2.1 acute inflammation, part 2 Flashcards Preview

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Flashcards in 2.1 acute inflammation, part 2 Deck (33):
1

What are the three major, general phases of inflammation?

1. Fluid phase
2. PMN phase
3. Macrophage phase

2

What is the peak time of the PMN phase of inflammation?

24 hours

3

What is the peak time of the macrophage phase of inflammation?

2-3 days

4

Where in the blood stream to heavy particles sit? What happens to them with vasodilation?

-Center

-Move toward the periphery with vasodilation

5

What is the first step of PMN arrival? What is involved in this step?

Margination
-Vasodilation slows blood flow
-Cells marginate from center of flow to the periphery

6

Where do PMNs marginate at?

Post capillary venule

7

What is the second step in PMN migration, and what occurs with this?

Rolling
-Selectins (speed bumps) slow down the rolling marginated PMNs

8

What are the "speed bumps" that cause the rolling phase of PMN migration? What cells do these come from?

P-selectin
-Weibel-Palade bodies

E-selectin induced by TNF and IL-1

9

What are the chemokines that induce E-selectin upregulation?

TNF and IL-1

10

What are the two proteins contained within Weibel-Palade bodies?

P-selectin
vWF

11

What chemokine induces WP bodies to release P-selectin?

Histamine

12

What is the molecule on leukocytes that bind selectins? What does this interaction cause?

-Sialyl Lewis X
-Interaction results in rolling of leukocytes along the vessel wall

13

What is Sialyl Lewis X, and what does it do?

Molecule on leukocyte that binds to selectins on endothelium that results in rolling

14

What is the third step of PMN migration? What occurs with this?

Adhesion:
-Cellular adhesion molecules upregulated on endothelium

15

What are the cytokine that upregulate adhesion molecules on the endothelium?

TNF and IL-1

16

What are the cytokines that upregulate integrins on leukocytes, to facilitate bind to ICAMs and VCAMs on the endothelium?

C5a and LTB4

17

What is the pathophysiology of leukocyte adhesion deficiency? Inheritance pattern?

AR defect of integrins (CD18 subunit)

18

What are the clinical findings of leukocyte adhesion deficiency? (3)

-Delayed separation of the umbilical cord
-Increased circulating PMNs
-Recurrent bacterial infections that lack pus formation

19

Delayed separation of the umbilical cord = ? Why?

-Leukocyte adhesion deficiency
-No PMNs to cause inflammation to necrotic umbilical cord

20

Recurrent bacterial infections that lack pus = ?

Leukocyte adhesion deficiency

21

Why is there an increase in the circulating PMNs with leukocyte adhesion deficiency?

Marginated pool shrinks d/t lack of ability to adhere

22

What, generally, is pus? Why, then, is there no pus with leukocyte adhesion deficiency?

-Dead PMNs sitting in fluid
-No PMNs d/t lack of adhesion

23

What is the 4th and final step of PMN migration?

Transmigration and chemotaxis
-Leukocytes transmigrate across the endothelium of postcapillary venule

24

What guides PMNs once they cross the postcapillary venules? (4)

chemoattractants:
-IL-8
-C5a
-LTB4
-Bacterial products

25

What are the two major opsonins that enhance phagocytosis by PMNs?

IgG
C3b

26

How does the general process of phagocytosis occur?

Pseudopods from leukocytes extend to form phagosomes, which then internalize and merge with lysosomes to form phagolysosomes

27

What is Chediak-Higashi syndrome? Inheritance pattern?

AR Protein trafficking defect, characterized by impaired phagolysosome formation

28

What are the components of the BAILIN mnemonic for Chediak-Higashi syndrome?

-Bleeding disorders
-Albinism
-Infections
-Leukopenia
-Infiltrative lymphohistiocytosis
-Neuropathy

29

Why is there neutropenia in Chediak-Higashi syndrome?

No way to separate cells d/t defective microtubules

30

Why are there giant granules in leukocytes in Chediak-Higashi syndrome?

Inability to distribute granules produced by the golgi

31

Why is there defective primary hemostasis with Chediak-Higashi syndrome?

Loss of platelets d/t loss of movement out of megakaryocytes

32

Why is there peripheral neuropathy with Chediak-Higashi syndrome?

Inability to traffic nutrients to the periphery

33

Why is there albinism with Chediak-Higashi syndrome?

Melanocyte cannot transfer melanin to the keratinocytes d/t crappy microtubules