Inflammation, healing & fluids , haemodynamics

Question 1

definition and features of inflammation

Answer 1

the body’s protective response to injury. The first stage of healing, a sequential response mediated by chemicals

Question 2

Acute inflammation

Answer 2

• develops within minutes to hours and can persists for up to several days
• mild tissue destruction
• mainly neutrophils

Question 3

Chronic inflammation

Answer 3

• May develop anew of if acute response fails to clear injury
• persists for a longer duration
• more tissue destruction
• macrophages/monocytes and lymphocytes

Question 4

sequence of acute reaction

Answer 4

1. Recognition of injurious agent
2. Vascular phase and cellular phase
3. Removal of agent
4. Resolution

Question 5

Recognition of injurious agent

Answer 5

• crucial for survival
• several cellular receptors and circulating proteins are important, such as phagocytes and dendritic cells that express receptors that bind to foreign agents, triggering production of chemical mediators
• complement system recognises microbes and encites chemical mediator production

Question 6

Vascular phase and the recruitment of leukocytes

Answer 6

• major component of acute inflammation
• Host of chemical mediators act on blood vessels and help to recruit leukocytes

Question 7

exudate

Answer 7

fluid that escapes into the extravascular tissues when endothelial cells contract during acute inflammation. This fluid has a high protein content.

Question 8

cellular phase

Answer 8

1. adhesion of leukocytes to endothelium
2. Leukocytes migrate through vessel wall
3. Leukocytes move towards injury via chemotaxis

Question 9

selectins

Answer 9

protein adhesion molecules produced by endothelial cells during acute inflammation

Question 10

Leukocyte rolling

Answer 10

firm adhesion to endothelium via surface proteins called integrins

Question 11

Phagocytosis

Answer 11

neutrophils and monocyte/macrophages digest debris/microbe, this debris/microbe is recognised by phagocyte receptors

Question 12

serous inflammation - acute

Answer 12

accumulation of protein-rich exudate

Question 13

Fibrinous inflammation - acute

Answer 13

fibrin deposits

Question 14

purulent inflammation - acute

Answer 14

production of pus

Question 15

abscesses

Answer 15

localised collection of pus

Question 16

ulcers - acute

Answer 16

defect produces by shedding of inflamed necrotic tissue

Question 17

chronic inflammation

Answer 17

• a prolonged hot response to persistent stimuli

Question 18

aetiology of chronic inflammation

Answer 18

• persistent infections
• hypersensitivity reactions
• autoimmune diseases
• prolonged exposure to toxic agents

Question 19

granulomatous inflammation

Answer 19

attempt to contain an offending agent by forming a granuloma

Question 20

granuloma

Answer 20

a tiny cluster of white blood cells and other tissue

Question 21

Cytokine induced systemic effects of chronic inflammation

Answer 21

• fever
• leukocytosis
  malaise, sweating, chills, anorexia, increased heart rate

Question 22

cytokine induced systemic effects acute inflammation

Answer 22

Increased hepatic production of plasma proteins
- C-reactive protein
- serum amyloid
- Fibrinogens

Question 23

Healing

Answer 23

Restoration of tissue architecture and function after injury

Question 24

Regeneration

Answer 24

proliferation of cells that survive injury, results in a return to normal state

Question 25

Scar formation

Answer 25

replacing damaged cells by laying down CT

Question 26

Determinants of regenerates

Answer 26

1. proliferative capacity of cell 2. Signals provided by growth factors 3. Development of mature cells from stem cells

Question 27

capillary structure

Answer 27

a single-layer of endothelial cells

Question 28

Hydrostatic Pressure of capillary

Answer 28

the pressure generated against the capillary wall

Question 29

Hydrostatic pressure of intertitial fluid

Answer 29

The pressure of the fluid outside the capillary wall onto the membrane

Question 30

Oncotic pressure

Answer 30

osmotic pressure of osmotic proteins such as albumin

Question 31

oedema

Answer 31

accumulation of fluid within tissues

Question 32

Effusion

Answer 32

Extravascular fluid accumulated in body cavities

Question 33

transudate

Answer 33

low in plasma proteins

Question 34

aetiology of oedema

Answer 34

1. increased capillary hydrostatic pressure 2. decrease in oncotic pressure 3. lymphatic obstruction 4. sodium and water retention

Question 35

hyperaemia

Answer 35

increase in blood volume as a result of arteriolar dilation and increased blood flow. Tissues are engorged with oxygenated blood

Question 36

Congestion

Answer 36

Increase in blood volume as a result of impaired outflow of venous blood. Tissues are cyanotic due to the accumulation of deoxygenated blood

Question 37

Thrombosis

Answer 37

PROCESS OF FORMING A THROMBUS (CLOT) WITHIN AN UNINTERRUPTED CV SYSTEM. attched to a vessel wall

Question 38

aetiology of thrombosis

Answer 38

- endothelial injury - abnormal blood flow - hypercoagulability

Question 39

Turbulence and stasis

Answer 39

promote endothelial activation/dysfunction and promote prothrombotic gene expression