Inflammation and Repair Practice Questions

Q: Which of the following are acute phase reactants in acute inflammation?

All of the above. **Explanation:** Acute Phase Reactants (APRs) are plasma proteins whose concentrations change by at least 25% in response to inflammatory stimuli (IL-1, IL-6, and TNF) [1]. They are synthesized primarily in the liver. **1. Why the answer is "All of the above":** APRs are categorized into two groups: * **Positive APRs:** These **increase** during inflammation to assist the immune system. **Fibrinogen** (Option B) increases to aid in clot formation and is responsible for the elevated ESR seen in inflammation. **Haptoglobin** (Option C) increases to bind free hemoglobin, preventing oxidative tissue damage and depriving bacteria of iron. * **Negative APRs:** These **decrease** during inflammation to conserve amino acids for the synthesis of positive APRs. **Albumin** (Option A) is the classic example of a negative APR. Since the question asks which of the following *are* acute phase reactants (without specifying positive or negative), all three options qualify. **2. Analysis of Options:** * **Albumin:** Decreases (Negative APR). * **Fibrinogen:** Increases (Positive APR); causes "rouleaux" formation of RBCs. * **Haptoglobin:** Increases (Positive APR); also an antioxidant. **Clinical Pearls for NEET-PG:** * **C-Reactive Protein (CRP):** The most sensitive and commonly used clinical marker for acute inflammation. It acts as an opsonin. * **Ferritin:** A positive APR; its elevation during inflammation can mask an underlying iron deficiency (Anemia of Chronic Disease). * **Procalcitonin:** A specific marker used to distinguish bacterial infections from viral or non-infectious inflammation. * **Transthyretin (Pre-albumin) and Transferrin:** Other important **negative** APRs to remember [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 83-99.

Q: In the cyclooxygenase (COX) pathway of arachidonic acid metabolism, which of the following products promotes platelet aggregation and vasoconstriction?

Thromboxane A2. The correct answer is **Thromboxane A2 (TXA2)**. Arachidonic acid is released from membrane phospholipids by phospholipase A2 [1] and metabolized via two major pathways: the Cyclooxygenase (COX) pathway and the Lipoxygenase (LOX) pathway. 1. **Why Thromboxane A2 is correct:** TXA2 is synthesized primarily in platelets via the COX pathway. It is a potent **vasoconstrictor** and a powerful **inducer of platelet aggregation** [1]. It acts in physiological antagonism to Prostacyclin (PGI2), which is a vasodilator and inhibitor of aggregation. The balance between TXA2 and PGI2 is critical for maintaining vascular homeostasis. 2. **Why other options are incorrect:** * **C5a:** This is a component of the Complement System (Anaphylatoxin). Its primary roles are chemotaxis for neutrophils and increasing vascular permeability [1]; it is not a product of the COX pathway. * **Leukotriene B4 (LTB4):** While derived from arachidonic acid, it is a product of the **Lipoxygenase (LOX) pathway**. It is a potent chemotactic agent for neutrophils but does not cause platelet aggregation [1]. * **C1 activators:** These are proteins involved in the initiation of the Classical Complement pathway, unrelated to arachidonic acid metabolism. **NEET-PG High-Yield Pearls:** * **Aspirin's Mechanism:** Low-dose aspirin irreversibly inhibits COX-1, shifting the balance toward PGI2 (antithrombotic) by inhibiting TXA2 synthesis in platelets (which cannot regenerate the enzyme) [1]. * **Chemotaxis Mnemonic:** "Big B" (**LTB4**), **C5a**, and **IL-8** are the primary "attractants" for neutrophils. * **Vasodilation:** Prostaglandins **PGI2, PGE1, PGE2, and PGD2** are primarily vasodilators [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 95-96.

Question 1

Necrotizing epithelioid cell granulomas are seen in all, except?

Accepted Answer

Leprosy

Answer

Tuberculosis

Answer

Wegener's granulomatosis

Answer

Cat's Scratch disease

Question 2

What is the correct sequence of cellular appearance in wound healing?

Accepted Answer

Platelet, Neutrophils, Macrophages, Fibroblast

Answer

Macrophage, Platelet, Neutrophils, Fibroblast

Answer

Neutrophils, Macrophages, Platelet, Fibroblast

Answer

Platelet, Macrophages, Neutrophils, Fibroblast

Question 3

Which of the following are acute phase reactants in acute inflammation?

Accepted Answer

All of the above

Answer

Albumin

Answer

Fibrinogen

Answer

Haptoglobin

Question 4

All of the following are false regarding vascular leakage in acute inflammation, except:

Accepted Answer

A hallmark of acute inflammation is increased permeability in the post-capillary venules.

Answer

Chemical mediators such as histamine play a role in delayed vascular leakage.

Answer

Transcytosis is not a contributing factor to vascular leakage.

Answer

In most cases, vascular leakage starts several hours after injury.

Question 5

Tuberculosis is typically associated with which type of necrosis?

Accepted Answer

Caseous necrosis

Answer

Coagulative necrosis

Answer

Liquefactive necrosis

Answer

Fibrinoid necrosis

Question 6

Serotonin, a mediator of inflammation, is secreted/released by which of the following cells?

Accepted Answer

Platelets

Answer

Leukocytes

Answer

Endothelial cells

Answer

Mast cells

Question 7

In a granuloma, epithelioid cells and giant cells are derived from which cell type?

Accepted Answer

Monocyte-macrophages

Answer

T lymphocytes

Answer

B lymphocytes

Answer

Mast cells

Question 8

Which of the following is an exogenous pyrogen?

Accepted Answer

Lipopolysaccharide

Answer

TNF-a

Answer

Neurotropic factor

Answer

IL-6

Question 9

In the cyclooxygenase (COX) pathway of arachidonic acid metabolism, which of the following products promotes platelet aggregation and vasoconstriction?

Accepted Answer

Thromboxane A2

Answer

C5a

Answer

Leukotriene B4

Answer

C1 activators

Question 10

The healing of an extraction socket where flaps are approximated occurs by which type of intention?

Accepted Answer

Primary intention

Answer

Secondary intention

Answer

Tertiary intention

Answer

Any of the above

Inflammation and Repair — MCQs

Inflammation and Repair — MCQs

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