May 14, Review for final exam (May 21, 2011, 8 AM)

Transcription

1 May 14, 2011 Review for final exam (May 21, 2011, 8 AM) The final exam is comprehensive. Two thirds of the test will cover material from the last one third of the class. The remaining one third of the test will be split equally between the first two thirds of the class. The previous review sheets and your first two exams for the semester are the best guides for preparing for this portion of the final exam. The reading assignments below are for the third portion of class, listed in the order of coverage in class. As always, material covered in class is of primary importance. Fig Box 30.3 Fig For information only, not test material Table 31.3 Section 31.2 Fig Section 31.3 Fig Table 31.4 Fig Fig Table 31.5 Fig For information only, not test material For information only, not test material Fig Fig Section 32.6 Fig Fig Fig Table 32.5 Fig Section 33.7 Table 33.3 Fig Section 33.8 Figure Figure 32.5 Fig Fig Fig Survey, not details for test

2 Fig Fig Fig Fig Section 35.3 Fig Fig Fig Fig Fig Figs and NOT assigned Fig Fig Fig Section 36.7 Table 36.2 Table 36.3 Epidemiology (Assigned, but not covered in class) Sections 36.1 through 36.6 (pages 874 through 885) Enclosed below are multiple choice questions 64 to 145 and short answer questions from last year s final exam. These questions covered the material from the third portion of the course. The questions from last year s final not included here (1-63 and ) were drawn from the first two thirds of the course. Answers are included after the exam questions. The exam will have 145 multiple choice questions and 5 short answer questions. This examination has twice the value of each of the midterms. They were each worth 17.5% of your course grade and the final is worth 35%, to arrive at the total of 70% for the lecture part of the course. 64. The normal microbiota (also called the normal microflora) is defined as: a) microorganisms in our surroundings. b) microorganisms in our blood. c) the harmless presence of microorganisms at specific sites on the human body. d) the prevention of microorganisms growth. 65. The bacterial microenvironment within a human host: a) can be made by virally infected cells. b) can be created by the bacteria.

3 c) is created by the immune response. 66. A common way for bacteria to infect a human host is: a) through a cut in the skin. b) by crossing through intact skin. c) through the gastrointestinal tract 67. The relationship between humans and microbes is: a) constant or fixed and does not change. b) always pathogenic. c) always commensal. d) dynamic and does change. 68. An infection is: a) the same thing as a disease. b) the unmanaged interaction of microbe with host. c) the penetration of a tissue barrier to enter an host. d) the relative ability of a microorganism to cause a disease. 69. In a commensal relationship: a) the bacteria harm the host. b) the host harms the bacteria. c) both bacteria and host benefit. d) none of the above. 70. The skin surface is not a suitable environment for the growth of some bacteria because: a) it is slightly acidic. b) has a high salt concentration. c) of the presence of bactericidal or bacteriostatic products. 71. Bacteria are found within human tissues: a) most of the time, for example, in the intestines. b) only before birth, but are effectively removed from the bodies of young babies. c) only after an infection has occurred. d) only after death has occurred. 72. Studies with gnotobiotic animals showed: a) which bacteria are important in causing cancer. b) that normal mammalian physiology and anatomy do not develop properly in the absence of bacteria. c) that birds, bit not mammals, can be kept alive if bacteria are excluded. d) which bacteria are necessary lead to the strongest reaction of the immune system. 73. Infections: a) always lead to diseases. b) can produce symptoms, such as swelling and redness around a cut, even if no disease results. c) are the penetration of a tissue barrier by a microorganism.

4 d) only occur after a tissue injury, such as a wound. 74. Pathogenicity: a) describes the relative ability to cause a disease. b) is one of the components of virulence. c) is not an important concept for bacteria that produce exotoxins. d) relates exclusively to diseases caused by viruses. 75. Invasiveness: a) is the same thing as infectivity. b) is necessary for a bacterium to be able to cause disease. c) only matters for virus-caused diseases. d) is the ability of a bacterium to spread within tissues. 76. Bacterial Pathogenesis requires: a) the destruction of T helper cells. b) destruction of the host complement system. c) production of antibiotics from B cells. d) initial evasion of the host immune responses. 77. To establish an infection, a bacterial cell: a) must secrete endotoxin. b) always secretes extotoxin. c) must adhere to, colonize and/or invade the host. d) none of the above. 78. Which of the following is TRUE? a) Endotoxins are antibodies. b) Exotoxins are part of the bacterial cell wall. c) Endotoxins are antibiotics. d) Exotoxins can inhibit protein synthesis. 79. Which of the following is FALSE? a) Exotoxins can increase the virulence of a non-invasive bacterium. b) Endotoxins are required in large amounts to cause a disease. c) Endotoxins cause the bacteria cell to lyse. d) Exotoxins are generally heat-sensitive. 80. Endotoxins: a) are lipopolysaccharide secreted by the bacteria b) may be converted to toxoids. c) are only produced by Gram negative bacteria. d) are tissue-destroying enzymes. 81. Which of the followings is true of exotoxins? a) They are convertible to toxoids. b) Most of them are heat resistant. c) Some, such as those produced by flesh-eating bacteria act to degrade human tissues. d) They enhance the invasive ability of bacteria. 82. In the "AB dimer" model of exotoxins:

5 a) one subunit is responsible for attachment, the other for damage. b) both subunits are responsible for attachment and damage. c) Gram positive bacteria produce much more dangerous exotoxins than Gram negative bacteria do. d) the poisonous effect only happens after lysogenic conversion. 83. Which of the following is true of inflammation? a) It causes a fever. b) Swelling is reduced due to fluid leakage. c) It causes a spread of the infection d) All of the above. 84. Pus: a) is mostly composed of dead white blood cells. b) indicates that an infection has occurred. c) is formed by bacteria to destroy white blood cells. d) stimulates the inflammatory response. 85. The ID 50 for a specific microorganism: a) is the amount of time needed for 50% of the bacteria to die. b) is higher for more virulent organisms. c) is smaller for more pathogenic organisms. d) records the number of test animals which become ill. 86. ID 50 : a) cannot be determined for bacteria which produce exotoxins. b) cannot be determined for bacteria which produce endotoxins. c) never changes for a given type of bacteria. d) measures relative disease-causing ability in a quantitative way. 87. Inflammation: a) is a non-specific response to infection. b) causes pain. c) cause the chemotaxis of leukocyte or white blood cells to the site of infection. 88. Vascular permeability is important for inflammation because it: a) allows the bacteria to leave the site. b) allows leukocytes into the site of inflection. c) allows leukocytes to leave the site of infection. d) keeps the blood vessel healthy. 89. Antibodies are produced by: a) T cells. b) bacterial cells. c) plasma cells. d) viruses. 90. IgG Antibodies are: a) multispecific. b) bivalent. c) bound only by haptens.

6 d) none of the above. 91. An antibody: a) reacts with all the epitopes on an antigen. b) must be a lipid. c) recognizes one antigenic determinant. 92. Haptens: a) may interfere with Ab-Ag reactions by binding to the Ab. b) are epitopes that have become detached from their Ag. c) are formed by the human defense cells as they destroy pathogens. d) a) and b). 93. Antibodies protect against disease by: a) directly destroying the pathogen. b) stimulating the complement system, which destroys the pathogen. c) stimulating antibiotic production by the normal flora. d) none of the above 94. Antibodies bind directly to their antigens: a) using the Fc region. b) using the constant region. c) using Fab region. 95. Antibodies bind to immune cells (such as B and T cells): a) using the constant region. b) Fab site. c) variable site. d) epitope site. 96. An antigen: a) is monospecific and recognized by one antibody. b) is monovalent and recognized by one antibody. c) can be recognized by several antibodies. 97. Neutralization is best described as: a) a process mediated by antibiotics made by B cells through clonal selection. b) a process to destroy viral infected cells. c) a process that prevents viruses or toxins from binding their targets on host cells. 98. Which of the following is TRUE? a) Bacteria can be neutralized by antibodies. b) Viruses can be neutralized by antibodies. c) Complement can help with neutralization. d) a) and b). 99. The alternative pathway of complement activation:

7 a) only occurs individuals who lack the ability to make antibodies. b) begins with the recognition of repeating units on a pathogen, such as the lipopolysaccharide on the outer membrane of a Gram negative bacterium. c) can lead to the formation of the attack complex, just as the classical pathway does. d) b) and c) Opsonization occurs to the maximal extent: a) when viruses bind to the host cell prior to infecting it. b) when viruses bind to bacterial cells. c) when complement and antibody bind to a pathogen Cell-mediated cyotoxicity: a) only works to destroy cells that have been infected by a virus. b) uses natural killer cells to destroy other human cells. c) may remove tumor cells that have gained certain surface molecules During inflammation, chemotaxis: a) is carried out by bacteria to confuse the host response. b) attracts defense cells in the blood to the area of infection. c) causes the destruction of phagocytes at the site of infection. d) causes bacteria to accumulate in the infected area. ******* same as Part of the lethal action of phagocytosis during inflammation: a) is the destruction of bacterial cell structures by enzymes. b) occurs due to the respiratory consumption of molecular oxygen (O 2 ) consumption by the phagocytes. c) is brought about by the consumption of toxic forms of oxygen by the bacteria Serology is the study of: a) microbes in the blood. b) microbes in the serum in the laboratory. c) antibody-antigen interaction in the laboratory. d) none of the above During the process of diagnostic serology: a) the patient s serum is tested directly for a virus or toxin. b) a drug added to serum samples to detect the virus antibodies in the serum. c) the patient s serum is being tested for antibodies to a particular virus, toxin or bacterium. d) none of the above Part of the lethal action of phagocytosis during inflammation: a) is the destruction of bacterial cell structures by enzymes. b) occurs due to the respiratory consumption of molecular oxygen (O 2 ) consumption by the phagocytes. c) is brought about by the consumption of toxic forms of oxygen by the bacteria.

8 107. The Monocyte-Macrophage system: a) is composed of cells which circulate in the blood stream. b) requires the presence of antibodies to provide protection. c) is composed of cells that are fixed in place in several tissues. d) is most effective against bacteria which possess capsules Agglutination: a) works well with univalent as well as bivalent antibodies. b) forms a visible clump of the agglutinated antigen in the test tube. c) is blocked by bivalent antibodies. d) does not occur if the antigen is multivalent Agglutination: a) occurs during the drug test when the antigen is not present. b) occurs during the viral hemagglutination test when antibodies to the virus are not present. c) occurs during the pregnancy test when the antigen is not present The primary immune response: a) is faster than the secondary response. b) produces a higher antibody titer during the plateau phage. c) has approximately a 14 day lag phage. d) has a steeper slope during the log phase Which is true regarding B cells and the primary and secondary immune responses? a) Memory B cells are responsible for the higher antibody titer in the primary response. b) B cells become neutrophils and ingest the antigen. c) Memory B cells are responsible for the faster response in the secondary response. d) All of the above B cells: a) are produced in the human bone marrow. b) recognize several antigens each. c) recognize one type of epitope each. d) a and c Stem cells: a) are undifferentiated cells that can become several different cell types. b) destroy cells in the bone marrow. c) are the first to produce antibodies in response to viral infection. d) are formed by B cells Antibody-antigen interactions: a) are an extract fit, like a key and lock. b) can occur in the body and outside the body. c) are non-specific. d) are required for bacterial survival Clonal selection is: a) the development of T Cells. b) the selective cloning of material in a bacterium.

9 c) the proliferation of a B cell responding to a specific epitope. d) the development of B cells in the bone marrow Memory cells: a) are passively transferred to fetuses in utero. b) are the lasting cells of the primary response. c) cause the secondary response to occur quickly. d) b and c Which of the followings is true regarding T-Cell biology? a) T killer cells stimulate B cells. b) T suppressor cells suppressor viral replication. c) T helper cells are positive regulators of the immune response. d) T cytotoxic cells stimulate T helper cells HIV infects: a) T killer cells. b) T cytotoxic cells. c) T-helper cells. d) B-cells CD4 cells: a) assist in the differentiation of B cells. b) are the target of HIV. c) interact with the epitope presented by the macrophage An attenuated pathogen: a) is made from the tissues of someone who died from the disease. b) may arise in the lab by itself. c) usually causes a mild form of disease. d) is one which has become more dangerous to humans Which of the following is correct? a) Transfer of antibodies to infants across the placenta is an example of active natural immunity. b) Antibodies produced by a natural infection is called passive immunity. c) Vaccination is artificial passive immunity. d) None of the above A horse was injected with diphtheria toxin and its serum was collected after several weeks. This serum was then injected in a patient who was exposed to diphtheria toxin. Which of the following is true? a) The patient is artificially passively immunized. b) The horse is artificially actively immunized. c) Anti-diphtheria toxin antibodies from the horse are transferred to the patient. d) All of the above The transfer of antibodies in the breast milk to infant is: a) natural active immunity. b) natural passive immunity. c) artificial active immunity.

10 d) artificial passive immunity Vaccination is: a) natural active immunity. b) natural passive immunity. c) artificial active immunity. d) artificial passive immunity A vaccine: a) should be as similar to the pathogen as possible so the primary response will be more effective. b) can cause only a primary response not a secondary one. c) is used to treat an existing disease; it does not prevent a disease from occurring Edward Jenner s experiment with smallpox on the small boy was an example of: a) natural active immunity. b) natural passive immunity. c) artificial active immunity. d) artificial passive immunity Jenner s experiment worked because: a) Cowpox and smallpox are extremely diffirent viruses, but the human immune system can tell them apart. b) Cowpox and smallpox are the same virus, just one is in a cow and the other in a human. c) The antibodies made against cowpox react against smallpox. d) Cowpox is a fatal cousin of smallpox that tricks the human immune system Active immunization involves: a) the exposure of a human to the wild-type pathogen. b) the injection of a human with preformed antibodies from another animal. c) the exposure of a human to a pathogen s epitopes. d) the active injection of horse antibodies into a human Passive immunization involves: a) the exposure of a human to the wild-type pathogen. b) the injection of a human with preformed antibodies from another animal. c) the exposure of a human to the pathogen s epitopes. d) the active injection of horse antibodies into a human Vaccination: a) leaves the vaccinated person passively immune. b) is the infection of a patient with a pathogen. c) utilizes antigens that are similar to pathogens Whole organism vaccines: a) use the whole protein of the pathogen. b) use the whole DNA of the pathogen. c) use inactivated or attenuated pathogen. d) none of the above Purified macromolecules vaccines:

11 a) use the whole protein of the pathogen. b) use the whole DNA of the pathogen. c) use inactivated pathogen. d) none of the above Vaccination: a) is the infection of a patient with a pathogen. b) utilizes antigens that are very different from pathogens. c) works very well against exotoxin-caused diseases. d) leaves the vaccinated person passively immune The injection of DNA containing the information to synthesize a pathogen s epitope is an example of: a) purified macromolecules vaccination. b) recombinant-vector vaccination. c) DNA vaccination. d) Whole organism vaccination A toxoid: a) is an altered exotoxin or endotoxin. b) causes immune response to bacterial cells. c) is formed by chemical modification of an endotoxin. d) cannot be formed from an endotoxin An endemic disease: a) is one which has a high incidence of fatality. b) is one which occurs with a steady low-level frequency at a moderately regular interval. c) becomes epidemic after a long period of time. d) is termed pandemic if it occurs over a very wide range The morbidity rate: a) is a measure of the frequency of fatal diseases in a population. b) increases during an epidemic. c) and mortality rate measure the same thing. d) is a term which applies primarily to non-fatal diseases A common-source epidemic: a) is usually is of much longer duration than a propagated epidemic. b) usually continues only for a few days. c) describes the first stages of a propagated epidemic. d) occurs when most of the population has the disease Herd immunity: a) requires the vaccination of livestock such as cattle. b) causes a person who is not immune to become sick because of the immunity of others in the population. c) is most effective when a large proportion of people in the population have become immune. d) is a frequent cause of epidemics "Antigenic shift": a) describes the production of altered epitopes by pathogens such as the influenza virus.

12 b) is the changing of human receptor targets by a pathogen. c) causes more problems to humans for pathogens which have an animal reservoir. d) is the production of haptens by some bacteria Fomites: a) are diseases that cause excessive salivation in animals. b) are animals that transmit diseases to humans. c) are diseased humans that can spread a disease. d) are frequent sources of infection in a medical setting Carriers: a) are animals which transmit diseases to humans. b) are very rare for diseases such as diphtheria for which there are few cases each year. c) are more common in populations which are isolated from most other humans. d) do not show symptoms of a disease although they are infected A reservoir of a disease: a) may be living or nonliving. b) contains those pathogenic bacteria which live in water. c) is a localized infection, such as found in a boil. d) is a natural (not human-made) source of pathogenic bacteria Nosocomial infectious: a) are respiratory diseases. b) occur in hospitals. c) are not contagious. d) usually cause epidemics Zoonoses: a) are respiratory diseases of animals. b) have animal reservoirs. c) only occur with the action of insect vectors. d) are diseases with animate reservoirs, either humans or other animals What is the difference between natural passive immunity and artificial passive immunity? 150. What is the difference between morbidity and mortality rates? Answers 64. c 65. b 66. a or c 67. d 68. c 69. d 70. d 71. c 72. b 73. c

13 74. a 75. d 76. d 77. c 78. d 79. c 80. c 81. a 82. a 83. a 84. a 85. c 86. d 87. d 88. b 89. c 90. b 91. c 92. d 93. d 94. c 95. a 96. c 97. c 98. b 99. d 100. c 101. b 102. b 103. a 104. c 105. c 106. credit given to every student 107. c 108. b 109. b 110. c 111. c 112. d 113. a 114. b 115. c 116. d 117. c 118. c 119. d 120. b 121. d 122. d 123. b 124. c 125. a 126. c 127. c

14 128. c 129. b or d 130. c 131. c 132. d 133. c 134. c 135. d 136. b 137. b 138. b 139. c 140. a 141. d 142. d 143. a 144. b 145. b 149. What is the difference between natural passive immunity and artificial passive immunity? Natural passive immunity occurs when a fetus or baby receives antibodies from its mother. In artificial passive immunity, a person receives an injection of antibodies produced by another human or other animal What is the difference between morbidity and mortality rates? Morbidity rate measures the number of people becoming ill with a particular disease while the mortality rate measures the number of deaths from a given disease within the group of people suffering from the disease.