Inflammation Practice Questions

Q: A 39-year-old male presents to your office with nodular skin lesions that progress from his right hand to right shoulder. The patient reports that the initial lesion, currently necrotic and ulcerative, developed from an injury he received while weeding his shrubs a couple weeks earlier. The patient denies symptoms of respiratory or meningeal disease. Which of the following most likely characterizes the pattern of this patient’s skin lesions:

Ascending lymphangitis. ***Ascending lymphangitis*** - The patient's presentation of a primary lesion on the hand that progresses to nodular lesions along the right arm to the shoulder, following an injury sustained while gardening, is characteristic of **sporotrichosis**. - **Sporotrichosis** causes **lymphocutaneous spread** via the lymphatic system, manifesting as a chain of nodules along lymphatic channels, which is consistent with ascending lymphangitis. *Contact dermatitis* - This condition involves an **inflammatory reaction** of the skin to an irritant or allergen, typically presenting as an itchy rash, redness, and sometimes blisters, - It does not usually result in distinct nodular lesions that specifically track along lymphatic pathways in an ascending pattern. *Dermatophyte colonization* - This refers to a superficial fungal infection affecting the skin, hair, or nails, causing conditions like **tinea corporis** or **tinea pedis**. - Dermatophyte infections typically present as **ring-shaped lesions** with central clearing or scaling and do not cause ascending nodular lesions along lymphatic routes. *Hematogenous dissemination* - This route involves the spread of pathogens through the **bloodstream**, leading to systemic infection or multiple lesions in various, often distant, organs or skin sites. - While it can manifest with skin lesions, the specific pattern of **localized trauma followed by ascending nodules** along a limb is more indicative of lymphatic spread rather than systemic hematogenous dissemination. *Arthropod bite* - An arthropod bite typically results in a **localized reaction** at the site of the bite, such as a wheal, papule, or erythema, often accompanied by itching or pain. - While an arthropod bite could be an initial injury, it would not directly explain the subsequent development of multiple, progressively ascending nodular lesions characteristic of lymphatic spread.

Question 1

A 39-year-old male presents to your office with nodular skin lesions that progress from his right hand to right shoulder. The patient reports that the initial lesion, currently necrotic and ulcerative, developed from an injury he received while weeding his shrubs a couple weeks earlier. The patient denies symptoms of respiratory or meningeal disease. Which of the following most likely characterizes the pattern of this patient’s skin lesions:

Accepted Answer

Ascending lymphangitis

Answer

Contact dermatitis

Answer

Dermatophyte colonization

Answer

Hematogenous dissemination

Answer

Arthropod bite

Question 2

A 36-year-old man is admitted to the hospital because of a 1-day history of epigastric pain and vomiting. He has had similar episodes of epigastric pain in the past. He drinks 8 oz of vodka daily. Five days after admission, the patient develops aspiration pneumonia and sepsis. Despite appropriate therapy, the patient dies. At autopsy, the pancreas appears gray, enlarged, and nodular. Microscopic examination of the pancreas shows localized deposits of calcium. This finding is most similar to an adaptive change that can occur in which of the following conditions?

Accepted Answer

Chronic kidney disease

Answer

Primary hyperparathyroidism

Answer

Sarcoidosis

Answer

Multiple myeloma

Answer

Congenital CMV infection

Inflammation — MCQs

Inflammation — MCQs

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