Inflammation and Repair Practice Questions

Q: Which of the following is most characteristic of a granuloma?

Epithelioid cells. ### Explanation A **granuloma** is a focal collection of inflammatory cells, representing a form of chronic inflammation (Type IV hypersensitivity). It is the body's attempt to contain an offending agent that is difficult to eradicate. **1. Why Epithelioid Cells are the Correct Answer:** The **defining and most characteristic feature** of a granuloma is the presence of **epithelioid cells**. These are activated macrophages that have undergone a morphological change: they have abundant pink granular cytoplasm and indistinct cell borders, resembling epithelial cells. Without the presence of epithelioid cells, a collection of inflammatory cells is simply "chronic inflammation," not a granuloma. **2. Analysis of Incorrect Options:** * **B. Giant Cells:** While frequently present (formed by the fusion of multiple epithelioid cells, e.g., Langhans giant cells), they are **not mandatory** for the diagnosis of a granuloma. * **C. Fibroblasts:** These are often found at the periphery of older granulomas (forming a "fibrous rim" or scar), but they are a non-specific feature of healing and repair. * **D. Endothelial Cells:** These line blood vessels. While angiogenesis occurs in chronic inflammation, they are not a diagnostic component of the granulomatous architecture itself. **Clinical Pearls for NEET-PG:** * **High-Yield Definition:** A granuloma = A collection of epithelioid cells surrounded by a rim of lymphocytes and often containing giant cells. * **Caseating vs. Non-caseating:** Caseating granulomas (central necrosis) are classic for **Tuberculosis**. Non-caseating granulomas are seen in **Sarcoidosis**, Leprosy, and Crohn’s disease [1]. * **Cytokine Key:** **IFN-gamma** (secreted by Th1 cells) is the primary cytokine responsible for activating macrophages into epithelioid cells. **TNF-alpha** is essential for maintaining the structural integrity of the granuloma.

Q: Which of the following is a known effect of bradykinin?

Pain at the site of inflammation. **Explanation:** Bradykinin is a potent inflammatory mediator belonging to the **Kinin system**. It is derived from high-molecular-weight kininogen (HMWK) through the action of the enzyme kallikrein [1]. **Why the correct answer is right:** Bradykinin is one of the primary chemical mediators responsible for the sensation of **pain** during acute inflammation (along with prostaglandins) [1]. It acts by sensitizing and stimulating nociceptors (sensory nerve endings) at the site of injury. **Analysis of incorrect options:** * **A. Vasoconstriction:** Bradykinin is a powerful **vasodilator**, not a vasoconstrictor [1]. It acts on endothelial cells to release nitric oxide and PGI2, leading to smooth muscle relaxation. * **C. Bronchodilatation:** Bradykinin causes **bronchoconstriction** (contraction of bronchial smooth muscle) [1]. This is particularly relevant in allergic reactions and asthma. * **D. Decreased vascular permeability:** Bradykinin significantly **increases vascular permeability** by causing endothelial cell contraction, leading to the formation of intercellular gaps (exudation/edema) [1]. **High-Yield NEET-PG Pearls:** * **The "Triple Response" of Bradykinin:** Vasodilation, increased vascular permeability, and pain. * **ACE Inhibitor Link:** Angiotensin-Converting Enzyme (ACE) normally degrades bradykinin [1]. Therefore, ACE inhibitors lead to increased bradykinin levels, which can cause the classic side effects of **dry cough** and **angioedema**. * **C1 Esterase Inhibitor Deficiency:** This leads to Hereditary Angioedema due to the overproduction of bradykinin. * **Short Half-life:** Bradykinin is rapidly inactivated by kinases (like kininase II/ACE) [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 100-101.

Question 1

Candida infections are commonly seen in patients with which of the following conditions?

Accepted Answer

Myeloperoxidase deficiency

Answer

Chronic granulomatous disease

Answer

Chediak-Higashi syndrome

Answer

Lazy leukocyte syndrome

Question 2

Which of the following is NOT a positive acute-phase reactant?

Accepted Answer

Transthyretin

Answer

Serum Amyloid A protein

Answer

Fibrinogen

Answer

Hepcidin

Question 3

A 25-year-old woman sustains a deep, open laceration over her right forearm in a motorcycle accident. The wound is cleaned and sutured. Which of the following cell types mediates contraction of the wound to facilitate healing?

Accepted Answer

Myofibroblasts

Answer

Endothelial cells

Answer

Fibroblasts

Answer

Macrophages

Question 4

Which of the following is most characteristic of a granuloma?

Accepted Answer

Epithelioid cells

Answer

Giant cells

Answer

Fibroblasts

Answer

Endothelial cells

Question 5

Which of the following diseases is caused by an inflammatory reaction involving neutrophils?

Accepted Answer

Acute respiratory distress syndrome

Answer

Septic shock

Answer

Asthma

Answer

Arthritis

Question 6

Which of the following statements is true about wound healing?

Accepted Answer

Deep dermal wounds heal by scar formation.

Answer

Infected wounds heal by primary intention.

Answer

Wound contraction is found in healing by secondary intention.

Answer

Primary intention healing involves a more intense inflammatory response.

Question 7

Which of the following is a known effect of bradykinin?

Accepted Answer

Pain at the site of inflammation

Answer

Vasoconstriction

Answer

Bronchodilatation

Answer

Decreased vascular permeability

Question 8

What is a characteristic of exudative fluid?

Accepted Answer

Cellular debris

Answer

Low protein content

Answer

Specific gravity < 1.012

Answer

Normal vascular permeability

Question 9

Trapping of parasites by Neutrophil Extracellular Traps (NETs) is assisted by which of the following cell types?

Accepted Answer

Neutrophils and Eosinophils

Answer

Neutrophils and Monocytes

Answer

Eosinophils and Monocytes

Answer

NK cells

Question 10

Which of the following statements about fibroblasts is not true?

Accepted Answer

Derived from blood precursor cells

Answer

Secrete and synthesize collagen

Answer

Migrate to wound along fibers used as a scaffold

Answer

A large fibrin clot acts as a barrier to fibroblast penetration

Inflammation and Repair — MCQs

Inflammation and Repair — MCQs

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