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Until renamed by Paul Ehrlich in the 1890s, the heat-labile, nonspecific part of the immune system that enhances inflammation was known as "alexin". We now know that various proteins of this system have a variety of functions, including bursting pathogens by insertion of a membrane-attack complex. What did Erhlich rename this specific part of the innate immune system?


A) immunoglobulins
B) major histocompatibility proteins
C) mannose-binding lectins
D) the complement system
E) Toll-like receptors

F) None of the above
G) A) and B)

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A young child is extremely susceptible to infections by a wide range of bacteria. A genome sequencing test determines that the boy has an inactivating mutation in a single gene. What is the most-likely candidate for the mutated gene?


A) a major histocompatibility class I protein
B) an immunoglobulin
C) a Toll-like receptor
D) a CD8 protein
E) a type I interferon

F) C) and D)
G) C) and E)

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What is true regarding cytokines?


A) Cytokines protect in the attack of pathogens by phagocytosis.
B) Cytokines are secreted by pathogens during infection.
C) Cytokines are immune cells involved in producing antibodies.
D) Cytokines are secreted by TH cells and bind to receptors.
E) Cytokines bind to intracellular receptors.

F) C) and E)
G) A) and E)

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What statement does NOT correctly describe antidiuretic hormone?


A) ADH secretion is stimulated by high blood osmolarity.
B) It inhibits the synthesis of aquaporins.
C) It binds to membrane receptors of cells in the mammalian kidneys.
D) It ultimately acts to reabsorb more water.
E) Damage to the posterior pituitary will decrease the production of ADH.

F) A) and D)
G) C) and E)

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Starving children in war-torn countries have stick-thin limbs, as their muscle proteins are being broken down and the resultant amino acids are being used by other cells for energy. What hormone(s) would you expect to be especially elevated in these children?


A) glucagon
B) glucocorticoids
C) aldosterone
D) prolactin
E) insulin

F) B) and C)
G) D) and E)

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This molecule or ion never uses active transport as its motive force for reabsorption into blood capillaries in the kidney.


A) Na+ ions
B) glucose
C) amino acids
D) Cl- ions
E) water
F) HCO3- ions

G) A) and B)
H) All of the above

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Select the correct statement regarding the temperature response of the immune system.


A) Fever contributes to the body's defenses by stimulating the liver and spleen to store glucose.
B) Fever contributes to the body's defenses by stimulating the maturation of B cells into plasma cells.
C) After binding to a pathogen, macrophages release interleukin-1, which stimulates neurons in the hypothalamus to raise the body's temperature, producing a fever.
D) When neutrophils encounter invading cells, they release immunoglobulin-1, which is carried to the brain by the circulatory system.
E) Fevers between 99 °\degree and 100 °\degree F are often fatal.

F) A) and D)
G) B) and D)

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A patient has come to you for a second opinion. "I have these mysterious lumps in my right armpit," he says, "The other doctor says we may have to remove them. What do you think?" You notice red scratches on the patient's right arm. "You must have a new kitten. Cat scratch disease, from the bacterium Bartonella ," you say, "And we certainly won't remove those lumps, they are really important! Those are your..."


A) "spleen, where hematopoietic stem cells produce lymphoid and myeloid progenitors."
B) "lymph nodes, where T-cell receptor genes are rearranged as T cells mature."
C) "lymph nodes, where naive B and T cells encounter antigens and become activated."
D) "thymus glands, where naive B and T cells encounter antigens and become activated."

E) A) and C)
F) A) and B)

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If blood transports hormones throughout the body, how do they communicate with specific targets?


A) Axonal pathfinding mediates the delivery of hormones to their specific targets.
B) Special gateway valves in the blood vessels direct hormones to their target tissues.
C) Special carrier proteins "walk" along microtubule tracts to deliver the hormones to their targets.
D) Only target tissues have receptors that allow them to receive the signal.

E) A) and B)
F) B) and C)

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You have a patient in your office who has the autoimmune disease systemic lupus erythematosus, which is being successfully treated using immunosuppressive drugs. Generally you recommend a yearly flu shot to your patients, which is available either in an injected, inactivated form or as a live, attenuated virus nasal spray. For this patient, what detail should you consider?


A) Since she has an autoimmune disease, the patient is likely to be allergic to chicken eggs, and should not get the vaccine.
B) You should wait about six weeks to vaccinate, until the lupus passes through the patient and she is well.
C) Having lupus demonstrates that the patient does not have a functional immune system, and therefore it would be pointless to vaccinate.
D) The injected, inactivated vaccine would be a better choice than the live attenuated nasal spray vaccine, since the patient is on immunosuppressive drugs.

E) A) and B)
F) C) and D)

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Adult giraffes can be up to 20 ft tall, and thus require special adaptations to maintain appropriate blood pressure. One adaptation is the rete mirabile, a group of blood vessels that form a web or net-like structure to slow blood flow. -The giraffe, as the tallest living land animal, has several adaptations for its height. To prevent blood from pooling in the head when it bends down to drink, the jugular veins of a giraffe have multiple one-way valves. Furthermore, a web of arteries and veins in the neck called the rete mirabile ("wonderful net") slows the flow of blood into the brain. These specializations of the ______________________ act as mechanisms to maintain ______________________.


A) nervous system; homeothermy
B) nervous system; temperature homeostasis
C) circulatory system; blood pressure homeostasis
D) circulatory system; pH homeostasis

E) A) and D)
F) None of the above

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Connor decides to celebrate his 21st birthday by drinking a few beers at a local sports bar. After a while, Connor notices that he is making many more trips to the men's room than the week before, when he drank similar amounts of carbonated water. Why is that?


A) Alcohol stimulates secretion of ions into the nephron and water follows by osmosis.
B) Alcohol stimulates filtration of the blood plasma by theglomeruli.
C) Alcohol inhibits reabsorption of sugars, amino acids and other small metabolites, which decreases reabsorption of water.
D) Alcohol inhibits the secretion of ADH by the posterior pituitary gland, thereby decreasing water reabsorption.
E) Alcohol stimulates the insertion of aquaporins into the plasma membranes of cells that line the collecting ducts, thereby decreasing water reabsorption.

F) C) and E)
G) A) and B)

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What statement does NOT correctly describe hormones that can directly enter a cell?


A) Once these hormones enter a cell, they bind to a cytoplasmic receptor and travel as a complex to the nucleus, or they may bind to the receptor after entering the nucleus.
B) Water-soluble hormones can enter directly into cells because of their nonpolar makeup.
C) Steroid hormones dissolve poorly in the plasma and are transported to target cells via special protein carriers.
D) Steroid hormones can enter directly into cells because of their hydrophobic makeup.

E) A) and C)
F) A) and B)

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You are an engineer at a power plant that creates large volumes of hot waste water, which disrupts the ecosystem of the river it drains into. Another part of the plant requires warm oil, and the plant uses large amounts of energy to heat it. Inspired by countercurrent exchange in whales, you save energy and benefit the environment by doing what?


A) running the oil pipes under the river after dumping in the hot waste water
B) running the oil pipes around the waste water pipes, to allow heat transfer from water to oil
C) running the waste water and oil through a single pipe
D) adding a sensor, integrating center and effectors to control temperature in both pipes

E) A) and C)
F) None of the above

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Women often receive synthetic oxytocin to induce childbirth or augment contractions. What is an important consideration about the use of synthetic oxytocin?


A) The synthetic form does not travel down motor neurons, so it is less effective than the natural form.
B) It is impossible to mimic its chemical structure, so it may act on other receptors and cause side effects.
C) It can be difficult to get the levels just right, so uterine contractions can be too strong.
D) If you fail to simultaneously provide synthetic G protein, the hormone is ineffective.

E) A) and D)
F) C) and D)

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A patient with melanoma receives three types of therapy: surgery, radiation, and interferon. Which of these represents something the immune system uses against cancer as well?


A) Interferon -- cytotoxic T cells and natural killer cells insert interferon into the membranes of tumor cells, creating large pores that burst the cells.
B) Interferon -- T cells and natural killer cells secrete interferon in response to tumor cells
C) Interferon -- In complexes bound with MHC proteins, the interferons indicate the presence of altered tissue to B cells.
D) Radiation -- a class of lymphocytes uses powerful electromagnetic radiation to attack "altered self" cells

E) B) and C)
F) A) and D)

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A friend tells you the following story. "My aunt just received a heart transplant. Her doctors warned us that her body might reject the tissue. I just can't understand how that could happen as human hearts are made of the same tissues, aren't they?" How do you respond?


A) "Yes, all human hearts are made of cardiac muscle. But, most people have different MHC class I proteins on their cell surfaces. Your aunt's immune system can cause tissue rejection because of the 'nonself' MHC proteins on the donor heart."
B) "Yes, all human hearts are made of cardiac muscle, so I am as perplexed as you are."
C) "Yes, all human hearts are made of cardiac muscle. As far as the rejection of tissues goes, your aunt might have different antibodies than did the donor, which could lead to a rejection."
D) "Yes, all human hearts are primarily made of cardiac musclec, except some humans have different tissues inside their hearts and this could lead to a tissue rejection by the recipient."
E) "Yes, all human hearts are made of cardiac muscles. However, your aunt might have been given some type of drug during the transplant operation that might cause tissue rejection. You can never be too careful in a hospital, you know."

F) All of the above
G) A) and C)

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What is NOT a function of parathyroid hormone?


A) It increases calcium production in the liver.
B) It stimulates osteoclasts to dissolve CaPO4 crystals in bone.
C) It increases calcium absorption across the intestine.
D) It increases reabsorption of Ca2+ in the kidney.

E) A) and C)
F) A) and B)

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In the old days, milkmaids were exposed to cowpox from milking the cows, and this fortuitously gave them some protection from smallpox. What was happening in the milkmaids?


A) They were receiving a dose of generic IgG from the sick cows.
B) They were effectively receiving a vaccination from a related virus.
C) They were heightening their overall immune response due to exposure to the cowpox and other cow parasites.
D) They had a stronger immune response from drinking the milk, which sent cow B cells circulating through their blood.

E) B) and C)
F) All of the above

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What condition is not associated with diabetes?


A) reduced body cell sensitivity to insulin
B) lowered production of insulin by the pancreas
C) careful diet and exercise measures are required to balance blood sugar levels
D) defects in pituitary gland function
E) elevated levels of blood glucose

F) B) and E)
G) A) and B)

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