Inflammation (Week 1)

Question 0

Inflammation designed to:

Answer 0

Break down and remove dead cells
Inactivate the injurious agent
Initiate healing of tissues

Question 1

Inflammation involves responses from what systems?

Answer 1

Vascular
Humoral
Neurologic
Cell

Question 2

Humeral

Answer 2

Chemical components from cellular reactions carried in the blood by plasma and/or tissue fluid

Question 3

Acute inflammation

Answer 3

Lasts hours to a few days
Rapid in onset
Stops when harmful stimulus is removed
Can become chronic if inflammatory stimulus is not removed

Question 4

How can acute inflammation become chronic?

Answer 4

Poor rehab/tx can lead to alteration of joint structure and lead to more inflammation

Question 5

Goal of acute inflammation

Answer 5

Deliver white blood cells and plasma proteins (antibodies) to the area of injury or infection

Question 6

Why is chronic inflammation bad?

Answer 6

Inflammation can damage healthy tissue (leakage of hypochlorite & peroxynitrite)

Question 8

How are WBCs delivered to injury/infection site

Answer 8

1. Vasodilation
2. Increased permeability of capillary walls
3. Chemotaxis

Question 9

How does vasodilation help get WBCs to injury/infection site?

Answer 9

• Allows increased blood flow to area
• Reduces speed at which blood travels
• Sets up hemodynamic change that causes WBCs to collect along endothelium
• Gives WBCs more time to move thru capillary wall, resulting in more WBCs getting to site

Question 9

Chemotaxis

Answer 9

Chemically mediated movement of WBCs

• along chemical gradient
• bacteria: produce peptides that are chemoattractants
• injured tissue: produces compounds (cytokines, IL-8, and leukotriene B4) that attach to WBCs and stimulate their migration

Question 10

Inappropriate or poorly controlled inflammation is thought to contribute to:

Answer 10

Rheumatoid arthritis
Atherosclerosis
Type II diabetes
Some types of cancer
Lung fibrosis
Emphysema
Allergic reactions

Question 11

What to white blood cells do?

Answer 11

Destroy foreign and dead tissues

Question 12

What are Toll-like receptors and where are they found

Answer 12

Detect presence of infection

Found on surface of WBCs

Question 13

What stimulates acute inflammation?

Answer 13

infection
tissue necrosis/injury
foreign bodies
immune reactions

Question 14

What initiates vasodilation

Answer 14

histamine and nitric oxide acting upon vascular smooth muscle

Question 15

How is vascular permeability increased?

Answer 15

histamine (primarily) causes endothelial cells contract, increasing the size of pores

Question 16

how is edema drained from area

Answer 16

lymphatics; results in swelling of lymph nodes

Question 17

what is an indication of infection

Answer 17

red streaks near a wound typically moving proximally; these red streaks will follow the course of lymph vessels

Question 18

what do some WBCs that encounter microbes/dead tissue release?

Answer 18

tumor necrosis factor (TNF)
interleukin-1 (IL-1)
chemokines

Question 19

what do TNF and IL-1 do?

Answer 19

enhance immune response to a microbea

Question 20

what do chemokines do?

Answer 20

attract more WBCs to area

Question 21

what are DMARDs

Answer 21

Disease Modifying Anti-Rheumatic Drugs (drug class)

• Slows, stops, and may reverse immunologic attack on healthy tissue
• 2 Classes: biologic & classic

Question 22

how do biologic DMARDs work?

Answer 22

inhibit TNF or some interleukins

Question 23

How do WBCs recognize dead tissue?

Answer 23

receptors on WBCs recognize components released by injured/dead tissue: platelet activating factor, prostaglandins, leukotrienes

Question 24

immune complex

Answer 24

antibody attached to something that does not belong

Question 25

opsonization

Answer 25

signal for the WBCs that the item the antibody is attatched to should be phagocytosed

Question 26

Process of WBC attaching to and phagocytosing object

Answer 26

1. immune complex formed (antibody attached to something that does not belong) 2. immune complex attaches to receptor on WBC 3. attachment activates WBC 4. Phagocytosis occurs 5. chemokines released to attract more WBCs 6. chemotaxis

Question 27

what is the phagocytosed particle exposed to?

Answer 27

hydrogen peroxide + myeloperoxidase (enzyme) --> hypochlorite (active ingredient in bleach) nitric acid--> peroxynitrite (highly corrosive)

Question 28

2 types of mediators of inflammatory response

Answer 28

``` cell derived (humeral compounds) plasma protein derived (from immune system & clotting cascade system) ```

Question 29

cell derived mediators of inflammatory response

Answer 29

``` histamine serotonin phosphatidyl inositol arachidonic acid prostaglandins ```

Question 30

histamine

Answer 30

released by mast cells when they undergo degranulation cause vasodilation cause increased capillary wall permeability

Question 31

serotonin

Answer 31

released from platelets when they aggregate cause vasodilation cause increased capillary permeability

Question 32

phosphatidyl inositol

Answer 32

part of every cell membrane released into tissue fluid acted upon by phospolipase --> arachidonic acid

Question 33

arachidonic acid

Answer 33

can be converted into prostglandins, leukotrienes, and lipoxins

Question 34

prostaglandins

Answer 34

converted from arachidonic acid by COX enzymes COX1=good prostaglandins (necessary for normal tissue fxn) COX2=bad prostaglandins (stimulation of pain, increased dilation and permeability of vessels) COX3=not fully understood

Question 35

how do steroids reduce inflammation?

Answer 35

inhibit phospholipase (converts phosphatidyl inositol --> arachidonic acid)