Acute inflammation

Question 1

3 key features of acute inflammation

Answer 1

1. Increased blood flow - vasodilation
2. Increased vascular permeability
3. Recruitment and activation of leukocytes

Question 2

3 transudate features of edema

Answer 2

1. Low fluid protein
2. Low fluid cellularity
3. Low specific gravity

–> NO inflammatory process

Question 3

Exudate features of edema

Answer 3

1. High fluid protein
2. High cellularity and
3. High specific gravity

–> Indicates INFLAMMATION

Question 4

Vasodilation and stasis of edema and swelling is due to

Answer 4

1. Nitric oxide

2. Histamine

Question 5

4 mechanisms of increasing vascular permeability

Answer 5

1. Endothelial retraction
2. Direct endothelial injury
3. Leukocyte induced endothelial injury
4. Transcytosis

Question 6

Mechanism of endothelial cell retraction and describe onset and duration

Answer 6

1. Nitric oxide/histamine

2. Rapid onset and short-lived

Question 7

Describe onset and duration of direct endothelial cell injury

Answer 7

Rapid
LONG-lived (takes time to re-endothelialize vessels)

• caused by burns/toxins

Question 8

Describe onset and duration of Leukocyte induced endothelial injury

Answer 8

DELAYED onset
LONG-lived
- late in inflammation

Question 9

Mechanism of Transcytosis

Answer 9

Interconnected, uncoated vesicles - vesiculovacuolar organelle

Question 10

Example of disease with a transudate fluid

Answer 10

CHF
renal failure
liver failure (decrease in proteins and decreased oncotic pressure)

Question 11

Example of disease with exudate fluid

Answer 11

Acute pneumonia

cancer

Question 12

Order of leukocyte response

Answer 12

1. Macrophages secrete IL-1, TNF
2. stimulate expression of secretins
3. adhesion of neutrophils
4. integrins stop the rolling
5. Diapedesis
6. chemotaxis

Question 13

What are selectins?

Answer 13

LOW affinity adhesion molecules bind Lewis antigens on leukocytes

Question 14

Endothelial cells express selectins after secretion of which cytokines

Answer 14

IL-1 and TNFa from macrophages

Question 15

Integrins are

Answer 15

HIGH affinity adhesion molecules that bind endothelium

Question 16

Describe Diapedesis

Answer 16

Migration of the leukocyte through endothelium with help of CD31

Question 17

Chemotaxis

Answer 17

Migration of leukocytes along a chemokine gradient in interstitium

Question 18

Examples (3) of chemokine gradient proteins

Answer 18

1. Bacterial products
2. Leukotriene B4
3. Complement 5A

Question 19

After phagocytosis there is the formation of the

Answer 19

phagolysosome

Question 20

2 methods employed by the lysosome to degrade offending agents

Answer 20

1. Digestion by lysosomal enzymes

2. Free radicals/ROS production

Question 21

3 free radicals in the lysosome

Answer 21

1. Phagocyte oxidase - superoxide anion
2. Myeloperoxidase - Hypochlorite anion
3. Nitric oxide synthase - NOS - peroxynitrie anion- created by inducible NOS

Question 22

What is Chediak-Higashi syndrome?

Answer 22

Failure of lysosome and phagosome fusion - accumulation of enzymes in dilated lysosomes

Question 23

What is chronic granulomatous disease?

Answer 23

failure of oxidative burst -
Deficiency in PHAGOCYTE OXIDASE
leads to accumulation of phagocytes (macrophages)

Question 24

Myeloperoxidase deficiency

Answer 24

Defective halogenation and inefficient bacterial killing

-need chloride anion

Question 25

Neutrophils are thought of as.... what type of responder?

Answer 25

Early responders

Question 26

Key features of neutrophils

Answer 26

1. Lower phagocytic activity 2. HIGH lysosomal enzymes - secrete into interstitium and leads to injury

Question 27

Monocytes and macrophages peak

Answer 27

2 days after edema

Question 28

Key features of macrophages

Answer 28

LOWer quantity of enzymes HIGHER phagocytic activity -- remove debris and wound repair

Question 29

IFN-gamma induces what type of macrophage?

Answer 29

M1 - microbicidal - pathologic inflammation

Question 30

which 2 cytokines promote a M2 macrophage response - wound repair and fibrosis?

Answer 30

IL-13 and IL-4

Question 31

The mediators of inflammation are

Answer 31

activated by a variety of stimuli SHORT-lived - Extensive crosstalk

Question 32

The mediators of inflammation are present in what form

Answer 32

Inactive precursor enzymes

Question 33

4 cardinal features of acute inflammation

Answer 33

redness, swelling, heat, pain, and LOSS OF FUNCTION

Question 34

what is acute lymphangitis

Answer 34

When inflammation which is normally found in venules and capillaries now tracks along lymphatic system