Flashcards in MOD Deck (186)
What enzymes are involved in the metabolism of alcohol?
What is the intermediate and product in alcohol metabolism? What is created?
Why are women more sensitive to alcohol?
Lower levels of alcohol dehydroginase
What are the effects of chronic alcohol intake?
Fatty liver from increased acetyl coA and NAPDH
What could occur in acute very excessive alcohol intake?
Acute alcoholic hepatitis
What is produced when normal paracetamol metabolism is saturated?
What effect does this have?
NAPQI which is conjugated to glutathione
NAPQI is directly toxic binding to sulphydryl groups
Glutathione depletion leaves cells vulnerable to ROS
What patients are high risk in paracetamol overdoses?
Taken with alcohol
Enzyme inducing drug patients
How does n-acetyl cystine work?
Prodrug precursor to l-cysteine which is precursor to glutathione
What occurs in an aspirin OD?
Stimulation of resp centre causing a resp alkalosis
Body compensates with a metabolic acidosis
Decreased platelet aggregation causes bleeding
What are the four signs of inflammation?
What are the two phases of acute inflammation?
What occurs in the vascular phase of acute inflammation?
Vasodilation increasing blood flow and capillary hydrostatic pressure
Increased permeability of blood vessels
Leakage of exudate
Raised cellular concentration of blood slowing it down
What triggers the vascular phase of acute inflammation?
Histamine released from mast cells, basophils and platelets due to:
C3a C5a and IL-1 from neutrophils and platelets
What causes pain in vascular phase of acute inflammation?
What chemical mediators cause increased vascular permeability in acute inflammation?
Differentiate transudate from exudate
Exudate contains proteins and is only formed when vessel permeability increases as well as hydrostatic and osmotic pressure
What proteins leave the vascular compartment during the vascular phase of acute inflammation? What effect does this have?
Fibrin - formation of fibropurilent exudate to contain inflammation
General proteins - increase oncotic pressure increasing exudate formation
What occurs in the cellular phase of acute inflammation?
Extravasation of neutrophils
Phagocytosis of debris and pathogens
How do neutrophils enter the tissue fluid?
Margination - slow blood leads to cells moving to vessel walls
Rolling - adhere to selectins and roll along wall
Adhesion - adhere tightly to adherins
Emigration - squeeze through gaps between cells digesting basement membrane as they do.
How are neutrophils attracted to areas of acute inflammation?
Chemotaxis along concentration gradients of C5a and bacterial peptides
How does acute inflammation aid us?
Swelling and pain - enforces rest
Exudation of fibrin - contains damage
Fluid exudation - dilutes toxins
Increased lymph drainage - removes pathogens
Exudation of immune cells - destroy pathogens and debris
Vasodilation - faster delivery of fluid and cells
What are local complications of acute inflammation?
Loss of function
What are systemic complications of acute inflammation?
Altered plasma proteins
What are outcomes of acute inflammation?
Progression to chronic inflammation
Repeated acute inflammation
What aids acute inflammation resolution?
Short half life of mediators
Binding of inhibitors
How does inflammation cause fever?
ILs, prostaglandins and TNF alpha are pyrogens that effect the hypothalamus
Why does chronic inflammation occur?
Take over from acute inflammation if damage is too severe to be repaired within a few days
Alongside acute inflammation in repeat irritation
Without acute inflammation in some conditions eg. RA, TB, small foreign body
Hw does chronic inflammation differ from acute?
More variable course
Macrophages, lyphocytes, plasma cells and eosinophils
What is the function of macrophages in chronic inflammation?
Release of cytokines, complement and clotting factors