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Sixteen questions that test your understanding of inflammatory processes, the associated histological changes and some classic clinical examples.

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Introduction to Inflammation MCQ

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Question 1
There are two types of immune response: acute and chronic.  Using your knowledge of "inflammation" generally speaking, and which type of immune response it comes under, which cell is involved in inflammation acutely?
A
Neutrophil
B
T lymphocyte
C
Memory cell
D
Plasma cell
Question 2
Which of the following is not a function of inflammation?
A
Delivery of leucocytes
B
Concentration of toxins
C
Initiate repair processes
D
Vasodilation
Question 2 Explanation: 
Rather than concentrate toxins, the increased interstitial permeability leads to their relative dilution.
Question 3
What typifies chronic inflammation?
A
immediate defensive reaction
B
vascular and exudative processes predominate
C
transient inflammation
D
scar tissue formation
Question 4
Which of the following are not classic signs of acute inflammation
A
rubor
B
dolor
C
collagen deposition
D
loss of function
Question 4 Explanation: 
rubor, dolor, calor, tumour and loss of function are all the classic hallmarks of inflammation (that is redness, pain, heat, swelling in the latin forms respectively)
Question 5
If you were to look at an acute inflammation episode with a light microscope, what would you find?
A
keloid formation
B
satellite cells
C
collagen deposition
D
leucocyte infiltration diffusely
Question 5 Explanation: 
vascular and granulation tissue (leucocytes termed neutrophils, eosinophils and basophils) typify the acute inflammatory response.
Question 6
Which of the following is a low-risk for chronic inflammation?
A
AIDS
B
bed sores for the bed-bound
C
suture material left in situ
D
first-degree burn
Question 7
A patient with history of unstable angina presents with STEMI. They are given ASA, oxygen, morphine and transferred to a cardiac catheterisation laboratory where blood flow is restored for their blocked PIVA.  In the aftermath, chronic inflammation has damaged the heart about the ischaemic foci. Were a sample to be taken of the infarct region, which process would be observable that has resulted in reduced cardiac functionality?
A
Loss of troponin enzymes
B
Neovascularisation
C
Fibrosis
D
Coagulative necrosis
Question 8
Cytotoxic T lymphocyte infiltrate of tissue is a sign of?
A
acute inflammation
B
chronic inflammation
C
ischaemic foci
D
caseous necrosis
Question 9
Which of the following is a classical pattern of inflammation?
A
Keloid
B
Caseous
C
Serous
D
Monopathic
Question 9 Explanation: 
GUS is the mnemonic to remember common patterns of inflammation: granuloma, ulcer, suppuration, serous and fibrinous.
Question 10
A patient with insidious fever, haemoptysis and recurrent URTI has a lung parenchyma granuloma pathologically assessed. What will the outer ring of the granuloma show?
A
Eosinophil
B
Lymphocytes
C
Necrosis
D
Basophils
Question 10 Explanation: 
Specifically, the outer ring will consist of T cells.
Question 11
A granuloma has formed on the skin surface post laceration.  What is the inner collar about the necrotic tissue?
A
T cell
B
B cell
C
NK cell
D
Macrophage
Question 12
An aphthous break in the mucosal epithelium is otherwise known as what?
A
An ulcer
B
A granuloma
C
A serous inflammatory event
D
A suppuration
Question 12 Explanation: 
An epithelial break is an ulcer by definition.
Question 13
A patient with 12 month history of diffuse epigastric pain presents. The history is worse with lying down, shortly after eating and with hot drinks. Given the most likely diagnosis, which of the options below would you not expect to find in the chronic lesion within the submucosa of the duodenal bulb?
A
Fibrous scar
B
Acute Inflammatory exudate
C
Vascular granulation tissue
D
Fibrovascular granulation tissue
Question 13 Explanation: 
The clinical vignette describes a duodenal ulcer. Ulcers consist of several layers and the question specifically asks what layer you would NOT expect to find in the submucosal layer. The submucosal consists of the acute inflammatory exudate and vascular and fibrovascular granulation tissue. The fibrous scar forms in the muscular (muscularis propria) layer and is therefore the right answer.
Question 14
Given the patient described in the above question, what kind of fluid accumulation has occurred?
A
Gangrenous
B
Caseous
C
Serous
D
Fibrinous
Question 14 Explanation: 
We have ascertained this is a chronic ulcer. Thus the vocabulary for a chronic accumulation of fluid is a fibrinous type.
Question 15
A patient with alternating diarrhoea and constipation, with occasional blood in their stool and unexplained weight loss has a colonoscopy. Localised inflammation is seen. A sample is taken. The results include: granulomatous lesions with transmural inflammation. Which is the most appropriate diagnosis?
A
Biliary cancer
B
IBS
C
Crohn's disease
D
Ulcerative colitis
Question 16
A similar patient presentation has a sample taken with the following pathologist report:
'lesions were isolated to the sigmoid colon with readily bleeding inflamed regions.  Ulceration was noted to be confined to the mucosal layer only'.
What is the most appropriate diagnosis?
A
Crohn's disease
B
Ulcerative colitis
C
Bowel cancer
D
IBS
Question 16 Explanation: 
UC travels proximally from the rectum, which is always involved. Only the mucosal layer is affected.
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