Module 4 - Chapter 6 - Acute and Chronic Inflammation

Question 1

What is acute inflammation?

Answer 1

Acute inflammation is a short-term response to tissue injury or infection, typically lasting about 8 to 10 days until the threat is eliminated.

Question 2

How does acute inflammation aim to resolve issues in the body?

Answer 2

Acute inflammation is self-limiting and aims to resolve problems quickly, returning the tissue to normal.

Question 3

What is chronic inflammation?

Answer 3

Chronic inflammation can develop when the acute response is inadequate or when the cause of tissue damage persists, and it can last for weeks or months.

Question 4

What is the purpose of a granulomatous response in chronic inflammation?

Answer 4

A granulomatous response aims to contain the cause of tissue damage, preventing further harm. It forms structures called granulomas.

Question 5

Give an example of a disease that results in a granulomatous response.

Answer 5

Tuberculosis (TB) is an example of a disease that triggers a granulomatous response, particularly in the lungs.

Question 6

Why is tuberculosis (TB) difficult to treat?

Answer 6

TB is challenging to treat because the infection is contained within granulomas but not fully eliminated. The bacteria can remain latent until the host’s immune defenses weaken.

Question 7

How do the early (acute) and later (chronic) phases of inflammation differ?

Answer 7

The early phase (acute) differs from the later phase (chronic) in terms of the biochemical mediators and cells involved in the response.

Question 8

What determines the outcome of acute and chronic inflammation?

Answer 8

The outcome depends on the successful containment of tissue damage and infection. Healing with limited permanent tissue damage can occur if containment is successful.

Question 9

What are the local manifestations of acute inflammation?

Answer 9

The local manifestations of acute inflammation include swelling, pain, heat, and redness (erythema).

Question 10

What causes these local manifestations in acute inflammation?

Answer 10

These local manifestations result from vascular changes and the leakage of circulating components into the affected tissue.

Question 11

What is the exudate of inflammation, and how does its composition vary?

Answer 11

The exudate of inflammation is a fluid that results from increased vascular permeability. Its composition varies depending on the stage of the inflammatory response and the nature of the injury.

Question 12

Describe the exudate in early or mild inflammation.

Answer 12

In early or mild inflammation, the exudate may be watery (serous exudate) and contains very few plasma proteins or leukocytes, similar to the fluid in a blister.

Question 13

What characterizes the exudate in more severe or advanced inflammation?

Answer 13

Purulent exudate consists of pus and is characteristic of inflammation with a large accumulation of leukocytes, often seen in persistent bacterial infections and walled-off lesions like cysts or abscesses.

Question 14

When does an exudate become hemorrhagic?

Answer 14

If bleeding occurs within the inflamed area, the exudate becomes filled with erythrocytes, resulting in a hemorrhagic exudate.

Question 15

What are the three primary systemic changes associated with the acute inflammatory response?

Answer 15

The three primary systemic changes associated with acute inflammation are fever, leukocytosis, and increased levels of circulating plasma proteins.

Question 16

What is fever, and how is it induced during inflammation?

Answer 16

Fever is an elevated body temperature. It is induced during inflammation by specific cytokines, such as interleukin-1 (IL-1), which are released by neutrophils and macrophages. These cytokines are called endogenous pyrogens and act on the hypothalamus in the brain to raise the body’s temperature.

Question 17

Why is fever considered beneficial during infection?

Answer 17

Fever is considered beneficial during infection because some microorganisms, like those causing syphilis or gonococcal urethritis, are highly sensitive to small increases in body temperature. Elevated temperature can help the body combat these pathogens.

Question 18

What are the adverse effects of fever in some cases of inflammation?

Answer 18

In some cases of inflammation, fever can have adverse effects by enhancing the host’s susceptibility to endotoxins associated with Gram-negative bacterial infections. This can lead to increased inflammation and tissue damage.

Question 19

What is leukocytosis, and what characterizes it during infection?

Answer 19

Leukocytosis is an increase in the number of white blood cells in the bloodstream. During infection, leukocytosis is characterized by a left shift, which means that there is a higher proportion of immature neutrophils (band cells, metamyelocytes, myelocytes) in circulation compared to mature neutrophils.

Question 20

Where does the increased production of white blood cells, particularly neutrophils, occur during infection?

Answer 20

The increased production of white blood cells, especially neutrophils, occurs primarily in the bone marrow as a response to infection.

Question 21

What are acute-phase reactants, and when do their levels peak during inflammation?

Answer 21

Acute-phase reactants are plasma proteins, many of which are produced by the liver, that increase in synthesis during inflammation. Their levels peak within 10 to 40 hours after the start of inflammation.

Question 22

How is the synthesis of acute-phase reactants in the liver initiated during inflammation?

Answer 22

The synthesis of acute-phase reactants in the liver is initiated during inflammation by cytokines, particularly interleukin-1 (IL-1), which indirectly stimulates their production through the induction of interleukin-6 (IL-6). IL-6 then directly stimulates liver cells to synthesize these proteins.

Question 23

What are some coagulation components that show increased levels during inflammation?

Answer 23

During inflammation, coagulation components such as fibrinogen, prothrombin, Factor VIII, plasminogen, and various protease inhibitors like α1-antitrypsin and α1-antichymotrypsin typically have increased levels.

Question 24

Which transport proteins exhibit increased levels during inflammation?

Answer 24

Inflammation leads to increased levels of transport proteins, including haptoglobin, hemopexin, ceruloplasmin, and ferritin. These proteins play roles in transporting and regulating various substances in the bloodstream.

Question 25

What complement components are elevated during inflammation?

Answer 25

Several complement components, including C1s, C2, C3, C4, C5, C9, factor B, and C1 inhibitor, tend to have increased levels during inflammation. The complement system plays a crucial role in immune responses.

Question 26

Which miscellaneous proteins show increased levels during inflammation?

Answer 26

Miscellaneous proteins that exhibit increased levels during inflammation include α1-acid glycoprotein, fibronectin, serum amyloid A (SAA), and C-reactive protein (CRP). These proteins have various roles in the immune response and tissue repair.

Question 27

Are there any coagulation components that decrease during inflammation?

Answer 27

No, among the listed coagulation components, none of them typically decrease during inflammation.

Question 28

What transport protein levels decrease during inflammation?

Answer 28

Transferrin is a transport protein that tends to have decreased levels during inflammation.

Question 29

Which protease inhibitor levels decrease during inflammation?

Answer 29

Inter-α1-antitrypsin is a protease inhibitor that often has decreased levels during inflammation.

Question 30

Are there any complement components that decrease during inflammation?

Answer 30

Yes, properdin is a complement component that usually has decreased levels during inflammation.

Question 31

What is the function of albumin in the bloodstream during inflammation?

Answer 31

Albumin, which is not specifically mentioned in the table, is an important protein in the blood that helps maintain osmotic pressure. During inflammation, albumin levels can decrease.

Question 32

What is the function of prealbumin in the bloodstream during inflammation?

Answer 32

Prealbumin, which is not specifically mentioned in the table, is another protein involved in maintaining osmotic pressure. Like albumin, its levels can decrease during inflammation.

Question 33

What is the role of α1-Lipoprotein in the bloodstream during inflammation?

Answer 33

α1-Lipoprotein, which is not specifically mentioned in the table, may also be affected during inflammation, and its levels can change.

Question 34

Why are changes in the levels of acute-phase reactants important during inflammation?

Answer 34

Changes in the levels of acute-phase reactants are important because they reflect the body’s response to inflammation and can serve as diagnostic markers for various diseases and conditions.

Question 35

Break this down into detailed flashcards in question format with answers.

Answer 35

ESR measures the rate at which red blood cells settle in a tube over a specified time, often one hour. It indirectly reflects inflammation in the body.

Question 36

How does the ESR work as an indicator of inflammation?

Answer 36

During inflammation, proteins like fibrinogen increase in the blood. This causes red blood cells to stick together more, leading to faster sedimentation, which is detected by the ESR test.

Question 37

Is the ESR a specific marker for a particular type of inflammation?

Answer 37

No, the ESR is a nonspecific marker of inflammation. It indicates that inflammation is occurring but doesn’t pinpoint the exact cause.

Question 38

What does C-reactive protein (CRP) measure?

Answer 38

CRP is a protein produced by the liver in response to inflammation. It directly measures the presence of inflammation in the body.

Question 39

How does CRP work as an indicator of inflammation?

Answer 39

When inflammation occurs, the liver releases CRP into the bloodstream. Elevated CRP levels are a direct sign of ongoing inflammation.

Question 40

Is CRP a specific or nonspecific marker of inflammation?

Answer 40

CRP is a specific marker of inflammation. It directly reflects the presence of inflammation in the body.

Question 41

Which laboratory test, ESR or CRP, is more commonly used in clinical practice to indicate inflammation?

Answer 41

CRP is more commonly used in clinical practice as an indicator of inflammation due to its specificity and ability to provide direct information about the presence of inflammation.

Question 42

Why are laboratory tests for inflammation important in healthcare?

Answer 42

Laboratory tests for inflammation help diagnose and monitor inflammatory conditions, guide treatment decisions, and assess the effectiveness of treatment. They provide valuable information to healthcare professionals in managing various inflammatory diseases.

Question 43

What is the main difference between acute and chronic inflammation?

Answer 43

The primary difference between acute and chronic inflammation is their duration. Chronic inflammation lasts for two weeks or longer, regardless of the cause.

Question 44

Can chronic inflammation result from an unsuccessful acute inflammatory response?

Answer 44

Yes, chronic inflammation can follow an unsuccessful acute inflammatory response, especially if bacterial contamination or foreign objects persist in a wound. Prolonged inflammation in such cases may lead to pus formation, suppuration, and incomplete wound healing.

Question 45

Are there cases of chronic inflammation that do not have a preceding acute phase?

Answer 45

Yes, chronic inflammation can occur as a distinct process without a prior acute inflammatory response. Some microorganisms have characteristics that make them less sensitive to phagocyte breakdown or capable of surviving within macrophages, leading to chronic inflammation. Additionally, certain microorganisms produce toxins that cause persistent inflammation, even after the microorganism is killed. Chemicals, particulate matter, or physical irritants can also trigger prolonged inflammatory responses.

Question 46

How does chronic inflammation manifest clinically?

Answer 46

Chronic inflammation is characterized by a dense infiltration of lymphocytes and macrophages. In cases where macrophages cannot adequately protect the host from tissue damage, the body may form granulomas to isolate the infected area. These granulomas consist of epithelioid cells, multinucleated giant cells, and lymphocytes, often surrounded by fibrous deposits of collagen.

Question 47

What drives the formation of granulomas in chronic inflammation?

Answer 47

TNF-α (tumor necrosis factor alpha) is primarily responsible for driving the formation of granulomas in chronic inflammation.

Question 48

Describe the components of a granuloma.

Answer 48

A granuloma typically consists of a core containing epithelioid cells and multinucleated giant cells, surrounded by a wall of lymphocytes. The entire structure may be encapsulated by fibrous deposits and can sometimes become cartilaginous or calcified

Question 49

What happens to the tissue within a granuloma over time?

Answer 49

Tissue within a granuloma may undergo caseous necrosis, resulting in a cheese-like proteinaceous center. Decay of cells within the granuloma can release acids and enzymes, causing cellular debris to break down into basic constituents and eventually leave behind a hollow, thick-walled structure, reducing the function of the affected organ or tissue.