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General pathology 2008-2009

Compiled by Bhupinder Bawa


Q1. Formation of endothelial gaps in venules is elicited by all of the following except?

A. Histamine
B. Bradykinin
C. Leukotrines
D. Nitric oxide
E. Neuropeptide substance

Q2. TNF and IL-1 induce endothelial expression of the following molecules?

A. E-Selectins
B. P-Selectins
C. ICAM -1
D. VCAM -1
E. Integrins

a. 1,2,3
b. 1,4,5
c. 2,4,5
d. 1,3,4
e. 2,3,4

Q3. Extravasted leukocytes are able to bind to ECM by virtue of?

A. β 1 integrins
B. β2 integrins
C. CD44
D. CD31
E. A and C

Q4. In leukocytes adhesion deficiency type 2 the leukocytes are unable to bind to?

A. ICAM-1
B. VCAM-1
C. E-selectin
D. P-selectin
E. Both C and D

Q5. The surface proteins that mediate homing of lymphocytes in lymph node and
peripheral site of inflammation are respectively?

A. L-selectin and VLA-4


B. L-selectin and MAC-1
C. E-selectin and VLA-4
D. P-selectin and LFA-1
E. L-selectin and LFA-1
General pathology 2008-2009
Compiled by Bhupinder Bawa

Q6. The sequence of events during leukocyte adhesion cascade is?

1. Rolling
2. Activation
3. Tethering
4. Migration
5. Firm adhesion

A. 1,2,3,4,5
B. 2,3,1,5,4
C. 3,1,2,4,5
D. 2,1,3,4,5
E. 3,2,1,4,5

Q7. Which of the following is not a hallmark of acute inflammation?

A. Pain
B. Heat
C. Swelling
D. Necrosis
E. Loss of function

Q8. The changes in vascular flow and caliber during acute inflammation occur in what
order?

1. Blood stasis
2. Vasodilation
3. Exudation of plasma proteins
4. Transient arteriolar vasoconstriction
5. Increased microvascular permeability

A. 1, 2, 3, 4, 5
B. 2, 1, 4, 5, 3
C. 2, 4, 5, 3, 1
D. 4, 2, 5, 3, 1
E. 4, 2, 1, 5, 3

Q9. The net accumulation of fluid (edema) in tissues due to inflammation is caused by
which of the following mechanisms?

1) Increased oncotic pressure gradient between the tissues and the plasma
2) Decreased oncotic pressure gradient between the tissues and the plasma
3) Increased leakage of plasma water due to increased vascular permeability
4) Increased hydrostatic pressure gradient between the vasculature and the tissues
General pathology 2008-2009
Compiled by Bhupinder Bawa
5) Decreased hydrostatic pressure gradient between the tissues and the vasculature

A. 1, 3, 5
B. 1, 4
C. 2, 3, 4
D. 2, 5
E. 2, 4

Q10. Active hyperemia occurs as a result of the action of all of the following chemical
mediators except:

A. Bradykinin
B. Nitric oxide
C. Prostaglandins
D. Leukotriene B4
E. A and D

Q11. Which of the following is not a chemotactic mediator?

A. C3a
B. C5a
C. Peptidoglycan
D. Leukotriene B4
E. Lipopolysaccharide

Q12. Increased blood flow to a tissue in inflammation is due to which of the following?

A. Opening of new capillary beds


B. Mast cell degranulation
C. Production of NO
D. Arteriolar dilation
E. all of the above

Q13. Which of the following substances acts on venules 20-60 um in diameter to produce
larger intercellular gaps?

A. Histamine
B. Bradykinin
C. Substance P
D. Leukotrienes
E. All of the above

Q14. Which of the following is found pre-made in granules in platelets and endothelial
cells?

A. P-selectin
General pathology 2008-2009
Compiled by Bhupinder Bawa
B. E-selectin
C. L-selectin
D. D-selectin
E. all of the above

Q15. TNF and IL-1 can induce expression of ligands for integrins such as?

A. ICAM
B. VCAM
C. E-selectin
D. P-selectin
E. a and b

Q16. Which of the following is a cause of increased vascular permeability during acute
inflammation?

A. Leukocyte-dependant endothelial cell injury


B. Increased endothelial cell transcytosis
C. Opening of endothelial gaps
D. Direct endothelial cell injury
E. All of the above

Q17. The order of leukocyte extravasation is

1. Rolling
2. Adhesion
3. Tethering
4. Diapedesis
5. Margination

A. 2,3,1,4,5
B. 3,5,1,2,4
C. 3,2,1,4,5
D. 5,1,3,2,4
E. 5,3,1,2,4

Q18. Which of the following does not play a role in leukocyte adhesion?

A. Selectins
B. Integrins
C. Endothelins
D. Immunoglobulins
E. Mucin-like glycoproteins
General pathology 2008-2009
Compiled by Bhupinder Bawa

Q19. Cardinal signs of inflammation include:

1. Rubor (Redness)
2. Calor (Heat)
3. Odor (Smell)
4. Tumor (Swelling)
5. Dolor (Pain)

A. 1, 2, 3, 4
B. 1, 2, 4, 5
C. 1, 2, 3, 5
D. 2, 3, 4, 5
E. 1, 2, 3, 4, 5

Q20. Formation of endothelial gaps during an acute inflammatory response occurs


primarily in:

A. arterioles
B. capillaries
C. venules
D. lymphatics
E. both c & d

Q21. In the leukocyte adhesion cascade, tethering and rolling of leukocytes is largely
mediated by:

A. L- and P-selectins
B. E-selectin and β2 integrins
C. β2 integrins and ICAM-1
D. E-selectin and ICAM-2
E. PECAM-1 and JAM

Q22. Cattle, dogs, and humans with leukocyte adhesion deficiency (LAD) type I lack
functional expression of:

A. E-selectin
B. β2 integrins
C. ICAM-1
D. P-adherin
E. sialyl-Lewis X

Q23. All of the following proteins can acts opsonins except?

F. Fibronectin
G. Fibrinogen
General pathology 2008-2009
Compiled by Bhupinder Bawa
H. Phospholipase C
I. C-reactive protein
J. Mannose binding protein

Q24. The most efficient bactericidal system in neutrophils involves?

A. Bactericidal permeability increasing protein


B. H2O2-MPO-halide system
C. Major basic protein
D. NADPH oxidase
E. Defensins

Q25. Which one of the following is not a characteristic of Chediak-Higashi syndrome?

A. neutropenia
B. platelet abnormalities
C. delayed microbial killing
D. giant granules in leukocytes
E. defective neutrophil chemotaxis

Q26. All of the following are present in azurophil granules of neutrophils except?

A. Elastase
B. Defensins
C. Lysozyme
D. Lactoferrins
E. Myeloperoxidase

Q27. All of the following are functions of substance P except?

A. Vasodilation
B. Vasoconstriction
C. Bronchoconstriction
D. Increased vascular permability
E. Leukocyte activation and chemotaxis

Q28. Which of the following is not an actin-regulating protein?

A. Profilin
B. Filamin
C. Gelsolin
D. Parafilin
E. Calmodulin
General pathology 2008-2009
Compiled by Bhupinder Bawa
Q29. All of the following takes part in the activation of leukocytes except?

A. Antigen-antibody complexes
B. Cytokines and chemokines
C. Products of necrotic cells
D. Apoptotic cells
E. Microbes

Q30. Majority of the microbial killing of bacteria by phagocytes takes place by?

A. Altering pH in a phagolysosome
B. Pore forming proteins
C. Enzymatic digestion
D. Oxidative burst
E. All the above

Q31. A mouse with NADPH oxidase defect in neutrophils will have

1. Inability to generate Superoxides


2. Inability to fight microbial infection
3. Inability to generate arachidonic acid metabolites
4. Inability of cellular receptors to bind to opsonized particles
5. Inability to halogenate oxygen free radicals in the phagolysosome

A. 1&2
B. 1&3
C. 1&5
D. 2&3
E. 2&5

Q32. Which of the following does NOT result in leukocyte activation?

A. Binding of CD14 molecules on the cell surface


B. Binding of CD34 molecules on the cell surface
C. Binding of toll-like receptors on the cell surface
D. Binding of mannose receptors on the cell surface
E. Binding of seven-transmembrane G-protein coupled receptors on the cell surface

Q33. Which of the following is NOT part of the reactive oxygen burst that occurs in
neutrophils?

A. NADPH oxidase
B. Myeloperoxidase
C. Superoxide anion
D. Hydrogen peroxide
E. Superoxide dismutase
General pathology 2008-2009
Compiled by Bhupinder Bawa

Q34. Which of the following are endogenous chemoattractants

A. Chemokines
B. Complement components
C. N-formyl-methionine terminal amino acid
D. A&B
E. All of the above

Q35. Which inflammatory mediator can be produced by platelets

A. Cytokines
B. Nitric oxide
C. Leukotrienes
D. Prostaglandins
E. Platelet-activating factors

Q36. Eosinophils are not associated with which of the following

A. Mast cell tumors


B. Collagen degredation
C. Histamine production
D. Parasitic inflammation
E. Elaboration of cytokines

Q37. Leukocyte activation occurs by

A. Recognition of N-formylmethionyl by seven-transmembrane G-protein receptors


B. Binding of mannose to opsonin receptors
C. Activation of phospholipase A2
D. Activaion of Toll-like receptors
E. All of the above

Q38. Which two receptors typically initiate phagocytosis of microbes and dead cells?

1. Toll-like receptors
2. Mannose receptors
3. Scavenger receptors
4. Opsonin receptors
5. Seven-transmembrane G-protein-coupled receptors

A. 1&2
B. 1&5
C. 2&3
D. 2&5
E. 3&4
General pathology 2008-2009
Compiled by Bhupinder Bawa

Q39. Polymerization of actin is an important step in leukocyte...

A. chemotaxis
B. activation
C. phagocytosis
D. a&b
E. a&c

Q40. Preformed chemical mediators of inflammation include

1. Histamine
2. Prostaglandins
3. Leukotrienes
4. Serotonin
5. Lysosomal enzymes

A. 1, 2, 3
B. 1, 4, 5
C. 2, 3, 4
D. 2, 4, 5
E. 3, 4, 5

Q41. The most efficient bactericidal system in neutrophils is...

A. lysozyme
B. NADPH oxidase
C. major basic protein
D. H2O2-MPO-halide
E. bactericidal permeability increasing enzyme

Q42. Following are the endogenous chemoattractants EXCEPT

A. C5a
B. GCRs
C. IL8
D. LTB4
E. a&c

Q43. Toll- like receptors (TLRs) play an essential role in cellular response to the
following components of bacterial cell EXCEPT
A. LPS
B. RNA
C. Endotoxin
D. Proteoglycans
E. Unmethylated CpG nucleotides
General pathology 2008-2009
Compiled by Bhupinder Bawa

Q44. The process of phagocytosis is dependent on polymerization of

A. myosin filaments
B. actin filaments
C. independent process
D. both a and b
E. none of above

Q45. What enzyme is present in the azurophilic granules of neutrophils

A. MPO
B. Catalase
C. Elastase
D. Lysozymes
E. Major basic protein

Q46. What is the common cell precursor for mast cell and basophils that originates and
differentiates in bone marrow?

A. CD4
B. CD34+
C. IL-5
D. IL-3
E. All of the above

Q47. What is the normal distribution of mast cells in the connective tissue?

A. blood vessels of skin


B. lymphatics of skin
C. lymphatics of mucous membrane
D. blood vessels of mucous membrane
E. all of the above

Q48. What is the typical location of the mast cells in the mucous membrane?

A. Respiratory epithelium
B. Intestinal epithelium
C. Cutaneous epithelium
D. a and b
E. b and c

Q49. Which two proteolytic enzymes released by mast cells are responsible for the
remodeling of the extracellular matrix?

A. Tryptase
General pathology 2008-2009
Compiled by Bhupinder Bawa
B. Chymase
C. Elastase
D. a and b
E. b and c

Q50. The eosinophilic granules of horse eosinophils are rich in which of the following
amino acid
A. Glycine
B. Alanine
C. Arginine
D. Tryptophan
E. Ornithine

Q51. All of the following can inhibit complement activation system EXCEPT?

A. Decay accelerating factor


B. C1 inhibitor
C. Factor 1
D. Plasmin
E. CD59

Q52. Which of the following facilitates activation of Hageman factor?

1. Collegen and basement membrane


2. Activated platelets
3. HMWK
4. Kallikrein
5. Plasmin
A. 1,2
B. 1,2,3
C. 3,4,5
D. 1,2,3,4
E. 1,2,3,4,5

Q53. Activation of protease activation receptors-1 by thrombin can induce acute


inflammation by?

1. Mobilization of P-selectin
2. Induction of cyclooxygenase
3. Production of prostaglandins
4. Production of PAF and NO
5. expression of endothelial adhesion molecules

A. 1,2,3
B. 1,3,5
C. 2,3,4,5
General pathology 2008-2009
Compiled by Bhupinder Bawa
D. 1,2,4,5
E. 1,2,3,4,5

Q54. Which of the following is the most essential link between coagulation system and
inflammation?
A. Factor I
B. Factor II
C. Factor XI
D. Factor XIa
E. Factor II

Q55. Which of the following about kallikrein is incorrect?

A. Is converted to active form by factor XIIa


B. Converts plasminogen to plasmin
C. Is inactivated by kininase
D. Produces bradykinin
E. Converts C5 to C5a

Q56. Which of the following about factor XIIa is incorrect?

A. Is inactivated by plasmin
B. Initiates the clotting cascade
C. Converts prekallikrein to kallikrein
D. Can be produced by kallikrein by feedback
E. Cleaved from factor XII by collagen and basement membranes

Q57. Which complement protein is not part of early complement activation


A. Activated C1
B. C2
C. C3b
D. C4b
E. C5

Q58. Which of the following are known as C5 convertase?


1) C2bBc3b
2) C3bBb3b
3) C3bBb5a
4) C4b2b3b
5) C4b2bBb

A. 1 and 2
B. 2 and 3
C. 2 and 4
D. 3 and 4
E. 4 and 5
General pathology 2008-2009
Compiled by Bhupinder Bawa
Q59. Which of the following is NOT a function of C5a?
A. Causes vasodilation
B. Acts as an opsonin
C. Chemotactic for neutrophils
D. Causes increased vascular permeability
E. Activates the lipoxygenase pathway of arachidonic acid metabolism in
neutrophils and monocytes

Q60. Anaphylatoxins C5a and C3a affect vascular permeability by which of the
following mechanisms?

A. direct endothelial injury


B. stimulate histamine release from mast cells
C. activating the lipoxygenase pathway of arachidonic acid metabolism
D. a,b,c
E. b and c

Q61. The functions of Plasmin include which of the following?

1. Activation of C3
2. Activation of C5
3. Dissolution of fibrin
4. Activation of Hageman Factor
5. formation of the membrane attack complex

A. 1,2,3,4,5
B. 1,2,3,4
C. 1,2,3
D. 2,3,4,5
E. 2,3,4

Q62. Activation of the intrinsic clotting pathway can lead to which of the following?

A. Formation of vasoactive peptides like Bradykinin


B. Chemotaxis and phagocytosis of microbes
C. Endothelial and leukocyte activation
D. Fibrinolysis
E. All of the above

Q63. Deficiency in which of the following complement proteins will result in


autoimmune diseases

A. C2 & C3
B. C2 & C4
C. C3 & C4
D. C2 & C5
General pathology 2008-2009
Compiled by Bhupinder Bawa
E. C3 & C5

Q64. The functions of protease kallikreins include


A. Cleaves plasma proteins to produce kininogens
B. Converts plasminogen to plasmin
C. Activates Hageman factor
D. Converts C5 to C5a
E. All the above

Q65. Which of the following is a powerful chemoattractant?

A. C3
B. C5
C. C3a
D. C5a
E. All

Q66. The alternative pathway of complement can be triggered by all except…


A. LPS
B. Endotoxin
C. Cobra venom
D. Mannose-binding lectin
E. Complex polysaccharides

Q67. The classical pathway C3 convertase is also known as…


A. C4b2b
B. C4b2b3b
C. C3bBb
D. C3bBb3b
E. C5-9

Q68. Activated Hageman factor (factor XIIa) initiates…


A. The kinin system
B. The clotting system
C. The fibrinolytic system
D. The complement system
E. All of the above

Q69. Formation of Lipoxins A4 and B4 by 12-lipoxygenase takes place in?


A. Platelets
B. Monocytes
C. Neutrophils
D. Vascular endothelium
E. All of the above
General pathology 2008-2009
Compiled by Bhupinder Bawa
Q70. An imbalance of the following has been implicated as an early event in the
thrombosis.

A. Thromboxane-prostaglandins
B. Prostaglandins-leukotrienes
C. Thromboxane-prostacyclin
D. Thromboxane-leukotrienes
E. Prostacyclin-leukotrienes

Q71. Products of LTA4 have all of the following functions except?

A. Vasoconstriction
B. Platelet aggregation
C. Inhibit neutrophils chemotaxis
D. Stimulate neutrophil chemotaxis
E. Increased vascular permeability

Q72. Which of the following class of chemokines causes chemotaxis of neutrophil?

A. C
B. CC
C. CXC
D. CX3C
E. CX2C

Q73. All of the followings are true regarding NO except?

A. It is a potent vasodilator
B. Has microbicidal properties
C. Inhibits mast cell induced inflammation
D. Reduced platelet aggregation and adhesion
E. Endogenous enhancer of inflammatory responses

Q74. Leukotrienes C4, D4, and E4 are associated with:


1. Chemotaxis
2. Vasodilation
3. Vasoconstriction
4. Leukocyte adhesion
5. Increased vascular permeability

A. 1,2,4,5
B. 1,3,5
C. 1,3,4,5
D. 2,4,5
E. 3,5
General pathology 2008-2009
Compiled by Bhupinder Bawa
Q75. TNF and IL-1 do not have an effect on

A. Acute-phase proteins
B. Endothelial cells
C. Myeloblasts
D. Leukocytes
E. Fibroblasts

Q76. Low concentrations of PAF cause

A. Chemotaxis
B. Vasoconstriction
C. Platelet aggregation
D. Bronchoconstriction
E. Increased vascular permeability

Q77. Principal cytokine functions are

A. Hematopoeitc growth factors


B. Inflammatory mediators
C. T-cell activation
D. Chemotaxis
E. All of the above

Q78. Which of the following eicosanoids does NOT act as a vasoconstrictor?


A. Prostacyclin
B. Leukotriene C4
C. Leukotriene D4
D. Leukotriene E4
E. Thromboxane A2

Q79. Which of the following mediators is a potent chemotactic agent for neutrophils?
A. PGF2α
B. Lipoxin A4
C. Leukotriene B4
D. Prostaglandin D2
E. Thromboxane A2

Q80. Which of the following statements about lipoxins are incorrect?


A. Causes vasoconstriction
B. Inhibit neutrophil chemotaxis
C. Secreted primarily by platelets
D. Stimulate macrophage adhesion to endothelial cells in blood vessels
E. Production requires cell to cell interaction between leukocytes and platelets

Q81. Which of the following is NOT a function of platelet activating factor (PAF)?
General pathology 2008-2009
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A. Vasoconstriction
B. Platelet aggregation
C. Bronchoconstriction
D. Leukocyte chemotaxis
E. Inhibition of the neutrophil oxidative burst mechanism

Q82.Platelet lipoxins LXA4 and LXB4 are generated by the action of platelet 12-
lipoxygenase on…
A. Platelet derived LTA4
B. Platelet derived LTB4
C. Neutrophil derived LTA4
D. Neutrophil derived LTB4
E. Macrophage derived LTB4

Q83. Which of the following arachadonic acid products leads to vasoconstriction?


1. Lipoxin A4
2. Leukotriene C4
3. Prostaglandin E2
4. Thromboxane A2
5. Platelet activating factor
A. 1,2,3
B. 1,4,5
C. 2,3,4
D. 2,4,5
E. 1,2,4,5

Q84. The systemic acute phase responses associated with infection or injury are induced
by…
1. TNF
2. IL-1
3. IL-6
4. IL-8
5. IFN-α
A. 1,2,3
B. 1,3,5
C. 2,3,5
D. 2,4,5
E. 1,2,3,4

Q85. Functions of NO include all except


A. Vasodilation
B. Microbicidal
C. Promotes platelet aggregation
D. Reduces inflammatory response
E. Reduces leukocyte adhesion
General pathology 2008-2009
Compiled by Bhupinder Bawa
Q86. Accumulation of macrophages at the site of inflammation is predominately due to?

A. Immobilization of macrophages with the site of inflammation


B. Proliferation of macrophages in blood circulation
C. Continued recruitment from microcirculation
D. Proliferation of macrophages after emigration
E. All of the above

Q87. Acute phase proteins are released from liver in response to?

A. IL-6
B. IL-1
C. TNF
D. All of the above
E. B and C only

Q88. Macrophages are potently activated by which of the following?

A. C5a
B. TNF
C. IL-1
D. IFN-γ
E. IL-12

Q89. Necrotic tissue can perpetuate inflammation by which of the following ways?

A. activation of bradykinin
B. activation of coagulation
C. activation of complement
D. liberation of uric acid from cells
E. all of the above

Q90. Autocrine stimulation of T lymphocytes occurs through production of which of the


following?

A. IL-2
B. TNF
C. IL-10
D. IL-12
E. IFN-γ

Q91. The functions of acute phase proteins include all of the following except?

A. act as opsonins
B. Fix complement
C. Aid in clearing of nuclear debris
General pathology 2008-2009
Compiled by Bhupinder Bawa
D. Redirect lipids to macrophages for energy
E. Cause the accelerated release of leukocytes from bone marrow

Q92. Which of the following mediators are chemotactic for monocytes?

1) C5a
2) TGF-α
3) Fibronectin
4) Platelet-derived growth factor
5) Monocyte-chemoattractant protein 1 (MCP-1)

A. 1, 2
B. 1, 2, 5
C. 1, 2, 3, 4, 5
D. 2, 3, 5
E. 5

Q93. One of the major eosinophil secretory substances that is toxic to parasites is?

A. Lysozyme
B. Substance P
C. Acid hydrolase
D. Myeloperoxidase
E. Major basic protein

Q94. The increase in which of the following component of acute phase proteins forms the
basis for measuring the erythrocyte sedimentation rate to determine the severity of
inflammation

A. Fibrinogen
B. C-reactive proteins
C. Serum amyloid A protein
D. A&B
E. A&C

Q95. Chronic inflammation is characterized by all except...


A. Edema
B. Fibrosis
C. Angiogenesis
D. Tissue destruction
E. Infiltration with mononuclear cells

Q96. Which of the following does not activate macrophages?

A. IL-1
B. IFN-γ
General pathology 2008-2009
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C. Endotoxin
D. Fibronectin
E. Both a and d

Q97. Increased concentrations of acute phase proteins can lead to all except...
A. Fever
B. Amyloidosis
C. Increased opsonization
D. Decreased erythrocyte sedimentation rate
E. Both a and d

Q98. Increased levels of IL-1 and/or TNF during an inflammatory response can lead to...
A. DIC
B. Fever
C. Leukocytosis
D. Increase in some acute phase proteins
E. All of the above (and then some)

Q99. Chronic inflammation is characteristically caused by

1. Pox virus
2. Lupus erythematosus
3. Mycoplasma infection
4. Staphlococcus infection
5. Prolonged exposure to silica particulates

A. 1,2,3
B. 1,2,3,4,5
C. 2,3,5
D. 2,3,4,5
E. 3,4,5

Q100. Macrophage accumulation in chronic inflammation occurs by

A. Recruitment of monocytes
B. Local proliferation of macrophages
C. Immobilization of macrophages at the site of inflammation
D. A&B
E. All of the above

Q101. A granuloma

1. May contain giant cells


2. Contains epitheloid macrophages
3. Can be foreign body type or immune type
4. Is surrounded primarily by lymphocytes and plasma cells
General pathology 2008-2009
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5. Becomes a tubercle in the presence of central caseous necrosis

A. 1
B. 1,2
C. 1,2,3
D. 1,2,3,4
E. 1,2,3,4,5

Q102. All of the following are true regarding defensins except?

A. Induce IL-8 synthesis


B. Induce lymphocytes chemotaxis
C. Stimulate mast cell degranulation
D. Activate lymphocyte and macrophages
E. Opsonize and aggregate bacterial pathogens

Q103. Which of the following molecules are not involved in the LPS activation of acute
inflammatory cytokines?

A. NFκB
B. TLR4
C. CD14
D. MyD88
E. Peptidoglycan

Q104. Which of the following is a direct neutrophil chemotactic agent?

A. α-Defensins
B. β-Defensins
C. Cathelicidins
D. Surfactants A and D
E. A and B

Q105. Leukocytes produce all of the following except?

A. α-Defensins
B. β-Defensins
C. Cathelicidins
D. Surfactants A and D
E. a,b, and c

Q106. The direct effects of endotoxin are

1. Secretion of TNF
2. Activation of Bradykinin
3. Induction of TLR4 pathway
General pathology 2008-2009
Compiled by Bhupinder Bawa
4. Activation of Hageman factor
5. Activation of complement cascade

A. 1,3,4
B. 1,4,5
C. 2,3,4
D. 2,4,5
E. 3,4,5

Q107. Lethal endotoxic shock is prevented by anti-antibodies or receptor inhibitors


against

A. LPS
B. TNF
C. IL-1
D. IL-6
E. CD14

Q108. Inflammatory exudates with high protein concentrations (i.e.>1.020) include…

1. Serous
2. Catarrhal
3. Fibrinous
4. Suppurative

A. 1,2
B. 2,3
C. 3,4
D. 2,3,4
E. 1,2,3,4

Q109. Failure of acute inflammatory response is characterized by all of the following


except?

A. Extensive tissue injury and necrosis


B. Connective tissue reorganization with fibrosis
C. Persistence of inciting stimulus for a long period of time
D. Removal of inciting stimulus with minimal tissue damage
E. Shift of inflammatory cells from neutrophils to macrophages

Q110. The predominant cell type presenting antigen to naïve CD4+ lymphocyte is?

A. Dendritic cells
B. B-lymphocyte
C. Macrophages
General pathology 2008-2009
Compiled by Bhupinder Bawa
D. Neutrophils
E. Mast cells

Q111. The commitment of Th1 pathway is induced by?

A. IL-10
B. IL-12
C. IL-9
D. IL-5
E. IL-4

Q112. All of the following can inhibit preTh/CD4+ cells from committing to Th1
pathway except?
A. IL-4
B. IL-5
C. IL-10
D. IL-13
E. IL-12

Q113. Johne’s disease in sheep can have which of the following type of inflammation?

A. Lepromatous granulomatous
B. Eosinophilic granulomatous
C. Tuberculoid granulomatous
D. A and C only
E. All of the above

Q114. The strength and balance of Th-1 and Th-2 response can be regulated by?
A. Macrophages
B. Plasma cells
C. B-lymphocytes
D. α/β T-lymphocytes
E. Regulatory T- lymphocytes

Q115. Abscess formation occurs due to

A. Chronic inflammatory response failing to eliminate the inciting cause


B. Acute inflammatory response failing to eliminate the inciting cause
C. Excess recruitment of neutrophils to the site of inflammation
D. Action of the bacterial endotoxins
E. All the above

Q116. The sequence of events in TH1 immunological process

1. IL-12 acts on CD4 cells


2. Dendritic cells release IL-12
General pathology 2008-2009
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3. T lymphocytes produce IFN-γ and TNF-β
4. CD4 cells release IL-2 and increased T lymphocytes
5. IFN-γ and TNF-β activates macrophages (cellular response)

A. 2,1,4,3,5
B. 1,2,3,4,5
C. 2,1,3,4,5
D. 4,3,2,1,5
E. 4,2,3,1,5

Q117. The cytokine that plays an important role in fibrosis

A. TGF- β
B. IL-12
C. TNF
D. IL-2
E. IFN

Q118. Maturation of monocyte to macrophages requires stimulus by which of the


following cytokines

A. IFN-γ , TNF-β
B. IL-4, IL-13
C. IL-12
D. A&C
E. All

Q119. Which of the following is not characteristic of TH1-biased granulomas?

A. May be mineralized
B. Formation of nodular granulomas
C. Often contains central area of necrosis
D. Organisms not commonly detected with acid-fast stain
E. Typically seen with Johne’s disease (M. avium-intracellulare)

Q120. All of the following inhibit macrophages in chronic inflammation except…

A. Toll-like receptor binding


B. Macrophage phagocytosis of LDL’s
C. Macrophage phagocytosis of apoptotic bodies
D. Macrophage acetylcholine receptor activation
E. Peroxisome proliferator-activated receptor (PPAR) activation

Q121. Which type of lymphocyte has been shown to contribute to granuloma formation?

A. B lymphocytes
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B. γ/δ lymphocytes
C. α/β lymphocytes
D. Natural killer cells
E. T-regulatory lymphocytes

Q122. Which of the following is NOT a positive acute phase protein?

A. Albumin
B. Fibrinogen
C. Haptoglobin
D. Serum Amyloid A
E. C-reactive protein

ANSWERS:
1) D (Robbins pp 50)
2) D (Robbins pp 54)
3) E (Robbins pp 56)
4) E (Robbins pp 55-56)
5) A (Robbins pp 55)
6) C (PBVD pp 110-111)
7) D (Robbins pp 49) heat, swelling, pain, loss of function, redness are hallmarks of
acute inflammation
8) D (Robbins pp 50)
9) E (Robbins pp 50) Capillaries and venules are permeable to water in the resting
state. Fluid accumulation occurs due to increased hydrostatic pressure combined with
leakage of plasma proteins into tissues (increased vascular permeability) which
General pathology 2008-2009
Compiled by Bhupinder Bawa
lowers the oncotic pressure gradient that normally favors fluid movement back into
the venules.
10) E (PBVD p. 103) Bradykinin is involved in increasing vascular permeability and
causing pain. It does not cause vasodilation
11) A (PBVD p. 105)
12) E (Robbins pp50) In acute inflammation vasodilation is the result of arteriolar
dilation, opening of new capillary beds from the action of histamine and NO on
smooth muscle cells.
13) E (Robbins pp50) Binding of histamine and others substances to endothelial cells
of venules activates intracellular signaling pathways that result in the phosphorylation
and contraction of cytoskeletal proteins such as myosin which separates intercellular
junctions. This is short lived (15-30 minutes) and occurs rapidly. Cytokines such as
IL-1, TNF and IFN-γ produces a similar response but is delayed (4-6 hours after) and
long lived (last 24 hours).
14) A (Robbins pp54) P selectin was identified first in the secretory granules of
platelets, and then wsa found in secretory granules of endothelial cells called Weibel-
palade bodies.
15) E (Robbins pp54). VCAM is the ligand for the VLA-4 (β1) integrin and ICAM in
the ligand for LFA-1, and MAC (β2 integrins).
16) E (Robbins 51-52)
17) E (PBVD 110-112)
18) C (Robbins 54)
19) B (Robbins p. 49)
20) C (Robbins p. 50)
21) A (PBVD p.111)
22) B (PBVD p.114)
23) C (Robbins pp 50) except phosopholipase C the rest are plasma proteins which can coat
microbes and are recognized by phagocytes
24) B ( Robbins pp 61-62) H2O2-MPO-Halide is the most potent bactericidal and kills
bacteria by halogenation
25) E (Robbins pp 61-62) The gene associated with this syndrome encodes a large cytosolic
protein involoved in vesicular trafficing
26) D (PBVD pp 120) azurophils are primary granules and lactoferrin is present in specific or
secondary granules. Lactoferrin inhibits the growth of phagocytosed bacteria by
sequestering free iron.
27) C (PBVD pp 124)
28) D (Robbins P-57)
29) D (Robbins P-57)
30) D (Robbins P-59)
31) A (Robbins P-61)
32) B (Robbins p. 68)
33) E (Robbins p. 60)
34) D (Robbins 56)
35) D (Robbins 63)
36) C (PBVD 120)
37) E (Robbins 57-58)
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Compiled by Bhupinder Bawa
38) C (Robbins p. 59)
39) E (Robbins p. 57 and 59)
40) B (Robbins p. 63)
41) D (Robbins p. 61)
42) B (Robbins pg 56)
43) B (Robbins pBg 58)
44) B (Robbins pg 59)
45) A (Robbins pg 61)
46) B (PBVD pg 117)
47) E (PBVD pg 117)
48) D (PBVD pg 117)
49) D (PBVD pg 117)
50) C (PBVD pg 121)
51) D (Robbins pp 66) Plasmin activates complement activation system
52) E (Robbins pp 65-68) all these helps in activation of Hagemen factor
53) E (Robbins pp 67-68)All these can induce acute inflammation by activation of PAR-1
54) E (Robbins pp 65) Thrombin is the main link between coagulation system and
inflammation by binding to receptors called as protease activated receptors
expressed on platelets, endothelial cells and smooth muscle cells.
55) C (Robbins 65) kininase inactivates bradykinin
56) A (Robbins p 68) plasmin is capable of activating factor XIIa from XII
57) E (Robbins pp 66) C5 is part of the late complement activation
58) C (Robbins pp 66)
59) B (Robbins pp 64) C3b acts as opsonin
60) E. ( p64-66 Robbins) Both C5a and C3a cause the release of histamine from mast
cells, and C5a activates the lipoxygenase pathway (forming leukotirenes C,D,E) that
increase vascular permeability.
61) B (p 64-65 Robbins) several proteolytic enzymes in inflammatory exudate can
activate C5 and C3, including plasmin and lysosomal enzymes.
62) E (p68 Robbins) Activation of Hageman factor initiates the intrinsic clotting
cascade as well as activating the kinin cascade resulting in formation of Kallikrein
(activation of C5) Bradykinin (vascular permeability and vasodilation) and plasmin
(fibrinolysis and activation of C3 and C5). The clotting cascade results in the
formation of thrombin which in addition to activating fibrinogen also affects
endothelial cells and leukocytes.
63) B (Robbins P.64)
64) E (Robbins-P.65)
65) D (Robbins-P.65)
66) D (Robbins p.64)mannose-binding-lectin is involved with the lectin pathway to
directly activate C1
67) A (Robbins p.66) b (classical pathway C5 convertase), c (alternative pathway C3
convertase), d (alternative pathway C5 convertase), e (membrane attack complex)
68) E (Robbins p.68) all systems are initiated by factory XIIa
General pathology 2008-2009
Compiled by Bhupinder Bawa
69) A (Robbins pp 70) activated neutrophils generates LTB4 from AA by the action
of 5-lipoxygenase. LTB4 translocates to platelets which has 12-lipoxygenase to
convert LTB4 to Lipoxins
70) C (Robbins pp 68)
71) B. (Robbins pp 69) vasoconstriction and increased vascular permeability (LTC-
E4) stimulate neutrophil chemotaxis (LTB4), Inhibit neutrophils chemotaxis
(Lipoxins)
72) C (Robbins pp 71-72) C attracts lymphocytes, CC attracts monocytes, basophils,
eosinophils and lymphocytes but not neutrophils, CX3C attracts T-cell and
monocytes
73) E (Robbins pp 72-73) Nitric oxide reduces inflammatory responses
74) E(Robbins 69)
75) C (Robbins 71)
76) E (PBVD 129) (low levels of PAF cause vasodilation and increased permeability)
77) E
78) A (Robbins p. 69) – prostacyclin is produced by vascular endothelium and causes
vasodilation
79) C (Robbins p. 69)
80) A (PBVD p. 128) Lipoxin A4 causes vasodilation and dampens leukotriene-
induced vasoconstriction
81) E (PBVD p. 128) PAF enhances the neutrophil oxidative burst mechanism
82) C (Robbins p.69)
83) D (Robbins p. 69) Vasoconstrictors= TXA2, LTC4, LTD4, LTE4, and PAF
Vasodilators= PGI2, PGE1, PGE2 PGD2, LXA4, LXB4

84) A (Robbins p.71)


85) C (Robbins p.72) reduces platelet aggregation
86) C (Robbins pp 80)
87) D (Robbins pp 84) C-reactive protein and fibrinogen are stimulated by IL-6. SAA
is stimulated mainly by IL-1 and TNF
88) D (p80-81 Robbins). C5a is chemotactic, TNF and IL-1 are major products of
activated macrophages. IL-12 is produced by activated macrophages and activate T
Lymphocytes.
89) E (p81 Robbins). Necrotic tissue exposes basement membrane and collagen
which activates Hageman factor and leads to activation of Bradykinin, and the
coagulation cascade, which leads to thrombin and plasmin. Plasmin activates C3 and
HF, and Thrombin activates endothelium. Uric acid is chemotactic to leukocytes
which can further damage tissue and lead to more inflammation.
90) A (p 83 Robbins). IL-2 is produced by activated T lymphocytes which further
stimulates itself and other T lymphocytes
91) E (p 84 Robbins). Acute phase proteins bind chromatin helping to clear it away,
and replace apolipoprotein which may re-direct the targeting of high density
lipoproteins from liver cells to macrophages. IL-1 and TNF cause the accelerated
release of cells from BM.
92) C. (Robbins pp 80)
93) E. (Robbins pp 82)
General pathology 2008-2009
Compiled by Bhupinder Bawa
94) A (Robbins pp.84) Fibrinogen increases in response to an infection will facilitate
rouleaux formation and early sedimentation rate
95) A (Robbins p.79)
96) A (Robbins p.80) IL-1 is produced by macrophages
97) E (Robbins p.84) Fever is produced in response to exogenous (LPS) or
endogenous (IL-1 and TNF) pyogens that act by stimulating prostaglandin synthesis
in the hypothalamus
98) E (Robbins p.84)
99) C (Robbins 79)
100) E (Robbins 80)
101) E (Robbins 83)
102) C (PBVD pp 137)
103) E (p 136 fig 3-18 PBVD). LPS bound to LPSbp attach to TLR4 and with the help
of CD14 and MD-2 and can involve MyD88 leading to NFκB activation.
104) B (p137 table 3-11 PBVD). Α-Defensin can induce IL-8 production and indirectly
attract neutrophils
105) D (p 137 table 3-11 PBVD). Surfactant proteins are produced by epithelial cells.
Mannose binding proteins are produced by the liver and are found in serum. Their
function is to opsonize pathogens and macrophage activation
106) E (PBVD pp 139)
107) B (PBVD p.139)
108) C (PBVD p. 140-142)
109) D (PBVD pp 155-156)
110) A (PBVD pp 155-157) macrophages are the predominant cell type presenting
antigen to memory CD4+ lymphocytes
111) B (PBVD pp 157)
112) E (PBVD pp 158) IL-12 induce commitment to Th1 pathway the rest inhibit it.
113) D Johne’s diseae in sheep have both paucibacillary form (tuberculoid form) with
few bacteria and multibacillary form (lepromatous) form with abundant macrophages
containing Mycobacterium.
114) E
115) B (P.156)
116) A (P.157)
117) A (P. 156 &160)
118) E (P.167) A, C-Classic activation (TH1 response), B-Alternate activation (TH2 response)
119) E (PBVD p. 160)
120) A (PBVD p. 162)
121) B (PBVD p. 172)
122) A (PBVD pp 137) albumin is a negative APP

Robbins chapter 2
BGC

1. Acute inflammation is characterized by which of the following:


1. Short duration
2. Fluid exudation
General pathology 2008-2009
Compiled by Bhupinder Bawa
3. Protein leakage
4. emigration of tneutrophils
5. Proliferation of blood vessels

A. 1,2,3,4,5
B. 1.2.3.4
C. 1,2,3
D. 2,4,5
E. 3,4,5

Answer: B p49

2. Chronic Inflammation is characterized by which of the following?

1. necrosis
2. Tissue fibrosis
3. Blood vessels proliferation
4. The presence of lymphocytes, macrophages and neutrophils

A. 1.2,3,4
B. 1,2,3
C. 2,3,4
D. 2,3
E. 2

Answer: B p49 yes in chronic active inflammation there will be neutrophils

3. Vascular leakage by endothelial gaps in venules is mediated by which of the


following?
A. Substance P
B. Bradykinin
C. IL-1
D. IFN-γ
E. All of the Above

Answer: E pp50-51

4. Delayed prolonged leakage of venules and capillaries can be caused by which of the
following?

1. Mechanical trauma
2. Bacterial toxins
3. Thermal injury
4. UV radiation
5. X-ray
.
General pathology 2008-2009
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A. 1,2,3,4,5
B. 2,3,4,5
C. 3,4,5
D. 4,5
E. 5

Answer: B p52

5. Which of the following growth factors and cytokines causes increased transcytosis
through vesicular vacuolar organelles in vascular endothelium?

A. FGF
B. IL-1
C. VEGF
D. TNF-alpha
E. IFN-gamma

Answer: C p52

6. Leukocyte adhesion molecule Sialyl-lewis X binds to which of the following


endothelial molecules?

1. P-selectin
2. E-selectin
3. CD62E
4. ELAM-1
5. CD62P

A. 1,2
B. 1,2,3,4,5
C. 3,4,5
D. 3,4
E. 4,5

Answer: B p55. CD62E is E selectin, Cd62P is P selectin, and ELAM 1 is one of them
also- they are all synonyms

7. Weibel-Palade bodies are…?


A. Found in platelets and contain P-selectin
B. Found in endothelial cells and contain E-selectin
C. Found in endothelial cells and contain P-selectin
D. Found in leukocytes and contain various cytokines
E. None of the above

Answer: C p54 Platelets contain P selectin in alpha granules.


General pathology 2008-2009
Compiled by Bhupinder Bawa
8. Firm adhesion of leukocytes to endothelium are the result of which of the following?
1. TNF and IL-1 induced expression of integrins VCAM-1 and ICAM-1 on endothelial
cells
2. Chemokine induced expression of high affinity integrins in leukocytes
3. Chemokine induced expression of VLA-4 and LFA-1 in leukocytes
4. Chemokine induced expression of CD26L in lymphocytes
5. Chemokine induced expression of P-selectins

A. 1,2,3,4,5
B. 1,2,3
C. 2,3,4,5
D. 2,3
E. 3,4,5

Answer: B p54

9. Functions of the compliment system include which of the following:

1. chemotaxis
2. opsonization
3. lysis of microbes
4. activation of leukocytes
5. increased vascular permeability

A. 1,2,3
B. 1,2,3,5
C. 1,2,3,4,5
D. 2,3,5
E. 3,4,5

Answer: C p64

10. Which of the following statements about Hageman factor is false?

A. It begins the fibrinolytic system by activating kallikrein


B. It is activated by contact with collagen, and platelets.
C. It initiates the extrinsic coagulation pathway
D. It converts prekallikrein to kallikrein
E. It converts factor XI to factor Xia

Answer: C p67

11. The clotting system intersects with the inflammatory cascade in all of the following
ways except:
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A. Thrombin causes mobilization of P-selectin and production of chemokines
B. It causes induction of COX-2 and production of prostoglandins
C. Activated Hageman factor initiates the kinin system
D. Thrombin binds to protease-activated receptors
E. Thrombin converts C3 to C3a

Answer: E pp66-68

12. Arachidonic acid metabololites responsible for vasoconstriction include all of the
following except?
A. Thromboxane A2
B. LTC4
C. LTD4
D. LTB4
E. None of the above

Answer: D p69

13. Eicosnaoids that cause increased vascular permeanility include all of the following
except:
A. LTB4
B. LTC4
C. LTD4
D. LTE4
E. None of the above

Answer: A p69 table 2A

14. All of the following statements about Lipoxins are true EXCEPT:
A. Lipoxins are generated by platelets from Leukotrienes
B. Contact between neutrophils and platelets are involved
C. 12-lipoxygenase converts LTA4 to lipoxin
D. Lipoxins inhibit leukocyte recruitment
E. None of the above

Answer: E p70

15. Which of the following cells do NOT produce PAF?


A. Basophils
B. Neutrophils
C. Lymphocytes
D. Macrophages
E. Endothelial cells

Answer: C p70
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Compiled by Bhupinder Bawa
16. Which of the following are not functions of PAF?
A. Vasoconstriction
B. Bronchoconstriction
C. Increased venular permeability
D. Vasodilation
E. None of the above

Answer: E. p70 At very low concentrations it causes vasodilation and increased venular
permeability

17. Which of the following are NOT functions of PAF?


A. Increased leukocyte adhesion to endothelium
B. Oxidative burst
C. Degranulation
D. Chemotaxis
E. None of the above

Answer: E p70

18. Endothelial activation by TNF and IL-1 cause which of the following effects?
A. induce endothelial adhesion molecules
B. Increasing the surface thrombogenicity of endothelium
C. Production of enzymes associated with remodeling
D. Induction of NO and eicosanoids
E. All of the above

Answer: E. p71

19. The acute phase response produced by IL-1, TNF and IL-6 include which of the
following:
A. Fever
B. Loss of eappetite
C. Release of neutrophils
D. Corticotropin and Corticosteroid release
E. All of the above

20. C-X-C chemokines act primarily on which type of cell


A. Lymphocytes
B. Neutrophils
C. Eosinophils
D. Monocytes
E. All of the above

Answer: B Il-8 is secreted by activated macrophages and endothelial cells and causes
activation and chemotaxis of neutrophils with limited activity on monocytes and
eosinophils
General pathology 2008-2009
Compiled by Bhupinder Bawa

21. C-C chemokines include all of the following except?


A. Macrophage inflammatory protein-1 alpha
B. Monocyte chemoattractant protein
C. Fractalkine
D. RANTES
E. Eotaxin

Answer C: p 72 Fractalkine is a CX,C chemokine. It exists in a surface bound form and


promotes strong adhesion between monocytes and endothelium, and a soluble form that
has potent chemoattractant activity.

22. All of the following is true of eNOS except?


A. NO is synthesized by L-arginine by eNOS
B. eNOS is constitutively expressed
C. Can be activated rapidly by increased intracellular calcium
D. eNOS is induced when macrophages are activated by TNF and IFN-gamma
E. None of the above

Answer: D p72, iNOS is inducible by TNF and IFN-y

23. All of the following are true about the functions of NO except?

A. Reduces platelet aggregation and adhesion


B. Overproduction of NO occurs in diabetes
C. Reduces leukocyte rolling and adhesion
D. Inhibits mast cell induced inflammation
E. No is microbicidal

Answer: B. p73

24. Neutrophils contain both specific granules and azurophil granules. Which of them is
potentially more destructive if released extacellularly?

Answer: Azurophil granules p73. S[ecific granules are secreted extracellularly more
readily and by lower concentrations of agonists

25. Which of the following are serum antiproteases that limit neutrophil destructivity?

1. alpha-2 macroglobulin
2. alpha-1 antielastase
3. alpha-1 antitrypsin
4. Myeloperoxidase
General pathology 2008-2009
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A. 1,2
B. 1,3
C. 2,3
D. 2,4
E. None of the above

Answer: B p73

26. Effects of oxygen derived free radicals include:


1. Combining with NO to form reactive nitrogen intermediates
2. Inactivation if alpha-1 antitrypsin
3. Increase expression if IL-8
4. Endothelial cell damage
5. vasoconstriction

A. 1,2,3,4,5
B. 1,2,3,4
C. 2,3,4,5
D. 2,3,4
E. 3,4

Answer: B 73-74

27. Which of the following can induce a chronic inflammatory response?


1. Treponema pallidum
2. Autoimmune disease
3. Particulate silica
4. Septicemia
5. Fungi

A. 1,2,3,4,5
B. 1,2,3,5
C. 1,3,5
D. 2,3,5
E. 3,4,5

Answer: B p79

28. Which of the following are chemotactic for monocytes?


1. fibronectin
2. TGF-alpha
3. MCP-1
4. PDGF
5. C5a
6. C3a
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A. 1,2,3,4,5,6
B. 1,2,3,4,5
C. 1,2,3
D. 2,3,4,5
E. 2,3,4,5,6

Answer: B p80

29. In severe bacterial sepsis, the combination of which two substances cause DIC by
inducing tissue factor?
A. LPS and IL-1
B. LPS and TNF
C. LPS and C3b
D. TNF and IL-1
E. None of the above

Answer B p85

30. . In severe bacterial sepsis, the combination of which two substances cause DIC by
inhibitng Tissue factor pathway inhibitor and endothelial cell thrombomodulin?
A. LPS and IL-1
B. LPS and TNF
C. LPS and C3b
D. TNF and IL-1
E. None of the above

Answer B p85

31. Which of the following are involved in septic shock?


1. DIC
2. Hypoglycemia
3. Hemodynamic shock
4. Overproduction of NO
5. Adult respiratory distress syndrome

A. 1,2,3,4,5
B. 1,2,3,4
C. 1,3,4
D. 1,2,4,5
E. 2,3,4

Answer: B p85

Robbins Ch 2
General pathology 2008-2009
Compiled by Bhupinder Bawa
137) Which of the following are preformed chemical mediators of inflammation?

1. serotonin
2. histamine
3. leukotrienes
4. prostaglandins
5. lysosomal enzymes

A. 1,2,3
B. 1,2,4
C. 1,2,5
D. 1,2,3,4
E. 1,2,3,4,5

138) Which of the following can be directly triggered by plasmin?

1. lysis of fibrin clots


2. C3 fragment production
3. activation of fibrinolytic system
4. activation of complement cascade
5. activation of Hageman factor (Factor XII)

A. 1,2,3
B. 1,2,5
C. 1,2,3,4
D. 1,2,3,5
E. 1,2,3,4,5

139) Leukocyte adhesion deficiency type 1 can result in dysfunction of

A) CD11a/CD18
B) CD11b/CD18
C) CD11c/CD18
D) A and B
E) All

140) Leukocyte adhesion deficiency type 2 is a result of

A) Defect in fucosyl transferase


B) Absence of P-selectin
C) Absence of L-selectin
D) Absence of E-selectin
E) All the above

141) Which of the following are characteristics of an exudate?


a. Low protein content
General pathology 2008-2009
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b.High protein content
c.Specific gravity of less than 1.012
d.Cellular debris
e.Specific gravity of over 1.020
a. A, C
b. B, E
c. B, D, E
d. B, D
e. D only
142) Which is a mediator involved in the formation of endothelial gaps in acute
inflammation?
f. Histamine
g. Leukotrienes
h. Bradykinin
i. Neuropeptide substance P
j. All of the above

143) A molecule that plays a key role in leukocyte rolling is?


k. E-selectin
l. ICAM-1
m. PECAM-1
n. All of the above
o. None of the above

144) The following are the ligands for the G-protein coupled receptors

1) Complement breakdown products


2) N-formyl methionyl peptides
3) Lipopolysaccharide
4) Lipid mediators
5) Chemokines

A) 1, 2, 3, 4, 5
B) 1, 2, 4, 5
C) 2, 4, 5
D) 1, 2, 4
E) 5

145) Mannose receptors on macrophages recognize these terminal residues on


glycoproteins and glycolipids of bacteria

1) Fucose
2) Mannose
3) Sialic acid
4) N-acetyl-galactosamine
General pathology 2008-2009
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A) 1, 2, 3, 4
B) 1, 2, 3
C) 1, 2
D) 2, 3
E) 2

146) Major opsonins include

1) C3b
2) C5a
3) IgG
4) IgA
5) Mannose binding lectin

A) 1, 2, 3, 4, 5
B) 1, 2, 3, 4
C) 1, 2, 3
D) 1, 3, 5
E) 2, 3, 5

147) The most efficient bactericidal system in neutrophils involves


A) Bactericidal permeability increasing protein
B) H2O2-MPO-halide system
C) Major basic protein
D) NADPH oxidase
E) Defensins

148) The basic defect in Chediak-Higashi syndrome is

A) NADPH oxidase
B) Fucosyl transferase
C) MPO-H2O2 system
D) Decreased oxidative burst
E) Defective protein involved in organelle membrane docking and fusion

149) The following chemical mediators of inflammation are present/produced in platelets

1) Histamine
2) Seratonin
3) Prostaglandins
4) Platelet activating factor

A) 1, 2, 3, 4
B) 1, 2, 3
C) 1, 2, 4
D) 1, 2
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Compiled by Bhupinder Bawa
E) 1

150) The following are chemotactic for eosinophils

1) Histamine
2) RANTES
3) Eotaxin
4) C5a
5) IL5

A) 1, 2, 3, 4, 5
B) 1, 2, 3, 5
C) 3, 5
D) 3
E) 5

151) Chemicals/molecules considered endogenous chemoattractants include which of the


following?
a. Components of the complement system
b. Products of the lipoxygenase pathway
c. Cytokines
d. All of the above
e. None of the above
152) Microbial killing by oxygen dependent mechanisms to produce reactive oxygen
intermediates is initiated by what enzyme?
f. Superoxide dismutase
g. Myeloperoxidase
h. NADPH oxidase
i. Catalase
j. None of the above

153) Which of the following is not an oxygen independent mechanism of microbial


killing?
k. Hypochlorite
l. Defensins
m. Major basic protein
n. Lysozyme
o. Lactoferrin
154) All of the following are present in eosinophil large specific granules except?
p. Major basic protein
q. Collagenase
r. Eosinophilic cationic protein
s. Eosinophil peroxidase
t. Eosinophil-derived neurotoxin
General pathology 2008-2009
Compiled by Bhupinder Bawa
155) Primary granules of neutrophils contain which of the following?
u. Myeloperoxidase
v. Defensins
w. Elastase
x. Lysozyme
y. All of the above

156) Morphologic characteristics of Bovine Leukocyte Adhesion deficiency include:


1. oral ulcers
2. Intestinal mucosal ulcers
3. thickened intestinal serosa
4. Lack of neutrophils in spleen
5. Lack of leukocytes in peyers patches

A. 1,2,3,4,5
B. 1,3,4
C. 1,2,3
D. 2,3
E. 4,5

157) Use of a leukocyte migration inhibitors as a therapeutic strategy for Mannheimia


pneumonia makes sense because…
A. Alveolar migration of leukocytes via selectin is inhibited
B. Bronchiolar migration of leukocytes via Beta-2 integrins is inhibited
C. such a strategy would prevent excessive leukocyte infiltration into the lung
D. All of the above
E. None of the above

158) Which of the following statements is true regarding basophils and mast cells?
1. Fibroblasts and endothelial cells produce a glycoprotein that induces
CD34+ cells to mature.
2. Basophils and mast cells are derived form different stem cell lines
3. They arise from a common CD34+ progenitor in bone marrow
4. Basophils later differentiate into tissue mast cells
5. Differentiation is dependent on stem cell factor

A. 1,3,5
B. 1,3,4
C. 2,3,4
D. 3,4,5
E. 4,5

159) Mast cell degranulation releases which of the following substances in rodents?
A. TNF-alpha
B. Proteases
C. Serotonin
General pathology 2008-2009
Compiled by Bhupinder Bawa
D. tryptase
E. All of the above

160) Acute inflammation is characterized by which of the following:


1. Short duration
2. Fluid exudation
3. Protein leakage
4. emigration of neutrophils
5. Proliferation of blood vessels

A. 1,2,3,4,5
B. 1.2.3.4
C. 1,2,3
D. 2,4,5
E. 3,4,5

161) Chronic Inflammation is characterized by which of the following?


1. necrosis
2. Tissue fibrosis
3. Blood vessels proliferation
4. The presence of lymphocytes, macrophages and neutrophils

A. 1.2,3,4
B. 1,2,3
C. 2,3,4
D. 2,3
E. 2

162) Vascular leakage by endothelial gaps in venules is mediated by which of the


following?
A. Substance P
B. Bradykinin
C. IL-1
D. IFN-gamma
E. All of the Above

163) Delayed prolonged leakage of venules and capillaries can be caused by which of the
following?

1. Mechanical trauma
2. Bacterial toxins
3. Thermal injury
4. UV radiation
5. X-ray
.
A. 1,2,3,4,5
General pathology 2008-2009
Compiled by Bhupinder Bawa
B. 2,3,4,5
C. 3,4,5
D. 4,5
E. 5

164) 5. Which of the following growth factors and cytokines causes increased
transcytosis through vesicular vacuolar organelles in vascular endothelium?

A. FGF
B. IL-1
C. VEGF
D. TNF-alpha
E. IFN-gamma

165) Leukocyte adhesion molecule Sialyl-lewis X binds to which of the following


endothelial molecules?

1. P-selectin
2. E-selectin
3. CD62E
4. ELAM-1
5. CD62P

A. 1,2
B. 1,2,3,4,5
C. 3,4,5
D. 3,4
E. 4,5

166) Weibel-Palade bodies are…?


A. Found in platelets and contain P-selectin
B. Found in endothelial cells and contain E-selectin
C. Found in endothelial cells and contain P-selectin
D. Found in leukocytes and contain various cytokines
E. None of the above

167) Firm adhesion of leukocytes to endothelium are the result of which of the
following?
1. TNF and IL-1 induced expression of integrins VCAM-1 and ICAM-1 on endothelial
cells
2. Chemokine induced expression of high affinity integrins in leukocytes
3. Chemokine induced expression of VLA-4 and LFA-1 in leukocytes
4. Chemokine induced expression of CD26L in lymphocytes
5. Chemokine induced expression of P-selectins

A. 1,2,3,4,5
General pathology 2008-2009
Compiled by Bhupinder Bawa
B. 1,2,3
C. 2,3,4,5
D. 2,3
E. 3,4,5

168) Which of the following cells are sources of histamine? (p. 63)
1) platelets
2) basophils
3) mast cells
4) eosinophils
5) endothelial cells

A) 1, 2, 3
B) 1, 3, 5
C) 2, 3, 4
D) 2, 3, 5
E) 3, 4, 5

169) Which one of the following is not a characteristic of Chediak-Higashi syndrome?


(p. 61-62)
A) neutropenia
B) platelet abnormalities
C) delayed microbial killing
D) giant granules in leukocytes
E) defective neutrophil chemotaxis

170) Which one of the following is not able to initiate the alternative pathway of the
complement cascade? (PBVD p. 124)
A) plasmin
B) antibody
C) kallikrein
D) lipopolysaccharide
E) activated factor XII

171) Which one of the following components of the complement cascade acts as an
opsonin? (PBVD p. 124)
A) C3a
B) C3b
C) C5a
D) C5b
E) C4

172) The following complement components act as opsonins

A) Inactive C3b (iC3b)


B) C3b
General pathology 2008-2009
Compiled by Bhupinder Bawa
C) C3a
D) A and B
E) All

173) The following protein regulates regulate complement activation by inhibiting


formation of membrane attack complex

A) CD59
B) CD49
C) CD39
D) CD51
E) CD61

174) Kallikrein is involved in conversion of

A) High-molecular weight kininogen to bradykinin


B) Plasminogen to plasmin
C) Factor XII to XIIa
D) C5 to C5a
E) All

175) Which of the following are the major effects of leukotrienes? (PBVD p. 128)
1) vasodilation
2) vasoconstriction
3) leukocyte chemotaxis
4) complement activation
5) increased vascular permeability

A) 1, 2, 3
B) 1, 3, 4
C) 1, 4, 5
D) 2, 3, 4
E) 2, 3, 5

176) Which one of the following eicosanoids causes vasoconstriction and increased
vascular permeability? (p. 69)
A) lipoxin A4
B) prostacyclin
C) leukotriene C4
D) thromboxane A2
E) prostaglandin E2

177) Which of the following statements about prostacyclin (PGI2) is incorrect? (p 68)

A) it is a vasodilator
B) it acts as chemotaxin
General pathology 2008-2009
Compiled by Bhupinder Bawa
C) it is formed in vascular endothelium
D) it is a potent inhibitor of platelet aggregation
E) it potentiates the permeability-increasing and chemotactic effects of other mediators

178) Il-1 and TNF can mediate which of the following effects? (p 71)

1) Fever
2) Reduced appetite
3) Collagen synthesis
4) Increased procoagulant activity
5) Increased leukocyte adherence to endothelium

A) 1, 2, 3
B) 1, 2, 4
C) 1, 2, 4, 5
D) 1, 2, 5
E) 1, 2, 3, 4, 5

179) C-X-C chemokines are primarily chemoattractants for which leukocyte? (p 71)

A) Monocytes
B) Eosinophils
C) Neutrophils
D) Mast cells
E) Lymphocytes

180) All the following eicosanoids cause vasoconstriction except,

A) Leukotrien C4
B) Leukotrien D4
C) Leukotrien E4
D) Prostaglandin E2
E) Thromboxane A2

181) All the following eicosanoids cause vasodilatation except,

A) PGI2
B) PGE1
C) PGE2
D) PGD2
E) LTB4

182) All the following eicosanoids increase vascular permeability except,

A) LTB4
B) LTC4
General pathology 2008-2009
Compiled by Bhupinder Bawa
C) LTD4
D) LTE4
E) PGD2

183) All the following are produced in neutrophils except,

A) LTA4
B) LTB4
C) LTC4
D) TNF
E) Platelet activating factor

184) The following are true regarding primary granules of neutrophils except,

A) Contain defensins
B) Contain lysozymes
C) Are peroxidase-negative
D) Contain bactericidal permeability increasing protein
E) Requires high levels of agonists for their extracellular release

185) The major prostanoid produced by mast cells is

A) PGD2
B) PGE2
C) PGI2
D) PGF2
E) TXA2

186) Action of phospholipase A on omega 3 fatty acids results in the following

1) Thromboxane A2
2) Thromboxane A3
3) Leukotriene B4
4) Leukotriene B5

A) 1, 2, 3, 4
B) 1, 2
C) 3, 4
D) 1, 3
E) 2, 4

187) The following enzymes are involved in synthesis of platelet activating factor from
lipid membranes

A) PAF-synthesizing phosphocholinetransferase
B) LysoPAF acetyltransferase
General pathology 2008-2009
Compiled by Bhupinder Bawa
C) PAF acetylhydrolase
D) A, B & C
E) A & B

188) Important products of the cycloxygenase pathway include which of the following?
a. Thromboxane
b. Prostacyclin
c. Leukotrienes
d. Lipoxin
e. Prostaglandins
a. A, B, C
b. A, B , D
c. A, B, E
d. A and B only
e. C and D only

189) Prostacyclin performs which of the following action (s)?


f. Vasodilation
g. Inhibitor of platelet aggregation
h. Potentiates increased permeability by other factors
i. Potentiates increased chemotaxis by other factors
j. All of the above

190) Two major cytokines that mediate inflammation are?


k. IL-1, TNF-alpha
l. IL-1, PAF
m. IL-1, RANTES
n. PAF, TNF-alpha
o. None of the above

191) MCP-1, eotaxin, macrophage inflammatory protein-1alpha, and RANTES belong to


what chemokine family?
p. C-X-C chemokines
q. C-C chemokines
r. C chemokines
s. CX3C chemokines
t. None of the above

192) Which of the following may be caused by platelet activating factor?

1. vasodilation
2. vasoconstriction
3. bronchoconstriction
4. increased chemotaxis
5. increased leukocyte adhesion
General pathology 2008-2009
Compiled by Bhupinder Bawa
A. 1,2,3
B. 2,3,4
C. 2,3,5
D. 1,3,4,5
E. 1,2,3,4,5

193) Chronic inflammation is characterized by which of the following? (p79)

1) Tissue destruction
2) Formation of edema
3) Infiltration with mononuclear cells
4) Infiltration with predominantly neutrophils
5) Attempts at healing by connective tissue replacement of damaged tissue

A) 1, 2, 3
B) 1, 2, 3, 4, 5
C) 1, 2, 3, 5
D) 1, 3, 5
E) 3, 5

194) Activation of macrophages results in the following changes EXCEPT: (p80)

A) Increased cell size


B) More active metabolism
C) Increased levels of lysosomal enzymes
D) Increased macrophage secretion of IFN-γ
E) Greater ability to phagocytose and kill ingested microbes

195) Which of the following is least likely to induce a granulomatous inflammatory


reaction?

A. Rhodococcus equi
B. Hairy vetch toxicosis
C. Porcine circovirus type 2
D. Malignant catarrhal fever (ovine herpesvirus 2)
E. Mycobacterium avium-intracellulare paratuberculosis

196) Which of the following products produced by activated macrophages can contribute
to the development of fibrosis? (p. 80)
1) IFN-γ
2) fibronectin
3) fibroblast growth factor
4) transforming growth factor β
5) platelet-derived growth factor

A) 1, 2, 3
General pathology 2008-2009
Compiled by Bhupinder Bawa
B) 1, 3, 5
C) 2, 3, 4
D) 2, 4, 5
E) 3, 4, 5

197) Which one of the following is NOT a positive acute phase protein? (p. 84, FVCP p.
260-261)
A) transferrin
B) fibrinogen
C) haptoglobin
D) serum amyloid A
E) C-reactive protein

198) Progression to chronic/granulomatous inflammation is characterized by? (PBVD


p155-156)

1) Extensive tissue injury and necrosis


2) Persistence of the inciting stimulus for weeks to months
3) Extensive connective tissue reorganization followed by fibrosis
4) Shift of the cellular elements from neutrophils to lymphocytes and macrophages

A) 1, 2, 3
B) 1, 2, 4
C) 1, 3, 4
D) 1, 2, 3, 4

199) TH1 immunologic responses often occur in response to? (PBVD p157)

1) Asthma
2) Foreign bodies
3) Mycobacterium spp
4) Histoplasma capsulatum
5) Endogenous antigens such as myelin basic protein

A) 1, 2, 3
B) 1, 3, 4, 5
C) 2, 3, 4
D) 2, 3, 4, 5
E) 1, 2, 3, 4, 5

200) Predominantly TH1 type of immunologic response is observed in response to the


following stimuli except,

A) Allergen
B) Foreign bodies
C) Myelin basic protein
General pathology 2008-2009
Compiled by Bhupinder Bawa
D) Mycobacterium bovis
E) Listeria monocytogenes

201) The following cytokines are associated with TH2 type immunologic response
except,

A) IL 4
B) IL 5
C) IL 10
D) IL 12
E) IL 13

202) The following molecules play a role in fibrosis

1) Polyamines
2) Citrulline
3) Proline
4) TGF-β
5) IL-13

A) 1, 2, 3, 4, 5
B) 1, 3, 4, 5
C) 2, 3, 4, 5
D) 3, 4, 5
E) 3, 4

September 13, 2005


Robbins Chap2, page 48-56
Kei K.

An exudate has a specific gravity above:

a. 1.002
b. 1.008
c. 1.012
d. 1.016
e. 1.020

(Answer e page 49)

A transudate has a specific gravity less than:

a. 1.002
b. 1.008
c. 1.012
General pathology 2008-2009
Compiled by Bhupinder Bawa
d. 1.016
e. 1.020

(Answer c page 49)

Normal hydrostatic pressure at the arterial end of a capillary bed is:

a. 12 mm Hg
b. 20 mm Hg
c. 25 mm Hg
d. 32 mm Hg
e. 50 mm Hg

(Answer d page 51, fig 2-3)

All of the following exclusively increase vascular permeability in venules, EXCEPT:

a. Sunburn
b. Histamine
c. Bradykinin
d. Leukotrienes
e. Neuropeptide substance P

(Answer a ref. Page 51, fig 2-4)

Which of the following endothelial molecule binds with the leukocyte receptor
CD11/CD18?

a. ICAM-1
b. PECAM
c. VCAM-1
d. P-selectin
e. E-selectin

(Answer a ref. page 54, table 2-1)

Which of the following endothelial molecule is a homophilic adhesion molecule involved


in the leukocyte migration?

a. CD31
b. ICAM-1
c. VCAM-1
d. P-selectin
e. GlyCam-1
General pathology 2008-2009
Compiled by Bhupinder Bawa

(Answer a ref. page 54, table 2-1)

Which of the following endothelial molecule is found in Weibel-Palade bodies?

a. ICAM-1
b. VCAM-1
c. P-selectin
d. E-selectin
e. GlyCam-1

(Answer c ref. page 55, Box 2-1)

(KK) Memo:
• CD11b CD18 (Mac-1) mediate leukocyte attachment to endothelium and
subsequent extravasation and also functions as a fibrinogen receptor and as a
complement receptor on phagocytic cells
• CD11a CD18 (LFA-1, leukocyte function-associated antigen-1) plays an
important role in the adhesion of lymphocytes and other leukocytes with other
cells
• CD11c CD18 (CR4) mediate leukocyte attachment to endothelium and
subsequent extravasation

L-selectin (expressed on most leukocytes) can be bound by which of the following


endothelial cell ligands?

1. MadCam-1 (mucosal addressin cell adhesion molecule)


2. GlyCam-1 (glycan-bearing cell adhesion molecule)
3. VCAM-1
General pathology 2008-2009
Compiled by Bhupinder Bawa
4. CD34
5. CD31

(Answer 1, 3, 4 ref. page 55, Box 2-1. CD31: ligand for CD31, homophilic
adhesion molecules. VCAM-1 (vascular cell adhesion molecule): ligand for VLA-4
(α4β1) integrin.

Ligand binding by selectin is:

a. Zinc dependent
b. Sodium dependent
c. Calcium dependent
d. Potassium dependent

(Answer c ref. page 55, Box 2-1)

Which of the following mediator increases extravasation through increasing the number
of vesiculovacuolar organelles?

a. IGF-1
b. VEGF
c. Bradykinin
d. Leukotrienes
e. Neuropeptide substance P

(Answer b ref. Page 52)

Which of the following is false concerning increased vascular permeability?

A. TNF may cause reorganization of the cytoskeleton in an endothelial cell.


B. Endothelial cells may contract as a result histamine binding to its receptor.
C. New blood vessels remain leaky until their endothelial cells have matured.
D. In the immediate sustained response all levels of the vasculature are affected.
E. Proteolytic enzymes released from activated leukocytes may cause increased
transcytosis.

Answer: E pg 50-52

Which of the following endothelial molecules play a role in leukocyte adhesion?

1. ICAM-1
2. PECAM
General pathology 2008-2009
Compiled by Bhupinder Bawa
3. VCAM-1
4. P-selectin
5. E-selectin

A. 1,2,3
B. 1,3,5
C. 2,3,4
D. 2,3,5
E. 3,4,5

Answer: B pg 54 Table 2-1

Which of the following is false concerning phagocytosis?

A. Recognition and attachment is the first step in the process.


B. The phagolysosome is formed during killing and degradation.
C. The optimal pH for enzyme action in the phagolysosome is 4-5.
D. Microbial killing may be oxygen-dependent or oxygen-independent.
E. Mannose and scavenger receptors function to bind and ingest microbes.

Answer: B pg. 59-61

Which of the following may stimulate mast cell degranulation?

1. C3a
2. IL-8
3. heat
4. substance P
5. histamine-releasing proteins

A. 1,2,3
B. 2,3,4
C. 3,4,5
D. 1,3,4,5
E. 1,2,3,4,5

Answer: E pg. 63-64

(KK) All of the followings are actin-regulating proteins interact with actin in the
filopodium, EXCEPT:
General pathology 2008-2009
Compiled by Bhupinder Bawa
a. Profilin
b. Filamin
c. Gelsolin
d. Lipophilin
e. Calmodulin

(Answer d ref. page 57)

(KK) Which of the following is the chief source of cytokines in inflammation?

a. Activated mast cells


b. Activated eosinophils
c. Activated neutrophils
d. Activated lymphocytes
e. Activated macrophages

(Answer e ref. page 57)

(KK) Which of the following receptor on leukocytes recognizes N-formylmethionyl


peptides?

a. Integrin
b. Toll-like receptor
c. Mannose receptor
d. Scavenger receptor
e. Seven α-helical transmembrane receptor

(Answer e ref. page 58)

(KK) Which of the following are receptors on macrophages to bind microbe for
phagocytosis?

1. Mac-1
2. Toll-like receptor
General pathology 2008-2009
Compiled by Bhupinder Bawa
3. Mannose receptor
4. Scavenger receptor
5. Seven α-helical transmembrane receptor

a. 1, 2, 3
b. 1, 3, 4
c. 1, 4, 5
d. 2, 3, 4
e. 3, 4, 5

(Answer b ref. page 59 & fig. 2-11)

(KK) Which of the following is the most efficient bactericidal system in neutrophils?

a. Defensins
b. Lysozyme
c. Lactoferrin
d. Halogenation
e. Permeability increasing protein

(Answer d page 61)

September 27, 2005


Robbins Chap 2 page 64-68
Kei K.

Which of the following fragments of complement systems are anaphylatoxins?

1. C3a
2. C3b
3. C4a
4. C5a
5. C5b

a. 1, 2, 3
b. 1, 3, 4
c. 1, 4, 5
d. 2, 3, 5
e. 3, 4, 5

(Answer b ref. page 64)

Which of the following act as an opsonin when fixed to the bacterial cell wall?
General pathology 2008-2009
Compiled by Bhupinder Bawa
a. C3a
b. C3b
c. C4a
d. C5a
e. C5b

(Answer b ref, page 64)

Kinin is inactivated by angiotensinconverting enzyme chiefly passage through which of


the following organ?

a. Lung
b. Liver
c. Heart
d. Spleen
e. Kidney

(Answer a ref. page 65)

All of the following are functions of kallikrein, EXCEPT:

a. Activates Hageman factor


b. Converts C5 to produce C5a
c. Converts factor XI to produce XIa
d. Cleaves HMWK to produce bradykinin
e. Cleaves plasminogen to generate plasmin

(Answer c ref. page 65)

Which of the following complement proteins are defective in systemic lupus


erythematosus?

1. C1
2. C2
3. C3
4. C4
5. C5

a. 1, 3
b. 1, 4
c. 2, 4
General pathology 2008-2009
Compiled by Bhupinder Bawa
d. 2, 5
e. 3, 5

(Answer c ref. page 67, Box 2-2)

October 4, 2005
Robbins Chap 2 page 68-75
Kei K.

Which of the following is the major source of thromboxane synthetase?

a. Platelets
b. Neutrophils
c. Macrophages
d. Lymphocytes
e. Vascular endothelium

(Answer a ref. page 68)

All of the following eicosanoids cause vasodilation, EXCEPT:

a. PGI2
b. TxA2
c. PGE2
d. PGD2
e. PGF2α

(Answer b ref. page 69, Table 2-4)

Which of the following eicosanoids inhibits neutrophil chemotaxis and adhesion to


endothelium?

a. PGI2
b. TxA2
c. PGE2
d. LTC4
f. Lipoxin

(Answer e ref. page 69, Table 2-4)

Which of the following is a C-X-C chemokine?

a. IL-18
b. MCP-1 (monocytes chemoattractant protein)
General pathology 2008-2009
Compiled by Bhupinder Bawa
c. Eotaxin
d. MIP-1α (macrophage inflammatory protein-1α)
e. RANTES (regulated and normal T cell expressed and secreted)

(Answer a ref. page 71. b, c, d, and e are all C-C chemokines)

C-C chemokines generally attract all of the following, EXCEPT:

a. Basophiles
b. Monocytes
c. Eosinophils
d. Neutrophils
e. Lymphocytes

(Answer d ref. page 71. C-X-C chemokines attract neutrophils)

Nitric oxide is derived from which of the following amino acid?

a. Glycine
b. Cysteine
c. Arginine
d. Glutamic acid
e. Asparatic acid

(Answer c ref. page 72)

Which of the following antioxidants is a copper transfer serum protein?

a. Catalase
b. Transferring
c. Ceruloplasmin
d. Superoxide dismutase
e. Glutathione peroxidase

(Answer c ref. page 74)

All of the followings increase vascular permeability, EXCEPT:

a. C3a
b. C5a
c. PAF
d. LTB4
e. Substance P
General pathology 2008-2009
Compiled by Bhupinder Bawa
(Answer d ref. page 74, Table 2-5, 2-6)

All of the followings act as a chemotaxis, EXCEPT:

a. C3a
b. C5a
c. PAF
d. LTB4
e. Nitric oxide

(Answer a ref. page 74, Table 2-5, 2-6)

October 11, 2005 Robbins Chap 2 Page 75-85


Kei K.

The half-life of blood monocytes is:

a. 1 day
b. 3 days
c. 1 week
d. 3 weeks
e. 1 month

(Answer ref. page 80)

All of the following are chemotactic stimuli for monocytes, EXCEPT:

a. C3a
b. C5a
c. PDFG
d. TFG-α
e. MCP-1

(Answer ref. page 80)

MCP-1 (monocytes chemoattractant protein) is which of the following chemokine?

a. C chemokine
b. C-C chemokine
c. CX2C chemokine
d. CX3C chemokine
General pathology 2008-2009
Compiled by Bhupinder Bawa
e. C-X-C chemokine

(Answer ref. page 71. There are no CX2X chemokine)

The following adhesion molecule is directly involved with leukocyte transmigration


through the endothelium:
A) PECAM
B) VCAM-1
C) P-selectin
D) E-selectin
E) Sialyl-Lewis X

Answer: A page 54

The following members of the complement system are considered anaphylatoxins:


1) C1
2) C3a
3) C3b
4) C5a
5) C4b2b

A) 1,2
B) 1,4
C) 2,3
D) 2,4
E) 4,5

Answer: D page 64

Bradykinin is directly produced by cleavage of this compound:


A) Thrombin
B) Kallikrein
C) Prekallikrein
D) Hageman factor
E) High molecular weight kininogen

Answer: E page 65

The following are preformed mediators of inflammation:


1) Histamine
2) Serotonin
3) Nitric oxide
4) Leukotrienes
5) Lysosomal enzymes
General pathology 2008-2009
Compiled by Bhupinder Bawa
A) 1, 2, 3
B) 1, 2, 5
C) 1, 3, 5
D) 2, 3, 4
E) 2, 3, 5

Answer: B page 63

The following chemotactic agents bind to specific 7-transmembrane G protein coupled


receptors on surface of leukocytes except
A) C5A
B) Leukotriene B4
C) Platelet activating factor
D) Bacterial Lipopolsaccharide
E) N-formylmethionyl peptides

Answer: D page 58

Which of the following pathways is not initiated by factor XIIa?


a. Complement cascade
b. Kinin cascade
c. Clotting cascade
d. Aracidonic acid cascade
e. Fibrinolytic cascade

Answer: d Reference: Page 68

Collectin-dependent complement activation is initiated by:


a. Endotoxin
b. Bacterial glycoproteins
c. Bacterial polysaccharides
d. Immune-complexes
e. Bacterial glycolipids

Answer: b Reference: Page 66

11-30-04

1) Bradykinin is degraded by

a) Kallikrein
b) Plasmin
General pathology 2008-2009
Compiled by Bhupinder Bawa
c) C3 convertase
d) Kininase
e) Thrombin

Answer- d, (and also Angiotensin convertase in the lungs) Ref:- 65

2) Complement fragment mainly involved in opsonization is?

a) C1
b) C3a
c) C5a
d) C3b
e) C9

Answer- d, Ref:- 64

Q. Which of the following factor usually increases vascular permeability in all levels of
microcirculation?

f. Histamine
g. Bradykinin
h. Leukotriene C4D4E4
i. Lytic bacterial infections
j. Neuropeptide substance P

(A. d ref. Page 50-52)

Q. Which of the following is the correct sequence of the leukocyte response in


inflammation?

1) Margination
2) Rolling
3) Pavementing
4) Emigration
5) Chemotaxis
6) Phagositosis

a) 1, 2, 3, 4, 5, 6
b) 1, 3, 2, 4, 5, 6
c) 1, 2, 3, 5, 4 ,6
General pathology 2008-2009
Compiled by Bhupinder Bawa
d) 2, 1, 3, 5, 4, 6
e) 2, 3, 1, 5, 4, 6

(A. a ref. page 53-54)

Q. Which of the following is the correct statement of leukocyte adhesion in


inflammation?

a) Platelet activating factor redistributes P-selectin from Weible-Palade bodies to the


leukocyte cell surface
b) E-selectin is present in endothelium and platelets
c) VCAM-1 is the ligand for the LFA-1 integrin
d) ICAM-1 is the ligand for the VLA-4 integrin
e) None of the above

(A. e ref. page 54)

Q. Which of the following statement is TRUE?

a.The H2O2-myeloperoxidase-halide system is the most efficient bactericidal system


in neutrophils
b. Activated neutrophils are the chief source of the cytokines involved in
leukocyte activation
c.Neutrophils cannot engulf bacteria without attachment to specific receptors
d. Neutrophilia is one of the characteristics of Chediak-Higashi syndrome
e.None of the above

(A. a ref. pages p57, 59, and 61)

All the following statements are true, EXCEPT?

a. C3b binds to the previously generated fragments to form C5 convertase which


cleaves C5 to release C5a.
b. The alternative pathway can be triggered by microbe’s surface molecules without
the presence of antibodies.
c. The classical pathway is triggered by fixation of C1 to IgG or IgM combined with
antigen.
d. Membrane attack complex (MAC) consists of C5a and the late components (C6 –
C9).
e. The lectin pathway is triggered by mannose binding lectin.
General pathology 2008-2009
Compiled by Bhupinder Bawa
(A. d ref. P64 and P65 Fig. 2-14)

1) A defect in the neutrophil NADPH oxidase would result in which of the


following?

A) Inability to kill phagocytized bacteria


B) Inability to generate arachidonic acid metabolites
C) Inability of cellular receptors to bind to opsonized particles
D) Inability to generate oxygen free radicals in the phagolysosome
E) Inability to halogenate oxygen free radicals in the phagolysosome

Answer: D Page #’s 59-62

2) Opsonins include all of the following except?

A) Laminin
B) Fibrinogen
C) IgG antibodies
D) Mannose-binding lectin
E) Complement protein C3

Answer A Page #’s: 59, 105

Which of the following is not a function of the complement factor C5a?

A) Release of histamine from mast cells


B) Increases vascular permeability
C) Chemotactic for neutrophils
D) Opsonin for bacteria
E) Vasodilation

Answer: D Page #64-65

Which of the following adhesion molecules is stored pre-formed in endothelial cell


Weibel – Palade bodies?

A) CD31
General pathology 2008-2009
Compiled by Bhupinder Bawa
B) ICAM-1
C) GlyCam-1
D) E-Selectin
E) P-Selectin

Answer: E Page #: 54-56

Which of the following adhesion molecules is specific for lymphocyte homing to high
endothelial venules in lymph nodes?

A) CD31
B) ICAM-1
C) GlyCam-1
D) E-Selectin
E) P-Selectin

Answer: C Page #54

Please place the following processes involved in the inflammatory process in the correct
order?

1) Leukocytes marginate in the postcapillary venule


2) Leukocytes transmigrate through the endothelial cells and venule wall
3) Leukocyte “roll” along the endothelial cells of the postcapillary venule
4) Mediators induce the expression of selectins and mucin-like glycoproteins
5) Integrins and immunoglobulin family molecules are expressed on leukocytes
and endothelial cells

A) 1, 4, 3, 5, 2
B) 1, 5, 3, 2, 4
C) 4, 1, 5, 3, 2
D) 4, 3, 5, 1, 2
E) 5, 1, 2, 4, 3

Answer: A Page #53-56

Which of the following is the correct order of the vascular events of inflammation?

1) Vasodilation
2) Neovascularization
3) Transient vasoconstriction
4) Increased vascular permeability

A) 1, 2, 3, 4
General pathology 2008-2009
Compiled by Bhupinder Bawa
B) 1, 3, 4, 2
C) 3, 2, 1, 4,
D) 3, 1, 4, 2
E) 4, 1, 2, 3

Answer: D Page #’s: 50-53

All of the following can lead to increased vascular permeability in the inflammatory
process EXCEPT?

A) Angiogenesis
B) Vasodilation
C) Histamine release
D) Apoptosis of endothelial cells
E) Leukocyte-dependent injury of endothelial cells

Answer: B Page #’s 50-53


Q. Which of the following does not induce platelet aggregation?

1. Nitric oxide
2. Prostaglandin E2
3. Thromboxane A2
4. Platelet-activating factor
5. Prostaglandin I2 (prostacyclin)

a. 1 and 2
b. 2 and 3
c. 3 and 4
d. 4 and 5
e. 1 and 5

A. e. ref. page 68, 72

Q. All of the followings act as a leukocyte chemotactic factor, EXCEPT

a. C3a
b. C5a
c. IL-1
d. 5-HETE
e. Platelet-activating factor
General pathology 2008-2009
Compiled by Bhupinder Bawa
A. a. ref. page 69, 74 (Table 2-5), 75 (Table 2-6)

Q. All of the followings are correct, EXCEPT

a. iNOS is induced by TNF-α


b. Nitric oxide induces vasodilaion
c. Nitric oxide has a microbicidal potential
d. Nitric oxide is synthesized from L-asparagine
e. Constitutively expressed nitric oxide syntheses are activated by Ca2+ influx

A. d. ref. page 72,73

December 14, 2004


Robbins General Patho
Kei K

Q. All of the followings are chemotactic stimuli for monocytes, EXCEPT

a. C5a
b. TGF-β
c. MCP-1
d. Fibronectin
e. Platelet-derived growth factor

A. b ref. page 80

The following are true regarding a transudate except:

A) Specific gravity less that 1.012


B) Results from osmotic imbalance
C) Protein content is mostly albumin
D) Results from hydrostatic imbalance
E) Results from leakage from new vessels

Answer: E, pages 49,52


General pathology 2008-2009
Compiled by Bhupinder Bawa

The following are true regarding an exudate except:


A) Results from angiogenesis
B) Results from increased transcytosis
C) Results from leukocyte mediated endothelial injury
D) Results from formation of endothelial gaps in arterioles
E) Results from affect of IL-1 and TNF on endothelial cells

Answer: D, pages 50-52

The following are true regarding L-selectin except:


A) Can bind to CD 34
B) Expressed on lymphocytes
C) Expressed on cytokine activated endothelial cells
D) Can bind to glycan-bearing cell adhesion molecule 1 (GlyCam-1)
E) Can bind to mucosal adhesion cell adhesion molecule-1 (MAdCAM-1)

Answer: C page 55

The following are opsonins for microbes except:


A) C3b
B) C5a
C) Fibronectin
D) IGg antibodies
E) Mannose binding lectin (MBL)

Answer: B page58-59

The following are oxygen independent mechanisms of bacterial killing in leukocytes


except:
A) Defensins
B) Lysozyme
C) Lactoferrin
D) H2O2-MPO-halide system
E) Bacterial permeability increasing (BPI) protein
Answer: D page 61

Kallikrein is directly involved in all of the following except:


A) Activation of factor XII
B) Opsonization of bacteria
C) Conversion of C5 to C5a
D) Conversion of plasminogen to plasmin
E) Cleavage of high molecular weight kininogen
General pathology 2008-2009
Compiled by Bhupinder Bawa
Answer: B page 65, 67

The following are directly involved in the alternative pathway of complement activation:
1) C4b2b
2) Factor B
3) Properdin
4) Bacterial LPS
5) Antigen-antibody complex

A) 1,2,3,
B) 1,3,4
C) 2,3,4
D) 2,4,5
D) 3,4,5

Answer: C page 66

The following are true regarding Lipoxins except:


A) Act to inhibit leukocyte recruitment
B) They are generated by action of 12-Lipoxygenase
C) Intermediates for synthesis produced by neutrophils
D) Need cell-cell interaction between neutrophils and platelets for synthesis
E) There is direct relationship between amount of Lipoxin and Leukotrienes formed

Answer: E pages 69-70

The following inflammatory mediators cause vasodilation except:


A) Histamine
B) Lipoxin A4
C) Nitric oxide
D) Leukotrienes C4, D4, E4
E) Prostacyclin and PG D2, PGE2, PGF2

Answer: D pages 69 and 75

The following are true regarding macrophages in chronic inflammation except:


A) Activated by IFN-γ
B) Activated by Endotoxin
C) Display antigens to T-cells
D) Local proliferation will occur after emigration
E) Have granules that contain Major Basic Protein

Answer: E pages 80,81


General pathology 2008-2009
Compiled by Bhupinder Bawa

The following are true regarding the acute phase response except:
A) Increased plasma concentration of fibrin
B) Fever is produced in response to pyrogens
C) Increased plasma concentration of C-reactive protein
D) Accelerated release of leukocytes from bone marrow
E) Increased plasma concentration of serum amyloid A (SAA) protein

Answer: A pages 84-85

Which of the following is not a product of activated macrophages?

A) TGF-β
B) FGF
C) IgG
D) TNF
E) NO

Answer: C Page #: 80

Which of the following is a major activator of macrophages?

A) IFN-γ
B) PDGF
C) FGF
D) TGF
E) NO

Answer: A Page #: 80-81

Which of the following is not involved in the production of a fever?

A) COX
B) IL-1
C) PGE2
D) SAA
E) TNF

Answer: D Page #: 84

Which of the following does not increase vascular leakage?


General pathology 2008-2009
Compiled by Bhupinder Bawa

A) Bradykinin
B) Leukotriene C4, D4, E4
C) Platelet activating factor
D) Tumor necrosis factor (TNF)
E) Complement components C3a and C5a

Answer: D Page #: 74

Which of the following is not chemoattractant for neutrophils?

A) C5a
B) IL-8
C) LTB4
D) LXB4
E) 5-HETE

Answer: D Page #’s: 64, 68, 69, 70, 71

Which of the following is produced by transcellular metabolism?

A) C5a
B) IL-8
C) LTB4
D) LXB4
E) 5-HETE

Answer: D Page #’s: 69-70

The sequence of events for extravasation of leukocytes to the interstitium occurs in the
following order:
A) Migration, margination, rolling, pavementing and transmigration
B) Pavementing, rolling, margination, transmigration and migration
C) Margination, pavementing, rolling, transmigration and migration
D) Margination, rolling, pavementing, transmigration and migration
E) Migration, transmigration, margination, rolling and pavementing

Answer: D

THF and IL-1 induce endothelial expression of the following ligand for the LFA-1 and
Mac-1 integrins:
A) ELAM-1
General pathology 2008-2009
Compiled by Bhupinder Bawa
B) VCAM-1
C) ICAM-1
D) P-selectin
E) GlyCam-1

Answer: C Box 2-1

All of the following are actin regulating proteins that are important for leukocyte
chemotaxis except:
A) Filamin
B) Prolifin
C) Gelsolin
D) Porphyrin
E) Calmodulin

Answer: D page 57

Which of the following receptors is a macrophage lectin that binds terminal mannose and
fucose residues of glycoproteins and glycolipids:
A) FCγ receptors
B) Mannose receptors
C) Scavenger receptors
D) CR1-Type 1 complement receptors
E) Seven transmembrane G-proetin-coupled receptors

Answer: B page 58-59


binds sugars found on microbial cell walls
FCgamma-IGg ab Scavenger- LDL particles CR1-C3

Which of the following mechanism of increased vascular permeability in acute


inflammation involves capillaries?

1. Delayed prolonged leakage in sunburn


2. Leukocyte mediated endothelial injury
3. Direct endothelial injury in severe burn
4. Increased transcytosis elicited by VEGF
5. Formation of endothelial gap elicited by histamine

A. 1, 2, 3
B. 1, 2, 4
C. 1, 4, 5
D. 2, 3, 4
E. 3, 4, 5
General pathology 2008-2009
Compiled by Bhupinder Bawa

(Answer A ref. page 51-52, Fig 2-4)

Which of the following endothelial molecule is directly relevant to transmigration of


neutrophils in extravasation?

A. P-selectin
B. E-selectin
C. VCAM-1
D. PCAM-1
E. ICAM-1

(Answer D ref. page 53, $$$$fig 2-6)

Which of the following leukocyte receptor binds to P-selectin?

A. CD31
B. L-selectin
C. α4β1 integrin
D. Sialyl-Lewis X
E. CD11/CD18 integrin

(Answer D ref. page 54, table 2-1)

Cellular events: Leukocyte extravasation


(vascular events- stasis) > margination > rolling (transient adhesion to endothelium by P-
selectin, E-selectin) > pavementing (stable adhesion by integrin-integrin ligand ICAM-1)
> transmigration “diapedesis” (PECAM-1 = CD31)

Weibel-Palade bodies (normal organells in the endothelium, the main constituent is von
Willebrand factor)  redistribution of P-selectin by histamine, thrombin and PAF (page
56, fig 2-7)

Ligand binding by selectins is:

A. Phosphorous-dependent
B. Magnesium-dependent
C. Calcium-dependent
D. Copper-dependent
E. Zinc-dependent

(Answer C ref. page 55, Box2-1)


General pathology 2008-2009
Compiled by Bhupinder Bawa
Which one of the following statements is incorrect regarding formation of gaps due to
endothelial contraction in venules during acute inflammation are correct? (p 50-52)

A. It is reversible.
B. It is short-lived (15-30 minutes).
C. Capillaries and arterioles are not affected.
D. It is due to direct damage to the endothelium.
E. It occurs rapidly after exposure to the mediator.

Answer: D

Which one of the following is not a mucin-like glycoproteins? (p 54)

A. Sialyl-Lewis X
B. GlyCAM-1
C. PSGL-1
D. ESL-1
E. CD34

Answer: A

Which one of the following is expressed only on cytokine activated


endothelial cells? (p 55)

A. Mac-1
B. PECAM
C. P-selectin
D. L-selectin
E. E-selectin

Answer: E

Which of the following statements regarding ICAM-1 and VCAM-1 is/are correct? (p 54-
55)

1. Both are members of immunoglobulin family molecules.


2. Both are endothelial adhesion molecules.
3. The ß1 integrins bind to ICAM-1.
4. The ß2 integrins bind to VCAM-1.
5. Expression of both is induced by IFN and IL-1.

A. 1, 2
B. 1, 2, 3, 4
C. 1, 2. 5
D. 1, 3, 5
General pathology 2008-2009
Compiled by Bhupinder Bawa
E. 5

Answer: A

Which of the following endothelial molecules are responsible for leukocyte rolling?

1. ICAM-1
2. PECAM
3. VCAM-1
4. P-selectin
5. E-selectin

A. 1,2
B. 1,3
C. 2,3
D. 3,4
E. 4,5

Answer: E pg 54, Table 2-1

All of the following are true concerning P-selectin except:

A. major role in leukocyte rolling


B. stored in Weibel-Palade bodies
C. mediates binding of multiple leukocytes
D. is responsible for homing of lymphocytes to lymph nodes
E. is translocated to cell surface after stimulation of endothelial cells

Answer: D pg 54-55

Which of the following is NOT recognized by Toll-like receptors?

A. Lipopolysaccharide
B. Double-stranded RNA
C. Bacterial proteoglycan
D. N-formylmethionyl residues
E. Unmethylated CpG nucleotides

(Answer ref. page 58)

Exchange of GTP for GDP on which of the following receptors activates numerous
cellular enzymes?

A. Toll-like receptors
General pathology 2008-2009
Compiled by Bhupinder Bawa
B. Opsonin receptors
C. Cytokine receptors
D. Mannose receptors
E. Seven-transmembrane G-protein-coupled receptors

Answer: E pg 58-59

All of the following proteins are actin-regulating proteins EXCEPT: (p 57)


A. Profilin
B. Filamin
C. Tenanin
D. Gelsolin
E. Calmodulin

Answer: C

Which of the following receptors on the leukocytes surface mediate endocytosis of


oxidized or acetylated LDL particles? (p 59)

A. Toll-like receptors
B. Mannose receptors
C. Scavenger receptors
D. Receptors of cytokines
E. Receptors for opsonins

Answer: C

Which of the following oxygen-independent mechanisms is found only in eosinophils? (p


61)

A. Defensins
B. Lysozyme
C. Lactoferrin
D. Major basic protein
E. Bactericidal permeability increasing protein

Answer: D

Which of the following is the most efficient bactericidal system in neutrophils? (p 61)

A. Defensins
B. Lysozyme
C. NADPH oxidase
D. Major basic protein
E. H2O2-MPO-Halide system
General pathology 2008-2009
Compiled by Bhupinder Bawa
Answer: E

Which of the following is NOT a component of membrane attack complex?

A. C3b
B. C5b
C. C7
D. C8
E. C9

(Answer A ref. page 66, Box 2-2)

Which of the following is the classical pathway C3 convertase?

A. C5-C9 complex
B. C4b2b complex
C. C3bBb complex
D. C4b2b3b complex
E. C3bBb3b complex

(Answer B ref. page 66, Box 2-2)

Which of the following fragments of complement system activates lipoxygenase pathway


of arachidonic acid? (p 64)

A. C3a
B. C3b
C. C4a
D. C5a
E. C5b

Answer: D

Which of the following factors does not act as C5 convertase? (p 66)

A. Kallikrein
B. C3bBb3b
C. C4b2b3b
D. Plasmin
E. C4b2b

Answer: E

Which of the following statements regarding C5a is false? (p 64-67)


General pathology 2008-2009
Compiled by Bhupinder Bawa
A. It activates the lipoygenase pathway of arachidonic acid metabolism.
B. It is produced by directly converting C5 by HMWK.
C. It is a mediator of increased vascular permeability.
D. It is a powerful chemotactic agent for leukocyte.
E. It is an anaphylatoxin.

Answer: B

Which of the following proteins directly converts C5 to C5a? (p 65)

A. HMWK
B. Kininase
C. Thrombin
D. Kallikrein
E. Prekallikrein

Answer: D

Engagement of protease-activated receptor type 1 (PAR-1) by thrombin triggers all the


following responses EXCEPT: (p 67-68)

A. Mobilization of P-selectin
B. Production of chemokines
C. Production of prostaglandin
D. Production of PAF and nitric oxide
E. Suppression of endothelial adhesion molecules for integrins

Answer: E

Which of the following is directly responsible for forming C5convertase which in turn
results in the formation of the membrane attack complex?

A. C1a
B. C1b
C. C3a
D. C3b
E. C5a

Answer: D pg 64

Which of the complement factors also acts as an opsonin when fixed to bacterial cell
walls?

F. C1b
G. C3a
General pathology 2008-2009
Compiled by Bhupinder Bawa
H. C3b
I. C4a
J. C4b

Answer: C pg 64

Deficiencies in which of the complement proteins are associated with systemic lupus
erythermatosus?

1. C1
2. C2
3. C3
4. C4
5. C5

K. 1,2
L. 1,3
M. 2,3
N. 2,4
O. 4,5

Answer: D pg 67, Box 2-2

Which of the following eicosanoids does NOT cause vasodilation?

A. Lipoxin
B. Prostacyclin
C. Prostaglandin E2
D. Prostaglandin D2
E. Thromboxane A2

(Answer E ref. page 69, fig. 2-16)

Which of the following inflammatory mediator does not act as a chemotaxis?

A. C3a
B. C5a
C. Nitric oxide
D. Leukotriene B4
E. Platelet activating factor

(Answer A ref. page 74, table 2-5)


General pathology 2008-2009
Compiled by Bhupinder Bawa

Which of the following inflammatory mediator does not increase vascular permeability?

A. C3a
B. C5a
C. Nitric oxide
D. Leukotriene B4
E. Platelet activating factor

(Answer D ref. page 74, table 2-5)

Which of the following complement components is a powerful chemotactic agent for


neutrophils, monocytes, eosinophils and basophils?
A) C1
B) C3a
C) C5b
D) C5a
E) C6a

Answer: D page 64

Which of the following inactivate bradykinin?


1) Kininase
2) Kallikrein
3) Hageman factor
4) Angiotensin converting enzyme
5) High-molecular weight kininogen

A) 1
B) 1,3
C) 1,4
D) 2,3
E) 3, 5

Answer: C page 65
Factor 12 fragment converts prekallikrein to Kallikrein that cleave high molecular weight
kininogen to bradykinin

Which of the following eicosanoids causes vasodilation?


A) Leukotriene C4
B) Leukotriene D4
C) Leukotriene E4
D) Thromboxane A2
E) Prostacyclin PGI2
General pathology 2008-2009
Compiled by Bhupinder Bawa
Answer: E page 69

Which of the following chemokines attract neutrophils?


A) IL-8
B) Eotaxin
C) RANTES
D) Fractalkine
E) Monocyte chemoattaractant protein

Answer: A D=monocytes and T lymphocytes; all other WBC for other choices

Which of the following mediators directly causes both vascular leakage and chemotaxis?
1) C5a
2) Histamine
3) Bradykinin
4) Nitric oxide
5) Leukotriene B4

A) 1,2
B) 1,4
C) 1,2,3,4
D) 2,3,4
E) 3,4,5

Answer: B page 74
Histamine, bradykinin= vascular leakage LTB4=chemotaxis and activation and
adhesion

Which of the following arachidonic acid metabolites acts as a vasoconstrictor and


increases vascular permeability? (p 68-69)

A. PGE1
B. Lipoxin A4
C. Leukotriene B4
D. Leukotriene C4
E. Thromboxane A2

Answer: D

Please match the following pairs: (p 68-71)

1. Edema potentiator A. PGE2


2. Anti-inflammatory protein B. TXA2
C. LXA4
D. Lipocortin 1
E. 5-lipoxygenase
General pathology 2008-2009
Compiled by Bhupinder Bawa
3. Platelet major thromboxane
4. Neutrophil chemotxis inhibitor
5. Predominant lipoxygenase in neutrophil

Answer: 1:A, 2:D, 3:B, 4:C, 5:E

Which of the following is false regarding nitric oxide (NO) roles in inflammation? (pp
72-73)

A. It is a vasoconstrictor.
B. It reduces platelet adhesion.
C. It reduces platelet aggregation.
D. It inhibits mast cell-induced inflammation.
E. Endogenously it regulates leukocyte recruitment.

Answer: A

Which of the followings are the main cytokines released from activated macrophages
during chronic inflammation that promote leukocyte recruitment? (p 81)

F. IFN-γ
G. IL-12
H. TNF
I. IL-6
J. IL-1

A. 1, 2, 3
B. 2, 4
C. 3, 4, 5
D. 3, 4
E. 3, 5

Answer: D

All of the following statements regarding serum amyloid A (SAA) are correct EXCEPT:
(p 84)

F. It binds to chromatin.
G. It binds to microbial cell wall.
H. It acts as opsonins and fixes complement.
I. Its synthesis by liver is upregulated by IL-6.
J. It may cause secondary amyloidosis in chronic inflammation.

Answer: D
General pathology 2008-2009
Compiled by Bhupinder Bawa
Which of the following products of activated macrophages does not cause tissue injury
during a chronic inflammation? (p 80)

F. Neutrophil chemotactic factors


G. Arachidonic acid metabolites
H. Nitric oxide
I. Proteases
J. TGFβ

Answer: E

Fibrinogen and C-reactive protein are mainly upregulated by: (p 84)

6. IL-1
7. IL-4
8. IL-6
9. IFNγ
10. TGFα

Answer: C

PAF induces all of the following except:

A. vasodilation
B. degranulation
C. bronchodilation
D. vasoconstriction
E. increased vascular permeability

Answer: C pg 70

Which of the following mediators induces increased vascular permeability and leukocyte
adhesion?

F. C5a
G. IL-1
H. TNF
I. Leukotriene B4
J. Oxygen metabolites

Answer: A pg 74, Table 2-5

Eosinophils are abundant in immune reactions involving which of the following?

A. IgA
B. IgD
General pathology 2008-2009
Compiled by Bhupinder Bawa
C. IgE
D. IgG
E. IgM

Answer: C pg 82
Which of the following are endogenous pyrogens:
1) C3a
2) TNF
3) IL-1
4) IL-12
5) IFN-γ

A) 1,2
B) 2,3
C) 2, 5
D) 3,5
E) 4,5

Answer: B IFN is macrophage activator; C3a =anaphylatoxin IL-12 stimulate T


cells

All of the following are functions of platelet derived growth factor (PDGF) except:
A) Stimulates angiogenesis
B) Stimulates wound contraction
C) Promotes platelet aggregation
D) Chemotactic for PMN’s and macrophages
E) Causes migration and proliferation of fibroblasts

Answer: C inhibits page 95

Which of the following growth factors blocks the cell cycle by increasing expression of
Cip/Kip and INK4/ARF families?
A) HGF
B) EGF
C) VEGF
D) TGF-α
E) TGF-β

Answer: E page 96

Which of the following is an adaptor protein of the MAP kinase pathway that binds with
SOS?
A) IP3
B) GRB-2
C) ERK (MK)
General pathology 2008-2009
Compiled by Bhupinder Bawa
D) MEK (MKKK)
E) RAF (MKKK)

Answer: B page 99

Robbins Chap. 2 p. 68-75


Which one of the following eicosanoids causes vasoconstriction and increased vascular
permeability? (p. 69)
F) lipoxin A4
G) prostacyclin
H) leukotriene C4
I) thromboxane A2
J) prostaglandin E2

Answer: C

Robbins Chap. 2 p. 56-64


Which of the following cells are sources of histamine? (p. 63)
6) platelets
7) basophils
8) mast cells
9) eosinophils
10) endothelial cells

F) 1, 2, 3
G) 1, 3, 5
H) 2, 3, 4
I) 2, 3, 5
J) 3, 4, 5

Answer: A

All of the following are characteristics of Chediak-Higashi syndrome except: (p. 61-62)
F) neutropenia
G) defective chemotaxis
H) abnormal melanocytes
I) delayed microbial killing
J) giant granules in leukocytes

Answer: B

Robbins Chap. 2 p. 75-85


Which of the following products produced by activated macrophages can contribute to
the development of fibrosis? (p. 80)
6) IFN-γ
7) fibronectin
General pathology 2008-2009
Compiled by Bhupinder Bawa
8) fibroblast growth factor
9) transforming growth factor β
10) platelet-derived growth factor

F) 1, 2, 3
G) 1, 3, 5
H) 2, 3, 4
I) 2, 4, 5
J) 3, 4, 5

Answer: E

Which one of the following is NOT a positive acute phase protein? (p. 84, FVCP p. 260-
261)
F) transferrin
G) fibrinogen
H) haptoglobin
I) serum amyloid A
J) C-reactive protein

Answer: A (albumin is also a negative acute phase protein)