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1
Q

What is the effect of lipoxins

A

Suppress inflammation and recruitment of leukocytes

2
Q

What is the composition of transudate

A

Low protein concentration, no cellular material, and low specific gravity (close to a super filtrate of plasma)

3
Q

What are the characteristic of chronic inflammation morphology

A

1) Infiltration of mononuclear cells (monocytes,lymphocytes)
2) Tissue destruction
3) Attempts at healing (angiogenesis and fibrosis)

4
Q

What is the mechanism of action of asparin

A

Acetylates and inactivations cyclooxygenases (COX 1&2)

5
Q

What is the effect of TxA2

A

Vasoconstriction, promotes platelet coagulation and aggregation

6
Q

What is the function of PGF2alpha

A

Contraction of uterus, Bronchial, and small arterioles

7
Q

What occurs in the first or priming phase of the liver regeneration

A

IL-6 production by Kupffer cells (allows ability to respond to GFs)

8
Q

What is the expression level of COX1

A

Constitutively expressed in all tissues and maintain homeostatic function

9
Q

What are the common locations for fibrinous inflammation

A

Pleura, meninges, Cardia

10
Q

What are the characteristics of purulent/suppurative inflammation or abcess

A

Production of pus, exuadate containing neutrophils.

11
Q

What is the function and example of CX3X

A

Only member is fractalkine

-Promotes strong adhesion of monocytes and T cells (membrane bound form), or chemoattractant (soluble form)

12
Q

What are the functions of the neutral proteases

A

Degradation of extracellular companents such as collagen, elastin, and cartilage

13
Q

What is the most important C-X-C cytokine

A

IL-8

14
Q

During first intention wound healing, what occurs by day 5

A

Neovascularization appears and reaches its peak. Migration of fibroblasts and proliferation triggered by macrophages cytokines. Epidermis reaches its normal thickness

15
Q

C-C chemokines have what structural characteristic

A

First two conserved cysteines are adjacent

16
Q

What are the molecules leading to fever

A

TNF, IL-6, IL-1 (main one)

17
Q

What is the maximum amount of liver that can be removed and still result in correction

A

90%

18
Q

What are the characteristics of the immune granulomas

A

Agents that are able to sustain a persistent T cell mediated response. Usually associated with a central area of necrosis

19
Q

Deficiency of C1 inhibitor can lead to which condition

A

Hereditary angioedema

20
Q

What are the two types of granules that are contained in neutrophils

A

1) Smaller, specific, secondary granules

2) Larger, azurophil, primary granules

21
Q

What is dehiscence and what is the common cause

A

Rupture of a wound, common after an abdominal surgery where the intrabdominal pressure increases (from coughing, vomiting, or ileus)

22
Q

Purulent/suppurative inflammation is generally caused by which pathogen

A

Pyogenic (pus causing) bacteria, such as staphylcocci

23
Q

What is a tertiary lymphoid organ, and which cells are present

A

Lymphocytes, APCs and plasma cells cluster to form lymphoid tissue resembling LN, aka lymphoid organogensis

24
Q

What type of receptors do eicosanoids bind to

A

GCPR

25
Q

How can COX 2 inhibitors lead to thrombosis

A

COX2 produces prostaglandins that cause vasodilation, while COX 1 produces platelet aggregation and vasoconstriction. Unopposed COX 1 leads to smaller vessels and clot formation

26
Q

What are the contents of the smaller specific granules

A

Lysozyme, collagenase, gelatinase, lactoferrin, plasminogen activator, histaminase, alkaline phosphatase

27
Q

What is the role of PDGF in angiogenesis

A

Recruits smooth muscle cells

28
Q

What does fibrosis generally mean

A

Abnormal deposition of collagen that occurs in internal organs in chronic diseases

29
Q

What is the condition of stasis

A

Small vessels dilate, causing the blood to move slower and an increase of locate RBCs

30
Q

What cells are recruited during angiogenesis

A

Periendothelial cells (pericytes for small capillaries and smooth muscle for larger vessels)

31
Q

During first intention wound healing, what occurs within the first 24 hours

A

Neutrophils appear and clear debris. Cut edge of epidermis shows mitotic activity

32
Q

When is tissue said to be undergoing organization

A

When fibrosis occurs in a tissue space that is occupied by an inflammatory exudate

33
Q

How is PGI2 broken down

A

Into PGF1 alpha, which is a stable end product

34
Q

C-X-C Cytokines have what characteristics on structures

A

1 amino acid between the first two of four conserved cysteine residues

35
Q

What are the three major components of acute inflammation

A

1) Dilation of blood vessels
2) Increased permeability of the blood vessels
3) Emigration of leukocytes

36
Q

What group of enzymes make leukotrienes and lipoxins

A

Lipoxygenases

37
Q

What is occurring during primary union or healing by first intention

A

Wound involving on the epithelial layer, typical of a surgical wound

38
Q

What is the process of granulation of tissue in tissue repair

A

Migration and proliferation of fibroblasts and deposition of loose connective tissue, forming the granulation tissue (amount varies based on size of wound and amount in inflammation)

39
Q

C5a has the ability to activate which pathway

A

Lipoxygenase pathway (increased leukotrienes)

40
Q

What is the effect of platelet activating factor (PAF)

A

Vasoconstriction, bronchoconstriction and high levels, but dilation at low levels

41
Q

Within 6 weeks, what is the size of the large skin defects, and what is the mechanism

A

large skin defects are 5-10% their original size, mainly by wound contraction

42
Q

How is Bradykinin broken down

A

Very quickly via kininase

43
Q

During first intention wound healing, what occurs during the second week

A

Collagen accumulation and fibroblast proliferation. Blanching begins as the increased collagen and decreased vasculature causes turning white

44
Q

Chemoattractants bind to what type of receptors on leukocytes

A

GCPR, activating GTPs and RAC/Rho/cdc42

45
Q

What are the contents of the larger azurophil

A

Myeloperoxidase, lysozymes, defensins, acid hydrolases and proteases

46
Q

What is the enzyme that creates PGI2

A

Prostacyclin synthase

47
Q

What is a condition that glucocorticoids can be given to reduce fibrosis

A

During corneal infections, so that there is a decrease in collagen deposition

48
Q

What is the most important source of growth factors to illicit tissue repair

A

Macrophages

49
Q

How does angiogenesis occur in scar formation

A

New blood vessels form to help deliver the blood and oxygen needed. They are very leaky due to underdeveloped inter-endothelial junctions and high levels of VEGF.

50
Q

What is the common cause of wound ulcerating

A

Inadequate vascularization during healing

51
Q

What is the affect of NSAIDs affect lipoxygenases

A

Does not affect them

52
Q

What is the pathogenic effect of IL-1 and TNF on skeletal muscle

A

Insulin resistance

53
Q

How is TXA2 broken down

A

Spontaneously (unstable) into the inactive form of TXB2

54
Q

What are the characteristics of labile tissues

A

Continual dividing cells that are constantly being lost and replaced by maturation of tissue stem cells. Regeneration occurs as long as the tissue stem cell pool is intact

55
Q

What are the two mechanisms of liver repair

A

1) Proliferation of remaining hepatocyte

2) Repopulation from progenitor cells

56
Q

What are epithelioid cells

A

Macrophages with large cytoplasms at a site of injury and resemble epithelial cells

57
Q

What is the enzyme responsible for ROS creation

A

NADPH oxidase aka phagocyte oxidase

58
Q

In pseudomonas bacteria, how is the inflitrate different

A

Dominated by continuous neutrophil recruitment

59
Q

What is the characteristic of tissue in syphilis

A

Gamma: microscopic lesion, enclosed wall of histiocytes, plasma cell infiltrate, central cells are necrotic without loss of cellular line

60
Q

What is the location of thromboxane synthase

A

In platelet cells

61
Q

Inhibiting leukotriene production with drugs most helps what condition

A

Asthma with Zileuton or montelukast (antileukotriene drug)

62
Q

What is the cause of Cat scratch disease

A

Gram neg bacillus

63
Q

How is most superoxide anion converted to hydrogen peroxide

A

Spontaneous dismutation

64
Q

What is the overall effect of PGD2 and PGE2

A

Vasodilation, Increased permeability

65
Q

What type of injury is there wound contraction

A

Only secondary intention

66
Q

What is the pathogenic effect of TNF on blood cells

A

Thrombus due to increased permeability

67
Q

What is the effect of leukotriene B4

A

1) Adhesion of leukocytes to epithelium
2) Chemoattractant and activator of neutrophils
3) ROS generation
4) Lysosomal enzyme release

68
Q

What is the cause of leprosy

A

Mycobacterium leprae

69
Q

What are the most important mediators of acute inflammation

A

1) Vasoactive amines
2) lipid products
3) cytokines
4) products of complement

70
Q

What are two examples of serous inflammation

A

Effusion and skin blisters

71
Q

What is the role of alpha 1-antitrypsin and alpha 2-macroglobulin

A

Major inhibitor of neutrophil elastase and works to prevent breakdown of healthy tissue

72
Q

What molecule do mammals contain on their glycoproteins and glycolipids

A

Sialic acid and N-acetylgalactosamine

73
Q

Are activated B cells and plasma cells present at the site of chronic inflammation

A

Yessirie Bob

74
Q

What is the characteristic of tissue in cat scratch disease

A

Rounded or stellate granuloma, giant cells uncommon, debris and recognizable debris

75
Q

What is a Desmond or aggressive fibromatoses

A

Incision scars or traumatic injuries followed by exuberant proliferation will recur after excision

76
Q

What is the strength of a wound following the removal of sutures

A

10% but increases over next 4 weeks

77
Q

What is the role of APP and anemia in chronic inflammation

A

Hepcidin is produced as part of APP. This decreases the availability of iron for RBCs, leading to anemia

78
Q

What is the characteristic of tissue in crohn’s disease

A

Occasional noncaseating granuloma in intestine wall, dense chronic inflammation

79
Q

Which pathogens are associated with leukopenia

A

Aka decrease in WBCs.

-Typhoid fever, some viruses, rickettsiae, protozoa

80
Q

What conditions are associated with lymphoid organogenesis

A

Hashimoto’s thyroiditis and RA

81
Q

What are the factors involved in the laying down of connective tissue and what is the source

A

PDGF, FGF-2, and TGF-beta from M2 macros

82
Q

What is the composition of exudate

A

High protein concentration and contains cellular debris (due to increased permeability of vessel)

83
Q

What is the location of prostacyclin synthase

A

In vascular endothelium

84
Q

How are the granules of neutrophils able to make hydrogen peroxide into a killing substance

A

Myeloperoxidase (MPO) which turns Cl- (a halides) into hypochlorite (bleach).

85
Q

What are Weibel-palade bodies

A

Storage location of P selectin in the intracellular stores in endothelial cell granules

86
Q

What is the function of DAF

A

Blocks formation of the C3 convertase

87
Q

What molecule does 5-lipooxygenase create

A

5-HPETE

88
Q

What does the mannose receptors bind to

A

Mannose and fuctose on glycoproteins and glycolipids

89
Q

How do APP cause erythrocyte sedimentation

A

Fibrinogen binds to RBCs, causing a stack known as rouleaux. This will increase the sedimentation rate

90
Q

What is the left shift during leukemoid reactions

A

Leukemoid reactions are which WBCs reach leukemia levels. During this time, there are the increase presence of more immature neutrophils, knows as band cells

91
Q

What is the role of MMP (matrix metalloproteinases) in tissue remodeling

A

Degrades the ECM to permit remodeling and extension of vascular tube

92
Q

What is the characteristic of tissue in tuberculosis

A

Caceating granuloma aka tubercle, central necrotic area, occasional giant cells, acid fast bacilli

93
Q

What is the cause of autoinflammatory syndromes

A

Gain of function mutations in the receptor sensors from inflammasomes, leading to spontaneous inflammation

94
Q

What is the cause of syphilis

A

Treponema pallidum

95
Q

Granulomatous inflammation is associated with collections of which type of cells

A

Macrophages, often T cells

96
Q

What is a keloid

A

Formation of a scar that grows beyond the boundary of the original wound

97
Q

How do histamines and leukotrienes compare in eliciting vasculature permeability and bronchospasms

A

Leukotrienes are more potent than histamines

98
Q

What cells are driving regeneration from progenitor cells and where are they located

A

Oval cells located in the canals of Hering

99
Q

What is the immediate transient response and what is it mediated by

A

The increased permeability of the vessels due to histamines, leukotrienes, and bradykinin

100
Q

What are the two vasoactive amines

A

Histamine and serotonin

101
Q

What are examples that will lead to a foreign body granuloma

A

Talc (IV drug users), sutures, and fibers that can not be engulfed by phagocytosis

102
Q

What is the characteristic of tissue in leprosy

A

Acid fast bacilli in macrophages, noncaseating granuloma

103
Q

What is characteristic of fibrinous inflammation

A

Leakage of fibrinogen into the space, forming fibrin. Usually occurs when vascular leakages are large and there is a procoagulant stimulus

104
Q

Administration of TNF antagonist will help which conditions, but more susceptible to which conditions

A

Treats: chronic inflammation diseases (RA, psoriasis, IBD)

Susceptible to: mycobacteria (macros cant kill IC bacteria)

105
Q

What are the molecules leading to leukocyte production

A

TNF,IL-1,IL-6

106
Q

What is the most common mechanism of vascular leakage

A

Contraction of the endothelial cells resulting in the increased interendothelial spaces

107
Q

What is the role of TGF beta in connective tissue being laid down

A

1) Fibroblast activation and migration
2) synthesis of collagen and fibronectin
3) Decreased MMP (decreased ECM degredation)

108
Q

What are the characteristics of the second intention that are different than the primary intention

A

1) More abundant granulation tissue
2) More pronounce inflammation
3) Accumulation of ECM and large scar
4) Would contraction via myofibroblasts

109
Q

What are the general ligands fro selectins

A

Sialyted oligosaccharides bound to mucin like glycoprotein backbones

110
Q

What is the family of ADAM MMPs

A

Anchored to the plasma membrane and cleave/release EC domains of cell associated cytokines and growth factors

111
Q

What is the most important cytokine for the synthesis and deposition of connective tissue protein

A

TGF-Beta

112
Q

What is a exuberant granulation or pound flesh

A

Consists of the formation of excessive amounts of granulation tissues that procured above the layer of surrounding skin and block reepithelization

113
Q

What is serous inflammation marked by

A

Exudation of cell poor fluid that does not contain high levels of leukocytes

114
Q

What is a hypertrophic scar

A

Scar that is raised and generally involves injury to the deep dermis following thermal or traumatic injury

115
Q

What is the role of FGF in angiogenesis

A

Stimulates proliferation of endothelial cells

116
Q

What is the pathogenic effect of TNF on the heart

A

Low output

117
Q

What is the characteristic of tissue in sarcoidosis

A

noncaseating granulomas with abundant activated macrophages

118
Q

How is DAF and CD59 attached to a cell and how does this influence conditions it can cause

A

It is anchored to the membrane via and GPI anchor. Any deficiency in the ability to make this anchor will lead to paroxysmal nocturnal hemoglobinuria (PNH)

119
Q

What are the causes for transudate

A

Increased hydrostatic pressure or decreased osmotic pressure

120
Q

IL1/TNF lead to the formation of which APP

A

SAP

121
Q

What is a secondary function of PGD2

A

Neutrophil attractant

122
Q

Where is PGD2 and PGE2 created and stored

A

Mast cells

123
Q

What is the effect of Leukotrienes C4,D4,E4

A

1) Bronchospasm
2) increased vascular permeability
3) Vasoconstriction

124
Q

During first intention wound healing, what occurs by day three

A

Neutrophils have been replaced by macrophages and granulation tissue invades the incision space. Collagen fibers begin to appear

125
Q

What occurs in the second or growth phase of liver regeneration

A

Growth factors, HGF and TGF-alpha, stimulate entry in the cell cycle

126
Q

What are the characteristics of stable tissues

A

Normally quiescent (in G0 state) and only minimally proliferate. Under injury, it can proliferate, such as the kidney, pancreas, smooth muscle cells, but have a limited capacity to regenerate

127
Q

What is the collective group of macrophages referred to

A

Mononuclear phagocyte system or reticuloendothelial system

128
Q

What is the role of angiopoietins 1 &2 (Ang 1&2)

A

Interactions with Tie2 (tyrosine kinase) to help stabilize vessels

129
Q

What is the site of action for major basic protein

A

Targets and harmful to parasites

130
Q

What group of enzymes create prostaglandins

A

Cyclooxygenases

131
Q

What are the two type of complications that arise from inadequate formation of granulation tissues

A

Wound dehiscence and ulceration

132
Q

Administration of steroid affects which pathway in eiconisoids

A

Blocks phospholipase A2, and COX2

133
Q

In wound healing, what is the increases in strength due to

A

1) Excess of collagen synthesis vs degradation during first 2 months
2) The collagen modification (cross-linking and increased fiber size) when the synthesis ceases

134
Q

When do foreign body granulomas from

A

Inert foreign bodies in the absence of T cell

135
Q

Kinins are derived from which proteins and are activated by which enzymes

A

Derived from kininogens, and are activated by the activity of kallikriens

136
Q

What does the enzyme NADPH oxidase do

A

Reduces oxygen to superoxide anion (.O2)

137
Q

Where does most leukocyte transmigration occur

A

Postcapillary venules

138
Q

How can glucocorticoids result in wearing of scars

A

Inhibition of TGF beta, leading to diminished fibroblast recruitment and fibrosis

139
Q

What are the functions of the acid proteases

A

Degradebacteria and debris within the phagolysosomes, which are supplied by the proton pumps

140
Q

Where are resident macrophages created

A

Fetal liver or yolk sac

141
Q

C chemokines have what function

A

Specific from lymphocytes (lymphotactin)

142
Q

IL-6 leads to the formation of which APP

A

CRP and fibrinogen

143
Q

What is the cause of tuberculosis

A

Mycobacterium tuberculosis

144
Q

What are the three acute phase proteins

A

CRP, fibrinogen, serum amyloid protein (SRP)

145
Q

C chemokines have what general structure

A

Lack first and third conserved cysteins

146
Q

What population of people is a keloid formation more likely

A

African American population

147
Q

What are the two step involved in the laying down of connective tissue

A

1) Migration and proliferation of fibroblasts into site of injury
2) deposition of ECM proteins

148
Q

C-C chemokines include which molecules and generally have which function

A
  • Attracting monocytes, eiosinophils, and lymphocytes

- MCP-1, eotaxin, MIP-1alpha, RANTES

149
Q

During first intention wound healing, what occurs 24 to 48 hours

A

Epithelial cell edges have begun to migrate and proliferate

150
Q

What are the arachidonic acid mediators (aka eicosanoids)

A

Prostaglandins and leukotrienes

151
Q

How do Liver abscesses affect the liver’s ability to regenerate

A

There is extensive destruction to the reticulum framework, which leads to scar formation (Even through there are liver cells that can regenerate)rather than regeneration

152
Q

What is the function of CD59

A

Blocks the formation of CD59

153
Q

In secondary healing, what is the process of change in the matrix

A

1) First the matrix contains fibrin, plasma fibronectin, and type 3 collagen
2) After 3 weeks, this is replaced with a matrix containing type 1 collagen

154
Q

What is the most prominent lipooxygenase in neutrophils

A

5-lipooxygenase

155
Q

What is the effect of PGI2

A

Vasodilation, inhibits coagulation and platelet aggregation

156
Q

What is the function of 5-HETE

A

Chemoattractant for neutrophils

157
Q

In most organs, kidneys and lungs, what is the main source of collagen

A

Myofibroblasts

158
Q

What is the enzyme that creates TxA2

A

Thomboxane synthase

159
Q

What are the molecules leading to acute phase proteins

A

IL-1, IL-6 (main one)

160
Q

What is the site of action for lysozymes

A

Hydrolyzes muramic acid N-acetylglucoasamine bond in bacterial coats

161
Q

Receptors leading to inflammasomes bind to which molecules

A

1) Uric acid (from DNA break down)
2) ATP
3) Decreased intracellular potassium levels
4) DNA

162
Q

What is the expression level of COX 2

A

Induced by inflammatory stimulus and generate prostaglandins involved in the inflammatory response, so it usually expressed at low or non existing levels

163
Q

What are the characteristics of the permanent tissues

A

Cells of tissues that are terminally differentiated and no proliferative in postnatal life. Damage results in scar formation

164
Q

In liver cirrhosis, what is the main collagen producer

A

Stellate cells

165
Q

What is the dominant cell in chronic inflammation

A

Macrophages

166
Q

What is the condition of paroxysmal nocturnal hemoglobinuria

A

Excessive complement activation and RBC lysis