Acute Inflammation CC

Question 1

How does an inflamed appendix look compared to a normal one

Answer 1

purple- Vasodilation
Normal looks shiny. Inflamed not as shiny because of fibrinoplurulent exudate
Inflamed larger

Question 2

The appendix can burst. What can this lead to?

Answer 2

Peritonitis

Question 3

Apart from peritonitis, what 5 other complications can arise from acute appendicitis

Answer 3

Abcess around the burst appendix
Subphrenic abcess (Under the diaphragm)
Sepsis
Portal vein pyemia (Suppurative inflammation of the portal vein)-->Portal vein thrombosis
Liver abcess

Question 4

What predisposing factors are there to acute appendicitis

Answer 4

Age- 10 to 30
Infection (Esp in Gi system)
trauma
llow fibre diet–>constipation–>faecal impactin in the appendix–>Appendicitis
Adhesions in the bowel–>Blocking of appendicix–>Appendicitis (Can be secondary to trauma)

Question 5

What can be seen in the sulci of the brain in someone who has meningitis? What effect may this have?

Answer 5

Yellow fluid- Pus/Purulent exudate

Can increase the pressure in the skull–>compression of the brain

Question 6

What organisms commonly cause meningitis in the following age groups?
Neonates
Children
Young adult
older age groups

Answer 6

Neonates: Group B streptococci, Escherichia coli, Listeria monocytogenes
Children: Streptococcus pneumoniae, Neisseria meningitidis (Meningococcus), Haemophilus influenzae type B
Young adults: Neisseria Meningitidis, Streptococcus pneumoniae
Older age groups: Streptococcus pneumoniae, Neiserria meningitidis, Listeria monocytogenes

Question 7

List some complications related to meningitis

Answer 7

Disseminated Intravascular Coagulation
Encephalitis
Persistent fever
Seizures
Syndrome of inappropriate ADH use–>Fluid build up
Brain damage and everything that encumbers eg. vision loss, hearing loss, epilepsy
Sepsis
Waterhouse-Fredrickson Syndrome: bleeding into the adrenal glands

Question 8

With acute inflammation what leukocyte would most likely show the most abnormal count and what causes this?

Answer 8

Neutrophils
Because of colony-stimulating factor released by macrophages and endothelial cells stimulating the bone marrow to increase neutrophil production

Question 9

A man come in who has gallstones for months. Has an abcess in his liver. What Liver function test chemicals would you expect to be raised?

Answer 9

Serum bilirubin, Alanine transaminase, Alkaline phosphatase

Question 10

Why are the liver function tests raised with the liver abcess?

Answer 10

Because the liver function test chemicals are usually metabolised in the liver. Not so to the same extent now so build up in the blood

Question 11

Why could gallstones lead to a hepatic abscess?

Answer 11

Blocks the bileduct
Stasis as bile flow stopped
Infection develops that spreads up to the liver

Note an infection of the bile duct is called Ascending cholangitis

Question 12

What type of bacteria are most often the cause of this ascending cholangitis

Answer 12

Escherichia coli
Klebsella
In general Gram Negative bacteria

Question 13

Give four other complications of gallstones

Answer 13

bilary colic
Gallbladder cancer as it tries to heal itself
Gallstone ileus- Gallstone gets into ileus, causes obstruction in bowel. Gallstone enters the ileum through a fistula between the gallbladder and ileum
Acute pancreatitis

Question 14

Difference between lobar and bronchopneumonia

Answer 14

Lobar is acute inflammation of an entire lobe
broncho- Characterized by patchy foci of consolidation (pus in many alveoli and adjacent air passages) scattered in one or more lobes of one or both lungs

Question 15

What is the most ccommon causative organism of lobar pneumonia?

Answer 15

Streptococcus Pneumoniae

Question 16

whhat are the 4 stages of evolution of lobar pneumonia if it isnt treated?

Answer 16

1. Congestion- Affected lung parenchyma becomes partially consolidated and red-purple
   Alveolar lumen contains serous exudate, bacteria and rare leucocytes
2. Red hepatisation- Lobe appears consolidate, red brown, dry and firm (Like liver)
   Fibrin rich exudate accumulates in alveoli as well as bacteeria, erythrocytes and leucocytes
   Alveolar walls thicken as well due to capillary congestion and oedema
3. Grey hepatisation- Uniform grey colour, liver like consistency.
   Alveolar lumen fill with suppuative exudate (macrophages, neutrophils to remove the fibrin exudate)
4. Resolution. Exudate drained through the lymphatics and airways (Ie productive cough)

Question 17

What complications can arise in pneumonia (8)

Answer 17

Acute resp distress syndrome (Fluid builds up in lungs when damaged-->Can't breath)
Empyema
Lung abscess
Meningitis
Pericarditis
Pulmonary fibrosis
Resp. failure
Sepsis

Question 18

What is hereditary Angiooedema

Answer 18

Autosomal dominant

Episodic swelling of face, exteemities, genitals, most importantly airways too

Question 19

How does hereditary angiooedema present

Answer 19

Begins around puberty
Recurrent swelling
Sensation of fullness
Not really any pain or itching (Except with abdo swelling- experience acute abdo pain)

Question 20

What is Chronic granulomatosu disease

Answer 20

immune cells can’t make reactiv eoxygen species–>granuloma formation in many organs