Topic 9. Pathophysiology of inflammation.

1. A 7-year-old child fell ill sharply. Hi has catarrh, cough, lacrimation and large-spot rash on skin; his temperature is increased up to 38^oC. Mucous membrane of patient’s pharynx is edematous and red; buccal mucous membrane has whitish spots. What is the character of inflammation underlying changes of buccal mucous membrane?

A. Hemorrhagic

B. Serous

C. Purulent

D. Catarrhal

E. Fibrinous

2. Painfulness of tooth and edema of lower part of face at the side of ill tooth are present in a patient with acute pulpitis. What is leading mechanism of edema development in this case?

A. Increase in production of aldosterone

B. Disturbances of trophic function of nervous system

C. Disorder of neural regulation of water-salt metabolism

D. Disorders of microcirculation at the focus of injury

E. Hypoproteinemia

3. A 63-year-old woman has signs of rheumatic arthritis. Which of below enumerated indices of blood test will be most significant for diagnosis verification?

A. R-glycosidase

B. Lipoproteins

C. Acid Phosphatase

D. Summary glycosaminoglycans

E. General cholesterol

4. A 5-year-old girl has high temperature and sore throat. At the examination of this patient the following was revealed: edema of soft palate, gray films on tonsils, which were removed difficulty and left after themselves deep hemorrhagic defects of tissue. Which disease of bellow enumerated is the most possible?

A. Lacunar tonsillitis

B. Simanovsky-Vincent’s tonsillitis

C. Necrotic tonsillitis

D. Diphtheria of pharynx

E. Infectious mononucleosis

5. A cook burnt his arm with steam. What substance increased and led to development of redness, edema and painfulness of affected area of skin?

A. Lysine

B. Histamine

C. Thiamine

D. Galactosamine

E. Glutamine

6. A child with asphyxia was taken to the hospital. On examination of the child whitish and difficulty separating films were revealed in his larynx. What type of inflammation is observed in this case?

A. Croupous inflammation

B. Diphtheritic inflammation

C. Purulent inflammation

D. Catarrhal inflammation

E. Serous inflammation

7. Enlargement and deformation of joints were revealed in a patient with rheumatism. What type of inflammation underlies these changes?

A. Alterative

B. Proliferative

C. Exudative

D. Fibrinous

E. Hemorrhagic

8. A painful blisters full of opaque fluid has formed in patient after thermal burn. What type of inflammation has appeared?

A. Granulomatous

B. Croup

C. Serous

D. Proliferative

E. Diphtheritic

9. Prevalence of proliferative processes was revealed in a patient with chronic inflammation of skin and subcutaneous adipose tissue. Which hormone deficiency can lead to this situation?

A. Cortisol

B. Aldosterone

C. Insulin

D. Growth hormone

E. Thyroxin

10. A patient complains of a pain in joints. Edema and redness are visible above joints. Which enzyme activity has to be analyzed for establishing the diagnosis?

A. Hyaluronidase

B. Creatine kinase

C. Alkaline phosphatase

D. Acid phosphatase

E. Urease

11. Indicate inflammatory mediators which have to be inhibited for decrease in exudation:

A. Catecholamines

B. Histamine

C. Heparine

D. Thromboxan

E. Interleukine-1

12. Condition of biological active substances (BAS) prevalence over there inhibitors usually occurs in inflammation. Indicate correct correspondence of BAS to their inhibitor

A. Histamine - carboxypeptidase

B. Catecholamines - cholinesterase

C. Kinins - monoaminooxidase

D. Leukotriens - arylsulfatase

E. Serotonin-protease inhibitor

13. Edema has developed as a result of oncotic pressure elevation in the site of inflammation. What is the main reason of hyperoncia?

A. Activation of endotheliocytes

B. Protein catabolism

C. Drainage disorders

D. Macromolecules accumulation

E. Gluconeogenesis intensification

14. What factor promotes proliferation in focus of chronic inflammation?

A. Phospholipase activation

B. Hyperosmia

C. Protein catabolism

D. Hypoxia

E. Prostacyclin synthesis

15. A patient has high body temperature, redness, edema, painfulness on her right forearm. What biological active substances intensify inflammatory reaction?

A. Vasopressin

B. Prostacyclins

C. Phospholipase D

D. Proteolysis inhibitors

E. Kinins

16. A patient with inflammation of a forefinger has acute pain, edema, enlargement of local lymph nodes, temperature rising to 38,5^oC. What factors lead to exudation in the inflammatory focus?

A. Lymph flow augmentation

B. Proliferation

C. Resistive vessels tone increase

D. Increase of volumetric flow rate of blood

E. Increasing in endothelial permeability

17. Pleurisy with sequential formation of purulent exudation developed in a patient after the chest trauma. What is the main factor of pus formation?

A. Change of blood flow rate

B. Chemotaxis

C. Change of physicochemical properties in the site of inflammation

D. ATP production disorders

E. Hyperosmia

18. A patient has an inflammatory process on the outer surface of calf. Redness, edema, pain, enlargement of local lymph nodes, and body temperature rising are noticed in patient. What are the principles of pathogenetic therapy of acute inflammation?

A. Proteolysis activation blockage

B. Energy formation processes improving

C. Free radical oxidation increase

D. Introduction of mineralocorticoids

E. Introduction of thyroid hormones

19. A patient with finger inflammation has sharp pain and edema in the inflammatory focus. After opening of an abscess these symptoms have disappeared. What favors disappearance of pain?

A. Decrease of osmotic pressure

B. Increase in c-AMP concentration

C. Alkalosis

D. Kallikrein-kinin system activation

E. Mast cells degranulation

20. There are edema, redness and soreness in a place of injury. What is the reason for inflammation’s symptoms appearance?

A. Sympathetic nervous system activation

B. Monoamine oxidase activation

C. BAS discharged by cells

D. Carboxypeptidase activation

E. Limited proteolysis inhibition

21. Condition of biological active substances (BAS) prevalence over there inhibitors usually occurs in inflammation. Indicate correct correspondence of BAS to their inhibitor

A. Histamine - carboxypeptidase

B. Catecholamines - cholinesterase

C. Kinins – monoamine oxidase

D. Serotonin - arylsulfatase

E. Kallikrein - protease inhibitor

22. A 37-year-old male patient was admitted to the surgical department with symptoms of acute pancreatitis. Which preparation is the most advisable for use in the first turn?

A. Platyphyllin

B. Contrycal

C. Analgin

D. Ephedrine

E. Nospanum

23. Female patient, aged 32, was stung by wasp. On the skin of left cheek (place of sting) there is a zone of hyperemia and edema. What is the primary mechanism of edema in this case?

A. Decrease of oncotic pressure

B. Lymph drainage decease

C. Increase of oncotic pressure

D. Increase in capillary permeability

E. Increase of hydrostatic pressure in capillaries

24. What inflammatory mediator is formed due to limited proteolysis of plasma globulins?

A. Histamine

B. Leukotriens

C. Bradykinin

D. Prostaglandins

E. Lymphokines

25. Fever and increase of antibodies and leukocytes have appeared in animal under experimental modeling of inflammation. What substances conditioned to all these common reactions in inflammation?

A. Leukotriens

B. Interleukins

C. Mineralocorticoids

D. Glucocorticoids

E. Somatomedins

26. In a patient with eczema there are 5 typical symptoms of inflammation (Celsius - Halen pentad). Find the one of them:

A. Cyanosis

B. Jaundice

C. Pigmentation

D. Redness

E. Albinism

27. A patient sustained trauma of knee joint and posttraumatic hemorrhagic bursitis appeared. After 3 months passive movements limitation in extend was observed. Limitation was a result of scar formation. What inflammatory component was a basis of this complication?

A. Secondary alteration

B. Exudation

C. Tissue hyperplasia

D. Proliferation

E. Primary alteration

28. In female patient, 28, abscess opening was performed and fast wound reparation was observed. Reparation was preceded without score formation. What cells play the main role in proliferation?

A. Eosinophils

B. Neutrophils

C. Fibroblasts

D. Lymphocytes

E. Monocytes

29. In examination of abscess punctate under a microscope different blood cells were revealed. Which of them appears the first in inflammatory focus?

A. Monocytes

B. Mast cells

C. Eosinophils

D. Neutrophils

E. Lymphocytes

30. What is the main factor of pain formation in pulpitis?

A. BAS action

B. Hydrostatic pressure increasing

C. Excess of pain receptors excitability

D. Ischemia

E. Excess of brain centers sensitivity

31. What is the main factor of edema formation in pulpitis?

A. Capillaries permeability increasing

B. Hypoproteinemia

C. Tissue hyperosmia

D. Blood hyperosmia

E. Capillaries hydrostatic pressure increasing

32. Which of following inflammatory mediators are formatted under the influence of lypooxygenases?

A. Leukotriens

B. Prostaglandins E1, E2

C. Prostacyclins

D. Thromboxans

E. Thrombocytes activation factor

33. Patient has a caries complicated with pulpitis. This condition is accompanied by unbearable pain. What is the main reason of pain?

A. Ischemia

B. Emigration

C. Primary alteration

D. Exudation

E. Proliferation

34. It is known, that inflammatory mediators play the main role in inflammation pathogenesis. What is the histamine action on inflammation?

A. Chemotaxis

B. Blood vessel permeability increasing

C. Thrombocytes aggregation

D. Blood vessels constriction

E. Blood coagulation

35. Female patient, 19, complains of pain in gums, gingival hemorrhage. These symptoms have appeared 3 days after sulphamide drugs taking. Objectively: gingival papilli and gum margin are reddened and swollen; there is a hemorrhage appeared in response of touching. What type of inflammation is observed in patient?

A. Acute cattharal inflammation

B. Hemorrhagic inflammation

C. Fibrinous inflammation

D. Pus inflammation

E. Chronic cattharal inflammation

36. A patient 6 years old was admitted to the hospital with asphyxia. The membranous coats on mucosa of fauces were revealed. The coats can be removed easy. What type of inflammation is in patient?

A. Fibrinous

B. Necrotic

C. Pus

D. Cattharal

E. Hemorrhagic

37. In child patient there are following symptoms of inflammation over the skin scratch: pain, swallowing, redness. These sings are symptoms of immediate hypersensitivity. What blood cells lead to such changings?

A. Lymphocytes

B. Eosinophils

C. Basophiles

D. Monocytes

E. Neutrophils

38. In a girl patient, 5, there are intense throat pain and fever. Objectively were revealed edema and membranous coats on mucosa of fauces. The coats cannot be removed easy. What of the followings are more probably?

A. Simanovsky - Vensann tonsillitis

B. Infectious mononucleosis

C. Diphtheria of fauces

D. Necrotic tonsillitis

E. Lacunar tonsillitis

39. Patient has a caries complicated with pulpitis. This condition is accompanied by unbearable pain. What is the main factor of pain appearing?

A. High pressure of fluid in inflammatory area

B. Bradykinin

C. Prostaglandins

D. Histamine

E. Serotonin

40. There are lots of neutrophils in abdominal pus exudates in a patient with peritonitis. What is the main function of neutrophils in inflammatory area?

A. Phagocytosis

B. Prostaglandins secretion

C. Degranulation

D. Histamine liberation

E. Local blood flow regulation

41. Keloid cicatrix has formatted in a place of abscess. Name the stage of inflammation, which caused scar appearing.

A. Proliferation

B. Exudation

C. Primary alteration

D. Secondary alteration

E. Emigration

42. A male patient, 16, was admitted to the hospital with acute appendicitis. What typical pathological process is the basis of this disease?

A. Inflammation

B. Hypoxia

C. Fever

D. Tumor

E. Allergy

43. Eyeball inflammation resulted pus in the anterior chamber of the eye (hypopyon). What stage of inflammation was it?

A. Exudation

B. Proliferation

C. Primary alteration

D. Secondary alteration

E. Emigration

44. In a patient with skin pathological process which has 5 typical symptoms: tumor, rubor, calor, dolor, functio laesa. The development of such process includes 3 stages: Alteration,.........., proliferation. What is the second one?

A. Exudation

B. Regeneration

C. Reparation

D. Fibrosis

E. Petrification

45. The secondary alteration is caused by:

A. Lysosomal enzymes

B. Kinins

C. Lympokynes

D. Prostaglandins

E. Complement components C3a and C5a

46. In proliferation cells multiplying and defect compensation take place. What is the reason of cells growth in specific clones?

A. Keylones

B. Platelet-derived grow factor

C. Interleukins

D. Somatomedine

E. Lymphocytes peptide

47. There are following components in pleural effusion: proteis-62g/l, abundance of neutrophils. What is the type of inflammation in this case?

A. Serous

B. Suppuratuve

C. Fibrinous

D. Hemorrhagic

E. Putrefactive

48. Necrotic focus has appeared on burn, swallowing and red skin. What is the main mechanism of necrobyosis improvement in inflammatory area?

A. Secondary alteration

B. Primary alteration

C. Emigration of leucocytes

D. Dyapedesis of erythrocytes

E. Fibroblasts proliferation

49. Glucocorticoid treatment is usefull in rheumatic arthritis. What is the basal action of glucocoricoids?

A. Histamine decreasing

B. Emigration inhibition

C. Phagocytosis inhibition

D. Prostaglandins synthesis inhibition

E. Cell membranes stabilization

50. A patient with abscess of finger has some local and general symptoms of inflammation. What from following is a local inflammatory sing?

A. Swelling

B. Fiver

C. Headache

D. Lymphangitis

E. Leucocytosis

51. It is known that inflammatory mediators are cellular or humoral. What from the following is a humoral mediator?

A. Kallidine

B. Histamine

C. Serotonin

D. Interleukine-2

E. Hydrogenium peroxide

ANSWERS:

l.-E, 2.-D, 3.-D, 4.-D, 5.-В, 6.-В, 7.-В, 8.-С, 9.-А, 10.-А, 1 l.-B, 12.-D, 13.-А, 14.-D, 15.-Е.16.-Е, 17.-В, 18.-А, 19.-А, 20.-С, 21.-Е, 22.-В, 23.-D, 24.-С, 25.-В, 26.-D, 27.-D, 28.-С, 29.-D, ЗО.-В, 31.-А, 32.-А, 33.-D, 34.-В, 35.-В, 36.-А, 37.-С, 38.-С, 39.-А, 40.-А, 41.-А, 42.-А' 43.-А, 44.-А, 45.-А, 46.-А, 47.-В, 48.-А, 49.-Е, 50.-А, 51.-А.

Дата добавления: 2015-07-25