Inflammation Flashcards

1
Q

What is the cause of acute inflammation

A

Any form of tissue injury

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2
Q

Give the three phases of tissue injury

A

Fluidic, Cellular, Reparative

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3
Q

Give 4 signs of acute inflammation

A

Redness and heat (increased blood flow)
Swelling (fluid accumulation)
Pain (chemical release stimulates nerve endings)
Loss of function

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4
Q

Describe the process of cellular and vascular response through acute inflammation

A
  1. Momentary vasoconstriction - reflex process to reduce blood loss
  2. Dilation of Blood vessels - Caused by release of chemical mediators
  3. Exudation of fluid - Reduced blood flow, proteinaceous fluid released
  4. Leukocyte migration - Adherence of circulatory WBCs to altered endothelium
  5. Leukocyte emigration - Migrate into tissues via diapedesis
  6. Temperature increase
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5
Q

Define transudates and describe their appearance

A

Extracellular filtrate of plasma with a little protein and few/no nucleated cells
- Glossy, clear and watery appearance

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6
Q

Describe how transudate is produced

A

Produced by fluid leakage due to increased hydrostatic pressure or reduced osmotic potential in the blood vessels

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7
Q

Define exudates and describe its appearance

A

ECF that is protein rich and contains high numbers of cells

- Purulent, fibrinous, serous

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8
Q

Describe how exudates are formed

A

Formed during inflammation due to increased vascular permeability

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9
Q

Define effusion

A

Accumulation of fluid in a body space or cavity

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10
Q

Describe the process by which pyrexia is produced

A

= Raised body temperature/fever

  • Exogenous factors cause release of endogenous factors which in turn activate the arachidonic pathway and PGE2 release
  • PGE 2 acts on the preoptic are of the hypothalamus through the EP3 receptor leading to the stimulation of the sympathetic output system which evokes non-shivering and shivering thermogenesis to produce body heat and skin vasoconstriction to decrease heat loss from the body surface
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11
Q

Where do antipyretic drugs act on the pyrexia process?

A

Act at the hypothalamus, overriding the action of PGE2 in causing increased temperature

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12
Q

Give three inflammatory mediators that cause vasodilation

A

Nitric Oxide
Bradykinin
Prostaglandins PGE2

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13
Q

Give three inflammatory mediators that cause inceraced vascular permeabilities

A

Vasoconstrictive amines e.g. histamine
Complement factors e.g. C5a, C3a
Leukotrines

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14
Q

Give three inflammatory mediators that cause chemotaxis and leukocyte activation

A

Leukotrines
C5a
Chemokines e.g. IL-8, IL-5

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15
Q

Give two inflammatory mediators that cause tissue damage

A

Neutrophil granule content : matrix metalloproteinases

ROS

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16
Q

Give two inflammatory mediators that cause Pain

A

Bradykinin

PGE2

17
Q

Give three inflammatory mediators that cause Fever

A

Cytokines e.g. IL-1 TNF, IL-6

18
Q

Describe Plasma derived chemical mediators

A

e. g. complement proteins, kinins

- Present in the plasma as precursors that must be activated

19
Q

Describe cell derived chemical mediators

A

e.g. histamine

Sequestered in intracellular granules that need to be secreted

20
Q

Describe acute phase proteins

A
  • Inflammatory biomarkers
  • Plasma protein synthesised by liver
  • Increase in serum concentration over 25% in response to cytokines
  • Causes fever and leucocytosis (part of the innate immune system)
21
Q

Describe the complement cascade

A
  • Helps the innate immune system to clear pathogens from an organism
  • Plasma complement C1-9 synthesized in the liver
  • Are activated and induce inflammation and further activation of the immune system
  • End result is cell killing membrane attack complex (MAC)
22
Q

Describe arachidonic acid metabolites

A
  • Damage of the cell leads to the cell membrane lipids rearranging to create biologically active lipid mediators (derived from arachidonic acids)
  • Effects are short lived due to rapid decay and enzymatic destruction of lipid metabolites
23
Q

Describe 4 causes of chronic infection

A
  • Persistent infection
  • Prolonged toxin exposure
  • Indestructible foreign material
  • Immune mediated disease
24
Q

Describe the morphology of chronic inflammation

A
  • Tissue destruction
  • Healing attempts
  • Infiltration with mononuclear cells (macrophages, lymphocytes)
25
Describe macrophage activity in chronic inflammation
Migration and Activation - extravasation controlled by ashesion molecules and chemical mediators with chemostatic activating properties. Activated Macrophage - Eliminate injurious agent - Instigate the healing process (fibrosis and angiogenesis) - Cause tissue injury (chronic) - Release products that are toxic to microorganisms
26
Describe the involvement of lymphocytes in chronic inflammation
Interact bidirectionally by recruiting and being recruited by macrophages
27
Describe the involvement of Plasma cells in chronic inflammation
Activated by B lymphocytes and produce antibodies against persistent foreign antigens
28
Describe the involvement of eosinophils in chronic inflammation
Present in parasite and some fungal infections | Also hypersensitivity infection
29
Describe the involvement of mast cells in chronic inflammation
Found in the connective tissue both in acute and chronic inflammation
30
Describe the involvement of neutrophils in chronic inflammation
Characteristic in acute may be found in chronic e.g. abcesses
31
Give the three phases of healing
Blood clot Proliferation and granulation Remodelling and maturation
32
Describe an abcess
Collection of pus circumscribed by a fibrous capsule that is visible grossly (most commonly caused by bacteria)
33
Describe pus
Plasma proteins, leukocyte based yellow/green liquid
34
Describe a granuloma
Nodular aggregation of macrophages surrounded by a collar of mononuclear leucocytes Aims to contain agent that is difficult to eradicate against : parasite, fungi, bacteria, viruses, foreign body
35
Define regeneration
Proliferation of cells and tissues to replace lost structures
36
Define repair
Replacement of injured cells with connective tissue
37
Describe the blood clot stage of healing
- Activation and coagulation - Blood clot formation - Neutrophils arrive
38
Describe the Proliferation and granulation stage of healing
- Macrophages replace neutrophils (clean and promote proliferation) - Granulation tissue formed from proliferation of fibroblasts and endothelial cells - Fibroblasts and connective tissue grow parallel to the wound surface and perpendicular to proliferating capillaries
39
Describe the remodelling and maturation phase of healing
Leukocytes and increased vascularity disappear after the second week Granulosa converted into a pale avascular scar (fibroblasts and dense collagen) Wound contraction