acute infl. Flashcards
exam 1 (121 cards)
1
Q
rubor
A
redness
2
Q
tumor
A
swelling
3
Q
calor
A
warmth
4
Q
dolor
A
pain
5
Q
functio laesa
A
loss of function
6
Q
Why does inflammation occur?
A
response of vascularized tissue to injury, attempt to contain/ inactivate the insult
7
Q
are first on the scene, 4-24 hours and undergo apoptosis in 24-48 hours
A
neutrophils
8
Q
“the clean up crew” arrive after 24 hours (usually day 3), can proliferate, in the tissue they are called macrophages
A
Monocytes
9
Q
arrive typically late and are associated with chronic inflammation (*viruses)
A
lymphocytes
10
Q
are also late, produce antibodies
A
plasma cells
11
Q
may be early responders and are associated with allergic reaction, parasites, etc
A
eosinophils
12
Q
Develops within hours to days
Neutrophils and later macrophages
A
Acute
13
Q
Long lasting; weeks, months, years
Lymphocytes and plasma cells
A
Chronic
14
Q
a specialized form of chronic inflammation with granuloma formation
A
Granulomatous
15
Q
is defined by the accumulation of pus (dead neutrophils)
A
Purulent or suppurative
16
Q
Fibrin-rich exudate (protein rich fluid, with many cells).
A
Fibrinous
17
Q
Fibrinogen leaves the ______ and _____ is formed in the extracellular space
A
Fibrinogen leaves blood vessel and fibrin is formed in the extracellular space
18
Q
is fluid accumulation caused by a transudate (protein poor fluid, with few cells)
A
serous
19
Q
Acute inflammation sequence:
- Initiation of ________
- _________ vascular permeability
- Leukocyte ________
A
Acute inflammation sequence:
- Initiation of inflammation
- Increased vascular permeability
- Leukocyte extravasation
20
Q
Regulation and Resolution for acute inflammation
A
Mediators
Systemic changes
Outcome
21
Q
Signal comes from _________ of epithelial and dendritic cells that recognize bacteria and dead cells
A
TLR (toll like receptors)
22
Q
Cells secrete cytokines: __________ and __________
A
tumor necrosis factor (TNF) and interleukin-1 (IL-1)
23
Q
Found in mast cells/basophils and platelets; premade in intracellular granules
*** key mediator of inflammation
A
histamine
24
Q
Histamine:
Promotes _________ of arterioles, _________ vascular permeability of venules, endothelial activation by _______
A
promotes vasodilation
increases vascular permeability
and endothelial activation by H1receptor.
25
Immediate response (first 15 to 30min):
Histamine *
Bradykinin **
leukotrienes
26
Sustained response (4-24 hrs or more):
Histamine *
Bradykinin **
leukotrienes
TNF and IL-1 (cytokines with local and systemic effects)
27
mediator involved in pain
bradykinin
28
H1 receptor antagonist
Antihistamine drugs
29
Histamine effects:
Pruritus,__________, hypotension, flushing, headache, tachycardia, ____________, increase in vascular permeability.
vasodilation and bronchoconstriction
30
fluid moves into the extravascular tissue
increased vascular permeability
31
with increased vascular permeability, Red blood cells become concentrated resulting in _______ blood viscosity and a ______ of flow
increase in blood viscosity and reduction of flow
32
vascular changes first stars with a brief, transient ________ and the it is followed by arteriolar ________; the main vascular change of acute inflammation
vasoconstriction followed by vasodilation
33
Clinically manifested as erythema and warmth at site
vasodilation vascular change
34
Stack of coins of RBC
Rouleau
35
low protein content, few cells
transudate
36
high protein content, and may contain some white and red cells
exudate
37
A fluid that passed through the blood vascular wall as a result of hydrodynamic forces.
transudate
38
A fluid that escaped from the blood vasculature, usually as a result of inflammation.
exudate
39
Specific gravity <1.015
transudate
40
Specific gravity > 1.015
exudate
41
Leukocytes (principally neutrophils) accumulate along the vascular endothelial surface
margination
42
Leukocytes roll along the endothelium and interact via _______
selectins
43
Expression of selectins regulated by the cytokines ________ and _______
TNF and IL-1
44
L-selectin on
leukocytes
45
E selectin on
endothelium
46
P- selectin on
platelets
47
p-selectin and von Willebrand factor released from___________ granules of endothelial cells due to histamine and thrombin
Weibel-Palade bodies
48
induce expression of ligands for integrins,
TNF-1 and IL-1
49
Mac-1 mediates arrest
(the brakes)
50
vascular cell adhesion molecule
VCAM-1
51
Leukocytes normally express integrins in a _____ affinity state.
low
52
VLA-4 and LFA -1 integrins turn into _________ affinity state during inflammation.
high
53
Chemokines bind to endothelial cell
proteoglycans
54
Binding to____(platelet endothelial cell adhesion molecule) mediates transmigration
PECAM-1
55
Piercing the basement membrane(collagenase) and entering the extravascular tissue.
Transmigration
56
Movement in a direction corresponding to a gradient of increasing or decreasing concentration of a particular substance
chemotaxis
57
bacterial products
Exogenous
58
Chemokines (IL-8)
Complements (C5a)
arachidonic acid metabolite, leukotriene B4 (LTB4)
endogenous
59
Most abundant WBC to come to the site of acute injury 4-24 hrs
neutrophils
60
Phagocytize opsonized (IgG and C3b) bacteria, then _________
phagolysosome
61
Myeloperoxidase
reactive oxygen sp.
62
NADPH oxidase enzyme
free radicals
63
histamine & serotonin
Vasoactive amines
64
prostaglandins and leukotrienes
Lipid products
65
TNF,IL-1,IL-8
Cytokines/chemokines
66
Fibrin split products, C3a, C5a.
plasma derived
67
Proteins produced by many cell types (leukocytes, macrophages, dendritic cells, endothelial, epithelial, connective tissue cells) to mediate and regulate immune and inflammatory reactions
cytokines
68
Small proteins that act as chemoattractants for specific types of leukocytes.
chemokines
69
IL-8
chemokines
70
activator of FXII, chemotaxis, C5 to C5a
Kallikrein
71
vascular permeability, contraction of smooth muscle, vasodilation and pain
Bradykinin
72
prostaglandins
| Bradykinin
pain
73
IL-1,
fever
74
TNF, IL-1
| chemokines
Chemotaxis, leukocyte activation
75
Histamine
Increased vascular permeability
76
Histamine
| Prostaglandins
Vasodilation
77
Acute phase reactants::
_____ acts upon hepatocytes, causing increased synthesis of certain serum proteins.
IL- 6
78
Leukocytosis:
| ______ promote increased release of leukocytes from bone marrow.
IL-1 & TNFa
79
the best test overall
C-reactive protein, CRP
80
the worst test overall
ESR
81
Lactate dehydrogenase
tissue damage
82
ALT/AST Liver enzymes
cellular damage
83
catabolized during inflammation so will be low
Albumin
84
fibrin rich exudate accumulating on the surface of the damaged tissue and commonly seen on serosal lining
fibrinous
85
blister filled with fluid after a burn injuryor a viral blister; transudate
serous
86
for firm adhesion
integrins
87
for weak binding during rolling
selectins
88
blood flow slows and neutrophils pushed to the periphery of the vessel
margination and rolling
89
a normal cell has very low or no expression of selectin?
Correct!!!
90
neutrophil adhesion to endothelial cell
pavementing
91
firm adhesion is due to _______ and ___________ which bind to integrins on the leukocyte
VCAM and ICAM
92
responsible for the binding needed for the leukocyte to pass through the endothelium
PECAM-1
93
________ produce collagenase to destroy type IV collagen in order to cross the basement mebrane
neutrophils
94
Opsonin carried out by?
IgG and C3b
95
produced constitutively by endothelial cells and causes vasodilation
nitric oxide
96
outcome of acute inflammation [4]
1. healing
2. abscess
3. ulcer
4. fistula
97
acute inflammation where stimulus is removed resulting in connective tissue and scar formation
healing
98
produced by the sloughing of inflamed necrotic tissue
ulcer
99
accumulation of pus (dead WBC and tissue debris) that is walled off with fibrosis
abscess
100
abnormal patent connection btw two organs
fistula
101
best marker for inflammation
CRP
102
increase in leokocyte count
leukocytosis
103
clinical triad of:
1. large quantities of cytokines produced
2. disseminated intravascular coagulation
3. hypoglycemia and hypotensive shock
septic shock
104
left shift
IL-1 and TNF mediated leukocytosis
105
collagen type III gets replaced with _____
type I
106
basophils in tissues are called
mast cells
107
seen in chronic inflammation
lyymphocytes
108
monocytes that once in tissues they become
macrophages
109
indicator of chronic inflammation or neoplastic process
plasma cells
110
nucleus is pushed to side and there is a halo btw the nucleus and cytoplasm
plasma cells
111
Starlings Equilibrium
Forces promoting outward flow include plasma hydrostatic pressure and tissue osmotic pressure, while forces that promote inward flow include plasma osmotic pressure and tissue hydrostatic pressure.
112
The majority of leukocytes transmigrate via the ______________________ (between endothelial cells).
paracellular route
113
Leukocytes that cross the blood brain barrier travel via the
trans-cellular route
114
Neutrophil cytoplasmic granules contain ____________, which is involved in the generation of free radicals that kill bacteria.
myeloperoxidase
115
Myeloperoxidase produces _______which destroys bacteria by halogenation or oxidation of proteins & lipids.
HOCl
116
Lysozyme, Cathepsin G, lactoferrin, defensins, and BPI (bactericidal permeability increasing protein) are all part of the _______________ response of phagocytic cells.
oxygen-independent
117
___________ is a radical whose formation is dependent on the presence of oxygen.
Superoxide
118
Exudate would be seen later in an inflammatory response __________
4-6 hours later.
119
Edema/ fluid accumulation is the earliest response to tissue injury, and the earliest part of the response is _____________ due to increased vascular permeability.
transudate-formation
120
__________ is expressed by endothelial cells for the neutrophil chemotaxis and activation within damaged tissues.
Il-8
121
Pyrogens from bacteria and cytokines from inflammatory cells can induce ________________ in the hypothalamus to induce raising the body temperature
prostaglandins
