MLT GlobeBasic Pathology: Inflammation
134 Basic Pathology MCQs on Inflammation with answers and explanations.
In the first hours of acute bacterial inflammation, which cell dominates the tissue infiltrate?
Neutrophils are the first responders, arriving within hours. Macrophages, lymphocytes and plasma cells predominate later and in chronic inflammation.
A raised serum C-reactive protein most directly indicates:
CRP is an acute-phase protein made by the liver in response to IL-6 during infection or inflammation. It is non-specific.
Which cell type is the hallmark of acute inflammation in a tissue section?
Neutrophils dominate the first 6–24 hours of acute inflammation. Plasma cells and macrophages characterize chronic inflammation.
A lung biopsy shows granulomas with cheesy central necrosis. This pattern is most characteristic of:
Caseous necrosis is typical of tuberculous granulomas. Infarction causes coagulative necrosis and pancreatitis causes fat necrosis.
In granulomas, activated macrophages with abundant pink cytoplasm that resemble epithelial cells are called:
Epithelioid cells are activated macrophages; they may fuse to form Langhans giant cells. Foam cells are lipid-laden macrophages.
A lung biopsy shows compact nodules of epithelioid cells, some multinucleated giant cells and a rim of lymphocytes. Which cell type is the defining component of such a lesion?
A granuloma is defined by aggregates of activated macrophages transformed into epithelioid cells. Lymphocytes and central (caseous) necrosis are often present but are not required, so they are not the defining feature.
In most chronic inflammatory lesions, which cell is the central player, secreting cytokines and growth factors, killing invaders and activating T cells?
Macrophages dominate chronic inflammation: they phagocytose, secrete cytokines and growth factors, and present antigen to T cells. Neutrophils characterise acute inflammation.
Which finding would argue AGAINST a diagnosis of chronic inflammation in a tissue section?
Chronic inflammation shows mononuclear infiltrates, tissue destruction and attempted repair (angiogenesis, fibrosis). Edema with neutrophil predominance marks acute inflammation.
When a splinter enters the skin, what must happen first before an inflammatory response can begin?
Inflammation starts with recognition of microbes or damaged cells by receptors on sentinel cells, followed by recruitment of leukocytes and plasma proteins, removal of the agent, and repair.
Whatever kills cells — ischemia, trauma or toxins — inflammation follows. Which trigger explains this?
Necrotic cells release DAMPs that stimulate inflammation regardless of the original cause of death.
Which mediator is chiefly responsible for the immediate arteriolar dilation at the start of acute inflammation?
Histamine from mast cells produces early arteriolar dilation and venular leakage. Thromboxane A2 is a vasoconstrictor, and C3b is an opsonin.
Severe, progressive tissue destruction and fibrosis are most typical of which inflammatory pattern?
Chronic inflammation involves ongoing tissue injury alongside attempts at repair, leading to progressive destruction and scarring.
A biopsy taken about 12 hours after onset of an acute bacterial skin infection would show predominantly which cell?
Neutrophils dominate during the first 6-24 hours of acute inflammation and are replaced by macrophages over 24-48 hours.
A tissue sample shows edema with plasma protein leakage and many emigrating polymorphonuclear leukocytes. This pattern indicates:
Exudation of fluid and proteins plus neutrophil emigration are the main features of acute inflammation.
Antigen-antibody complexes deposited in tissue activate complement through which route?
Binding of C1q to IgG or IgM in immune complexes activates the classical pathway. The lectin pathway uses mannose-binding lectin; the alternative pathway needs no antibody.
In acute inflammation, which tissue cell is the richest source of preformed histamine that increases vascular permeability?
Mast cells in connective tissue store histamine in granules and release it immediately on activation. Basophils and platelets are other sources.
A rapid host response that begins within minutes to hours and lasts only a short time is termed:
Acute inflammation is the early, short-lived response to infection or injury, dominated by fluid exudation and neutrophils.
A second-degree burn produces a skin blister filled with clear, cell-poor fluid. This is an example of:
Serous inflammation is exudation of cell-poor fluid into spaces created by injury, such as a burn blister.
Complement proteins, kinins and clotting factors circulate as inactive precursors needing proteolytic activation. They are grouped as:
Plasma-derived mediators are made mainly in the liver and circulate inactive until cleaved. Cell-derived mediators such as histamine are stored or synthesized in cells.
Which pair of mediators is chiefly responsible for pain in inflammation?
Bradykinin stimulates pain fibres and prostaglandins (e.g., PGE2) sensitize them (hyperalgesia).