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Pathology bs > Acute & Chronic inflammation > Flashcards

Acute & Chronic inflammation Flashcards

1
Q

What is inflammation?

A

The host response to tissue damage

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2
Q

Why does inflammation occur?

A

as a protective response

  • to remove/contain cause
  • initiate repair
  • reinstate useful function
  • it is essential for healing
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3
Q

What are the 5 triggers for inflammation?

A
  • foreign body
  • infection
  • ischaemia/ infarction
  • physical/ chemical injury
  • immune reaction
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4
Q

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

A
  • Vasodilation
  • Increased permeability (leads to OEDEMA)
  • blood stasis (pooling the blood at the site of injury
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5
Q

In acute vasodilation the vascular change of vasodilation leads to…

A
  • increased blood flow
  • causing redness and heat (erythema)
  • endothelial cells of vessel wall contract
  • Transcytosis - increased transport of fluid and proteins
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6
Q

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

A
  • 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)
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7
Q

What do the vascular changes in acute inflammation cause?

A
  • cause leakage of intravascular fluid into the extravascular spaces
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8
Q

What is the main aim of inflammation?

A

to recruit leucocytes to area of damage

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9
Q

What do neutrophils and macrophages do ?

A
  • ingest and kill bacteria and necrotic cells

- promote repair

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10
Q

Where are white blood cells recruited from in inflammation?

A

vessel lumens

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11
Q

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

A

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

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12
Q

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

A

6-24 hours

chemokines

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13
Q

How long does it take monocytes to appear ?

A

24-48hours

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14
Q

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

A

phagocytosis

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15
Q

how do leucocytes kill harmful agents?

A
  • attaching to bacteria through opsonin receptors
  • leucocytes engulfs the cell
  • then kills and degrades, removing its harmful effects
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16
Q

What are the outcomes of the process of acute inflammation?

A
  • healing with connective tissue replacement (fibrosis

- if not resolved chronic inflammation or abscess

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17
Q

What are the causes of chronic inflammation?

A
  • persistent infection or inflammation

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

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18
Q

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

A

macrophages, lymphocytes and plasma cells

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19
Q

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

A
  • cells try to contain offending agent
  • strong activation of macrophages and T lymphocytes
  • causes damage to surrounding tissue
20
Q

What examples of conditions may cause granulomas?

A
  • TB
  • rheumatoid arthritis
  • chrones disease
21
Q

What kind of things may cause acute inflammation?

A
  • infarction
  • bacterial infection
  • trauma
  • burn
22
Q

What kind of things may cause chronic inflammation?

A
  • virus
  • autoimmune diease
  • acute inflammation that’s not resolved
  • persistent infection
23
Q

What are the clinical signs of acute inflammation?

A
  • 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
Q

What can chronic inflammation lead to?

A

fibrosis

25
Q

What are the medical signs and symptoms of inflammation?

A
  • fever
  • tachycardia
  • hypotension
  • raised white cell count
  • raised CRP (blood test)
26
Q

What are the signs of chronic inflammation?

A
  • anorexia
  • general malaise
  • weight loss
  • sepsis- large amount of toxins stimulate cytokines, can lead to cardiovascular failure (septic shock)
27
Q

What is the predominate white cell in acute inflammation?

A

neutrophils

28
Q

What can make inflammatory responses poor?

A
  • immunodeficiency / disease
    eg. chemotheraphy, steroids
  • HIV
  • Hereditary
29
Q

How can are natural inflammatory response be negative?

A
  • asthma
  • hypersensitivity
  • allergic reaction
30
Q

What medicines can help with inflammation?

A
  • NSAIDs
  • anti-histamine
  • steroids (rheumatoid arthritis)
  • targeted biologics against immune response proteins
31
Q

What happens if no inflammatory response?

A
  • increased risk of infection
  • delayed healing of wounds
  • tissue damage
32
Q

What are examples of inflammation?

*don’t need to memorise these

A
  • acute appendicitis
  • septic arthritis
  • minor injuries (sprained ankle)
  • rheumatoid arthritis
  • ## peptic ulcers
33
Q

What are the signs of acute appendicitis?

A

pyrexia
raised heart rate
raised white cell count
raised CRP

34
Q

What are the symptoms of acute appendicitis ?

A
  • central abdo pain which localises to right iliac fossa
  • pain is worse on movement
  • may have nausea and vomiting
35
Q

What is the treatment of acute appendicitis?

A

appendectomy

36
Q

What are the complications with acute appendicitis?

A

perforation leading to peritonitis

abscess formation

37
Q

What are the symptoms of septic arthritis?

A
  • red, hot, swollen joint

- unable to move joint

38
Q

What are the signs of septic arthritis?

A

pyrexia
tachycardia
raised white cell count
raised CRP

39
Q

What are the risk factors for septic arthritis?

A 
prosthetic joint 
recent surgery or trauma to knee
age
rheumatoid arthritis 
immunodeficiency
40
Q

What are the treatment options for septic arthritis?

A

joint aspirate
IV antibiotics
sepsis 6

41
Q

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

A
  • swelling, pain, heat

- muscle cells are damaged

42
Q

What is the treatment for a sprained ankle?

A 
REST - prevent further injury  
ICE - reverse vasodilation 
COMPRESS - reduce oedema 
ELEVATE - prevent blood stasis 
ANTI-INFLAMMATORY
43
Q

What are the signs of rheumatoid arthritis?

A
  • warm, swollen, stiff and painful joints
  • vessels can become involved leading to vasculitis
  • chronic inflammatory response
44
Q

What are the treatments for rheumatoid arthritis?

A

steroids
DMARDs
biologics

45
Q

how are peptic ulcers developed?

A
  • acute inflammatory response from h.pylori/excess acid
  • necrotic inflamed mucousa falls away
  • exposed to stomach acid
  • leads to chronic inflammation
46
Q

What are people with peptic ulcers at risk of ?

A

developing a bleed/perforation

47
Q

What are the treatments for peptic ulcers?

A

PPIs
histamine receptor agonist
antibiotics

Pathology bs (21 decks)

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