Deck 9: Cellular and Physiological Response to Injury:The Role of the Immune System
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Deck 9: Cellular and Physiological Response to Injury:The Role of the Immune System
1
When an individual begins to experience the first signs of an infection, this is classified as the _____ period
A)prodromal
B)acute
C)incubation
D)recovery
A)prodromal
B)acute
C)incubation
D)recovery
A
2
Injury to cells can include the breakdown of hemoglobin in red blood cells to _____
A)myoglobin
B)bilirubin
C)hemosiderin
D)globin
A)myoglobin
B)bilirubin
C)hemosiderin
D)globin
C
3
Central organs of our immune system actually synthesize the functional cells of the immune system These organs include the:
A)bone marrow and thymus
B)spleen and GALT
C)heart and MALT
D)tonsils and adenoids
A)bone marrow and thymus
B)spleen and GALT
C)heart and MALT
D)tonsils and adenoids
A
4
Which of the following is not an organ of the immune system?
A)thymus
B)GALT
C)pituitary gland
D)MALT
A)thymus
B)GALT
C)pituitary gland
D)MALT
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5
The first line of defense against microorganism invasion is the host's:
A)skin.
B)respiratory system.
C)white blood cells.
D)lymphatic system.
A)skin.
B)respiratory system.
C)white blood cells.
D)lymphatic system.
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6
_____ is the study of disruption of normal physiologic processes
A)Etiology
B)Epidemiology
C)Pathogenesis
D)Pathophysiology
A)Etiology
B)Epidemiology
C)Pathogenesis
D)Pathophysiology
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7
Hyaline deposits are composed of all the following except:
A)cartilage.
B)fibrin.
C)amyloid.
D)collagen.
A)cartilage.
B)fibrin.
C)amyloid.
D)collagen.
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8
When we isolate blood, body fluids, and wastes that have come from an infected client, we are following:
A)sterilization precautions.
B)standard precautions.
C)antiseptic precautions.
D)the nutrition care process.
A)sterilization precautions.
B)standard precautions.
C)antiseptic precautions.
D)the nutrition care process.
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9
Which of the following does not have a direct influence on an individual's susceptibility to infectious disease?
A)gender
B)environment
C)nutritional status
D)hormones
A)gender
B)environment
C)nutritional status
D)hormones
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10
Infectious disease is an example of which etiological category of disease?
A)multifactorial
B)acquired
C)genetic
D)idiopathic
A)multifactorial
B)acquired
C)genetic
D)idiopathic
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11
When treating a patient whose signs and symptoms go undiagnosed due to an unknown etiology, you refer to his or her condition as _____ in origin
A)iatrogenic
B)multifactorial
C)acquired
D)idiopathic
A)iatrogenic
B)multifactorial
C)acquired
D)idiopathic
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12
You have a patient experiencing xerostomia (dry mouth) His/her protection against microorganisms is lowered due to a:
A)decreased production of gastric juice.
B)decreased production of mucus.
C)decreased production of digestive enzymes.
D)decreased production of saliva.
A)decreased production of gastric juice.
B)decreased production of mucus.
C)decreased production of digestive enzymes.
D)decreased production of saliva.
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13
A common cellular response to injury and disease is the deposition of _____ within and between the cells
A)calcium deposits
B)hyaline
C)keratin
D)RBCs
A)calcium deposits
B)hyaline
C)keratin
D)RBCs
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14
Which of the following does not contribute to atrophy of cells?
A)loss of innervation
B)aging
C)inadequate nutrition
D)vasodilation/increased blood supply
A)loss of innervation
B)aging
C)inadequate nutrition
D)vasodilation/increased blood supply
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15
_____ is the study of the distribution of disease within populations
A)An outbreak
B)Etiology
C)Epidemiology
D)Pathology
A)An outbreak
B)Etiology
C)Epidemiology
D)Pathology
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16
Which of the following is not an example of natural resistance?
A)epithelial cells
B)mucus secretion
C)presence of immunoglobulins
D)tears
A)epithelial cells
B)mucus secretion
C)presence of immunoglobulins
D)tears
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17
Which of the following is the correct order of the stages of infection?
A)incubation, acute, prodromal, and convalescence
B)incubation, convalescence, prodromal, and acute
C)acute, incubation, prodromal, and convalescence
D)incubation, prodromal, acute, and convalescence
A)incubation, acute, prodromal, and convalescence
B)incubation, convalescence, prodromal, and acute
C)acute, incubation, prodromal, and convalescence
D)incubation, prodromal, acute, and convalescence
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18
One of your patients is diagnosed with hyperplasia of the adrenal gland due to an excess stimulation of cortisol What would be the best explanation for this occurrence?
A)Cushing's syndrome
B)Addison's disease
C)Zollinger-Ellison syndrome
D)metabolic syndrome
A)Cushing's syndrome
B)Addison's disease
C)Zollinger-Ellison syndrome
D)metabolic syndrome
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19
Dysplactic cellular growth is most often:
A)a benign growth.
B)pre-cancerous.
C)a swollen lump.
D)non-malignant.
A)a benign growth.
B)pre-cancerous.
C)a swollen lump.
D)non-malignant.
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20
Which of the following is an example of antiseptic use?
A)using hand sanitizer
B)cleaning a wound with betadine
C)cleaning the sink with bleach
D)rinsing your mouth with Listerine
A)using hand sanitizer
B)cleaning a wound with betadine
C)cleaning the sink with bleach
D)rinsing your mouth with Listerine
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21
An incomplete antigen that matures when combined with a larger molecule is called:
A)an erythrocyte.
B)a hapten.
C)an allergen.
D)an immunoglobulin.
A)an erythrocyte.
B)a hapten.
C)an allergen.
D)an immunoglobulin.
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22
Mature monocytes are called:
A)neutrophils.
B)macrophages.
C)natural killer cells.
A)neutrophils.
B)macrophages.
C)natural killer cells.
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23
You have a patient experiencing an inflammatory response After vasoconstriction, the patient will immediately begin to experience which of the following?
A)loss of sensation
B)bruising
C)hyperemia
D)jaundice
A)loss of sensation
B)bruising
C)hyperemia
D)jaundice
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24
Macrophages are primarily involved in phagocytosis and presentation of the antigen to:
A)T lymphocytes.
B)B lymphocytes.
C)natural killer cells.
A)T lymphocytes.
B)B lymphocytes.
C)natural killer cells.
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25
Types of polymorphonuclear leukocytes include:
A)T lymphocytes.
B)B lymphocytes.
C)natural killer cells.
D)immunoglobulins.
E)basophils.
A)T lymphocytes.
B)B lymphocytes.
C)natural killer cells.
D)immunoglobulins.
E)basophils.
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26
In adults, the cells of the immune system originate from:
A)stem cells of the bone marrow.
B)monocytes.
C)glial cells in the nervous system.
D)Langerhan's cells.
A)stem cells of the bone marrow.
B)monocytes.
C)glial cells in the nervous system.
D)Langerhan's cells.
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27
If a patient breathes in an antigen, the closest lymphoid tissue aggregate to respond is:
A)GALT.
B)MALT.
C)BALT.
D)the thymus.
A)GALT.
B)MALT.
C)BALT.
D)the thymus.
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28
When differentiating into various cells, the myeloid tissue will produce:
A)lymphocytes, macrophages, and monocytes.
B)monocytes, eosoniphils, and T cells.
C)macrophages, neutrophils, and monocytes.
D)B cells, leukocytes, and NK cells.
A)lymphocytes, macrophages, and monocytes.
B)monocytes, eosoniphils, and T cells.
C)macrophages, neutrophils, and monocytes.
D)B cells, leukocytes, and NK cells.
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29
Why is important to detect whether cancer has spread to lymph nodes?
A)because T and B cells are differentiated in the nodes
B)because cancer cells can then be spread throughout the body
C)because lymph organs allow antigens to interact with antigen-specific cells
D)because cancer cells will be destroyed by concentrated lymphoid tissue
A)because T and B cells are differentiated in the nodes
B)because cancer cells can then be spread throughout the body
C)because lymph organs allow antigens to interact with antigen-specific cells
D)because cancer cells will be destroyed by concentrated lymphoid tissue
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30
Molecules that are recognized by the immune system as potential pathogens are called:
A)antigens.
B)antibodies.
C)histamines.
D)microbes.
A)antigens.
B)antibodies.
C)histamines.
D)microbes.
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31
You have a patient reporting symptoms such as swelling, pain, and warmth in her elbow and other joints Which laboratory value would you assess in regards to her symptoms?
A)CRP
B)creatinine
C)albumin
D)transthyretin
A)CRP
B)creatinine
C)albumin
D)transthyretin
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32
As a result of an injury, proteins can accumulate in tissue spaces This is referred to as _____
A)polyps
B)fibroids
C)cyst
D)exudate
A)polyps
B)fibroids
C)cyst
D)exudate
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33
_____ is a protein that promotes the healing of damaged tissue
A)Keratin
B)Collagen
C)Elastin
D)Fibrinogen
A)Keratin
B)Collagen
C)Elastin
D)Fibrinogen
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34
B lymphocytes mature in the _____
A)thymus gland
B)bone marrow
C)adrenal gland
A)thymus gland
B)bone marrow
C)adrenal gland
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35
Which of the following is not a mediator of vasodilation?
A)histamine
B)nitric oxide
C)thromboxanes
D)androgens
A)histamine
B)nitric oxide
C)thromboxanes
D)androgens
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36
Which of the following fatty acids is the precursor for many lipid mediators that are involved in the immune response?
A)stearic
B)myristic
C)arachidonic
D)oleic
A)stearic
B)myristic
C)arachidonic
D)oleic
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37
T lymphocytes mature in the _____ gland
A)bone marrow
B)thymus
C)adrenal
A)bone marrow
B)thymus
C)adrenal
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38
Signs of inflammation include all of the following except:
A)loss of sensation.
B)swelling.
C)pain.
D)warmth.
A)loss of sensation.
B)swelling.
C)pain.
D)warmth.
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39
The cell-mediated response differs from the humoral immune response in that, in the humoral response, _____ is/are produced
A)lymphokines
B)cytokines
C)antibodies
D)complement
A)lymphokines
B)cytokines
C)antibodies
D)complement
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40
If a patient is infected for the first time with an new antigen, the Ig likely produced is:
A)IgE.
B)IgM.
C)IgA.
D)IgG.
A)IgE.
B)IgM.
C)IgA.
D)IgG.
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41
When the influenza vaccine is given to an elderly patient, this is which type of immunization?
A)passive immunization
B)attenuated vaccine
C)active immunization
D)toxoids
A)passive immunization
B)attenuated vaccine
C)active immunization
D)toxoids
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42
A patient with severe cirrhosis of the liver has received a new liver He is post op 3 months and is rejecting Through what main mechanism has this occurred?
A)the complement cells reject the host T cells
B)vasculature to the new organ has not been optimal
C)there was insufficient immunosuppressive therapy
D)antibody to minor histocompatibility antigens
A)the complement cells reject the host T cells
B)vasculature to the new organ has not been optimal
C)there was insufficient immunosuppressive therapy
D)antibody to minor histocompatibility antigens
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43
Allergy shots work by increasing levels of
A)IgE.
B)IgD.
C)IgG.
D)IgC.
A)IgE.
B)IgD.
C)IgG.
D)IgC.
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44
During the inflammatory response, when macrophages begin phagocytosis they trigger the release of _____, which stimulate the _____ to increase body temperature
A)prostaglandins, pineal gland
B)acute-phase proteins, hypothalamus
C)prostaglandins, hypothalamus
D)acute-phase proteins, pineal gland
A)prostaglandins, pineal gland
B)acute-phase proteins, hypothalamus
C)prostaglandins, hypothalamus
D)acute-phase proteins, pineal gland
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45
Case Study Multiple Choice
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
How many kcalories per kilogram of body weight would you use to estimate her caloric needs?
A)15-20
B)25-30
C)30-35
D)35-40
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
How many kcalories per kilogram of body weight would you use to estimate her caloric needs?
A)15-20
B)25-30
C)30-35
D)35-40
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46
Case Study Multiple Choice
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
How many grams of protein per kilogram of body weight does she need?
A)0.8
B)1.0
C)1.3
D)2.0
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
How many grams of protein per kilogram of body weight does she need?
A)0.8
B)1.0
C)1.3
D)2.0
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47
When a suspect food is eliminated from the diet, symptoms should improve within _______ week(s) after removal of the food
A)1-2
B)3-4
C)6-8
A)1-2
B)3-4
C)6-8
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48
Healing that occurs from the bottom of the injury upward to the surface is called:
A)healing by second intention.
B)healing by first intention.
C)healing by tertiary intention.
A)healing by second intention.
B)healing by first intention.
C)healing by tertiary intention.
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49
Which of the following is not characteristic of a Type I hypersensitivity reaction?
A)can occur at any point after the first exposure to the antigen
B)long-term complications occur from deposition of antigen within organs and cells
C)symptoms are caused primarily by release of histamine from the mast cells
D)can be a food allergy
A)can occur at any point after the first exposure to the antigen
B)long-term complications occur from deposition of antigen within organs and cells
C)symptoms are caused primarily by release of histamine from the mast cells
D)can be a food allergy
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50
NSAIDs used to alleviate inflammation inhibit _____ production by blocking _____
A)prostaglandin, cyclooxygenase enzymes
B)acute-phase proteins, cytokines
C)prostaglandin, cytokines
D)acute-phase proteins, cyclooxygenase enzymes
A)prostaglandin, cyclooxygenase enzymes
B)acute-phase proteins, cytokines
C)prostaglandin, cytokines
D)acute-phase proteins, cyclooxygenase enzymes
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51
You have a patient who is taking a medication to alleviate pain due to inflammation He/She describes the medication as "blocking the enzyme that stimulates prostaglandins" What medication is he/she taking?
A)proton-pump inhibitors
B)statins
C)NSAIDs
D)dopamine reuptake inhibitors
A)proton-pump inhibitors
B)statins
C)NSAIDs
D)dopamine reuptake inhibitors
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52
Which of the following unlikely to delay healing?)
A)infection
B)poor blood flow
C)mobility
D)dehydration
A)infection
B)poor blood flow
C)mobility
D)dehydration
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53
When a physician inoculates a patient with measles, mumps, and rubella, he is activating which kind of immunity?
A)active natural immunity
B)active artificial immunity
C)natural passive immunity
D)passive artificial immunity
A)active natural immunity
B)active artificial immunity
C)natural passive immunity
D)passive artificial immunity
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54
The most common food allergies in children include all of the following except:
A)fructose.
B)peanuts.
C)wheat.
D)eggs.
A)fructose.
B)peanuts.
C)wheat.
D)eggs.
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55
Which of the following people have the highest risk for developing osteoporosis?
A)individuals who use glucocorticoids long term
B)individuals who use aspirin long term
C)individuals who use diuretics long term
D)individuals who use statins long term
A)individuals who use glucocorticoids long term
B)individuals who use aspirin long term
C)individuals who use diuretics long term
D)individuals who use statins long term
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56
Case Study Multiple Choice
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
How many milliliters of fluid per kilogram of body weight does she need?
A)20
B)25
C)30
D)40
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
How many milliliters of fluid per kilogram of body weight does she need?
A)20
B)25
C)30
D)40
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57
The biggest difference(s) between a Type I reaction and a Type IV reaction is/are:
A)the amount of time before onset of symptoms
B)Type IV involves T cells and Type I involves an immunoglobulin.
C)Type IV involves an immunoglobulin and Type I involves T cells.
D)a and b
E)a and c
A)the amount of time before onset of symptoms
B)Type IV involves T cells and Type I involves an immunoglobulin.
C)Type IV involves an immunoglobulin and Type I involves T cells.
D)a and b
E)a and c
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58
When Samuel was stung by a bee, his reaction was a drop in blood pressure, difficulty breathing, and fainting This severe reaction is called:
A)cytotoxic hypersensitivity.
B)ABO blood reaction.
C)anaphylaxis.
A)cytotoxic hypersensitivity.
B)ABO blood reaction.
C)anaphylaxis.
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59
Case Study Multiple Choice
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
Which of the following supplements, if Mrs P is deficient, would the RD give to Mrs P as part of her nutrition prescription based on the available literature?
A)vitamin C
B)iron
C)vitamin E
D)omega-3 fatty acids
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
Which of the following supplements, if Mrs P is deficient, would the RD give to Mrs P as part of her nutrition prescription based on the available literature?
A)vitamin C
B)iron
C)vitamin E
D)omega-3 fatty acids
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60
Case Study Multiple Choice
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
What type of wound has Mrs P likely developed?
A)Stage I
B)Stage II
C)Stage III
D)Stage IV
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
What type of wound has Mrs P likely developed?
A)Stage I
B)Stage II
C)Stage III
D)Stage IV
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61
Case Study Multiple Choice
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
The RD may also provide which of the following oral supplements to aid in collagen deposition?
A)arginine
B)glutamine
C)pantothenic acid
D)there are currently no oral supplements for wound healing
Mrs.P is a 95 yo F who is a resident of a long-term care facility.The wound nurse was doing her rounds and noticed that Mrs.P has developed a partial thickness loss of dermis, open ulcer with a red-pink wound bed.She is 5'2" and weighs 109 #s.Mrs.P's intake is good as per nurse and care technicians.The wound nurse schedules a nutrition consultation for Mrs.P and discusses her finding with you.
The RD may also provide which of the following oral supplements to aid in collagen deposition?
A)arginine
B)glutamine
C)pantothenic acid
D)there are currently no oral supplements for wound healing
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62
Match between columns
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