Path 3: Inflammation

Question 1

Steps of inflamation

Answer 1

1) Recognition of of noxious agent
2) Recruitment of leukocytes and plasma proteins
3) Removal of stimulus (mainly by phagocytes)
4) Regulation (terminates reaction)
5) Repair of tissue

Question 2

Mediator of vascular changes in inflamation

Answer 2

Histamine

Question 3

Three components of acute inflammation:

Answer 3

1) Small vessel dilation (increase blood flow)
2) Increased microvasculature permeability (enables leukocytes to leave circulation)
3) Emigration of leukocytes from microcirculation to the offending site

Question 4

Exudate

Answer 4

Extravascular fluid with high protein containing cellular debris

Question 5

Transudate

Answer 5

Fluid with low protein content

Question 6

Increased vascular permeability accomplished by

Answer 6

Contraction of endothelial cells

Question 7

Contraction of endothelial cells in inflammation is induced by

Answer 7

Histamine, bradykinin and other chemical mediators

Question 8

Edema is drained via

Answer 8

Lymphatics

Question 9

Lymphagitis vs lymphadenitis

Answer 9

Lymphagitis: lymphatic system inflammation

Lymphadenitis: inflmmation of draining lymph nodes

Question 10

Reactive lymphadenitis

Answer 10

Hyperplasia of lymphoid follicles and increased lymphocytes causes lymph node enlargement

Often seen with red streaks near wound

Question 11

Chemokines

Answer 11

adhesion molecules and cytokines that mediate leukocyte migration from vessel lumen to tissue

Question 12

Diapedesis

Answer 12

AKA transmigration

Procress in which leukocytes migrate through intact endothelium

Question 13

Chemotaxis

Answer 13

Locomotion along chemical gradient. Leukocytes move toward attractants such as bacterial products, cytokines and complement products

Question 14

_____ initially predominate in inflamatory infiltrate

Answer 14

Neutrophils (6-24 hours)

Question 15

______ replace neutrophils in inflammatory infiltrate

Answer 15

Monocytes (24-48 hours)

Question 16

Steps of phagocytosis

Answer 16

Recognition and attachment of particle to be ingested

Engulfment

Killing of microbe

Question 17

Phagocytosis is dependent on polymerization of ______

Answer 17

Actin filaments

Question 18

Killing of microbes in lysosomes is accomplished with

Answer 18

Reactive oxygen species (ROS)

Enzymes

Question 19

Respiratory burst

Answer 19

Oxidative reaction that accompanies phagocytosis

Question 20

Neutrophil Extracellular traps (NETs)

Answer 20

Extracellular fibrillar networks that concentrate antimicrobial substances at sites of infection and trap microbes, helping to prevent their spread

Question 21

Neutrophil half lives

Answer 21

Are short. They commit seppuku a few hours after leaving blood

Question 22

Histamine is secreted by

Answer 22

granule exocytosis

Question 23

Prostaglandins, leukotrines and cytokines are produced _____ during inflamation

Answer 23

De novo

Question 24

Plasma derived mediators

Answer 24

e.g. Complement proteins. produced in liver and circulate in inactive form. Activated by proteolytic cleavages

Question 25

Two major vasoactive amines

Answer 25

Histamine and serotonin

Question 26

Prostaglandin production

Answer 26

Arachandonic acid converted by COX1 and COX2

Question 27

Thromboxane A2

Answer 27

Prostaglandin that causes vasoconstriction, promotes platelet aggregation

Question 28

Prostacylin PGI2

Answer 28

Causes vasodilation, inihibits platelet aggregation

Question 29

PGD 2 and PGE 2

Answer 29

Vasodilation Increased vasular permeability Leukocyte chemotaxis

Question 30

Leukotrienes C4 D4 E4 cause

Answer 30

Bronchospasm

Question 31

TNF and IL-1 function

Answer 31

Leukocyte recruitment and adhesion

Question 32

TNF pathological effects

Answer 32

Decreased CO Insulin resistance Vascular permeability

Question 33

What triggers classical complement pathway

Answer 33

C1 binding to IgM or IgG

Question 34

How is the alternative pathway activated

Answer 34

Bacterial surface molecule in the absence of antibody

Question 35

How is the lectin pathway activated

Answer 35

C1 is activated by plasma mannose binding lectin

Question 36

Serous inflammation

Answer 36

Marked by exudation of cell poor fluid into spaes created by cell injury (burn blister)

Question 37

Fibrinous inflammation

Answer 37

occurs with large vascular leaks or procoagulant stimulus

Question 38

Purulent abscess

Answer 38

Made of pus, an exudate of neutrophils, liquified necrotic cell debris, and edema

Question 39

Ulcer

Answer 39

Excavation caused by sloughing of inflammed necrotic tissue

Question 40

Chronic inflammation caused by

Answer 40

Persistent infections Hypersensitivity reactions Prolonged toxic agent exposure

Question 41

Chronic inflamation characterized by

Answer 41

Mononuclear cell infiltration Tissue destruction Attempts at healing by connective tissue replacement

Question 42

Kupffer cells

Answer 42

Macrophages in liver

Question 43

Macrophages are derived from

Answer 43

Bone marrow in post natal life Yolk sac and liver during development

Question 44

Alternatively activated macrophages (M2)

Answer 44

Stimulate tissue repair and anti-inflammatory effects

Question 45

Major basic protein

Answer 45

Secreted from eosinophil granule to injure wormz

Question 46

Granulomatous inflammation

Answer 46

Characterized by collections of activated macrophages, often T cells and associated with necrosis

Question 47

Foreign granuloma

Answer 47

Granuloma that forms around foreign body that does not have antigenic properties (sutures, talc)

Question 48

Immune granulomma common cause

Answer 48

Tuberculosis :)

Question 49

Features of acute phase response (systemic inflammation)

Answer 49

Fever Leukocytosis Elevated acute phase proteins (C-reactive protein, fibrinogen)

Question 50

Infections associated with leukopenia

Answer 50

Rickettsiea, typhoid, protozoa

Question 51

What stimulates angiogenesis

Answer 51

VEGF Vascular endothelial growth factor

Question 52

TGF-B

Answer 52

Tissue growth factor B. Activated by M2 cells. Important for connective tissue deposition during repair