Lecture 6 - inflammation

Question 1

What is acute inflammation

Answer 1

Eliminating injured tissue & infectious agents and repairing tissue damage

Question 2

What causes redness in acute inflammation

Answer 2

vasodilation - caused by histamine and prostaglandin

Question 3

What causes swelling in acute inflammation

Answer 3

Increased vascular permeability - caused by histamine and leukotrienes

Question 4

What causes heat in acute inflammation

Answer 4

Vasodilation - caused by histamine and prostaglandin

Question 5

What causes pain in acute inflammation

Answer 5

Tissue damage - caused by prostaglandin and bradykinin

Question 6

What causes loss of function in acute inflammation

Answer 6

Tissue damage - caused by ROS, NO, lysosomal enzymes

Question 7

Describe purulent (suppurative) pattern of inflammation

Answer 7

Pus production (neutrophils)
Pyogenic organisms (tissue necrosis and liquefaction)
Abscess localised collection of pus

Question 8

Describe serous pattern of inflammation

Answer 8

Fluid-rich, cell-poor exudate (peritoneum, pleura, pericardium)

Question 9

Describe fibrinous pattern of inflammation

Answer 9

Fibrinogen-rich exudate and fibrin deposition (pericardium, peritoneum)

Question 10

What are the steps in acute inflammation

Answer 10

Recognition (PRR, vascular changes)
Recruitment (leukocytes)
Removal (killing and degradation - ROS/NO, phagocytosis)
Resolution (‘turning off’)

Question 11

Describe macrophages roles in recognition

Answer 11

In tissue - phagocytic and produce pro-inflammatory cytokines - damage/pathogen response (IL1-Beta and TNF-alpha)

Question 12

Describe mast cells roles in recognition

Answer 12

tissue resident - numerous granules (chemical mediators - histamine, leukotrienes and prostaglandin) - mediates vascular changes, pain
Mast cells survive degranulation

Question 13

Describe Pattern Recognition Receptors in recognition

Answer 13

DAMPs -> proinflammatory cytokines (TNF-alpha, IL-1-beta)
PAMPs -> chemical mediators

Question 14

How is recognition measured

Answer 14

Increased temp
acute phase proteins
Increased neutrophils in blood

Question 15

Describe neutrophils role in recruitment

Answer 15

Large granular cells - recruited into tissue in response to proinflammatory cytokines -> phagocytic (40-70% of WBC)

Question 16

Describe monocytes role in recruitment

Answer 16

Produce pro-inflammatory cytokines (2-10% of peripheral blood)

Question 17

What is involved in removal

Answer 17

Reactive oxygen species (ROS), Nitric Oxide (NO)
Complement pathways (Classical, lectin and alternate) - mediates opsonisation and agglutination
Lysis - MAC (release of contents)
Inflammation - increased adhesion to endothelium

Question 18

What is opsonisation and agglutination

Answer 18

Opsonisation - complement binds to microbes
Agglutination - microbes stuck together by complement

Question 19

Describe chemical mediators role in resolution

Answer 19

Short 1/2 life - destroyed by degradative enzymes

Question 20

Describe neutrophils role in resolution

Answer 20

Short lifespan in blood - die and are phagocytosed

Question 21

Describe activated macrophages role in resolution

Answer 21

Secretes IL-10 that down regulates macrophage response

Question 22

What is osteomyelitis

Answer 22

Inflammation of the bone

Question 23

What are the phases of osteomyelitis

Answer 23

Neutrophils attracted to site
Spread to periosteum
subperiosteal abscess - impaired blood supply -> necrosis
Dead bone -> released into sinus tract

Question 24

What are the features of chronic inflammation

Answer 24

Inflammatory cell infiltrate
Tissue destruction
Connective tissue deposition

Question 25

What WBC are involved in chronic inflammation

Answer 25

B cell -> antibody secretion - trigger inflammation Mast cell accumulate - secrete vasoactive and pro-inflammatory mediators eosinophils contribute to initiation and modulation of inflammation

Question 26

What makes up a granulomatous inflammation

Answer 26

Necrotic centre (if pathogen) Surrounded by macrophages and epithelioid cells Surrounded by lymphocytes Epithelioid cells fuse to form large giant cells (types of macrophages)

Question 27

What are granulomatous inflammation

Answer 27

Attempt to contain offending agent

Question 28

What conditions are associated with granulomatous inflammation

Answer 28

Infectious diseases (TB, leprosy, brucellosis, syphilis, mycotic infections) Autoimmunity/inflammation (sarcoidosis, Crohn's disease)