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Kumar: Robbins and Cotran Pathologic Basis of Disease, 8th Edition
Chapter 02: Acute and Chronic Inflammation
Test Bank
MULTIPLE CHOICE
a. | selectins |
b. | integrins |
c. | immunoglobulins |
d. | lectins |
e. | growth factors |
ANS: C, Surface proteins expressed on activated leukocytes are integrins, and they bind to intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1), which belong to the immunoglobulin family of proteins.
a. | Thromboxane A2 |
b. | Prostaglandin E2 |
c. | Platelet-activating factor |
d. | Leukotriene B4 |
e. | Interleukin-1 |
ANS: D, Leukotriene B4 is chemotactic. It is increased in persons who take aspirin, because aspirin inhibits the cyclooxygenase pathway, thus shunting more arachidonic acid early derivatives into the lipoxygenase pathway. This promotes the synthesis of leukotrienes.
a. | selectins |
b. | integrins |
c. | lectin type of vascular adhesion molecules |
d. | aminotransferases |
e. | glycosidases |
ANS: B, LAD-1 is characterized by a deficiency of CD18, a cell surface molecule that is a 2 integrin. The infections occur because the defective leukocytes cannot adhere to endothelial cells, cannot spread and attach, and cannot phagocytose bacteria. PBD7 62
a. | coagulation factor X |
b. | kallikrein |
c. | Hageman factor |
d. | complement C3 |
e. | protein C |
ANS: B, Kallikrein promotes the formation of bradykinin from the high-molecular weight kininogen. PBD7 67
a. | Calcium |
b. | Sodium |
c. | Potassium |
d. | Oxygen |
e. | Nitrate |
ANS: A, Endothelial cell nitric oxide synthase is constitutively expressed at low levels, but it can be increased by a calmodulin-mediated influx of calcium into the endothelial cells. PBD7 72
a. | Nitric oxide |
b. | Complement C3a |
c. | Bradykinin |
d. | Leukotriene B4 |
e. | Interleukin-1 |
ANS: C, Bradykinin causes pain. Other pain-causing substances are substance P and prostaglandin E2. PBD7 65
a. | Leukotriene B4 |
b. | Lipoxin |
c. | Thromboxane A2 |
d. | Prostacyclin |
e. | Prostaglandin E2 |
ANS: E, Aspirin inhibits the action of cyclooxygenase, and thus inhibits the synthesis of thromboxane A2, prostacyclin, and prostaglandin E2. However, only prostaglandin E2 is involved in thermoregulation. The synthesis of lipoxin and leukotrienes is not inhibited by aspirin. PBD7 70
a. | caspase |
b. | peroxidase |
c. | opsonin |
d. | anaphylatoxin |
e. | membrane attack protein |
ANS: C, C-reactive protein, an acute phase protein produced by the liver in acute and chronic inflammation, binds to microbes acting as an opsonin. Opsonization of bacteria facilitates phagocytosis.
Kumar: Robbins and Cotran Pathologic Basis of Disease, 8th Edition
Chapter 04: Hemodynamic Disorders, Thromboembolic Disease, and Shock
Test Bank
MULTIPLE CHOICE
a. | albumin |
b. | globulin |
c. | aldosterone |
d. | troponin |
e. | plasminogen |
ANS: C, Renal hypoperfusion due to heart failure leads to secondary hyperaldosteronism and consequent retention of sodium and water.
a. | obstruction of the lymph flow |
b. | arterial thrombosis |
c. | venous thrombosis |
d. | spread of cancer into the soft tissue of the arm |
e. | hypoalbuminemia secondary to liver injury caused by hepatic metastases |
ANS: A, Arm edema following a mastectomy is a complication of breast cancer treatment caused by an obstruction of the lymphatics in the axilla. This obstruction of lymphatics is a consequence of radiation injury or scarring associated with surgery.
a. | Pulmonary embolism |
b. | Pulmonary infarction |
c. | Pulmonary edema |
d. | Atelectasis |
e. | Lobar pneumonia |
ANS: C, Lungs that are heavy and on cross section show oozing of frothy fluid are filled with edema fluid. In this case, edema developed due to left-sided heart failure.
a. | atrophy of bile ducts |
b. | dilatation of bile ducts |
c. | intralobular cholestasis |
d. | centrolobular necrosis and loss of hepatocytes |
e. | fibrosis of the Glisson capsule |
ANS: D, Chronic passive congestion of the liver caused by heart failure leads to accumulation of blood in the terminal hepatic venule and the centrolobular sinusoids. Aggravation of the heart failure expands the blood-containing spaces, causing centrolobular liver cell necrosis.
a. | Multiple petechiae |
b. | Multiple ecchymoses |
c. | Solitary ecchymoses |
d. | Hematoma |
e. | Hemarthrosis |
ANS: A, Defective platelet function in uremia is typically associated with multiple petechiae in the skin and on mucosal surfaces.
a. | Von Willebrand factor |
b. | Prothrombin |
c. | Inhibitor of plasminogen activator |
d. | Thrombomodulin |
e. | Tissue factor |
ANS: D, Thrombomodulin is an anticoagulant that acts by binding to thrombin and converting it from a procoagulant to an anticoagulant capable of activating protein C.
a. | Hageman factor (factor XII) |
b. | Von Willebrand factor |
c. | Fibrinogen |
d. | Factor VIII |
e. | Thrombin |
ANS: B, GpIb, a platelet cell membrane glycoprotein, is the receptor for the von Willebrand factor (vWF), which mediates the adhesion of platelets to the damaged vascular wall. Congenital deficiency of GpIb, as seen in Bernard-Soulier syndrome, is similar to the deficiency of vWF in von Willebrand disease and results in a bleeding disorder.
a. | Protein C |
b. | Protein S |
c. | Antithrombin III |
d. | Plasmin |
e. | Thrombin |
ANS: A, Leyden mutation of factor V makes this factor resistant to the action protein C. Under normal circumstances, protein C inactivates factor V, and the mutation eliminates this very important anticoagulant control mechanism. As a result of these changes, there is uncontrollable activation of factor V, which promotes thrombosis.
a. | brain |
b. | heart |
c. | kidneys |
d. | intestines |
e. | bronchi |
ANS: A, Antiphospholipid syndrome is characterized by widespread venous and arterial thrombi. Venous thrombi are found most often in the veins of the lower extremities, whereas the arterial thrombi are most often found in the cerebral arteries.
a. | Brain |
b. | Heart |
c. | Kidneys |
d. | Lower extremities |
e. | Eyes |
ANS: D, The lower extremities are the major site of arteriolar thromboemboli. This site is involved in 75% of all cases.
a. | air embolism |
b. | bone marrow embolism |
c. | fat embolism |
d. | talc embolism |
e. | cholesterol crystal embolism |
ANS: C, Rash in nondependent areas of the body following fracture of major bones, especially if associated with thrombocytopenia, is suggestive of fat embolism. Shortness of breath is indicative of pulmonary embolization, and neurologic symptoms suggest that the emboli have passed through the lungs and entered the cerebral vessels.
a. | pyogenic |
b. | gram-positive |
c. | gram-negative |
d. | encapsulated |
e. | acid fast |
ANS: C, Most cases of septic shock (70%) are caused by endotoxin-producing gram-negative bacteria. Endotoxins produced by gram-negative bacteria are lipopolysaccharides that bind to leukocytes, stimulating the release of cytokine, which in turn acts on vessels and other cells, propagating the development of shock.
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