9. Chronic Inflammation

Question 1

A 77 year old female presents to the clinic with a red, swollen right foot. The skin is warm to the touch. You take a tissue sample and find that she is undergoing chronic inflammation because you see a lot of what types of cells (choose as many answers as relevant) (MG)

A. Neutrophils
B. Lymphocytes
C. Macrophages
D. Plasma Cells

Answer 1

B. Lymphocytes
C. Macrophages
D. Plasma Cells

Also many see mast cells and eosinophils depending on the underlying cause

Question 2

A 45 year old male patient presents to the clinic with a cough and fever that have persisted for 2 weeks. You perform a PPD skin test which comes back positive for mycobacterium tuberculosis. A tissue sample of his skin would reveal Langhans giant cells characterized by what nuclei? (MG)

A. Randomly Arranged nuclei
B. Bilobar nuclei
C. Cuboid nuclei
D. U-shaped nuclei

Answer 2

D. U-shaped nuclei

Langhans giant cells are found in granulomatus conditions like tuberculosis

Question 3

A cell is being studied it is noticed that it produces IL13 when it is stimulated. What is a possible role of this cell?

A. Activate M1
B. Recruit Neutrophils 
C. Recruit Macrophages
D. Initiate Apoptosis  
E. Recruit Eosinophils 

RFA

Answer 3

Ans. E Recruit Eosinophils- This is a TH2 cells they produce IL-4, IL-5 and IL-13 which will recruit Eosinophils and activate M2

A. Activate M1- this is TH1 cells, they produce IFN-G

B. Recruit Neutrophils- this is done by TH17 cells that produce IL-17

C Recruit Macrophages- Macrophages are induced by IFN-g so this would be more an TH1 recaction

D. Initiate Apoptosis- done by CD8 cells or by self made signals like caspases or cytochrome c

Question 4

You are a doctor in Boulder Colorado and a patient a 38 year old female farmer comes into your clinic with complaints of : fever of 104 F, a rash of rose colored spots, abdominal pain, constipation and headaches. Her farm is very remote and gets she get her power from a generator and water from a well. You take some samples and the lab find that the patient has typhoid fever, which is caused by the bacterium Salmonella typhimurium (S. typhi). What complementary findings would you expect to find in this patient.

A.  Eosinophilia 
B. Polycythemia
C. Leukopenia
D. Lymphocytosis 
E. Neutrophilia 

RFA

Answer 4

Ans. C Leukopenia- so while many bacterial infections cause Neutrophilia it was specially noted in our notes that some infections eg. Typhoid fever cause Leukopenia- reduction of Leukocytes

A. Eosinophilia- would be seen in parasitic infection

B. Polycythemia- increased red blood cells, seen in chronic hypoxia

D. Lymphocytosis- seen in viral infection

E. Neutrophilia- seen in most bacterial infection.