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Hematology (FORM AND FUNCTION) > 8. Inflammation > Flashcards

8. Inflammation Flashcards

1
Q

Immune system response:

A
  1. Innate immunity: 0-6hours
  2. Adaptive immunity: 12hrs to days (B and T lymphocytes)
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2
Q

Stages of inflammation:

A
  1. Inflammation triggers vasodilation of local blood vessels which leads to excess local blood flow
  2. Capillary permeability increases causing fluid to leak out of vascular space into surrounding tissue
  3. Large numbers of granulocytes and monocytes migrate into tissues (via diapedesis)
  4. Clots form in tissue due to fibrinogen leaking into tissue space
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3
Q

Step 1 of inflammation: redness and heat

A
  1. Vascular changes
  2. Cellular response
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4
Q

Vascular change: step 1a inflammation

A

-vasodilation
>subsequent widening of blood vessels
>increasing blood flow leading to redness and heat

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5
Q

Cellular responses: step 1b inflammation

A

-macrophage activation: tissue macrophages are activated
-chemokine and cytokine release: promote further immune response

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6
Q

Step 2 of inflammation: swelling and pain

A

-increased vascular permeability
>releases of chemokines and cytokines bind to endothelial receptors, triggering intracellular pathways
>endothelial cell contraction leads to increased inter-endothelial gaps
>passage of plasma proteins into tissue space facilitates swelling

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7
Q

Globulins:

A

-a major plasma protein
-intermediate in size
-one function: proteolytic enzyme systems (coagulation and complement)

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8
Q

Action of plasma proteins:

A

-kinins
-complement system activation
-acute phase proteins
-clotting factors

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9
Q

Kinins: plasma proteins

A

-promote vasodilation
-increase permeability
-contribute to PAIN sensation

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10
Q

Complement system activation: plasma proteins

A

-pathogen lysis via membrane attack complex (MAC)
-opsonization for enhanced phagocytosis

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11
Q

Acute phase proteins: plasma proteins

A

-C-reactive protein (CRP) marks dead or dying cells to activate the complement system
-reliable marker for inflammation

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12
Q

Clotting factors: plasma proteins

A

-initiate coagulation
-establish barrier
-provide scaffold for healing

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13
Q

Formation of transudate:

A

-transudate composed of plasma proteins and fluid accumulates in extracellular space
>includes plasma protein and solution (NO CELLS)

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14
Q

Stage 3 of inflammation: swelling and pain

A

-large numbers of granulocytes and monocytes migrate into tissue (via diapedesis)
>exudate

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15
Q

Exudate:

A

-fluid (plasma + cells) that leaks out of the blood vessels into the tissus

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16
Q

Diapedesis:

A
  1. Neutrophils loosely attached to endothelium normally
  2. When tissue macrophages are activated, they release cytokines
  3. Additionally signals triggers expression of a new ligand on neutrophils: intergrins
  4. Integrins bind tighter to endothelial receptor (ICAM-1) = adhesion (tight)
  5. Squeeze through the cells into the tissue
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17
Q

Neutrophils once they have squeezed through the endothelial cells into the tissue:

A

-walk along chemokine gradient produced at inflamed site

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18
Q

Ameboid movement of neutrophils:

A

-move along extracellular matrix in tissue
1. Pseudopodium: protrusion of cell from actin filament polymerization
2. Cell adhesion: integrin binds to extracellular matrix proteins, anchoring cell to surroundings
3. Actin myosin contraction: myosin motors generate force by sliding along actin filaments, leading to contraction in cells rear end
4. Rear end contraction: actin filaments disassemble, and cell’s rear end retracts, allowing the cell to move forward

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19
Q

Transition from neutrophils to other leukocytes: inflammation

A

-stimulus-dependent

20
Q

Eosinophilia and basophilia: inflammation

A

-signify allergic or parasitic inflammation

21
Q

Eosinophilia: inflammation

A

-parasitic infections and allergic responses in dogs and horse

22
Q

Basophilia: inflammation

A

-less common
-indicative of certain hypersensitivity and chronic inflammatory states

23
Q

Monocytosis: inflammation

A

-increased monocytes in blood for PROLONGED inflammatory response
-differentiate into macrophages at the site for extended defense and tissue repair

24
Q

Activation of adaptive immunity: tissue changes

A

-monocytes may increase as they differentiate into macrophages to present antigens
-lymphocytes rise as specific B and T cells are activated

25
Q

Activation of adaptive immunity: implications for CBC

A

-significant lymphocytosis due to inflammation is RARE

26
Q

Inflammation resolution:

A
  1. Return to homeostasis
  2. Tissue repair
  3. Bone marrow return to steady-state
27
Q

Return to homeostasis after inflammation:

A

-normalization of WBC counts and acute phase proteins

28
Q

Tissue repair after inflammation:

A

-initiation of healing processes that may show a return of blood parameters to baseline

29
Q

Chronic inflammation:

A

-7 days to weeks/months
1. Macrophage activation
2. Granuloma formation

30
Q

Macrophage activation: chronic inflammation

A

-tissue: dominance in chronic inflammatory sites, essential for long-term resolution
-CBC: activated monocytes may suggest systemic response

31
Q

Granuloma formation: chronic inflammation

A

-collection of immune cells that form to wall off and isolate lesion
>if in tissue samples=persistent inflammation

32
Q

Hematologic response to inflammation:

A

-increase production
-increase release of reserve
-increase tissue consumption

33
Q

Neutrophil levels:

A

-based on marrow output vs. tissue damage

34
Q

Neutrophilia:

A

-more marrow delivery
-less tissue consumption

35
Q

Neutropenia:

A

-less marrow delivery
-more tissue consumption

36
Q

Inflammatory response when marrow production meets demand

A

-leukocytosis caused by neutrophilia and a left shift

37
Q

Inflammatory response when marrow production overwhelmed by demand

A

-leukopenia caused by neutropenia and a left shift

38
Q

Dog bone marrow contribution to neutrophils in inflammatory response:

A

-reserve: relatively high
-regenerative capacity: rapid
-range: 20-120 (x10^9/L)
-neutropenia during acute inflammation: very severe lesion

39
Q

Cat bone marrow contribution to neutrophils in inflammatory response:

A

-reserve: intermediate
-regenerative capacity: intermediate
-range: 20-60 (x10^9/L)
-neutropenia during acute inflammation: very severe lesion

40
Q

Horse bone marrow contribution to neutrophils in inflammatory response:

A

-reserve: intermediate
-regenerative capacity: intermediate
-range: 15-30 (x10^9/L)
-neutropenia during acute inflammation: probably severe lesion

41
Q

Cow bone marrow contribution to neutrophils in inflammatory response:

A

-reserve: relatively low
-regenerative capacity: slow
-range: 10-25 (x10^9/L)
-neutropenia during acute inflammation: usual findings, regardless of severity

42
Q

Acute inflammation:

A

-lesion with increased blood flow and swelling
-small vs. bigger injury

43
Q

Small injury:

A

-consumption and production is somewhat balanced
>mild to moderate neutrophilia with variable left-shift depending on severity

44
Q

Bigger injury:

A

-consumption may exceed production
>neutropenia with prominent left shift

45
Q

Chronic, walled off inflammatory lesions:

A

-may result in high neutrophil concentrations
>lesions continue to stimulate the marrow to achieve maximal production, but the rate of consumption is reduced due to closed-cavity lesion

Hematology (FORM AND FUNCTION) (10 decks)

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