Pathopharmacology Test Quiz- Chapters 5 & 7

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  • 1/40 Questions

    Which genes are responsible for an autosomal dominant form of breast CA?

    • LCAT genes
    • CHK1 and CHK2 genes
    • BRCA1 and BRCA2 genes
    • TP53 and TP54 genes
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About This Quiz

Pathopharmacology quiz for MSN students. Credit goes to Dr. Nmezi for creating the quiz. I simply put it in this format to make studying easier. This quiz covers chapters 5 & 7 from the McCance Pathophysiology -text.

Pathopharmacology Test Quiz- Chapters 5 & 7 - Quiz

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  • 2. 

    Which risk factor for HTN is influenced by genetic factors and lifestyle?

    • Sodium intake

    • Physical inactivity

    • Psychological stress

    • Obesity

    Correct Answer
    A. Obesity
    Explanation
    The most important environmental risk factors for hypertension are increased sodium intake, decreased physical activity, psychosocial stress, and obesity (but, as discussed later, the latter factor is itself influenced by genes and environment).

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  • 3. 

    The _____ risk of developing a disease is expressed as the ratio of the disease rate among the exposed population to the disease rate in an unexposed population.

    • Attributable

    • Contingency

    • Causal

    • Relative

    Correct Answer
    A. Relative
    Explanation
    A common measure of the effect of a specific risk factor is the relative risk.

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  • 4. 

    What is an example of an endogenous antigen?

    • Yeast

    • Cancer cells

    • Bacteria

    • Fungus

    Correct Answer
    A. Cancer cells
    Explanation
    Endogenous antigens are synthesized within a cell and also may include those uniquely produced by cancerous cells.

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  • 5. 

    Cancers that cluster strongly in families include:

    • Breast and colon

    • Lung and ovarian

    • Brain and lung

    • Lung and brain

    Correct Answer
    A. Breast and colon
    Explanation
    Lung and colon cancers have proven to show a strong familial tendency.

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  • 6. 

    The BRCA and BRCA2 mutations increase the risk of which cancer in women?

    • Ovarian

    • Lung and ovarian

    • Uterine

    • Pancreatic

    Correct Answer
    A. Ovarian
    Explanation
    BRCA1 mutations increase the risk of ovarian cancer among women (20% to 50% lifetime risk), and BRCA2 mutations also confer an increased risk of ovarian cancer (10% to 20% lifetime prevalence).

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  • 7. 

    The portion of the antigen that is configured for recognition and binding is called an antigenic determinant or a(n):

    • Immunotope

    • Paratope

    • Epitope

    • Antigenitope

    Correct Answer
    A. Epitope
    Explanation
    The precise portion of the antigen that is configured for recognition and binding is called its antigenic determinant, or epitope.

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  • 8. 

    Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen?

    • Passive acquired

    • Active acquired

    • Passive innate

    • Active innate

    Correct Answer
    A. Active acquired
    Explanation
    Active acquired immunity (active immunity) is produced by an individual after natural exposure to an antigen or after immunization, whereas passive acquired immunity (passive immunity) does not involve the host’s immune response at all.

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  • 9. 

    Which type of immunity is produced when an immunoglobulin crosses the placenta?

    • Passive acquired

    • Active acquired

    • Passive innate

    • Active innate

    Correct Answer
    A. Passive acquired
    Explanation
    Passive acquired immunity (passive immunity) does not involve the host’s immune response at all. Rather, passive immunity occurs when preformed antibodies or T lymphocytes are transferred from a donor to the recipient. This can occur naturally, as in the passage of maternal antibodies across the placenta to the fetus, or artificially, as in a clinic using immunotherapy for a specific disease.

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  • 10. 

    During which phase of life does the generation of clonal diversity occur?

    • Fetus

    • Neonate

    • Infant

    • Ovum

    Correct Answer
    A. Fetus
    Explanation
    Although generation of clonal diversity primarily occurs in the fetus, it probably continues to a low degree throughout most of adult life.

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  • 11. 

    Some viruses, such as measles and herpes, are inaccessible to antibodies after the initial infection because they:

    • Do not circulate in the blood

    • Do not have antibody receptors

    • Resist agglutination

    • Are soluble antigens

    Correct Answer
    A. Do not circulate in the blood
    Explanation
    Many viruses (e.g., measles, herpes) are inaccessible to antibodies after initial infection because they do not circulate in the bloodstream but instead remain inside infected cells, spreading by direct cell-to-cell contact.

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  • 12. 

    Which immunoglobulin is present in blood, saliva, breast milk, and respiratory secretions?

    • IgA

    • IgE

    • IgG

    • IgM

    Correct Answer
    A. IgA
    Explanation
    IgA can be divided into two subclasses, IgA1 and IgA2. IgA1 molecules are found predominantly in the blood, whereas IgA2 is the predominant class of antibody found in normal body secretions.

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  • 13. 

    The primary characteristic that differentiates the immune response from other protective mechanisms is that the immune response is:

    • Similar each time it is activated

    • Specific to the antigen that activates it

    • A short term response to a specific pathogen

    • An innate response, rather than acquired

    Correct Answer
    A. Specific to the antigen that activates it
    Explanation
    Unlike inflammation, which is nonspecifically activated by cellular damage as well as pathogenic microorganisms, the immune response is primarily designed to afford long-term specific protection (i.e., immunity) against particular invading microorganisms, that is, it has a “memory” function.

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  • 14. 

    B lymphocytes mature and undergo changes that commit them to becoming B cells in the:

    • Thymus gland

    • Regional lymph nodes

    • Bone marrow

    • Spleen

    Correct Answer
    A. Bone marrow
    Explanation
    This process is called the generation of clonal diversity and occurs in specialized (primary) lymphoid organs; the thymus for T cells and the bone marrow for B cells.

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  • 15. 

    The most important determinant of immunogenicity is the antigen's:

    • Size

    • Foreignness

    • Complexity

    • Quantity

    Correct Answer
    A. Foreignness
    Explanation
    Foremost among the criteria for immunogenicity is the antigen’s foreignness. A self-antigen that fulfills all these criteria except foreignness does not normally elicit an immune response. Thus most individuals are tolerant to their own antigens. The immune system has an exquisite ability to distinguish self (self-antigens) from non-self (foreign antigens).

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  • 16. 

    If a person had very low levels of Ig__, that individual is more susceptible to infections of the mucous membranes.

    • G

    • M

    • A

    • E

    Correct Answer
    A. A
    Explanation
    The IgA molecules found in bodily secretions are dimers anchored together through a J-chain and “secretory piece.” This secretory piece is attached to the IgAs inside mucosal epithelial cells and may function to protect these immunoglobulins against degradation by enzymes also found in the secretions.

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  • 17. 

    Which is an example of a bacterial toxin that has been inactivated, but still retains its immunogenicity to protect the person?

    • Poliomyelitis

    • Measles

    • Tetanus

    • Gonorrhea

    Correct Answer
    A. Tetanus
    Explanation
    The symptoms of tetanus or diphtheria are mediated by specific toxins. To prevent harming the recipient of immunization, bacterial toxins are chemically inactivated so that they have lost most of their harmful properties but still retain their immunogenicity. These are referred to as toxoids.

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  • 18. 

    The data reporting that sickle cell disease affects approximately 1 in 600 American blacks is an example of which concept?

    • Incidence

    • Prevalence

    • Ratio

    • Risk

    Correct Answer
    A. Prevalence
    Explanation
    Prevalence rate is the proportion of the population affected by a disease at a specific point in time. Prevalence is thus determined by both the incidence rate and the length of the survival period in affected individuals. (Incidence is the number of new cases)

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  • 19. 

    Antibodies are produced in:

    • Helper T lymphocytes

    • The thymus gland

    • Plasma cells

    • The bone marrow

    Correct Answer
    A. Plasma cells
    Explanation
    An antibody, or immunoglobulin, is a serum glycoprotein produced by plasma cells in response to a challenge by an immunogen.

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  • 20. 

    What is the cause of familial hypercholesterolemia (FH)?

    • A diet high in saturated fats

    • An increased production of cholesterol by the liver

    • A reduction in the number of LDL receptors on cell surfaces

    • An abnormal function of lipoprotein receptors circulating in the blood

    Correct Answer
    A. A reduction in the number of LDL receptors on cell surfaces
    Explanation
    FH is caused by a reduction in the number of functional LDL receptors on cell surfaces. Lacking the normal number of LDL receptors, cellular cholesterol uptake is reduced and circulating cholesterol levels increase.

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  • 21. 

    An autosomal dominant form of breast cancer accounts for ___% of all cases.

    • 5

    • 10

    • 15

    • 20

    Correct Answer
    A. 5
    Explanation
    An autosomal dominant form of breast cancer accounts for approximately 5% of breast cancer cases in the United States.

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  • 22. 

    What is the term for the process in which lymphoid stem cells migrate from the bone marrow to the central lymphoid organs (thymus or bone marrow) where they undergo cellular changes into either immunocompetent T cells or immunocompetent B cells?

    • Generation of clonal diversity

    • Clonal differentiation

    • Clonal selection

    • Clonal competence

    Correct Answer
    A. Generation of clonal diversity
    Explanation
    This process is called the generation of clonal diversity and occurs in specialized (primary) lymphoid organs: the thymus for T cells and the bone marrow for B cells.

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  • 23. 

    At birth, samples of blood from the umbilical cord indicate which immunoglobulin levels, if any, are near adult levels?

    • None

    • IgG

    • IgM

    • IgE

    Correct Answer
    A. IgG
    Explanation
    At birth, total IgG levels in the umbilical cord are near adult levels.

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  • 24. 

    Empirical risks for most multifactorial diseases are based on:

    • Chromosomal testing

    • Direct observation

    • Liability thresholds

    • Relative Risk

    Correct Answer
    A. Direct observation
    Explanation
    For most multifactorial diseases, empirical risks (i.e., risks based on direct observation of data) have been derived.

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  • 25. 

    Which antibody indicates a typical primary immune response?

    • IgG

    • IgM

    • IgA

    • IgE

    Correct Answer
    A. IgM
    Explanation
    This is the initial response, or primary immune response. Typically, IgM is produced first, followed by IgG against the same antigen.

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  • 26. 

    When a person is exposed to most antigens, how long does it take before an antibody can be detected in the circulation?

    • 12 hours

    • 24 hours

    • 3 days

    • 6 days

    Correct Answer
    A. 6 days
    Explanation
    After approximately 5 to 7 days, IgM antibody specific for that antigen can be detected in the circulation.

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  • 27. 

    Antibodies protect the host from bacterial toxins by:

    • Lysing the cell membrane of the toxins

    • Binding to the toxins to neutralize their biologic effects

    • Inhibiting synthesis of DNA proteins needed for growth

    • Interfering with the DNA enzyme needed for replication

    Correct Answer
    A. Binding to the toxins to neutralize their biologic effects
    Explanation
    To cause disease, most toxins must bind to surface molecules on the individual’s cells. Protective antibodies can bind to the toxins, prevent their interaction with cells, and neutralize their biologic effects.

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  • 28. 

    Which T cell controls or limits the immune response to protect the host's own tissues against an autoimmune response?

    • Cytotoxic T cells

    • Th1 cells

    • Th2 cells

    • Regulatory T (Treg) cells

    Correct Answer
    A. Regulatory T (Treg) cells
    Explanation
    The role of Treg cells is to control or limit the immune response to protect the host’s own tissues against autoimmune reactions.

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  • 29. 

    If a woman has one first-degree relative with breast CA, her risk of developing breast CA is ___ times what it would otherwise be.

    • 2

    • 3

    • 6

    • 10

    Correct Answer
    A. 2
    Explanation
    If a woman has one affected first-degree relative, her risk of developing breast cancer doubles.

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  • 30. 

    How are functions of the major histocompatibility molecules and CD1 molecules alike?

    • They are both antigen-presenting (APC) molecules

    • They both bind antigens to antibodies

    • They both secrete interleukins during the immune process

    • They are both capable of activating cytotoxic T lymphocytes

    Correct Answer
    A. They are both antigen-presenting (APC) molecules
    Explanation
    An essential set of recognition molecules are members of the MHC. Most antibody and cellular immune responses are dependent on antigen presentation by APCs. Another set of antigen-presenting molecules are members of the CD1 group.

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  • 31. 

    What are characteristics of the generation of clonal diversity?

    • The process involves antigens selecting those lymphocytes with compatible receptors

    • The process allows the differentiation of cells into antibody-screening plasma cells or mature T cells

    • The process takes place in the primary (central) lymphoid organs (i.e. thymus and bone marrow)

    • The process causes antigens to expand and diversify their populations

    Correct Answer
    A. The process takes place in the primary (central) lymphoid organs (i.e. thymus and bone marrow)
    Explanation
    Where does it occur? Central lymphoid organs: thymus for T cells, bone marrow for B cells.

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  • 32. 

    Vaccinations are able to provide protection against certain microorganisms because of the:

    • Strong response of IgM

    • Level of protection provided by IgG

    • Memory cells for IgE

    • Rapid response from IgA

    Correct Answer
    A. Level of protection provided by IgG
    Explanation
    IgG production is increased considerably, making it the predominant antibody class of the secondary response. It is often present in concentrations several times larger than those of IgM, and levels of circulating IgG specific for that antigen may remain elevated for an extended period of time.

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  • 33. 

    When antigens are administered to individuals to produce immunity, why are different routes of administration used (IV, SQ, nasal)?

    • Different routes allow the speed of onset of the antigen to be varied, with the IV route being fastest

    • Some individuals appear to be unable to respond to an antigen by a specific route, thus requiring the availability of different routes for the same antigen

    • Antigen-presenting cells (APCs) are highly specialized and thus require stimulation by different routes

    • Each route stimulates a different lymphocyte-containing tissue resulting in different types of cellular and humoral immunity

    Correct Answer
    A. Each route stimulates a different lymphocyte-containing tissue resulting in different types of cellular and humoral immunity
    Explanation
    Each route preferentially stimulates a different set of lymphocyte-containing (lymphoid) tissues and therefore results in the induction of different types of cell-mediated or humoral immune responses.

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  • 34. 

    Increased age may cause which of these changes in lymphocyte function?

    • Increased production of antibodies against self antigens

    • Decreased number of circulating T cells

    • Decreased production of autoantibodies

    • Increased production of helper T cells

    Correct Answer
    A. Increased production of antibodies against self antigens
    Explanation
    B-cell function is altered with age as shown by decreases in specific antibody production in response to antigenic challenge, with concomitant increases in circulating immune complexes and in circulating autoantibodies (antibodies against self-antigens).

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  • 35. 

    B-cell receptor (BCR) complex function differs from the function of circulating antibodies because the BCR complex:

    • Communicates information about the antigen to the helper T cell

    • Secretes chemical signals to communicate between cells

    • Recognizes the antigen on the surface of the B lymphocyte

    • Communicates information about the antigen to the cell nucleus

    Correct Answer
    A. Communicates information about the antigen to the cell nucleus
    Explanation
    Its role is to recognize antigen, but unlike circulating antibody, the receptor must communicate that information to the cell’s nucleus.

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  • 36. 

    Which cytokine is needed for the maturation of a functional helper T cell?

    • IL-1

    • IL-2

    • IL-4

    • IL-12

    Correct Answer
    A. IL-2
    Explanation
    Without IL-2 production, the Th cell cannot efficiently mature into a functional helper cell.

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  • 37. 

    Which are characteristics of clonal selection?

    • The process is driven by hormones and does not require foreign antigens

    • The process involves antigens selecting those lymphocytes with compatible receptors

    • The process takes place in the primary (central) lymphoid organs (i.e. thymus and bone marrow)

    • The process generates immature but immunocompetent T and B cells with receptors

    Correct Answer
    A. The process involves antigens selecting those lymphocytes with compatible receptors
    Explanation
    Clonal selection, during which antigen selects those lymphocytes with compatible receptors, expands their population, and causes differentiation into antibody-secreting plasma cells or mature T cells.

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  • 38. 

    Th2 cells produce IL-4 that suppresses:

    • B lymphocytes

    • Cytotoxic T lymphocytes

    • Th1

    • Memory T lymphocytes

    Correct Answer
    A. Th1
    Explanation
    Th2 cells produce IL-4, which suppresses Th1 and Th17 cells through their IL-4 receptors.

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  • 39. 

    What are the characteristics of Th1 cells?

    • They are induced by antigens derived from allergens

    • They are induced by antigens derived from cancer cells

    • They produce IL-4, IL-5, IL-6 and IL-13

    • They assist in the development of humoral immunity

    Correct Answer
    A. They are induced by antigens derived from cancer cells
    Explanation
    Antigens derived from viral or bacterial pathogens and those derived from cancer cells are hypothesized to induce a greater number of Th1 cells relative to Th2 cells.

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  • 40. 

    What are the characteristics of Th2 cells?

    • They are induced by antigens derived from allergens

    • They are induced by antigens derived from cancer cells

    • They produce IL-2, TNF-B and IFN-

    • They assist in the development in cell-mediated immunity

    Correct Answer
    A. They are induced by antigens derived from allergens
    Explanation
    For example, antigens derived from multicellular parasites and allergens are hypothesized as a result in production of more Th2 cells.

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