CHAPTER 10
The Body’s Defenses Against Infection
The Immune System, Third Edition
© 2009 Garland Science Publishing
Questions
10–1
_____ microorganisms are microbes that colonize mucosal surfaces but under normal
circumstances do not cause disease.
a. Opportunistic
b. Commensal
c. Parasitic
d. Mesenteric
e. Pathogenic.
10–2
_____ makes up the membranes of connective tissue that help to anchor the
gastrointestinal tract and hold it in place.
a. The mesentery
b. Peyer’s patches
c. The lamina propria
d. The subepithelial dome
e. Waldeyer’s ring.
10–3
Waldeyer’s ring includes which of the following? (Select all that apply.)
a. Peyer’s patches
b. lingual tonsils
c. adenoids
d. mesenteric lymph nodes
e. palatine tonsils.
10–4
Which of the following describe M cells in the gut? (Select all that apply.)
a. They derive their name from mucus cells.
b. They are located in the dome of a Peyer’s patch.
c. They deliver antigens and pathogens from the lymphoid tissue to the luminal
side of the gut mucosa by transcytosis.
d. They are protected from digestive enzymes by a thick glycocalyx and a layer
of mucus.
e. They do not directly participate in antigen processing or presentation.
10–5
Mucosae of a healthy intestinal tract _____. (Select all that apply.)
a. have a large number of activated T and B cells
b. harbor T cells bearing a very wide diversity of antigen specificities
c. contain intraepithelial lymphocytes
d. have large numbers of resident neutrophils
e. are populated with both α:β and γ:δ CD8 effector T cells.
10–6
_____ is the vascular addressin found on endothelial cells of intestinal mucosa
that binds to integrins of gut-homing effector lymphocytes.
a. CCL25
b. C-cadherin
c. NOD1
,d. MAdCAM-1
e. CCR9.
10–7
The dominant immunoglobulin synthesized at mucosal surfaces is _____.
a. IgA
b. IgD
c. IgE
d. IgG
e. IgM.
10–8
If a B cell has been activated by antigen in the mucosa of the respiratory tract
then _____. (Select all that apply.)
a. lactating mothers will provide antigen-specific natural IgA in breast milk.
b. secretory IgA will be synthesized in the lamina propria of all mucosae.
c. it does not enter the bloodstream, but instead remains in the mucosa and
differentiates into an effector B cell.
d. it will recirculate through all mucosal tissues including respiratory and
gastrointestinal mucosae.
e. monomeric IgA is secreted into the lamina propria.
10–9
In which of the following tissues is IgA2 produced at approximately twice the level
as IgA1?
a. spleen
b. mammary glands
c. large intestine
d. gastric mucosa
e. upper small intestine.
10–10
Secretory IgA is best described as _____.
a. a non-inflammatory immunoglobulin that restricts the passage of antigens
across mucosal surfaces
b. a complement-activating immunoglobulin that causes destruction of invasive
microflora through the membrane-attack complex
c. an opsonizing antibody that facilitates uptake by M cells through Fc
receptors
d. an inflammatory immunoglobulin that stimulates the chemotaxis of neutrophils
into mucosal surfaces
e. a monomeric IgA that neutralizes antigen effectively at mucosal surfaces.
10–11
Secretory IgA and _____ can bind to the poly-Ig receptor and be transported into
the lumen of the gut or across other mucosal surfaces.
a. IgG
b. IgE
c. IgD
d. monomeric IgM
e. pentameric IgM.
10–12
Intracytoplasmic bacteria in enterocytes of the gastrointestinal tract are detected
by _____.
a. poly-Ig receptor
b. major basic protein
c. MIC-A and MIC-B
d. NOD proteins
,e. receptors for phosphoantigens.
10–13
NOD1 responds to _____, forms oligomers, and then activates the protein kinase
_____.
a. muramyl dipeptide; RICK
b. muramyl dipeptide; NFκB
c. defensins; RICK
d. muramyl tripeptide containing diaminopimelic acid: RICK
e. chemokines; NFκB.
10–14
Ligand binding of NOD2 results in the activation of the _____ signaling pathway and
the production of defensins, chemokines, and cytokines.
a. NFκB
b. NKG2D
c. Toll-like receptor
d. CD94:NKG2A
e. poly-Ig receptor.
10–15
Which of the following characterize MIC-A and MIC-B proteins? (Select all that
apply.)
a. recognized by NKG2D receptors of NK cells and some CD8 T cells
b. activate the NFκB signaling pathway
c. activate mast cells in the intestinal wall
d. closely related to MHC class I heavy chains
e. bind to MHC class I molecules and activate CD8 T cells.
10–16
Which of the following types of immune responses are most beneficial in clearing
helminth infections in the intestinal tract? (Select all that apply.)
a. production of IgG2 antibodies
b. production of IgE antibodies
c. complement fixation
d. eosinophil activation
e. antibody-dependent cell-mediated cytotoxicity
f. IFN-γ-induced production of mucus
g. TH1-derived cytokines.
10–17
Indicate whether the following questions are true (T) or false (F).
__ a. Secondary immune responses take the same amount of time as primary
immune responses to become effective.
__ b. On secondary exposure to an infectious agent there is reduced
mortality.
__ c. Only immune responses made in mucosal secondary lymphoid tissues can
provide protective immunity.
__ d. If an individual acquires a second cold in the same season it will most
likely be caused by a different type of cold virus.
__ e. Plasma cells generated in a secondary immune response have longer life-
spans than those made during a primary immune response.
__ f. During a primary immune response, only memory B cells are generated.
10–18
In which ways do memory B cells active in a secondary immune response differ from
the naive B-cell population activated in a primary immune response? (Select all
that apply.)
a. The antibody produced is of higher affinity in a secondary immune response.
, b. The frequency of antigen-specific B cells is lower in a secondary immune
response.
c. The level of somatic hypermutation is higher in a secondary immune response.
d. Higher levels of IgM are produced in secondary immune responses.
e. B cells do not require T-cell help in secondary immune responses.
f. Memory B cells express higher levels of MHC class II molecules.
g. Naive B cells express higher levels of co-stimulatory molecules.
10–19
Which of the following characterizes immunological memory? (Select all that apply.)
a. The host retains the capacity to mount a secondary immune response.
b. The host retains the ability to respond to pathogen many years after primary
exposure.
c. Naive T cells are activated more quickly when exposed to pathogen.
d. Memory B cells produce higher-affinity antibody than naive B cells.
e. Memory T cells undergo somatic hypermutation.
f. Memory T cells express CD45RA.
10–20
What would be the outcome if a naive B cell were to simultaneously bind to pathogen
coated with specific antibody made by an effector B cell in a primary immune
response using FcγRIIB1, and bind to the same pathogen using its B-cell receptor?
a. a positive signal leading to the production of low-affinity IgM antibodies
b. a positive signal leading to isotype switching and production of IgG, IgA, or
IgE antibodies
c. a positive signal leading to somatic hypermutation and production of high-
affinity IgM antibodies
d. a negative signal leading to inhibition of the production of low-affinity IgM
antibodies
e. a negative signal leading to apoptosis.
10–21
Which of the following explains why the first baby born to a Rh– mother and a Rh+
father does not develop hemolytic disease of the newborn?
a. Fetal erythrocytes do not cross the placenta and therefore do not stimulate
an antibody response.
b. The antibodies made by the Rh– mother during the first pregnancy are
predominantly IgM and have low affinity for the rhesus antigen.
c. Maternal macrophages in the placenta bind to anti-rhesus antibodies and
prevent their transfer to the fetus.
d. Hemolytic disease of the newborn is a T-cell-mediated disease and maternal T
cells do not cross the placenta during pregnancy.
e. The rhesus antigen is not immunogenic and does not stimulate an antibody
response.
10–22
By which process are fetal erythrocytes destroyed in hemolytic anemia of the
newborn?
a. lysis of erythrocytes by cytotoxic T cells
b. lysis of erythrocytes by complement activation
c. clearance of antibody-coated erythrocytes by macrophages in the fetal spleen
d. lysis of erythrocytes by NK cells via antibody-dependent cell-mediated
cytotoxicity
e. cytotoxicity caused by major basic protein released from eosinophils.
10–23
Which of the following explain why infections with influenza virus erode
immunological memory over time? (Select all that apply.)
a. Influenza is a highly mutable virus that changes its epitope composition.
The Body’s Defenses Against Infection
The Immune System, Third Edition
© 2009 Garland Science Publishing
Questions
10–1
_____ microorganisms are microbes that colonize mucosal surfaces but under normal
circumstances do not cause disease.
a. Opportunistic
b. Commensal
c. Parasitic
d. Mesenteric
e. Pathogenic.
10–2
_____ makes up the membranes of connective tissue that help to anchor the
gastrointestinal tract and hold it in place.
a. The mesentery
b. Peyer’s patches
c. The lamina propria
d. The subepithelial dome
e. Waldeyer’s ring.
10–3
Waldeyer’s ring includes which of the following? (Select all that apply.)
a. Peyer’s patches
b. lingual tonsils
c. adenoids
d. mesenteric lymph nodes
e. palatine tonsils.
10–4
Which of the following describe M cells in the gut? (Select all that apply.)
a. They derive their name from mucus cells.
b. They are located in the dome of a Peyer’s patch.
c. They deliver antigens and pathogens from the lymphoid tissue to the luminal
side of the gut mucosa by transcytosis.
d. They are protected from digestive enzymes by a thick glycocalyx and a layer
of mucus.
e. They do not directly participate in antigen processing or presentation.
10–5
Mucosae of a healthy intestinal tract _____. (Select all that apply.)
a. have a large number of activated T and B cells
b. harbor T cells bearing a very wide diversity of antigen specificities
c. contain intraepithelial lymphocytes
d. have large numbers of resident neutrophils
e. are populated with both α:β and γ:δ CD8 effector T cells.
10–6
_____ is the vascular addressin found on endothelial cells of intestinal mucosa
that binds to integrins of gut-homing effector lymphocytes.
a. CCL25
b. C-cadherin
c. NOD1
,d. MAdCAM-1
e. CCR9.
10–7
The dominant immunoglobulin synthesized at mucosal surfaces is _____.
a. IgA
b. IgD
c. IgE
d. IgG
e. IgM.
10–8
If a B cell has been activated by antigen in the mucosa of the respiratory tract
then _____. (Select all that apply.)
a. lactating mothers will provide antigen-specific natural IgA in breast milk.
b. secretory IgA will be synthesized in the lamina propria of all mucosae.
c. it does not enter the bloodstream, but instead remains in the mucosa and
differentiates into an effector B cell.
d. it will recirculate through all mucosal tissues including respiratory and
gastrointestinal mucosae.
e. monomeric IgA is secreted into the lamina propria.
10–9
In which of the following tissues is IgA2 produced at approximately twice the level
as IgA1?
a. spleen
b. mammary glands
c. large intestine
d. gastric mucosa
e. upper small intestine.
10–10
Secretory IgA is best described as _____.
a. a non-inflammatory immunoglobulin that restricts the passage of antigens
across mucosal surfaces
b. a complement-activating immunoglobulin that causes destruction of invasive
microflora through the membrane-attack complex
c. an opsonizing antibody that facilitates uptake by M cells through Fc
receptors
d. an inflammatory immunoglobulin that stimulates the chemotaxis of neutrophils
into mucosal surfaces
e. a monomeric IgA that neutralizes antigen effectively at mucosal surfaces.
10–11
Secretory IgA and _____ can bind to the poly-Ig receptor and be transported into
the lumen of the gut or across other mucosal surfaces.
a. IgG
b. IgE
c. IgD
d. monomeric IgM
e. pentameric IgM.
10–12
Intracytoplasmic bacteria in enterocytes of the gastrointestinal tract are detected
by _____.
a. poly-Ig receptor
b. major basic protein
c. MIC-A and MIC-B
d. NOD proteins
,e. receptors for phosphoantigens.
10–13
NOD1 responds to _____, forms oligomers, and then activates the protein kinase
_____.
a. muramyl dipeptide; RICK
b. muramyl dipeptide; NFκB
c. defensins; RICK
d. muramyl tripeptide containing diaminopimelic acid: RICK
e. chemokines; NFκB.
10–14
Ligand binding of NOD2 results in the activation of the _____ signaling pathway and
the production of defensins, chemokines, and cytokines.
a. NFκB
b. NKG2D
c. Toll-like receptor
d. CD94:NKG2A
e. poly-Ig receptor.
10–15
Which of the following characterize MIC-A and MIC-B proteins? (Select all that
apply.)
a. recognized by NKG2D receptors of NK cells and some CD8 T cells
b. activate the NFκB signaling pathway
c. activate mast cells in the intestinal wall
d. closely related to MHC class I heavy chains
e. bind to MHC class I molecules and activate CD8 T cells.
10–16
Which of the following types of immune responses are most beneficial in clearing
helminth infections in the intestinal tract? (Select all that apply.)
a. production of IgG2 antibodies
b. production of IgE antibodies
c. complement fixation
d. eosinophil activation
e. antibody-dependent cell-mediated cytotoxicity
f. IFN-γ-induced production of mucus
g. TH1-derived cytokines.
10–17
Indicate whether the following questions are true (T) or false (F).
__ a. Secondary immune responses take the same amount of time as primary
immune responses to become effective.
__ b. On secondary exposure to an infectious agent there is reduced
mortality.
__ c. Only immune responses made in mucosal secondary lymphoid tissues can
provide protective immunity.
__ d. If an individual acquires a second cold in the same season it will most
likely be caused by a different type of cold virus.
__ e. Plasma cells generated in a secondary immune response have longer life-
spans than those made during a primary immune response.
__ f. During a primary immune response, only memory B cells are generated.
10–18
In which ways do memory B cells active in a secondary immune response differ from
the naive B-cell population activated in a primary immune response? (Select all
that apply.)
a. The antibody produced is of higher affinity in a secondary immune response.
, b. The frequency of antigen-specific B cells is lower in a secondary immune
response.
c. The level of somatic hypermutation is higher in a secondary immune response.
d. Higher levels of IgM are produced in secondary immune responses.
e. B cells do not require T-cell help in secondary immune responses.
f. Memory B cells express higher levels of MHC class II molecules.
g. Naive B cells express higher levels of co-stimulatory molecules.
10–19
Which of the following characterizes immunological memory? (Select all that apply.)
a. The host retains the capacity to mount a secondary immune response.
b. The host retains the ability to respond to pathogen many years after primary
exposure.
c. Naive T cells are activated more quickly when exposed to pathogen.
d. Memory B cells produce higher-affinity antibody than naive B cells.
e. Memory T cells undergo somatic hypermutation.
f. Memory T cells express CD45RA.
10–20
What would be the outcome if a naive B cell were to simultaneously bind to pathogen
coated with specific antibody made by an effector B cell in a primary immune
response using FcγRIIB1, and bind to the same pathogen using its B-cell receptor?
a. a positive signal leading to the production of low-affinity IgM antibodies
b. a positive signal leading to isotype switching and production of IgG, IgA, or
IgE antibodies
c. a positive signal leading to somatic hypermutation and production of high-
affinity IgM antibodies
d. a negative signal leading to inhibition of the production of low-affinity IgM
antibodies
e. a negative signal leading to apoptosis.
10–21
Which of the following explains why the first baby born to a Rh– mother and a Rh+
father does not develop hemolytic disease of the newborn?
a. Fetal erythrocytes do not cross the placenta and therefore do not stimulate
an antibody response.
b. The antibodies made by the Rh– mother during the first pregnancy are
predominantly IgM and have low affinity for the rhesus antigen.
c. Maternal macrophages in the placenta bind to anti-rhesus antibodies and
prevent their transfer to the fetus.
d. Hemolytic disease of the newborn is a T-cell-mediated disease and maternal T
cells do not cross the placenta during pregnancy.
e. The rhesus antigen is not immunogenic and does not stimulate an antibody
response.
10–22
By which process are fetal erythrocytes destroyed in hemolytic anemia of the
newborn?
a. lysis of erythrocytes by cytotoxic T cells
b. lysis of erythrocytes by complement activation
c. clearance of antibody-coated erythrocytes by macrophages in the fetal spleen
d. lysis of erythrocytes by NK cells via antibody-dependent cell-mediated
cytotoxicity
e. cytotoxicity caused by major basic protein released from eosinophils.
10–23
Which of the following explain why infections with influenza virus erode
immunological memory over time? (Select all that apply.)
a. Influenza is a highly mutable virus that changes its epitope composition.
