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Flashcards in 4 Surgery Deck (34):
1

Nucleus relaying messages of localized injury to brain

nucleus tractus solitarius

2

Hormones released in response to injury

ACT
glucocorticoids

3

NT's released

sympathetics: epi/norepi

parasympahetics: ACh

4

During stress/injury when is ACTH highest?

diurnal pattern is REVERSED
elevated during DAY (normally night)

5

Elevated in burn-injured patients

cortisol/glucocorticoids

6

Causes hyperglycemia and stimulates gluconeo

cortisol/glucocorticoids

--> increased glucagon and epi --> hyperglycemia

7

Glucocorticoid antagonist

macrophage inhibitory factor

released from ant. pituitary and T cells

8

Promotes protein synthesis
Promotes insulin resistance
Enhances mobilization of fats

GH and IGF-1

9

Secreted by chromaffin cells in adrenal medulla

catecholamines

10

Catecholamines on inflammation?

inhibit inflammatory cytokines

enhance release of anti-inflammatory IL-10

11

Conserves Na
Eliminates K and H

aldosterone

12

Widely used protein marker of proinflammatory response

C-reactive protein

13

Cells that do not secrete eicosanoids

lymphocytes

14

Eicosanoids are pro-inflammatory in general.
What anti-inflammatory compound results from the eicosanoid pathway?

lipoxin

inhibits chemotaxis and NF-kB activation

15

Precursor of leukotrienes

HPETE (LOX pathway)

16

Vasodilator
Increases capillary permeability and tissue edema.
Increase bronchoconstriction

bradykinins

17

5-HT is derived from

tryptophan

18

5-HT is secreted from

platelets
chromaffin cells

19

H1 activation:

bronchoconstriction
intestinal motility
mycardial contractility

20

H2 activation

inhibits histamine release

21

Most potent inflammatory mediator

cytokines

22

Stimulates muscle catabolism and cachexia during stress.
Synthesized in macrophages and T cells

TNF

23

IL similar to TNF

induces febrile response to injury

IL-1

24

Promoter of T cell proliferation, Ig production, and gut integrity

IL-2

25

Anti-inflammatory IL against activated macrophages.

IL-4

Produced by TH2

26

Mediator of hepatic acute phase response

IL-6

27

interferon pro and anti inflamm

IFN-γ

28

Regulator of cell mediated immunity
TH1 differentiation
PMN and coagulation activation

IL-12

29

Upregulates granulocyte/monocyte...

Delays apoptosis of macrophages and neutrophils

GM-CSF

30

Released 24-48 hours after sepsis
ARDS

HMGB1

31

Associated with death receptors

extrinsic pathway of apoptosis

32

Associated with protein mediators

intrinsic pathway of apoptosis

33

Thrombocytopenia is a hallmark of

septic response

(could also be ITP and DHF)

34

Acute blood loss: % volume

25%+