A patient with right ventricular failure develops fever and accumulation of fluid in pleural space. the fluid has high specific gravity and contains neutrophils, the most likely cause of accumulation of fluid is
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A 4-year-old child has had a high-volume diarrhea for the past 2 days. On examination she is dehydrated. A stool sample examined by serologic assay is positive for rotavirus. She is treated with intravenous fluids and recovers. Which of the following components is found on intestinal cells and recognizes double-stranded RNA of this virus to signal transcription factors that upregulate interferon production for viral elimination?
Toll-like receptor
A 72-year-old man with severe emphysema has had worsening right ventricular failure for the past 5 years. For the past 4 days, he has had fever and increasing dyspnea. A chest radiograph shows an accumulation of fluid in the pleural spaces. Fluid obtained by thoracentesis has a specific gravity of 1.030 and contains degenerating neutrophils. The most likely cause of this fluid accumulation is due to changes in which of the following?
Vascular permeability
A 35-year-old man has had increasing dyspnea for the past 24 hours. A chest radiograph shows large, bilateral pleural effusions. Thoracentesis yields 500 mL of slightly cloudy yellow fluid from the right pleural cavity. Cytologic examination of the fluid shows many neutrophils, but no lymphocytes or RBCs. Which of the following mechanisms contributes most to the pleural fluid accumulation?
Endothelial contraction
A 6-year-old child has a history of recurrent infections with pyogenic bacteria, including Staphylococcus aureus and Streptococcus pneumoniae. The infections are accompanied by a neutrophilic leukocytosis. Microscopic examination of a biopsy specimen obtained from an area of soft tissue necrosis shows microbial organisms, but very few neutrophils. An analysis of neutrophil function shows a defect in rolling. This child's increased susceptibility to infection is most likely caused by a defect involving which of the following molecules?
Selectins
In an experiment, bacteria are introduced into a perfused tissue preparation. Leukocytes leave the vasculature and migrate to the site of bacterial inoculation. The movement of these leukocytes is most likely to be mediated by which of the following substances?
Chemokines
A 12-month-old boy with a 6-month history of repeated infections has had a fever and cough for the past 3 days. A Gram stain of sputum shows many gram-positive cocci in chains. CBC shows neutrophilia. Laboratory studies show that the patient's neutrophils phagocytose and kill organisms promptly in the presence of normal human serum, but not in his own serum. The neutrophils migrate normally in a chemotaxis assay. Which of the following is the most likely cause of this boy's increased susceptibility to infection?
Diminished opsonization
A 5-year-old child has a history of recurrent bacterial infections, including pneumonia and otitis media. Analysis of leukocytes collected from the peripheral blood shows a deficiency in myeloperoxidase. A reduction in which of the following processes is the most likely cause of this child's increased susceptibility to infections?
Hydroxy-halide radical (HOCl-) formation
In an experiment, neutrophils collected from peripheral blood are analyzed for a "burst" of oxygen consumption. This respiratory burst is an essential step for which of the following events in an acute inflammatory response?
Generation of microbicidal activity
A 4-year-old girl has had numerous infections with Staphylococcus aureus since infancy. Genetic testing shows a defect leading to a lack of β2 integrin production. Which of the following abnormalities of neutrophil function is most likely responsible for these clinical symptoms?
Inadequate adhesion on cytokine-activated endothelium
In an experiment, peripheral blood cells are isolated and placed into a culture medium that preserves their metabolic activity. Interferon-γ is added to this culture, along with viable Escherichia coli organisms. Which of the following blood cell types in this medium is the most likely to have bactericidal activity against E. coli?
Monocyte
A woman who is allergic to cats visits a neighbor who has several cats. During the visit, she inhales cat dander, and within minutes, she develops nasal congestion with abundant nasal secretions. Which of the following substances is most likely to produce these findings?
Histamine
In a 6-month randomized trial of a pharmacologic agent, one group of patients receives a cyclooxygenase-2 (COX-2) inhibitor, and a control group does not. Both groups of adult males had mild congestive heart failure and bilateral symmetric arthritis of small joints. Laboratory measurements during the trial show no significant differences between the groups in WBC count, platelet count, hemoglobin, and creatinine. The group receiving the drug reports subjective findings different from those of the control group. Which of the following findings was most likely reported by the group receiving the drug?
Toll-like receptor
A 72-year-old man with severe emphysema has had worsening right ventricular failure for the past 5 years. For the past 4 days, he has had fever and increasing dyspnea. A chest radiograph shows an accumulation of fluid in the pleural spaces. Fluid obtained by thoracentesis has a specific gravity of 1.030 and contains degenerating neutrophils. The most likely cause of this fluid accumulation is due to changes in which of the following?
Vascular permeability
A 35-year-old man has had increasing dyspnea for the past 24 hours. A chest radiograph shows large, bilateral pleural effusions. Thoracentesis yields 500 mL of slightly cloudy yellow fluid from the right pleural cavity. Cytologic examination of the fluid shows many neutrophils, but no lymphocytes or RBCs. Which of the following mechanisms contributes most to the pleural fluid accumulation?
Endothelial contraction
A 6-year-old child has a history of recurrent infections with pyogenic bacteria, including Staphylococcus aureus and Streptococcus pneumoniae. The infections are accompanied by a neutrophilic leukocytosis. Microscopic examination of a biopsy specimen obtained from an area of soft tissue necrosis shows microbial organisms, but very few neutrophils. An analysis of neutrophil function shows a defect in rolling. This child's increased susceptibility to infection is most likely caused by a defect involving which of the following molecules?
Selectins
In an experiment, bacteria are introduced into a perfused tissue preparation. Leukocytes leave the vasculature and migrate to the site of bacterial inoculation. The movement of these leukocytes is most likely to be mediated by which of the following substances?
Chemokines
A 12-month-old boy with a 6-month history of repeated infections has had a fever and cough for the past 3 days. A Gram stain of sputum shows many gram-positive cocci in chains. CBC shows neutrophilia. Laboratory studies show that the patient's neutrophils phagocytose and kill organisms promptly in the presence of normal human serum, but not in his own serum. The neutrophils migrate normally in a chemotaxis assay. Which of the following is the most likely cause of this boy's increased susceptibility to infection?
Diminished opsonization
A 5-year-old child has a history of recurrent bacterial infections, including pneumonia and otitis media. Analysis of leukocytes collected from the peripheral blood shows a deficiency in myeloperoxidase. A reduction in which of the following processes is the most likely cause of this child's increased susceptibility to infections?
Hydroxy-halide radical (HOCl-) formation
In an experiment, neutrophils collected from peripheral blood are analyzed for a "burst" of oxygen consumption. This respiratory burst is an essential step for which of the following events in an acute inflammatory response?
Generation of microbicidal activity
A 4-year-old girl has had numerous infections with Staphylococcus aureus since infancy. Genetic testing shows a defect leading to a lack of β2 integrin production. Which of the following abnormalities of neutrophil function is most likely responsible for these clinical symptoms?
Inadequate adhesion on cytokine-activated endothelium
In an experiment, peripheral blood cells are isolated and placed into a culture medium that preserves their metabolic activity. Interferon-γ is added to this culture, along with viable Escherichia coli organisms. Which of the following blood cell types in this medium is the most likely to have bactericidal activity against E. coli?
Monocyte
A woman who is allergic to cats visits a neighbor who has several cats. During the visit, she inhales cat dander, and within minutes, she develops nasal congestion with abundant nasal secretions. Which of the following substances is most likely to produce these findings?
Histamine
In a 6-month randomized trial of a pharmacologic agent, one group of patients receives a cyclooxygenase-2 (COX-2) inhibitor, and a control group does not. Both groups of adult males had mild congestive heart failure and bilateral symmetric arthritis of small joints. Laboratory measurements during the trial show no significant differences between the groups in WBC count, platelet count, hemoglobin, and creatinine. The group receiving the drug reports subjective findings different from those of the control group. Which of the following findings was most likely reported by the group receiving the drug?
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