Cutaneous Inflammation

Question 1

5 cardinal signs of acute inflammation

Answer 1

Heat
Redness
Swelling
Pain
Loss of function

Question 2

Cells found in skin during inflammation

Answer 2

Neutrophil
Eosinophil
Lymphocyte
Plasma cell
Macrophage
Mast cell

Question 3

What type of cell are langerhans cells

Answer 3

Dendritic

Question 4

Langerhans location and function

Answer 4

Epidermis
Present antigens to CD4+ helper T cells and transport antigens to lymph nodes

Question 5

What types of inflammation are Th1, TH2, and Th17 cells involved in

Answer 5

1 - neutrophilic inflam - extracellular
2 - monocytic inflam - intracellular
3 - eosinophilic, basophils, mast cell - helminths

Question 6

Types of inflammation in skin

Answer 6

1 Mast cell mediated
2 Antibody mediated
3 Immune complex mediated
4 Delayed hypersensitivity
5 Granuloma formation

Question 7

What type of inflammation causes urticaria

Answer 7

Mast cell mediated

Question 8

What type of inflammation causes pemphigus

Answer 8

Antibody mediated

Question 9

What type of inflammation causes vasculitis

Answer 9

Immune complex mediated

Question 10

What type of inflammation causes contact allergic dermatitis

Answer 10

Delayed hypersensitivity

Question 11

What type of inflammation causes TB and sarcoidosis

Answer 11

Granuloma formation

Question 12

Causes of mast cell degranulation

Answer 12

Aspirin
NSAIDs
Serum factors
Insect stings
Allergens

Question 13

What does mast cell degranulation release

Answer 13

Histamine
Leukotrienes
Prostaglandins
Platelet aggregating factor

Question 14

Which cells are recruited and activated by mast cell degranulation

Answer 14

Monocytes and macrophages
Dendritic cells
T cells
Neutrophils basophils eosinophils
Epithelial cells

Question 15

Effects of mast cell degranulation

Answer 15

Vascular leak
Bronchoconstriction
Intestinal hypermotility
Inflammation
Tissue remodelling
Phagocytosis
Antimicrobial activity
Degradation of endogenous toxic mediators

Question 16

Effects of Histamine

Answer 16

Stimulates sensory nerves - itch
Bronchospasm
Smooth muscle contraction -> vessel leakage and oedema
Arteriole dilation -> headache + hypotension
Modulation of immune response

Question 17

Which receptor does histamine modulate the immune response via

Answer 17

H2 receptor

Question 18

Where is the Der P1 enzyme allergen found

Answer 18

Faecal pellets of dust mites

Question 19

Which type of inflammation causes urticaria asthma and hay fever

Answer 19

Mast cell mediated

Question 20

Anaphylaxis process

Answer 20

Antigen released into blood -> binds to IgE on basophils -> massive inflammatory mediators release -> bronchospasm + circulatory collapse

Question 21

Urticaria

Answer 21

pruritic, pale, blanching swellings of the superficial dermis that last for up to 24 hours

Question 22

Cutaneous demographism

Answer 22

Exaggerated urticarial response to pressure or scratching on skin
Allows words to be written on skin

Question 23

Acute Angioedema

Answer 23

Sudden swelling often caused by allergic reaction

Question 24

Which monoclonal antibody is now being used for resistant urticaria and asthma

Answer 24

Omalizumab

Question 25

Desmosome

Answer 25

Junction betweeen keratinocytes

Question 26

Acanthiolysis

Answer 26

loss of intercellular connections, such as desmosomes, resulting in loss of cohesion between keratinocytes Occurs in pemfigus

Question 27

Pemphigus vulgaris

Answer 27

autoimmune bullous diseases characterised by blisters and erosions of the mucous membranes and skin Pemphigus vulgaris is most common variant

Question 28

Pemphigus vulgaris on histology

Answer 28

Suprabasal splitting Acanthiolysis

Question 29

Pemphigus vulgaris treatments

Answer 29

Oral steroids Immunosuppression - c mycophenolate mofetil, Azathioprine Rituximab

Question 30

Pathophysiology of complex mediated vasculitis

Answer 30

Immune complexes lead to -> Deposition of fibrin Vessel wall necrosis Proteases degrade basement membrane zone Leaky vessel extravasion of blood and oedema

Question 31

Cutaneous manifestations of vasculitis

Answer 31

Erythema and oedema Palpable pereira Ulceration and necrosis

Question 32

What antigen and antibody lead to systemic lupus erythematosus

Answer 32

DNA anti-DNA

Question 33

What antibody and antigen cause polyarteritis nodosa

Answer 33

HBsAg Anti-HBsAb

Question 34

Effects of IL2 and IFNgamma in allergic contact dermatitis

Answer 34

Promote Th1 response Promote macrophage response Skin inflammation 48-72hrs after challenge

Question 35

Granuloma formation process

Answer 35

Mycobacterium tb -> Clinal T cell expansion -> Th1 cytokine excretion -> Macrophage activation Macrophages transform to form epithelioid macrophages and fuse to form langhans giant cells + foreign body giant cells -> Combine to form granuloma

Question 36

What can cause formation of a granuloma

Answer 36

Tb Sarcoidosis Foreign body granulomas - eg tattoos

Question 37

What condition is caused by an autoimmune attack on the hair follicle

Answer 37

Alopecia areata

Question 38

What condition is caused by an autoimmune attack on melanocytes

Answer 38

Vitiligo

Question 39

What hair abnormalities can alopecia areata cause

Answer 39

Hair falling out Hair regrowing white Hair Turing white

Question 40

Does vitiligo respond better to treatment on the hands or face

Answer 40

Face

Question 41

What new drug can be used for alopecia areata and vitiligo

Answer 41

JAK inhibitors - ruxolitinib

Question 42

Potential risks of JAK inhibitors

Answer 42

Thromboembolic disease Cancer