Ch.15 The Adaptive Immune Response Test Bank nan

Nester’s Microbiology, 9e (Anderson)

Chapter 15 The Adaptive Immune Response

1) The scientist who received the first Nobel Prize in Medicine for his work on antibody therapy was

A) Koch.

B) von Behring.

C) Jenner.

D) Roux.

E) Pasteur.

2) Proteins that react specifically with the chemical structures in the antigen that induced them are called

A) determinants.

B) antibodies.

C) proteases.

D) macroproteins.

E) epitopes.

3) Antibodies are made by

A) red blood cells.

B) macrophages.

C) B cells/plasma cells.

D) T cells.

E) all leukocytes.

4) Cytotoxic T cells primarily are responsible for

A) humoral immunity.

B) cell-mediated immunity.

C) anamnestic immunity.

D) producing haptens.

E) producing antibodies.

5) Secondary lymphoid organs

A) facilitate interactions between cells.

B) are hematopoietic.

C) are the site of T cell maturation.

D) include the bone marrow and thymus.

E) are the site of B cell maturation.

6) Epitopes or antigenic determinants

A) are parts of the antibody molecule.

B) are T cell receptors.

C) are parts of an antigen recognized by an antibody.

D) are B cell receptors.

E) are parts of an antibody recognized by an antigen.

7) The humoral immune response is delivered by

A) antibodies.

B) T cells.

C) lymphokines.

D) antigens.

E) antibodies AND lymphokines.

8) Which of the following is not typical of an antigen?

A) Protein

B) Foreign

C) Low molecular weight

D) Polysaccharide

E) Low molecular weight AND protein

9) Specific regions on an antigen molecule to which the immune response is directed are

A) antigenic determinants.

B) an autoimmune response.

C) monomers.

D) allergens.

E) antibody determinants.

10) Which of the following molecules would be expected to be immunogenic?

A) Progesterone, a lipid hormone.

B) Serum albumin, a large protein.

C) Glucose, a simple sugar.

D) Linoleic acid, a fatty acid.

E) These are all equally immunogenic.

11) Which of the following is/are secondary lymphoid organ(s)?

A) Thymus AND spleen

B) Spleen AND lymph nodes

C) Lymph nodes AND bone marrow

D) Spleen AND bone marrow

E) Thymus AND bone marrow

12) A term synonymous with antibody is

A) antigen.

B) immunoglobulin.

C) epitope.

D) determinant.

E) immunotope.

13) Which of the following do not induce a strong immune response?

A) Lipids

B) Proteins

C) Polysaccharides

D) Simple sugars

E) Lipids AND simple sugars.

14) There are ________ class(es) of antibody.

A) one

B) three

C) five

D) seven

E) twelve

15) Which of the following antibodies is a pentamer?

A) IgA

B) IgD

C) IgM

D) IgE

E) IgG

16) The chains of an antibody molecule are bonded to one another by

A) disulfide bonds.

B) hydrogen bonds.

C) ionic bonds.

D) oxygen bonds.

E) ligases.

17) Which of the following antibodies is a dimer?

A) IgD

B) IgA

C) IgM

D) IgE

E) IgG

18) The immunoglobulin monomer consists of

A) four large chains.

B) two heavy and two light chains.

C) five light chains.

D) three heavy and three light chains.

E) one heavy and two light chains.

19) Which class of antibody accounts for most of the circulating antibodies?

A) IgA

B) IgD

C) IgG

D) IgE

E) IgM

20) The characteristic function and properties of each class of antibody is determined by the

A) variable region on the light chains.

B) hinge region of all chains.

C) constant region on the light chains.

D) constant region on the heavy chains.

E) variable region on the heavy chains.

21) An IgG molecule has two

A) heavy chains, light chains, AND antibody binding sites.

B) heavy chains, light chains, AND antigen binding sites.

C) light chains, antigen binding sites, AND antibody binding sites.

D) antibody binding sites AND antigen binding sites.

E) Fc regions AND one Fab region.

22) The variable region of an antibody occurs

A) only on the heavy chains.

B) only on the light chains.

C) on one of the light chains.

D) on all four chains.

E) at the hinge region only.

23) Each class of antibody is specifically defined by its

A) amino acid sequence of the constant region of the heavy chain.

B) amino acid sequence of the variable region of the light chain.

C) ability to cross the placenta.

D) presence of disulfide bonds.

E) ability to bind a range of antigens.

24) Antigens interact with antibodies at

A) the outer end of each arm of the Y.

B) the junction of heavy and light chains.

C) different regions depending on the class of antibody.

D) the bottom stem of the heavy chain of the Y.

E) the disulfide bridges of the antibody molecule.

25) Ag-Ab binding may result in all of the following EXCEPT

A) neutralization.

B) immobilization.

C) agglutination.

D) opsonization.

E) fever.

26) The Fc region on IgG

A) interacts with complement AND contains a variable region.

B) attaches to receptors on macrophages AND contains a variable region.

C) interacts with complement AND attaches to receptors on macrophages.

D) reacts with and coats the antigen AND interacts with complement.

E) reacts with and coats the antigen AND attaches to receptors on macrophages.

27) How long after initiation of a primary response do significant amounts of antibody appear in the blood?

A) One day

B) 10–14 days

C) 4 weeks

D) 6 months

E) 48 hours

28) The only class of antibody that can cross the placenta is ________.

A) IgA

B) IgD

C) IgG

D) IgE

E) IgM

29) Which is the first antibody class made during the primary response to an antigen?

A) IgA

B) IgM

C) IgG

D) IgE

E) IgD

30) Which of the following is the most abundant immunological class produced?

A) IgA

B) IgD

C) IgG

D) IgE

E) IgM

31) Which is the most efficient at initiating the classical pathway of the complement cascade?

A) IgA

B) IgD

C) IgM

D) IgE

E) IgG

32) Which of the following class of antibody is primarily found in external secretions?

A) IgA

B) IgD

C) IgG

D) IgE

E) IgM

33) The function of the secretory component of the IgA molecule is

A) to protect IgA from being destroyed by proteolytic enzymes.

B) to coat the antigen.

C) to facilitate opsonization.

D) to protect breast-fed infants against intestinal pathogens.

E) to protect IgA from being destroyed by lipases.

34) The immunoglobulin that is important in hypersensitivity reactions is ________.

A) IgA

B) IgD

C) IgG

D) IgE

E) IgM

35) According to the clonal selection theory

A) antibodies are modified, at the time of antigen exposure, to specifically react with the antigen.

B) self-reactive T cells are killed in the thymus.

C) B cells producing autoantibodies are eliminated in the thymus.

D) each B cell is already programmed to produce a specific antibody.

E) self-reactive T cells are killed in the thymus AND B cells producing autoantibodies are eliminated in the thymus.

36) "Clonal selection" and "clonal expansion"

A) imply that each individual lymphocyte produces a single antibody.

B) describe how a single lymphocyte proliferates in a population of effector cells.

C) depend on an antibody recognizing a specific epitope.

D) explain how an antigen stimulates the production of matching antibodies.

E) All of the answer choices are correct.

37) T cells and B cells are produced in the

A) bone marrow.

B) thymus.

C) Peyer's patches.

D) nervous tissue.

E) appendix.

38) T cells mature in the

A) bone marrow.

B) thymus.

C) Peyer's patches.

D) nervous tissue.

E) tonsils.

39) The cells that actually secrete antibodies are

A) natural killer cells.

B) phagocytes.

C) plasma cells.

D) T cells.

E) naive B cells.

40) CD4 cells are also known as 

A) T helper cells.

B) natural killer cells.

C) T cytotoxic cells.

D) macrophages.

E) neutrophils.

41) CD8 cells are

A) T helper cells.

B) natural killer cells.

C) T cytotoxic cells.

D) macrophages.

E) plasma cells.

42) Antigens may be processed for presentation by

A) macrophages AND erythrocytes.

B) dendritic cells AND erythrocytes.

C) erythrocytes, macrophages, AND dendritic cells.

D) T cytotoxic cells, B cells, AND dendritic cells.

E) macrophages, B cells, AND dendritic cells.

43) Macrophages and dendritic cells are

A) T cells.

B) B cells.

C) antigen-presenting cells.

D) antibody-producing cells.

E) lymphocytes.

44) Only antigen-presenting cells

A) produce MHC class I molecules.

B) produce MHC class II molecules.

C) produce antibodies.

D) activate cytotoxic T cells.

E) activate regulatory T cells.

45) It would be useful if antigens were delivered directly to

A) Peyer's patches.

B) W Cells.

C) M cells.

D) red blood cells.

E) Peyer's patches AND M cells.

46) Class II MHC molecules are found primarily on

A) macrophages AND erythrocytes.

B) dendritic cells AND erythrocytes.

C) T cytotoxic cells AND dendritic cells.

D) macrophages AND dendritic cells.

E) T cytotoxic cells AND macrophages

47) The stimulation of B cells to divide and mature is provided by

A) T helper cells.

B) macrophages.

C) T cytotoxic cells.

D) plasma cells.

E) erythrocytes.

48) The peptides presented by MHC class II peptide molecules are

A) from plasma cells.

B) exogenous antigens.

C) endogenous antigens.

D) from T helper cells.

E) antibodies.

49) T-independent antigens

A) include polysaccharides.

B) require the involvement of T cells.

C) interact with MHCI molecules.

D) are usually proteins.

E) include polysaccharides AND require the involvement of T cells.

50) Which of the following does NOT form a memory population after activation and differentiation?

A) B cells.

B) T cytotoxic cells.

C) T helper cells.

D) Macrophages.

E) These all form memory cells.

51) The surface receptors on B and T cells both

A) play the same role in each type of cell.

B) bind to free antigen.

C) have two binding sites for antigen.

D) have variable and constant regions.

E) play the same role in each type of cell AND bind to free antigen.

52) Which is involved in reacting to virus-infected cells?

A) B cells AND cell-mediated immunity 

B) MHC class II molecules, B cells AND cytotoxic T cells

C) B cells, leukocytes AND MHC class II molecules

D) MHC class I molecules, helper T cells AND humoral immunity

E) MHC class I molecules, cell-mediated immunity AND cytotoxic T cells

53) Perforin is produced by

A) B cells.

B) macrophages.

C) NK cells.

D) T helper cells.

E) B cells AND NK cells.

54) Giant cells are

A) a fusion of B cells.

B) a fusion of T cells.

C) used to contain bacterial infections.

D) activated T helper cells.

E) used to engulf very large pathogens.

55) Apoptosis

A) is a form of programmed cell death AND results specifically in T cell death.

B) is induced in target cells by effector T cytotoxic cells AND results specifically in T cell death.

C) results specifically in T cell death AND refers to the transformation of B cells into plasma cells.

D) is a form of programmed cell death AND is induced in target cells by effector T cytotoxic cells.

E) refers to the transformation of B cells into plasma cells.

56) The immune response is directed against an entire molecule.

57) All antigens are immunogens.

58) Antibody molecules are very rigid in structure.

59) Antibody and antigen are held to one another by covalent bonds.

60) IgA is the most abundant immunoglobulin made by the body.

61) Gene rearrangement is responsible for the generation of the various antibody molecules.

62) T cells are responsible for directly manufacturing antibodies.

63) T cell receptors are identical to antibodies.

64) T-independent antigens can activate B cells directly.

65) How is the central portion of a T cell receptor complex functionally analogous to the center of the B cell receptor complex?

A) It has two protein chains, just like a B-cell receptor.

B) Both receptors bind epitopes (small amino acid sections of antigen molecules).

C) Both bind structures directly on the surface of microbes.

D) Both can be secreted from lymphocytes to bind to pathogens under certain situations.

E) Both have two heavy chains and two light chains.

66) How is a T-cell receptor different from a B-cell receptor?

A) T-cell receptors must have antigen broken down inside a cell and presented to them by a major histocompatibility complex (MHC) molecule.

B) B-cell receptors must have antigen broken down inside a cell and presented to them by a major histocompatibility complex (MHC) molecule.

C) T-cell receptors are composed of four protein chains (pieces), while B-cell receptors are composed of only two chains.

D) T-cell receptors are eventually secreted into the bloodstream by activated T-cells, whereas B-cell receptors are not; they always stay with the B-cell.

E) B-cell receptors are composed of chains of amino acids, while T-cell receptors are composed of chains of carbohydrates.

67) Why would a person who has their tonsils removed be more susceptible to certain types of infections of the throat and respiratory tract?

A) Tonsils are primary lymphoid organs found in the oral cavity that produce high levels of lactoferrin and transferrin; these are strong natural antibacterial compounds that protect the lungs.

B) Tonsils are secondary lymphoid organs found in the oral cavity that produce large amounts of interferons; these are natural antiviral compounds that protect the respiratory tract.

C) Tonsils are secondary lymphoid organs; they help to provide a constant response to the microbes in the oral cavity, helping to keep them in check and preventing them from spreading to other areas.

D) Tonsils are the location where T cells develop and mature. Without them, a person won't have T cells, and will be more likely to suffer from infections that would normally be eliminated by such cells.

E) Tonsils are primary lymphoid organs; they help to provide a constant response to the microbes in the gut, helping to keep them in check and preventing them from spreading to other areas.

68) Would a denatured antigen be expected to have the same epitopes as its native (non-denatured) counterpart? Why?

A) Yes; epitopes are just a sequence of amino acids in a row, so they do not change regardless of 3D shape of the protein molecule they lie within.

B) Yes; all proteins must be broken down into individual epitopes for presentation to B and T cells on MHC molecules, so each antigen protein MUST be denatured to yield ANY epitopes.

C) No; ALL epitopes are dependent on being in the proper original 3D conformation of the protein. Denaturing them would destroy them by destroying that conformation.

D) No; denaturing an antigen results in epitopes with a different amino acid sequence from those on an intact antigen, so they are not the same at all.  

E) Yes AND No; SOME epitopes are dependent on 3D conformation (conformational epitopes), while some simply depend on the sequence of amino acids (linear epitopes). So, really, it depends on the particular epitope.

69) In opsonization with IgG, why would it be important that IgG react with the antigen BEFORE a phagocytic cell recognizes the antibody molecule?

A) If the IgG is bound to the phagocyte BEFORE opsonization, it would most likely be ingested by the phagocyte before it could bind to a pathogen (it would be "naked," so to speak).

B) Binding of IgG by phagocytes would block the antigen binding sites on the IgG molecules, preventing them from binding to the microbes.

C) Binding of IgG by phagocytes changes their conformation—and by changing their protein conformation, their antigen binding sites are changed and they can no longer recognize their specific antigenic epitopes.

D) Binding of antibody by phagocytes results in immediate release of protein-destroying enzymes to the outside of the cell. Since antibodies are proteins, they would be destroyed by these enzymes (and would then be unable to bind to their specific antigenic epitopes).

70) A scientist reports the isolation of a new blood-borne virus that completely shuts down presentation of viral epitopes on MHC molecules in the cells it infects. He produces an internet video describing the virus, claiming it will be indestructible by CD8+ cytotoxic T cells and will kill millions of people. The medical community quickly denounces the warning as irrelevant, and the whole thing is quickly forgotten. Why?

A) CD8+ T cells are not the cells that are responsible for killing virally infected cells. The scientist has confused the information. The medical community denounces the information so that people are not unnecessarily alarmed by the video.

B) While CD8+ T cells ARE important for eliminating a viral infection, they are not the ONLY things that can do so. Natural killer cells can kill virally infected cells that have shut down MHC antigen presentation, and interferons can assist in cleaning virally infected cells.

C) A blood-borne virus would not be capable of rapidly infecting millions of people, due to its difficult mode of transmission AND CD8+ T cells are not the cells that are responsible for killing virally infected cells. The scientist has confused the information. The medical community denounces the information so that people are not unnecessarily alarmed.

D) B cells would be primed right away to produce complement proteins to destroy the virus. This would prevent cells from being infected with it in the first place. The medical community denounces the scientist's video to prevent people from becoming alarmed.

E) While CD8+ T cells ARE important for eliminating a viral infection, they are not the ONLY things that are capable of doing so. Natural killer cells can kill virally infected cells that have shut down MHC antigen presentation, and interferons can assist in cleaning virally infected cells AND a blood-borne virus would not be capable of rapidly infecting millions of people, due to its difficult mode of transmission.

71) The best possible analogy available for the way in which variable (V), diversity (D), and joining (J) antibody gene segments get put together to create the diversity possible in hypervariable regions is

A) to think of the various segments as a deck of cards—when you get dealt a hand of five cards, you have a very high likelihood of getting a different hand every time. The quality of the hand you have dealt will dictate whether you have a "winning" hand (capable of binding to antigenic epitopes).

B) to think of the various segments as the pieces of a house—you need a strong foundation first (the joining segments), followed by a frame (the diversity segments), then the interior walls (the variable segments) before the structure is complete.

C) to think of the various segments as building a highway—you need to prepare the area first by clearing a path (the joining segments do this), then grade/slope the area (the diversity segments) before you can finally lay down the asphalt (the variable segments).

D) to think of the various segments as a bingo game—each segment is randomly selected, but you're going to need one of each (V, D, and J) to form a functional molecule. The "right" combination varies depending on which antigen is eventually going to be binding to the molecule (i.e., your bingo card would be the eventual antigen, and the random calling out of the number/letter combinations would be the forming of the VDJ hypervariable region).

E) to think of the various segments as the characters in a game of Clue. Each character is assigned a specific weapon with which to commit a murder (the joining segments), but once that is assigned, the room in which the murder occurs is random (the diversity segments); to get a complete picture, you need to know the name of the victim (variable segments).

72) Which of the following is/are a(n) antigen-presenting cell(s)?

A) Macrophages

B) Dendritic cells

C) B cells

D) Macrophages, dendritic cells, AND B cells

E) Macrophages AND dendritic cells

73) What is a naive lymphocyte?

A) A lymphocyte that has an antigen receptor but has not yet encountered the antigen recognized by the receptor.

B) A lymphocyte that has encountered the antigen recognized by its receptor but has not yet made antibodies.

C) A lymphocyte that has encountered the antigen recognized by its receptor but has not yet made antibodies and cytokines.

D) A lymphocyte that has encountered the antigen recognized by its receptor but has not yet undergone apoptosis.

E) A lymphocyte that has not yet encountered the antigen recognized by its receptor but is making antibodies.

74) What happens when a helper T cell is activated?

A) Two populations of cells are formed: helper T cells and cytotoxic T cells; the TH cells activate B cells and the TC  cells target virus-infected cells.

B) Two populations of cells are formed: memory TH cells and effector TH cells; the effector TH cells produce a variety of antibodies.

C) Two populations of cells are formed: memory TH cells and effector TH cells; the effector TH cells play a role in activating B cells.

D) Two populations of cells are formed: effector TH cells and effector TC cells; these work together to activate B cells and macrophages.

E) Activated TH cells produce cytokines that stimulate dendritic cells, converting them into antigen-presenting cells.

75) Please identify the incorrect definition.

A) Cytotoxic T cell—type of lymphocyte programmed to destroy infected or cancerous "self" cells.

B) Plasma cell—effector form of a B cell; it functions as an antibody-secreting factory.

C) T cell receptor—molecule on a T cell that enables the T cell to recognize a specific antigen.

D) MHC class II—molecules that cells use to present antigen to cytotoxic T cells.

E) Fab region—portion of an antibody molecule that binds to the antigen.

76) Please select the CORRECT statement regarding MHC molecules.

A) Cytotoxic T cells recognize antigens presented on MHC class II molecules.

B) Dendritic cells are the only cells that make MHC class II molecules.

C) All nucleated cells express MHC class II molecules.

D) Helper T cells recognize antigens presented on MHC class II molecules.

E) Endogenous antigens are presented on MHC class II molecules.

77) Which of the following contribute to antibody diversity?

A) Gene rearrangement AND imprecise joining

B) Imprecise joining AND combinatorial associations

C) Imprecise joining AND negative selection

D) Gene rearrangement, imprecise joining AND combinatorial associations

E) Positive selection, negative selection AND gene rearrangement

78) Identify the role(s) of natural killer cells.

A) Phagocytosis of virus infected cells AND production of cytokines that help regulate and direct certain immune responses.

B) Antibody-dependent cellular cytotoxicity AND negative selection of lymphocytes that recognize normal "self" molecules AND regulation and direction of certain immune responses.

C) Destruction of stressed host cells such as those infected with viruses AND negative selection of lymphocytes that fail to recognize normal "self" molecules.

D) Antibody-dependent cellular cytotoxicity OR destruction of stressed host cells such as those infected with viruses.

E) Regulation and direction of certain immune responses AND phagocytosis of virus infected cells AND stimulation of MHC class I molecules.

79) What would be an appropriate response if an antigen is presented on MHC class II molecules?

A) An effector CD4 cell activates the presenting cell.

B) An effector CD8 cell activates the presenting cell.

C) An effector CD4 cell kills the presenting cell.

D) An effector CD8 cell kills the presenting cell.

E) An effector CD8 cell activates a naive CD4 cell.

80) Which of the following is the definition of clonal selection?

A) The killing of antibody-coated target cells by natural killer cells, granulocytes, or macrophages.

B) The process in which a lymphocyte's antigen receptor binds to an antigen, allowing the lymphocyte to multiply.

C) The process that allows a B cell to change the antibody class it is programmed to make.

D) The immune response that protects the mucous membranes, which involves secretory IgA.

E) The generation of diversity in antigen specificity through rearrangement of gene segments.

Your friend Ellie is pregnant. She tells you that her mother, a microbiologist, has warned her not to clean out the cat's litter box while she is pregnant in case she contracts a disease called toxoplasmosis, which can affect her fetus. She says her mom told her toxoplasmosis is caused by a parasite called Toxoplasma gondii, that may be found in the feces of infected cats and also in raw meat. Your friend's mom tells her that when a person has not had a particular disease, they are not immune to the pathogen that causes the disease, and lack antibodies against that microbe. Your friend has never had toxoplasmosis but she doesn't quite understand why this, and the fact that she doesn't have antibodies to T. gondii, is important. You help her understand some facts about her adaptive immune system.

81) You explain to Ellie that when a person is exposed to an antigen, they generate antibodies against the antigen. Antibodies are ________ generated by ______.

A) carbohydrates; plasma cells

B) epitopes; plasma cells

C) proteins; effector B cells

D) carbohydrates; effector B cells

E) proteins; effector T cells

82) You tell your friend that antibodies

A) bind to and destroy an antigen such as the toxoplasmosis parasite.

B) bind to and tag an antigen for elimination by white blood cells such as macrophages.

C) bind to and destroy any self cells in which a pathogen may reside and multiply.

D) coat the cytoplasmic membrane of a self cell so a pathogen cannot enter it.

E) All of the choices are correct.

83) Ellie doesn't understand why it is important as to whether a woman has a first or subsequent exposure to a pathogen such as T. gondii when she is pregnant. You explain to her the difference between a primary and a secondary immune response. Which of the following would you NOT say to her?

A) When memory B cells become activated, some quickly differentiate to form plasma cells, resulting in the rapid production of antibodies. IgG crosses the placenta and protects the fetus.

B) In the first (primary) exposure to an antigen, it takes about 10 to 14 days for a significant concentration of antibodies to accumulate. IgM is made, followed by IgG.

C) The second exposure to an antigen, which characterizes the memory of adaptive immunity, causes rapid production of relatively large quantities of IgM but no IgG.

D) If the same antigen is encountered later in life, a stronger antigen-specific adaptive immune response occurs, called the secondary response. Large amounts of IgG are made.

E) The first adaptive immune response to an antigen is the primary response; effector cells and memory cells are formed as a result of this initial encounter.

84) A fetus is protected by maternal antibodies that cross the placenta. You explain to Ellie that the fetus

A) is protected by both maternal IgG and maternal IgM, because these can easily cross the placenta.

B) is protected by maternal IgM but not by maternal IgG, because IgM can cross the placenta but IgG cannot because it is a pentamer.

C) will make large amounts of its own IgG and IgM immediately if the mother contracts some type of pathogen.

D) is protected by maternal IgG but not by maternal IgM—IgG can cross the placenta but IgM cannot because it is a pentamer.

E) will make its own IgG if the mother contracts any type of pathogen; it cannot make IgM because this is a pentamer.

85) Your friend asks you how her B cells "know" when to make antibodies. You tell her that B cells must become activated, and that she has another type of cell that assists in this. These are the 

A) TH cells that bind to the B cell and release cytokines that activate that B cell.

B) TC cells that bind to the B cell and release cytokines that activate that B cell.

C) TH cells that bind to the B cell and release cytokines that activate that T cell.

D) TC cells that bind to the B cell and release cytokines that activate that T cell.

E) TH cells that present the antigen to the B cell, leading to activation of that B cell.

86) Ellie wonders whether she has fully understood what you have told her, so she tells you what she knows but she makes one mistake. Which statement made by your friend is INCORRECT?

A) When a person is exposed to an antigen, B cells get activated by TH cells, proliferating and differentiating to form populations of plasma cells and memory cells.

B) Plasma cells produce antibodies which are specific proteins that bind to the antigens, tagging them for elimination by other immune cells such as macrophages and neutrophils.

C) On first exposure to an antigen, a person makes IgM followed by IgG. On second exposure to that same antigen, memory cells produce large amounts of IgG.

D) If a woman experiences a primary exposure to a particular while pregnant, she makes IgM in response. This antibody crosses the placenta and protects her fetus from that pathogen.

E) If a woman experiences a secondary exposure to a particular pathogen while pregnant, she makes IgG that crosses the placenta and protects the fetus from that antigen.

Your patient has recently been diagnosed with an immunodeficiency disorder. Your supervisor asks you to help the patient understand what this means and the impact it will have on her.

87) You inform your patient that the human body has several mechanisms of defense: innate immunity, which is routine protection present at birth, and adaptive immunity, which is a more specific response that develops after birth. You tell your patient that her adaptive immune response uses two basic strategies for eliminating foreign material: humoral immunity, which involves ________ and cell-mediated immunity, which involves ________.

A) T lymphocytes; B lymphocytes

B) B lymphocytes; T lymphocytes

C) T lymphocytes; NK cells

D) B cells; neutrophils

E) neutrophils; macrophages

88) You explain to your patient the role of the lymphocytes in her adaptive immune response. In the middle of your explanation, you are distracted and you tell her something that is NOT correct. Identify that statement.

A) After activation, T lymphocytes divide and proliferate to form a population of helper T cells and a population of cytotoxic T cells; activated T cells secrete cytokines that exert an effect on other cells.

B) After activation, B lymphocytes divide and proliferate to form a population of plasma cells and a population of memory cells; plasma cells produce antibodies that tag microbial invaders for elimination by phagocytes. 

C) Once activated, helper T cells form a population of TH effector cells and a population of TH memory cells; TH effector cells produce cytokines that activate B cells and macrophages.

D) Once activated, cytotoxic T cells form a population of TC effector cells and a population of TC memory cells; TC effector cells produce cytokines that induce apoptosis in virally infected self cells.

E) Effector B cells and T cells express traits that help eliminate invaders in a primary response. Memory B cells and T cells are responsible for the effectiveness of the secondary response.

89) You describe for your patient the sequence of events that occurs when a B cell is activated. Please select the correct order of statements.

1. TH cells recognize the presented antigen-MHC complex on the B cell and bind to it. 

2. B cell receptor binds to an antigen and the antigen is internalized by endocytosis.

3. The bound TH delivers cytokines to the B cell that initiate the process of clonal expansion of that particular B cell.

4. The antigen is degraded and peptide fragments are expressed at the B cell membrane with MHC class II molecules.

A) 1, 2, 3, 4

B) 4, 3, 1, 2

C) 1, 3, 2, 4

D) 2, 3, 1, 4

E) 2, 4, 1, 3

90) You explain to your patient the role of cytotoxic T cells in immunity, telling her that

A) TC cells induce apoptosis in infected "self" cells.

B) TC produce antibodies AND TC destroy cancerous "self" cells.

C) TC destroy cancerous "self" cells AND TC cells induce apoptosis in infected "self" cells.

D) TC cells activate B cells AND TC cells induce apoptosis in infected "self" cells.

E) TC cells activate B cells and macrophages AND TC cells produce antibodies AND TC destroy cancerous "self" cells