00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - The accumulation of eosinophils within tissues is mostly regulated by which of the...

    Correct

    • The accumulation of eosinophils within tissues is mostly regulated by which of the following cytokines?

      Your Answer: Interleukin-5

      Explanation:

      IL-5 is produced by TH2 helper cells and by mast cells. They stimulate increased secretion of immunoglobulins and stimulate B cell growth. They are the major regulators in eosinophil activation and control. They are also released from eosinophils and mast cells in asthmatic patients and are associate with a many other allergic conditions.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      8.7
      Seconds
  • Question 2 - Which of the following mediators of inflammation requires arachidonic acid for synthesis? ...

    Correct

    • Which of the following mediators of inflammation requires arachidonic acid for synthesis?

      Your Answer: Prostaglandins

      Explanation:

      Arachidonic acid is normally present in the phospholipids that make up the cell membrane and is cleaved by phospholipase A2 from the phospholipid. Arachidonic acid is a precursor for the production of eicosanoids which include: 1) prostaglandins, prostacyclins and thromboxane, 2) leukotrienes and 3) anandamides. The production of these products along with their action on the body is called the arachidonic acid cascade.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      6.5
      Seconds
  • Question 3 - What is the role of ICAM-1 and VCAM-1 in the inflammatory process? ...

    Correct

    • What is the role of ICAM-1 and VCAM-1 in the inflammatory process?

      Your Answer: Leukocyte adhesion

      Explanation:

      Steps involved in leukocyte arrival and function include:

      1. margination: cells migrate from the centre to the periphery of the vessel.

      2. rolling: selectins are upregulated on the vessel walls.

      3. adhesion: upregulation of the adhesion molecules ICAM and VCAM on the endothelium interact with integrins on the leukocytes. Interaction of these results in adhesion.

      4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product.

      5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      7.9
      Seconds
  • Question 4 - A young girl who presented with a clinical picture of type I hypersensitivity...

    Correct

    • A young girl who presented with a clinical picture of type I hypersensitivity reaction with eosinophilia is most likely to have?

      Your Answer: Liver flukes

      Explanation:

      Usually a parasitic infection will be associated with a type I hypersensitivity reaction.

      Amyloid deposition will not cause an immune reaction.

      Organic dust will lead to a type III hypersensitivity reaction.

      Cell mediated as well as humoral immune mechanism play a part in syphilis, but they are do not specifically cause a type I reaction.

      Malaria is cause by plasmodium and is not cause of a hypersensitivity reaction.

      Atopic dermatitis will not be accompanied by eosinophilia.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      10.1
      Seconds
  • Question 5 - Which of these is secreted by both macrophages and muscle cells? ...

    Correct

    • Which of these is secreted by both macrophages and muscle cells?

      Your Answer: Interleukin-6

      Explanation:

      IL-6 is secreted by the T cells and macrophages and is a pro inflammatory cytokine. It is secreted in response to trauma e.g. burns and tissue damage that leads to inflammation. Apart from this its is also a myokine and is elevated due to muscle contraction. Other functions include: stimulate osteoclast formation when secreted by osteoblasts, mediate fever in acute phase response and are responsible for energy metabolism in muscle and fatty tissues. Inhibitors of IL-6 e.g. oestrogen are used as a treatment for postmenopausal osteoporosis.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      9.5
      Seconds
  • Question 6 - Which of the following cells would be increased in a patient suffering from...

    Correct

    • Which of the following cells would be increased in a patient suffering from a hydatid cyst in the liver?

      Your Answer: Eosinophils

      Explanation:

      Eosinophils are granulocytes that respond to parasitic infections. They are also involved in allergy response and asthma. They contain granules which stain red with Romanowsky’s method and contain peroxidase, Rnase, Dnase, histamine, lipase and major basic proteins that are toxic to the parasite as well as the hosts tissue. They are about 1-5% of the total WBC population and persist in the blood for 6-12 hours.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      6.2
      Seconds
  • Question 7 - Langhans giant cells are characteristically seen in which type of inflammation? ...

    Correct

    • Langhans giant cells are characteristically seen in which type of inflammation?

      Your Answer: Granulomatous inflammation

      Explanation:

      Langhans giant cells are characteristically seen in granulomatous inflammation. They form when epithelioid cells fuse together. They usually contain a nuclei with a horseshoe-shaped pattern in the periphery of the cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      4.5
      Seconds
  • Question 8 - A 35 year old man presented to the surgical OPD with a lump...

    Correct

    • A 35 year old man presented to the surgical OPD with a lump on his right forearm which appeared 3 weeks ago and was tender on examination. He gave a history was being in a car accident with pieces of glass from the windshield piercing his forearm removed manually and on further elective surgery. Which of these cells are characteristically found during inflammation in this situation?

      Your Answer: Giant cell

      Explanation:

      A foreign body reaction Is characteristic of giant cells. Glass being the foreign object initiates an inflammatory response in this condition.

      Mast cells are involved in allergic reactions.

      Eosinophils are characteristic of a parasitic infection and allergic inflammatory process but are not due to foreign bodies.

      Plasma cells are typical of chronic inflammation.

      Lymphocytes are involved in viral infections.

      Macrophages combine together to form giant cells.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      14.1
      Seconds
  • Question 9 - Which of the following terms best describes the movement of leukocytes towards a...

    Correct

    • Which of the following terms best describes the movement of leukocytes towards a specific target?

      Your Answer: Chemotaxis

      Explanation:

      The movement of leukocytes towards a chemical mediator is termed chemotaxis and the mediators likewise called chemoattractants.

      Diapedesis is the squeezing of the leukocytes from the capillary wall into the intercellular space.

      Endocytosis is engulfing of a small substance by the cells e.g. glucose, protein, fats.

      Margination is lining of the WBC along the periphery of the blood vessel.

      Adhesion is attachment with the vessel wall.

      Phagocytosis is described as engulfing the bacteria or the offending substance.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      6.2
      Seconds
  • Question 10 - Which of the following is the most abundant WBC seen in a smear...

    Correct

    • Which of the following is the most abundant WBC seen in a smear from a healthy person.

      Your Answer: Neutrophils

      Explanation:

      neutrophils are the most abundant cell type of the WBC. These phagocytes are found normally in the blood and increase in number are seen during an acute inflammation. These the percentages of WBC in blood Neutrophils: 40 to 60%

      Lymphocytes: 20 to 40%

      Monocytes: 2 to 8%

      Eosinophils: 1 to 4%

      Basophils: 0.5 to 1%

      Band (young neutrophil): 0 to 3%. eosinophils, basophils, neutrophils are known as granulocytes and monocytes and lymphocytes as agranulocytes.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      5.6
      Seconds
  • Question 11 - Following a bee sting, a women develops a 2cm red, raised, swollen lesion...

    Correct

    • Following a bee sting, a women develops a 2cm red, raised, swollen lesion at the site of the sting . Which of the following findings is likely to be seen in this lesion?

      Your Answer: Vasodilation

      Explanation:

      Inflammation is the immediate response of the body towards infections or irritations. The cardinal signs of inflammation are 1. redness/rubor, 2. tumour/swelling, 3.dolar/pain, 4.calor/heat and organ dysfunction (function laesa). Inflammation has 2 components; vascular and cellular. Blood vessels dilate upstream of the inflamed area leading to the rubor and calor and constrict downstream, increasing pressure and causing fluid to leak out of the capillary, resulting in swelling. The cellular component includes infiltration by neutrophils. Leukocyte arrival and functions include; 1. margination: cells marginated from the centre to the periphery of the vessel, 2. rolling: selectins are upregulated on the vessel walls, 3. adhesion: upregulation of the adhesion molecules ICAM and VCAM on the endothelium interact with integrins on the leukocytes resulting in adhesion, 4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product and 5. phagocytosis: engulfing the offending substance/cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      11.2
      Seconds
  • Question 12 - An experiment is carried out to observe engulfment and phagocytosis of microbes. Strep...

    Correct

    • An experiment is carried out to observe engulfment and phagocytosis of microbes. Strep pneumoniae are added to a solution of leukocytes with a substance added to enhance the process of phagocytosis. What is this substance?

      Your Answer: Complement C3b

      Explanation:

      C3b is cleaved from C3 complement with the help of the enzyme C3- convertase. It binds to the cell surface of the offending substance and opsonizes it. This makes it easy for the phagocytes to detect and eliminate them.

      IgM does not act as an opsonin but igG does.

      Selectins aid leukocytes to bind to the endothelial surfaces.

      C5a is a chemo-attractant and histamine a vasodilator.

      NADPH oxidises offending substance after phagocytosis within the macrophage.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      15.5
      Seconds
  • Question 13 - T lymphocytes that express the MCH type II antigen are most likely to...

    Correct

    • T lymphocytes that express the MCH type II antigen are most likely to produce which of the following cytokines?

      Your Answer: Gamma interferon

      Explanation:

      Interferon gamma is a soluble cytokine previously known as the macrophage activating factor. It is the only member belonging to the type II class of the interferons. It is secreted by a number of cells taking part in the immune reaction including: T-helper cells (CD-4), cells with immunological memory (CD45PA), killer cells (CD8), dendrite cells (CD23,35), natural killer cells (CD16) and B lymphocytes (CD22,CD23). It has both a defending as well as a pathological effect. It induces differentiation in the myeloid cell in the bone marrow. If macrophages are infected by parasites it activates the macrophages to destroy them. IFN-γ strengthens the anti-tumour activities of the cytotoxic lymphocytes. Together with CD4 or CD8 toxins, produced by lymphocytes, it suppresses the growth of the tumour cells. along with these functions it increases the non specific response of the natural killer cells, causing changes in the cell membrane surface to prevent adhesion and penetration of a virus. It can either increase or decrease B cell response and it activates osteoclasts which increases bone resorption.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      17.3
      Seconds
  • Question 14 - A 30 year old lawyer presented with a history of pleural effusions, pericarditis,...

    Correct

    • A 30 year old lawyer presented with a history of pleural effusions, pericarditis, arthralgia without joint deformity and episodes of myalgia for the past 12 months. Blood tests reveal a normocytic anaemia. Which of the following tests should be performed to investigate this condition further?

      Your Answer: Antinuclear antibody test

      Explanation:

      These non specific findings are suggestive of autoimmune disease. Antinuclear antibody (ANA) is the first test that should be performed when autoimmune diseases are suspected and later on more specific tests should be performed. This tests aids in the diagnosis of SLE, scleroderma, Sjogren’s syndrome, Raynaud’s disease, juvenile chronic arthritis, rheumatoid arthritis and antiphospholipid antibody syndrome etc. To confirm the disease a history, physical examination along with specific tests are required.

      CPK is more specific for acute conditions.

      ESR is a non specific test for inflammation.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      9.9
      Seconds
  • Question 15 - A week after a renal transplant the patient received antilymphocyte globulins. Shortly after...

    Correct

    • A week after a renal transplant the patient received antilymphocyte globulins. Shortly after she developed fever and hypotension. Which of the following mechanisms is involved in this response?

      Your Answer: Type III hypersensitivity

      Explanation:

      Type III hypersensitivity is characterized by soluble immune complexes which are aggregations of IgG and IgM antibodies with antigens that deposit in different tissues e.g. the skin, joints, kidneys. They can then trigger an immune response by activating the complement cascade. This reaction can take hours to develop and examples include: immuno-complex glomerulonephritis, rheumatoid arthritis, SLE, subacute bacterial endocarditis, arthus reaction and serum sickness.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      9.8
      Seconds
  • Question 16 - Leukotrienes normally function during an asthma attack and work to sustain inflammation. Which...

    Correct

    • Leukotrienes normally function during an asthma attack and work to sustain inflammation. Which of the following enzymes would inhibit their synthesis?

      Your Answer: 5-lipoxygenase

      Explanation:

      Leukotrienes are produced from arachidonic acid with the help of the enzyme 5-lipoxygenase. This takes place in the eosinophils, mast cells, neutrophils, monocytes and basophils. They are eicosanoid lipid mediators and take part in allergic and asthmatic attacks. They are both autocrine as well as paracrine signalling molecules to regulate the body’s response and include: LTA4, LTB4, LTC4, LTD4, LTE4 and LTF4.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      10.7
      Seconds
  • Question 17 - Perforin are present in the granules of which cell? ...

    Correct

    • Perforin are present in the granules of which cell?

      Your Answer: Natural killer cell

      Explanation:

      Perforins are characteristically found In the granules of CD8+ T cells and natural killer cells. They are cytolytic proteins that insert into the target plasma membrane forming a hole and resulting in lysis. They along with granzyme B induce apoptosis in the target cell.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      5.9
      Seconds
  • Question 18 - Which cells are most commonly seen in a granulomatous lesion that suggests an...

    Correct

    • Which cells are most commonly seen in a granulomatous lesion that suggests an underlying chronic inflammation?

      Your Answer: Lymphocytes

      Explanation:

      Lymphocytes and monocytes are commonly and characteristically recognised in a case of chronic inflammation.

      Eosinophils and neutrophils are seen with acute inflammation.

      Mast cells release histamine in early inflammation.

      Basophils are seen with allergies.

      Plasma cells are seen with viral infection.

      Platelets are not characteristic of any type of inflammation.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      10.2
      Seconds
  • Question 19 - An 8 year old boy presents with a history of repeated bacterial/pyogenic infections....

    Correct

    • An 8 year old boy presents with a history of repeated bacterial/pyogenic infections. He had a normal recovery from chickenpox and measles and shows normal antibody response. A decrease in which of the cell types can best explain this history of repeated pyogenic infections?

      Your Answer: Neutrophils

      Explanation:

      A decrease in the number of granulocytes, particularly neutrophils is known as agranulocytosis and it increases the susceptibility of an individual towards recurrent infections. Neutropenia can be either due to decreased production or increased elimination of neutrophils.

      Ineffective agranulopoiesis is seen in: 1. myeloid stem cell suppression, 2. disease conditions associated with granulopoiesis such as megaloblastic anaemia and myelodysplastic syndromes, 3. rare genetic diseases, 4. splenic sequestration and 5. increased peripheral utilization.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      11.5
      Seconds
  • Question 20 - Where do the cells belonging to the mononuclear phagocyte system originate? ...

    Correct

    • Where do the cells belonging to the mononuclear phagocyte system originate?

      Your Answer: Bone marrow

      Explanation:

      The macrophage originates from a committed bone marrow stem cell. It is called the pluripotent hematopoietic stem cell. This differentiates into a monoblast and then into a promonocyte and finally matures into a monocyte. When called upon they leave the bone marrow and enter into the circulation. Upon entering the tissue they transform into macrophages. Tissue macrophages include: Kupffer cells (liver), alveolar macrophages (lung), osteoclasts (bone), Langerhans cells (skin), microglial cells (central nervous system), and possibly the dendritic immunocytes of the dermis, spleen and lymph nodes.

    • This question is part of the following fields:

      • Inflammation & Immunology
      • Pathology
      5.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Inflammation & Immunology (20/20) 100%
Pathology (20/20) 100%
Passmed