ACUTE & CHRONIC INFLAMMATION- 1

Question 1

Identify the mediator responsible for all of the following actions

intense vasoconstriction,bronchospasm (important in asthma), increased perme­ability of venules.

Answer 1

LTC₄, LTD₄, and LTE₄

Question 2

Major cytokine responsible for induction of the acute phase response

Answer 2

IL-6

Question 3

Identify the substance , based on its function described and the WBC that produces it

cytotoxic to helminths

Answer 3

Substance: Major Basic protein

Produced by: Eosinophils

Question 4

Identify the substance , based on its function described and the WBC that produces it

binds iron that is necessary for normal bacterial growth and reproduction

Answer 4

Substance: Lactoferrin

Produced by: Neutrophil granules

Question 5

What’s the most likely underlying mechanism for the fluid having characteristics described below?

protein rich

cellular

specific gravity >1.020

Answer 5

The fluid exhibits characteristic features of an exudate. Mechanism: increase in the normal permeability of small blood vessels in an area of injury

Question 6

Identify the condition described and its basis

• Increased susceptibility to catalase positive organisms - ( S.aureus, E.coli, Aspergillus)
• Negative nitroblue tetrazolium dye reduction test
• Abnormal dihydrorhodamine (flow cytometry) test (reduced green fluorescence).
• Decrease ROS and absent respiratory burst

Answer 6

Condition: Chronic granulomatous disease (CGD)

Basis: Lack of NADPH oxidase

Question 7

family of proteins that mediate initial rolling interactions

Answer 7

Selectins

Question 8

Exudate or transudate?

protein rich

cellular

specific gravity >1.020

Answer 8

Exudate

Question 9

How do you distinguish between Chronic granulomatous disease due to NADPH oxidase deficiency from MPO deficiency?

Answer 9

Question 10

Exudate or transudate?

1. Effusion protein/serum protein ratio lesser than 0.5
2. Effusion lactate dehydrogenase (LDH)/serum LDH ratio lesser than 0.6
3. Effusion LDH level lesser than two-thirds the upper limit of the laboratory’s reference range of serum LDH

Answer 10

Transudate

Question 11

Identify the mediator

stimulates the contraction of uterine and bronchial smooth muscle and small arterioles

Answer 11

PGF2_α

Question 12

List 2 examples of transudate occuring due to decreased oncotic pressure

Answer 12

Cirrhosis

Nephrotic Syndrome

Question 13

Which cell adhesion molecule mediates the process depicted in the attached image?

Answer 13

PECAM 1 (aka CD31 ie. cluster of differentiation 31)

Question 14

List 4 conditions characterized by exudate formation

Answer 14

Infections

Inflammation

Malignancy

Trauma

Collagen vascular disease

Question 15

3 mechanisms of increased vascular permeability

Answer 15

a. Contraction of endothelial cells resulting in increased interendothelial spaces
b. Endothelial injury, resulting in endothelial cell necrosis and detachment.
c. Transcytosis

Question 16

LAD-1 OR LAD-2?

absence of sialyl-Lewis X

NO DELAYED DETACHMENT OF UMBILICAL CORD

NEUTROPHILIC LEUKOCYTOSIS

Answer 16

LAD-2

Question 17

Give one word that best fits the description:

1. Painful, enlarged lymph nodes
2. Inflammed lymphatic channnels visible as red streaks over skin

Answer 17

1. Lymphadenitis
2. Lymphangitis

Question 18

Exudate or transudate?

protein poor

hypocellular

specific gravity <1.012

Answer 18

Transudate

Question 19

Type of leukocyte most likley to predominate in :

a. 6-24 hours
b. 24-48 hours

Answer 19

a. Neutrophils
b. Monocytes

Question 20

Exudate or transudate?

1. Effusion protein/serum protein ratio greater than 0.5
2. Effusion lactate dehydrogenase (LDH)/serum LDH ratio greater than 0.6
3. Effusion LDH level greater than two-thirds the upper limit of the laboratory’s reference range of serum LDH

Answer 20

Exudate

Question 21

List examples of the morphologic pattern of inflammation depicted in the attached image

Answer 21

Pattern: Ulcer

Examples: Duodenal Ulcer, Peptic ulcer

Question 22

class of adhesion molecules that mediate firm adhesion

Answer 22

Integrins

Question 23

List examples of the morphologic pattern of inflammation depicted in the attached image

Answer 23

Pattern: Suppurative/Purulent Inflammation

Examples: Lung abscess, acute appendicitis

Question 24

Where is P- selectin expressed?

Answer 24

a. Wiebel-Palade bodies on the surface of platelets
b. Endothelial cells

Question 25

**Which process is characterized by the following sequence of steps?** 1. recognition and attachment of the particle to be ingested by the leukocyte 2. its engulfment, with subsequent formation of a phagocytic vacuole 3. killing or degradation of the ingested material

Answer 25

Phagocytosis

Question 26

List the 3 events occuring _within the lumen_ during the process of extravasation

Answer 26

margination, rolling, and adhesion to endothelium

Question 27

List 1 example of a transudate occuring due to increased hydrostatic pressure

Answer 27

Congestive heart failure

Question 28

**Identify the condition and its basis** 1. Progressive neurodegeneration 2. Lymphohistiocytosis 3. Albinism (partial) 4. peripheral Neuropathy 5. recurrent pyogenic Infections by Staph and Strep 6. Giant granules seen in platelets

Answer 28

**_Condition:_** Chediak Higashi Syndrome ``` **_Basis:_** Defect in lysosomal trafficking regulator gene (LYST). ``` microtubule dysfunction in phagosome-lysosome fusion

Question 29

List examples of the morphologic pattern of inflammation depicted in the attached image

Answer 29

**_Pattern:_** Fibrinous Inflammation **_Example:_** Fibrinous pericarditis

Question 30

List 4 endogenous chemoatrractants

Answer 30

**Mnemonic : CILK** C - C5a I - IL-8 L - Leukotriene B4 K - Kallikrein

Question 31

**Give 1 word that best fits the description provided:** Purulent exudate

Answer 31

Pus

Question 32

Mediators of vasodilatation

Answer 32

Histamine, Nitric oxide

Question 33

**Identify the mediator** vasodilator potent inhibitor of platelet aggregation

Answer 33

PGI₂ (prostacyclin)

Question 34

Ligands for P-selectin and E-selectin?

Answer 34

**(Sialyl-Lewis-X)** sialylated oligosaccharides bound to mucin like glycoprotein backbones.

Question 35

**Identify the mediator** potent platelet-aggregating agent vasoconstrictor

Answer 35

TxA2 (thromboxane A2)

Question 36

**Give one word that best fits the description provided:** process of leukocyte redistribution in inflammation wherein white cells assume a peripheral position along the endothelial surface due to stasis and decrease in wall shear stress

Answer 36

Margination

Question 37

**Type of leukocyte likely to predominate in :** a. Viral Infections b. Hypersensitivity reactions

Answer 37

a. Lymphocytes b. Eosinophils

Question 38

**Identify the mediator responsible for all of the following actions:** 1. Causes fever, acute inflammation. 2. Activates endothelium to express adhesion molecules. 3. Induces chemokine secretion to recruit WBCs

Answer 38

Interleukin-1

Question 39

**Give one word that best fits this description** The process wherein leukocytes emigrate in tissues toward the site of injury along a chemical gradient

Answer 39

Chemotaxis

Question 40

**Give 1 word that best fits the description provided:** escape of fluid, proteins, and blood cells from the vascular system into the interstitial tissue or body cavities

Answer 40

Exudation

Question 41

Name the mediator that increases vascular permeability and causes contraction of smooth muscle, dilation of blood vessels, and pain when injected into the skin.

Answer 41

Bradykinin

Question 42

**Identify the mediator responsible for all of the following actions:** a. Endothelial activation b. Together with IL-1 and Il-6, induces systemic acute phase response c. Activation of leukocytes

Answer 42

Tumor necrosis factor-α

Question 43

**Exudate or transudate?** 1. Effusion protein/serum protein ratio lesser than 0.5 2. Effusion lactate dehydrogenase (LDH)/serum LDH ratio greater than 0.6 3. Effusion LDH level greater than two-thirds the upper limit of the laboratory's reference range of serum LDH

Answer 43

Exudate

Question 44

3 outcomes of acute inflammation

Answer 44

1. Complete resolution 2. Organization 3. Chronic Inflammation

Question 45

Components of complement that stimulate histamine release from mast cells

Answer 45

C3a and C5a aka anaphylatoxins

Question 46

List examples of the morphologic pattern of inflammation depicted in the attached image

Answer 46

**_Pattern:_** Pseudomebranous **_Examples:_** Pseudomembranous colitis Diphtheria

Question 47

List examples of the morphologic pattern of inflammation depicted in the attached image

Answer 47

**_Pattern:_** Serous Inflammation **_Examples:_** blisters in second-degree burns; viral pleuritis

Question 48

**What's the most likely underlying mechanism for the fluid having characteristics described below?** protein poor hypocellular specific gravity \<1.012

Answer 48

The fluid exhibits characteristic features of an _transudate._ **Mechanism: osmotic or hydrostatic imbalance across the vessel wall without an increase in vascular permeability**

Question 49

**Ligand for the following integrins?** a. LFA-1, MAC-1 (Beta 2 integrins) b. VLA-4 (Beta 1 integrins)

Answer 49

a. ICAM-1 b. VCAM-1

Question 50

**LAD-1 OR LAD-2?** defect in the biosynthesis of the β2 chain shared by the LFA-1 and Mac-1 integrins Delayed detachment of the umbilical cord Neutrophilic leukocytosis

Answer 50

LAD-1