A)

B)
C)
D)

1.Which characteristic best describes the inflammatory response?

specific response to microorganisms
initiated by certain types of injury
hormone-mediated
regulated by chemical mediators

A)
B)
C)
D)

2.Which is not a major goal of the inflammatory response?

increase blood flow to the site of injury
form an antigen-antibody response
dilute harmful substances at the site of injury
remove injured tissue

A)
B)
C)
D)

3.The cell that must be loosened in order for the products of healing to get to the site of
injury:
endothelial
basement membrane
epithelial
plasma

A)
B)
C)
D)

4.The cell most likely responsible for an immediate release of chemical mediators right at
the site of injury is the:
mast cell
platelet
eosinophil
endothelial

A)
B)
C)
D)

5.You sprained your ankle and are told to take ibuprofen to reduce the inflammation. What
is the mechanism of action for this drug?
blocks chemokines
enhances mast cell activation
blocks prostaglandins
The mechanism of action is unknown

A)
B)
C)
D)

6.The activation of complement induces all of the following except:

coagulation
opsonization
chemotaxis
cell lysis

A)

7.Which of the following does not explain why multiple pathways are needed for the
activation and suppression of chemical mediators?
Healing requires multiple chemical mediators
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B)
C)
D)

The chemical mediators are so potent

The response must be overzealous to be effective
Autoimmunity can occur if unregulated

A)
B)
C)
D)

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?
pus
water
exudate
plasma

A)
B)
C)
D)

9.What is the role of the clear fluid referred to in the previous question?
carries proteins and leukocytes
promotes clotting
replaces epithelial cells
indicates edema in the underlying tissues

A)
B)
C)
D)

10.Which is not an essential step in the cellular response?

cellular migration
cellular adherence
cellular chemotaxis
cellular degranulation

A)
B)
C)
D)

11.Without this process, leukocytes would be unable to move across endothelial cells and get
to the site of injury:
diapedesis
separation
adherence
leukocytosis

A)
B)
C)
D)

12.You are visiting the clinic for a possible infection. You are told that you have a high
neutrophil count. This implies:
You have a streptococcal infection
You have an acute infection
You have a chronic infection
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

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B)
C)
D)

She has an acute infection

She has a chronic infection
She does not have an infection

A)
B)
C)
D)

14.How does the inflammatory response know when to retreat?

feedback mechanisms regulated by plasma protein systems
multiple processes of cellular inhibition
inhibition is time-dependent, the inflammatory response lasts 72 hours
when all microorganisms have been destroyed

A)
B)
C)
D)

15.You notice that after you sprained your ankle that the ankle became swollen, red, and hot.
Why did the ankle get hot?
exudate accumulated at the site
increased blood flow to the site
the ankle became infected
There was a thermal injury as well

A)
B)
C)
D)

16.In chronic inflammation, extensive scarring is due to:

fibroblast activity
degradation of collagen
proteinase activity
loss of labile cells

A)
B)
C)
D)

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:
adenomas
granulomas
basement membranes
granulation tissues

A)
B)
C)
D)

18.Poor tissue perfusion can lead to this complication of chronic inflammation:

keloid formation
wound dehiscence
adhesions
ulceration

19.Which of the following types of burns can interrupt cardiac conduction and lead to
sudden death?
A)
thermal
B)
chemical

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C)
D)

electrical
radiation

A)
B)
C)
D)

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?
superficial partial thickness burn
deep partial thickness burn
full thickness burn
none of these

A)
B)
C)
D)

21.Rheumatoid arthritis is characterized by all of the following except:

autoimmune processes against synovial cells
formation of immune complexes
genetic susceptibility and a triggering event
chronic inflammatory processes predominated by neutrophils

A)
B)
C)
D)

22.In rheumatoid arthritis, this is a type of granulation tissue that forms over the inflamed
synovium and cartilage:
matrix tissue
ankylosis
pannus
nodular

A)
B)
C)
D)

23.What is the relationship between severe burns and the development of gastritis?
Burns shunt blood away from stomach
Eating spicy foods can burn the stomach
Burns increase blood flow to the stomach
Burns require the use of long-term analgesics, which irritate the stomach

A)
B)
C)
D)

24.Which of the following is not a characteristic clinical manifestation of Crohn disease?

weight loss
constipation
abdominal pain
occult blood in stool

A)
B)
C)

25.Which of the following statement is not true regarding ulcerative colitis?

It can occur anywhere in the gastrointestinal tract from the mouth to the anus
It is associated with an increased risk of colon cancer
It presents as a continuous friable intestinal lesion

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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.

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Answer Key
1.D
2.B
3.A
4.A
5.C
6.A
7.C
8.C
9.A
10.D
11.A
12.B
13.C
14.A
15.B
16.A
17.B
18.D
19.C
20.B
21.D
22.C
23.A
24.B
25.A
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

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mediators.
29.Inflammatory phasevascular 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 phaserestoring 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 phasea 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.

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