Inflammatory Mediators and Chronic Granulomatous Inflammation MCQs

Scar formation may follow very severe acute injury, but occurs more often as a reaction to chronic injury. The principal cell type involved in scar deposition is the peri-sinusoidal hepatic stellate cell. Following liver injury, stellate cells may become activated and convert into highly fibro genic my fibroblasts, which produce the fibrous scar. Stellate cell activation involves complex interactions between Kupffer cells, hepatocytes, and inflammatory cells. Reference: Robbins Basic Pathology, 10 th ed, Pg-639

The complement complex attacking the cell membrane is membrane attack complex having a composition of C56789. Action of this complex leads to entry of fluid and ions inside the cells leading to cell lysis. Reference: Robbins & Cotran Pathologic Basis of Diseases 10 th edition, chapter 3, pg 85

Histamine is vasoactive amine that is located in most body tissues but is highly concentrated in the lungs, skin and gastrointestinal tract. It is stored in mast cell and basophils. When it is injected intradermally, it causes the triple response: Red spot: due to dilatation Wheal: due to exudation of fluid from capillaries Flare: Redness in surrounding area due to arterial dilatation Reference: Goodman and Gilman, 10 th ed, Pg: 650.

Arachidonic acid metabolites(prostaglandins and leukotrienes), platelet activating factors are involved in vascular reactions, leukocyte chemotaxis and other reactions of inflammation; antagonized by lipoxins. Lipoxins also are generated from arachidonic acid by the lipoxygenase pathway, but unlike prostaglandins and leukotrienes, the lipoxins suppress inflammation by inhibiting the recruitment of leukocytes. Reference: Robbins and Cotran Pathologic Basis of Diseases, 10 th ed, Pg: 78.

The following are the anti inflammatory cytokines: IL-10, TGF-B, IL-4, IL-13. Reference: Robbins 10 th edition, chapter 3, pg 85

In chronic hepatitis B, 'ground-glass' hepatocytes (cells with endoplasmic reticulum swollen by HBsAg) are a diagnostic hallmark, and the presence of viral antigen in these cells can be confirmed by immunostaining. 'ground-glass' hepatocytes are liver cells which have eosinophilic granular, glassy cytoplasm on light microscopy. This appearance corresponds to a proliferated smooth endoplasmic reticulum ultrastructure. These changes may be drug-induced or associated with hepatitis b antigenaemia, particularly in carriers. Reference: Robbins Basic Pathology, 10 th ed, Pg-649

Ans. is 'c' i.e., Bridging necrosis . Portal tracts show severe chronic inflammation with inflammatory cells extending into the liver lobules disrupting the limiting plate of hepatocytes. - Piecemeal necrosis - Portal fibrosis . Bridging necrosis - Interface hepatitis

Microscopic polyangiitis is a necrotizing vasculitis that generally affects capillaries as well as small arterioles and venules. Unlike PAN, all lesions of microscopic polyangiitis tend to be of the same age in any given patient, suggesting a single episode of antibody or immune complex deposition. It is also called hypersensitivity vasculitis or leukocytoclastic vasculitis. The skin, mucous membranes, lungs, brain, heart, gastrointestinal tract, kidneys, and muscle all can be involved. Most cases are associated with MPO-ANCA positivity. Microscopic polyangiitis is characterized by segmental fibrinoid necrosis of the media with focal transmural necrotizing lesions; granulomatous inflammation is absent. Reference : Robbins 10th Ed pg 514