Inflammation 2

Question 1

What is an endotoxin?

Answer 1

LPS = Lipopolysaccharide

Part of the cell wall, thus it is associated ONLY with gram-negative bacteria

Question 2

What is an exotoxin?

Answer 2

Proteins produced by bacteria

Generally, gram-positive bacteria; however, gram-negative bacteria are also capable

Question 3

What can both endotoxin and exotoxin lead to?

Answer 3

Sepsis

Question 4

What does reddened serosa indicate?

Answer 4

Hyperemia

Question 5

What does omphalophlebitis mean?

Answer 5

Umbilicus vein inflammation

Question 6

What does polyserositis mean?

Answer 6

Multiple serosal (outside visceral) layers have inflammation

Question 7

What are some associated findings with sepsis?

Answer 7

Suppurative meningitis
Hypopyon
Congested vessels
Fibrinous arthritis
Vertebral abscess

Question 8

Define suppurative meningitis

Answer 8

Pus and inflammation of the brain

- will see pus on the ventral aspect (gravity)

Question 9

Define hypopyon

Answer 9

Pus in the anterior chamber of the eye

Question 10

What is fibrinous arthritis?

Answer 10

Fibrin and/or pus in the joint space(s)

Question 11

What is a vertebral abscess and what can it lead to?

Answer 11

Bacteria get lodged in the physis of growing animals and forms an abscess
Leads to hind limb paresis/paralysis

Question 12

Who is the the silver fox? What is he known for?

Answer 12

Rudolf Virchow

He created Virchow’s triangle and is considered the father of modern pathology

Question 13

What are the three components of Virchow’s triangle? What are all three related to?

Answer 13

Stasis, vessel wall injury, and hypercoagulability

All three are related to thrombosis

Question 14

What are the five cardinal signs of inflammation?

Answer 14

Heat, redness, swelling, pain and loss of function

Question 15

Why do we get heat in areas of inflammation?

Answer 15

Inflammation results in hyperemia.

Vascular dilation results in increased warm blood flow to the area of the cause of inflammation

Question 16

Why do we see redness in inflammation?

Answer 16

The hyperemia (increased blood flow)

Question 17

Why do we see swelling with inflammation?

Answer 17

It’s due to edema

Question 18

What are the two phases of edema?

Answer 18

Fluid phase - accumulation of fluid in the extravascular space
Cellular phase - accumulation of inflammatory cells migrating to the area)

Question 19

Define edema

Answer 19

Exudation of fluid and plasma protein

Question 20

Why do we get pain with inflammation?

Answer 20

Stretching of the region due to edema and increased inflammatory cells.
We also get chemical mediators
- Prostaglandins (induce pain)

Question 21

Why do we get loss of function with inflammation?

Answer 21

Movement of the inflamed area is reduced either due to pain (conscious or by reflex) and physical swelling

Question 22

What are the three main events of inflammation?

Answer 22

Hemodynamic events, permeability events, and cellular events

Question 23

What happens in the hemodynamic event of inflammation?

Answer 23

Vasodilation (causes hyperemia) which is induced by HISTAMINE

Question 24

What are chemical mediators involved in vasodilation?

Answer 24

Mainly histamine, but also prostaglandins and nitric oxide

Question 25

What happens during the permeability event of inflammation?

Answer 25

Changes in the microvasculature (capillary) permeability that allow for plasma proteins and leukocytes to leave the circulation

Question 26

What are the 4 causes of edema?

Answer 26

Increased vascular permeability Increased intravascular hydrostatic pressure Decreased intravascular osmotic pressure Decreased lymphatic drainage

Question 27

What protein is a huge contributor to oncotic pressure?

Answer 27

albumin

Question 28

What causes transudate?

Answer 28

Think changes in starling forces (hydrostatic and oncotic pressure)

Question 29

What is the protein and cellular content of a transudate?

Answer 29

Low protein and few cells

Question 30

What causes exudate?

Answer 30

Think changes in vascular permeability (inflammation) | -- The vessel is super leaky and is letting out tons of cells and tons of proteins

Question 31

What is the protein and cellular content of an exudate?

Answer 31

High protein and lots of cells

Question 32

What are the two mechanisms that cause an increase in vascular permeability?

Answer 32

Contraction of endothelial cells and endothelial injury

Question 33

What will make endothelial cells contract? How quickly will it happen?

Answer 33

Chemical mediators like histamine It's an immediate transient response but only last for 15-30 minutes

Question 34

How can endothelial injury lead to an increase in permeability? How long can it last for?

Answer 34

Necrosis leads to detachment with leads to increased leakage -- Think burns and toxins Rapid onset, but it can last hours to days

Question 35

What does histamine do?

Answer 35

Vasodilation and Increased vascular permeability

Question 36

Increased vascular permeability means that what can escape (or exude)?

Answer 36

Larger proteins like immunoglobulins (destroy microbes) and coagulation factors (fibrinogen)

Question 37

How do we get fibrin from fibrinogen?

Answer 37

Thrombin!

Question 38

What is fibrin usually associated with?

Answer 38

often associated with infectious causes, but not always! Anything that causes enough vascular leakage can lead to fibrin

Question 39

What happens during the cellular event of inflammation?

Answer 39

Leukocytes accumulate at the site of injury and (hopefully) eliminate the offender

Question 40

RBCs and WBCs normally flow in the center of the vessel (axial flow). What do they have to do during inflammation? What is this process called?

Answer 40

Vasodilation will cause blood flow to slow down and these cells will begin to flow near the vessel wall along the endothelium. Margination

Question 41

What would an exudate look like?

Answer 41

Thick fluid, full of leukocytes and proteins

Question 42

What would a transudate look like?

Answer 42

It would be a thinner fluid like synovial fluid

Question 43

If an exudate is due to bacteria, what leukocyte is the main player?

Answer 43

Neutrophils - first responder