Robbinsj&jCotranjReviewjofjPathology Pg.j17
2. AcutejandjChronicjInflammation
PBD7jandjPBD8jChapterj2:jAcutejandjChronicjInflammation
BP7jandjBP8jChapterj2:jAcutejandjChronicjInflammation
1 Injaj6-monthjrandomizedjtrialjofjajpharmacologicjagent,jonejgroupjofjpatientsjreceivesjajcyclooxygenase-2j(COX-
2)jinhibitor,jandjajcontroljgroupjdoesjnot.jLaboratoryjmeasurementsjduringjthejtrialjshowjnojsignificantjdifferencesjbetweenjthej
groupsjinjWBCjcount,jplateletjcount,jhemoglobin,jandjcreatinine.jThejgroupjreceivingjthejdrugjreportsjsubjectivejfindingsjdiff
erentjfromjthosejofjthejcontroljgroup,jhowever.jWhichjofjthejfollowingjfindingsjwasjmostjlikelyjreportedjbyjthejgroupjreceivingjth
ejdrug?
□ (A)jAnklejswelling
□ (B)jIncreasedjboutsjofjasthma
□ (C)jEasyjbruisability
□ (D)jReducedjurticaria
□ (E)jIncreasedjfebrilejepisodes
□ (F)jReducedjarthritisjpain
2 Anjexperimentjintroducesjbacteriajintojajperfusedjtissuejpreparation.jLeukocytesjleavejthejvasculaturejandjmigratejtojthejsit
ejofjbacterialjinoculation.jThejmovementjofjthesejleukocytesjisjmostjlikelyjtojbejmediatedjbyjwhichjofjthejfollowingjsubstances
?
□ (A)jBradykinin
□ (B)jChemokines
□ (C)jHistamine
□ (D)jProstaglandins
□ (E)jComplementjC3a
3 Aj53-year-
oldjwomanjhasjhadjajhighjfeverjandjcoughjproductivejofjyellowishjsputumjforjthejpastj2jdays.jHerjvitaljsignsjincludejtemperature
jofj37.8°C,jpulsejofj83/min,jrespirationsjofj17/min,jandjbloodjpressurejofj100/60jmmjHg.jOnjauscultation jofjthejchest,jcrac
klesjarejaudiblejinjbothjlungjbases.jAjchestjradiographjshowsjbilateraljpatchyjpulmonaryjinfiltratesjandjfluidjinjthejrightjpleuralj
cavity.jThoracentesisjyieldsj500jmLjofjcloudyjyellowjfluid.jWhichjofjthejfollowingjinflammatoryjcelljtypesjisjmostjlikelyjtojbejsee
njinjgreatlyjincreasedjnumbersjinjajsputumjspecimen?
□ (A)jMacrophages
□ (B)jNeutrophils
□ (C)jMastjcells
□ (D)jSmalljlymphocytes
□ (E)jLanghansjgiantjcells
4 Aj63-year-
oldjmanjdevelopsjworseningjcongestivejheartjfailurej2jweeksjafterjanjacutejmyocardialjinfarction.jAnjechocardiogramjsh
owsjajmarkedlyjdecreasedjejectionjfraction.jHejdiesj1jdayjlater.jAtjautopsy,jajsectionjofjthejinfarctjshowsjthatjthejnecroticjm
yocardiumjhasjlargelyjbeenjreplacedjbyjcapillaries,jfibroblasts,jandjcollagen.jVariousjinflammatoryjcellsjarejpresent.jW
hichjofjthejfollowingjinflammatoryjcelljtypesjinjthisjlesionjplaysjthejmostjimportantjrolejinjthejhealingjprocess?
□ (A)jMacrophages
□ (B)jPlasmajcells
, Robbinsj&jCotranjReviewjofjPathology Pg.j18
□ (C)jNeutrophils
□ (D)jEosinophils
□ (E)jEpithelioidjcells
5 Aj10-year-
oldjchildjdevelopedjajsorejthroatjandjfeverjoverj24jhours.jPhysicaljexaminationjshowsjpharyngealjerythemajandjswelling.jLab
oratoryjfindingsjincludejleukocytosis.jThejchildjisjgivenjacetylsalicylicjacidj(aspirin).jWhichjofjthejfollowingjfeaturesjofjtheji
nflammatoryjresponsejisjmostjaffectedjbyjthisjdrug?
□ (A)jVasodilation
□ (B)jChemotaxis
□ (C)jPhagocytosis
□ (D)jEmigrationjofjleukocytes
□ (E)jReleasejofjleukocytesjfromjbonejmarrow
6 Ajwomanjwhojisjallergicjtojcatsjvisitsjajneighborjwhojhasjseveraljcats.jDuringjthejvisit,jshejinhalesjcatjdander,jandjwithinjmin
utes,jshejdevelopsjnasaljcongestionjwithjabundantjnasaljsecretions.jWhichjofjthejfollowingjsubstancesjisjmostjlikelyjtojproducejt
hesejfindings?
□ (A)jBradykinin
□ (B)jComplementjC5a
□ (C)jHistamine
□ (D)j Interleukin-1
□ (E)j PhospholipasejC
□ (F)jPlatelet-activatingjfactor
□ (G)jTumorjnecrosisjfactor
7 Aj32-year-
oldjwomanjhasjhadjajchronicjcoughjwithjfeverjforjthejpastjmonth.jOnjphysicaljexamination,jshejhasjajtemperaturejofj37.5°
C,jandjonjauscultationjofjthejchest,jcracklesjarejheardjinjalljlungjfields.jAjchestjradiographjshowsjmanyjsmall,jill-
definedjnodularjopacitiesjinjalljlungjfields.jAjtransbronchialjbiopsyjspecimenjshowsjinterstitialjinfiltratesjwithjlymphocytes,jpl
asmajcells,jandjepithelioidjmacrophages.jWhichjofjthejfollowingjinfectiousjagentsjisjthejmostjlikelyjcausejofjthisjappearance
?
□ (A)j Staphylococcusjaureus
□ (B)jPlasmodiumjfalciparum
□ (C)jCandidajalbicans
□ (D)jMycobacteriumjtuberculosis
□ (E)jKlebsiellajpneumoniae
□ (F)jCytomegalovirus
8 Aj36-year-
oldjmanjhasjhadjmidepigastricjabdominaljpainjforjthejpastj3jmonths.jAnjupperjgastrointestinaljendoscopyjshowsjaj2-
cm,jsharplyjdemarcated,jshallowjulcerationjofjthejgastricjantrum.jAjbiopsyjspecimenjofjthejulcerjbasejshowsjangiogenesis,jfib
rosis,jandjmononuclearjcelljinfiltratesjwithjlymphocytes,jmacrophages,jandjplasmajcells.jWhichjofjthejfollowingjtermsjbestjde
scribesjthisjpathologicjprocess?
, Robbinsj&jCotranjReviewjofjPathology Pg.j19
□ (A)jAcutejinflammation
, Robbinsj&jCotranjReviewjofjPathology Pg.j20
□ (B)jSerousjinflammation
□ (C)jGranulomatousjinflammation
□ (D)jFibrinousjinflammation
□ (E)jChronicjinflammation
9 Aj5-year-
oldjchildjreachesjupjtojthejstovejandjtouchesjajpotjofjboilingjsoup.jWithinjseveraljhours,jtherejisjmarkedjerythemajofjthejskinj
ofjthejfingersjonjthejchild'sjrightjhand,jandjsmalljblistersjappearjonjthejfingerjpads.jWhichjofjthejfollowingjtermsjbestjdescribe
sjthisjprocess?
□ (A)jFibrinousjinflammation
□ (B)jPurulentjinflammation
□ (C)jSerousjinflammation
□ (D)jUlceration
□ (E)jGranulomatousjinflammation
10 Forjthejpastj2jdays,jaj41-year-
oldjmanjhasjhadjajseverejheadache,jandjhejnowjhasjajtemperaturejofj39.2°C.jAjlumbarjpuncturejisjperformed,jandjthejcere
brospinaljfluidjobtainedjhasjajWBCjcountjofj910/mm3jwithj94%jneutrophilsjandj6%jlymphocytes.jWhichjofjthejfollowingjsubsta
ncesjisjthejmostjlikelyjmediatorjforjthejfeverjobservedjinjthisjpatient?
□ (A)jBradykinin
□ (B)jLeukotrienejB4
□ (C)jHistamine
□ (D)jMyeloperoxidase
□ (E)jNitricjoxide
□ (F)jPhospholipasejC
□ (G)jTumorjnecrosisjfactor
11 Aj6-year-
oldjchildjhasjajhistoryjofjrecurrentjinfectionsjwithjpyogenicjbacteria,jincludingjStaphylococcusjaureusjandjStreptococcusjpn
eumoniae.jThejinfectionsjarejaccompaniedjbyjajneutrophilicjleukocytosis.jMicroscopicjexaminationjofjajbiopsyjspecimenjobtain
edjfromjanjareajofjsoftjtissuejnecrosisjshowsjmicrobialjorganisms,jbutjveryjfewjneutrophils.jAnjanalysisjofjneutrophiljfunctionj
showsjajdefectjinjrolling.jThisjchild'sjincreasedjsusceptibilityjtojinfectionjisjmostjlikelyjcausedjbyjajdefectjinjwhichjofjthejfollo
wingjmolecules?
□ (A)jSelectins
□ (B)jIntegrins
□ (C)jLeukotrienejB4
□ (D)jComplementjC3b
□ (E)jNADPHjoxidase
12 Onejmonthjafterjanjappendectomy,jaj25-year-
oldjwomanjpalpatesjajsmalljnodulejbeneathjthejskinjatjthejsitejofjthejhealedjrightjlowerjquadrantjincision.jThejnodulejisjexcised,j
andjmicroscopicjexaminationjshowsjmacrophages,jcollagen,jajfewjsmalljlymphocytes,jandjmultinucleatedjgiantjcells.jPolariza
ble,jrefractilejmaterialjisjseenjinjthejnodule.jWhichjofjthejfollowingjcomplicationsjofjthejsurgeryjbestjaccountsjforjthesejfindings
?
2. AcutejandjChronicjInflammation
PBD7jandjPBD8jChapterj2:jAcutejandjChronicjInflammation
BP7jandjBP8jChapterj2:jAcutejandjChronicjInflammation
1 Injaj6-monthjrandomizedjtrialjofjajpharmacologicjagent,jonejgroupjofjpatientsjreceivesjajcyclooxygenase-2j(COX-
2)jinhibitor,jandjajcontroljgroupjdoesjnot.jLaboratoryjmeasurementsjduringjthejtrialjshowjnojsignificantjdifferencesjbetweenjthej
groupsjinjWBCjcount,jplateletjcount,jhemoglobin,jandjcreatinine.jThejgroupjreceivingjthejdrugjreportsjsubjectivejfindingsjdiff
erentjfromjthosejofjthejcontroljgroup,jhowever.jWhichjofjthejfollowingjfindingsjwasjmostjlikelyjreportedjbyjthejgroupjreceivingjth
ejdrug?
□ (A)jAnklejswelling
□ (B)jIncreasedjboutsjofjasthma
□ (C)jEasyjbruisability
□ (D)jReducedjurticaria
□ (E)jIncreasedjfebrilejepisodes
□ (F)jReducedjarthritisjpain
2 Anjexperimentjintroducesjbacteriajintojajperfusedjtissuejpreparation.jLeukocytesjleavejthejvasculaturejandjmigratejtojthejsit
ejofjbacterialjinoculation.jThejmovementjofjthesejleukocytesjisjmostjlikelyjtojbejmediatedjbyjwhichjofjthejfollowingjsubstances
?
□ (A)jBradykinin
□ (B)jChemokines
□ (C)jHistamine
□ (D)jProstaglandins
□ (E)jComplementjC3a
3 Aj53-year-
oldjwomanjhasjhadjajhighjfeverjandjcoughjproductivejofjyellowishjsputumjforjthejpastj2jdays.jHerjvitaljsignsjincludejtemperature
jofj37.8°C,jpulsejofj83/min,jrespirationsjofj17/min,jandjbloodjpressurejofj100/60jmmjHg.jOnjauscultation jofjthejchest,jcrac
klesjarejaudiblejinjbothjlungjbases.jAjchestjradiographjshowsjbilateraljpatchyjpulmonaryjinfiltratesjandjfluidjinjthejrightjpleuralj
cavity.jThoracentesisjyieldsj500jmLjofjcloudyjyellowjfluid.jWhichjofjthejfollowingjinflammatoryjcelljtypesjisjmostjlikelyjtojbejsee
njinjgreatlyjincreasedjnumbersjinjajsputumjspecimen?
□ (A)jMacrophages
□ (B)jNeutrophils
□ (C)jMastjcells
□ (D)jSmalljlymphocytes
□ (E)jLanghansjgiantjcells
4 Aj63-year-
oldjmanjdevelopsjworseningjcongestivejheartjfailurej2jweeksjafterjanjacutejmyocardialjinfarction.jAnjechocardiogramjsh
owsjajmarkedlyjdecreasedjejectionjfraction.jHejdiesj1jdayjlater.jAtjautopsy,jajsectionjofjthejinfarctjshowsjthatjthejnecroticjm
yocardiumjhasjlargelyjbeenjreplacedjbyjcapillaries,jfibroblasts,jandjcollagen.jVariousjinflammatoryjcellsjarejpresent.jW
hichjofjthejfollowingjinflammatoryjcelljtypesjinjthisjlesionjplaysjthejmostjimportantjrolejinjthejhealingjprocess?
□ (A)jMacrophages
□ (B)jPlasmajcells
, Robbinsj&jCotranjReviewjofjPathology Pg.j18
□ (C)jNeutrophils
□ (D)jEosinophils
□ (E)jEpithelioidjcells
5 Aj10-year-
oldjchildjdevelopedjajsorejthroatjandjfeverjoverj24jhours.jPhysicaljexaminationjshowsjpharyngealjerythemajandjswelling.jLab
oratoryjfindingsjincludejleukocytosis.jThejchildjisjgivenjacetylsalicylicjacidj(aspirin).jWhichjofjthejfollowingjfeaturesjofjtheji
nflammatoryjresponsejisjmostjaffectedjbyjthisjdrug?
□ (A)jVasodilation
□ (B)jChemotaxis
□ (C)jPhagocytosis
□ (D)jEmigrationjofjleukocytes
□ (E)jReleasejofjleukocytesjfromjbonejmarrow
6 Ajwomanjwhojisjallergicjtojcatsjvisitsjajneighborjwhojhasjseveraljcats.jDuringjthejvisit,jshejinhalesjcatjdander,jandjwithinjmin
utes,jshejdevelopsjnasaljcongestionjwithjabundantjnasaljsecretions.jWhichjofjthejfollowingjsubstancesjisjmostjlikelyjtojproducejt
hesejfindings?
□ (A)jBradykinin
□ (B)jComplementjC5a
□ (C)jHistamine
□ (D)j Interleukin-1
□ (E)j PhospholipasejC
□ (F)jPlatelet-activatingjfactor
□ (G)jTumorjnecrosisjfactor
7 Aj32-year-
oldjwomanjhasjhadjajchronicjcoughjwithjfeverjforjthejpastjmonth.jOnjphysicaljexamination,jshejhasjajtemperaturejofj37.5°
C,jandjonjauscultationjofjthejchest,jcracklesjarejheardjinjalljlungjfields.jAjchestjradiographjshowsjmanyjsmall,jill-
definedjnodularjopacitiesjinjalljlungjfields.jAjtransbronchialjbiopsyjspecimenjshowsjinterstitialjinfiltratesjwithjlymphocytes,jpl
asmajcells,jandjepithelioidjmacrophages.jWhichjofjthejfollowingjinfectiousjagentsjisjthejmostjlikelyjcausejofjthisjappearance
?
□ (A)j Staphylococcusjaureus
□ (B)jPlasmodiumjfalciparum
□ (C)jCandidajalbicans
□ (D)jMycobacteriumjtuberculosis
□ (E)jKlebsiellajpneumoniae
□ (F)jCytomegalovirus
8 Aj36-year-
oldjmanjhasjhadjmidepigastricjabdominaljpainjforjthejpastj3jmonths.jAnjupperjgastrointestinaljendoscopyjshowsjaj2-
cm,jsharplyjdemarcated,jshallowjulcerationjofjthejgastricjantrum.jAjbiopsyjspecimenjofjthejulcerjbasejshowsjangiogenesis,jfib
rosis,jandjmononuclearjcelljinfiltratesjwithjlymphocytes,jmacrophages,jandjplasmajcells.jWhichjofjthejfollowingjtermsjbestjde
scribesjthisjpathologicjprocess?
, Robbinsj&jCotranjReviewjofjPathology Pg.j19
□ (A)jAcutejinflammation
, Robbinsj&jCotranjReviewjofjPathology Pg.j20
□ (B)jSerousjinflammation
□ (C)jGranulomatousjinflammation
□ (D)jFibrinousjinflammation
□ (E)jChronicjinflammation
9 Aj5-year-
oldjchildjreachesjupjtojthejstovejandjtouchesjajpotjofjboilingjsoup.jWithinjseveraljhours,jtherejisjmarkedjerythemajofjthejskinj
ofjthejfingersjonjthejchild'sjrightjhand,jandjsmalljblistersjappearjonjthejfingerjpads.jWhichjofjthejfollowingjtermsjbestjdescribe
sjthisjprocess?
□ (A)jFibrinousjinflammation
□ (B)jPurulentjinflammation
□ (C)jSerousjinflammation
□ (D)jUlceration
□ (E)jGranulomatousjinflammation
10 Forjthejpastj2jdays,jaj41-year-
oldjmanjhasjhadjajseverejheadache,jandjhejnowjhasjajtemperaturejofj39.2°C.jAjlumbarjpuncturejisjperformed,jandjthejcere
brospinaljfluidjobtainedjhasjajWBCjcountjofj910/mm3jwithj94%jneutrophilsjandj6%jlymphocytes.jWhichjofjthejfollowingjsubsta
ncesjisjthejmostjlikelyjmediatorjforjthejfeverjobservedjinjthisjpatient?
□ (A)jBradykinin
□ (B)jLeukotrienejB4
□ (C)jHistamine
□ (D)jMyeloperoxidase
□ (E)jNitricjoxide
□ (F)jPhospholipasejC
□ (G)jTumorjnecrosisjfactor
11 Aj6-year-
oldjchildjhasjajhistoryjofjrecurrentjinfectionsjwithjpyogenicjbacteria,jincludingjStaphylococcusjaureusjandjStreptococcusjpn
eumoniae.jThejinfectionsjarejaccompaniedjbyjajneutrophilicjleukocytosis.jMicroscopicjexaminationjofjajbiopsyjspecimenjobtain
edjfromjanjareajofjsoftjtissuejnecrosisjshowsjmicrobialjorganisms,jbutjveryjfewjneutrophils.jAnjanalysisjofjneutrophiljfunctionj
showsjajdefectjinjrolling.jThisjchild'sjincreasedjsusceptibilityjtojinfectionjisjmostjlikelyjcausedjbyjajdefectjinjwhichjofjthejfollo
wingjmolecules?
□ (A)jSelectins
□ (B)jIntegrins
□ (C)jLeukotrienejB4
□ (D)jComplementjC3b
□ (E)jNADPHjoxidase
12 Onejmonthjafterjanjappendectomy,jaj25-year-
oldjwomanjpalpatesjajsmalljnodulejbeneathjthejskinjatjthejsitejofjthejhealedjrightjlowerjquadrantjincision.jThejnodulejisjexcised,j
andjmicroscopicjexaminationjshowsjmacrophages,jcollagen,jajfewjsmalljlymphocytes,jandjmultinucleatedjgiantjcells.jPolariza
ble,jrefractilejmaterialjisjseenjinjthejnodule.jWhichjofjthejfollowingjcomplicationsjofjthejsurgeryjbestjaccountsjforjthesejfindings
?
