Path Inflammation Dr Johnson Part 2
.JPG "Path Inflammation Dr Johnson Part 2 - Quiz")
- 1.
Which of the following is responsible for the necrosis seen in this microphotograph?
- A.
Macrophages
- B.
Plasma cells
- C.
Basophils
- D.
Neutrophils
- E.
Lymphocytes
Correct Answer
D. NeutropHilsExplanation
Neutrophils release degradative enzymes that completely digest tissue and cause liquefactive necrosis as seen in the center of this abscess.Rate this question:
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- 2.
In myocardial infarction, the necrosis of cardiac myocytes is usually followed immediately by:
- A.
Atrophy
- B.
Inflammation
- C.
Regeneration
- D.
Repair
- E.
Resolution
Correct Answer
B. InflammationExplanation
Necrotic or dead myocardiocytes attract PMNs (acute inflammatory cells). Hence inflammation is immediately followed by inflamation.
Atrophy of heart muscle cells is seen only in the very elderly and associated with lipofuscin (brown atrophy).
Cardiac muscle cells are permanent non-dividing cells that are NOT capable of regeneration. Hence resolution is NOT possible.
Repair of irreversibly injured myocardiocyte occurs via scarring and follows chronic inflammation.Rate this question:
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- 3.
Research shows that within the first 24 hours of a myocardial infarction, neutrophils migrate towards the infarct. Which of the following is responsible for this migration?
- A.
Diapedesis
- B.
Exudation
- C.
Emigration
- D.
Anaphylaxis
- E.
Chemotaxis
Correct Answer
E. ChemotaxisExplanation
Chemotaxis or movement of PMNs towards the necrotic myocardial cells.
Diapedesis or emigration is the movement of WBCs from the vascular space to the interstitium.
Exudation involves the escape of proteins from the microvascular space.
Anaphylaxis is an allergic type I hypersensitivity reaction that does not play a role in MI. Eosinophils are associated with type I hypersensitivity reactions.Rate this question:
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- 4.
Enzymes responsible for inflammation seen in this image are derived chiefly from:
- A.
Tissue
- B.
Serum
- C.
Neutrophils
- D.
Lymphocytes
- E.
Plasma cells
Correct Answer
C. NeutropHilsExplanation
Enzymes derived from neutrophils are responsible for the liquefactive necrosis seen in the center of this abscess.
The other answer choices listed do not play a role in abscess or suppurative inflammation. Lymphocytes and macrophages are seen in granulomatous inflammation.Rate this question:
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- 5.
The suppurative response of inflammation is the result of:
- A.
Activation of eosinophils
- B.
Degranulation of mast cells
- C.
Extrusion of enzymes from macrophages
- D.
Release of bacterial toxins
- E.
Release of hydrolases from neutrophils
Correct Answer
E. Release of hydrolases from neutropHilsExplanation
The release of hydrolases from PMNs is responsible for the suppurative response of inflammation.
Activation of eosinophils occurs in type I hypersensitivity reactions or in parasitic infections.
Degranulation of mast cells results in the release of several mediators, but most importantly histamine which caused increase vascular permeability.
Release of bacterial toxins will cause liquefactive necrosis.Rate this question:
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- 6.
Leukocytic emigration during an inflammatory response occurs primarily from:
- A.
Arteries
- B.
Arterioles
- C.
Capillaries
- D.
Venules
- E.
Veins
Correct Answer
D. VenulesExplanation
Venules, followed by capillaries and rarely arterioles are the most likely sites where WBC emigration or diapedesis occurs.Rate this question:
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- 7.
A patient dies after being stung by a bee. Autopsy reveals severe laryngeal edema. Which of the following is most likely responsible for this finding?
- A.
Venous congestion
- B.
Lymphatic obstruction
- C.
Increased arterial flow
- D.
Increased arterial pressure
- E.
Increased vascular permeability
Correct Answer
E. Increased vascular permeabilityExplanation
Edema is caused by increased vascular permeability.
Venous congestion, lymphatic obstruction, increased arterial flow and pressure can cause edema but do not occur in this case.Rate this question:
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- 8.
Which one of the following is the most important in chemotaxis?
- A.
Histamine
- B.
Complement
- C.
Kinins
- D.
Serotonin
- E.
Hageman factor
Correct Answer
B. ComplementExplanation
Complement (C5a) is an important chemotactic agent, particularly for PMNs.
Hageman factor (XII), kinins, serotonin and histamine are all chemical mediators of inflammation but do not cause chemotaxis.
Histamine causes arteriolar dilation and results in venular endothelial contraction & interendothelial gaps and ultimately increased vascular permeability
Hageman factor (XII) activation initiates 4 systems involved in plasma derived mediators that regulate many of the effects inflammation. These 4 systems inlcude:
1) Kinin system (activation leads to formation of Bradykinin which causes pain & increased vascular permeability
2) Clotting system (activation results in thrombin which is responsible for the conversion of soluble circulating fibrinogen
to become an insoluble fibrin clot (cement between the PLTs (bricks or blocks)
3) Fibrinolytic system (activation results in formation of plasmin which cleaves fibrin to solubilize the clot (secondary
hemostatic clot)
4) Complement system (activation leads to opsonization (C3b), chemotaxis of WBCs, and cell lysis (C5-9)
Serotonin (5-hydroxytryptamine) is a preformed vasoactive mediator with similar effects to histamine. It is found primarily within platelet dense body granules and released during platelet aggregation.
Hageman factor is a protein synthesized by liver which circulates in an inactive form and activates when it encounters collagen, basement membrane, or activated platelets (at site of endothelial injury)Rate this question:
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- 9.
The presence of neutrophils in the tonsils in an acute bacterial pharyngitis is most likely a result of:
- A.
C1
- B.
C3a
- C.
C4
- D.
C5a
- E.
C5b67
Correct Answer
D. C5aExplanation
C5a is responsible of chemotaxis of PMNs.
C3a & C5a are anaphylatoxins and are major mediators of increased vascular permeability and edema seen in inflammation and anaphylaxis. Please see slide 51 (Fig 2-13) for further details.Rate this question:
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- 10.
Which of the following plasma components is central to the activation of the complement, coagulation, and kinin systems?
- A.
Plasmin
- B.
Hageman factor (XIIa)
- C.
C1 esterase
- D.
Thrombin
- E.
Kininogen
Correct Answer
B. Hageman factor (XIIa)Explanation
Hagman factor activation initiates the complement, coagulation, kinin, and fibrinolytic system.
Plasmin is produced and degrades thrombin and the fibrin in an insoluble clot.
Thrombin cleaves fibrinogen and produces fibrin which causes an insoluble clot to form. Thrombin also enhances WBC adhesion to endothelium by generating fibrinopeptides (during fibrinogen cleavage). Thrombin causes increased vascular permeability and chemotaxis of WBCs.
High molecular weight kininogen cofactor is important in the activation of Hageman factor (XII). When the kinin system is activated the formation of bradykinin occurs. Bradykinin is responsible for pain and increased vascular permeability which causes edema.Rate this question:
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- 11.
The chronic inflammation of a delayed hypersensitivity reaction is mediated by
- A.
Lymphokines
- B.
Histamine
- C.
Bradykinin
- D.
Complement
Correct Answer
A. LympHokinesExplanation
Lymphokines are released from lymphocytes and are important for the activation of macrophages in delayed hypersensitivity type IV reactions, particularly granulomatous inflammation.
Histamine causes arteriolar dilation and results in venular endothelial contraction & interendothelial gaps and ultimately increased vascular permeability
Bradykinin is responsible for pain and increased vascular permeability which causes edema.Rate this question:
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- 12.
A mediator of acute inflammation that causes increased vascular permeability and pain is:
- A.
Bradykinin
- B.
Complement
- C.
Endotoxin
- D.
Histamine
- E.
Tumor necrosis factor
Correct Answer
A. BradykininExplanation
Bradykinin is responsible for pain and increased vascular permeability which causes edema.
Complement system (activation leads to opsonization (C3b), chemotaxis of WBCs, and cell lysis (C5-9).
Endotoxin from bacteria is responsible for vasodilation, particularly in gram negative sepsis and shock.
Histamine causes arteriolar dilation and results in venular endothelial contraction & interendothelial gaps and ultimately increased vascular permeability
Tumor Necrosis Factor (TNF) is an important mediator of acute phase reactions and play a role in the production of Il-1 and fever. TNF is secreted by activated macrophages and other cells.Rate this question:
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- 13.
A 27-year-old woman develops an acute bacterial pyelonephritis accompanied by fever, myalgia, and malaise. The fever is the result of chemical mediators released primarily from which of the following inflammatory cells?
- A.
Basophil
- B.
Eosinophil
- C.
Lymphocyte
- D.
Macrophage
- E.
Neutrophils
Correct Answer
D. MacropHageExplanation
Macrophages release TNF& IL-1 which both act on the thermoregulatory centers of the hypothalamus via prostaglandin E (PGE) to induce fever.
Basophils release mediators of inflammation, mainly histamine
Lymphocytes release lymphokines that activate macrophages
Eosinophils release major basic protein to kill parasites
Neutrophils release degradative enzymes to kill bacteriaRate this question:
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- 14.
A complete blood count (CBC) has a comment indicating that there has been a "left shift" in the neutrophil series. Which of the following is most likely seen on peripheral blood smear?
- A.
Immature lymphocytes
- B.
Immatute band forms of PMNs
- C.
Increase in mature PMNs
- D.
A decrease in PLTs
- E.
An anemia
Correct Answer
B. Immatute band forms of PMNsExplanation
A shift to the left means that immature band forms are seen in the peripheral blood.
Thrombocytopenia is a decrease in PLT numbers.
Anemia is a decrease in hemoglobin and hematocrit.
Increase in mature PMNs is a neutrophilic leukocytosis.
Immature lymphocytes or lymphoblasts may be seen in cases of severe chronic inflammation in which there is a lymphocytic hyperplasia in the bone marrow and an increase loss of lymphocytes from the blood supply.Rate this question:
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- 15.
The cell seen in this microphotograph most likely originated from multinucleated giant cells of the foreign body type originate from
- A.
Nuclear division of granulocytes
- B.
Atypical regeneration of epithelium
- C.
Megakaryocytes
- D.
Fusion or nuclear division of macrophage
- E.
Multiplication of nuclei in surrounding fibrocytes
Correct Answer
D. Fusion or nuclear division of macropHageExplanation
The multinucleated giant cells seen in this granuloma are a result of fusion or nuclear division of macrophages (IL-4 & Inteferon gamma).Rate this question:
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- 16.
Which of the following cells is most abundant in an abscess?
- A.
Eosinophil
- B.
Lymphocyte
- C.
Macrophage
- D.
Neutrophil
- E.
Plasma cell
Correct Answer
D. NeutropHilExplanation
An abscess or a collection of pus primarily consists of neutrophils.
Eosinophils are usually increased in parasitic or allergic reactions.
Lymphocytes are usually increased in viral infections unless the infection is so severe that there is a net loss of lymphocytes from the circulating pool.
Macrophages are found in granulomas.
Plasma cells are mature and differentiated B lymphoctyes that secrete immunoglobulins or antbodies.Rate this question:
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- 17.
The most important cell in the destruction of pyogenic cocci is the
- A.
Neutrophil
- B.
Lymphocyte
- C.
Basophil
- D.
Eosinophil
- E.
Monocyte
Correct Answer
A. NeutropHilExplanation
Neutrophils are responsible for killing pyogenic cocci.
Lymphocytes respond to virus (karate kid)
Eosinophils respond to parasitic infections and allergic reactions.
Basophils release mediators that help orchestrate inflammation.
Monocytes are macrophages in the blood which are responsible for phagocytosis.Rate this question:
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- 18.
Which of the following cells can liberate histamine?
- A.
Plasma cells
- B.
Eosinophils
- C.
Vascular endothelial cells
- D.
Tissue mast cells
Correct Answer
D. Tissue mast cellsExplanation
Mast cells can liberate histamine. See Slide 43 (Fig 2-11)Rate this question:
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.JPG "Enzymes responsible for inflammation seen in this image are derived chiefly from:")
.JPG "The cell seen in this microphotograph most likely originated from multinucleated giant cells of the foreign body type originate from")
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Mar 21, 2023Quiz Edited by
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Jun 08, 2012Quiz Created by
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