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Inflammation > Robbins & Cottran Ch. 3 > Flashcards

Robbins & Cottran Ch. 3 Flashcards

1
Q

What is the correct sequence of vascular changes in acute inflammation?

  1. leukocytic margination
  2. slowing of circulation
  3. vasodilation
  4. increased blood flow
  5. increased permeability
        A.  3,4,5,2,1
	B.  1,3,2,4,5
	C.  3,2,5,4,1
	D.  4,3,5,2,1
	E.  2,3,4,5,1
A

A

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2
Q

Which of the following are characteristic of endothelial contraction during acute inflammation?

  1. affects only venules
  2. the response is long-lived (24 hours or more)
  3. mediated by histamine
  4. is the most common mechanism of vascular leakage
  5. involves tumor necrosis factor
A.  1,2,4
B.  2,4,5
C.  1,3,4
D.  2,3
E.  1,3,4,5
A

C

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3
Q

All the following endothelial cell-mediated events contribute to acute inflammation EXCEPT:
A. Release of P-selectin from Weibel-Palade bodies
B. Binding of P-selectin to leukocyte VLA-4
C. Binding of ICAM-1 to leukocyte CD11/CD18
D. Secretion of plasminogen-activator inhibitor
E. Secretion of IL-1

A

B

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4
Q 
Which of the following molecules plays an essential role in leukocyte diapedesis?
A.  L-selectin
B.  LFA-1
C.  P-selectin
D.  PSGL-1
E.  PECAM-1
A

E

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5
Q 
Which of the following endothelial molecule is incorrectly paired with its leukocyte receptor?
A.  VCAM-1, alpha4 Beta1
B.  P-selectin, sialyl Lewis X  PSGL-1
C.  ICAM-1, LFA-1
D.  L-selectin, GlyCam-1
E.  E-selectin, VLA-4
A

E

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6
Q 
6.  Which of the following is not a component of basement membranes?
A.  collagen type IV
B.  laminin
C.  fibronectin
D.  proteoglycans
E.  reticulin
A

E

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7
Q 
Which of the following can result in increased permeability of arterioles?
A.  direct toxic injury
B.  endothelial contraction
C.  increased transcytosis
D.  cytoskeletal reorganization
E.  leukocyte-dependent injury
A

A

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8
Q

Which of the following is an important step in chemotaxis?
A. phospholipase C-mediated hydrolysis of PIP2
B. conversion of 5-HPETE to lipoxin B4
C. the production of arachidonic acid metabolites
D. activation of phospholipase D
E. conversion of H2O2 to HOCl by myeloperoxidase

A

A

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9
Q 
All of the following substances are involved in oxygen-independent mechanisms of bacterial killing EXCEPT:
	A.  lactoferrin
	B.  major basic protein
	C.  BPI
	D.  MPO  
	E.  lysozyme
A

D

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10
Q 
Which of the following is the substance secreted by eosinophils which is cytotoxic to parasites?
	A.  lysozyme
	B.  major basic protein
	C.  BPI
	D.  defensin 
	E.  lactoferrin
A

B

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11
Q

Chediak-Higashi syndrome is associated with which of the following?
A. a deficiency of 2 integrins
B. an absence of sialyl-Lewis X
C. reduced formation of NADPH oxidase
D. a deficiency of myeloperoxidase
E. a reduced ability to form phagolysosomes

A

E

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12
Q

Identify the correct sequence of events in antigen-antibody induced neutrophil activation:

  1. Release of inositol triphosphate and diacylglycerol
  2. Activation of phospholipase A and protein kinase C
  3. Release of calcium from the endoplasmic reticulum
  4. G-protein mediated activation of phospholipase C
  5. Synthesis of prostaglandins and leukotrienes
A. 2,1,3,4,5
B. 2,5,3,4,1
C. 4,1,3,2,5
D. 4,3,1,2,5
E. 4,5,3,2,1
A

C

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13
Q

All of the following are true of the complement system EXCEPT:
A. the alternative pathway is dependent on the properidin system
B. C3a causes release of histamine by mast cells
C. the classic pathway is triggered by microbial surfaces
D. the membrane attack complex is composed of complement components C5-C9
E. C3 can be activated by plasmin

A

C

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14
Q 
Which of the following is a major opsonin?
	A.  C3
	B.  C5
	C.  C3a
	D.  C5b
   	E.  C3b
A

E

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15
Q

All of the following are functions of C5a EXCEPT:
A. stimulates release of histamine from mast cells
B. is a powerful chemotactic agent
C. initiates assembly of the MAC
D. increases adhesion of leukocytes to endothelium
E. activates the lipoxygenase pathway

A

C

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16
Q

Complement components which stimulate the release of histamine include which of the following?

	1. C3a
	2. C2
	3. C5b
	4. C3b
	5. C5a
	A.  3,4
	B.  2,5
	C.  1,5
	D.  1,3
	E.  3,5
A

C

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17
Q

All of the following are characteristic of the complement system EXCEPT:
A. the alternative pathway involves the properidin system
B. central to both pathways is the activation of C1
C. a critical component of C5 convertase is C3b
D. the lectin pathway results in the production of C4b2a
E. C1 inhibitor blocks the classic pathway

A

B

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18
Q

Which of the following components of the clotting system are inflammatory mediators?

	1. thrombin
	2. factor Xa
	3. factor IX
	4. factor XIa
	5. factor XIIa
	A.  2,4,5
	B.  1,2
	C.  3,5
	D.  1,2,5
	E.  1,4,5
A

B

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19
Q 
All of the following arachidonic acid metabolites (eicosanoids) cause vasodilation  
       EXCEPT:
 	A.  TXA2
	B.  PGE2
	C.  LXA4
	D.  PGF2
	E.  PGD2
A

A

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20
Q 
NSAIDs derive their anti-inflammatory activity by blocking which of the following?
	A.  5-lipoxygenase
	B.  prostacyclin synthetase
	C.  LTC4 synthase
       	D.  cyclooxygenase
	E.  phospholipase A
A

D

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21
Q 
The production of pain and fever during inflammation involves which of the  
       following?
	A.  TxA2
	B.  PGE2
	C.  histamine
	D.  C3b
	E.  LTC4
A

B

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22
Q

Which of the following eicosanoids mediate chemotaxis?

	1. LTB4
	2. TxA2
	3. PGE2
	4. LTE4
	5. 5-HETE	
	A.  2,3
	B.  1,4
	C.  1,5
	D.  2,3,4
	E.  1,4,5
A

C

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23
Q

The anti-inflammatory effects of dietary fish oil are the result of
A. the inhibition of cyclooxygenase
B. the down-regulation of genes that encode pro-inflammatory cytokines
C. the production of less potent leukotrienes
D. increased production of lipocortin 1
E. decreased formation of lipid bodies

A

C

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24
Q 
Which of the following cytokines is incorrectly matched with one of its major functions?
A.  IL-8   neutrophil chemotaxis
B.  IL-1   proinflammatory mediator
C.  TGF-β   inhibits lymphocyte growth
D.  IFN-γ   activates macrophages
E.  IL-2   stimulates hematopoiesis
A

E

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25
Q 
Which of the following is a negative regulator of immune responses?
	A.  IL-2
	B.  IL-3
	C.  TNF-
	D.  IL-10
	E.  IFN-
A

D

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26
Q

Cytokines which stimulate hematopoiesis include:

	1. TNF-
	2. IL-10
	3. IL-3
	4. c-kit ligand
	5. IL-12
	A.  1,3
	B.  2,3,4
	C.  3,4
	D.  2,3,5
	E.  1,5
A

C

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27
Q 
The major cytokines which mediate inflammation are
	A.  IL-1, TNF-alpha, and TNF-beta
	B.  IL-2 and IL-4
	C.  IL-1, IL-3, and IL-6
	D.  IL-5 and IFN-
	E.  TNF-, IL-3, and IL-7
A

A

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28
Q 
All of the following are effects of IL-1 and TNF in inflammation EXCEPT:
	A.  cause fever
	B.  increase leukocyte adherence
	C.  are chemotactic for leukocytes
	D.  cause priming of neutrophils
	E.  are anticoagulant
A

E

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29
Q 
Cancer cachexia is mediated by which of the following?
	A.  IL-1
	B.  TNF-alpha
	C.  IL-3
	D.  IFN-gamma
	E.  TNF-beta
A

B

30
Q 
Which chemokine which causes activation and chemotaxis of neutrophils?
	A.  MIP-1alpha
	B.  eotaxin
	C.  IL-4
	D.  RANTES
	E.  IL-8
A

E

31
Q

Nitric oxide does all of the following EXCEPT:
A. causes vascular smooth muscle relaxation and vasodilation
B. reduces platelet aggregation and adhesion
C. inhibits mast cell-induced inflammation
D. increases leukocyte recruitment
E. has antimicrobial activity

A

D

32
Q 
All of the following cause increased vascular permeability during inflammation EXCEPT:
	A.  thromboxane
	B.  histamine
	C.  C5a
	D.  bradykinin
	E.  substance P
A

A

33
Q

Prostaglandins are involved with which of the following during inflammation?

	1. vasodilation
	2. pain
	3. fever
	4. chemotaxis
	5. tissue damage
	A.  1,5
	B.  2,3,4
	C.  1,2,3
	D.  2,4,5
	E.  1,2,3,4
A

C

34
Q

Which of the following substances contribute to chemotaxis during inflammation?

	1. C5a
	2. fractalkine
	3. leukotriene C4
	4. histamine
	5. bradykinin
	A.  1,2
	B.  2,4,5
	C.  3,5
	D.  1,2,3
	E.  3,4,5
A

A

35
Q 
The cytokine secreted by T cells which activates macrophages is
	A.  TGF-beta
	B.  IFN--gamma
	C.  IL-1
	D.  TNF-alpha
	E.  PDGF
A

B

36
Q

Which of the following are secreted by activated macrophages?

	1. nitric oxide
	2. acid hydrolases
	3. TNF-
	4. EGF
	5. reactive oxygen species
	A.  2,3
	B.  1,3,5
	C.  2,4,5
	D.  1,2,3,4,5
	E.  2,3,4,5
A

D

37
Q 
Eosinophils are directed to sites of inflammation by which of the following?
	A.  major basic protein
	B.  MIP-1alpha
	C.  eotaxin
	D.  IL-8
	E.  fractalkine
A

C

38
Q

Which of the following are involved in fever?

	1. IL-4
	2. TNF-alpha
	3. IL-1
	4. IL-6
	5. nitrous oxide
	A.  1,3
	B.  2,3,4
	C.  1,3,4
	D.  2,4,5
	E.  2,3,4,5
A

B

39
Q 
All of the following are characteristic of chronic inflammation EXCEPT:
	A.  tissue destruction
	B.  granuloma formation
	C.  fibrosis
	D.  neutrophil accumulation
	E.  angiogenesis
A

D

40
Q

Increased vascular permeability is the hallmark of acute inflammation. Which of the following is NOT a mechanism of increased permeability in acute inflammation?
A. contraction of endothelial cells in venules in response to histamine and leukotrienes.
B. reorganization of endothelial cell cytoskeleton in venules in response to IL-1 or TNF.
C. direct injury to endothelial cells in arterioles capillaries and venules in response to thermal injury.
D. leukocyte mediated injury of endothelial cells in pulmonary and glomerular capillaries.
E. endothelial cell transcytosis secondary to increased capillary hydrostatic pressure in response to systemic release of IL-1, TNF, and IL-6.

A

E

41
Q

Leukocyte extravasation occurs in a series of inter-related steps. Chose an answer that places the steps the following list in the correct order:

  1. leukocyte activation
  2. transmigration
  3. rolling
  4. chemotaxis
  5. adhesion
A.	1, 3, 5, 4, 2
B.	1, 3, 5, 2, 4
C.	3, 5, 1, 2, 4
D.	3, 1, 5, 2, 4
E.	1, 3, 5, 4, 2
A

D

42
Q 
Adhesion, rolling, and transmigration during leukocyte extravasation involves the interaction of numerous cell surface molecules on leukocyte and endothelial cells. Which of the following molecular interactions causes firm leukocyte adhesion?
A.  L-selectin to GlyCam-1 (CD34)
B.  E selectin to Sialyl-Lewis X
C.  Integrin (LFA-1 or Mac-1) to ICAM-1
D.  P selectin to PSGL-1
E.  PECAM-1 to CD31
A

C

43
Q

Many small molecules affect venules to produce vascular leakage and edema, and this process is in some ways the key to acute inflammation. To an extent, the elaboration of these molecules is regulated by their cell type restriction, which is in turn regulated by the cell type restriction of the enzymes that produce the molecules.

Match the following enzymes to the cell in which they are restricted:

  1. prostacyclin synthetase a. macrophage
  2. thromboxane synthetase b. neutrophil
  3. 5-lipoxygenase c. platelet
  4. inducible nitric oxide synthetase d. endothelial cell
A.  1a, 2c, 3b, and 4d
B.  1d, 2b, 3c, and 4a
C.  1c, 2a, 3b, and 4d
D.  1d, 2c, 3b, and 4a
E.  1a, 2d, 3c, and 4b
A

D

44
Q

Several genetic diseases that manifest as immunodeficiency are linked to specific defects in lymphocyte function. Absence of which of the following molecules would render neutrophils incapable of producing HOCl?
A. myeloperoxidase (MPO)
B. lysozyme
C. Mac-1 (CD11b, CR3)
D. bacteria permeability increasing protein (BPI)
E. major basic protein

A

A

45
Q

Arachidonic acid metabolites are key inflammatory mediators, and inhibitors of this pathway are commonly used clinically. Inhibitors of which of the following enzymes would inhibit fever?

  1. phospholipase A2
  2. 5-lipoxygenase
  3. cyclooxygenase
A.  1, 2 and 3
B.  1 and 2
C.  1 and 3
D.  2 and 3
E.  3 only
A

C

46
Q

Chemokines act primarily as activators and chemoattractants for specific types of leukocytes. They are divided into four classes based on their conserved cysteine residues. Match the target leukocyte with its most important chemokine.

  1. eosinophils a. IL-8
  2. basophils b. MIP-1alpha, MCP-1
  3. neutropils c. eotaxin
  4. monocytes d. lymphotaxin
  5. lymphocytes e. RANTES
A.  3a, 4b, 1c, 5d, 2e
B.  3a, 2b, 1c, 5d, 4e
C.  4a, 3b, 1c, 5d, 2e
D.  4a, 3b, 5c, 1d, 2e
E.  3a, 2b, 5c, 1d, 4e
A

A

47
Q 
Which of the following is not found in the specific (secondary) granules of neutrophils?
A.  lactoferrin
B.  myeloperoxidase
C.  phospholipase A2
D.  collagenase
E.  lysozyme
A

B

48
Q 
Acute inflammation can have several possible outcomes (resolution, abscess formation, fibrosis, and progression to chronic inflammation). Which of the following types of leukocyte largely determines the outcome of acute inflammation?
A.  neutrophil
B.  eosinophil
C.  B cell
D.  T cell
E.  macrophage
A

E

49
Q 
While vasoactive amines, prostaglandins, leukotrienes, PAF, and nitric oxide are mediators of acute inflammation, when inflammation progresses, interleukins generally become more important regulators of outcome. However some interleukins play a key role in both acute illness and chronic processes. Which of the following interleukins is most important in establishing chronic processes with little  
        affect on acute inflammation?
A.  IL-1
B.  IL-6
C.  TNF
D.  IL-4
E.  IL-8
A

D

50
Q 
Which of the following chemokines can mediate both chemotaxis and adhesion of leukocytes?
	A.  IL-8
	B.  MIP-1alpha
	C.  fractalkine
	D.  eotaxin
	E.  RANTES
A

C

51
Q

Which of the following is the term for the movement and localization of leukocytes
to higher concentrations of bound chemokine?
A. chemotaxis
B. chemokinesis
C. haptotaxis
D. leukotaxis
E. chemoattraction

A

C

52
Q

All of the following statements about chemokines are true EXCEPT:
A. the division of chemokine subfamilies is based on the presence or absence of cysteine residues
B. CXC chemokines mediate angiogenesis
C. Th1 and Th2 T cells have different types of chemokine receptors
D. lymphocytes must undergo an additional activation step before the chemokine receptor becomes functional
E. each cell type has its own unique chemokine receptor

A

E

53
Q

Chemokines bind to which of the following?

	1. leukocytes
	2. endothelial cells
	3. neurons
	4. epithelial cells
	5. extracellular matrix glycoproteins
	A.  1,2
	B.  1,2,4
	C.  3,4,5
	D.  1,3,4,5
	E.  1,2,3,4,5
A

E

54
Q

Which of the following mechanisms involving chemokines is utilized by simian immunodeficiency virus?
A. secretion of proteins that bind and neutralize chemokines
B. use of chemokine receptors as coreceptors
C. lysis of chemokine producing cells
D. encoding of viral chemokine receptor homologs
E. causing mutations which result in the production of defective chemokines

A

B

55
Q

Which of the following are C3 convertases?

	1. C4b2a
	2. C3b2a
	3. C4bBb
	4. C4a2b
	5. C3bBb
	A.  1,2
	B.  2,3
	C.  1,4
	D.  3,5
	E.  1,5
A

E

56
Q 
Serotonin is produced by which of the following?
	A.  platelets
	B.  neutrophils
	C.  endothelial cells
	D.  macrophages
	E.  lymphocytes
A

A

57
Q

Kallikrein does which of the following?

  1. activates Hageman factor
  2. acts as a chemotactic agent
  3. converts high molecular weight kininogen into bradykinin
  4. converts C5 into C5a
  5. converts plasminogen into plasmin
	A.  1,3
	B.  2,3,5
	C.  1,2,3
	D.  2,3,4,5
	E.  1,2,3,4,5
A

E

58
Q

Which of the following mechanisms helps to explain the anti-inflammatory actions of glucocorticoids?
A. upregulation of COX2 genes
B. inhibition of 5-lipooxygenase
C. increased production of lipocortin 1
D. stabilization of arachidonic acid
E. inhibition of cyclooxygenase

A

C

59
Q 
RANTES attracts all of the following cell types EXCEPT:
	A.  neutrophils
	B.  basophils
	C.  monocytes
	D.  eosinophils
	E.  lymphocytes
A

A

60
Q

Addressins are cell adhesion molecules involved in movement of which of the following?
A. lymphocytes within lymph nodes
B. neutrophils within the gastrointestinal tract
C. eosinophils within the skin
D. lymphocytes within the brain
E. monocytes within the spleen

A

A

61
Q

Which of the following integrins is incorrectly matched with its major function?
A. α1β4 leukocyte-endothelial cell adhesion
B. αvβ3 angiogenesis
C. αIIbβ3 leukocyte-extracellular matrix interactions
D. αMβ2 leukocyte-endothelial cell adhesion
E. α6β4 plasma membrane-basement membrane adhesion

A

C

62
Q 
All of the following are opsonins EXCEPT:
	A.  N-formyl methionine
	B.  Fc portion of IgG
	C.  C3b
	D.  collectins
	E.  mannose-binding protein
A

E

63
Q 
All of the following cause fever EXCEPT:
	A.  IL-1
	B.  bradykinin
	C.  TNF-α
	D.  PGD2
	E.  IL-6
A

B

64
Q 
All of the following cause increased vascular permeability EXCEPT:
	A.  serotonin
	B.  LTC4
	C.  bradykinin
	D.  PGF2α
	E.  PAF
A

D

65
Q 
All of the following cause vasodilation EXCEPT:
	A.  LTE4
	B.  nitric oxide
	C.  PGD2
	D.  PGI2
	E.  LXA2
A

A

66
Q

Which of the following mechanisms is primarily responsible for the increased
permeability caused by vasoactive amines?
A. endothelial contraction
B. direct injury
C. increased transocytosis
D. cytoskeletal reorganization
E. basement membrane separation

A

A

67
Q 
Decay-accelerating factor (DAF) inhibits which of the following pathways?
	A.  lipooxygenase pathway
	B.  complement cascade
	C.  fibrinolytic system
	D.  kinin cascade
	E.  clotting cascade
A

B

68
Q 
Factor I cleaves which of the following complement components?
	A.  C5a
	B.  C1
	C.  C3b
	D.  C5b
	E.  C3a
A

C

69
Q

Functions of plasmin include all of the following EXCEPT:
A. breaks down fibrin into fibrin-split products
B. converts C3 to C3a
C. converts high molecular weight kininogen into bradykinin
D. activates Hageman factor

A

C

70
Q

Effects of lipoxins include which of the following?

	1. bronchospasm
	2. inhibition of neutrophil chemotaxis
	3. stimulation of monocyte adhesion
	4. vasodilation
	5. increase vascular permeability
	A.  2,3
	B.  1,4
	C.  1,2,4
	D.  2,3,4
	E.  1,3,4,5
A

D

Inflammation (4 decks)

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