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Path 3

front 1

A patient with congestive heart failure develops ankle edema. The fluid is low protein due to hydrostatic/oncotic imbalance. What is it called?
A. Exudate
B. Seroma
C. Transudate
D. Hematoma

back 1

C. Transudate

front 2

A swollen joint aspirate is cloudy and protein-rich from increased vascular permeability. What is this fluid?
A. Exudate
B. Transudate
C. Seroma
D. Lymph

back 2

A. Exudate

front 3

A macrophage senses cytosolic ATP and low intracellular K+ during tissue damage. Which receptor family detects these danger signals?
A. Toll-like receptors
B. Selectins
C. Integrins
D. NOD-like receptors

back 3

D. NOD-like receptors

front 4

Inflammasome activation most directly increases production of:
A. IL-4
B. IL-1
C. IL-10
D. IFN-γ

back 4

B. IL-1

front 5

The initiating step of inflammation begins with recognition of microbial components by:
A. Toll-like receptors
B. MHC I molecules
C. B-cell receptors
D. T-cell receptors

back 5

A. Toll-like receptors

front 6

In postcapillary venules, the initial rolling of neutrophils along endothelium is mediated by:
A. Integrins
B. PECAM-1
C. Selectins
D. Cadherins

back 6

C. Selectins

front 7

The main ligands for selectins on leukocytes are:
A. Collagen fibers
B. Sialylated oligosaccharides
C. Complement fragments
D. Fibrin polymers

back 7

B. Sialylated oligosaccharides

front 8

Endothelial cells increase coordinated adhesion molecule expression primarily in response to:
A. IL-4 and IL-5
B. IL-6 and IL-8
C. IFN-α and IFN-β
D. TNF and IL-1

back 8

D. TNF and IL-1

front 9

A patient twists an ankle and develops rubor, calor, tumor, dolor, and impaired use. Which sign completes this classic set?
A. Loss of function
B. Blistering
C. Cyanosis
D. Pruritus

back 9

A. Loss of function

front 10

Which pairing correctly matches inflammation type with its dominant tissue change?
A. Acute: fibrosis
B. Chronic: exudation
C. Acute: granulomas
D. Acute: fluid exudation

back 10

D. Acute: fluid exudation

front 11

In acute inflammation, vasodilation occurs first at the:
A. Capillaries
B. Arterioles
C. Venules
D. Lymphatics

back 11

B. Arterioles

front 12

Vasodilation in acute inflammation is quickly followed by:
A. Basement membrane synthesis
B. Platelet aggregation
C. Increased microvascular permeability
D. Smooth muscle hypertrophy

back 12

C. Increased microvascular permeability

front 13

Endothelial cell retraction causing leakage is induced by:
A. Histamine serotonin thromboxane
B. IL-12 IL-23 IL-17
C. TNF IFN-γ IL-2
D. Histamine bradykinin leukotrienes

back 13

D. Histamine bradykinin leukotrienes

front 14

The system that generates multiple inflammatory mediators (e.g., anaphylatoxins) is the:
A. Renin-angiotensin system
B. Complement system
C. Coagulation cascade only
D. Kinetochore complex

back 14

B. Complement system

front 15

In autoimmune disease, inflammation is commonly driven by:
A. Cytokines from B cells
B. Histamine from mast cells
C. Cytokines from T lymphocytes
D. IgE cross-linking only

back 15

C. Cytokines from T lymphocytes

front 16

In tuberculosis, infectious granulomas can become poorly perfused; the combination of hypoxia and free-radical–mediated injury most classically produces which type of necrosis within the granuloma?
A. Coagulative necrosis
B. Caseous necrosis
C. Liquefactive necrosis
D. Fat necrosis

back 16

B. Caseous necrosis

front 17

Which is a major component of acute inflammation involving movement from blood to tissue?
A. Fibroblast proliferation
B. Collagen deposition
C. Granuloma formation
D. Leukocyte emigration to injury

back 17

D. Leukocyte emigration to injury

front 18

In the general steps of inflammation, controlling and shutting down the reaction corresponds to:
A. Recognition
B. Regulation
C. Recruitment
D. Repair

back 18

B. Regulation

front 19

The initiating step of inflammation is best described as:
A. Recognition of harmful stimulus
B. Fibrosis of injured tissue
C. Epithelial regeneration
D. Antibody class switching

back 19

A. Recognition of harmful stimulus

front 20

Red streaks tracking proximally from a skin wound most strongly suggest:
A. Allergic urticaria
B. Sterile inflammation
C. Bacterial infection
D. Autoimmune vasculitis

back 20

C. Bacterial infection

front 21

In resting endothelium, P-selectin is stored in a specific granule type and later redistributed to the cell surface during inflammation. Where is it stored?
A. Specific neutrophil granules
B. Weibel-Palade bodies
C. Rough ER cisternae
D. Lysosomal granules

back 21

B. Weibel-Palade bodies

front 22

Early, weak rolling interactions that slow leukocytes and create time for endothelial binding are mediated by:
A. Selectins
B. Cadherins
C. Integrins
D. PECAM-1

back 22

C. Integrins

front 23

During endothelial activation, ligands for integrins are upregulated primarily by which cytokines?
A. TNF and IL-1
B. IL-4 and IL-5
C. IL-10 and TGF-β
D. IFN-α and IFN-β

back 23

A. TNF and IL-1

front 24

A neutrophil squeezes between endothelial cells (diapedesis). This transmigration occurs mainly in:
A. Arterioles
B. Capillaries
C. Small arteries
D. Postcapillary venules

back 24

D. Postcapillary venules

front 25

A key immunoglobulin-superfamily molecule for leukocyte diapedesis is CD31, also called:
A. ICAM-1
B. PECAM-1
C. VCAM-1
D. E-selectin

back 25

B. PECAM-1

front 26

A patient with bacterial cellulitis has strong neutrophil recruitment. The most common exogenous chemoattractant signal is:
A. N-formylmethionine peptides
B. Leukotriene B4
C. IL-8 chemokines
D. Complement fragments

back 26

A. N-formylmethionine peptides

front 27

Which set contains only endogenous chemoattractant sources listed in these notes?
A. Histamine, bradykinin, serotonin
B. Albumin, fibrinogen, IgM
C. Cytokines, complement, leukotriene B4
D. Myeloperoxidase, elastase, defensins

back 27

C. Cytokines, complement, leukotriene B4

front 28

Chemotactic agents guide leukocytes by binding to:
A. Nuclear steroid receptors
B. Ligand-gated ion channels
C. Cytosolic tyrosine kinases
D. Transmembrane G-protein receptors

back 28

D. Transmembrane G-protein receptors

front 29

In the first 6–24 hours of acute inflammation, the dominant inflammatory infiltrate is:
A. Eosinophils
B. Neutrophils
C. Macrophages
D. Plasma cells

back 29

B. Neutrophils

front 30

Once recruited to a site of infection/cell death, leukocytes recognize offending agents primarily via:
A. Toll-like receptors
B. T-cell receptors
C. MHC class II
D. Fcε receptors

back 30

A. Toll-like receptors

front 31

Leukocyte activation triggers signaling with increased cytosolic ion levels plus enzyme activation. Which option matches these notes?
A. ↓Ca2+, inhibits PKC
B. ↑cAMP, inhibits PLA2
C. ↓Ca2+, activates NOS
D. ↑Ca2+, activates PKC and PLA2

back 31

D. ↑Ca2+, activates PKC and PLA2

front 32

A bacterium is coated to enhance phagocytosis. Which trio lists the major opsonins from these notes?
A. IgG, C3b, plasma lectins
B. IgE, C5a, albumin
C. IL-1, TNF, IL-6
D. LTB4, histamine, bradykinin

back 32

A. IgG, C3b, plasma lectins

front 33

A receptor that binds and mediates endocytosis of LDL particles and microbial particles is best described as a:
A. Toll-like receptor
B. Selectin receptor
C. Scavenger receptor
D. Complement receptor only

back 33

C. Scavenger receptor

front 34

The primary mechanism listed for killing ingested microbes by phagocytes is:
A. Complement MAC formation
B. Reactive oxygen species
C. Antibody secretion
D. Collagen synthesis

back 34

B. Reactive oxygen species

front 35

ROS are produced mainly within the:
A. Cytosol
B. Nucleus
C. Extracellular space
D. Phagolysosome

back 35

D. Phagolysosome

front 36

The most potent bactericidal system in neutrophils (per these notes) is the:
A. Complement MAC pathway
B. Nitric oxide pathway
C. H2O2–MPO–halide system
D. Lactoferrin chelation system

back 36

C. H2O2–MPO–halide system

front 37

An inherited deficiency of components of the phagocyte oxidase system causes:
A. Leukocyte adhesion deficiency
B. Chronic granulomatous disease
C. Chediak-Higashi syndrome
D. Hyper-IgE syndrome

back 37

B. Chronic granulomatous disease

front 38

A macrophage generates the gas NO for antimicrobial activity. NO is produced from which amino acid via which enzyme?
A. Ornithine via nitric oxide synthase
B. Arginine via arginase
C. Tyrosine via nitric oxide synthase
D. Arginine via nitric oxide synthase

back 38

D. Arginine via nitric oxide synthase

front 39

Neutrophil specific (secondary) granules contain lysozyme, collagenase, gelatinase, lactoferrin, plasminogen activator, histaminase, and ALP. Which is a secondary granule component?
A. Lactoferrin
B. Myeloperoxidase
C. Defensins
D. Elastase

back 39

A. Lactoferrin

front 40

The two major phagocytes emphasized in acute inflammation are:
A. Basophils, eosinophils
B. NK cells, dendritic cells
C. Neutrophils, macrophages
D. Mast cells, plasma cells

back 40

C. Neutrophils, macrophages

front 41

A neutrophil’s azurophilic (primary) granules carry enzymes for antimicrobial killing. Which primary-granule protein is classically present?
A. Lactoferrin
B. Collagenase
C. Myeloperoxidase
D. Gelatinase

back 41

C. Myeloperoxidase

front 42

A lab isolates neutrophil primary granules (azurophilic). Which set best matches their contents?
A. Defensins, elastase, cathepsin G
B. Lysozyme, ALP, histaminase
C. Lactoferrin, gelatinase, collagenase
D. Plasminogen activator, ALP, lysozyme

back 42

A. Defensins, elastase, cathepsin G

front 43

Neutrophil extracellular traps (NETs) require an enzyme that converts arginine → citrulline to drive downstream nuclear changes. Which enzyme is cited here?
A. Nitric oxide synthase
B. Lipoxygenase-5
C. Phospholipase A2
D. Arginine deaminase

back 43

D. Arginine deaminase

front 44

In NET formation, arginine-to-citrulline conversion most directly leads to:
A. Microtubule stabilization
B. Chromatin decondensation
C. Ribosomal shutdown
D. Membrane lipid peroxidation

back 44

B. Chromatin decondensation

front 45

A patient develops recurrent cold abscesses and is unusually susceptible to fungal and bacterial infections due to impaired neutrophil recruitment. Loss of which cytokine best fits?
A. IL-17
B. IL-10
C. TNF
D. IL-1

back 45

A. IL-17

front 46

Resolution of inflammation can occur when anti-inflammatory cytokines are liberated. Which pair best dampens the response?
A. IL-1 and TNF
B. IL-17 and TNF
C. TGF-β and IL-10
D. IL-1 and IL-17

back 46

C. TGF-β and IL-10

front 47

Histamine and serotonin are among the earliest mediators released in inflammation. Histamine IS NOT ACTIVATED BY:
A. Physical injury
B. Antigen cross-links IgE
C. C3a/C5a fragments
D. Leukotriene B4

back 47

D. Leukotriene B4

front 48

In leukocytes, arachidonic acid is freed from membrane phospholipids by:
A. Cyclooxygenase-2
B. Phospholipase A2
C. Lipoxygenase-5
D. Myeloperoxidase

back 48

B. Phospholipase A2

front 49

Leukotrienes are generated in leukocytes and mast cells mainly through:
A. Lipoxygenase
B. Nitric oxide synthase
C. Myeloperoxidase
D. Inflammasome protease

back 49

A. Lipoxygenase

front 50

In neutrophils, 5-lipoxygenase converts arachidonic acid into which intermediate that precedes leukotrienes?
A. Prostaglandin H2
B. Thromboxane A2
C. 5-hydroxyeicosatetraenoic acid
D. Lipoxin A4

back 50

C. 5-hydroxyeicosatetraenoic acid

front 51

A patient with acute bronchospasm has mediator-driven airway narrowing. Which leukotriene set is the cysteinyl group that causes intense vasoconstriction and bronchospasm?
A. LTB4, LTA4, LTB5
B. LTC4, LTD4, LTE4
C. LXA4, LXB4, LTB4
D. PGE2, PGI2, TXA2

back 51

B. LTC4, LTD4, LTE4

front 52

Lipoxins primarily:
A. Suppress inflammation, inhibit chemotaxis
B. Amplify inflammation, activate chemotaxis
C. Increase vasodilation, increase edema
D. Activate complement, activate IL-1

back 52

A. Suppress inflammation, inhibit chemotaxis

front 53

A patient on high-dose corticosteroids has reduced inflammatory gene expression. Which target is explicitly downregulated in these notes?
A. Arginine deaminase
B. Lipoxygenase-5
C. Cathepsin G
D. TNF

back 53

D. TNF

front 54

IL-1 generation depends on the:
A. Membrane attack complex
B. Phagolysosome
C. Inflammasome
D. NET scaffold

back 54

C. Inflammasome

front 55

Prolonged TNF production can cause:
A. Urticaria
B. Cachexia
C. Polycythemia
D. Thrombocytosis

back 55

B. Cachexia

front 56

A cytokine program driven by IL-1 and TNF induces chemokines that act primarily on neutrophils. Which chemokine class fits?
A. C chemokines
B. CX3C chemokines
C. C-C chemokines
D. C-X-C chemokines

back 56

D. C-X-C chemokines

front 57

C-C chemokines act on monocytes, eosinophils, basophils, and lymphocytes. Which mediator selectively recruits eosinophils?
A. Eotaxin
B. IL-1
C. Lipoxin
D. IL-17

back 57

A. Eotaxin

front 58

Which chemokine class is relatively specific for lymphocytes?
A. C-C chemokines
B. C-X-C chemokines
C. C chemokines
D. CX3C chemokines

back 58

C. C chemokines

front 59

Which chemokine family promotes strong adhesion of monocytes and T cells?
A. C-X-C chemokines
B. CX3C chemokines
C. C-C chemokines
D. C chemokines

back 59

B. CX3C chemokines

front 60

In complement activation, the critical step is proteolysis of C3. Which trio lists the pathways that can cleave C3?
A. Terminal, MAC, lytic
B. IgE, histamine, serotonin
C. Neutrophil, monocyte, mast
D. Classical, alternative, lectin

back 60

D. Classical, alternative, lectin

front 61

A patient mounts an antibody response; immune complexes form on a pathogen surface. Which event initiates the classical complement pathway?
A. C1 binds IgM/IgG on antigen
B. MBL binds microbial mannose
C. C3a binds neutrophil receptors
D. Factor H cleaves C3b

back 61

A. C1 binds IgM/IgG on antigen

front 62

In the classical pathway, C1 binds to which immunoglobulins after they have bound antigen?
A. IgA or IgE
B. IgG or IgM
C. IgD or IgA
D. IgE or IgM

back 62

B. IgG or IgM

front 63

A septic patient has complement activation triggered directly by microbial surface molecules without antibody involvement. Which pathway matches, per these notes?
A. Classical pathway
B. Lectin pathway
C. Alternative pathway
D. Terminal pathway

back 63

C. Alternative pathway

front 64

In these notes, the alternative pathway is described as being triggered when microbial surface molecules activate:
A. C3a
B. C1 inhibitor
C. C4a
D. CD59

back 64

A. C3a

front 65

A child with recurrent infections has impaired lectin-pathway recognition. The initiating binding molecule is:
A. C1 inhibitor
B. Mannose-binding lectin
C. Decay accelerating factor
D. Complement factor H

back 65

B. Mannose-binding lectin

front 66

In the lectin pathway, mannose-binding lectin binds carbohydrates on microbes and then:
A. Directly activates C1
B. Directly activates CD59
C. Cleaves C3b to iC3b
D. Blocks C3 convertase

back 66

A. Directly activates C1

front 67

All three complement activation pathways converge on formation of which enzyme complex?
A. C1 inhibitor
B. Membrane attack complex
C. C3 convertase
D. Lipoxygenase

back 67

C. C3 convertase

front 68

The key action of C3 convertase is to:
A. Split C5 into C5a/C5b
B. Split C3 into C3a/C3b
C. Split C4 into C4a/C4b
D. Split IgG into fragments

back 68

B. Split C3 into C3a/C3b

front 69

Which trio of complement fragments is listed as mediators of inflammation?
A. C3b, iC3b, C5b
B. C5a, C3a, C4a
C. C1q, C2, C9
D. Factor H, DAF, CD59

back 69

B. C5a, C3a, C4a

front 70

A lab studies leukocyte chemotaxis and finds a complement fragment strongly attracting multiple leukocyte types. Which fragment is chemotactic here?
A. C4a
B. C3b
C. C5a
D. C5b

back 70

C. C5a

front 71

In these notes, C5a is chemotactic for:
A. Neutrophils, monocytes, eosinophils, basophils
B. Lymphocytes, plasma cells, platelets, RBCs
C. Fibroblasts, myocytes, osteocytes, neurons
D. Hepatocytes, adipocytes, chondrocytes, keratinocytes

back 71

A. Neutrophils, monocytes, eosinophils, basophils

front 72

Beyond chemotaxis, C5a also activates which pathway (explicitly noted as not complement) ?
A. Cyclooxygenase pathway
B. Lipoxygenase pathway
C. Nitric oxide pathway
D. Kallikrein pathway

back 72

B. Lipoxygenase pathway

front 73

Opsonization is impaired in a patient with complement dysfunction. Which complement proteins act as opsonins here?
A. C3a and C4a
B. C5a and C5b
C. C3b and iC3b
D. C1 and C2

back 73

C. C3b and iC3b

front 74

A patient has recurrent swelling episodes due to uncontrolled complement activation. Which regulator normally blocks activation of C1?
A. CD59
B. DAF
C. C1 inhibitor (C1INH)
D. Factor H

back 74

C. C1 inhibitor (C1INH)

front 75

Deficiency of C1 inhibitor most directly causes:
A. Hemolytic uremic syndrome
B. Hereditary angioedema
C. Paroxysmal nocturnal hemoglobinuria
D. Macular degeneration

back 75

B. Hereditary angioedema

front 76

Two complement regulators are membrane-linked by a specific anchor; loss of that anchor predisposes RBCs to lysis. What anchor links DAF and CD59?
A. GPI anchor
B. Actin anchor
C. Integrin anchor
D. Collagen anchor

back 76

A. GPI anchor

front 77

Decay accelerating factor (DAF) protects cells by preventing formation of:
A. C3 convertases
B. C1 complexes
C. C5a fragments
D. Bradykinin

back 77

A. C3 convertases

front 78

CD59 protects cells by inhibiting formation of the:
A. C3 convertase
B. Membrane attack complex
C. Mannose lectin complex
D. C1 inhibitor complex

back 78

B. Membrane attack complex

front 79

Defective enzymes that create GPI anchors cause excess RBC lysis in:
A. Hereditary angioedema
B. Hemolytic uremic syndrome
C. Paroxysmal nocturnal hemoglobinuria
D. Macular degeneration

back 79

C. Paroxysmal nocturnal hemoglobinuria

front 80

Complement factor H inhibits the alternative pathway by promoting:
A. Proteolysis of C3
B. Cleavage and destruction of C3b
C. Assembly of MAC
D. Activation of C1

back 80

B. Cleavage and destruction of C3b

front 81

A patient has thick yellow “pus” draining from a wound; the reaction is purulent. The most common cause of purulent inflammation is:
A. Viral cytolysis
B. Autoimmune reaction
C. Fungal infection
D. Bacterial infection

back 81

D. Bacterial infection

front 82

A tender, fluctuant skin lesion is incised and a localized collection of pus is released. This lesion is a(n):
A. Abscess
B. Ulcer
C. Granuloma
D. Serous blister

back 82

A. Abscess

front 83

Endoscopy shows a crater-like defect/excavation on mucosa caused by sloughing of inflamed necrotic tissue. This is a(n):
A. Abscess
B. Seroma
C. Ulcer
D. Granuloma

back 83

C. Ulcer

front 84

Compared with acute inflammation, chronic inflammation is best characterized by:
A. Neutrophils only, no repair
B. Mononuclear cells, destruction, repair
C. Vasodilation only, no cells
D. Edema only, no injury

back 84

B. Mononuclear cells, destruction, repair

front 85

Which cell types are commonly present at sites of chronic inflammation (beyond macrophages)?
A. Basophils and platelets
B. Neutrophils and mast cells
C. Erythrocytes and fibroblasts
D. B cells and plasma cells

back 85

C. Erythrocytes and fibroblasts

front 86

Classical macrophage activation (M1) is induced by microbial products plus:
A. Interferon-gamma
B. IL-4
C. IL-13
D. IL-10

back 86

A. Interferon-gamma

front 87

Alternative macrophage activation (M2) is most strongly induced by:
A. IL-1 and TNF
B. IFN-gamma and IL-17
C. IL-4 and IL-13
D. C3a and C5a

back 87

C. IL-4 and IL-13

front 88

A cytokine that predominates in classical macrophage activation (not alternative) is:
A. IL-5
B. Interferon-gamma
C. IL-4
D. IL-13

back 88

B. Interferon-gamma

front 89

Which pairing correctly matches macrophage activation pathway to primary role?
A. Classical repair; Alternative defense
B. Classical eosinophils; Alternative neutrophils
C. Classical antibodies; Alternative complement
D. Classical defense; Alternative repair

back 89

D. Classical defense; Alternative repair

front 90

CD4+ T lymphocytes at inflamed sites primarily:
A. Neutralize toxins directly
B. Phagocytose microbes
C. Promote and shape inflammation
D. Secrete IgG antibodies

back 90

C. Promote and shape inflammation

front 91

A CD4+ subset drives classical macrophage activation by producing IFN-gamma. Which subset is this?
A. Th1
B. Th2
C. Th17
D. Treg

back 91

A. Th1

front 92

A CD4+ subset secretes IL-4, IL-5, IL-13, recruits eosinophils, and promotes alternative macrophage activation. Which subset is this?
A. Th1
B. Th2
C. Th17
D. Treg

back 92

B. Th2

front 93

A CD4+ subset secretes IL-17, inducing chemokines that recruit neutrophils and monocytes. Which subset is this?
A. Th2
B. Treg
C. Th1
D. Th17

back 93

D. Th17

front 94

Th1 and Th17 responses are most involved in defense against:
A. Helminths and allergy
B. Protozoa only
C. Bacteria, viruses, autoimmunity
D. Tumors only

back 94

C. Bacteria, viruses, autoimmunity

front 95

Th2 responses are most involved in defense against:
A. Helminths and allergy
B. Bacteria and viruses
C. Autoimmune diseases
D. Intracellular bacteria only

back 95

A. Helminths and allergy

front 96

A long-standing T-cell–macrophage interaction in chronic inflammation can result in:
A. Serous blistering
B. Granuloma formation
C. Immediate pus formation
D. Pure edema only

back 96

B. Granuloma formation

front 97

In granulomatous inflammation, which cell types are typically elevated at the lesion?
A. Eosinophils and basophils
B. Neutrophils and platelets
C. T lymphocytes and macrophages
D. RBCs and fibroblasts

back 97

C. T lymphocytes and macrophages

front 98

Foreign body granulomas characteristically occur in the absence of:
A. Neutrophil recruitment
B. Complement activation
C. Antibody production
D. T cell responses

back 98

D. T cell responses

front 99

In immune granulomas, elevated IFN-gamma is most associated with production by:
A. Th1 cells
B. Th2 cells
C. B cells
D. Mast cells

back 99

A. Th1 cells

front 100

In IgE-mediated allergy and parasitic reactions, which pairing is correct?
A. Eosinophil: IgE Fc receptor; Mast: MBP
B. Mast: IgE Fc receptor; Eosinophil: MBP
C. Mast: MBP; Eosinophil: prostaglandins
D. Eosinophil: histamine; Mast: MBP

back 100

B. Mast: IgE Fc receptor; Eosinophil: MBP

front 101

In tuberculosis, infectious granulomas can become poorly perfused; the combination of hypoxia and free-radical–mediated injury most classically produces which type of necrosis within the granuloma?
A. Coagulative necrosis
B. Caseous necrosis
C. Liquefactive necrosis
D. Fat necrosis

back 101

A. Coagulative necrosis

front 102

Which three cytokines are the most important mediators of the acute-phase reaction?
A. IL-4, IL-5, IL-13
B. IFN-γ, IL-2, IL-12
C. TGF-β, IL-10, IL-35
D. TNF, IL-1, IL-6

back 102

D. TNF, IL-1, IL-6

front 103

A patient with pneumonia has fever, leukocytosis, elevated acute-phase proteins, and increased heart rate/blood pressure with reduced sweating. This systemic pattern is best termed the:
A. Acute-phase response
B. Type I hypersensitivity
C. Complement deficiency syndrome
D. Granulomatous inflammation

back 103

A. Acute-phase response

front 104

Which pair are the key endogenous pyrogens?
A. IL-6 and TGF-β
B. IFN-γ and IL-17
C. IL-1 and TNF
D. Histamine and serotonin

back 104

C. IL-1 and TNF

front 105

During the acute-phase reaction, the prostaglandin that drives neurotransmitter production involved in hypothalamic temperature regulation is:
A. PGI2
B. PGE2
C. TXA2
D. PGD2

back 105

B. PGE2

front 106

Which acute-phase protein is most IL-1/TNF–dependent?
A. C-reactive protein
B. Fibrinogen
C. Albumin
D. Serum amyloid A

back 106

D. Serum amyloid A

front 107

Which mediator reduces iron availability to erythroid progenitors in bone marrow?
A. Transferrin
B. Ferritin
C. Hepcidin
D. Haptoglobin

back 107

C. Hepcidin

front 108

A CBC shows leukocytosis with a marked neutrophil predominance after a new lobar pneumonia. This leukocyte pattern most strongly suggests:
A. Bacterial infection
B. Viral infection
C. Helminth infestation
D. Typhoid fever

back 108

A. Bacterial infection

front 109

Which pairing correctly matches the condition with its expected leukocyte pattern?
A. Viral infection: neutrophilia
B. Bacterial infection: lymphocytosis
C. Typhoid: eosinophilia
D. Helminths: eosinophilia; typhoid: leukopenia

back 109

D. Helminths: eosinophilia; typhoid: leukopenia

front 110

A patient with severe infection develops disseminated intravascular coagulation (DIC), hypotensive shock, and insulin resistance with hyperglycemia. This “clinical triad” is most consistent with:
A. Acute-phase response alone
B. Septic shock triad
C. Viral syndrome
D. Granulomatous inflammation

back 110

B. Septic shock triad

front 111

Following tissue injury, repair proceeds through two core processes. Which pair correctly names them?
A. Chemotaxis and exudation
B. Necrosis and apoptosis
C. Regeneration and scarring
D. Vasodilation and edema

back 111

C. Regeneration and scarring

front 112

After a fibrin-rich exudate fills a tissue space, fibrovascular ingrowth produces fibrosis within that exudate-occupied space. This outcome is called:
A. Organization
B. Regeneration
C. Caseation
D. Metaplasia

back 112

A. Organization

front 113

In wound healing, the highly vascular granulation tissue that initially fills the defect is gradually replaced by:
A. Fibrin
B. Elastin
C. Keratin
D. Collagen

back 113

D. Collagen

front 114

The macrophage population most associated with repair and wound healing is predominantly derived from which activation pathway?
A. Classically activated macrophages
B. Alternatively activated macrophages
C. Neutrophil-derived macrophages
D. Plasma-cell derived macrophages

back 114

B. Alternatively activated macrophages

front 115

In liver regeneration, Kupffer cells release a cytokine that “primes” hepatocytes (makes them competent) before growth factors push cell-cycle entry. Which cytokine is this?
A. IL-6
B. IL-4
C. IL-10
D. IFN-γ

back 115

A. IL-6

front 116

In the second phase of hepatocyte proliferation, which growth factors act on primed hepatocytes to stimulate metabolism and move them from G0 toward G1?
A. VEGF and FGF-2
B. TNF and IL-1
C. HGF and TGF-alpha
D. Angiopoietin-1 and -2

back 116

C. HGF and TGF-alpha

front 117

After hepatocytes complete the replication phase, return to quiescence is driven by which antiproliferative cytokine?
A. IL-6
B. HGF
C. TGF-alpha
D. TGF-beta

back 117

D. TGF-beta

front 118

If liver injury is too severe for mature hepatocytes to restore mass effectively, which cells become primarily responsible for repair?
A. Stellate cells
B. Progenitor cells
C. Kupffer cells
D. Endothelial cells

back 118

B. Progenitor cells

front 119

During angiogenesis, the earliest step includes vasodilation and increased permeability. Which pair matches this step?
A. NO and VEGF
B. VEGF and endothelin
C. Histamine and serotonin
D. FGF-2 and IL-6

back 119

A. NO and VEGF

front 120

Which factors are most associated with maturation of the new vessel wall?
A. VEGF and NO
B. FGF-2 and Angiopoietin-1
C. Angiopoietin-1 and -2
D. Nitric oxide and Angiopoietin-1

back 120

C. Angiopoietin-1 and -2

front 121

Stabilization of newly formed vessels and pericytes is primarily mediated by:
A. VEGF and FGF-2
B. PDGF and TGF-beta
C. IL-1 and TNF
D. IL-4 and IL-13

back 121

B. PDGF and TGF-beta

front 122

PDGF stabilizes newly formed vessels mainly by:
A. Inhibiting endothelial proliferation
B. Increasing metalloproteinases
C. Driving vessel branching
D. Recruiting smooth muscle cells

back 122

D. Recruiting smooth muscle cells

front 123

TGF-beta stabilizes new vessels mainly by:
A. Suppressing endothelium, increasing ECM
B. Recruiting smooth muscle cells
C. Stimulating neutrophil chemotaxis
D. Triggering mast cell degranulation

back 123

A. Suppressing endothelium, increasing ECM

front 124

Sprouting and branching of new vessels is regulated by the:
A. MAPK signaling pathway
B. JAK-STAT signaling pathway
C. NOTCH signaling pathway
D. Hedgehog signaling pathway

back 124

C. NOTCH signaling pathway

front 125

VEGF promotes vessel branching by stimulating expression of:
A. Notch ligands
B. Smooth muscle actin
C. C3 convertase
D. Myofibroblast networks

back 125

A. Notch ligands

front 126

During angiogenic sprouting, ECM proteins aid vessel extension by binding:
A. Selectins
B. Toll-like receptors
C. Cadherins
D. Integrins

back 126

D. Integrins

front 127

ECM remodeling and vascular tube extension are enabled by:
A. Tight junction proteins
B. Matrix metalloproteinases
C. Sialylated oligosaccharides
D. Complement anaphylatoxins

back 127

B. Matrix metalloproteinases

front 128

Connective tissue deposition is driven by macrophage-released:
A. IL-1, TNF, IL-6
B. VEGF, NO, Angiopoietins
C. PDGF, FGF-2, TGF-beta
D. Histamine, serotonin, bradykinin

back 128

C. PDGF, FGF-2, TGF-beta

front 129

The growth factors for connective tissue deposition are mainly released by:
A. Th1 lymphocytes
B. Neutrophils
C. Mast cells
D. M2 macrophages

back 129

C. Mast cells

front 130

The single most important cytokine for connective tissue synthesis/deposition is:
A. TGF-beta
B. IL-6
C. IFN-gamma
D. IL-17

back 130

A. TGF-beta

front 131

TGF-beta decreases ECM degradation primarily by:
A. Activating lipoxygenase
B. Increasing elastase release
C. Inhibiting metalloproteinases
D. Upregulating complement pathways

back 131

C. Inhibiting metalloproteinases

front 132

A factor that prolongs inflammation and increases local tissue injury is:
A. Rapid re-epithelialization
B. Early wound contraction
C. Angiogenesis maturation
D. Infection

back 132

D. Infection

front 133

Glucocorticoids inhibit inflammation partly by decreasing:
A. TGF-beta production
B. Notch ligand expression
C. PDGF receptor density
D. Integrin binding affinity

back 133

A. TGF-beta production

front 134

Healing by first intention most typically involves:
A. Large tissue defects
B. Skin wounds
C. Deep abscess cavities
D. Extensive necrotic slough

back 134

B. Skin wounds

front 135

In second intention healing, type III collagen is replaced over weeks by:
A. Type II collagen
B. Type IV collagen
C. Type I collagen
D. Type V collagen

back 135

C. Type I collagen

front 136

Wound contraction is driven primarily by networks of:
A. Keratinocytes
B. Endothelial cells
C. Neutrophils
D. Myofibroblasts

back 136

D. Myofibroblasts

front 137

Venous leg ulcers result from chronic venous hypertension and often show:
A. Hemosiderin deposits
B. Amyloid plaques
C. Bilirubin crystals
D. Melanin accumulation

back 137

A. Hemosiderin deposits

front 138

Arterial ulcers most often develop in patients with:
A. Chronic venous hypertension
B. Peripheral artery atherosclerosis
C. Prolonged tissue compression
D. IgE-mediated reactions

back 138

B. Peripheral artery atherosclerosis

front 139

Pressure sores are skin ulcerations/necrosis caused by:
A. Immune complex deposition
B. Ischemia from vasculitis
C. Prolonged compression against bone
D. Excessive collagen breakdown

back 139

C. Prolonged compression against bone

front 140

Excessive formation of repair components most directly causes:
A. Caseous necrosis
B. Serous effusion
C. Purulent exudate
D. Hypertrophic scars and keloids

back 140

D. Hypertrophic scars and keloids

front 141

Scar tissue that grows beyond the original wound boundary is a:
A. Keloid
B. Contracture
C. Ulcer
D. Granuloma

back 141

A. Keloid

front 142

Hypertrophic scars commonly follow thermal/traumatic injury involving:
A. Epidermis
B. Deep dermis layers
C. Mucosa
D. Subcutaneous fat

back 142

B. Deep dermis layers

front 143

Contractures are most prone to develop in the:
A. Neck, scalp, face
B. Abdomen, flank, back
C. Palms, soles, anterior thorax
D. Hips, thighs, calves

back 143

C. Palms, soles, anterior thorax

front 144

Liver progenitor cells are found within the:
A. Space of Disse
B. Central vein
C. Portal triad artery
D. Canals of Hering

back 144

D. Canals of Hering