A patient with long-standing chronic inflammatory disease develops systemic amyloidosis. Which amyloid protein subtype is characteristically deposited?

1. A

   A. ATTR

2. B

   B. Abeta2m

3. C

   C. AL

4. D

   D. AA

Appeared in: INI-CET EXAM -2026

Explanation

• AA amyloidosis, also known as secondary amyloidosis, is a direct consequence of chronic inflammatory states.
• During persistent inflammation, the liver overproduces Serum Amyloid A (SAA), an acute-phase protein.
• This SAA protein can misfold and deposit as insoluble AA fibrils in organs, particularly the kidneys.
• Conditions like rheumatoid arthritis, inflammatory bowel disease (IBD), and chronic infections (e.g., tuberculosis) are classic triggers for AA amyloidosis.

Why Other Options Were Wrong

• Option A: ATTR amyloidosis is caused by the deposition of transthyretin protein, not a protein related to inflammation.
• Option B: Abeta2m (Aβ2M) amyloidosis is associated with the accumulation of beta-2 microglobulin.
• Option C: AL amyloidosis, or primary amyloidosis, results from the deposition of immunoglobulin light chains produced by a clonal population of plasma cells.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Pathophysiology and classification of systemic amyloidosis to guide bedside assessment, documentation, and the next nursing action.
• Nurses caring for patients with chronic inflammatory conditions (e.g., rheumatoid arthritis, Crohn's disease) must be vigilant for signs of renal dysfunction, such as new-onset proteinuria or edema, which could indicate the development of AA amyloidosis.
• Early detection is crucial. Monitoring urine for protein and assessing renal function (BUN, creatinine) are key nursing responsibilities in this patient population.
• Management of AA amyloidosis primarily focuses on treating the underlying inflammatory disease to reduce the production of SAA protein.

How to Approach the Question

• First, identify the core information in the question stem: the patient has a 'long-standing chronic inflammatory disease'.
• This key phrase should trigger the recall of 'secondary' or 'reactive' processes.
• Next, review the options, which are different subtypes of amyloid protein.
• Connect the concept of secondary/reactive processes to the specific type of amyloidosis. Recall that chronic inflammation leads to the overproduction of Serum Amyloid A (SAA).
• This directly links chronic inflammation to AA amyloidosis.
• Eliminate the other options by recalling their specific causes: AL (plasma cell disorders), ATTR (hereditary/age-related), and Aβ2M (long-term dialysis).

Concept Tested & Keywords

• Concept Tested: Pathophysiology and classification of systemic amyloidosis.
• Stem keywords: long-standing chronic inflammatory disease, systemic amyloidosis, amyloid protein subtype
• Lead-in keywords: Which
• Clinical cues: The key clinical cue is 'long-standing chronic inflammatory disease', which directly points to secondary (reactive) amyloidosis.

Question ID

QB1CtRSWp6pCXvnFhQCiyM

Copy ID

Reference Book

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 1 (1-214) pp. 173-175, 174-176

E6 Medicine Harrison 22e Part 1 p. 936-938