Acute and Chronic Inflammation

Question 1

A tissue must be _______ and ________ to become inflamed.

Answer 1

living and vascularized

Question 2

What are the five cardinal signs of inflammation?

Answer 2

Tumor, calor, rubor, dolor, functio laesa

Question 3

What are the three components of inflammation?

Answer 3

1. Vascular
2. Cellular
3. Chemical

Question 4

What is the function of inflammation?

Answer 4

To localize and eliminate the cause of injury and initiate the repair process to attempt to restore normal structure and function.

Question 5

What are the three possible inflammatory outcomes?

Answer 5

Resolution (best)
Scar
Chronic inflammation

Question 6

Does scar tissue function as well as the original tissue?

Answer 6

Nope

Question 7

The severity of injury determines the ________ phase of the inflammatory process.

Answer 7

amplification

Question 8

An inability to eliminate the offending agent often results in _______ ________.

Answer 8

chronic inflammation

Question 9

What cells infiltrate tissues during acute inflammation?

Answer 9

Neutrophils (type of polymorph)

Question 10

What cells infiltrate tissues during chronic inflammation?

Answer 10

macrophages, lymphocytes (NK cells, B cells, T cells)

Question 11

Compare tissue injury and fibrosis in acute inflammation with chronic inflammation.

Answer 11

In acute, tissue injury and fibrosis are mild and localized whereas in chronic inflammation it is severe and progressive.

Question 12

Define the following:
Transudate
Exudate
Fibrinous exudate
Purulent exudate

Answer 12

Transudate is edema fluid with low protein content. (<1.015)
Exudate is edema fluid with high protein content.
Fibrinous exudate has a large amount of fibrin.
Purulent exudate has lots of cellular components.

Question 13

Describe the changes blood vessels undergo during acute inflammation.

Answer 13

1. Immediate vasoconstriction - short lasting.
2. Vasodilation (hyperemia) and increased vascular permeability.
3. Stasis (blood flow slows).

Question 14

What is the “immediate transient response” of blood vessels during acute inflammation?

Answer 14

The vasodilatory effects caused by mediators such as histamine.

Question 15

What is leukocyte margination?

Answer 15

Same thing as extravasation - leukocytes migrate out of vessels into tissues.

Question 16

Which molecule is responsible for initiation of leukocyte “rolling” along the endothelium? Which molecule helps anchor the leukocyte to the endothelium?

Answer 16

P-selectin helps roll. Integrin helps anchor.

Question 17

What do chemokines do to leukocytes?

Answer 17

They are chemoattractants and also activate the leukocyte to express high avidity integrin surface molecules.

Question 18

What are Weibel-Palade bodies?

Answer 18

Storage bodies of P-selectin and von Willebrand Factor in endothelial cells.

Question 19

How long do polymorphs live after they have extravasated into tissues?

Answer 19

7-8 hours

Question 20

What cell types are capable of the respiratory burst?

Answer 20

Immune cells such as neutrophils.

Question 21

What are the two general types of leukocyte deficits?

Answer 21

Congenital (Chediak-Higashi, etc.) and acquired (chemo, radiation, leukemia, etc).

Question 22

What is Chediak-Higashi Syndrome?

Answer 22

Defective phagocytosis due to poor chemotaxis and defective lysosomal granules.

Question 23

What is chronic granulomatous disease?

Answer 23

Deficient NADPH oxidase - no respiratory burst capability

Question 24

What is serous inflammation? Name an example.

Answer 24

Outpouring of a watery, protein-poor fluid that derives from either plasma or mesothelial cells. Example is a skin blister - called an effusion.

Question 25

What is fibrinous inflammation? What causes it? Name one example.

Answer 25

Caused by more severe injury that allows large molecules such as fibrinogen to pass the endothelial barrier. Fibrinogen polymerizes –> fibrin –> scarring. Ex. fibrinous pericarditis.

Question 26

What is supperative (purulent) inflammation?

Answer 26

Collection of purulent exudate consisting of neutrophils, necrotic cells, and edema fluid. Often caused by pyogenic organisms.

Question 27

What is an ulcer?

Answer 27

A local defect or excavation of the surface of an organ that is produced by sloughing of inflamed necrotic tissue.

Question 28

What does Sialyl-Lewis-X on leukocytes do?

Answer 28

Promotes leukocyte rolling along the endothelium

Question 29

What do LFA-1 and MAC-1 (on leukocytes) and ICAM-1 and VCAM-1 (on endothelial cells) do?

Answer 29

They promote stable adhesion between leukocytes and endothelial cells.

Question 30

What does CD31 (PECAM-1) on endothelial cells do?

Answer 30

Promotes transmigration of leukocytes

Question 31

Coagulation, fibrinolytic molecules, Kinins, and complement molecules are _______-derived.

Answer 31

plasma

Question 32

Arachidonic acid-derived, histamine, serotonin, and NO are ____-derived.

Answer 32

cell

Question 33

Infiltration of mononuclear cells such as macrophages, lymphocytes, and plasma cells is often due to _______ inflammation.

Answer 33

chronic

Question 34

What is a granuloma?

Answer 34

A collection of immune cells called granulocytes and epithelioid cells (activated macrophages) that forms when the immune system attempts to wall off substances that it perceives as foreign but is unable to eliminate.

Question 35

Name six causes of granulomatous inflammation.

Answer 35

1. Fungal infections
2. TB
3. Leprosy
4. Syphillis
5. Persistent foreign material
6. Some autoimmune diseases

Question 36

Name six systemic effects of inflammation.

Answer 36

1. Fever from IL-1, TNF
2. Increased acute phase proteins
3. Increased leukocytes (leukocytosis)
4. Increased HR and BP
5. Chills
6. Septic shock

Question 37

What are C5a, LTB4, and IL-8 involved in?

Answer 37

Chemotaxis

Question 38

What does the presence immature neutrophils (neutrophilia) indicate?

Answer 38

Systemic inflammation - body is pulling all the WBCs out of the bone marrow even though they aren’t ready.