Deck 2: Inflammation and Healing

Question 1

Chemical mediators released during the inflammatory response include:

A)albumin and fibrinogen
B)growth factors and cell enzymes
C)macrophages and neutrophils
D)histamine and prostaglandins

Answer 1

histamine and prostaglandins

Question 2

The process of phagocytosis involves the:

A)ingestion of foreign material and cell debris by leukocytes
B)shift of fluid and protein out of capillaries
C)formation of a fibrin mesh around the infected area
D)movement of erythrocytes through the capillary wall

Answer 2

ingestion of foreign material and cell debris by leukocytes

Question 3

Edema associated with inflammation results directly from:

A)increased fluid and protein in the interstitial compartment
B)increased phagocytes in the affected area
C)decreased capillary permeability
D)general vasoconstriction

Answer 3

increased fluid and protein in the interstitial compartment

Question 4

Which of the following statements applies to fever?

A)Viral infection is usually present.
B)Heat-loss mechanisms have been stimulated.
C)It is caused by a signal to the thalamus.
D)It results from release of pyrogens into the circulation.

Question 5

The inflammatory response is a nonspecific response to:

A)phagocytosis of foreign material
B)local vasodilatation
C)any tissue injury
D)formation of purulent exudates

Question 6

Scar tissue consists primarily of:

A)granulation tissue
B)epithelial cells
C)collagen fibers
D)new capillaries and smooth muscle fibers

Question 7

Which of the following promotes rapid healing?

A)closely approximated edges of a wound
B)presence of foreign material
C)exposure to radiation
D)vasoconstriction in the involved area

Question 8

What is the correct order of the following events in the inflammatory response immediately after tissue injury
1)increased permeability of blood vessels
2)dilation of blood vessels
3)transient vasoconstriction
4)migration of leukocytes to the area
5)hyperemia

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

Question 9

Which of the following result directly from the release of chemical mediators following a moderate burn injury
1)pain
2)local vasoconstriction
3)increased capillary permeability
4)pallor

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

Question 10

The term leukocytosis means :

A)increased white blood cells in the blood
B)decreased white blood cells in the blood
C)increased number of immature circulating leukocytes
D)significant change in the proportions of WBC

Question 11

Mechanisms to bring an elevated body temperature down to the normal level include:

A)general cutaneous vasodilatation
B)generalized shivering
C)increased heart rate
D)increased metabolic rate

Question 12

A granuloma is best described as:

A)a small mass of cells with a necrotic center,which may develop as part of the immune response.
B)an erosion through the wall of viscera leading to complications
C)a type of adhesion
D)a form of stenosis in a duct
E)hypertrophic scar tissue on the skin

Question 13

Patients taking glucocorticoids for long periods of time are likely to develop all of the following EXCEPT:

A)decreased bone density
B)wasting of skeletal muscle
C)opportunistic infections
D)increased leukocyte production

Question 14

Which of the following is the best description of granulation tissue?

A)multiple layers of collagen fibers and epithelial cells
B)several layers of new epithelial cells
C)white fibrous tissue
D)fibroblasts and vascular endothelial cells

Question 15

Tears are considered to be part of th:
1)first line of defense
2)second line of defense
3)third line of defense
4)specific defenses
5)nonspecific defenses

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

Question 16

Systemic effects of severe inflammation include:

A)erythema and warmth
B)loss of movement at the affected joint
C)fatigue,anorexia,and mild fever
D)abscess formation

Question 17

The warmth and redness related to the inflammatory response results from:

A)increased interstitial fluid
B)production of complement
C)large number of WBCs entering the area
D)increased blood flow into the area

Question 18

A specific defense for the body is:

A)phagocytosis
B)sensitized T-lymphocytes
C)the inflammatory response
D)intact skin and mucous membranes

Question 19

Replacement of damaged tissue by similar functional cells is termed:

A)fibrosis
B)regeneration
C)resolution
D)repair by scar tissue

Question 20

Glucocorticoids are used to treat inflammation because they directly:

A)promote the release of prostaglandins at the site
B)decrease capillary permeability
C)mobilize lymphocytes and neutrophils
D)prevent infection

Question 21

The number of neutrophils in the blood is increased significantly:

A)during allergic reactions
B)during chronic inflammation
C)to produce antibodies
D)in order to promote phagocytosis

Question 22

The advantages of applying a biosynthetic skin substitute to a large area of full-thickness burns include:
1)reduced risk of infection
2)decreased loss of plasma protein and fluid
3)developing stronger fibrous scar tissue
4)more rapid healing
5)regeneration of all glands,nerves,and hair follicles

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

Question 23

Indicators of a general inflammatory response would include:

A)high,spiking fever and chills
B)elevated C-reactive protein
C)leukopenia and reduced ESR
D)elevated ALT and CK-MB

Question 24

Prolonged administration of glucocorticoids such as prednisone may cause:
1)atrophy of lymphoid tissue
2)increased resistance to infection
3)thrombocytopenia
4)decreased protein synthesis

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

Question 25

Which of the following drugs relieves fever and some types of pain but is NOT an anti-inflammatory agent?

A)Acetaminophen
B)Prednisone
C)Aspirin
D)Ibuprofen

Question 26

A large burn area predisposes to decreased blood pressure because:

A)bleeding occurs under the burn surface
B)the heart is damaged by toxic materials from the burn
C)fluid and protein shift out of the vascular compartment
D)vasoconstriction occurs in the burn area

Question 27

Isoenzymes in the circulating blood:

A)are a type of plasma protein normally present in the circulating blood
B)often indicate the precise location of an inflammatory response
C)are normally released from leukocytes during the inflammatory response
D)are pyrogens,causing low-grade fever

Question 28

A serous exudate is best described as a:

A)thin,watery,colorless exudate
B)thick,sticky,cloudy secretion
C)thick,greenish material containing microbes
D)brownish,clotted material

Question 29

Purulent exudates usually contain:

A)small amounts of plasma protein & histamine in water
B)red blood cells & all types of white blood cells
C)numerous leukocytes,bacteria,and cell debris
D)large amounts of water containing a few cells

Question 30

Application of ice to an injured knee reduces edema by:

A)promoting return of lymph fluid
B)causing local vasoconstriction
C)increasing the rate of tissue repair
D)causing systemic vasodilatation

Question 31

A major source of infection in burn areas is:

A)the skin grafts
B)microbes surviving in the hair follicles in the burn area
C)circulating blood bringing microbes to the burn wound
D)the patient's hands transferring microbes to the burn area

Question 32

Nonspecific agents that protect uninfected cells against viruses are called:

A)neutrophils
B)macrophages
C)interferons
D)pyrogens

Question 33

A woman has burns on the anterior surfaces of her right arm,chest,and right leg.The body surface area (BSA)or the percentage of body surface area burned is approximately:

A)13.5%
B)18%
C)22.5%
D)31.5%

Question 34

During an inflammatory response,erythema is caused by:

A)vasodilatation in the area
B)increased capillary permeability
C)irritation of sensory nerve endings by histamine
D)increased leukocytes in the area

Question 35

The characteristic appearance of a full-thickness burn is:

A)painful with multiple blisters
B)heavy bleeding
C)red with some swelling
D)dry,firm,charred,or hard white surface

Question 36

Systemic manifestations of an inflammatory response include:

A)edema and erythema
B)area of necrosis and loss of function
C)pain and tenderness
D)elevated C-reactive protein and leukocytosis

Question 37

Healing of large areas of skin loss (including dermis and epidermis)would be most successful through:

A)rapid mitosis and regeneration of skin layers
B)resolution of damaged cells in the area
C)covering the area with biosynthetic skin substitute
D)graft of fibrous tissue to the area

Question 38

A burn area in which the epidermis and part of the dermis is destroyed is classified as:

A)full-thickness
B)deep partial-thickness
C)superficial partial-thickness
D)first-degree

Question 39

Prostaglandins are produced from ___________ and cause ___________.

A)activated plasma protein;increased capillary permeability
B)mast cells;vasodilatation and pain
C)platelets;attraction of neutrophils,chemotaxis
D)mast cell granules;activation of histamines and kinins

Question 40

An abscess contains:

A)serous exudate
B)purulent exudate
C)fibrinous exudate
D)hemorrhagic exudate

Question 41

Systemic manifestations of inflammation include all EXCEPT:

A)pyrexia
B)malaise
C)chest pain
D)anorexia

Question 42

Identify the correct statement about burns:

A)The severity of the burn depends on the temperature,and the duration and extent of the burn.
B)Young children are less likely to suffer severe burns from immersion in excessively hot water.
C)Burns to the palms of the hands are more damaging than burns on the face.
D)With a major burn,excessive bleeding may cause shock.

Question 43

Which chemical mediator is involved in prolonging the inflammatory response?

A)bradykinin
B)histamine
C)leukotrienes
D)chemotactic factors

Question 44

Which of the following cellular elements found in the inflammatory response are responsible for phagocytosis?

A)macrophages
B)basophils
C)B-lymphocytes
D)T-lymphocytes
E)eosinophils

Question 45

Inhalation of carbon monoxide is a threat for many burn patients because this gas:

A)causes swelling in the trachea
B)quickly reduces the available oxygen in the blood
C)prevents full expansion of the lungs
D)is toxic to the nervous system

Question 46

Which of the following helps to localize and contain the foreign material during an inflammatory response?

A)lymphocytes
B)increased fluid
C)fibrinogen
D)antibodies

Question 47

Which of the following statements regarding inflammation is incorrect?

A)Inflammation caused by an allergen or a burn will contain a serous exudate.
B)Infection is one cause of inflammation.
C)Inflammation is the body's nonspecific response to tissue injury.
D)Disorders are named using the ending -sarcoma to indicate inflammation.

Question 48

Aspirin (ASA)is discouraged for treatment of viral infection in children because of:

A)decreased bone growth after puberty
B)frequent production of blood clots
C)formation of a granuloma filled with virus
D)the risk of developing Reye's syndrome

Question 49

Drugs that have anti-inflammatory,analgesic,and antipyretic activities include:
1)COX-2 inhibitors (NSAIDs)
2)glucocorticoids (e.g. ,prednisone)
3)ibuprofen (NSAIDs)
4)acetaminophen
5)aspirin (ASA)

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

Question 50

Hypermetabolism is common with major burns because of:

A)increased heat loss from the burn wound
B)demand for tissue repair
C)recurrent stress response
D)a,c
E)a,b,c

Question 51

In normal capillary exchange,what is net hydrostatic pressure based on?

A)the difference between the hydrostatic pressure within the capillary,as compared with the hydrostatic pressure of the interstitial fluid
B)the relative osmotic pressures in the blood and the interstitial fluid
C)the difference between the hydrostatic pressure and osmotic pressure within the capillary
D)the difference between the concentrations of blood cells,plasma proteins,and dissolved substances in the blood and the interstitial fluid

Question 52

The cardinal signs of inflammation include all of the following EXCEPT:

A)redness
B)loss of function
C)nausea
D)swelling
E)pain

Question 53

Identify the proper sequence in the healing process.

A)A blood clot forms;granulation tissue grows into the gap;new blood vessels develop;phagocytosis of foreign material and cell debris occurs;and collagen fibers form a tight,strong scar.
B)A blood clot forms;phagocytes remove foreign material and cell debris;granulation tissue grows into the gap;new blood vessels form;and collagen fibers promote formation of a tight,strong scar.
C)Collagen fibers form in the damaged area;a blood clot forms;granulation tissue grows into the gap;angiogenesis takes place;and foreign material and cell debris have been removed by phagocytes.
D)Foreign material and cell debris have been removed by phagocytes;a blood clot forms;granulation tissue grows into the gap;new blood vessels form;and collagen fibers grow and cross-link.

Question 54

Causes of inflammation include:

A)direct physical damage such as cuts and sprains
B)ischemia or infarction
C)allergic reactions
D)infection
E)all the above

Question 55

All are factors that promote healing EXCEPT:

A)good nutrition: protein,vitamins A and C
B)clean,undisturbed wound
C)effective circulation
D)advanced age
E)adequate hemoglobin

Question 56

Which statement applies to the recommended emergency care for burns?

A)Drop and lie completely still on your back.
B)Call a neighbor for help if the burn appears to be extensive.
C)Apply lotion and cover burn tightly with a sheet or towel.
D)Cover the burn area with clean,cool,or tepid water and remove nonsticking clothing.

Question 57

Potential complications after healing by scar formation include all the following EXCEPT:

A)lack of sensory function in the area
B)contractures and adhesions
C)increased hair growth
D)keloid formation

Question 58

Why is an application of cold recommended as part of the RICE first aid measures immediately following an inflammatory response due to injury? Because cold:

A)improves circulation in the area removing chemical mediators
B)causes local vasoconstriction to reduce local edema
C)draws more phagocytic cells to the area to remove debris
D)promotes immediate healing

Question 59

All of the following are correct statements regarding wound healing EXCEPT:

A)Resolution occurs where there is minimal tissue damage and the cells can recover.
B)Granulation tissue forms a permanent replacement for damaged tissue.
C)Regeneration occurs where the cells are capable of mitosis.
D)Scar tissue forms where the surrounding cells are incapable of mitosis.

Question 60

One goal for current research in tissue engineering is to:

A)create a functional replacement tissue when regeneration is not possible
B)adapt cells from the injured organ to produce replacement tissue
C)design a nonliving synthetic replacement tissue
D)use stem cells as a temporary covering for damaged tissue

Question 61

Which of the following is a serious potential complication found only with the anti-inflammatory COX-2 inhibitor drugs?

A)increased risk of infection at the site of inflammation
B)Reye's syndrome developing in children and young adults
C)increased incidence of heart attacks and strokes
D)greatly delayed blood clotting

Question 62

How does scar tissue usually cause obstructions to develop in tube-like structures?

A)Scar tissue continues to grow and spread,causing a blockage.
B)Scar tissue does not stretch,but rather shrinks in time,causing narrowing.
C)Scar tissue twists and forms knots as it develops.
D)Scar tissue attaches to nearby normal tissue causing obstruction.