Inflammation – introduction MCQs With Answer

Inflammation – introduction MCQs With Answer

Inflammation is a fundamental topic in pharmacology and pathophysiology for B. Pharm students, covering acute and chronic responses, cellular events, and inflammatory mediators. This introduction explores mechanisms such as vascular changes, leukocyte recruitment, prostaglandin and cytokine signaling, complement and kinin systems, and pharmacologic interventions like NSAIDs and corticosteroids. Emphasis on biomarkers (CRP, ESR), granulomatous inflammation, resolution versus fibrosis, and targeted biologic therapies helps link theory to therapeutics. These focused, keyword-rich MCQs will reinforce clinical reasoning and drug action relevant to inflammatory diseases. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What is the primary difference between acute and chronic inflammation?

• Acute inflammation is always caused by infection, chronic inflammation is not
• Acute inflammation is short-lived with neutrophil predominance, chronic involves mononuclear cells and fibrosis
• Acute inflammation leads only to resolution, chronic inflammation leads only to scarring
• Acute inflammation does not involve vascular changes, chronic does

Correct Answer: Acute inflammation is short-lived with neutrophil predominance, chronic involves mononuclear cells and fibrosis

Q2. Which of the following is not a classic cardinal sign of acute inflammation?

• Rubor (redness)
• Dolor (pain)
• Pyknosis (nuclear condensation)
• Calor (heat)

Correct Answer: Pyknosis (nuclear condensation)

Q3. Increased vascular permeability in acute inflammation primarily facilitates which process?

• Delivery of oxygen to injured tissue
• Leakage of plasma proteins and leukocyte extravasation
• Rapid apoptosis of damaged cells
• Synthesis of collagen by fibroblasts

Correct Answer: Leakage of plasma proteins and leukocyte extravasation

Q4. Which cell is typically the first responder in acute inflammation?

• Macrophage
• Neutrophil
• Lymphocyte
• Fibroblast

Correct Answer: Neutrophil

Q5. Histamine is stored preformed in which cells and released during inflammation?

• Neutrophils and monocytes
• Mast cells and basophils
• Endothelial cells and fibroblasts
• T lymphocytes and B lymphocytes

Correct Answer: Mast cells and basophils

Q6. Which mediator is primarily responsible for chemotaxis of neutrophils?

• Prostaglandin E2 (PGE2)
• Leukotriene B4 (LTB4)
• Bradykinin
• Interleukin-10 (IL-10)

Correct Answer: Leukotriene B4 (LTB4)

Q7. Prostaglandin E2 (PGE2) contributes to inflammation by causing:

• Chemotaxis of neutrophils
• Vasoconstriction and reduced vascular permeability
• Fever and increased pain sensitivity
• Direct opsonization of bacteria

Correct Answer: Fever and increased pain sensitivity

Q8. Which enzyme family converts arachidonic acid to prostaglandins?

• Lipoxygenases (LOX)
• Cyclooxygenases (COX)
• Phospholipases A2 (PLA2)
• Monooxygenases

Correct Answer: Cyclooxygenases (COX)

Q9. Aspirin reduces inflammation by which primary mechanism?

• Reversible inhibition of COX-2 only
• Irreversible acetylation of COX enzymes
• Blocking leukotriene receptors
• Inhibiting TNF-alpha production

Correct Answer: Irreversible acetylation of COX enzymes

Q10. Corticosteroids exert anti-inflammatory effects mainly by:

• Activating COX enzymes
• Inhibiting phospholipase A2 via induction of lipocortin
• Stimulating prostaglandin synthesis
• Enhancing leukocyte recruitment to tissues

Correct Answer: Inhibiting phospholipase A2 via induction of lipocortin

Q11. Which complement fragment is a major opsonin?

• C3a
• C3b
• C5a
• C9

Correct Answer: C3b

Q12. C5a in the complement cascade primarily functions as a:

• Membrane attack complex component
• Chemotactic factor for neutrophils
• Protein that binds antibodies
• Inhibitor of coagulation

Correct Answer: Chemotactic factor for neutrophils

Q13. Which pathway of complement activation is initiated by mannose-binding lectin?

• Classical pathway
• Alternative pathway
• Lectin pathway
• Intrinsic coagulation pathway

Correct Answer: Lectin pathway

Q14. Leukocyte extravasation involves selectins primarily for which step?

• Firm adhesion to endothelium
• Transmigration through basement membrane
• Initial rolling along the endothelium
• Phagocytosis of microbes

Correct Answer: Initial rolling along the endothelium

Q15. Firm adhesion of leukocytes to endothelium is mainly mediated by:

• Selectins binding to sialyl-Lewis X
• Integrins binding to ICAM-1
• Complement C3b on pathogens
• Histamine-induced gaps between endothelial cells

Correct Answer: Integrins binding to ICAM-1

Q16. NADPH oxidase deficiency leads to recurrent infections due to impaired:

• Complement activation
• Respiratory burst and reactive oxygen species generation
• Antibody production
• T cell activation

Correct Answer: Respiratory burst and reactive oxygen species generation

Q17. Myeloperoxidase in neutrophils produces which potent antimicrobial agent?

• Nitric oxide (NO)
• Hypochlorous acid (HOCl)
• Superoxide dismutase
• Hydrogen peroxide exclusively

Correct Answer: Hypochlorous acid (HOCl)

Q18. Opsonization enhances phagocytosis by coating microbes with:

• Lipids and carbohydrates
• Opsonins such as IgG and C3b
• Histamine and bradykinin
• Proteoglycans from the extracellular matrix

Correct Answer: Opsonins such as IgG and C3b

Q19. Which acute phase reactant is most commonly measured as a marker of systemic inflammation?

• Albumin
• C-reactive protein (CRP)
• Transferrin
• Alkaline phosphatase

Correct Answer: C-reactive protein (CRP)

Q20. An elevated erythrocyte sedimentation rate (ESR) in inflammation is mainly due to increased:

• Albumin levels
• Fibrinogen and plasma proteins causing RBC aggregation
• White blood cell count
• Plasma viscosity from lipids

Correct Answer: Fibrinogen and plasma proteins causing RBC aggregation

Q21. Granulomatous inflammation is characterized by which cell type?

• Neutrophils predominating in clusters
• Epithelioid macrophages and multinucleated giant cells
• Basophils and eosinophils predominating
• Fibroblasts only with no inflammatory cells

Correct Answer: Epithelioid macrophages and multinucleated giant cells

Q22. Caseous necrosis is most characteristically associated with:

• Streptococcal pharyngitis
• Tuberculosis
• Acute appendicitis
• Viral hepatitis

Correct Answer: Tuberculosis

Q23. Bradykinin primarily contributes to inflammation by causing:

• Fever through hypothalamic action
• Vasodilation, increased vascular permeability, and pain
• Opsonization of bacteria
• Direct neutrophil apoptosis

Correct Answer: Vasodilation, increased vascular permeability, and pain

Q24. Leukotrienes produced via 5-lipoxygenase mainly mediate:

• Vasodilation and platelet aggregation
• Bronchoconstriction, increased vascular permeability, and chemotaxis
• Direct protein synthesis in hepatocytes
• Inhibition of neutrophil migration

Correct Answer: Bronchoconstriction, increased vascular permeability, and chemotaxis

Q25. Which drug class blocks synthesis of prostaglandins by inhibiting COX enzymes?

• Statins
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Beta-blockers
• Antifungals

Correct Answer: Nonsteroidal anti-inflammatory drugs (NSAIDs)

Q26. Selective COX-2 inhibitors were developed to reduce gastrointestinal toxicity but increased risk of:

• Hepatotoxicity
• Renal stones
• Cardiovascular events such as myocardial infarction
• Ototoxicity

Correct Answer: Cardiovascular events such as myocardial infarction

Q27. TNF-alpha and IL-1 are key cytokines that mediate which systemic effect in inflammation?

• Hypothermia and anemia
• Fever, acute phase response, and cachexia
• Direct collagen deposition
• Inhibition of leukocyte extravasation

Correct Answer: Fever, acute phase response, and cachexia

Q28. Anti-TNF biologics are effective in treating which inflammatory condition?

• Type 1 diabetes
• Rheumatoid arthritis
• Acute bacterial meningitis
• Hereditary angioedema

Correct Answer: Rheumatoid arthritis

Q29. Tissue repair by fibrosis is mainly driven by which growth factor?

• Interleukin-8 (IL-8)
• Transforming growth factor-beta (TGF-beta)
• Interferon-gamma (IFN-gamma)
• Histamine

Correct Answer: Transforming growth factor-beta (TGF-beta)

Q30. Angiogenesis during chronic inflammation and healing is primarily stimulated by:

• VEGF (vascular endothelial growth factor)
• Bradykinin
• Complement C5b-9
• Fibrinogen

Correct Answer: VEGF (vascular endothelial growth factor)

Q31. Healing by primary intention refers to wound repair that:

• Involves large tissue loss and granulation tissue formation
• Occurs when wound edges are approximated with minimal scarring
• Always results in keloid formation
• Is mediated exclusively by macrophages without fibroblast involvement

Correct Answer: Occurs when wound edges are approximated with minimal scarring

Q32. Chronic inflammation is most likely when the offending agent:

• Is rapidly cleared within hours
• Cannot be eliminated or persists for a long time
• Is limited to a superficial skin abrasion
• Is neutralized by histamine

Correct Answer: Cannot be eliminated or persists for a long time

Q33. Which interleukin is a major chemokine for neutrophils (also known as CXCL8)?

• IL-2
• IL-8
• IL-4
• IL-10

Correct Answer: IL-8

Q34. Neutrophil extracellular traps (NETs) are composed mainly of:

• Lipids and polysaccharides
• DNA and granular antimicrobial proteins
• Fibrin and collagen fibers
• Hyaluronan and proteoglycans

Correct Answer: DNA and granular antimicrobial proteins

Q35. Which cell-surface receptor on macrophages recognizes mannose residues on microbes?

• Toll-like receptor 4 (TLR4)
• Mannose receptor
• Fc receptor for IgM
• CD28

Correct Answer: Mannose receptor

Q36. Resolution of acute inflammation with minimal scarring is more likely when:

• There is extensive tissue destruction and heavy exudation
• The extracellular matrix scaffold is preserved and injury is limited
• The wound is infected with pyogenic bacteria
• There is persistent foreign body reaction

Correct Answer: The extracellular matrix scaffold is preserved and injury is limited

Q37. Persistent activation of macrophages in chronic inflammation may lead to formation of:

• Edematous transudates
• Granulomas
• Acute serous exudates
• Immediate type hypersensitivity only

Correct Answer: Granulomas

Q38. Which laboratory finding is typical of the acute phase reaction in inflammation?

• Decreased CRP and increased albumin
• Increased CRP and decreased albumin
• Decreased fibrinogen and low ESR
• Marked hypoglycemia

Correct Answer: Increased CRP and decreased albumin

Q39. The classical pathway of complement activation requires:

• Direct microbial surfaces without antibodies
• Binding of C1q to antibody-antigen complexes
• Mannose-binding lectin binding to sugars
• Spontaneous hydrolysis of C5

Correct Answer: Binding of C1q to antibody-antigen complexes

Q40. Among the following, which is a vasoactive amine released during immediate inflammation?

• Prostaglandin I2 (prostacyclin)
• Histamine
• Interferon-alpha
• TGF-beta

Correct Answer: Histamine

Q41. Which mediator primarily mediates pain in inflammation by sensitizing nociceptors?

• Prostaglandins (e.g., PGE2)
• Complement C3b
• Interleukin-2
• Heparin

Correct Answer: Prostaglandins (e.g., PGE2)

Q42. Arachidonic acid is released from membrane phospholipids by the action of:

• Cyclooxygenase
• Phospholipase A2 (PLA2)
• 5-lipoxygenase
• Thromboxane synthase

Correct Answer: Phospholipase A2 (PLA2)

Q43. Complement membrane attack complex (MAC) leads to:

• Opsonization of bacteria
• Direct lysis of target cell membranes
• Chemoattraction of neutrophils
• Activation of T cells

Correct Answer: Direct lysis of target cell membranes

Q44. Which pattern of inflammation is characterized by pus formation?

• Serous inflammation
• Fibrinous inflammation
• Suppurative (purulent) inflammation
• Granulomatous inflammation

Correct Answer: Suppurative (purulent) inflammation

Q45. The major mechanism of action of nonselective NSAIDs causing gastric ulceration is:

• Inhibition of leukotriene synthesis
• Inhibition of COX-1 leading to reduced protective prostaglandins
• Direct cytotoxicity to gastric epithelial DNA
• Stimulation of gastric acid via histamine release

Correct Answer: Inhibition of COX-1 leading to reduced protective prostaglandins

Q46. In chronic inflammation, macrophages can be polarized into M1 or M2 phenotypes; M2 macrophages predominantly promote:

• Microbicidal activity and inflammation
• Tissue repair, fibrosis, and anti-inflammatory responses
• Immediate hypersensitivity reactions
• Platelet aggregation

Correct Answer: Tissue repair, fibrosis, and anti-inflammatory responses

Q47. Which of the following mediators links coagulation and inflammation by generating thrombin and fibrin?

• Factor VIII deficiency
• Tissue factor (factor III)
• Antithrombin III
• Protein C

Correct Answer: Tissue factor (factor III)

Q48. Fever in systemic inflammation is produced via increased hypothalamic synthesis of:

• Serotonin
• Prostaglandin E2 (PGE2)
• Nitric oxide
• Bradykinin

Correct Answer: Prostaglandin E2 (PGE2)

Q49. Chronic inflammation with formation of noncaseating granulomas is typical of which condition?

• Mycobacterium tuberculosis infection
• Rheumatoid arthritis and sarcoidosis
• Acute bacterial cellulitis
• Acute viral pharyngitis

Correct Answer: Rheumatoid arthritis and sarcoidosis

Q50. Prostacyclin (PGI2) produced by endothelium has which primary actions?

• Vasoconstriction and platelet aggregation
• Vasodilation and inhibition of platelet aggregation
• Increased vascular permeability and bronchoconstriction
• Direct neutrophil chemotaxis

Correct Answer: Vasodilation and inhibition of platelet aggregation

Download