Acute inflammation 1

Question 1

what is inflammation?

Answer 1

first response of living tissue to injury

Question 2

what are some causes of injury?

Answer 2

• Physical agents
• Chemicals
• Hypersensitivity
• Viral replication
• Microbial infection
• Necrosis

Question 3

what are the physical characteristics of inflammation?

Answer 3

• Rubor (red)
• Tumor (swollen)
• Dolor (pain)
• Calor (heat)
• Loss of function

Question 4

what is the suffix that indicates inflammation?

Answer 4

-itis

Question 5

what causes appendicitis?

Answer 5

Waste fragment or infection

Question 6

what are the symptoms of appendicitis?

Answer 6

Severe pain, loss of appetite, nausea

Question 7

what is pericarditis?

Answer 7

Inflammation of the membrane surrounding the heart

Question 8

what causes pericarditis?

Answer 8

Caused by infection, chest injury, radio/chemotherapy

Question 9

what is meningitis?

Answer 9

Inflammation of protective membrane surrounding the brain and spinal cord

Question 10

what are the symptoms of meningitis?

Answer 10

Fever, vomiting, headache, rash, stiff neck, aversion to light
Within 8 hours:
•	Cold hands/feet
•	Leg pain
•	Unusually pale, mottled skin
13-22 hours:
•	Purple rash
•	Light sensitivity
•	Headache, Fever
•	Stiff neck
•	Drowsiness, coma

Question 11

what happens if appendicitis is left untreated?

Answer 11

It can progress to peritonitis

Question 12

What can meningitis lead to if left untreated?

Answer 12

Septicaemia, neurological problems, amputations and death

Question 13

How is viral meningitis treated?

Answer 13

Painkillers, anti-sickness tablets

Question 14

How is bacterial meningitis treated?

Answer 14

IV antibiotics

Question 15

what happens during acute exudative inflammation?

Answer 15

escape of blood constituents into tissue, usually hours/days (can be longer)

Question 16

what happens during chronic formative inflammation?

Answer 16

production of new fibrous tissue, prolonged tissue injury - weeks/months (can be shorter)

Question 17

what are some problems with inflammation?

Answer 17

• severe allergy
• colitis/crohns disease
• rheumatoid arthritis
• Neurodegeneration

Question 18

what is severe allergy?

Answer 18

Allergy/anaphylaxis involving 2 or more body symptoms

Question 19

what can cause severe allergy?

Answer 19

Hypersensitivity (pollen, peanuts, dogs)

Question 20

what are the symptoms of severe allergy?

Answer 20

Acute inflammatory swelling of the airway, mucosal membranes, hives

Question 21

how can severe allergies be treated?

Answer 21

Antihistamines, corticosteroids, adrenalin (anaphylaxasis)

Question 22

what is colitis?

Answer 22

Inflammatory bowel disorder

Question 23

what can cause colitis/Crohn’s disease?

Answer 23

Genetic, immune reactions to gut bacteria, environment

Question 24

what are the symptoms of colitis/Crohn’s?

Answer 24

Abdominal pain, diarrhoea, tiredness

Question 25

how can colitis/Crohn's be treated?

Answer 25

Anti-inflammatory drugs, steroids, immune-suppressants, surgery

Question 26

what is rheumatoid arthritis?

Answer 26

Chronic progressive inflammation in joints leading to painful deformity and immobility in extremities

Question 27

what causes rheumatoid arthritis?

Answer 27

Autoimmune – body’s own immune system attacks tissue leading to inflammation

Question 28

what are the symptoms of rheumatoid arthritis?

Answer 28

Painful, swollen and stiff joints, fatigue

Question 29

how can rheumatoid arthritis be treated?

Answer 29

Painkillers, steroids, anti-TNF therapy

Question 30

what is neurodegeneration?

Answer 30

Neurodegeneration associated with Alzheimer’s Disease and Parkinson’s Disease (amongst others)

Question 31

what are the symptoms of neurodegeneration?

Answer 31

AD – 7% > 65yo Memory, cognition, behaviour Plaques (APP), tangles (tau) PD – 2% > 60yo Movement, cognition, sleep Lewy bodies (α-synuclein) Changes in the activity of microglia

Question 32

what are the pros of inflammation?

Answer 32

* Clears invading toxins * Promotes healing * Self-preservation

Question 33

what are the cons of inflammation?

Answer 33

* Can become chronic | * Can lead to disease

Question 34

what are the features of inflammation?

Answer 34

* fever * lack of energy * weakness

Question 35

what is IL-1?

Answer 35

An endogenous pyrogen

Question 36

where is IL-1 secreted from?

Answer 36

* Neutrophils * Monocytes * Macrophages

Question 37

what is the function of IL-1?

Answer 37

* Acts on CNS thermoregulatory centre to increase temperature * Acts on vascular system to increase dilation, more permeable

Question 38

what are the phases of acute inflammation?

Answer 38

vasodilation vascular permeability emigration chemotaxis

Question 39

where does vasodilation occur?

Answer 39

mainly arterioles, venues and capillaries of microcirculation

Question 40

what are the 3 stages in which blood flow changes?

Answer 40

constriction - reduced blood flow; tissue blanching relaxation - increased blood flow; engorged capillary network return to normal - blood flow slows back down; fluid loss and cell adhesion

Question 41

what happens during vascular permeability?

Answer 41

Vessel wall becomes more permeable to fluids and proteins

Question 42

what can vascular permeability lead to?

Answer 42

inflammatory oedema

Question 43

what can inflammatory oedema lead to?

Answer 43

* Swelling * Pain * Relative immobility – loss of function

Question 44

what is the exudate function of vascular permeability?

Answer 44

tissue repair barrier antibodies complement cascade transportation diluent sustenance

Question 45

what is the exudate like in mild inflammation?

Answer 45

watery (low protein) e.g. serous blisters

Question 46

what is the exudate like in severe inflammation?

Answer 46

protein-rich e.g. lobar pneumonia

Question 47

what happens in stage one of emigration of white blood cells?

Answer 47

* Drop out of main flow to the endothelial layer – margination * Adherence to endothelium – pavem enting – cell adhesion proteins

Question 48

What happens in stage 2 of the emigration of WBCs?

Answer 48

* Actively cross blood vessel wall – pseudopodia | * Flow through in amoeboid manner, pass basement membrane into tissues

Question 49

what are example chemotactics for a neutrophil?

Answer 49

- leukotrienes e.g LTB4 - cytokines - IL-8 - complement system e.g. C5a - collagen fibre fragments - bacterial products e.g. LPS - fibrinolytic system e.g. PAF

Question 50

which white blood cell has faster migration, neutrophils or monocytes?

Answer 50

neutrophils

Question 51

what are the functions of neutrophils in acute inflammation?

Answer 51

- bacterial phagocytosis - lysosomal degradation - cytokine production - attract further neutrophils/monocytes; IL-1 to increase temperature

Question 52

when may eosinophils be involved instead of neutrophils?

Answer 52

- helminth - hypersensitivity reactions e.g. hay fever - enzymatic degradation of inflammatory mediators

Question 53

what are the functions of macrophages in acute inflammation?

Answer 53

late arrival phagocytosis - red blood cells, debris, bacteria digest fibrin - inflammation resolution

Question 54

What are chemical mediators of inflammation?

Answer 54

Substances which signal injury has occurred to blood vessels and cells

Question 55

What are the properties of chemical mediators?

Answer 55

* Rapidly inactivated (enzymes) * Direct, indirect or chemotactic * Released/activated locally * Widespread * Linked interactions (amplification, +ve feedback, rapid response)

Question 56

What are microglia?

Answer 56

Macrophages of the brain – they are the only immune cells in the brain