Inflammation and Repair Practice Questions

Q: Epithelioid granulomatous lesions are found in all of the following diseases except:

Pneumocystis jirovecii. ***Pneumocystis carinii*** - Epithelioid granulomatous lesions are **not associated** with Pneumocystis carinii (now called **Pneumocystis jirovecii** in humans), which causes opportunistic infections without granulomatous response [1]. - Typically presents as **interstitial pneumonia** with foamy alveolar exudates rather than granulomatous inflammation [1]. *Berylliosis* - This condition is characterized by **granulomatous lung disease**, particularly with **epithelioid granulomas** in the lung tissue [2]. - It's caused by exposure to **beryllium**, often seen in occupational settings [2]. *TB* - Tuberculosis (TB) is well-known for inducing **caseating granulomas**, but it can also show **epithelioid granulomas** in active disease [3]. - Typically starts in the lungs and can disseminate, forming granulomas in various organs [3]. *Sarcoidosis* - Sarcoidosis is defined by the presence of **non-caseating epithelioid granulomas** primarily in the lungs but can affect other organs too [2]. - Commonly linked with **bilateral hilar lymphadenopathy** and respiratory symptoms. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 318-319. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 198-200. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 320-321.

Q: Which amino acid is derived from arginine and is important for the formation of neutrophilic extracellular traps (NETs)?

Citrulline. ***Citrulline*** - **Citrulline** is crucial for the formation of neutrophilic extracellular traps (NETs) [1] as it plays a role in the **post-translational modification** of histones, which is essential for uncoiling DNA. - Its metabolism is directly linked to the production of **neutrophil-derived reactive oxygen species (ROS)**, further supporting NET formation. *Methionine* - While **methionine** is an important amino acid, it is primarily involved in **protein synthesis** and **methylation processes**, not directly in NET formation. - It does not play a significant role in the **nuclear processes** required for the production of NETs. *Valine* - **Valine** is a branched-chain amino acid primarily involved in **energy metabolism** and muscle repair, and does not directly contribute to NET formation. - It lacks a specific role in the **activation of neutrophils** or the structural aspects of NET development. *Leucine* - **Leucine** is another branched-chain amino acid that plays a key role in **protein synthesis**, particularly in muscle tissue, rather than in **immune response mechanisms**. - Its function does not include the direct involvement in the mechanisms of **NET formation** by neutrophils. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 91-92.

Q: Vasodilation in acute inflammation is first shown by which blood vessels?

Arterioles. ***Arterioles*** - **Arterioles** are the primary sites of **vasodilation** in acute inflammation [1][2], allowing increased blood flow to affected tissues. - They respond rapidly to inflammatory mediators, leading to **decreased vascular resistance** and subsequent hyperemia. *Vein* - While veins can undergo changes in response to inflammation, they typically do not initiate **vasodilation** during acute inflammatory responses. - Their primary role is in **draining blood**, rather than altering flow dynamics significantly in acute conditions. *Capillaries* - Capillaries are where **exudate** occurs, but they do not initiate vasodilation; they primarily facilitate the **exchange** of fluids and nutrients. - Their diameter remains relatively constant; changes primarily occur in arterioles before affecting capillary perfusion. *Venules* - Venules primarily function as sites for **exudation** and are influenced by the arteriolar changes that precede their dilation. - They play a role in **collecting blood** but do not exhibit initial vasodilatory responses during acute inflammation. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 185-186. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, p. 101.

Q: What does the 'C' in CRP (C-reactive protein) stand for?

C-polysaccharide of pneumococcus. ***Capsular polysaccharide of pneumococcus*** - The "C" in CRP refers to the **C-reactive protein**, which was named after its interaction with the **capsular polysaccharide** of *Streptococcus pneumoniae*. - CRP is an acute phase reactant that increases in response to **inflammation and infection**, particularly in infections caused by encapsulated bacteria [1]. *Concanavalin A* - This is a **lectin derived from the Canavalia ensiformis** plant and is not related to CRP or its function. - It is mostly used in **immunological studies** and does not play a role in the acute phase response. *Cellular* - This term is too vague and does not accurately represent any component of CRP. - CRP is primarily a **protein** and not related to any specific cellular structure or classification. *Chondrotin sulfate in series with ARP, BRP* - Chondroitin sulfate refers to components involved in **cartilage structure**, not related to CRP. - ARP and BRP are not standard abbreviations associated with CRP or its function. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 501-502.

Q: During angiogenesis, what factors are responsible for the recruitment of pericytes and periendothelial cells?

Angiopoietins, TGF & PDGF. ***Angiopoietins, TGF & PDGF*** - **Angiopoietins** are crucial for the stabilization of blood vessels and recruitment of **pericytes**, enhancing vessel maturation [1]. - **TGF (Transforming Growth Factor)** and **PDGF (Platelet-Derived Growth Factor)** also play significant roles in the recruitment and proliferation of **pericytes** and periendothelial cells during angiogenesis [1]. *VEGF & PDGF* - While **VEGF (Vascular Endothelial Growth Factor)** is important for endothelial cell migration and proliferation, it does not directly recruit **pericytes** alone. - This combination lacks **angiopoietins**, which are key for the stabilization of newly formed blood vessels [1]. *VEGF, IL-2, IL-6* - **IL-2** and **IL-6** are primarily associated with immune responses and do not directly contribute to pericyte recruitment during angiogenesis. - **VEGF** alone supports endothelial cells but does not effectively recruit **pericytes** without the cooperation of other factors. *TGF, VEGF & PDGF* - Although both **TGF** and **PDGF** are involved in pericyte recruitment [1], the absence of **angiopoietins** limits the effectiveness of this combination for the recruitment process. - **VEGF** alone does not facilitate direct recruitment of **pericytes**, as it mainly focuses on endothelial cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 115-116.

Q: In the context of tissue repair, which cell type is predominantly found during the proliferative phase of wound healing?

Fibroblasts. ***Fibroblasts*** - During the proliferative phase, **fibroblasts** are stimulated to proliferate and migrate into the wound site [1], [2]. - They are responsible for synthesizing and depositing the **extracellular matrix**, including **collagen**, which forms the structural framework of the new tissue [1], [2]. *Mesenchymal cells* - **Mesenchymal cells** are multipotent **stem cells** that can differentiate into various cell types, including fibroblasts, but they are not the predominant cell type actively laying down collagen in the proliferative phase. - While they play a role in providing cells for wound repair, **fibroblasts** are the primary effector cells of collagen production [1]. *Odontoblast* - **Odontoblasts** are specialized cells found in the **dental pulp** that are responsible for forming **dentin**. - They are not involved in general tissue repair processes outside of tooth development or injury. *Ameloblast* - **Ameloblasts** are cells responsible for forming **tooth enamel** during tooth development. - They are not found in general wound healing and are specific to **enamel genesis**. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 105-106. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 115-119.

Q: Most important for diapedesis is

PECAM. ***Platelet Endothelial Cell Adhesion Molecule (PECAM)*** - PECAM plays a crucial role in the process of **diapedesis**, allowing white blood cells to pass through the endothelial barrier [1]. - It is specifically involved in **intercellular junctions**, facilitating the migration of leukocytes during **inflammation** [1]. *Selectins* - Selectins are important for **rolling** of leukocytes on the endothelium but do not directly mediate **diapedesis**. - They are crucial for initial attachment but do not promote the passage through the endothelial cell junctions. *Mucin like glycoprotein* - While mucin like glycoproteins can facilitate **cell adhesion**, they primarily contribute to the **rolling phase** rather than diapedesis itself. - They are not as directly involved in the **transmigration** across the endothelium as PECAM. *Integrins* - Integrins are involved in **firm adhesion** of leukocytes, but do not directly enable **diapedesis** across the endothelium. - They support the binding to the endothelium but play a lesser role compared to PECAM in the actual process of migration. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 87-89.

Question 1

Epithelioid granulomatous lesions are found in all of the following diseases except:

Accepted Answer

Pneumocystis jirovecii

Answer

TB

Answer

Sarcoidosis

Answer

Berylliosis

Question 2

Which amino acid is derived from arginine and is important for the formation of neutrophilic extracellular traps (NETs)?

Accepted Answer

Citrulline

Answer

Leucine

Answer

Methionine

Answer

Valine

Question 3

Vasodilation in acute inflammation is first shown by which blood vessels?

Accepted Answer

Arterioles

Answer

Venules

Answer

Capillaries

Answer

Veins

Question 4

Transmigration of white blood cells across the endothelium is called?

Accepted Answer

Diapedesis

Answer

Margination

Answer

Rolling

Answer

Pavementing

Question 5

What does the 'C' in CRP (C-reactive protein) stand for?

Accepted Answer

C-polysaccharide of pneumococcus

Answer

Concanavalin A

Answer

Chondroitin sulfate

Answer

Cellular

Question 6

During angiogenesis, what factors are responsible for the recruitment of pericytes and periendothelial cells?

Accepted Answer

Angiopoietins, TGF & PDGF

Answer

VEGF & PDGF

Answer

VEGF, IL-2, IL-6

Answer

TGF, VEGF & PDGF

Question 7

An elderly man gets a burn injury to his hands. Over several weeks, the burned skin heals without the need for skin grafting. The most critical factor responsible for the rapid healing in this case is:

Accepted Answer

Remnant skin appendages

Answer

Underlying connective tissues

Answer

Minimal edema and erythema

Answer

Granulation tissue

Question 8

The commonest variety of acute inflammation is:

Accepted Answer

Serous inflammation

Answer

Necrotic inflammation

Answer

Catarrhal inflammation

Answer

Purulent inflammation

Question 9

In the context of tissue repair, which cell type is predominantly found during the proliferative phase of wound healing?

Accepted Answer

Fibroblasts

Answer

Mesenchymal cells

Answer

Ameloblasts

Answer

Odontoblasts

Question 10

Most important for diapedesis is

Accepted Answer

PECAM

Answer

Selectins

Answer

Mucin like glycoprotein

Answer

Integrins

Inflammation and Repair — MCQs

Inflammation and Repair — MCQs

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