inflammation Flashcards

0
Q

Mediators of vascular permeability

A

Swelling
Early mediators: histamine, bradykinin, PAF, thrombin, leukotrienes
Late mediators: IL-1beta, TNF alpha

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1
Q

Mediators of Vascular dilation

A

Redness-

NO, PGI2, PAF, bradykinin

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2
Q

What does increased endothelial permeability cause?

A

swelling
exudate- fibrin (protein) rich, purulent/suppurative (pus)
transudate- cell poor

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3
Q

Patterns of acute inflammatory response

A
  1. Suppurative (pus)
  2. Abscess- liquefactive necrosis w fibrin wall
  3. Ulcerative- ice cream scoop
  4. Pseudomembranous- (ex. c diff)
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4
Q

Most common etiologies of acute inflammatory response?

A

bacteria and cell death

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5
Q

Acute inflammatory response can result in? (2)

A
  • resolution or scarring if stim is destroyed

- necrosis if stim is not destroyed (depends on how frequently affected cell divides)

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6
Q

Types of granulomas

A

Non-caseating: from foreign body, fungus, parasite, immune system
Caseating: TB (usually) or bartonella (cat scratch)
Necrotizing: fungus (ex. histoplasma) or immune

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7
Q

Etiologies of chronic inflammation?

A

bacterial, viral, parasitic, fungal, etc; immune response

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8
Q

What makes up a granuloma?

A
lymphocytes, fibroblasts
activated MAC (by Th1) --> epithelial histiocyte, aggregation --> multinucleated giant cell
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9
Q

Cytopathic changes are associated with what??

A

viral infection

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10
Q

Leukocyte adhesion steps?

A
  1. P-selectin (from weibel palade bodies) go to surface of endothelial cells; bind mucin (PSGL-1, ESL-1) of leukocytes
  2. chemokine dependent activation (TNFa, IL-1): chemokine binds low affinity integrin of leukocyte –> high affinity integrin to surface (VLA4, LFA1); chemokine –> VCAM-1 and ICAM-1 to endothelial surface, bind integrins
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11
Q

Transmigration of leukocyte?

A

Ca2+ influx –> mysoin contraction –> leukocyte transmigration paracellularly
PECAM1 and CD99 help

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12
Q

Chemotactic factors in leukocyte transmigration?

A

C5a, IL-8, LTB4, PAF; guide through ECM

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13
Q

Selectin?

A

Leukocyte adhesion
P-selectin in Weibel palade bodies of endothelial
Sent to surface of endothelial cell
Binds Mucin of leukocytes

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14
Q

Mucin?

A

Leukocyte adhesion
PSGL-1, ESL-1
on leukoctyes
binds selectins of endothelial cells

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15
Q

Weibel Palade bodies?

A

Leukocyte adhesion
contain P-selectin
in endothelial cells

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16
Q

PSGL-1

A

Leukocyte adhesion

Mucin

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17
Q

Integrin

A

Leukocyte adhesion
on leukocytes
cytokines binding to low affinity integrin induces high affinity integrin sent to surface (VLA4, LFA1)

18
Q

ESL-1

A

Leukocyte adhesion

Mucin

19
Q

VLA4

A

Leukocyte adhesion

high affinity integrin

20
Q

VCAM-1

A

Leukocyte adhesion
Sent to endothelial surface with cytokine activation
binds high affinity integrins (VLA4, LFA1)

21
Q

LFA-1

A

Leukocyte adhesion

High affinity integrin on leukocyte

22
Q

ICAM-1

A

leukocyte adhesiion
sent to endothelial surface with cytokine activation
binds high affinity integrins of leukocyte (VLA4, LFA1)

23
Q

PECAM1

A

helps with transmigration

24
CD99
helps with transmigration
25
Clinical features of inflammation (4)
erythema (red), warmth, swelling, pain
26
Diurnal variation
lower body temp in am than in pm
27
Pyrexia v hyperexia v hyperthermia
Pyrexia = higher set point Hyperpyrexia = super high set point (can --> infection and CNS damage) Hyperthermia=increase in temp (heat stroke)
28
What resets set point? How do they work?
Pyrogens | Works on anterior nucleus of hypothalamus --> PGE2 release (via NFkappaB TF) --> cAMP pathway --> increase set point
29
what does CRP target?
C-reactive protein binds PC and LPS of bacteria/fungi binds PC of damaged cells
30
What are acute phase proteins?
CRP and MBL from liver
31
What does MBL target?
mannose rich bacteria
32
ESR?
erythrocyte sedimentation rate normal 18mm/hr increases with infection
33
Leukocytosis
increase in # of WBC
34
Neutrophilia? what does path look like?
increase neutrophil # | "left sshift" increased immature forms: bands (horshoes) and metamyelocytes (kidneys)
35
Etiology of neutrophilia?
bacterial infection, tissue necrosis, prednisone (used to treat inflamm)
36
Leukomoid reaction
very high WBC count | similar to leukemia
37
Eosinophilia
Increase eosinophil #
38
Eosinophilia etiologies
immune response to allergies, psoriasiss eczema, parasitic infection
39
Lymphocytosis
Increase lymphocyte #
40
Lymphocytosis etiology
viral infection
41
Leukopenia
decrease WBC <4000/microL
42
Etiologies of leukopenia
bacterial, viral, protozoa