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Flashcards in Acute & Chronic inflammation Deck (47):
1

What is inflammation?

The host response to tissue damage

2

Why does inflammation occur?

as a protective response
- to remove/contain cause
- initiate repair
- reinstate useful function
* it is essential for healing

3

What are the 5 triggers for inflammation?

- foreign body
- infection
- ischaemia/ infarction
- physical/ chemical injury
- immune reaction

4

In acute inflammation what are the vascular changes to maximise movement of plasma proteins to site of injury?

- Vasodilation
- Increased permeability (leads to OEDEMA)
- blood stasis (pooling the blood at the site of injury

5

In acute vasodilation the vascular change of vasodilation leads to...

- increased blood flow
- causing redness and heat (erythema)
- endothelial cells of vessel wall contract
- Transcytosis - increased transport of fluid and proteins

6

In acute inflammation what are the cellular changes to maximise movement of plasma proteins to site of injury?

- margination - RBCs go to centre of lumen and WBCs go peripherally
- rolling - increased amount of leucocytes roll along edge of damaged endothelium
- adhesion - leucocytes stop and adhere to endothelium (cytokines encourage this)

7

What do the vascular changes in acute inflammation cause?

- cause leakage of intravascular fluid into the extravascular spaces

8

What is the main aim of inflammation?

to recruit leucocytes to area of damage

9

What do neutrophils and macrophages do ?

- ingest and kill bacteria and necrotic cells
- promote repair

10

Where are white blood cells recruited from in inflammation?

vessel lumens

11

In the cellular changes of inflammation what happens at the transmigration phase?

leucocyte encouraged to pass through endothelium to extravascular space
- chemokines stimulate this

12

How long does it take for neutrophils to appear and what do they respond to?

6-24 hours
chemokines

13

How long does it take monocytes to appear ?

24-48hours

14

opsonin receptors recognise microbes that have been coated with proteins this targets them for what?

phagocytosis

15

how do leucocytes kill harmful agents?

- attaching to bacteria through opsonin receptors
- leucocytes engulfs the cell
- then kills and degrades, removing its harmful effects

16

What are the outcomes of the process of acute inflammation?

- healing with connective tissue replacement (fibrosis
- if not resolved chronic inflammation or abscess

17

What are the causes of chronic inflammation?

- persistent infection or inflammation
eg. parasite, TB, toxic agent (asbestos) or when its an auto-immune disease as cant remove are own cells

18

Neutrophils not normally present in chronic inflammation as others have been recruited such as ..

macrophages, lymphocytes and plasma cells

19

In chronic inflammation you can get granulomas, what are these?

- cells try to contain offending agent
- strong activation of macrophages and T lymphocytes
- causes damage to surrounding tissue

20

What examples of conditions may cause granulomas?

- TB
- rheumatoid arthritis
- chrones disease

21

What kind of things may cause acute inflammation?

- infarction
- bacterial infection
- trauma
- burn

22

What kind of things may cause chronic inflammation?

- virus
- autoimmune diease
- acute inflammation that's not resolved
- persistent infection

23

What are the clinical signs of acute inflammation?

- redness (from vasodilation)
- heat (from vasodilation
- swelling ( due to vascular permilbilty and fluid moving from intra to extra vascular space)
- Pain
- loss of function

24

What can chronic inflammation lead to?

fibrosis

25

What are the medical signs and symptoms of inflammation?

- fever
- tachycardia
- hypotension
- raised white cell count
- raised CRP (blood test)

26

What are the signs of chronic inflammation?

- anorexia
- general malaise
- weight loss
- sepsis- large amount of toxins stimulate cytokines, can lead to cardiovascular failure (septic shock)

27

What is the predominate white cell in acute inflammation?

neutrophils

28

What can make inflammatory responses poor?

- immunodeficiency / disease
eg. chemotheraphy, steroids
- HIV
- Hereditary

29

How can are natural inflammatory response be negative?

- asthma
- hypersensitivity
-allergic reaction

30

What medicines can help with inflammation?

- NSAIDs
- anti-histamine
- steroids (rheumatoid arthritis)
- targeted biologics against immune response proteins

31

What happens if no inflammatory response?

- increased risk of infection
- delayed healing of wounds
- tissue damage

32

What are examples of inflammation?
*don't need to memorise these

- acute appendicitis
- septic arthritis
- minor injuries (sprained ankle)
- rheumatoid arthritis
- peptic ulcers
-

33

What are the signs of acute appendicitis?

pyrexia
raised heart rate
raised white cell count
raised CRP

34

What are the symptoms of acute appendicitis ?

-central abdo pain which localises to right iliac fossa
- pain is worse on movement
- may have nausea and vomiting

35

What is the treatment of acute appendicitis?

appendectomy

36

What are the complications with acute appendicitis?

perforation leading to peritonitis
abscess formation

37

What are the symptoms of septic arthritis?

- red, hot, swollen joint
- unable to move joint

38

What are the signs of septic arthritis?

pyrexia
tachycardia
raised white cell count
raised CRP

39

What are the risk factors for septic arthritis?

prosthetic joint
recent surgery or trauma to knee
age
rheumatoid arthritis
immunodeficiency

40

What are the treatment options for septic arthritis?

joint aspirate
IV antibiotics
sepsis 6

41

What are the signs and symptoms of a minor injury such as a sprained ankle?

- swelling, pain, heat
- muscle cells are damaged

42

What is the treatment for a sprained ankle?

REST - prevent further injury
ICE - reverse vasodilation
COMPRESS - reduce oedema
ELEVATE - prevent blood stasis
ANTI-INFLAMMATORY

43

What are the signs of rheumatoid arthritis?

-warm, swollen, stiff and painful joints
- vessels can become involved leading to vasculitis
- chronic inflammatory response

44

What are the treatments for rheumatoid arthritis?

steroids
DMARDs
biologics

45

how are peptic ulcers developed?

- acute inflammatory response from h.pylori/excess acid
- necrotic inflamed mucousa falls away
- exposed to stomach acid
- leads to chronic inflammation

46

What are people with peptic ulcers at risk of ?

developing a bleed/perforation

47

What are the treatments for peptic ulcers?

PPIs
histamine receptor agonist
antibiotics