Inflammation: acute phase response: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Inflammation: acute phase response

Sample item

A 30-year-old woman has three weeks of fever, and her erythrocyte sedimentation rate is 95 mm in the first hour. Which change underlies the raised sedimentation rate in systemic inflammation?

AReduced plasma fibrinogen and globulinsBRaised plasma fibrinogen promoting rouleaux formation of red cellsCIncreased zeta potential between red cellsDMarked polycythaemia

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Raised plasma fibrinogen promoting rouleaux formation of red cells

IL-6 stimulates hepatic synthesis of acute phase proteins such as fibrinogen, C-reactive protein and serum amyloid A. Fibrinogen reduces the negative surface charge repelling red cells, so they form rouleaux, which sediment faster. Polycythaemia, sickle cells and low fibrinogen reduce the sedimentation rate.

Option by option

A. Reduced plasma fibrinogen and globulins
Reduced fibrinogen and globulins would slow sedimentation.
B. Raised plasma fibrinogen promoting rouleaux formation of red cells (correct)
Correct. Fibrinogen-induced rouleaux formation increases the sedimentation rate.
C. Increased zeta potential between red cells
A higher zeta potential would keep red cells apart and slow sedimentation.
D. Marked polycythaemia
Polycythaemia lowers the sedimentation rate because crowding of red cells impedes rouleaux formation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Raised plasma fibrinogen promoting rouleaux formation of red cells. IL-6 stimulates hepatic synthesis of acute phase proteins such as fibrinogen, C-reactive protein and serum amyloid A.

Why is "Reduced plasma fibrinogen and globulins" not the answer?

Reduced fibrinogen and globulins would slow sedimentation.

Why is "Increased zeta potential between red cells" not the answer?

A higher zeta potential would keep red cells apart and slow sedimentation.

Why is "Marked polycythaemia" not the answer?

Polycythaemia lowers the sedimentation rate because crowding of red cells impedes rouleaux formation.

What concept does this question test?

It tests Inflammation: acute phase response in Pathology. Fibrinogen reduces the negative surface charge repelling red cells, so they form rouleaux, which sediment faster. Polycythaemia, sickle cells and low fibrinogen reduce the sedimentation rate.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Inflammation: acute phase response?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.