Flashcards in 3. Inflammation Deck (48):
What are the five cardinal signs of inflammation?
Rubor (redness), Calor (heat), Tumor (swelling), dolor (pain), functio laesa (loss of function). [RCTDF].
Describe the four steps of adhesion by complementary molecules on the surface of neutrophils and endothelium.
I.: at sites of inflammation, the endothelial cells have increased expression of E-selectin and P-selectin. II.: Neutrophils weakly bind to the endothelial selectins and roll along the surface. III.: Neutrophils are stimulated by chemokines to express their integrins. IV.: Binging of the integrins firmly adheres the neutrophil to the endothelial cell.
Where are P-selectins normally stored?
In Weibel-Palade bodies of endothelial cells. They are redistributed to the cell surface with exposure to inflammatory mediators such as histamine.
What is chemotaxis?
It is the attraction of cells toward a chemical mediator that is released in the area of inflammation.
What are four important chemotactic factors for neutrophils?
I. Bacterial products, such as N-formyl-methionine. II. Leukotriene B4 (LTB4). III. Complement system product C5a. IV. Alpha-chemokines (IL-8).
What are opsins and what are three examples of them?
They are factors that enhance the recognition and phagocytosis of bacteria. Important opsonins are: I. Fc portion of IgG. II. Complement system product of C3b. III. Plasma protein-collectins (bind to bacterial cell walls).
What is one syndrome with defect in phagocytosis?
What does myeloperoxidase produce in the intracellular killing?
Produces HOCL (hypochlorus acid). Requires hydrogen peroxide and halide (Cl-).
Where are histamines produced?
Produced by basophils, platelets, and mast cells.
What are four triggers for histmaine release?
I. IgE-mediated mast cell reactions. II. Physical injury. III. Anaphylatoxins (C3a and C5a). IV. Cytokines (IL-1).
Where are serotonin produced?
By the platelets.
What converts the prekallikrein to kallikrein?
The activated Hageman factor (factor XII).
What does kallikrein do?
It cleaves the high molecular weight kininogen (HMWK) to bradykinin.
What are the four effect of bradykinin?
Increased vascular permeability, pain, vasodilation, bronchoconstriction.
Who produces Thromboxane A2 and what does it do?
Produced by platelets, it causes vasoconstriction and platelet aggregation.
Who produces Prostacyclin (PGI2) and what does it do?
Produced by vascular endothelium, it causes vasodilation and inhibits platelet aggregation.
What are two mediators of pain?
Bradykinin and prostaglandins (E2).
Which prostaglandins are vasodilators?
PGE2, PGD2, PGF2.
Which leukotrine from the lipoxygenase pathway is a neutrophil chemotaxis?
Leukotrine B4 (LTB4).
Which leukotrine from the lipoxygenase pathway are vasoconstrictors?
C4, D4, E4.
Which product of the complement cascade are part of the membrane attack complex?
Which product of the complement cascade are anaphylotoxins that stumulate the release of histamine?
Which product of the complement cascade is a leukocyte chemotactic factor?
What does C3b do?
It's an opsonin.
What does IL-8 do?
It is a neutrophil chemoattractant produced by macrophages.
What do IL-1 and TNF do?
Fever and acute phase reactants. Enhances adhesion molecules. Stimulates and activates fibroblasts, endothelial cells, and neutrophils.
What are the mediators of fever?
Cytokines IL-1, IL-6, TNF-alpha, prostaglandins.
Where are macrophages derived from?
From blood monocytes.
What are the tissue-based monocytes for the liver?
What are the tissue-based monocytes for the connective tissue?
What are the tissue-based monocytes for the lung?
Pulmonary alveolar macrophages.
What are the tissue-based monocytes for the bone?
What are the tissue-based monocytes for the brain?
What is an example of a lymphocyte chemokine?
What is an example of a eosinophil chemokine?
What do Basophils do?
They play an important role in IgE mediated reactions (allergies and anaphylaxis).
What are mast cells?
They are tissue-based basophils; they are present in high numbers in the lung and skin. They release histamine.
What is chronic granulomatous inflammation?
A specialized form of chronic inflammation characterized by small aggregates of modified macrophages (epitheloid cells and multinucleated giant cells) usually surrounded by a rim of lymphocytes.
What are epitheloid cells?
Modified macrophage transformed byINF-gamma. It has an enlarged cell with abundant pink cytoplasm. They are components of granuloma.
What are multinucleated cells?
They are formed by fusion of epitheloid cells. They are components of granulomas.
Describe a Langerhas-type giant cell.
They have peripheral arrangement of nuclei.
Describe a Foregin body type giant cell.
Thy have haphazard arrangement of nuclei.
Where do we see central caseous necrosis?
In granulomas caused by tuberculosis. Rare in other granulomatous disease.
Describe exudative inflammation with examples.
Acute inflammatory response with neutrophils; bacterial meningits, bronchopneumonia and abscess.
Describe necrotizing inflammation with examples.
Virulent organism producing severe tissue damage and extensive cell death; necrotizing fasciitis, necrotizing pharyngitis.
Describe granulomatous inflammation with examples.
Granulomatous response predominates; slow-growing organisms such as mycobacteria, fungi, and parasites.
Describe interstitial inflammation with examples.
Diffuse mononuclear interstitial infiltrate; common response to viral infectious agents like in myocarditis due to Coxsackie virus and viral hepatitis.