Inflammation and Immune Pathology USMLE Step 1 Practice Question
A 34-year-old woman with a 10-year history of Crohn disease presents with acute bowel obstruction. Vital signs: BP 128/82 mmHg, HR 92/min, RR 16/min, temp 37.2°C. CT imaging reveals a 3-cm ileal stricture. Ileal resection specimen shows transmural mucosal ulceration with lymphocytes, plasma cells, activated macrophages, and extensive fibrosis. Notably absent: acute suppurative exudates. ESR is elevated at 48 mm/hr. Which feature best distinguishes chronic from acute inflammation?
Answer choices
- APredominance of neutrophils and edema only
- BTissue destruction with simultaneous repair attempts including angiogenesis and fibrosisCorrect answer
- CImmediate histamine release without cellular infiltration
- DCell swelling due to ATP depletion
- EAbsence of cytokine mediated signaling
- FPredominance of mononuclear cells with minimal vascular permeability changes
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