ISBN-13: 9781605473048 978-1605473048
1. Which characteristic best describes the inflammatory response?
A) specific response to microorganisms
B) initiated by certain types of injury
D) regulated by chemical mediators
2. Which is not a major goal of the inflammatory response?
A) increase blood flow to the site of injury
B) form an antigen-antibody response
C) dilute harmful substances at the site of injury
D) remove injured tissue
3. The cell that must be “loosened” in order for the products of healing to get to the site of injury:
B) basement membrane
4. The cell most likely responsible for an immediate release of chemical mediators right at the site of injury is the:
A) mast cell
5. You sprained your ankle and are told to take ibuprofen to reduce the inflammation. What is the mechanism of action for this drug?
A) blocks chemokines
B) enhances mast cell activation
C) blocks prostaglandins
D) The mechanism of action is unknown
6. The activation of complement induces all of the following except:
D) cell lysis
7. Which of the following does not explain why multiple pathways are needed for the activation and suppression of chemical mediators?
A) Healing requires multiple chemical mediators
B) The chemical mediators are so potent
C) The response must be overzealous to be effective
D) Autoimmunity can occur if unregulated
8. Although against your better judgment, you squeezed an acne pustule on your face. Now you notice a clear fluid seeping from the opening. What is this clear fluid?
9. What is the role of the clear fluid referred to in the previous question?
A) carries proteins and leukocytes
B) promotes clotting
C) replaces epithelial cells
D) indicates edema in the underlying tissues
10. Which is not an essential step in the cellular response?
A) cellular migration
B) cellular adherence
C) cellular chemotaxis
D) cellular degranulation
11. Without this process, leukocytes would be unable to move across endothelial cells and get to the site of injury:
12. You are visiting the clinic for a possible infection. You are told that you have a high neutrophil count. This implies:
A) You have a streptococcal infection
B) You have an acute infection
C) You have a chronic infection
D) You do not have an infection
13. Your mother has a clinic appointment for a possible infection and is told that she has a high monocyte count. This implies:
A) She has a streptococcal infection
B) She has an acute infection
C) She has a chronic infection
D) She does not have an infection
14. How does the inflammatory response know when to retreat?
A) feedback mechanisms regulated by plasma protein systems
B) multiple processes of cellular inhibition
C) inhibition is time-dependent, the inflammatory response lasts 72 hours
D) when all microorganisms have been destroyed
15. You notice that after you sprained your ankle that the ankle became swollen, red, and hot. Why did the ankle get hot?
A) exudate accumulated at the site
B) increased blood flow to the site
C) the ankle became infected
D) There was a thermal injury as well
16. In chronic inflammation, extensive scarring is due to:
A) fibroblast activity
B) degradation of collagen
C) proteinase activity
D) loss of labile cells
17. Formation of these is a protective mechanism during some cases of chronic inflammation where an area is walled off in order to protect surrounding unaffected tissues:
C) basement membranes
D) granulation tissues
18. Poor tissue perfusion can lead to this complication of chronic inflammation:
A) keloid formation
B) wound dehiscence
19. Which of the following types of burns can interrupt cardiac conduction and lead to sudden death?
20. You are cooking macaroni and cheese and while pouring the pasta into the colander you splash scalding water on your arm. The area becomes red, painful, and blisters form. How would this burn be classified?
A) superficial partial thickness burn
B) deep partial thickness burn
C) full thickness burn
D) none of these
21. Rheumatoid arthritis is characterized by all of the following except:
A) autoimmune processes against synovial cells
B) formation of immune complexes
C) genetic susceptibility and a triggering event
D) chronic inflammatory processes predominated by neutrophils
22. In rheumatoid arthritis, this is a type of granulation tissue that forms over the inflamed synovium and cartilage:
A) matrix tissue
23. What is the relationship between severe burns and the development of gastritis?
A) Burns shunt blood away from stomach
B) Eating spicy foods can burn the stomach
C) Burns increase blood flow to the stomach
D) Burns require the use of long-term analgesics, which irritate the stomach
24. Which of the following is not a characteristic clinical manifestation of Crohn disease?
A) weight loss
C) abdominal pain
D) occult blood in stool
25. Which of the following statement is not true regarding ulcerative colitis?
A) It can occur anywhere in the gastrointestinal tract from the mouth to the anus
B) It is associated with an increased risk of colon cancer
C) It presents as a continuous friable intestinal lesion
D) Perforation is a potential complication
26. Describe the rationale for each of the systemic manifestations: fever, leukocytosis, and increased circulating plasma proteins.
27. Erythrocyte sedimentation rate (ESR) is a nonspecific test for inflammation. What does this mean? What happens during the ESR test?
28. Identify the three treatment principles in acute inflammation.
29. Identify and describe the three phases of tissue healing and repair.
30. Describe the role of the basement membrane in tissue healing.
31. Differentiate labile, stable, and permanent cells.
26. Fever is a result of chemical mediators acting directly on the hypothalamus. The hypothalamus is responsible for controlling temperature in the body. An elevated body temperature stimulates phagocytosis and can also inhibit the growth of certain microorganisms. Leukocytosis is an elevation in the white blood cell, or leukocyte, with a count usually above 10,000/mm3. Typically, the individual has a white blood cell count of 5,000 to 10,000/mm3. Leukocytosis demonstrates the increased circulation of white blood cells to aid in healing. Plasma proteins are also increased as a result of the three plasma protein systems (complement, kinin, and clotting). These proteins are called acute-phase reactants and can be measured through the use of laboratory tests, such as C-reactive protein (CRP).
27. The erythrocyte sedimentation rate (also referred to as a sed rate, or ESR) is a nonspecific method of testing for inflammation. This means that, when elevated, inflammation is occurring somewhere in the body but the exact source or location is not identified by the test. During the inflammatory process, the coagulation cascade results in increased circulating levels of fibrinogen, which causes cells to stick together. When measured in a tube in the lab, RBCs exposed to the inflammatory process will fall faster and will clump together. The ESR test then measures (in mm/hr) the level of RBC stacking. The test takes about 45 minutes. Typically, a higher result equates to more severe inflammation.
28. Reduce blood flow to the site, decrease swelling, and block the action of chemical mediators.
29. Inflammatory phase—vascular and cellular response regulated by plasma protein systems and activated/inhibited by chemical mediators, the goal is to bring forth the products of healing to the site of injury and to remove foreign substances and necrotic tissue; proliferative phase—restoring structural integrity is dependent upon the delicate balance of tissue destruction and construction. Tissue lysis, or breakdown and removal, is accomplished through the work of enzymes that are needed to rid the body of the damaged tissue. Growth factors and matrix proteins are responsible for rebuilding the extracellular matrix (ECM), the layers of architectural structures that support the cells (basement membrane, connective tissue). Macrophage activity converts the provisional matrix into granulation tissue. Granulation tissue is a connective tissue characterized by extensive macrophages and fibroblasts, and the promotion of angiogenesis, or the generation of new blood vessels at the site. The generation of blood vessels, particularly capillaries, at the site is needed for oxygen/carbon dioxide exchange and to provide other nutrients to the newly developing tissue. Granulation tissue is most noted for the presence of an extensive network of capillaries. As the wound heals, granulation tissue loses the excessive capillary network and retains only that needed to support the final connective tissue matrix. The provisional matrix and specialized granulation tissue are no longer needed and are reabsorbed once the wound is healed and the final connective tissue matrix is in place. Parenchymal cells undergo resolution, regeneration, or replacement; remodeling phase—a process of continued tissue reconstruction that occurs over several months.
30. The basement membrane is a critical component of tissue healing and serves to provide a supportive architectural structure, support re-epithelialization, or the movement of epithelial cells to form a covering over the wound, store growth factors, restore neuromuscular function at the site, and support the development of parenchymal tissues, that is, those tissues made up of cells with a specific function, such as neurons, myocardial cells, and epithelial cells, at the site.
31. Labile cells constantly regenerate through mitosis, particularly epithelial cells of the skin, gastrointestinal tract, and urinary tract, and blood cells in the bone marrow. Stable cells stop regenerating when growth is complete but can resume regeneration if injured. Permanent cells, such as neurons, cardiac myocytes, and the lens of the eye, do not undergo mitosis and are unable to regenerate.