CHAPTERS 19 TO 22

1. The combination of plasma and formed elements is called

a) serum b) lymph c) whole blood d) extracellular fluid e) packed blood

2. The total volume of blood in the body of a 70 kg man is approximately __________ liters. a) 25-30
b) 10-15 c) 5-6 d) 2-4 e) less than 2

3. If a person has a low blood volume, they are said to be a) hypovolemic

b) hypervolemic c) normovolemic d) isovolemic e) antivolemic

4. The most abundant proteins in blood plasma are a) globulins

b) transport proteins c) albumins d) lipoproteins e) fibrinogens

5. Red blood cells are formed in a) the liver b) the spleen

c) red bone marrow d) yellow bone marrow e) lymph nodes

6. Stem cells responsible for the production of white blood cells originate in the
a) liver b) thymus c) spleen d) red bone marrow e) lymph tissue

7. Red blood cell production is regulated by the hormone a) thymosin

b) angiotensin I c) erythropoietin d) M-CSF e) cobalamin

8. The average lifespan of a red blood cell is a) 1 week

b) 1 month c) 4 months d) 6 months e) 1 year

9. Over 95% of the protein in a red blood cell is a) albumin

b) porphyrin c) hemoglobin d) immunoglobulin e) fibrinogen

10. A hemoglobin molecule is composed of a) two protein chains

b) three protein chains c) four protein chains and nothing else
d) four protein chains and four heme groups e) four heme groups but no protein

11. The function of hemoglobin is to a) carry oxygen b) protect the body against infectious agents
c) aid in the process of blood clotting
d) carry nutrients from the intestine to the body's cells e) all of these

12. Aged and damaged erythrocytes are broken down by the a) spleen
b) thymus gland c) kidneys d) digestive tract e) both a and c

13. The process of red blood cell production is called a) erythrocytosis

b) erythropenia c) hemocytosis d) erythropoiesis e) hematopenia

14. _____________ are immature erythrocytes that are sometimes found in peripheral blood samples. a)
Erythroblasts b) Normoblasts c) Myeloblasts d) Band cells
e) Reticulocytes

15. Erythropoiesis increases when a) oxygen levels in the blood increase

b) oxygen levels in the blood decrease c) carbon dioxide levels in the blood increase
d) carbon dioxide levels in the blood decrease
e) protein levels in the blood increase

16. A normal adult hematocrit would be a) 100 b) 75 c) 66 d) 45 e) 10

17. A person with type A blood has a) a agglutinins on their red blood cells
b) A agglutinogens in their plasma c) B agglutinogens on their red blood cells
d) b agglutinins in their plasma e) the ability to receive AB blood cells
18. The most numerous white blood cells in peripheral circulation are the
a) neutrophils b) eosinophils c) basophils d) lymphocytes e) monocytes

19. ___________ are large phagocytic white cells that spend most of their time outside of the blood as
fixed and free phagocytic cells. a) Neutrophils
b) Eosinophils c) Basophils d) Lymphocytes e) Monocytes

20. The white blood cells that are important in producing antibodies are the
a) neutrophils b) eosinophils c) basophils d) lymphocytes e) monocytes

21. Platelets are formed from cells in the bone marrow called a) erythroblasts
b) normoblasts c) megakaryoblasts d) myeloblasts e) lymphoblasts

22. Which of the following vitamins is needed for the formation of clotting factors?
a) vitamin A b) vitamin B c) vitamin D d) vitamin K e) vitamin E

23. A drifting blood clot is called a(n) a) embolus b) thrombus

c) plaque d) procoagulant e) platelet plug

24. The porphyrin ring of heme contains an atom of a) magnesium

b) calcium c) iron d) sodium e) copper

25. The disease sickle cell anemia is a good example of what can happen when
a) there is not enough iron in the diet b) there is not sufficient heme in the hemoglobin c) the amino
acid sequence of normal globin is altered
d) a red blood cell does not bind enough oxygen e) hemolysis occurs

26. A difference between the A, B, O blood type and the Rh factor is

a) Rh agglutinogens are not found on the surface of the red blood cells
b) Rh agglutinogens do not produce a cross reaction c) individuals who are Rh- do not carry
agglutinins to Rh factor unless they have been previously sensitized
d) Rh agglutinogens are found free in the plasma
e) Rh agglutinogens are found bound to plasma proteins

27. A disease that damages the stomach lining and interferes with gastric secretions could cause a)
hemophilia b) pernicious anemia c) thrombocytopenia
d) leukocytosis e) jaundice

28. A person's blood type is determined by the a) size of the red blood cells
b) shape of the red blood cells c) chemical character of the hemoglobin
d) presence or absence of specific molecules on the cell membrane
e) number of specific molecules on the cell membrane

29. Most of the iron that is removed from degraded hemoglobin is

a) excreted by the kidneys b) excreted by the liver c) excreted by the intestines
d) recycled to the bone marrow e) stored in yellow bone marrow

30. When a person who lives in a city at sea level and vacations in the Rocky Mountains, you would
expect to observe an increase in a) the number of platelets in their blood b) the number of
lymphocytes in their blood c) their red blood cell count d) their white blood cell count e) the
density of their bone marrow

31. The cusps of atrioventricular valves are attached to papillary muscles by the
a) pectinate muscles b) trabeculae carneae c) chordae tendineae
d) interatrial septa e) coronary sulci
 32. Blood returning from the lungs first enters the a) right atrium
b) right ventricle c) left atrium d) left ventricle e) conus arteriosus

33. The right ventricle pumps blood to the a) lungs b) left ventricle
c) left atrium d) systemic circuit e) right atrium

34. The left ventricle pumps blood to the a) lungs b) right ventricle
c) right atrium d) systemic circuit e) right atrium

35. The atrioventricular valve that is located on the side of the heart that receives the superior vena
cava is the __________ valve. a) mitral b) bicuspid
c) tricuspid d) pulmonary semilunar e) aortic semilunar

36. The bicuspid or mitral valve is located a) in the opening of the aorta
b) in the opening of the pulmonary trunk c) where the vena cavae join the right atrium d) between the
right atrium and right ventricle
e) between the left atrium and left ventricle

37. The entrance to the ascending aorta is guarded by the __________ valve.
a) atrioventricular b) semilunar c) bicuspid d) tricuspid e) mitral

38. The function of an atrium is to a) collect blood b) pump blood to the lungs
c) pump blood into the systemic circuit d) pump blood to the heart muscle
e) both a and d

39. The following is a list of vessels and structures that are associated with the heart. 1. right atrium 2.
left atrium 3. right ventricle 4. left ventricle
5. vena cavae 6. aorta 7. pulmonary trunk 8. pulmonary veins
What is the correct order for the flow of blood entering from the systemic
circulation? a) 1, 2, 7, 8, 3, 4, 6, 5 b) 1, 7, 3, 8, 2, 4, 6, 5
c) 5, 1, 3, 7, 8, 2, 4, 6 d) 5, 3, 1, 7, 8, 4, 2, 6 e) 5, 1, 3, 8, 7, 2, 4, 6

40. The heart wall is composed of ____ layers of tissue.

a) 2 b) 3 c) 4 d) 5 e) 6

41. The first blood vessels to branch from the aorta are the __________ arteries.
a) pulmonary b) coronary c) circumflex d) carotid e) subclavian

42. The pacemaker cells of the heart are located in the a) Purkinje fibers
b) SA node c) AV node d) wall of the left ventricle
e) both the left and right ventricles

43. The following are various components of the conducting system of the heart.
1. Purkinje cells 2. AV bundle 3. AV node 4. SA node 5. bundle branches
The sequence in which an action potential would move through this system is
a) 1, 4, 3, 2, 5 b) 3, 2, 4, 5, 1 c) 3, 5, 4, 2, 1 d) 4, 3, 2, 5, 1
e) 4, 2, 3, 5, 1

44. Depolarization of the ventricles is represented on an electrocardiogram by the

a) p wave b) t wave c) s wave d) QRS complex e) PR complex

45. The T wave on an ECG tracing represents a) atrial depolarization

b) atrial repolarization c) ventricular depolarization
d) ventricular repolarization e) ventricular contraction

46. The first heart sound is heard when the a) AV valves open b) AV valves close
c) semilunar valves close d) atria contract e) blood enters the aorta
47. The volume of blood ejected from each ventricle during a contraction is called the a) end-diastolic
volume b) end-systolic volume c) stroke volume
d) cardiac output e) cardiac reserve
 48. According to Starling's law of the heart, the cardiac output is directly related to the a) size of the
ventricle b) heart rate c) venous return
d) thickness of the myocardium e) end-systolic volume

49. As a result of the long refractory period, cardiac muscle cannot exhibit
a) tonus b) treppe c) tetany d) recruitment e) fatigue

50. When a clot forms on the plaque in a coronary vessel and obstructs blood flow to the muscle, the
condition is referred to as a(n) a) angioplasty b) myocardial infarction c) coronary thrombosis d)
angina pectoris e) pulmonary embolism
 51. Compared to arteries, veins a) are more elastic
b) have more smooth muscle in their tunica media c) have a pleated endothelium
d) have thinner walls e) hold their shape better when cut

52. The following is a list of the vessels that blood passes through from the heart back to the heart. 1.
venules 2. arterioles 3. capillaries 4. elastic arteries
5. medium veins 6. large veins 7. muscular arteries
The correct order in which blood passes through these structures from leaving the heart until its return
is a) 7, 4, 2, 3, 1, 5, 6 b) 6, 5, 1, 3, 2, 7, 4
c) 5, 6, 1, 3, 2, 7, 4 d) 2, 7, 6, 3, 1, 5, 6 e) 4, 7, 2, 3, 1, 5, 6

53. The blood vessels that play the most important role in the regulation of blood flow to a tissue and
blood pressure are the a) arteries b) arterioles
c) veins d) venules e) capillaries

54. Capillaries with an incomplete lining are called a) incomplete capillaries

b) continuous capillaries c) fenestrated capillaries d) sinuses e) vasa vasorum

55. The only blood vessels whose walls permit exchange between the blood and the surrounding
interstitial fluids are the a) arteries b) arterioles
c) veins d) venules e) capillaries

56. Blood flow through a capillary is regulated by the a) vasa vasorum

b) capillary plexus c) precapillary sphincter d) arterial anastomosis
e) central channel

57. As blood travels from the aorta toward the capillaries, the
a) pressure increases b) resistance increases c) flow increases
d) viscosity increases e) diameter of the blood vessels increases

58. The difference between the systolic and diastolic pressures is called the _____ pressure. a) critical
closing b) mean arterial c) pulse d) blood
e) circulatory

59. Blood moves forward through veins by all of the following, except
a) because the pressure in the veins is lower than in the arteries
b) because of contraction-relaxation pumping of the smooth muscle in the wall of the vein
c) with the aid of the thoracoabdominal pump d) because valves in the veins prevent the backflow of
blood e) with the aid of contractions of skeletal muscles

60. The blood osmotic pressure is most affected by changes in

a) the concentration of plasma sodium ions b) the concentration of plasma glucose
c) the concentration of plasma waste products
d) the concentration of plasma proteins e) the number of white blood cells

61. Vascular resistance is related to all of the following, except the

a) length of a blood vessel b) osmolarity of interstitial fluids
c) nature of the blood flow d) viscosity of the blood e) diameter of a blood vessel

62. Blood flow to a tissue will increase if the a) level of oxygen at the tissue increases b) level of
carbon dioxide at the tissue increases c) pH rises
d) vessel constricts e) both a and c

63. Pulmonary veins carry blood to the a) right atrium b) left atrium
c) lungs d) aorta e) the systemic circuit

64. During increased exercise a) vasoconstriction occurs at the active skeletal muscles b) venous
return increases c) both cardiac output and stroke volume decrease
d) both a and c only e) all of these
 65. In response to hemorrhage, there is a) decreased vasomotor tone and peripheral vasodilation b)
increased parasympathetic stimulation of the heart
c) mobilization of the venous reserve d) both a and c e) all of these

66. Symptoms of shock include a) hypotension b) rapid, weak pulse

c) decreased urine formation d) acidosis e) all of these

67. The vessel that receives blood from the head, neck, chest, shoulders, and arms is the a) internal
jugular vein b) external jugular vein c) superior vena cava
d) inferior vena cava e) coronary sinus

68. If a person has a blood pressure of 120/80, their mean arterial pressure would be __________ mm
Hg. a) 200 b) 100 c) 93 d) 80 e) 40

69. The lymphatic system is composed of all of the following, except

a) lymphatic vessels b) thyroid gland c) the spleen d) lymph nodes e) lymph

70. The primary function of the lymphatic system is a) circulation of nutrients

b) the transport of hormones c) the production, maintenance, and distribution of lymphocytes
d) the production, maintenance, and distribution of plasma proteins
e) both c and d

71. Most of the lymph returns to the venous circulation by way of the
a) right lymphatic duct b) thoracic duct c) cysterna chyli
d) hepatic portal vein e) dural sinus

72. In general, lymphocytes a) spend little time in the blood

b) have relatively long life-spans c) are evenly distributed in the lymphatic tissues
d) a and b only e) all of these

73. The cells known as lymphocytes a) are actively phagocytic

b) destroy red blood cells c) produce proteins called antibodies
d) are primarily found in red bone marrow e) decrease in number during infection

74. ______________ are clusters of lymphatic nodules located beneath the epithelial lining of the small
intestine. a) Tonsils b) Adenoids c) Peyer's patches
d) Immune complexes e) Lymph glands

75. Areas of the spleen that contain large numbers of lymphocytes are known as
a) Peyer's patches b) adenoids c) white pulp d) red pulp e) lymph nodes

76. The largest collection of lymphatic tissue in the adult body is located in the
a) liver b) thymus c) tonsils d) spleen e) lymph nodes

77. Characteristics of specific defenses include a) versatility

b) tolerance c) memory d) specificity e) all of these

78. Defense of the body against a particular bacteria or virus is provided by

a) nonspecific immunity b) specific immunity c) immunological surveillance
d) skin e) fever

79. Microphages include a) microglia b) Kuppfer's cells

c) neutrophils d) Langerhans cells e) monocytes

80. Immunity that is genetically determined and present at birth is called __________ immunity. a)
active b) natural passive c) passive d) auto e) innate

81. Immunity that results from the natural exposure to an antigen in the environment is called
__________ immunity. a) active b) natural passive c) passive
d) auto e) innate

82. Immunity that results from antibodies that pass the placenta from mother to fetus is called
__________ immunity. a) active b) natural passive c) passive
d) auto e) innate

83. In active immunization, the a) immune system attacks normal body cells
b) body is deliberately exposed to an antigen c) body receives antibodies produced by another
person d) body receives antibodies produced by another animal
e) genes for antibodies are introduced into the body

84. The cells responsible for humoral immunity are the __________ cells.
a) NK b) B c) helper T d) cytotoxic T e) suppressor T

85. Lymphocytes that attack foreign cells or body cells infected with viruses are __________ cells. a) B
b) plasma c) helper T d) cytotoxic T e) suppressor T

86. Cells that help to regulate the immune response are __________ cells.
a) B b) plasma c) helper T d) cytotoxic T e) NK

87. The cells that are actively involved in immunological surveillance are the __________ cells. a) NK
b) plasma c) B d) helper T e) suppressor T

88. Immunoglobulins that are single molecules and are mainly responsible for resistance against
viruses, bacteria, and bacterial toxins are
a) IgA b) IgD c) IgE d) IgG e) IgM

89. The specificity of an antibody is determined by the a) fixed segment

b) antigenic determinants c) variable region d) size of the antibody
e) antibody class

90. The binding of an antigen to an antibody can result in

a) neutralization of the antigen b) agglutination or precipitation
c) complement activation and opsonization d) a and b only e) all of these

91. In order for a lymphocyte to respond to an antigen, the antigen

a) must be phagocytized by the lymphocyte b) enter the cytoplasm of the lymphocyte
c) bind to the DNA of the lymphocyte d) bind to specific receptors on the lymphocyte membrane
e) must depolarize the lymphocyte

92. B cells are primarily activated by the activities of a) antigens

b) antibodies c) helper T cells d) macrophages e) plasma cells

93. Blocking the antigen receptors on the surface of lymphocytes would interfere with
a) phagocytosis of the antigen b) that lymphocyte's ability to produce antibodies
c) antigen recognition d) the ability of the lymphocyte to present antigen
e) opsonization of the antigen

94. A decrease in which population of lymphocytes would impair all aspects of an immune response?
a) cytotoxic T cells b) helper T cells c) suppressor T cells
d) B cells e) plasma cells

95. Skin tests are used to determine if a person a) has an active infection
b) has been exposed to a particular antigen c) carries a particular antigen
d) has measles e) can produce antibodies

96. The human immunodeficiency virus (HIV) that causes the disease known as AIDS selectively infects
__________ cells. a) B b) plasma c) cytotoxic T
d) helper T e) suppressor T
 97. Infection with the HIV virus occurs through a) eating contaminated food
b) airborne droplets from coughs and sneezes
c) intimate contact with an infected person's body fluids
d) casual contact with an infected individual
e) sharing clothes with an infected individual

98. Milly has just received a kidney transplant and is taking cyclosporin A. What does this medication
do? a) it prevents inflammation from destroying the transplanted kidney b) it depresses hematopoiesis
c) decreases the chemotaxis of macrophages to the transplanted kidney
d) increases the number of antibodies in the blood
e) suppresses cytotoxic T cells thus preventing rejection

99. Changes in the immune system that accompany aging include

a) T cells becoming less responsive to antigens b) more cytotoxic T cells responding to infections
c) increased numbers of T helper cells
d) higher levels of antibody after initial exposure to antigens
e) increased numbers of Langerhans cells

100. Each of the following is a physical barrier to infection except

a) body hair b) epithelium c) secretions d) complement e) basement membranes

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