Question 1

You tell your patient that tattoo ink can sometimes cause the skin reaction he is experiencing; red ink in particular can cause this because it commonly contains mercury and/or other heavy metals. Your patient has developed a granuloma at the site of his tattoo. When he asks you what a granuloma is, you tell him

Accepted Answer

A granuloma is a type of inflammation characterized by a collection of immune cells, including macrophages, giant cells, and T cells. These cells work together to isolate and contain foreign substances, such as tattoo ink or other particles, that the body cannot eliminate on its own.

Question 2

When microbes are introduced into normally sterile body sites, or when tissues are damaged, inflammation occurs. The purpose of this is to contain a site of damage, localize the response, eliminate the invader, and restore tissue function. Select the correct sequence of events for an inflammation response.
1) The phagocytes then produce other adhesion molecules that strengthen their attachment to the endothelial cells.
2) Tight junctions between endothelial cells are disrupted, allowing leakage from the vessels into the tissue.
3) Endothelial cells of the blood vessels produce adhesion molecules that loosely "grab" phagocytic cells.
4) In response to various chemoattractants, the phagocytes leave the blood vessels and move into the surrounding tissues.
5) The diameter of local blood vessels increases due to the action of inflammatory mediators, slowing blood flow in the area.

Accepted Answer

The correct sequence starts with the dilation of blood vessels to slow blood flow (5), followed by the disruption of tight junctions allowing leakage (2), then endothelial cells grabbing phagocytes (3), strengthening of the attachment (1), and finally, phagocytes moving to tissues (4).

Question 3

Given what you understand about inflammation, why do you think a person with LAD experiences neutrophilia (high numbers of neutrophils in the blood)?

Accepted Answer

In a person with LAD, the neutrophils cannot leave the blood vessel to enter infected tissue, which causes them to accumulate in the blood. Infections trigger an increase in neutrophil production, which exacerbates the neutrophilia.

Question 4

Which of the following do you think would be a possible way to cure a person with LAD?

Accepted Answer

The only way to cure LAD is to replace the person's defective leukocytes with healthy leukocytes. This can be achieved through a hematopoietic stem cell transplant, where the person's bone marrow is replaced with healthy bone marrow from a donor. Options A, B, and C may help manage symptoms or prevent infections, but they do not address the underlying issue of defective leukocytes. Option E is not feasible as it is impossible to maintain a completely microbe-free environment.

Question 5

Which of the following is NOT a leukocyte?

Accepted Answer

All of the options listed are types of leukocytes.

Question 6

Your patient doesn't understand all of the cell names that you have used. You educate him on the role of each cell type. One cell type that plays a role in adaptive immunity rather than innate immunity. Which cell is this?

Accepted Answer

Dendritic cells are involved in adaptive immunity as they present antigens to T cells and play a crucial role in their activation. The other cell types mentioned are all involved in innate immunity.

Question 7

You go on to explain to your patient that his skin and mucous membranes are protected from microbes by a number of antimicrobial substances. You inadvertently make a mistake during this explanation. Which of the following definitions is INCORRECT?

Accepted Answer

Defensins are actually short antimicrobial peptides found in various bodily fluids and tissues, including the skin and mucous membranes. They work by disrupting the membrane of microbes, leading to their death.

Question 8

Your patient questions why he has developed a granuloma. You explain to him that granulomas

Accepted Answer

Granulomas are formed as an attempt by the body to wall off and contain persistent antigens - in this case, the red tattoo ink containing mercury compounds. Granulomas are clusters of macrophages, giant cells, and T cells that form in response to a chronic stimulus that the body is unable to remove.

Question 9

Which of the following is NOT true of neutrophils?

Accepted Answer

Neutrophil numbers increase during bacterial infections, not decrease.

Question 10

Given the name "leukocyte adhesion deficiency," which of the following steps in the inflammation process given below do you think is/are not carried out in a person with this condition?
1) Tight junctions between endothelial cells are disrupted, allowing fluid to leak from the vessels into the tissue.
2) The phagocytes bind to the endothelial cells and exit the blood vessel by a process called diapedesis.
3) Once in the tissues, phagocytic cells engulf and destroy any microbial invaders.
4) The increase of fluids in the tissues causes the swelling and pain associated with inflammation.
5) The diameter of local blood vessels increases due to the action of inflammatory mediators.

Accepted Answer

In leukocyte adhesion deficiency, the phagocytes are unable to bind to the endothelial cells and exit the blood vessel by diapedesis, therefore step 2 is not carried out.

Question 11

Your patient wonders what giant cells are and how they form. You explain that giant cells

Accepted Answer

Giant cells are very large cells with multiple nuclei; they are formed by the fusion of many macrophages during a chronic inflammatory response.

Question 12

You tell your patient that when he got his tattoo, his first line of defense of his innate immunity was breached because his skin was damaged by the process. He asks you to explain what is included in the first line of defense and you tell him

Accepted Answer

The first line of defense includes the skin and mucous membranes as physical barriers to prevent pathogens from entering the body. White blood cells and lymphocytes are part of the second line of defense, which is the innate immune system's response to pathogens that breach the first line of defense.

Quiz 14: The Innate Immune Response

Given what you understand about inflammation, why do you think a person with LAD experiences neutrophilia (high numbers of neutrophils in the blood) ?