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Mediators Of Inflammation Flashcards

1
Q

Mediators of Inflammation

The mediators of inflammation are the substances that ________________ inflammatory reactions.

A

initiate and regulate

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2
Q

The most important mediators of acute inflammation are
 vasoactive _____,
 lipid products (_______ and ______),
_______ (including _______),
 products of _________

A

amines

prostaglandins and leukotrienes

cytokines; chemokines

complement activation

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3
Q

Mediators are either secreted by ____ or generated from _______

A

cells

plasma proteins.

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4
Q

Cell-derived mediators are normally sequestered in _______ and can be rapidly secreted by __________(e.g., histamine in mast cell granules) or are
 Synthesized ______ (e.g., prostaglandins and leukotrienes, cytokines) in response to a stimulus.

A

intracellular granules

granule exocytosis

de novo

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5
Q

Source of histamine ?

A

Mast cells
Basophils
Platelets

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6
Q

Source of prostaglandins

A

Mast cells
Leukocytes

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7
Q

Source of leukotrienes

A

Mast cells
Leukocytes

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8
Q

Source of Cytokines

A

Macrophages
Endothelial cell
Mast cells

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9
Q

Examples of cytokines

A

TNF
IL-1
IL-6, etc

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10
Q

Source of chemokines

A

Leukocytes
Activated macrophages

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11
Q

Source of Platelet activating factor

A

Mast cells
Leukocytes

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12
Q

Source of complement protein

A

Plasma

Produced in the liver

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13
Q

Source of kinins

A

Plasma

Produced in the liver

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14
Q

Mention 5 broad mediators involved in vascular dilation

A

Histamine
Prostaglandins
Complement protein
Kinin
PAF

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15
Q

Mention 4 broad mediators involved in increasing membrane permeability

A

Histamine
Leukotrienes
PAF
Kinins

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16
Q

Mention 2 broad mediators involved in pain

A

Kinins( bradykinin)
Prostaglandins

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17
Q

Mention broad mediators involved in

Leukocyte adhesion
Leukocyte activation
Leukocyte chrmotaxis

A

Leukotrienes and PAF

Leukotrienes and chemokines

Chemokines,PAF, complement protein

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18
Q

Mention broad mediators involved in endothelial activation

A

Histamine

Cytokines

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19
Q

The major cell types that produce mediators of acute inflammation are the sentinels that detect invaders and damage in tissues -

_____,________, and ________, but _______,_________,_________, and most epithelia can also be induced to elaborate some of the mediators.

A

macrophages, dendritic cells, and mast cells

platelets, neutrophils, endothelial cells

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20
Q

Plasma derived mediators are produced mainly in the ____ and are present in the circulation as _______ that must be ______.

A

liver

inactive precursors

activated

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21
Q

Most of the mediators are (short or long?) -lived.

A

Short

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22
Q

One mediator can stimulate the release of other mediators.

T/F

A

T

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23
Q

Vasoactive Amines: Histamine and Serotonin

 They have important actions on ______
 They are stored as preformed molecules in cells and are among the ___________ to be released during inflammation.
 The richest sources of histamine are the ______ that are normally present in the connective tissue adjacent to blood vessels.
 It is also found in blood ______ and _____

A

blood vessels.

first mediators

mast cells

basophils and platelets.

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24
Q

Histamine is stored in ______ and is released by _________ in response to a variety of stimuli, including
 (1) physical injury, such as trauma, cold, or heat, by unknown mechanisms;
 (2) binding of _____ to mast cells, which underlies ________ reactions and
 (3) products of complement called _____ (_________).

A

mast cell granules

mast cell degranulation

antibodies; immediate hypersensitivity (allergic) ; anaphylatoxins

C3a and C5a

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25
Q

_______ are thought to secrete some histamine-releasing
proteins.

A

leukocytes

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26
Q

Neuropeptides (e.g., substance P) and cytokines (IL-1, IL-8) may also trigger release of histamine.

T/F

A

T

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27
Q

Histamine

It causes ______ or _____ and ——— of ——-

A

dilation of arterioles and increases the permeability of venules.

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28
Q

_______ is considered to be the principal mediator of the immediate transient phase of increased vascular permeability, producing interendothelial gaps in venules.

A

Histamine

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29
Q

Histamine’s vasoactive effects are mediated mainly via binding to ___ receptors on microvascular endothelial cells.

A

H1

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30
Q

Histamine also causes (contraction or relaxation ?) of some smooth muscles.

A

Contraction

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31
Q

Serotonin (__________)
It is a preformed vasoactive mediator present in ______ and certain neuroendocrine cells, such as in the _________, and in _____ cells in _____ but not ______.
It function primarily as a neurotransmitter in the GIT. It is also a vaso (constrictor or dilator?)

A

5-hydroxytryptamine

platelets

gastrointestinal tract (GIT)

mast; rodents; humans

constrictor

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32
Q

The lipid mediators prostaglandins and leukotrienes are produced from ________ present in ____________

A

arachidonic acid (AA)

membrane phospholipids

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33
Q

Arachidonic acid is a ___-carbon ______ fatty acid (5,8,11,14- eicosatetraenoic acid) that is derived from ______ sources or by conversion from the essential fatty acid linoleic acid.

A

20

polyunsaturated

dietary

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34
Q

Arachidonic acid occurs free in the cell

T/F

A

F

It does not occur free in the cell but is normally esterified in membrane phospholipids.

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35
Q

Mechanical, chemical, and physical stimuli or other mediators (e.g., C5a) release AA from membrane phospholipids through the action of cellular ______, mainly _________.

A

phospholipases

phospholipase A2

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36
Q

AA-derived mediators, are synthesized by two major classes of enzymes:
________(which generate _______) and
__________ (which produce ________ and ______).

A

cyclooxygenases; prostaglandins

lipoxygenases; leukotrienes and lipoxins

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37
Q

AA-derived metabolites bind to _________ receptors on many cell types and can mediate virtually every step of inflammation

A

G protein-coupled

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38
Q

Which AA metabolites are involved in vasodilation

A

Prostaglandins I2

PGE1
PGE2
PGD2

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39
Q

Which AA metabolites are involved in vasoconstriction

A

Thromboxane

LT C4, D4, E4

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40
Q

Which AA metabolites are involved in increasing membrane permeability?

A

LT C4, D4, E4

Basically all the LT except B4

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41
Q

Which AA metabolites are involved in chemotaxis and leukocyte adhesion?

A

LT B4

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42
Q

Prostaglandins (PGs) are produced by _____,_______,_______, and many other cell types, and They are involved in the vascular and systemic reactions of inflammation.

A

mast cells, macrophages, endothelial cells

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43
Q

Prostaglandins are generated by the actions of two ______, called ______ and _____

A

cyclooxgenases

COX-1 and COX-2.

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44
Q

COX-1 is produced in response to _____ stimuli and is also constitutively expressed in _____ tissues, where it may serve a _____ function (e.g., fluid and electrolyte balance in the kidneys, cytoprotection in the gastrointestinal tract).
,

A

inflammatory

most

homeostatic

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45
Q

COX-2 is induced by _____ stimuli and thus generates the prostaglandins that are involved in inflammatory reactions, but it is (low or high?) or (present or absent?) in ________ tissues.

A

inflammatory

Low

Absent

most normal

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46
Q

Prostaglandins are divided into series based on structural features as coded by a letter (___________) and a subscript numeral (e.g., 1, 2), which indicates the ________ in the compound.

A

PGD, PGE, PGF, PGG, and PGH

number of double bonds

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47
Q

platelets contain the enzyme ________ synthase, and hence ____ is the major product in these cells.

A

thromboxane

TxA2

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48
Q

TxA2, a potent ________ agent and vaso______, is (stable or unstable?) and is rapidly converted to its inactive form _____.

A

platelet-aggregating

constrictor

Unstable

Thromboxane B2

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49
Q

Vascular endothelium lacks _____ synthase but possesses _____ synthase, which is responsible for the formation of _______ and its stable end product ______

A

thromboxane

prostacyclin

prostacyclin (PGI2)

PGF1a.

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50
Q

Prostacyclin is a vaso______, potent inhibitor of platelet aggregation, and also markedly potentiates the ______ and ________ effects of other mediators.

A

Dilator

permeability-increasing and chemotactic

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51
Q

_______ is the major prostaglandin made by mast cells; along with ______

it causes _______ and _______, thus potentiating ____ formation.

A

PGD2

PGE2

vasodilation and increases the permeability of postcapillary venules

edema

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52
Q

Which prostaglandin is most widely distributed

A

PGE2

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53
Q

PG____ stimulates the contraction of uterine and bronchial smooth muscle and small arterioles.

PG___ is a chemoattractant for neutrophils.

PG__ is hyperalgesic and makes the skin hypersensitive to painful stimuli, such as intradermal injection of suboptimal concentrations of histamine and bradykinin.

A

F2a; D2

E2

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54
Q

PG___ is I nvolved in cytokine-induced fever during infections

A

E2

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55
Q

Leukotrienes are produced by ______ and ______ by the action of ________.
 They are involved in ——— and ______ reactions and _____ recruitment.

A

leukocytes and mast cells

lipoxygenase

vascular and smooth muscle

leukocyte

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56
Q

There are three different lipoxygenases, _________ being the predominant one in neutrophils.

This enzyme converts AA to ____________________ acid, which is chemotactic for neutrophils, and is the precursor of the leukotrienes.

A

5-lipoxygenase

5-hydroxyeicosatetraenoic

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57
Q

LT____ is a potent chemotactic agent and activator of neutrophils, causing aggregation and adhesion of the cells to venular endothelium, generation of ROS, and release of lysosomal enzymes.

A

B4

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58
Q

The ______-containing leukotrienes LTC4, LTD4, and LTE4 cause intense vaso______, _________(important in asthma), and ____________

A

cysteinyl

vasoconstriction, bronchospasm

increased permeability of venules.

59
Q

Who is more potent in increasing vascular permeability and causing bronchospasm.

Histamine or leukotrienes?

A

Leukotrienes are more potent than is histamine in increasing vascular permeability and causing bronchospasm.

60
Q

Lipoxins

are generated from ____ by the ______ pathway.

They (support or suppress?) inflammation by ____________

They inhibit neutrophil ____ and ______ to endothelium.

A

AA

lipoxygenase

Suppress

inhibiting the recruitment of leukocytes.

chemotaxis; adhesion

61
Q

Lipoxins are also unusual in that ___ cell populations are required for the transcellular biosynthesis of these mediators.

A

two

62
Q

Leukocytes, particularly ______, produce intermediates in lipoxin synthesis, and these are converted to lipoxins by _____ interacting with the leukocytes.

A

neutrophils

platelets

63
Q

These anti-inflammatory drugs include the following: Cyclooxygenase inhibitors include _____ and other ________ drugs (NSAIDs), such as ______.
They inhibit _______ and thus inhibit prostaglandin synthesis.

A

aspirin

nonsteroidal anti-inflammatory

ibuprofen

COX-1 and COX-2

64
Q

Selective or non selective COX2 inhibitors

Which is newer
Has toxicity
Anti inflammatory effect
increased risk of CV and cerebrovascular events
Impair prostacyclin production
affect COX1

A

Selective COX-2 inhibitors are a newer class of these drugs

Non selective

Both

Selective
Selective
Non selective

65
Q

Selective cox 2 inhibitors are 200-300 fold more potent in blocking COX-2 than COX-1.

T/F

A

T

66
Q

5-lipoxygenase is affected by NSAIDs,

A

F
It’s not

67
Q

Pharmacologic agents that inhibit leukotriene production (e.g.,___) are useful in the treatment of _____.

A

Zileuton

Asthma

68
Q

________ are broad-spectrum anti-inflammatory agents that reduce the transcription of genes encoding COX-2, phospholipase A2, proinflammatory cytokines (e.g., IL-1 and TNF), and iNOS.

A

Corticosteroids

69
Q

Montelukast is useful in the treatment of ______.

A

asthma

70
Q

Another approach to manipulating inflammatory responses has been to modify the __________________

 The proposed explanation is that the —————————————

A

intake and content of dietary lipids by increasing the consumption of fish oil.

polyunsaturated fatty acids in fish oil are poor substrates for conversion to active metabolites by the cyclooxygenase and lipoxygenase pathways but are better substrates for the production of antiinflammatory lipid products.

71
Q

Cytokines are proteins produced by many cell types (principally activated _____,_______, and dendritic cells, but also endothelial, epithelial, and connective tissue cells).

A

lymphocytes, macrophages

72
Q

growth factors that act on epithelial and mesenchymal cells are grouped under cytokines.

T/F

A

F

They are not

73
Q

Cytokines: Tumor Necrosis Factor (TNF) and Interleukin-1 (IL-1)

They serve critical roles in _______ by promoting _____ of leukocytes to endothelium and their _____ through vessels.

A

leukocyte recruitment

adhesion; migration

74
Q

Cytokines: Tumor Necrosis Factor (TNF) and Interleukin-1 (IL-1)

These cytokines are produced mainly by activated _______ and ——— cells;

TNF is also produced by ______ and ———— cells, and IL-1 is produced by some ______ cells as well.

A

macrophages and dendritic

T lymphocytes and mast

epithelial

75
Q

The production of TNF is induced by signals through ____ and other microbial sensors

The synthesis of IL-1 is stimulated by _______ signals.

A

TLRs

the same

76
Q

The actions of TNF and IL-1 contribute to the _________ reactions of inflammation .

A

local and systemic

77
Q

The most important roles of these cytokines (TNF, IL-1) in inflammation are the following:
______ activation: by ______

Increased production of various mediators, including ______,_______, growth factors, and eicosanoids

Increased (pro or anti?) coagulant activity of the endothelium.

A

Endothelial; Both TNF and IL-1

other cytokines and chemokines

Pro

78
Q

Endothelial activation

These changes include increased expression of endothelial adhesion molecules, mostly ________________________

A

E- and P-selectins and ligands for leukocyte integrins.

79
Q

Activation of leukocytes and other cells.

 TNF __________ of neutrophils to other stimuli such as bacterial endotoxin and stimulates the _______ of macrophages.

 IL-1 activates ______ to synthesize collagen and stimulates proliferation of synovial and other mesenchymal cells.

 IL-1 also stimulates _____ responses, which in turn induce acute inflammation.

A

augments responses; microbicidal activity

fibroblasts

TH17

80
Q

Systemic acute-phase response.
 IL-1 and TNF (as well as ___) induce the systemic acute-phase responses including ______.
 They are also implicated in the syndrome of _____.
 TNF regulates energy balance by promoting _____________ and by ________

A

IL-6

fever

sepsis

lipid and protein mobilization ; suppressing appetite.

81
Q

Mention 4 mediators that cause fever

A

PGE2
TNF
IL-1
IL-6

82
Q

sustained production of TNF contributes to ___________ and ______ that accompanies some chronic infections and neoplastic diseases.

A

cachexia - weight loss

anorexia

83
Q

Chemokines

Chemokines are a family of small (8 to 10 kD) proteins that act primarily as _______ for specific types of leukocytes.

A

chemoattractants

84
Q

About ____ different chemokines and ___ different receptors for chemokines have been identified.

A

40; 20

85
Q

They are classified into four major groups:
List them

A

C-X-C chemokines
C-C chemokines
C chemokines
CX3C chemokines

86
Q

C-X-C chemokines
 These chemokines act primarily on ________.
_____ is typical of this group.

 It causes ________ and _______ of ______
 Limited activity on _____ and ____
 Its most important inducers are ____ products and other cytokines, mainly ____ and ____.

A

neutrophils

IL-8

activation and chemotaxis of neutrophils

monocytes and eosinophils.

microbial

IL-1 and TNF

87
Q

C-C chemokines

 Attract ______,________,_______ and ______
 Not as potent chemoattractants for ______.

A

monocytes, eosinophils, basophils and lymphocytes

neutrophils

88
Q

eotaxin selectively recruits ———-.

A

eosinophils

89
Q

C chemokines
 The C chemokines (e.g., _____) are relatively specific for ________.

A

lymphotactin

lymphocytes

90
Q

CX3C chemokines
The only known member of this class is called __________.

This chemokine exists in two forms:
A cell surface-bound protein induced on endothelial cells by inflammatory cytokines that promotes strong adhesion of ______ and _____ cells, and
a _____ form, derived by _________, that has potent chemoattractant activity for _____ cells.

A

fractalkine

monocytes and T

Soluble; proteolysis of the membrane-bound protein ; the same

91
Q

Chemokines mediate their activities by binding to __________ receptors.

A

seven-transmembrane G protein–coupled

92
Q

Chemokines have two main functions:

In acute inflammation.
They stimulate ______ to ______ by increasing the __________,
they stimulate ___________ of leukocytes in tissues.

A

leukocyte attachment to endothelium

affinity of integrins

migration (chemotaxis)

93
Q

Chemokines have two main functions:

Maintenance of tissue architecture.
Some chemokines are produced in tissues are called ______
chemokines.
These _____ various cell types in different ________ of the tissues, such as T and B lymphocytes in discrete areas of the spleen and lymph nodes.
Development of antagonists that block these chemokines has proven (easy or difficult?) .

A

homeostatic

organize; anatomic regions

Difficult

94
Q

Other Cytokines in Acute Inflammation

The list of cytokines implicated in inflammation is huge and constantly growing.
IL-__- made by macrophages and other cells, involved in local and systemic reactions,
IL-__- produced mainly by T lymphocytes, which promotes neutrophil recruitment.

A

6

17

95
Q

Type I interferons, whose normal function is to _________, contribute to some of the _____ manifestations of inflammation.

A

inhibit viral replication

systemic

96
Q

Cytokines also play key roles in chronic inflammation.

T/F

A

T

97
Q

Complement System
The complement system is a collection of (soluble or insoluble ?) proteins and membrane receptors.
They function mainly in host defense against ______ and in ________ reactions.

The system consists of more than 20 proteins, some of which are numbered ______________

A

Soluble

microbes; pathologic inflammatory

C1 through C9.

98
Q

Complement system function in only adaptive immunity

T/F

A

F
Both innate and adaptive

99
Q

Complement System

In the process of complement activation, several cleavage products of complement proteins are elaborated that cause _________,________, and ______

A

increased vascular permeability, chemotaxis, and opsonization.

100
Q

The critical step in complement activation is the proteolysis of the ___ component, ___.

A

third

C3

101
Q

most abundant component of the complement system is ____

A

C3.

102
Q

Cleavage of C3 can occur by one of three pathways:

The classical pathway, which is triggered by fixation of _____ to _____ (___ or ___) that has _________

The alternative pathway, triggered by ___________ (e.g.,______), complex polysaccharides,______, and other substances, in the absence of _____

The lectin pathway, in which plasma ___________ binds to _____ on _____ and (directly or indirectly?) activates C1.

A

C1 to antibody; IgM or IgG; combined with antigen

microbial surface molecules; endotoxin, or LPS; cobra venom; antibody

mannose-binding lectin ; carbohydrates; microbes;directly

103
Q

All three pathways of complement activation lead to the formation of _______, which splits C3 into two functionally distinct fragments, ________

_____ is _____, while ____ becomes covalently attached to the cell or molecule where complement is being activated.

A

C3 convertase; C3a and C3b.

C3a is released; C3b

104
Q

Activation of complement proteins:

More C3b then binds to the previously generated fragments to form _______ which then cleaves ___ to release ___ and leave ______ attached to the cell surface and that binds the late components (__________), culminating in the formation of the ______________________

A

C5 convertase.; C5; C5a; C5b

C6-C9

membrane attack complex (MAC)

105
Q

membrane attack complex is composed of multiple ____ molecules

A

C9

106
Q

The complement system has three main functions:

Inflammation.
____,_____ and, to a lesser extent, ___ - stimulate _____ release from mast cells and thereby increase _______ and ______.

They are called ________

A

C3a, C5a,; C4a

histamine

vascular permeability and cause vasodilation

anaphylatoxins

107
Q

Pro-inflammatory complement proteins are called ???

A

anaphylatoxins

108
Q

The complement system has three main functions:

Opsonization and phagocytosis.

____ and its cleavage product ____, when
fixed to a microbial cell wall, act as opsonins
 They promote ______ by _____ and _____

A

C3b; iC3b (inactive C3b)

phagocytosis; neutrophils; macrophages

neutrophils and macrophages.

109
Q

C5a is also a _____ agent for neutrophils, monocytes, eosinophils, and basophils.

In addition, C5a activates the _____ pathway of AA metabolism in neutrophils and monocytes, causing further release of inflammatory mediators.

A

chemotactic

lipoxygenase

110
Q

The complement system has three main functions:

Cell lysis.
 The deposition of the ____ on cells makes these cells __________ and results in cell death (lysis).

A

MAC

permeable to water and ions

111
Q

Regulation of complement activation

This is tightly controlled.
 The most important is _______ which blocks _________
 Inherited deficiency of this inhibitor is the cause of _______________

A

C1 inhibitor (C1 INH) - blocks the activation of C1

hereditary angioedema.

112
Q

Regulation of complement activation

_________(DAF) and ____ are two proteins that are linked to plasma membranes by a __________ anchor.

A

Decay accelerating factor ; CD59

glycophosphatidyl (GPI)

113
Q

Decay accelerating factor

Aka

_____

A

CD55

114
Q

DAF prevents formation of _______

CD59 inhibits _____________

A

C3 convertases

formation of the membrane attack complex.

115
Q

An acquired deficiency of the enzyme that creates GPI anchors leads to deficiency of these regulators(CD55,CD59) and excessive _______ and ______ in the disease called ____________

A

complement activation

lysis of red cells

paroxysmal nocturnal hemoglobinuria (PNH).

116
Q

Other Mediators of Inflammation
 Platelet-Activating Factor (PAF)
 PAF is a _____-derived mediator
 It causes _______.
 A variety of cell types, including platelets themselves, basophils, mast cells, neutrophils, macrophages, and endothelial cells, can elaborate PAF, in both ______ and ______ forms.
 PAF causes vaso_____ and broncho_____,
 At (low or high?) concentrations, it induces vasodilation and increased venular permeability.

A

phospholipid; platelet aggregation

secreted and cell-bound

constriction; constriction

Low

117
Q

Products of Coagulation

Discovery of protease-activated receptors (PARs), which are activated by _____, and are expressed on ______ and ———- is the link to inflammation.

A

thrombin; platelets and leukocytes

118
Q

The major role of the PARs is in ______ during ______

A

platelet activation during clotting.

119
Q

In fact, it is easy to dissociate clotting and inflammation

T/F

With reason

A

F

Very difficult since virtually all forms of tissue injury that lead to clotting also induce inflammation.

120
Q

Kinins
Kinins are vasoactive ____ derived from _________, called ______, by the action of specific proteases called _____.

A

peptides; plasma proteins

kininogens; kallikreins

121
Q

Kallikrein cleaves high-molecular-weight ———- to produce _______.

A

kininogen

bradykinin

122
Q

Bradykinin increases ______ and causes (contraction or relaxation?) of smooth muscle, (constriction or dilation?) of blood vessels, and ____ when injected into the skin.
These effects are similar to those of ____.

A

vascular permeability

Contraction ; dilation

pain; histamine

123
Q

The action of bradykinin is (short or long?) -lived

With reason

A

Short

because it is quickly inactivated by an
enzyme called kininase.

124
Q

Bradykinin has been implicated as a mediator in some forms of ——- reaction, such as anaphylaxis

A

allergic

125
Q

Neuropeptides
Neuropeptides are secreted by ____ nerves and various ______,

These small peptides, such as ______ and ______, are produced in the central and peripheral nervous systems.

A

sensory

leukocytes

substance P and neurokinin A

126
Q

Neuropeptides

May play a role in the initiation and regulation of inflammatory responses.

T/F

A

T

127
Q

Nerve fibers containing substance P are prominent in the ______ and ________

A

lung and gastrointestinal tract.

128
Q

Substance P has many biologic functions, including the transmission of _____ signals as well as regulation

A

pain

129
Q

Morphologic Patterns of Acute Inflammation

The morphologic hallmarks of acute inflammatory reactions are _______ and ___________ in the extravascular tissue.

A

dilation of small blood vessels

accumulation of leukocytes and fluid

130
Q

Serous Inflammation

Serous inflammation is marked by the ______ of ______ fluid into spaces created by _____ or into body cavities lined by the peritoneum, pleura, or pericardium.

A

exudation; cell poor; cell injury

131
Q

Typically, the fluid in serous inflammation is infected by destructive organisms and contains large numbers of leukocytes.

A

F

The fluid in serous inflammation is not infected by destructive organisms and does not contain large numbers of leukocytes.

132
Q

Serous inflammation

In body cavities, the fluid may be derived from the _____ or from the secretions of ________

accumulation of fluid in these cavities is called an ______.

A

plasma

mesothelial cells

effusion

133
Q

Serous inflammation

The ______ resulting from a burn or viral infection represents accumulation of serous fluid within or ___________ the damaged _____ of the skin.

A

skin blister

immediately beneath

epidermis

134
Q

Fibrinous Inflammation

A fibrinous exudate develops when the vascular leaks are (small or large?) or there is a local (pro or anti?) coagulant stimulus (e.g., cancer cells).
A fibrinous exudate is characteristic of inflammation in the _________, such as the meninges, pericardium, and pleura.

A

Large

Pro

Lining of body cavities

135
Q

Fibrinous Inflammation

Histologically, fibrin appears as an ___philic meshwork of threads or sometimes as ________.

A

eosino

an amorphous coagulum

136
Q

Fibrinous exudates may be dissolved by _______ and cleared by _______.

If the fibrin is not removed, over time it may stimulate the ____________________ and thus lead to _______

A

fibrinolysis

macrophages

ingrowth of fibroblasts and blood vessels and thus lead to scarring.

137
Q

Purulent (Suppurative) Inflammation, Abscess

Purulent inflammation is characterized by the production of ____ which is An exudate consisting of ____, the liquefied debris of _____ cells, and ____ fluid.

A

pus

neutrophils; necrotic; edema

138
Q

The most frequent cause of purulent (also called _______) inflammation is infection with ______ that cause ______, such as ______
 They are referred to as ______ ( ____-producing) bacteria.

A

suppurative

bacteria

liquefactive tissue necrosis

staphylococci; pyogenic; pus

139
Q

A common example of an acute suppurative inflammation is ____________.

A

acute appendicitis

140
Q

Abscesses are localized collections of __________ caused by ______ buried in a tissue, an organ, or a confined space.

Abscesses have a _____ region that appears as a _________ and ______

There is usually a zone of ______ around this necrotic focus, and outside this region there may be vascular ___- and parenchymal and fibroblastic proliferation.

A

purulent inflammatory tissue

suppuration buried

Central ; mass of necrotic leukocytes and tissue cells.

preserved neutrophils; dilation

141
Q

Ulcers
 An ulcer is a local defect, or _______, of the _____ of an organ or tissue that is produced by the ______ of inflamed necrotic tissue.

A

excavation; surface

sloughing

142
Q

Ulceration can occur only when ____ and resultant _____ exist on or near a _____.

It is most commonly encountered in
 the mucosa of the ____, ____,_____ or ______, and the skin and subcutaneous tissue of the _______ in older persons who have circulatory disturbances that predispose to extensive ________

A

tissue necrosis

inflammation; surface

mouth; stomach; intestines; genitourinary tract

lower extremities; ischemic necrosis.

143
Q

Ulcerations are best exemplified by peptic ulcer of the _______ or ______, in which ______________________ coexist.

A

stomach or duodenum

acute and chronic inflammation

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