Inflammation: fever pathogenesis: 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: fever pathogenesis

Sample item

A 25-year-old woman with pneumonia has a temperature of 39.5 degrees Celsius, which falls after she takes paracetamol. Which mediator, produced in response to IL-1 and TNF, acts directly on the hypothalamus to raise the thermoregulatory set point?

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

The answer and the reasoning

A. Prostaglandin E2

Pyrogens such as bacterial products stimulate release of IL-1, IL-6 and TNF, which induce cyclooxygenase in the hypothalamic vascular endothelium. The resulting prostaglandin E2 resets the thermostat upward. Antipyretics such as aspirin and paracetamol reduce fever by inhibiting cyclooxygenase.

Option by option

  • A. Prostaglandin E2 (correct)

    Correct. Prostaglandin E2 in the hypothalamus raises the set point, and antipyretics block its synthesis.

  • B. Leukotriene B4

    Leukotriene B4 is a chemotactic agent for neutrophils, not the central pyrogenic mediator.

  • C. Histamine

    Histamine causes vasodilation and increased permeability in tissue, and does not reset the hypothalamic set point.

  • D. Bradykinin

    Bradykinin mainly causes pain and vasodilation, rather than fever.

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.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Prostaglandin E2. Pyrogens such as bacterial products stimulate release of IL-1, IL-6 and TNF, which induce cyclooxygenase in the hypothalamic vascular endothelium.

Why is "Leukotriene B4" not the answer?

Leukotriene B4 is a chemotactic agent for neutrophils, not the central pyrogenic mediator.

Why is "Histamine" not the answer?

Histamine causes vasodilation and increased permeability in tissue, and does not reset the hypothalamic set point.

Why is "Bradykinin" not the answer?

Bradykinin mainly causes pain and vasodilation, rather than fever.

What concept does this question test?

It tests Inflammation: fever pathogenesis in Pathology. The resulting prostaglandin E2 resets the thermostat upward. Antipyretics such as aspirin and paracetamol reduce fever by inhibiting cyclooxygenase.

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: fever pathogenesis?

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.