Inflammation Flashcards Preview

Year 2 EMS MoD > Inflammation > Flashcards

Flashcards in Inflammation Deck (48):

What is acute inflammation?

A basic pathological process
Its a non specific initial reaction to tissue damage
Stereotyped irrespective of the aetiology - no matter what tissue or what kind of damage the response is the same


What are the 2 causes of inflammation?

1) Tissue death
2) Infection


What is a pyogenic bacteria?

Bacteria that on infection cause acute inflammation


What does the term pyogenic mean?



Acute inflammation is caused by a noxious agent, what 3 outcomes can come from acute inflammation?

1) Cells can regrow and heal by regeneration
2) Cells cannot regrow so the tissue has to be healed by repair
3) The damaging agent is not 'sorted out' by the acute inflammation so persists leading to chronic inflammation


What is suppuration and when does it occur in terms of the cycle of inflammation?

Suppuration is the formation of pus (accumulation of inflammatory cells)
Occurs if the damaging agent persists and can lead to further acute inflammation


What are the 3 purposes of acute inflammation?

1) Clear away dead tissues
2) Locally protect from infection
3) Allow access of immune system components


What are the 4 'cardinal signs' of inflammation? (latin and english)

1) Heat - calor
2) Redness - rubor
3) Pain - dolor
4) Swelling - tumor


Why is redness a sign of inflammation?

Get vascular dilatation which leads to redness


Why is heat a sign of inflammation?

Due to vascular dilatation


Why is swelling a sign of inflammation?

Occurs because of inflammatory exudate in tissues


What are the 4 macroscocpic terms used to describe inflammation?

1) Serous
2) Fibrinous
3) Purulent
4) Pseudomembranous


What is serous inflammation?

Acute inflammation characterised by the copious effusion of non viscous serous fluid


What is fibrinous inflammation?

Exudative inflammation where there is a disproportionately large amount of fibrin


What is purulent inflammation?

Inflammation accompanied by the formation of pus


What is pseudomembranous inflammation?

A form of exudative inflammation. Large amounts of fibrin in the exudate results in a membrane like structure covering the serous or mucous membrane of the acutely inflamed tissue


What are the 3 components of an acute inflammatory response? Describe them briefly

1) Vascular reaction - dilatation, changes in flow
2) Exudative reaction - formation of inflammatory exudate
3) Cellular reaction - migration of inflammatory cells out of vessels


Name 2 possible systemic effects of inflammation?

1) Pyrexia
2) Acute phase reaction


Name a protein thats levels in the blood can quantify the severity of an infection?

C reactive protein made in the liver as part of inflammatory reaction


What 3 components are there to the vascular reaction component of acute inflammation?

1) Microvascular dilatation (there is an intial transient vasoconstriction but this is not clinically significant)
2) Initially increased flow then reduced flow (because of increased permeability, more goes in than comes out)
3) Increased permeability (mediated and non mediated)


Why may you get non mediated increased permeability of blood vessels in an acute inflammatory reaction?

Inflammation may be due to damage to endothelial cells of the vessels - in which case the damage would have caused increased permeability to the vessels


Name 5 of the inflammatory mediators which lead to increased vascular permeability?

1) Histamine - released from mast cells
2) Bradykinin
3) NO
4) Leukotriene B4
5) Complement compounds


What is acute inflammatory exudate made up of?

Protein rich - 50g/l
Has immunoglobulins
And fibrinogen


What are the 6 purposes of the inflammatory exudate?

1) Dilution of noxious agents
2) Transport to lymph nodes
3) Supply of nutrients - O2
4) Spread of inflammatory mediators
5) Spread of antibodies
6) Spread of drugs


How can the fibrinogen help to contain the infection locally?

Forms fibrinous mesh to contain whatever is causing the infection


What does the cellular reaction of acute inflammation consist of?

Accumulation of neutrophils in the extracellular space
In severe cases, accumulation of neutrophils, cellular debris and bacteria forms pus


Where are neutrophils produced?

In bone marrow


Why can an FBC showing neutrophils be clinically useful?

Increased number of neutrophils in acute inflammation - this can give us a quantitative value for the severity of the infection


How can neutrophils move to the sight of infection?

They are motile and amoeboid
Show directional chemotaxis - move along the concentration gradient of inflammatory mediators


What is the lifespan of a neutrophil?

Short - only hours in tissues


How do neutrophils fight infection?

Phagocytic, microbiocidal


Describe the both oxygen dependent and oxygen independent processes that neutrophils use to kill bacteria?

Engulph them by phagocytosis to form a phagolyzosome
Oxygen dependent - Enzyme myeloperoxidase makes free radicals which damage the macromolecules from which the bacteria are formed thus killing them
Oxygen independent - Involves specific enzymes such as lysozyme which break down bacteria cell walls


How do neutrophils move into the tissues in an acute inflammatory reaction?

Normal flow in the blood vessel is an axial stream so neutrophils dont come into contact with the endothelium
When vessels dilate and exudate moves out of the vessles the flow is slowed and neutrophils are no longer adhered to an axial stream, they come into contact with the endothelium and various ligand-receptor reactions take place
1) Margination
2) Rolling - adhesion (pavementing when the neutrophils line up on the endothelium)
3) Migration into the tissues (facilitated by the increased permeability of the vessels)


Name the 6 synthesised and 1 stored cell derived mediators of acute inflammation?

1) Histamine
1) Prostaglandins
2) Leukotrienes
3) PAF
4) Cytokines (IL1, 8, TNFa)
5) NO
6) Chemokines


Name the 4 plasma derived mediators of acute inflammation?

1) Kinin system
2) Clotting pathway
3) Thrombolytic pathway
4) Complement pathway


Mediators of inflammation have a short half life, how are they disposed of?



Name the 5 mediators of inflammation that mediate vascular dilatation?

1) Histamine
2) PGE2/I2
3) VIP
4) NO
5) PAF


Name the 6 mediators of inflammation that mediate increased vascular permeability?

1) Histamine
2) Bradykinin
3) NO
4) C5a
5) LTB4
6) PAF


Name the 6 inflammatory mediators which lead to upregulation of adhesion molecules and therefore mediate neutrophil adhesion?

1) IL8
2) C5a
3) LTB4
4) PAF
5) IL 1
6) TNF


Name the 3 inflammatory mediators involved in neutrophil chemotaxis?

1) LTB4
2) IL 8
3) Chemokines


Why is it important to know the inflammatory mediators?

Important drug targets


Fibrinous necrosis in arteriolar walls is associated with what kind of hypertension?



Bradykinin is formed from a pre cursor by the action of which enzyme?



Give 3 examples of laboratory assessments of inflammation?

1) Full blood count
2) Erythrocyte sedimentation rate
3) Acute phase proteins


What is meant by the term resolution with regards to acute inflammation?

One of the possible outcomes of acute inflammation, occurs when minimal damage to tissues occurs, the noxious agent is dealt with and everything returns to normal - this is the ideal solution


What is meant by fibrosis in terms of as an outcome of acute inflammation?

Some tissue damage occurs and the tissue is not replaced by the same tissue, is just replaced by collagen - scar tissue - fibrosis of the organ, may get some deficit due to lack of functioning tissue


What is meant by the term suppuration in terms of as an outcome of acute inflammation?

An abscess forms, in this case you have got a marked neutrophil reaction with tissue damage


Why does acute inflammation sometimes become chronic inflammation?

This occurs when the damaging agent that caused the acute inflammatory reaction is not dealt with and thus persists leading to chronic inflammation