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Kumar: Robbins and Cotran Pathologic Basis of Disease, 8th Edition
Chapter 02: Acute and Chronic Inflammation
Test Bank
MULTIPLE CHOICE
1. Transmembrane adhesive heterodimeric proteins, composed of an and a ß chain, are
expressed on activated leukocytes during inflammation. They bind primarily to
intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1
(VCAM-1), both of which belong to the family of proteins known as
a. selectins
b. integrins
c. immunoglobulins
d. lectins
e. growth factors
ANS: C, Surface proteins expressed on activated leukocytes are integrins, and they bind to
intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-
1), which belong to the immunoglobulin family of proteins.
2. Which of the following mediators of inflammation has chemotactic properties and is
increased in persons taking aspirin?
a. Thromboxane A2
b. Prostaglandin E2
c. Platelet-activating factor
d. Leukotriene B4
e. Interleukin-1
ANS: D, Leukotriene B4 is chemotactic. It is increased in persons who take aspirin, because
aspirin inhibits the cyclooxygenase pathway, thus shunting more arachidonic acid early
derivatives into the lipoxygenase pathway. This promotes the synthesis of leukotrienes.
3. A 2-year-old child known to suffer from recurrent bacterial infections and poor wound
healing was found to have leukocyte adhesion molecule deficiency 1 (LAD-1). The
leukocytes of this patient do not express CD18, a molecule classified as belonging to the
family of
a. selectins
b. integrins
c. lectin type of vascular adhesion molecules
d. aminotransferases
e. glycosidases
Test Bank
Copyright © 2010 by Saunders, an Imprint of Elsevier Inc. All rights reserved.
2-2
ANS: B, LAD-1 is characterized by a deficiency of CD18, a cell surface molecule that is a ß2
integrin. The infections occur because the defective leukocytes cannot adhere to endothelial
cells, cannot spread and attach, and cannot phagocytose bacteria. PBD7 62
4. Bradykinin is produced from a high-molecular weight kininogen circulating in the blood.
This reaction is mediated by
a. coagulation factor X
b. kallikrein
c. Hageman factor
d. complement C3
e. protein C
ANS: B, Kallikrein promotes the formation of bradykinin from the high-molecular weight
kininogen. PBD7 67
5. Nitric oxide synthesis is augmented in endothelial cells by a calmodulin-mediated influx
of which element?
a. Calcium
b. Sodium
c. Potassium
d. Oxygen
e. Nitrate
ANS: A, Endothelial cell nitric oxide synthase is constitutively expressed at low levels, but it
can be increased by a calmodulin-mediated influx of calcium into the endothelial cells. PBD7
72
6. Which of the following mediators of inflammation causes pain?
a. Nitric oxide
b. Complement C3a
c. Bradykinin
d. Leukotriene B4
e. Interleukin-1
ANS: C, Bradykinin causes pain. Other pain-causing substances are substance P and
prostaglandin E2. PBD7 65
7. Aspirin lowers the body temperature by inhibiting the synthesis of which regulator of the
central thermostat in the hypothalamus?
a. Leukotriene B4
b. Lipoxin
c. Thromboxane A2
d. Prostacyclin
e. Prostaglandin E2
ANS: E, Aspirin inhibits the action of cyclooxygenase, and thus inhibits the synthesis of
Test Bank
Copyright © 2010 by Saunders, an Imprint of Elsevier Inc. All rights reserved.
2-3
thromboxane A2, prostacyclin, and prostaglandin E2. However, only prostaglandin E2 is
involved in thermoregulation. The synthesis of lipoxin and leukotrienes is not inhibited by
aspirin. PBD7 70
8. C-reactive protein binds to the surface of microbes in tissues acting as a(n)
a. caspase
b. peroxidase
c. opsonin
d. anaphylatoxin
e. membrane attack protein
ANS: C, C-reactive protein, an acute phase protein produced by the liver in acute and
chronic inflammation, binds to microbes acting as an opsonin. Opsonization of bacteria
facilitates phagocytosis.