue

d. To create immunity against subsequent tissue injury

 

2. How do surfactant proteins A through D provide innate resistance?

a. Initiate the complement cascade.

b. Promote phagocytosis.

c. Secrete mucus.

d. Synthesize lysosomes.

 

3. Which secretion is a first line of defense against pathogen invasion that involves antibacterial and antifungal fatty acids, as well as lactic acid?

a. Optic tears

b. Oral saliva

c. Sweat gland perspiration

d. Sebaceous gland sebum

 

4. Which bacterium grows in the intestines after prolonged antibiotic therapy?

a. Lactobacillus

b. Candida albicans

c. Clostridium difficile

d. Helicobacter pylori

 

5. What causes the edema that occurs during the inflammatory process?

a. Vasodilation of blood vessels

b. Increased capillary permeability

c. Endothelial cell expansion

d. Emigration of neutrophils

 

6. What process causes heat and redness to occur during the inflammatory process?

a. Vasodilation of blood vessels

b. Platelet aggregation

c. Decreased capillary permeability

d. Endothelial cell contraction

 

7. What does activation of the classical pathway begin with?

a. Viruses

b. Antigen-antibody complexes

c. Mast cells

d. Macrophages

 

8. What plasma protein system forms a fibrinous meshwork at an inflamed site?

a. Complement

b. Coagulation

c. Kinin

d. Fibrinolysis

 

9. Which component of the plasma protein system tags pathogenic microorganisms for destruction by neutrophils and macrophages?

a. Complement cascade

b. Coagulation system

c. Kinin system

d. Immune system

 

10. What is the vascular effect of histamine released from mast cells?

 a. Platelet adhesion

b. Initiation of the clotting cascade

c. Vasodilation

d. Increased endothelial adhesiveness

 

11. What is an outcome of the complement cascade?

a. Activation of the clotting cascade

b. Prevention of the spread of infection to adjacent tissues

c. Inactivation of chemical mediators such as histamine

d. Lysis of bacterial cell membranes

 

12. What is the function of opsonization related to the complement cascade?

a. To tag pathogenic microorganisms for destruction by neutrophils and macrophages

b. To process pathogenic microorganisms so that activated lymphocytes can be

created for acquired immunity

c. To destroy glycoprotein cell membranes of pathogenic microorganisms

d. To promote anaphylatoxic activity, resulting in mast cell degranulation

 

13. In the coagulation (clotting) cascade, the intrinsic and the extrinsic pathways converge at which factor?

a. XII

b. VII

c. X

d. V

 

14. Which chemical interacts among all plasma protein systems by degrading blood clots, activating complement, and activating the Hageman factor?

a. Kallikrein

b. Histamine

c. Bradykinin

d. Plasmin

 

15. How does the chemotactic factor affect the inflammatory process?

a. By causing vasodilation around the inflamed area

b. By stimulating smooth muscle contraction in the inflamed area

c. By directing leukocytes to the inflamed area

d. By producing edema around the inflamed area

 

16. What effect does the process of histamine binding to the histamine-2 (H2) receptor have on inflammation?

a. Inhibition

b. Activation

c. Acceleration

d. Termination

 

17. Frequently when H1 and H2 receptors are located on the same cells, they act in what fashion?

 a. Synergistically

b. Additively

c. Antagonistically

d. Agonistically

 

18. Some older adults have impaired inflammation and wound healing because of which problem?

a. Circulatory system cannot adequately perfuse tissues.

b. Complement and chemotaxis are deficient.

c. Underlying chronic illness(es) exists.

d. Number of mast cells is insufficient.

 

19. Which chemical mediator derived from mast cells retracts endothelial cells to increase vascular permeability and to cause leukocyte adhesion to endothelial cells?

a. Chemokines

b. Prostaglandin E

c. Platelet-activating factor

d. Bradykinin

 

20. What is the inflammatory effect of nitric oxide (NO)?

 a. Increases capillary permeability, and causes pain

b. Increases neutrophil chemotaxis and platelet aggregation

c. Causes smooth muscle contraction and fever

d. Decreases mast cell function, and decreases platelet aggregation

 

21. What is the correct sequence in phagocytosis?

a. Engulfment, recognition, fusion, destruction

b. Fusion, engulfment, recognition, destruction

c. Recognition, engulfment, fusion, destruction

d. Engulfment, fusion, recognition, destruction

 

22. When considering white blood cell differentials, acute inflammatory reactions are related to elevations of which leukocyte?

a. Monocytes

b. Eosinophils

c. Neutrophils

d. Basophils

 

23. In the later stages of an inflammatory response, which phagocytic cell is predominant?

a. Neutrophils

b. Monocytes

c. Chemokines

d. Eosinophils

 

24. In regulating vascular mediators released from mast cells, the role of eosinophils is to release what?

a. Arylsulfatase B, which stimulates the formation of B lymphocytes

b. Histaminase, which limits the effects of histamine during acute inflammation

c. Lysosomal enzymes, which activate mast cell degranulation during acute

inflammation

d. Immunoglobulin E, which defends the body against parasites

 

25. What is a role of a natural killer (NK) cells?

a. Initiation of the complement cascade

b. Elimination of malignant cells

c. Binding tightly to antigens

d. Proliferation after immunization with antigen

 

26. Which cytokine is produced and released from virally infected host cells?

a. IL-1

b. IL-10

c. TNF-?

d. IFN-?

ANS: D

 

27. Which manifestation of inflammation is systemic?

a. Formation of exudates

b. Fever and leukocytosis

c. Redness and heat

d. Pain and edema

 

28. The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by what?

a. Endogenous pyrogens

b. Bacterial endotoxin

c. Antigen-antibody complexes

d. Exogenous pyrogens

 

29. What occurs during the process of repair after tissue damage?

a. Nonfunctioning scar tissue replaces destroyed tissue.

b. Regeneration occurs; the original tissue is replaced.

c. Resolution occurs; tissue is regenerated.

d. Epithelialization replaces destroyed tissue.

 

30. What is the role of fibroblasts during the reconstructive phase of wound healing?

a. Generate new capillaries from vascular endothelial cells around the wound.

b. Establish connections between neighboring cells and contract their fibers.

c. Synthesize and secrete collagen and the connective tissue proteins.

d. Provide enzymes that débride the wound bed of dead cells.

 

31. A keloid is the result of which dysfunctional wound healing response?

a. Epithelialization

b. Contraction

c. Collagen matrix assembly

d. Maturation

 

32. A student is preparing to irrigate a patient’s wound and gathers supplies, including hydrogen peroxide. What response by the health care professional is best?

a. Help the student gather the rest of the supplies.

b. Instruct the student to dilute the hydrogen peroxide.

c. Tell the student to get some normal saline instead.

d. Ask the patient if pain medication is needed first.

 

33. Many neonates have a transient depressed inflammatory response as a result of which condition?

a. The circulatory system is too immature to perfuse tissues adequately.

 b. Complement and chemotaxis are deficient.

c. Mast cells are lacking.

d. The respiratory system is too immature to deliver oxygen to tissues.

 

34. During phagocytosis, what is occurring during the step referred to as opsonization?

a. Phagocytes recognize and adhere to the bacteria.

b. Microorganisms are ingested.

c. Microorganisms are killed and digested.

d. An intracellular phagocytic vacuole is formed.

 

35. Fusion is the step of phagocytosis during which what happens?

a. Microorganisms are killed and digested.

b. An intracellular phagocytic vacuole is formed.

c. Lysosomal granules enter the phagocyte.

d. Microorganisms are ingested.

 

36. What does the phagosome step result in during the process of endocytosis?

a. Microorganisms are ingested.

b. Microorganisms are killed and digested.

c. Phagocytes recognize and adhere to bacteria.

d. An intracellular phagocytic vacuole is formed.

 

37. When cellular damage occurs and regeneration is minor with no significant complications, what is the process of returning the cells to preinjury function referred to as?

a. Restoration

b. Resolution

c. Regrowth

d. Replacement

 

38. Newborns often have deficiencies in collectin-like proteins, making them more susceptible to what type of infection?

a. Cardiac

b. Urinary

c. Respiratory

d. Gastrointestinal

 

39. Which cell is the body’s primary defense against parasite invasion?

a. Eosinophil

b. Neutrophils

c. T lymphocytes

d. B lymphocytes

 

MULTIPLE RESPONSE

1. Which chemical mediators induce pain during an inflammatory response? (Select all that apply.)

a. Prostaglandins

b. Leukotrienes

c. Tryptase

d. Phospholipase

e. Bradykinin

 

2. What do sebaceous glands secrete in order to protect the body from infection? (Select all that apply.)

a. Antibacterial fatty acids

b. Antifungal fatty acids

c. Ascorbic acid

d. Lactic acid

e. Hydrochloric acid

3. Which body fluids have the ability to attack the cell walls of gram-positive bacteria? (Select all that apply.)

a. Perspiration

b. Semen

c. Tears

d. Saliva

e. Urine

 

4. What do the main functions of NK cells include? (Select all that apply.)

a. Recognizing virus-infected cells

b. Eliminating virus-infected cells

c. Recognizing bacteria-infected cells

d. Eliminating bacteria-infected cells

e. Eliminating previously identified cancer cells

 

5. An individual’s acquired immunity is dependent on the function of which cells? (Select all that apply.)

a. T lymphocytes

b. B lymphocytes

c. Macrophages

d. Opsonins

e. Neutrophils

 

6. Examples of pathogens capable of surviving and even multiplying inside a macrophage include what? (Select all that apply.)

a. Mycobacterium tuberculosis (tuberculosis)

b. Mycobacterium leprae (leprosy)

c. Salmonella typhi (typhoid fever)

d. Clostridium difficile

e. Brucella abortus (brucellosis)

 

7. An older adult is particularly susceptible to infections of which body parts? (Select all that apply.)

a. Lungs

 b. Skin

c. Liver

d. Eyes

e. Bladder