Inflammation Practice Questions

Question 1

A 56-year-old postmenopausal woman comes to the physician because of a 6-month history of worsening pain and swelling in her left knee. She has a history of peptic ulcer disease for which she takes cimetidine. Examination shows palpable crepitus and limited range of motion of the left knee. Which of the following is the most appropriate pharmacotherapy for this patient’s symptoms?

Accepted Answer

Celecoxib

Answer

Acetylsalicylic acid

Answer

Diclofenac

Answer

Meloxicam

Answer

Ketorolac

Question 2

A 31-year-old female receives a kidney transplant for autosomal dominant polycystic kidney disease (ADPKD). Three weeks later, the patient experiences acute, T-cell mediated rejection of the allograft and is given sirolimus. Which of the following are side effects of this medication?

Accepted Answer

Hyperlipidemia, thrombocytopenia

Answer

Nephrotoxicity, hypertension

Answer

Nephrotoxicity, gingival hyperplasia

Answer

Pancreatitis

Answer

Cytokine release syndrome, hypersensitivity reaction

Question 3

An 18-year-old woman presents to the emergency department with a complaint of severe abdominal pain for the past 6 hours. She is anorexic and nauseous and has vomited twice since last night. She also states that her pain initially began in the epigastric region, then migrated to the right iliac fossa. Her vital signs include a respiratory rate of 14/min, blood pressure of 130/90 mm Hg, pulse of 110/min, and temperature of 38.5°C (101.3°F). On abdominal examination, there is superficial tenderness in her right iliac fossa, rebound tenderness, rigidity, and abdominal guarding. A complete blood count shows neutrophilic leukocytosis and a shift to the left. Laparoscopic surgery is performed and the inflamed appendix, which is partly covered by a yellow exudate, is excised. Microscopic examination of the appendix demonstrates a neutrophil infiltrate of the mucosal and muscular layers with extension into the lumen. Which of the following chemical mediators is responsible for pain in this patient?

Accepted Answer

Bradykinin and prostaglandin

Answer

IgG and complement C3b

Answer

5- hydroperoxyeicosatetraenoic acid (5-HPETE) and leukotriene A4

Answer

Serotonin and histamine

Answer

Tumor necrosis factor and interleukin-1

Question 4

A 55-year-old woman with diabetes presents to the emergency department due to swelling of her left leg, fever, and chills for the past 2 days. The woman’s maximum recorded temperature at home was 38.3°C (101.0°F). Her left leg is red and swollen from her ankle to the calf, with an ill-defined edge. Her vital signs include: blood pressure 120/78 mm Hg, pulse rate 94/min, temperature 38.3°C (101.0°F), and respiratory rate 16/min. On physical examination, her left leg shows marked tenderness and warmth compared with her right leg. The left inguinal lymph node is enlarged to 3 x 3 cm. Which of the following chemical mediators is the most likely cause of the woman’s fever?

Accepted Answer

PGE2

Answer

Bradykinin

Answer

Histamine

Answer

Arachidonic acid

Answer

LTB4

Question 5

Which of the following patient presentations would be expected in an infant with defective LFA-1 integrin (CD18) protein on phagocytes, in addition to recurrent bacterial infections?

Accepted Answer

Skin infections with absent pus formation, delayed umbilicus separation

Answer

Cardiac defects, hypoparathyroidism, palatal defects, and learning disabilities

Answer

Chronic diarrhea, oral candidiasis, severe infections since birth, absent thymic shadow

Answer

Progressive neurological impairment and cutaneous telangiectasia

Answer

Eczema and thrombocytopenia

Question 6

During a clinical study evaluating the effects of exercise on muscle perfusion, 15 healthy individuals perform a 20-minute treadmill run at submaximal effort. Before and after the treadmill session, perfusion of the quadriceps muscle is evaluated with contrast-enhanced magnetic resonance imaging. The study shows a significant increase in muscle blood flow per unit of tissue mass. Which of the following local changes is most likely involved in the observed change in perfusion?

Accepted Answer

Increase in adenosine

Answer

Decrease in potassium

Answer

Increase in thromboxane A2

Answer

Increase in endothelin

Answer

Decrease in prostacyclin

Question 7

A 31-year-old woman scrapes her finger on an exposed nail and sustains a minor laceration. Five minutes later, her finger is red, swollen, and painful. She has no past medical history and does not take any medications. She drinks socially with her friends and does not smoke. The inflammatory cell type most likely to be prominent in this patient's finger has which of the following characteristics?

Accepted Answer

Segmented nuclei

Answer

Dramatically expanded endoplasmic reticulum

Answer

Large cell with amoeboid movement

Answer

Multiple peripheral processes

Answer

Dark histamine containing granules

Question 8

A 59-year-old male with a 1-year history of bilateral knee arthritis presents with epigastric pain that intensifies with meals. He has been self-medicating with aspirin, taking up to 2,000 mg per day for the past six months. Which of the following medications, if taken instead of aspirin, could have minimized his risk of experiencing this epigastric pain?

Accepted Answer

Celecoxib

Answer

Naproxen

Answer

Indomethacin

Answer

Ibuprofen

Answer

Ketorolac

Question 9

You are seeing a 4-year-old boy in clinic who is presenting with concern for a primary immune deficiency. He has an unremarkable birth history, but since the age of 6 months he has had recurrent otitis media, bacterial pneumonia, as well as two episodes of sinusitis, and four episodes of conjunctivitis. He has a maternal uncle who died from sepsis secondary to H. influenza pneumonia. If you drew blood work for diagnostic testing, which of the following would you expect to find?

Accepted Answer

Abnormally low number of B cells

Answer

Abnormally low number of T cells

Answer

Abnormally high number of B cells

Answer

Elevated immunoglobulin levels

Answer

Abnormally high number of T cells

Question 10

A 24-year-old man is brought to the emergency department after he is found sluggish, drowsy, feverish, and complaining about a headache. His past medical history is unremarkable. His vital signs include: blood pressure 120/60 mm Hg, heart rate 70/min, respiratory rate 17/min, and body temperature 39.0°C (102.2°F). On physical examination, the patient is dysphasic and incapable of following commands. Gait ataxia is present. No meningeal signs or photophobia are present. A noncontrast CT of the head is unremarkable. A T2 MRI is performed and is shown in the image. A lumbar puncture (LP) is subsequently performed. Which of the following CSF findings would you most likely expect to find in this patient?

Accepted Answer

Opening pressure: 15 cm H2O, color: clear, protein: 50 mg/dL, cell count: 40 cells/µL, mostly lymphocytes, ratio CSF:blood glucose: 0.65

Answer

Opening pressure: 28 cm H2O, color: cloudy, protein: 68 mg/dL, cell count: 150 cells/µL, mostly PMNs, ratio CSF:blood glucose: 0.3

Answer

Opening pressure: 38 cm H2O, color: cloudy, protein: 75 mg/dL, cell count: 80 cells/µL, mostly lymphocytes, ratio CSF:blood glucose: 0.25

Answer

Opening pressure: 18 cm H2O, color: clear, protein: 40 mg/dL, cell count: 2 cells/µL, mostly polymorphonuclear (PMNs), ratio CSF:blood glucose: 0.7

Answer

Opening pressure: 40 cm H2O, color: cloudy, protein: 80 mg/dL, cell count: 135 cells/µL, mostly lymphocytes with some PMNs, ratio CSF:blood glucose: 0.2

Inflammation

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Acute inflammation mechanisms

Vascular changes in inflammation

Chemical mediators of inflammation

Cellular components of inflammation

Resolution of acute inflammation

Chronic inflammation

Granulomatous inflammation

Systemic effects of inflammation

Patterns of inflammatory response

Inflammatory markers in laboratory testing

Anti-inflammatory therapies

Wound healing and repair

Abnormalities in wound healing

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About Inflammation for USMLE

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