Muhammad Medical and Dental College Mirpurkhas

Test inflammation 2nd year BDS

Total marks 100

1. Increased permeability in acute inflammation is induced by which of the following

mediators:
A) C3b and IgG
B) Prostaglandin
C) Bradykinin
D) Histamine & NO
E) Leukotriene

2. The following cells are important in the development in granuloma:

A) Platelet
B) Neutrophil
C) Basophils
D) Epitheloid
E) Lymphocytes

3. Granuloma having central caseous necrosis is:

A) Sarcoidosis
B) Multiple myeloma
C) Syphilis
D) Silicosis
E) Tuberculosis

4. Skin blister resulting from a burn is an example of:

A) Serous inflammation
B) Fibrous inflammation
C) Gangrene
D) Granulomatous inflammation
E) Suppurative inflammation
5. Suppurative inflammation is characterized by:
A) Out poring of a thin fluid.
B) Large amount of pus or purulent exudate.
C) Fluid derived from secretions of Mesothelial cells.
D) Eosinophile meshwork.
E) None of the above

6. Giant cells are present in:

A) Acute inflammation
B) Chronic inflammation
C) Granulomatous inflammation
D) Abscess formation
E) Fibrinous inflammation

7. A 45 -45-year-old woman after a silicone breast implant noted firmness with slight
deformity of the breast on the left. The implants are removed & there is evidence of leakage
of the implant centers on the left. Which of the following cell types is most likely to be
characteristic of the inflammatory response in this situation?
A) Eosinophil
B) Giant cell
C) Plasma cell
D) Lymphocytes
E) Mast cell

8. Chest Radiograph of 50-year-old man reveals multiple Nodules, lobes sputum microscopy
reveals Acid-fast bacilli. Which of the following types of inflammation is present?
A) Acute inflammation
B) Chronic inflammation
C) Granulomatous
D) Abscess formation
E) Fibrinous inflammation

9. Chemotaxis, leukocyte recruitment & activation is mediated by:

A) C5a
B) IL-1, TNF
C) Bradykinin
D) NO
 E) both a & b.

10. Repair involving a combination of regeneration and fibrosis is known as:

A) Healing
B) Regeneration
C) Hypertrophy
D) Atrophy
E) None of the above

11. Exuberant proliferation of fibroblasts & connective tissue following incisional scars are
called:
A) Scar
B) Keloid
C) Proud flesh
D) Granuloma
E) Desmoids

12. Which collagen type imparts the greatest tensile strength to healing wounds:
A) I
B) II
C) III
D) IV
E) V

13. Replacement of dead cells cannot occur by regeneration in the tissue of:
A) Labile cells
B) Stable cells
C) Permanent cells
D) Stem cells
E) none of the above

14. The most important delaying factor in wound healing is:

A) Foreign body
B) Infection
C) Deep tissues
D) Calcification
 E) Joint wound

15. The hallmark of healing and repair is;

A) Inflammation
B) Neutrophilic infiltration
C) Fibroblast proliferation
D) Granulation tissue
E) Wound contracture

16. A 15-year-old boy got cut on his arm. The wound becomes infected. Bacteria extend into
the extracellular matrix around capillaries. In the inflammatory response to this infection,
which of the following cells removes the bacteria?
A) B lymphocyte
B) Fibroblast
C) Macrophage
D) Mast cell
E) T lymphocyte

17. A The 6-year-old child has a history of recurrent infections with pyogenic bacteria, including
Staphylococcus aureus and Streptococcus pneumoniae. The infections are accompanied by
neutrophilic leukocytosis. Microscopic examination of a biopsy specimen obtained from an
area of soft tissue necrosis shows microbial organisms, but very few neutrophils. An analysis
of neutrophil function shows a defect in rolling. This child’s increased susceptibility to
infection is most likely caused by a defect involving which of the following molecules?
A) Complement C3b
B) Integrins
C) Leukotriene B4
D) NADPH oxidase
E) Selectins

18. A 5-year-old child has a history of recurrent bacterial infections, including pneumonia and
otitis media. Analysis of leukocytes collected from the peripheral blood shows a deficiency
in myeloperoxidase. A reduction in which of the following processes is the most likely cause
of this child’s increased susceptibility to infections?
A) Hydrogen peroxide (H2O2) elaboration
B) Hydroxy-halide radical (HOCl–) formation
C) Failure of migration resulting from complement deficiency
 D) Phagocytic cell oxygen consumption
E) Prostaglandin production

19. A 67-year-old man has had a cough productive of yellowish sputum for the past 2 days. On
examination, her temperature is 37° C. A chest radiograph shows bilateral patchy infiltrates.
Her peripheral blood shows leukocytosis. A week later she is afebrile. Which of the
following is the most likely outcome of her pulmonary disease?
A) Chronic inflammation
B) Fibrous scarring
C) Neoplasia
D) Resolution
E) Ulceration

20. A 40-year-old man has had mild epigastric pain for the past 3 months. An upper
gastrointestinal endoscopy shows a 2-cm, sharply demarcated, shallow ulceration of the
gastric antrum. Microscopic examination of a biopsy from the ulcer base shows
angiogenesis, fibrosis, and mononuclear cell infiltrates with lymphocytes, macrophages, and
plasma cells. Which of the following terms best describes this pathologic process?
A) Acute inflammation
B) Chronic inflammation
C) Fibrinous inflammation
D) Granulomatous inflammation
E) Serous inflammation

21. A 70-year-old man develops worsening congestive heart failure 2 weeks after acute
myocardial infarction. An echocardiogram shows a markedly decreased ejection fraction.
Now, capillaries, fibroblasts, collagen, and inflammatory cells have largely replaced the
infarcted myocardium. Which of the following inflammatory cell types in this lesion plays
the most important role in the healing process?
A) Eosinophils
B) Epithelioid cells
C) Macrophages
D) Neutrophils
E) Plasma cells

22. PECAM-1 is involved in which step of cellular phase of acute inflammation

A) margination
 B) rolling
C) firm adhesion
D) chemotaxis
E) diapedesis

23. A 51-year-old woman tests positive for hepatitis A antibody. Her serum AST level is 275 U/L,
and ALT is 310 U/L. One month later, these enzyme levels have returned to normal. Which
phase of the cell cycle best describes the hepatocytes 1 month after her infection?
A) G0
B) G1
C) S
D) G2
E) M

24. What are the main sets of events taking place in tissues during acute inflammation?
A) hemodynamic changes
B) increased permeability of vessel walls
C) emigration of leukocytes from vessels into the tissue
D) all of the above
E) none of the above

25. Regarding chronic inflammation which of the following is false

A) it is associated with persistent infections
B) it primarily involves tissue destruction
C) it may contribute to inflammation of Arteriosclerosis
D) it can be caused by exposure to the toxic agent
E) it involves mononuclear inflammatory cells

26. Which of the following are not classic signs of acute inflammation?
A) rubor
B) dolor
C) collagen deposition.
D) loss of function.
E) callor

27. Which of the following is a low risk of chronic inflammation?

 A) AIDS.
B) suture material left in situ.
C) bed sores for bed-bound.
D) first-degree burn.
E) tuberculosis

28. A patient with insidious fever, hemoptysis, and recurrent URTI has a lung parenchyma
granuloma pathologically assessed. what will the outer ring of the granuloma show?
A) eosinophil.
B) lymphocytes.
C) necrosis
D) basophils
E) Fibroblast

29. An aphthous break in the mucosal epithelium is otherwise known as what?

A) an ulcer.
B) a granuloma.
C) a serous inflammatory events.
D) a suppuration.
E) necrosis

30. Which of the following mediators of inflammation facilitate chemotaxis cytosis and
opsonization at the site of injury?
A) prostaglandins.
B) defensive.
C) kallikerin.
D) kinins.
E) complement protein

31. Adhesive molecules transmigration of leucocytes : VLA-4 binds to?

A) VCAM-1(vascular cell adhesive molecule-1)
B) ICAM-1( intra cellular adhesive molecule-1)
C) ICAM-2(intra cellular adhesive molecule-2)
D) glyCAM-1 (glycoprotein cell adhesive molecule-1)
32. In granulomatous inflammation one of the important mediators of the rim of lymphocyte
proliferation of fibroblast surrounding the epithelial cells
A) interleukin-1
B) Interferon-gamma
C) Complement C3b
D) leukotrienes C4
E) tumor necrosis factor

33. Platelet aggregation is the action of which of the following chemical mediators of
inflammation synthesized from the metabolites of arachidonic acid
A) Thromboxane A2
B) Prostacyclin
C) PGE-2
D) Lecukotrien-B4
E) PGF2 alpha

34. Inhibition of platelet aggregation is the action of one of the following chemical mediators of
inflammation
A) thromboxane A2
B) Prostacyclin PGI-2
C) PGE-2
D) leukotrienes B4
E) PGF 2 alpha

35. which of the following Eicosanoids inhibit neutrphilic chemotaxis

A) leukotriene B4
B) Lipoxin A4
C) Thromboxane A2
D) Prostacyclin PGI 2
E) PGD2

36. Bradykinins is a cleavage product of

A) kininogen -T
B) Pre kalikerin
C) kallikeren
D) Histamine
E) kallikerien
37. Cox 2 selective inhibitors are not drug of choice in patients of
A) peptic ulcer
B) dudenal ulcer
C) myocardial infarction
D) renal comprised
E) rheumatoid arthritis

38. Mast cells are biggest source of which mediator

A) serotonin
B) prostaglandin
C) leukotrienes
D) thromboxin
E) histamine

39. which of the following mediators are plasma derived

A) histamine
B) prostaglandin
C) chemokines
D) compliment
E) cytokines

40. which mediators cause chemotaxis

A) chemokines
B) leukotrienes
C) prostaglandin
D) thromboxin
E) all of the above

41. It is defined as the coating of pathogens with antibodies in order to increase their
susceptibility to ingestion by phagocytes.
A) chemotaxis
B) opsonization
C) margination
D) diapedesis
E) rolling
42. In cardinal sign of inflammation Dollars stand for
A) heat
B) pain
C) Redness
D) swelling
E) function less

43. what is hallmark of acute inflammation

A) increased vascular permeability
B) fibrosis
C) accumulation of leukocytes
D) angiogenesis
E) none of the above

44. permeability of blood vessels is increased by

A) Retraction of endothelial cells
B) transcytosis
C) leukocytes injury
D) direct injury e.g., in burn, toxin
E) all of the above
45. lymphocytes are prominent cell type in
A) acute inflammation
B) chronic inflammation
C) acute on chronic
D) all of the above
E) none of the above

46. inflammatory edema is

A) exudative
B) transudate
C) both
D) none of the above
E) transparent
47. A 40 years old patient is is admitted in emergency ward due to severe abdominal pain his
right lower abdomen is tender provisional diagnosis of surgeon is acute appendicitis, what
do you think which type of cells are predominantly present
A) lymphocytes
B) monocytes
C) neutrophils
D) mast cells
E) macrophages

48. which one of the following is most powerful killing agent during phagocytosis?
A) HOCL
B) O2
C) H2O
D) NO
E) OH

49. which of the following is not an antioxidant?

A) vitamin E
B) Glutathione
C) ceruloplasmin
D) transferrin
E) myeloperoxidase

50. A young kid suddenly developed flu, common cold and sore throat after observing his
Complete blood picture physician concludes he is suffering by viral infection what do you
think which type of cells predominantly present here
A) neutrophils
B) lymphocytes
C) monocytes
D) eosinophils
E) basophils

Short essay questions:

Attempt any 4
1. Describe cellular events in acute inflammation?
2. which one is the most important cell of chronic inflammation and how granuloma is
formed?
3. what are steps of wound healing by primary intention?
4. what factors causes delayed wound healing?
5. what are differences between acute and chronic inflammation?