Path INFLammation Dr Johnson Part 2

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  • 1/18 Questions

    Which of the following cells is most abundant in an abscess? 

    • Eosinophil
    • Lymphocyte
    • Macrophage
    • Neutrophil
    • Plasma cell
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Path Inflammation Dr Johnson Part 2 - Quiz
About This Quiz

Explore the role of neutrophils in inflammation through 'Path Inflammation Dr Johnson part 2'. This quiz assesses understanding of cellular responses in pathological conditions like myocardial infarction, focusing on neutrophil-driven processes such as chemotaxis and enzyme release.

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  • 2. 

     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?

    • Diapedesis

    • Exudation

    • Emigration

    • Anaphylaxis

    • Chemotaxis

    Correct Answer
    A. Chemotaxis
    Explanation
    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.

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  • 3. 

     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? 

    • Venous congestion

    • Lymphatic obstruction

    • Increased arterial flow

    • Increased arterial pressure

    • Increased vascular permeability

    Correct Answer
    A. Increased vascular permeability
    Explanation
    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.

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  • 4. 

     The suppurative response of inflammation              is the result of:

    • Activation of eosinophils

    • Degranulation of mast cells

    • Extrusion of enzymes from macrophages

    • Release of bacterial toxins

    • Release of hydrolases from neutrophils

    Correct Answer
    A. Release of hydrolases from neutrophils
    Explanation
    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.

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  • 5. 

     Which of the following cells can liberate histamine? 

    • Plasma cells

    • Eosinophils

    • Vascular endothelial cells

    • Tissue mast cells

    Correct Answer
    A. Tissue mast cells
    Explanation
    Mast cells can liberate histamine. See Slide 43 (Fig 2-11)

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  • 6. 

    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?

    • Immature lymphocytes

    • Immatute band forms of PMNs

    • Increase in mature PMNs

    • A decrease in PLTs

    • An anemia

    Correct Answer
    A. Immatute band forms of PMNs
    Explanation
    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.

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  • 7. 

     A mediator of acute inflammation that causes increased vascular permeability and pain is:

    • Bradykinin

    • Complement

    • Endotoxin

    • Histamine

    • Tumor necrosis factor

    Correct Answer
    A. Bradykinin
    Explanation
    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.

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  • 8. 

     The presence of neutrophils in the tonsils in an acute bacterial pharyngitis is most likely a result of: 

    • C1

    • C3a

    • C4

    • C5a

    • C5b67

    Correct Answer
    A. C5a
    Explanation
    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.

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  • 9. 

    The most important cell in the destruction of pyogenic cocci is the     

    • Neutrophil

    • Lymphocyte

    • Basophil

    • Eosinophil

    • Monocyte

    Correct Answer
    A. Neutrophil
    Explanation
    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.

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  • 10. 
    Enzymes responsible for inflammation seen in this image are derived chiefly from: - ProProfs

    Enzymes responsible for inflammation seen in this image are derived chiefly from:

    • Tissue

    • Serum

    • Neutrophils

    • Lymphocytes

    • Plasma cells

    Correct Answer
    A. Neutrophils
    Explanation
    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.

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  • 11. 
    The cell seen in this microphotograph most likely originated from multinucleated giant cells of the foreign body type originate from  - ProProfs

    The cell seen in this microphotograph most likely originated from multinucleated giant cells of the foreign body type originate from 

    • Nuclear division of granulocytes

    • Atypical regeneration of epithelium

    • Megakaryocytes

    • Fusion or nuclear division of macrophage

    • Multiplication of nuclei in surrounding fibrocytes

    Correct Answer
    A. Fusion or nuclear division of macrophage
    Explanation
    The multinucleated giant cells seen in this granuloma are a result of fusion or nuclear division of macrophages (IL-4 & Inteferon gamma).

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  • 12. 
     Which of the following is responsible for the necrosis seen in this microphotograph? - ProProfs

     Which of the following is responsible for the necrosis seen in this microphotograph?

    • Macrophages

    • Plasma cells

    • Basophils

    • Neutrophils

    • Lymphocytes

    Correct Answer
    A. Neutrophils
    Explanation
    Neutrophils release degradative enzymes that completely digest tissue and cause liquefactive necrosis as seen in the center of this abscess.

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  • 13. 

    The chronic inflammation of a delayed hypersensitivity reaction is mediated by

    • Lymphokines

    • Histamine

    • Bradykinin

    • Complement

    Correct Answer
    A. Lymphokines
    Explanation
    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.

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  • 14. 

    Which of the following plasma components is central to the activation of the complement, coagulation, and kinin systems?

    • Plasmin

    • Hageman factor (XIIa)

    • C1 esterase

    • Thrombin

    • Kininogen

    Correct Answer
    A. 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.

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  • 15. 

     Leukocytic emigration during an inflammatory response occurs  primarily from:

    • Arteries

    • Arterioles

    • Capillaries

    • Venules

    • Veins

    Correct Answer
    A. Venules
    Explanation
    Venules, followed by capillaries and rarely arterioles are the most likely sites where WBC emigration or diapedesis occurs.

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  • 16. 

    Which one of the following is the most important in chemotaxis?

    • Histamine

    • Complement

    • Kinins

    • Serotonin

    • Hageman factor

    Correct Answer
    A. Complement
    Explanation
    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)

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  • 17. 

     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?

    • Basophil

    • Eosinophil

    • Lymphocyte

    • Macrophage

    • Neutrophils

    Correct Answer
    A. Macrophage
    Explanation
    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 bacteria

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  • 18. 

     In myocardial infarction, the necrosis of cardiac myocytes is usually followed immediately by: 

    • Atrophy

    • Inflammation

    • Regeneration

    • Repair

    • Resolution

    Correct Answer
    A. Inflammation
    Explanation
    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.

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jun 08, 2012
    Quiz Created by
    Chachelly
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