12 - Inflammation and Healing

Question 1

Relevant examinations for inflammation
1)
2)
3)

Answer 1

1) Full blood examination
2) C-reactive protein
3) Erythrocyte sedimentation rate (ESR)

Question 2

Inflammation

Answer 2

Protective response of vascularised tissue to injury.

Closely associated with healing process.

Question 3

Acute inflammation
1)
2)
3)

Answer 3

1) Rapid onset
2) Short duration - Several days, sometimes longer
3) Features neutrophils, fluid and protein exudate, vasodilation, macrophages

Question 4

Chronic inflammation
1)
2)
3)

Answer 4

1) Later response
2) Lasts weeks/months/years
3) Macrophages, lymphocytes, plasma cells, fibrosis/scarring

Question 5

Aims of acute inflammation
1)
2)
3)

Answer 5

1) Mediate local defences
2) Destroy any infective agents
3) Remove debris

Question 6

Possible causes of acute inflammation 
1)
2)
3)
4)
5)

Answer 6

1) Certain infections
2) Trauma
3) Foreign material
4) Burns
5) Infarction

Question 7

Initiation of acute inflammatory response
1)
2)

Answer 7

1) Release of preformed mediators from E: mast cells, platelets (could be disrupted though trauma)
2) PRR on DCs, macrophages, epithelial cells lead to release of cytokines, which initiate inflammatory reponse

Question 8

Vascular response in acute inflammation 
1)
2)
3)
4)
5)
6)

Answer 8

1) Transient arteriolar constriction
2) Arteriolar, then capillary and
venular dilation
3) Increased vascular permeability
4) Vasocongestion
5) +/- vascular injury
6) Vascular responses involve
endothelial activation

Question 9

Factors released by normal endothelium to prevent blood clotting

Answer 9

Nitric oxide, prostacyclin

Question 10

Ability of leukocytes to adhere to normal endothelium

Answer 10

Poor. Normal endothelium is resistant to leukocyte adherence

Question 11

Molecules that mediate leukocyte rolling (margination)

Answer 11

P- and E-selectin on endothelial wall, sialyl-lewis X-modified glycoprotein and low-affinity-form integrin on leukocyte

Question 12

Molecules that mediate adhesion and diapedesis of leukocytes to endothelial cells

Answer 12

P-, E-selectin, ICAM-1, PECAM-1 on endothelial cells, activated integrin on leukocyte.

Question 13

Difference of histology of normal and acutely inflamed lung

Answer 13

Normal lung has air-filled alveoli, which don’t stain.

Inflamed lung has exudate in alveoli, which stains with eosin (full of proteins)

Question 14

Factors secreted by macrophages that promote tissue repair

Answer 14

TGF-beta, PDGF, FGF

Question 15

What creates ROS in phagocytes?

Answer 15

NADPH oxidase (phagocyte oxidase) in cell membrane converts NADPH to NADP+ and O2 to O2-.

Question 16

Three main types of inflammatory exudate

Answer 16

1) Serous
2) Purulent
3) Fibrinous

Question 17

Examples of purulent exudate
1)
2)
3)

Answer 17

1) Lobar pneumonia
2) Bacterial meningitis
3) Abscess

Question 18

Examples of fibrinous exudate
1)
2)
3)

Answer 18

1) Fibrinous pleuritis
2) Fibrinous pericarditis
3) Acute appendicitis

Question 19

Abscess

Answer 19

A localised collection of necrosis in an organ.

Question 20

Fibrinous inflammation

Answer 20

1) Occurs on serosal surfaces.

2) Heals via scarring.

Question 21

Serous inflammation

Answer 21

Mostly fluid

Question 22

Transudate

Answer 22

Oedema with normal vascular permeability, but increased hydrostatic pressure and/or reduced plasma oncotic pressure (to do with plasma proteins)

Question 23

Exudate

Answer 23

Oedema with impaired vascular permeability

Question 24

Types of oedema
1)
2)
3)

Answer 24

1) Transudate (normal vasc permeability)
2) Exudate (impaired vasc permeability)
3) Impaired lymphatic drainage

Question 25

Difference in composition between transudate and exudate

Answer 25

Transudate has less protein in it than exudate (as vascular permeability is normal so proteins can’t extravasate as easily)