inflammation

Question 1

Define inflammation.

Answer 1

A local physiological response to tissue injury.

Question 2

how is inflammation classed x2

Answer 2

acute
chronic

Question 3

summary of acute inflammation

Answer 3

1- initial reaction of tissue to injury
2- vascular component- dilation of vessels
3- exudative component, leakage of protein rich fluid
4- neutrophil is the first cell at the scene
5- outcome may be resolution, suppuration, organisation or progression to chronci

Question 4

what cells are involved in inflammation 5

Answer 4

neutrophil polymorphs
* Macrophages
* Lymphocytes
* Endothelial cells
* Fibroblasts

Question 5

what is chronic inflammation

Answer 5

Slow onset or sequel to acute
– Long duration
– May never resolve

Question 6

Causes of acute inflammation

Answer 6

Microbial infections
Hypersensitivity reactions
Physical agents
Bacterial toxins

Question 7

Characteristics of neutrophil polymorphs

Answer 7

Short lived cells
* First on the scene of acute inflammation
* Cytoplasmic granules full of enzymes that
kill bacteria
* Usually die at the scene of inflammation
* Release chemicals that attract other
inflammatory cells such as macrophages

Question 8

characteristics of macrophages

Answer 8

Long lived cells (weeks to months)
* Phagocytic properties
* Ingest bacteria and debris
* May carry debris away
* May present antigen to lymphocytes

Question 9

characteristics of lymphocytes

Answer 9

Long lived cells (years)
* Produce chemicals which attract in other
inflammatory cells
*produces memory cells from past infections

Question 10

what to endothelial cells produce that stops things from sticking

Answer 10

nitrous oxide

Question 11

why does an inflamed area look red and swollen

Answer 11

capillaries are open
swollen as it has more blood and fluid

Question 12

what does sepsis look like

Answer 12

all blood vessels are open,
not enough blood to fill them

Question 13

characteristics of fibroblasts

Answer 13

-Long lived cells
-Form collagen in areas of chronic
inflammation and repair
-spindle shaped

Question 14

what is a granuloma

Answer 14

An aggregate of epitheloid histocytes

Question 15

best known chemical mediator in acute inflammation

Answer 15

histamine

Question 16

what does histamine do

Answer 16

• causes vascular dilation
  -increases vascular permeability

Question 17

what is the role of mast cells

Answer 17

• On stimulation by c3a/c5a complement components they release preformed inflammatory mediators
  -metabolise arachidonic acid into newly synthesised inflammatory mediators

Question 18

what is a prostaglandin

Answer 18

chemical mediator of inflammation

Question 19

5 cardinal signs of inflammation

Answer 19

1. Redness (rubor).
2. Swelling (tumor).
3. Pain (dolor).
4. Heat (calor).
5. Loss of function.

Question 20

define exudate

Answer 20

fluid that leaks out of vessel walls due to increased vascular permeability

Question 21

what are the benefits of exudate formation

Answer 21

-dilution of toxins
-entry of antibodies
-transport of drugs
-fibrin formation

Question 22

what are the 4 systemic effects of acute inflammation

Answer 22

1. Fever.
2. Feeling unwell.
3. Weight loss.
4. Reactive hyperplasia of the reticuloendothelial system

Question 23

What are the 4 outcomes of acute inflammation

Answer 23

1. Resolution.
2. Suppuration- formation of pus
3. Organisation (scar tissue formation).
4. Progression onto chronic inflammation.

Question 24

what is resolution

Answer 24

initiating factor removed
tissue undamaged or able to regenerate

Question 25

what is repair

Answer 25

-initiating factor still present tissue damaged and unable to regenerate

Question 26

what is suppuration

Answer 26

formation of pus, a mixture of living, dying and dead neutrophils and bacteria

Question 27

what is organisation

Answer 27

the replacement by granulation tissue as part of the process of repair

Question 28

Give 4 causes of chronic inflammation.

Answer 28

1. Primary chronic inflammation. 2. Transplant rejection. 3. Recurrent acute inflammation. 4. Progression from acute inflammation.

Question 29

sequence of chronic inflammation

Answer 29

either progression from acute inflammation or starts as ‘chronic’ inflammation such as infectious mononucleosis * no or very few neutrophils * macrophages and lymphocytes, then usually fibroblasts * can resolve if no tissue damage (e.g. viral infection like glandular fever) but often ends up with repair and formation of scar tissue

Question 30

what is healing by 2nd intention

Answer 30

when you cant get the edges of skin together so the wound will be left open to heal naturally may be due to excess trauma

Question 31

why does repair occur

Answer 31

when tissue damage occurs where tissue can't regenerate

Question 32

what cells do not regenerate

Answer 32

* myocardial cells * neurones

Question 33

Names of the 4 stages of neutrophilic action

Answer 33

/Margination Adhesion Emigration Diapedesis

Question 34

Describe the 4 stages of neutrophilic action

Answer 34

Migration - increase in plasma viscosity , neutrophils line up along plasmatic zone Adhesion to neutrophils - adhesion to vascular endothelium occurs and attach Emigration - neutrophils pass through endothelial cells onto vessel wall Diapedesis- rbcs may also escape from vessels , indicates severe vascular injury

Question 35

What conditions might you see a granuloma

Answer 35

TB, LEPROSY chrons Sarcoodosis

Question 36

What are some macroscopic features of chronic inflammation

Answer 36

Chronic ulcer Chronic abscess activity Granulomatous inflammation Fibrosis

Question 37

The activity of what enzyme in the blood can act as a marker for granulomatous disease

Answer 37

ACE

Question 38

You suspect a patient has sarcoidosis which blood marker do you investigate

Answer 38

ACE - released by granulomas

Question 39

What is resolution

Answer 39

The complete restoration of tissues to normal Minimal cell death

Question 40

What is suppuration

Answer 40

Formation of pus Becomes surrounded by pyogenic membrane

Question 41

What is organisation

Answer 41

Replacement by granulation tissue New capillaries grow into the inflammatory exudate

Question 42

What is progression

Answer 42

Causative agent is not removed so there is progression to chronic inflammation

Question 43

what is the name of the cell that produces collagen in fibrous scarring

Answer 43

fibroblasts

Question 44

appendicitis is an example of ?

Answer 44

acute inflammation

Question 45

crohns disease is an example of ?

Answer 45

granulomatous inflammation

Question 46

Benefits on inflammation

Answer 46

Destruction of invading microbes

Question 47

Harmful effects of inflammation

Answer 47

Digestion of normal tissues Swelling Inappropriate inflammatory response

Question 48

what is the role of mast cells

Answer 48

- On stimulation by c3a/c5a complement components they release preformed inflammatory mediators -metabolise arachidonic acid into newly synthesised inflammatory mediators