P3 Exam Two - Inflammation and Wound Healing

The thymus is classified as a:

A. Primary lymphoid tissue

B. Secondary lymphoid tissue

C. Tertiary lymphoid tissue

D. Site of antigen presentation

A. Primary lymphoid tissue

Which of the following is NOT a secondary lymphoid organ?

A. Lymph node

B. Tonsil

C. Spleen

D. Bone marrow

D. Bone marrow

A patient with lymphoma involving the lymph nodes is most likely to have impaired function of secondary lymphoid tissue. Secondary lymphoid tissues are specialized primarily for:

A. Production of lymphocytes

B. Maturation of lymphocytes

C. Antigen capture and lymphocyte activation

D. Hematopoiesis

B. Maturation of lymphocytes

Which of the following is characteristic of innate immunity?

A. Antigen specificity

B. Memory response

C. Immediate response to pathogens

D. Clonal expansion of lymphocytes

C. Immediate response to pathogens

Neutrophils, mast cells, macrophages, and NK cells are primarily components of:

A. Adaptive immunity

B. Innate immunity

C. Secondary lymphoid tissues

D. Passive immunity

B. Innate immunity

A patient presents to the ED with an acutely inflamed, red, hot, swollen ankle after an inversion sprain. The term calor refers to which cardinal sign of inflammation?

A. Redness

B. Swelling

C. Heat

D. Pain

C. Heat

Loss of function (functio laesa) in inflammation is caused by:

A. Histamine release

B. Tissue edema and pain

C. Vasoconstriction

D. Fever

B. Tissue edema and pain

Vasodilation of arterioles primarily accounts for which cardinal sign?

A. Heat and redness

B. Pain

C. Swelling

D. Loss of function

A. Heat and redness

A patient with a sprained knee develops swelling within hours. The swelling (tumor) in inflammation is due to:

A. Increased blood flow

B. Edema from vascular permeability

C. Leukocyte chemotaxis

D. Fibroblast proliferation

B. Edema from vascular permeability

A patient presents with fever, leukocytosis, and elevated C-reactive protein. These findings indicate:

A. Localized inflammation

B. Systemic inflammation

C. Granulomatous inflammation

D. Serous inflammation

B. Systemic inflammation

Which acute-phase protein is most commonly measured as a clinical marker of inflammation?

A. Fibrinogen

B. Albumin

C. C-reactive protein (CRP)

D. Immunoglobulin G

C. C-reactive protein (CRP)

A patient with rheumatoid arthritis has an elevated ESR. The increased sedimentation rate occurs due to:

A. Elevated albumin

B. Increased fibrinogen causing RBC aggregation

C. Reduced plasma viscosity

D. Low hematocrit

B. Increased fibrinogen causing RBC aggregation

A patient with bacterial pneumonia presents with leukocytosis. The predominant WBC type in this setting is:

A. Neutrophils

B. Eosinophils

C. Basophils

D. Monocytes

A. Neutrophils

In a patient with acute appendicitis, the earliest vascular change in acute inflammation is:

A. Increased vascular permeability

B. Vasoconstriction

C. Vasodilation of arterioles

D. Leukocyte adhesion

C. Vasodilation of arterioles

A patient with allergic rhinitis develops tissue swelling within minutes of allergen exposure. The increased vascular permeability is most often mediated by:

A. Tight junction contraction in endothelium

B. Endothelial necrosis

C. Formation of granulomas

D. Smooth muscle contraction

A. Tight junction contraction in endothelium

In bacterial meningitis, neutrophils migrate across the endothelium into the CSF. This transmigration occurs primarily through:

A. Fenestrated capillaries

B. Junctions between endothelial cells

C. Arteriolar smooth muscle gaps

D. Lymphatic vessels only

B. Junctions between endothelial cells

Which mediator is most responsible for immediate vasodilation and increased vascular permeability?

A. Histamine

B. TNF-alpha

C. IL-1

D. IFN-gamma

A. Histamine

Bradykinin is responsible for:

A. Vasoconstriction

B. Fever and leukocytosis

C. Pain and increased permeability

D. Inhibition of clotting

C. Pain and increased permeability

Prostaglandins produced by COX pathways primarily mediate:

A. Vasoconstriction and clotting

B. Vasodilation, fever, and pain

C. Platelet aggregation only

D. Complement activation

B. Vasodilation, fever, and pain

Complement proteins are most important for:

A. Fever induction

B. Opsonization

C. Chemotaxis

D. Vasodilation

B. Opsonization

A patient with acute bacterial pneumonia has a dense infiltrate of neutrophils with fibrin exudate in the alveoli. This is most characteristic of:

A. Chronic inflammation

B. Acute inflammation

C. Granulomatous inflammation

D. Serous inflammation

B. Acute inflammation

Which cell type predominates in chronic inflammation?

A. Neutrophils

B. Lymphocytes and macrophages

C. Basophils

D. Eosinophils only

B. Lymphocytes and macrophages

A patient with long-standing hepatitis develops fibrosis and angiogenesis in the liver. These findings are hallmarks of:

A. Acute inflammation

B. Chronic inflammation

C. Serous inflammation

D. Ulcerative inflammation

B. Chronic inflammation

A case of persistent Helicobacter pylori gastritis with lymphocytic infiltration is best described as:

A. Acute inflammation

B. Chronic inflammation

C. Granulomatous inflammation

D. Serous inflammation

B. Chronic inflammation

A blister filled with clear fluid after a burn is an example of:

A. Serous inflammation

B. Fibrinous inflammation

C. Purulent inflammation

D. Ulcerative inflammation

A. Serous inflammation

Which form of inflammation is characterized by deposition of fibrin in body cavities, such as pericarditis?

A. Serous

B. Fibrinous

C. Purulent

D. Pseudomembranous

B. Fibrinous

Pseudomembranous inflammation is classically associated with:

A. Tuberculosis

B. Clostridioides difficile colitis

C. Rheumatoid arthritis

D. Burns

B. Clostridioides difficile colitis

A patient with chronic cough and weight loss is found to have granulomatous inflammation. This is most likely due to:

A. Acute viral infection

B. Tuberculosis or sarcoidosis

C. Hypersensitivity urticaria

D. Streptococcal pharyngitis

B. Tuberculosis or sarcoidosis

An ulcer represents inflammation associated with:

A. Necrosis and erosion of epithelium

B. Excessive fibrin exudate

C. Subcutaneous abscess

D. Endothelial proliferation

A. Necrosis and erosion of epithelium

A lung biopsy in sarcoidosis reveals granulomas. Which cell type is the hallmark of granulomatous inflammation?

A. Neutrophils

B. Epithelioid macrophages

C. Mast cells

D. NK cells

B. Epithelioid macrophages

Sarcoidosis is characterized by granulomas that are:

A. Caseating

B. Non-caseating

C. Purulent

D. Pseudomembranous

B. Non-caseating

Caseating granulomas are most classically associated with:

A. Tuberculosis

B. Sarcoidosis

C. Fungal infections

D. Rheumatoid nodules

A. Tuberculosis

A PT student sees a patient with rheumatoid arthritis who has fever, anemia of chronic disease, and elevated ESR. The pathophysiology of elevated ESR is primarily due to:

A. Decreased hematocrit

B. Increased fibrinogen and acute-phase proteins

C. Reduced viscosity

D. Autoantibodies

B. Increased fibrinogen and acute-phase proteins

A trauma patient has a wound with purulent discharge. The most likely predominant cell type is:

A. Neutrophil

B. Macrophage

C. Eosinophil

D. Plasma cell

A. Neutrophil

During acute inflammation, TNF-alpha and IL-1 are most important for:

A. Vasodilation

B. Inducing fever and expression of adhesion molecules

C. Opsonization of microbes

D. Clot formation

B. Inducing fever and expression of adhesion molecules

Labile cells are best defined as:

A. Cells that cannot divide once fully mature

B. Cells that continuously divide throughout life

C. Cells that remain quiescent but can proliferate when stimulated

D. Cells that only divide during embryogenesis

B. Cells that continuously divide throughout life

Stable cells such as hepatocytes are characterized by:

A. Inability to divide under any conditions

B. Rapid, continuous division

C. Quiescence with the ability to regenerate if injured

D. Terminal differentiation without repair capacity

C. Quiescence with the ability to regenerate if injured

Which of the following is an example of permanent cells?

A. Smooth muscle

B. Hepatocytes

C. Cardiac myocytes

D. Fibroblasts

C. Cardiac myocytes

The first leukocytes to arrive in the wound healing process are:

A. Neutrophils

B. Macrophages

C. Lymphocytes

D. Fibroblasts

A. Neutrophils

Which cell type is most important for clearing debris and releasing growth factors during wound healing?

A. Neutrophils

B. Macrophages

C. B cells

D. Eosinophils

B. Macrophages

Fibroblasts in wound healing primarily function to:

A. Phagocytose bacteria

B. Lay down collagen and extracellular matrix

C. Produce antibodies

D. Promote vasodilation

B. Lay down collagen and extracellular matrix

Granulation tissue is best described as:

A. Mature scar tissue with dense collagen

B. Proliferating fibroblasts, new capillaries, and loose ECM

C. Necrotic tissue awaiting clearance

D. Caseating granulomas

B. Proliferating fibroblasts, new capillaries, and loose ECM

Which of the following is NOT a component of granulation tissue?

A. Fibroblasts

B. Capillaries

C. Dense Type I collagen bundles

D. Loose extracellular matrix

C. Dense Type I collagen bundles

The vascular component of granulation tissue arises primarily from:

A. Endothelial cell proliferation and angiogenesis

B. Arteriolar smooth muscle hypertrophy

C. Fibroblast transdifferentiation

D. Platelet aggregation

A. Endothelial cell proliferation and angiogenesis

A surgical incision closed with sutures heals by:

A. Secondary intention

B. Primary intention

C. Chronic inflammation

D. Regeneration only

B. Primary intention

Which of the following best describes healing by secondary intention?

A. Minimal granulation tissue, minimal scarring

B. Wound edges are approximated by surgical closure

C. Large tissue defect filled with abundant granulation tissue, leading to significant scar formation

D. Healing occurs only through regeneration of labile cells

C. Large tissue defect filled with abundant granulation tissue, leading to significant scar formation

Which type of healing has a greater risk of hypertrophic scarring?

A. Primary intention

B. Secondary intention

C. Healing of permanent cells only

D. Regeneration

B. Secondary intention

During the proliferative phase of wound healing, the dominant histological feature is:

A. Neutrophil infiltration

B. Formation of granulation tissue with angiogenesis and fibroblast proliferation

C. Dense collagen cross-linking

D. Complete epithelial regeneration

B. Formation of granulation tissue with angiogenesis and fibroblast proliferation

The remodeling (maturation) phase of wound healing is characterized by:

A. Replacement of Type III collagen with Type I collagen

B. Macrophage infiltration and phagocytosis

C. Peak angiogenesis

D. Peak inflammation

A. Replacement of Type III collagen with Type I collagen

Which systemic condition is most likely to impair wound healing due to microvascular disease and poor leukocyte function?

A. Hypertension

B. Diabetes mellitus

C. Hyperthyroidism

D. Gout

B. Diabetes mellitus

Which nutritional deficiency is most directly associated with impaired collagen cross-linking and delayed wound healing?

A. Vitamin D

B. Vitamin C

C. Vitamin B12

D. Vitamin K

B. Vitamin C

Poor wound healing due to local hypoxia is most commonly caused by:

A. Excess granulation tissue

B. Inadequate blood supply

C. Hyperbaric oxygen therapy

D. Increased vascularity

B. Inadequate blood supply

Which local factor most contributes to wound dehiscence (reopening of a surgical wound)?

A. Adequate hemostasis

B. Infection at the wound site

C. Well-approximated wound edges

D. Early epithelialization

B. Infection at the wound site