SECTION 2: INFLAMMATION
1. Which cell responds earliest to chemotactic agents in an inflammatory response?
A) T lymphocyte B) B lymphocyte
C) Histiocyte D) Neutrophil
E) Plasma cell
2. Which of the following is not a feature of chronic inflammation?
A) Increased vascularization B) Lymphocytes
C) Polymorphonuclear leukocytes D) Histiocytes
E) Tissue destruction
3. Which of the following more strongly stimulates acute inflammation?
A) Autolysis B) Dysplasia
C) Necrosis D) Apoptosis
E) Metaplasia
4. Which of the following does not occur in response to local trauma?
A) Vasodilation B) Increased permeability
C) Inhibition of chemotaxis D) Leukocyte migration
E) Accumulation of exudate at the injury site
5. When leukocytes are mobilized during acute inflammation, what is the first intravascular event?
A) Margination B) Emigration
C) Diapedesis D) Phagocytosis
E) Opsonization
6. What term is used to describe the peripheral positioning of leukocytes along the vascular endothelium?
A) Stasis B) Transmigration
C) Exudation D) Adhesion
E) Margination
7. Which of the following best defines the process by which polymorphonuclear neutrophils are directed to the site of injury during acute
inflammation?
A) Active hyperemia B) Karyorrhexis
C) Passive hyperemia D) Chemotaxis
E) Karyolysis
8. Which of the following describes the active process in which arterioles dilate and blood flow increases in skeletal muscle during exercise?
A) Congestion B) Cyanosis
C) Edema D) Hemorrhage
E) Hyperemia
9. Which of the following occurs first in acute inflammation?
A) Leukocyte margination B) Transmigration
C) Vasodilation D) Vasoconstriction
E) Exudation
10. Which of the following is not a circulating cell?
A) Neutrophil B) Monocyte
C) Lymphocyte D) Basophil
E) Mast cell
11. Which of the following does not have a chemotactic effect on leukocytes?
A) Soluble bacterial products B) Complement C5a
C) Leukotriene B4 D) Complement C3b
E) Interleukin-8
12. Which of the following is an inflammatory mediator derived from plasma proteins and not synthesized by cells?
A) Histamine B) Serotonin
C) C3a D) Prostaglandins
E) Lysosomal enzymes
13. Which of the following chemical mediators contributes most to the major signs of acute inflammation (rubor, calor, and tumor)?
A) NO B) Bradykinin
C) C5a D) Prostaglandins
E) Histamine
14. Which of the following is most responsible for the redness observed in acute inflammation?
A) Edema B) Leukocyte margination
C) Thrombosis D) Blood vessel dilation
E) Fibrin deposition
15. Which of the following primarily triggers the rapid transient increase in vascular permeability observed in tissue injury?
A) Serum albumin B) Histamine
C) Complement D) Hageman factor
E) Anaphylatoxin
16. Endothelial cells located in which of the following vessels are most responsive to inflammatory mediators?
A) Veins B) Venules
C) Arterioles D) Muscular arteries
E) Elastic arteries
17. Which of the following mediators causes arteriolar dilation and is also found in basophils and platelets?
A) Lipoxin B) Histamine
C) Bradykinin D) Cytokine
E) Leukotriene
18. Which of the following mediators is involved in the transmission of pain signals, regulation of blood pressure, stimulation of secretion from
endocrine cells, and increased vascular permeability?
A) Substance P B) Nitric oxide
C) Histamine D) Platelet-activating factor
E) Bradykinin
19. Which of the following mediators causes arteriolar dilation and increased permeability of venules, similar to histamine?
A) Prostaglandin B) C3b
C) Leukotriene D) Bradykinin
E) Platelet-activating factor.
20. Which of the following conditions is most likely associated with "toxic granulation and a left shift" in a peripheral blood smear?
A) Allergic rhinitis B) Acute appendicitis
C) Whooping cough D) Rheumatoid arthritis
E) Pinworm infestation
21. Which of the following mediators directly causes tissue damage during acute inflammation?
A) Leukotriene B4 B) Tumor necrosis factor-alpha
C) Nitric oxide D) Platelet-activating factor
E) Interleukin 3
22. Which of the following is a low-molecular-weight vasodilator produced by endothelial cells that inhibits platelet aggregation?
A) Cytokine B) Defensin
C) Nitric oxide D) Selectin
E) Tumor necrosis factor
23. Which of the following lesions does not contain cholesterol or cholesterol esters?
A) Atherosclerosis B) Xanthoma
C) Cholesterolosis D) Niemann-Pick disease type C
E) Albinism
24. Which of the following lesions does not contain dense histiocytes?
A) Cholesterolosis B) Whipple's disease
C) Xanthoma D) Malakoplakia
E) Waldenström macroglobulinemia
25. Which cell type predominates in the inflammatory response to viral infections?
A) Mast cell B) Lymphocyte
C) Plasma cell D) Eosinophil
E) Neutrophil
26. Which cell type predominates in the inflammatory response to protozoal parasites?
A) Mast cell B) Lymphocyte
C) Plasma cell D) Eosinophil
E) Neutrophil
27. Which of the following peripheral blood findings is most likely in patients with typhoid fever and certain rickettsial diseases?
A) Leukocytosis B) Leukopenia
C) Eosinophilia D) Lymphocytosis
E) Eosinopenia
28. In which of the following conditions is an increase in eosinophils in peripheral blood least expected?
A) Strongyloidiasis B) Hookworm infestation
C) Drug allergy D) Contact dermatitis
E) Addison's disease
29. Which condition is characterized by absolute lymphocytosis but without atypical lymphocytes?
A) Pertussis B) Cytomegalovirus infection
C) Epstein-Barr virus infection D) Phenytoin use
E) Toxoplasmosis
30. A woman treated for erysipelas develops a fluctuating swelling in the subcutaneous tissue. The tissue is likely to exhibit which type of necrosis?
A) Coagulation necrosis B) Caseation necrosis
C) Fat necrosis D) Liquefaction necrosis
E) Gangrenous necrosis
31. Which of the following is a localized purulent infection within the parenchyma of an organ?
A) Sinus B) Fistula
C) Phlegmon D) Empyema
E) Abscess
32. What is the term for the accumulation of pus in the pleural cavity, commonly seen as a complication of staphylococcal pneumonia?
A) Septicemia B) Leukocytosis
C) Abscess D) Empyema
E) Wet gangrene
33. Which of the following substances is not directly involved in the killing of microbes?
A) Oxygen B) Complement C3b
C) Lactoferrin D) Defensin
E) Bacterial permeability-increasing protein.
34. Which of the following is not a morphological pattern of acute inflammation?
A) Serous inflammation B) Fibrinous inflammation
C) Suppurative inflammation D) Ulcers
E) Granulomatous inflammation
35. Which type of inflammation is characteristic of diphtheria?
A) Fibrinous B) Serous
C) Pseudomembranous D) Catarrhal
E) Purulent
36. Which of the following is the most characteristic feature of granulomatous inflammation?
A) Epithelioid histiocytes B) Necrosis
C) Lymphocytes D) Eosinophils
E) Multinucleated giant cells
37. The epithelioid cells found in granulomas originate from which of the following?
A) Mononuclear phagocytic cells B) Neutrophils
C) Plasma cells D) T lymphocytes
E) Mast cells
38. In which of the following diseases are Schaumann bodies and asteroid bodies found?
A) Berylliosis B) Silicosis
C) Cat-scratch disease D) Sarcoidosis
E) Schistosomiasis
39. Which of the following diseases is characterized by caseating granulomas?
A) Sarcoidosis B) Berylliosis
C) Cat-scratch disease D) Tuberculosis
E) Asbestosis
40. Which of the following diseases does not produce granulomatous inflammation?
A) Actinomycosis B) Leprosy
C) Schistosomiasis D) Cryptococcal infection
E) Granulosa cell tumor
41. In sarcoidosis, which of the following cells accumulates in the alveolar and interstitial spaces, playing a crucial role in the immune response?
A) CD8+ cytotoxic T lymphocytes B) CD4+ helper T lymphocytes
C) B lymphocytes D) Natural killer (NK) cells
E) Plasma cells
42. Which type of giant cell is observed in tuberculosis?
A) Reed-Sternberg cell B) Foreign body giant cell
C) Touton giant cell D) Langhans giant cell
E) Langerhans giant cell
43. Which of the following complements initiates the classical pathway by binding to an antigen-antibody complex?
A) C1 B) C2
C) C3a D) C3b
E) C5a
44. Which complement component is involved in the initiation of the alternative pathway?
A) C1 B) C2
C) C3b D) C4
E) C5a
45. At which step do the classical and alternative pathways of the complement system converge?
A) C1 B) C2
C) C3 D) C4
E) C5
46. Which of the following is the most abundant complement component?
A) C1 B) C2
C) C3 D) C4
E) C5
47. Which of the following complement components is involved in opsonization?
A) C3a B) C3b
C) C5a D) C6
E) C7
48. Which of the following does not have chemotactic activity?
A) Leukotriene B4 B) PGE2
C) Bacterial products D) Neutrophil cationic proteins
E) C5a
49. In which of the following processes does the complement system play a role?
A) Antibody-dependent cellular cytotoxicity B) Mast cell degranulation
C) Delayed hypersensitivity reaction D) Paroxysmal nocturnal hemoglobinuria (PNH)
E) Cytolysis by CD8 T cells
50. Which of the following complement components is incorrectly paired with its function?
A) C3a and C5a - Mast cell degranulation B) C3b - Opsonization
C) C4a - Interleukin-1 release D) C5a - Chemotaxis
E) C5b-9 - Cytolysis
51. Which of the following arachidonic acid metabolites enhances chemotaxis?
A) Thromboxane A2 B) Prostacyclin I2
C) Leukotriene B4 D) Lipoxin
E) Prostaglandin E2
52. Which of the following inflammatory mediators is involved in the development of fever?
A) Leukotriene B4 B) Bradykinin
C) Histamine D) Interleukin 1
E) Interleukin 8
53. Which of the following inflammatory mediators is associated with the sensation of pain?
A) Bradykinin B) C5a
C) Tumor necrosis factor D) PGF2alpha
E) LTC4
54. Which of the following acts as an opsonin?
A) Complement C3a B) Complement C5a
C) IgM Fc fragment D) IgG Fc fragment
E) PGE2
55. Which of the following is involved in the resolution of acute inflammation?
A) Lipoxins B) Platelet-activating factor
C) Kinin system D) Tumor necrosis factor
E) TGF-alpha
56. Which of the following cells contains high levels of myeloperoxidase?
A) Macrophage B) Basophil
C) Eosinophil D) Neutrophil
E) Epithelioid histiocyte
57. Which of the following is found only in primary granules and not in other granules?
A) Histaminase B) Lysozyme
C) Acid hydrolase D) Alkaline phosphatase
E) Cationic proteins
58. Which of the following cationic bactericidal proteins is released from the primary granules of polymorphonuclear leukocytes?
A) Bradykinin B) Cytokine
C) Selectin D) Lipocortin
E) Defensin
59. Which of the following is not an effect of anaphylatoxins?
A) Vasoconstriction B) Chemotaxis
C) Bronchoconstriction D) Fibrinolysis
E) Increased vascular permeability
60. Which of the following decreases during inflammation and is useful as an indicator of protein status?
A) C3 complement B) CRP
C) Haptoglobin D) Transferrin
E) Alpha1-antitrypsin
61. Which of the following is not part of the mononuclear phagocytic system?
A) Kupffer cell of the liver B) Sinus histiocytes
C) Alveolar macrophages D) Microglia
E) Plasma cells
62. Which of the following cells contain major basic protein and are protective against parasites?
A) Neutrophil B) Lymphocyte
C) Basophil D) Eosinophil
E) Plasma cell
63. The coexistence of pulmonary emphysema and liver cirrhosis is most likely due to a deficiency in which of the following?
A) Alpha-1-antitrypsin B) Galactokinase
C) Glucose-6-phosphatase D) Glucocerebrosidase
E) Phenylalanine hydroxylase
64. Which of the following conditions primarily presents with leukocyte adhesion defects?
A) Hemodialysis B) Thermal injury
C) Malignancy D) Sepsis
E) Immunodeficiency
65. NADPH oxidase deficiency is seen in which of the following diseases?
A) Chediak-Higashi syndrome B) Bruton's disease
C) Wiskott-Aldrich syndrome D) Chronic granulomatous disease
E) Agammaglobulinemia
66. In a disease where oxidative metabolism during phagocytosis is defective, which pathogen is most likely to cause frequent infections?
A) Mycobacterium tuberculosis B) Mycoplasma pneumoniae
C) Pneumococcus D) Rotavirus
E) Staphylococcus
67. Which syndrome involves delayed or reduced fusion of phagosomes with lysosomes, impairing bacterial phagocytosis?
A) Chronic granulomatous disease B) Job’s syndrome
C) Nezeloff syndrome D) Chediak-Higashi syndrome
E) Leukocyte adhesion deficiency (LAD) type I
68. Recurrent bacterial infections and poor wound healing are most characteristic of which of the following?
A) Nezeloff syndrome B) Isolated IgA deficiency
C) Chronic granulomatous disease D) Chediak-Higashi syndrome
E) Leukocyte adhesion deficiency (LAD)
69. Recurrent cold staphylococcal abscesses in fair-skinned, red-haired girls are characteristic of which of the following conditions?
A) Nezeloff syndrome B) Isolated IgA deficiency
C) Chronic granulomatous disease D) Chediak-Higashi syndrome
E) Job’s syndrome
70. A 5-year-old boy has recurrent Staphylococcus aureus infections. Peripheral blood leukocytes appear normal, but the Nitroblue Tetrazolium
(NBT) dye test is abnormal. Which of the following best explains the pathogenesis of his disease?
A) NADPH oxidase deficiency B) Defective fusion of phagosomes and lysosomes
C) C1-INH deficiency D) Myeloperoxidase deficiency
E) Immunoglobulin deficiency