Lab 4:

Question 1

What are the four things that characterize inflammation?

Answer 1

Redness, pain, heat, swelling and loss of function

Question 2

Rolling endothelial cell / Leukocyte

Answer 2

E-Selectin (CD62E) — Sialyl Lewis-X
P-Selectin (CD62P) — Sialyl Lewis-X
GlyCam1, CD34 — L-Selectin

Question 3

Adhesion and diapedesis
Endothelial: ICAM-1
Leukocyte?

Answer 3

CD11/CD18 (Beta-2 integrin)

Question 4

Adhesion and diapedesis
Endothelial: VCAM-1
Leukocyte?

Answer 4

VLA-4 Integrin (alpha4beta1)

Question 5

Adhesion and diapedesis
Endothelial: CD31 (PECAM-1)
Leukocyte?

Answer 5

CD31 (PECAM-1)

Question 6

What chemoattractant do bacteria produce?

Answer 6

Formyl peptides

Question 7

When tissue macrophages arrive, how do they recognize the bacteria?

Answer 7

TLR bind bacterial antigens such as lipopolysaccharide

Question 8

Which cytokines does the macrophage release in response to TLR binding?

Answer 8

IL-1, IL-8, TNF

Question 9

Mast cell degranulation releases…

Answer 9

Histamine

Question 10

How does histamine affect pre-capillary arterioles?

Answer 10

Vasodilation

Question 11

How does histamine affect post-capillary venules?

Answer 11

Increased vascular permeability

Question 12

What effect does histamine have on endothelial cell surface molecules?

Answer 12

Increased expression of E-selectin and P-selectin?

Question 13

What do E-Selectin and P-Selectin do?

Answer 13

Bind Sialyl-Lewis-X glycoproteins on neutrophil surface.

Question 14

What does selectin binding enable?

Answer 14

“Rolling” - the neutrophil slows down enough to detect chemoattractants

Question 15

What are examples of chemoattractants?

Answer 15

F-met-leu-phe, IL-8 or TNF

Question 16

What happens if the neutrophil binds any of these chemoattractants?

Answer 16

Neutrophil up regulates expression of Beta-Integrin

Question 17

What do endothelial cells do in response to IL-1 and TNF?

Answer 17

Upregulated expression of ICAM1

Question 18

What does Ca+ release from the ER do in neutrophils?

Answer 18

enables cytoskeleton changes
increases beta-integrin expression on cell surface
activates phospholipase A2
activates NADPH oxidase

Question 19

Why is phospholipase activation important?

Answer 19

to made arachadonic acid, which leads to prostaglandins and leukotrienes (part of inflammatory mediators)

Question 20

Why is NADPH oxidase important?

Answer 20

reactive oxygen species (bleach)

Question 21

What is deficient in people with chronic granulomatous disease?

Answer 21

NADPH oxidase

Question 22

What is deficient in people with Chediak-Higashi syndrome?

Answer 22

Defect in lysosomal trafficking to phagosome-lysosome fusion (microtubule issue).

Question 23

What is deficient in people with LAD type 1?

Answer 23

Defect in LFA-1 integrin, can’t migrate neutrophils

Question 24

What are classic signs of LAD type 1?

Answer 24

Recurrent bacterial infections, absent pus formation, impaired wound healing, delayed umbilical cord separation

Increased neutrophils in blood, decreased at infection sites.

Question 25

What are classic signs of Chediak-Higashi syndrome?

Answer 25

Giant granules in granulocytes and platelets, albinism, peripheral neuropathy, progressive neurodegeneration

Question 26

What are classic signs of chronic granulomatous disease?

Answer 26

susceptibility to catalase + organisms, abnormal dihydrohodamine test

Question 27

What is a left shift in leukocyte count?

Answer 27

more immature cells, so inflammation

Question 28

What are the four stages of lobar pneumonia?

Answer 28

1. Congestion 2. Red hepatization 3. Gray hepatization 4. Resolution

Question 29

What marks the congestion stage of lobar pneumonia?

Answer 29

vascular engorgement, intra-alveolar fluid, neutrophils, numerous bacteria, heavy lung and hyperemic (1-2 days)

Question 30

What marks the red hepatization of lobar pneumonia?

Answer 30

Vascular congestion persists, RBCs into alveolar spaces (3-4 days)

Question 31

What marks the gray hepatization of lobar pneumonia?

Answer 31

Red cells disintegrate, with persistence of the neutrophils and fibrin. (5-7 days)

Question 32

What marks the resolution phase of lobar pneumonia?

Answer 32

exudate is digested (8+ days)

Question 33

Exudate signs

Answer 33

An inflammatory extravascular fluid - High protein content - High specific gravity - Cell debris

Question 34

What does an exudate signal?

Answer 34

increase in vascular permeability

Question 35

Transudate signs

Answer 35

Nonimflammatory extravascular fluid - low protein content - low specific gravity - an ultrafiltrate of plasma - endothelial permeability is normal

Question 36

What does a transudate signal?

Answer 36

increase in hydrostatic pressure

Question 37

What are the 5 possible outcomes of acute inflammation in the setting of pneumonia?

Answer 37

1. Resolve completely 2. Abscess 3. Organization of the exudate 4. Bacteremic dissemination 5. Empyema

Question 38

What are the major causes of pulmonary edema?

Answer 38

- Hemodynamic | - Increased vascular permeability