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  • Question 1 - Typically, granulomatous inflammation is associated with one of the following infections: ...

    Correct

    • Typically, granulomatous inflammation is associated with one of the following infections:

      Your Answer: Tuberculosis

      Explanation:

      Granulomatous inflammation is typically seen when an infective agent with a digestion-resistance capsule (e.g. Mycobacterium tuberculosis) or a piece of inert foreign material (such as suture or glass) is introduced into the tissue. A transient acute inflammatory response occurs and when this is ineffective in eradicating the stimulus, chronic inflammation occurs. Tuberculosis is the prototype of the granulomatous diseases, but sarcoidosis, cat-scratch disease, lymphogranuloma inguinale, leprosy, brucellosis, syphilis, some mycotic infections, berylliosis, reactions of irritant lipids, and some autoimmune diseases are also included

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      3.2
      Seconds

  • Question 2 - 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:

      • Inflammatory Responses
      • Pathology
      5.8
      Seconds

  • Question 3 - A 15 year old girl presented to the emergency with a history of...

    Correct

    • A 15 year old girl presented to the emergency with a history of chronic cough, fever and weight loss. Her chest X-ray showed multiple nodules 1-4 cm in size and some of them with cavitation especially in the upper lobe. A sputum sample was positive for acid fast bacilli. Which of the following cells played a part in the development of the lung lesions?

      Your Answer: Macrophage

      Explanation:

      The characteristic cells in granulomatous inflammation are giant cells, formed from merging macrophages and epithelioid cells elongated with granular eosinophilic cytoplasm. Granulomatous reactions are seen in patients with tuberculosis. A tuberculous/caseating granuloma is characterised by a zone of central necrosis lined with giant multinucleated giant cells (Langhans cells) and surrounded by epithelioid cells, lymphocytes and fibroblasts. The caseous zone is present due to the damaged and dead giant cells and epithelioid cells. Mast cells are only few in number and fibroblasts lay down collagen. Basophils are not present. The giant cell made up of macrophages are the most abundant cells in this inflammatory process.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      6
      Seconds

  • Question 4 - Regarding apoptosis, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding apoptosis, which of the following statements is INCORRECT:

      Your Answer: Apoptosis leads to the formation of membrane-bound apoptotic bodies.

      Correct Answer: Apoptosis leads to cell swelling and eventual cell lysis.

      Explanation:

      Apoptosis is a controlled form of cell death in which no cellular contents are released from the dying cell, and thus no inflammatory reaction is seen. Apoptosis may occur physiologically or pathologically. Apoptosis may be induced in two main ways: by the engagement of surface death receptors e.g. TNF-alpha (extrinsic pathway) or through cellular injury (intrinsic pathway). The end result is the activation of proteases enzymes called caspases which dismantle the cell cytoplasm and nucleus. Apoptotic cells shrink down and fragment into apoptotic bodies, each of which retains an intact cell membrane; apoptotic bodies are then targeted or rapid removal by adjacent cells. Disordered apoptosis is thought to be central to a number of important disease processes, particularly carcinogenesis.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      23.9
      Seconds

  • Question 5 - Caseous necrosis is typically seen in which of the following: ...

    Correct

    • Caseous necrosis is typically seen in which of the following:

      Your Answer: Tuberculosis

      Explanation:

      Caseous necrosis is most commonly seen in tuberculosis. Histologically, the complete loss of normal tissue architecture is replaced by amorphous, granular and eosinophilic tissue with a variable amount of fat and an appearance reminiscent of cottage cheese.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      16.7
      Seconds

  • Question 6 - Which of the following cytokines is important for the maintenance of granulomatous inflammation:...

    Correct

    • Which of the following cytokines is important for the maintenance of granulomatous inflammation:

      Your Answer: TNF-alpha

      Explanation:

      Granulomatous inflammation is a distinctive pattern of chronic inflammation that is encountered in a limited number of infectious and some non-infectious conditions. Briefly, a granuloma is a cellular attempt to contain an offending agent that is difficult to eradicate. In this attempt, there is often strong activation of T lymphocytes leading to macrophage activation, which can cause injury to normal tissues. IL-1 is important in initiating granuloma formation, IL-2 can cause them to enlarge and TNF-α maintains them.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      5.2
      Seconds

  • Question 7 - Which of the following is NOT one of the cardinal features of acute...

    Correct

    • Which of the following is NOT one of the cardinal features of acute inflammation:

      Your Answer: Discharge

      Explanation:

      Classic signs: Rubor (redness) Calor (heat) Dolour (pain) Tumour (swelling) Functio laesa (loss of function) These classic signs are produced by a rapid vascular response and cellular events. The main function of these events is to bring elements of the immune system to the site of injury and prevent further tissue damage.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      4.5
      Seconds

  • Question 8 - A 24 year old male sustained an insect bite and presents with a...

    Correct

    • A 24 year old male sustained an insect bite and presents with a red hot arm and acute cellulitis has been diagnosed. The predominant white cells in this type of acute inflammation are:

      Your Answer: Neutrophils

      Explanation:

      Neutrophil polymorphs are the predominant type of white cells in an acute reaction. They pass between endothelial cell junctions to invade damaged tissue so that the effects of injury can be combated. Extravasation occurs with the movement of leukocytes out of the vessel lumen, and is achieved in five phases which are margination, ‘rolling’, adhesion, transmigration and chemotaxis.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      8.3
      Seconds

  • Question 9 - Fibrinoid necrosis is typically seen in which of the following: ...

    Correct

    • Fibrinoid necrosis is typically seen in which of the following:

      Your Answer: Malignant hypertension

      Explanation:

      Fibrinoid necrosis occurs in malignant hypertension where increased arterial pressure results in necrosis of smooth muscle wall. Eosinophilic and fibrinous deposits are seen.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      14.6
      Seconds

  • Question 10 - Which of the following features of cell damage tends to be reversible: ...

    Correct

    • Which of the following features of cell damage tends to be reversible:

      Your Answer: Swelling of endoplasmic reticulum and some mitochondria

      Explanation:

      Features of cell damage that tend to be reversible include: swelling of endoplasmic reticulum and some mitochondrialoss of ribosomescell stress response Features of cell damage that tend to be irreversible include: loss of nucleolus, no ribosomes, swelling of all mitochondria, nuclear condensation, membrane blebs and holes, lysosome rupture, fragmentation of all inner membranes, nuclear breakup

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      7.7
      Seconds

  • Question 11 - Coagulative necrosis is typically seen in which of the following: ...

    Correct

    • Coagulative necrosis is typically seen in which of the following:

      Your Answer: Myocardial infarction

      Explanation:

      Coagulative necrosis is the most common form of necrosis characterised by the loss of cell nuclei, but with general preservation of the underlying architecture. Dead tissue is macroscopically pale and firm. This is the classic pattern seen in myocardial infarction.Liquefactive necrosis leads to complete loss of cellular structure and conversion into a soft, semi-solid mass. This is typically seen in the brain following cerebral infarction.Caseous necrosis is most commonly seen in tuberculosis. Histologically, the complete loss of normal tissue architecture is replaced by amorphous, granular and eosinophilic tissue with a variable amount of fat and an appearance reminiscent of cottage cheese.Gangrenous necrosis is necrosis with putrefaction of tissues due to exposure to air (dry gangrene) or infection (wet gangrene).

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      18.6
      Seconds

  • Question 12 - Which of the following is NOT an effect of cytokine activity: ...

    Correct

    • Which of the following is NOT an effect of cytokine activity:

      Your Answer: Opsonisation of bacteria for phagocytosis

      Explanation:

      Cytokines are a family of chemical messengers, secreted by leucocytes, that act over short distances by binding specific receptors on target cell surfaces. They include: interleukins (act between leucocytes), interferons (inhibit replication of viruses within cells and activate macrophages and natural killer cells), growth factors, and tumour necrosis factors (kill tumour cells). Effects include: induction of fever and acute phase response, stimulation of leucocyte differentiation and maturation, leucocyte recruitment and activation and increased antibody production.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      21.1
      Seconds

  • Question 13 - C-reactive protein (CRP) synthesis is predominantly stimulated by which of the following cytokines:...

    Correct

    • C-reactive protein (CRP) synthesis is predominantly stimulated by which of the following cytokines:

      Your Answer: IL-6

      Explanation:

      Activated leukocytes, adipocytes, and endothelial cells all release interleukin 6 (IL-6), a significant proinflammatory cytokine. The main downstream mediator of the acute phase response is C-reactive protein, which is predominantly produced by IL-6–dependent hepatic biosynthesis.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      3.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Inflammatory Responses (12/13) 92%
Pathology (12/13) 92%
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