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 38oC. 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?
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?
Disorder of neural regulation of water-salt metabolism
Disorders of microcirculation at the focus of injury *
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?
Summary glycosaminoglycans *
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?
Diphtheria of pharynx *
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?
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?
Diphtheritic inflammation *
7. Enlargement and deformation of joints were revealed in a patient with rheumatism. What type of inflammation underlies these changes?
8. A painful blisters full of opaque fluid has formed in patient after thermal burn. What type of inflammation has appeared?
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?
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?
11. Indicate inflammatory mediators which have to be inhibited for decrease in exudation: A. Catecholamines
12. Condition of biological active substances (BAS) prevalence over there inhibitors usually occurs in inflammation. Indicate correct correspondence of BAS to their inhibitor
Histamine - carboxypeptidase
Catecholamines - cholinesterase
Kinins – monoamine oxidase
Leukotrienes – arylsulfatase *
13. Edema has developed as a result of oncotic pressure elevation in the site of inflammation. What is the main reason of hyperoncia?
Activation of endotheliocytes *
14. What factor promotes proliferation in focus of chronic inflammation?
15. A patient has high body temperature, redness, edema, painfulness on her right forearm. What biological active substances intensify inflammatory reaction?
16. A patient with inflammation of a forefinger has acute pain, edema, enlargement of local lymph nodes, temperature rising to 38,5oC. What factors lead to exudation in the inflammatory focus? A. Lymph flow augmentation
Resistive vessels tone increase
Increase of volumetric flow rate of blood
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?
Change of blood flow rate
Change of physicochemical properties in the site of inflammation
ATP production disorders
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?
Proteolysis activation blockage *
Energy formation processes improving
Free radical oxidation increase
Introduction of mineralocorticoids
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?
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
Monoamine oxidase activation
BAS discharged by cells *
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
Histamine - carboxypeptidase
Catecholamines - cholinesterase
Kinins – monoamine oxidase
Serotonin - arylsulfatase
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?
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?
Decrease of oncotic pressure
Lymph drainage decease
Increase of oncotic pressure
Increase in capillary permeability *
Increase of hydrostatic pressure in capillaries
24. What inflammatory mediator is formed due to limited proteolysis of plasma globulins? A. Histamine
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?
26. In a patient with eczema there are 5 typical symptoms of inflammation (Celsius - Galen pentad). Find the one of them:
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?
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?
29. In examination of abscess punctate under a microscope different blood cells were revealed. Which of them appears the first in inflammatory focus?
30. What is the main factor of pain formation in pulpitis?
Hydrostatic pressure increasing *
Excess of pain receptors excitability
Excess of brain centers sensitivity
31. What is the main factor of edema formation in pulpitis?
Capillaries permeability increasing *
Capillaries hydrostatic pressure increasing
32. Which of following inflammatory mediators are formatted under the influence of lipoxygenases? A. Leukotrienes *
Prostaglandins E1, E2
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?
34. It is known, that inflammatory mediators play the main role in inflammation pathogenesis. What is the histamine action on inflammation?
Blood vessel permeability increasing *
Blood vessels constriction
35. Female patient, 19, complains of pain in gums, gingival hemorrhage. These symptoms have appeared 3 days after sulphamide drugs taking. Objectively: gingival papillae and gum margin are reddened and swollen; there is a hemorrhage appeared in response of touching. What type of inflammation is observed in patient?
Acute catarrhal inflammation
Hemorrhagic inflammation *
Chronic catarrhal 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?
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?
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?
Simanovsky - Vensann tonsillitis
Diphtheria of fauces *
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?
High pressure of fluid in inflammatory area *
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?
Local blood flow regulation
41. Keloid cicatrix has formatted in a place of abscess. Name the stage of inflammation, which caused scar appearing.
42. A male patient, 16, was admitted to the hospital with acute appendicitis. What typical pathological process is the basis of this disease?
43. Eyeball inflammation resulted pus in the anterior chamber of the eye (hypopyon). What stage of inflammation was it?
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?
45. The secondary alteration is caused by:
Lysosomal enzymes *
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?
Platelet-derived grow factor
47. There are following components in pleural effusion: proteis-62g/l, abundance of neutrophils. What is the type of inflammation in this case?
48. Necrotic focus has appeared on burn, swallowing and red skin. What is the main mechanism of necrobiosis improvement in inflammatory area?
Secondary alteration *
Emigration of leukocytes
Diapedesis of erythrocytes
49. Glucocorticoid treatment is useful in rheumatic arthritis. What is the basal action of glucocorticoids?
A. Histamine decreasing * B. Emigration inhibition
Prostaglandins synthesis inhibition
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?
51. It is known that inflammatory mediators are cellular or humoral. What from the following is a humoral mediator?