Inflammation and Repair Practice Questions

Q: Which of the following is NOT a pro-inflammatory cytokine?

IL-4. ### Explanation In the context of the systemic inflammatory response syndrome (SIRS) and surgical trauma, cytokines are categorized based on their role in the inflammatory cascade. **Why IL-4 is the Correct Answer:** **Interleukin-4 (IL-4)** is a classic **anti-inflammatory cytokine**. It is produced primarily by Th2 cells and functions to downregulate the production of pro-inflammatory cytokines (like IL-1 and TNF-α) and inhibit macrophage activation. Other key anti-inflammatory cytokines include **IL-10**, **IL-13**, and **Transforming Growth Factor-beta (TGF-β)**. These mediators help limit the inflammatory response and promote tissue repair. **Analysis of Incorrect Options:** * **IL-1 (Option A):** A potent pro-inflammatory cytokine produced by macrophages. It is responsible for inducing fever (endogenous pyrogen) and stimulating the acute-phase response. * **TNF-alpha (Option B):** Often considered the "master regulator" of inflammation. It is one of the earliest cytokines released after injury or sepsis and mediates hemodynamic instability and cachexia. * **IL-8 (Option D):** A major chemoattractant cytokine (chemokine) that specifically recruits and activates neutrophils at the site of inflammation. **Clinical Pearls for NEET-PG:** * **Early Response:** TNF-α and IL-1 are the first cytokines to rise after surgical trauma or sepsis (half-life <20 mins). * **IL-6:** This is the primary cytokine responsible for stimulating the liver to produce **Acute Phase Reactants** (e.g., CRP, Fibrinogen). It is often used as a marker for the severity of surgical trauma. * **The Balance:** The body maintains a balance between the Systemic Inflammatory Response Syndrome (SIRS) and the Compensatory Anti-inflammatory Response Syndrome (CARS). IL-4 and IL-10 are the hallmarks of CARS.

Q: Which of the following chemokines binds to the CCR3 receptor?

Eotaxin-2. **Explanation:** Chemokines are small signaling proteins that direct the migration of leukocytes (chemotaxis). They are classified into four subfamilies (CXC, CC, C, and CX3C) based on the arrangement of conserved cysteine residues. **1. Why Eotaxin-2 is Correct:** **Eotaxin-2 (CCL24)** is a potent chemoattractant specifically for eosinophils. It binds primarily to the **CCR3 receptor**, which is highly expressed on the surface of eosinophils, basophils, and Th2 cells. This interaction is crucial in the recruitment of these cells to sites of allergic inflammation, such as in bronchial asthma or parasitic infections. **2. Analysis of Incorrect Options:** * **Option A: IL-8 (CXCL8):** This is the prototypical CXC chemokine. It binds to **CXCR1 and CXCR2** receptors and is the primary recruiter for **neutrophils**. * **Option C: CCL3 (MIP-1α):** Macrophage Inflammatory Protein-1α binds to **CCR1 and CCR5**. It is involved in the recruitment of monocytes and T-lymphocytes. * **Option D: Fractalkine (CX3CL1):** This is the only member of the CX3C class. It exists in both membrane-bound and soluble forms and binds to the **CX3CR1** receptor. **High-Yield NEET-PG Pearls:** * **CCR5:** Significant as a co-receptor for **HIV-1** entry into macrophages. Individuals with a CCR5-Δ32 mutation show resistance to HIV. * **CXCR4:** Another major co-receptor for HIV entry (T-cell tropic strains). * **Duffy Antigen (DARC):** A chemokine receptor on RBCs that acts as a "sink" for excess chemokines and serves as the attachment site for *Plasmodium vivax*. * **Eosinophil Recruitment:** Remember the "3 E's": **E**otaxin, **E**osinophil, and CCR**3**.

Question 1

A 25-year-old woman develops a sore, red, hot, swollen left knee. She has no history of trauma and no familial history of joint disease. Fluid aspirated from the joint space shows an abundance of segmented neutrophils. Aspirin is effective in relieving symptoms of acute inflammation in the patient because it inhibits which of the following enzymes?

Accepted Answer

Cyclooxygenase

Answer

Myeloperoxidase

Answer

Phospholipase A2

Answer

Protein kinase C

Question 2

What are the most important growth factors in angiogenesis?

Accepted Answer

Angiotensin I (Ang I)

Answer

Platelet-derived growth factor (PDGF)

Answer

Transforming growth factor alpha (TGF-α)

Answer

Transforming growth factor beta (TGF-β)

Question 3

Which of the following is not a negative acute-phase reactant?

Accepted Answer

Ferritin

Answer

Albumin

Answer

Transthyretin

Answer

Transferrin

Question 4

Important components of collagen synthesis, wound strength, and contraction include all of the following EXCEPT?

Accepted Answer

Vitamin D

Answer

Fibroblasts

Answer

Myofibroblasts

Answer

Vitamin C

Question 5

Which of the following is NOT an integrin ligand?

Accepted Answer

CD 34

Answer

CD 54

Answer

CD 102

Answer

CD 106

Question 6

Which of the following are considered slow mediators of inflammation?

Accepted Answer

Leukotrienes

Answer

Prostaglandins

Answer

Interleukins

Answer

Vasoactive amines

Question 7

Integrins are associated with all of the following processes except:

Accepted Answer

Rolling

Answer

Adhesion

Answer

Arrest

Answer

Transmigration of cells

Question 8

Which of the following is NOT a pro-inflammatory cytokine?

Accepted Answer

IL-4

Answer

IL-1

Answer

TNF alpha

Answer

IL-8

Question 9

Which of the following chemokines binds to the CCR3 receptor?

Accepted Answer

Eotaxin-2

Answer

IL-8

Answer

CCL3

Answer

Fractalkine

Question 10

Which of the following events occurs earliest in wound healing?

Accepted Answer

Neutrophils line the wound edge

Answer

A thin continuous epithelial cover appears

Answer

Fibroblasts lay down collagen fibers

Answer

Granulation tissue fills the wound

Inflammation and Repair — MCQs

Inflammation and Repair — MCQs

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