Practice questions: Acute inflammation (1&2)

Q.1 While drinking hot coffee at Zaffarano you accidentally knock your friend’s glass
and the coffee spills on his hand.

1. What is the clinical nature of this injury?

a. Acute
b. Subacute
c. Chronic
2. Match the arrows to one of the five cardinal signs of acute inflammation
a. Red arrow ---------- tumor
b. Yellow arrow ---------- rubor
3. Name two other cardinal signs of acute inflammation which are not visible in the
picture but which would be present in this patient.
a. ------------------ dolor
b. ------------------functio laesa
Q. 2 A 25-year old cyclist slips and falls down sustaining a lacerated wound on his ankle (see
image).

1. Which one of the following cellular inflammatory responses occurs last in response to
this injury?
a. Adhesion
b. Rolling
c. Margination
d. Phagocytosis
2. Which of the following cell types responds first in this type of injury at the site of the
wound?
a. Basophil
 b. Eosinophil
c. Lymphocyte
d. Neutrophil
Q.3 A 50-year old man is admitted to hospital for treatment of right-sided bacterial
pneumonia. After three days an X-ray chest shows a collection of fluid in the right pleural
cavity. The aspirated fluid is an exudate.
Which of the following would be most characteristic of this fluid?
a. Clear transparent appearance
b. Specific gravity 1020
c. Numerous polymorphs
d. Proteins 1g/dl
Q.4 A 5-year old child is brought by the mother to the clinic with history of high fever, sore
throat and running nose for the last 2 days. On examination, the throat is congested. Blood
differential counts show 60% lymphocytes (normal 20-40%).
Which of the following is the most likely etiology of the child’s illness?
a. Bacterial rhinitis
b. Immune reaction
c. Viral nasopharyngitis
d. Parasitic infection
Q.5 A 65-year old man has been suffering from diabetes since the last 15 years. He develops
an abscess on his leg which is not responding well to treatment.
Which of the following is an O2-dependant microbial-killing mechanism that is likely to be
defective in this patient?
a. Iron-binding lactoferrin
b. H2O2-MPO-halide system
c. Major basic protein
d. Elastase
Q.6 A 25-year old man healthy man develops wound infection after a cut sustained in an
accident. He receives appropriate treatment with wound care and antibiotics.
Activation of which of the following cells in the tissues will terminate the inflammatory
reaction and initiate the process of healing?
a. Neutrophils
b. Lymphocytes
c. M2 macrophages
d. Eosinophils

Practice questions: Acute inflammation (3) and Chronic inflammation 1

Q.1 Nitric oxide is used as a therapeutic gas for its action on the vasculature. Based on your
knowledge of its in vivo role in inflammation which therapeutic action is it likely to execute?
a. Vasoconstriction
b. Vasodilatation
c. Increased vascular permeability
d. Chemotaxis

Q.2. Low dose aspirin is prescribed to patients with coronary artery disease to prevent
platelet aggregation. Which of the following enzymes in the prostaglandin synthetic pathway
does it inhibit to achieve this action?
a. Phospholipase
b. Cyclooxygenase
c. 5-Lipooxygenase
d. 12-lipooxygenase
Q.3 A 25-year old male suffering from pyogenic arthritis (of bacterial origin) complains of
fever, loss of appetite and increased sleep.
Name two cytokines produced by macrophages that play an important role in these reactions.
1. IL 1
2. TNF
Q4. Which one of the following clinical conditions predisposes to infections due to defects in
all 4 inflammatory processes: chemotaxis, leucocyte adhesion, phagocytosis and microbicidal
action?
a. Burns
b. Sepsis
c. Diabetes
d. Malnutrition
Q5. A 60-year old man undergoes abdominal surgery to remove a part of the colon for
cancer. Ten days later the surgeon discovers an opening at the site of the sutured surgical
skin incision. On probing it he finds that it is extruding faecal material.
Which of the following postoperative complication has developed in the patient?
a. Abscess
b. Sinus
c. Ulcer
d. Fistula
Q. 6 A 40-year old man has developed a lung infection which has persisted for several
months. On an X-ray chest the area of infection shows a cavity with a well-defined wall.
Which of the following tissue reactions has resulted in development of the wall?
 a. Necrosis
b. Acute inflammation
c. Abscess
d. Fibrosis
Q.7 After prolonged treatment of a non-healing ulcer on the foot, healing has started slowly.
The release of which of the following would be most useful in this process?
a. Growth factors
b. Reactive oxygen species
c. Proteases
d. Coagulation factors
Q. 8. A 4-year old child is brought by the mother to the hospital with complaints of weakness
and poor appetite. The child is anaemic (low Hb) and stool examination shows a worm
infection. A peripheral blood smear of this child is placed below.
Which of the following substances is released by the predominant leucocytes seen in this
smear to target the worm infection.
a. Elastase
b. Major basic protein
c. Histamine
d. Serotonin

Practice questions: Week 4. Chronic inflammation (2) and Repair

Q. 2 A 25-year old cyclist slips and falls down sustaining a lacerated wound on his ankle (see
image).

3. Name three specific factors that would affect wound healing in this patient assuming
he has no other chronic illness? Bacteria infection + age + Surgical closure
Answer questions 3-7 based on the scenario and image provided below
A 55-year old obese man with history of diabetes for the last five years, presents with
discolouration and disfigurement of the nails of the feet for the last 3 months. He has
mild itching but no pain at the site. The physician diagnoses fungal infection of the
nails (onychomycosis) and advises oral antifungal treatment for the next three months
followed by review and continuation of therapy.

Q3. Is the patient’s disease acute or chronic? Give 3 reasons to support your answer?
Chronic- took a long time to develop, takes a long time to give medication + minimum pain.

Q4. Which of the following is the predominant inflammatory cell reaction in the lesion?
a. Basophil
b. Eosinophil
c. Lymphocyte
d. Neutrophil

Q 8. The CT scan chest of a patient with pulmonary tuberculosis is placed below.

8. a Which of the following tissue reactions is likely to be seen in a biopsy from these
lesions?
i. abscess
ii. coagulative necrosis
iii. granulomas
iv. haemorrhage
8. b Which inflammatory reaction leads to the circumscribed appearance of these
lesions on radiology?
a. caseous necrosis
b. macrophage response
c. lymphocytic infiltration
d. fibrosis
9. Match the following etiologic classes of granulomatous inflammation with the
appropriate disease listed
Etiologic class Correct answer Disease
Infectious C A. Sarcoidosis
Chemical D B. Rheumatic fever
Allergic B C. Leprosy
Unknown A D. Gout

Q. 11, The image below is a diagrammatic representation of the cellular components of a

granuloma.
Which type of cell does the cell indicated at the pointer originate from?

a. Macrophage
b. Lymphocyte
c. Plasma cell
d. Mast cell