Flashcards in MOD Deck (186)
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30
What enzymes are involved in the metabolism of alcohol?
Alcohol dehydroginase
Aldehyde dehydroginase
31
What is the intermediate and product in alcohol metabolism? What is created?
Acetylaldehyde
Acetic acid
32
Why are women more sensitive to alcohol?
Lower levels of alcohol dehydroginase
33
What are the effects of chronic alcohol intake?
Fatty liver from increased acetyl coA and NAPDH
34
What could occur in acute very excessive alcohol intake?
Acute alcoholic hepatitis
35
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
36
What patients are high risk in paracetamol overdoses?
Taken with alcohol
Alcoholics
Malnourished
Hiv/aids
Enzyme inducing drug patients
37
How does n-acetyl cystine work?
Prodrug precursor to l-cysteine which is precursor to glutathione
38
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
39
What are the four signs of inflammation?
Calor
Rubor
Dolor
Tumor
40
What are the two phases of acute inflammation?
Vascular
Cellular
41
What occurs in the vascular phase of acute inflammation?
Brief vasoconstriction
Vasodilation increasing blood flow and capillary hydrostatic pressure
Increased permeability of blood vessels
Leakage of exudate
Raised cellular concentration of blood slowing it down
42
What triggers the vascular phase of acute inflammation?
Histamine released from mast cells, basophils and platelets due to:
Damage
C3a C5a and IL-1 from neutrophils and platelets
Immunologic reactions
43
What causes pain in vascular phase of acute inflammation?
Histamine
44
What chemical mediators cause increased vascular permeability in acute inflammation?
Histamine
Il-2
TNF alpha
Direct damage
ROS
Leukotrines
45
Differentiate transudate from exudate
Exudate contains proteins and is only formed when vessel permeability increases as well as hydrostatic and osmotic pressure
46
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
47
What occurs in the cellular phase of acute inflammation?
Extravasation of neutrophils
Phagocytosis of debris and pathogens
48
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.
49
How are neutrophils attracted to areas of acute inflammation?
Chemotaxis along concentration gradients of C5a and bacterial peptides
50
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
51
What are local complications of acute inflammation?
Tube compression
Prolonged pain
Loss of function
52
What are systemic complications of acute inflammation?
Fever
Dehydration
Altered plasma proteins
Shock
53
What are outcomes of acute inflammation?
Resolution
Progression to chronic inflammation
Repeated acute inflammation
Death
54
What aids acute inflammation resolution?
Lymphatic drainage
Short half life of mediators
Proteolytic degradation
Binding of inhibitors
Dilution
55
How does inflammation cause fever?
ILs, prostaglandins and TNF alpha are pyrogens that effect the hypothalamus
56
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
57
Hw does chronic inflammation differ from acute?
More variable course
Macrophages, lyphocytes, plasma cells and eosinophils
Giant cells
58
What is the function of macrophages in chronic inflammation?
Phagocytosis
Antigen presentation
Release of cytokines, complement and clotting factors
59
