Cell Injury & Inflammation

Topics in this chapter

• Cellular Injury and Reversible Changes
• Apoptosis and Cell Death
• Necrosis Patterns and Special Forms
• Ischemia-Reperfusion Injury
• Acute Inflammation and Leukocyte Responses
• Chronic and Granulomatous Inflammation
• Immune-Mediated Pathology
• Protein Misfolding and Amyloidosis

Practice questions

1. Question 1Q-02477C

   A 54-year-old male presents with acute chest pain. An electrocardiogram confirms an acute anterior wall myocardial infarction. He undergoes emergent percutaneous coronary intervention with stent placement. However, reperfusion of the ischemic myocardium often leads to paradoxical exacerbation of cell injury and further release of cardiac enzymes. Which of the following is the primary mediator responsible for this reperfusion injury?

   1. A.Reactive oxygen species (ROS)
   2. B.Complement component C5a
   3. C.Intracellular accumulation of triglycerides
   4. D.Depletion of nuclear DNA polymerases
   See the answer and solution
2. Question 2Q-863233

   A 45-year-old chronic alcoholic undergoes a routine health check-up. An abdominal ultrasound reveals hepatomegaly with diffuse increased echogenicity, characteristic of hepatic steatosis. Which of the following biochemical alterations is the primary cause of triglyceride accumulation within the hepatocytes in this patient?

   1. A.Decreased synthesis of apolipoproteins
   2. B.Increased peripheral mobilization of free fatty acids
   3. C.Inhibition of mitochondrial beta-oxidation by excess NADH
   4. D.Increased uptake of dietary chylomicron remnants
   See the answer and solution
3. Question 3Q-813F88

   A 60-year-old smoker dies of a massive stroke. Autopsy examination of the brain reveals an area of liquefactive necrosis in the middle cerebral artery territory. Which of the following cells are primarily responsible for the complete digestion and removal of necrotic tissue in the central nervous system?

   1. A.Astrocytes
   2. B.Microglia and blood-derived macrophages
   3. C.Oligodendrocytes
   4. D.Neutrophils
   See the answer and solution
4. Question 4Q-31181F

   A 28-year-old female presents with recurrent oral and genital aphthous ulcers, along with painful erythematous nodules on her shins. Skin biopsy of a nodule shows a leukocytoclastic vasculitis with prominent neutrophil infiltration and nuclear debris (karyorrhexis). Which of the following adhesion molecules is primarily deficient or defective in leukocyte adhesion deficiency type 1 (LAD-1), which impairs similar acute inflammatory responses?

   1. A.P-selectin (CD62P)
   2. B.E-selectin (CD62E)
   3. C.LFA-1 (CD11aCD18)
   4. D.ICAM-1 (CD54)
   See the answer and solution
5. Question 5Q-BCDFBD

   A 32-year-old male sustains a deep puncture wound to his foot while walking barefoot. Three days later, the wound is painful, swollen, and exudes thick, creamy yellow pus. Gram stain of the exudate shows numerous Gram-positive cocci and degenerate polymorphonuclear neutrophils. What is the predominant mechanism of killing utilized by these neutrophils against the bacteria?

   1. A.Complement-mediated membrane attack complex (MAC)
   2. B.Myeloperoxidase-mediated ROS-hypochlorite system
   3. C.Perforin and granzyme release via cytotoxic T-cells
   4. D.Nitric oxide synthesis via inducible NOS in the absence of oxygen
   See the answer and solution