Flashcards in Path Midterm Deck (221):
what are the 5 clinical signs of inflammation?
loss of fxn
what are the 5 changes in the vascular system during inflammation?
dilation of bv by chemicals
increased permeability- loss of protein
change in rate of blood flow
change in blood stream
margination and immigration of leukocytes
what are the 3 mechanisms of extravasation?
endothelial cell contraction - most common
vascular leakage from direct endothelial cell injury
vascular leakage resulting from leukocyte injury adhesion cascade
which mechanism of extravasation acts on arterioles?
direct injury to endothelial cells leading to vascular leakage
in mild injury, what vessels become permeable?
post capillary venules
in moderate injury, what blood vessels become permeable?
capillaries and small venules
in severe injury, what vessels become permeable?
venules and arterioles
what vessels does the immediate transient response to injury occur?
post capillary venules
how long does immediate transient response (monophasic) last?
15 to 30 minutes
what vessels are involved in immediate prolonged response (biphasic) and how long did it last?
capillaries and venules
lasts minutes to days
what is immediate prolonged response mediated by in the early phase?
what is it called when many rbcs exit bv by diapedesis?
which response of vascular permeability lasts the longest?
sustained response - direct injury to endothelial cells
what are the 3 causes of slowing down of blood during inflammation?
loss of fluid - high viscosity of blood
stasis of lymph flow
what is leukocyte adhesion mostly determined by in margination?
complementary adhesion molecules (cam)
what are the 4 different types of adhesion molecules?
mucus like glycoproteins
What are the 4 beneficial effects of exudation during inflammation?
fibrin supports leukocyte mobility
fibrin localizes inflammation
What species are prone to leukocyte adhesion deficiencies?
Cows and dogs (irish setters)
What are the symptoms in cattle that have leukocyte adhesion deficiency?
severe gingivitis, tooth loss
oral and enteric ulcers
abcesses and pneumonia
What are the 2 vasoactive amines?
histamine and serotonin
What are the 2 vasoactive proteases?
plasmin and globulin factors
What are the 3 preformed chemical mediators of inflammation?
What are the 2 parts of the plasma chemical mediators in inflammation?
hageman factor activation
What cells store histamine in their granules?
What are the effects of histamine and serotonin in inflammation?
early transient dilation of BV (15-30 mins)
increase permeability of BV
What are the 2 functions of plasmin in inflammation?
cleaves C3 of complement
What cells release heparin during inflammation and what effect does it have?
prolongs exudation in acute phase
Which prostaglandins are involved in vasodilation?
PGE2 and PGI2
What are the 3 ways fibrin is removed?
fibrinolytic enzymes from leukocytes
What is the prostaglandin involved in hyperalgesia?
What leukotriene is a powerful chemotactic?
What leukotrienes are involved in vascular permeability?
Leuko-C4, D4, E4
What is responsible for vascular dilation after histamine?
Kinin activates hageman factor which results in what?
amplification mechanism in inflammation
What do prostaglandins and leukotrienes do to smooth muscles?
What other chemical mediators of inflammation do the prostaglandins and leukotriens enhance?
histamine and kinin
What are the 4 ways that oxygen derived free radicals cause cell damage?
peroxidation of cell membrane lipids
cross linking of proteins
What are the roles of nitric oxide during inflammation?
inhibits mast cells
What do interleukins do?
regulate interactions between lymphocytes and other WBCs
What are the three types of cytokines?
tumor necrosis factors
What cytokine produced by macrophages stimulates Th2 cells?
What cytokine is produced by macrophages and promotes B cell maturation?
What cytokine is produced by macrophages and is a co-stimulator of Th1 cells?
What are the major cytokines produced by macrophages?
IL 1, 6, 12, 18, and TNF
What 2 cytokines are produced by Th1 cells?
What are the cytokines produced by Th2 cells?
What do interferons do?
inhibit virus replication by interfering with viral RNA and protein synthesis
What are type 1 interferons?
have antiviral activity, used in pregnancy signaling
What is the type 2 interferon?
What are the 3 properties of neutrophils?
strong amoeboid movement
phagocytic and killing of microbes and tumors
How long do neutrophils survive in tissue?
1 to 4 days
What are the normal neutrophil percentages in different species?
Carnivores - 60-75%
Ruminants - 20-30%
Horse - 50%
What are the pHs of the smaller neutrophil granules? large ones?
small - acidic
large - alkaline
What does migration of neutrophils stimulate?
colony stimulating factor--> granulopoeisis
What is degenerative left shift?
band forms increase but number of mature neutrophils is normal or decreased
What are the 3 causes of neutropenia?
acute tissue demand (acute inflammation, sepsis)
decreased marrow production
What 2 conditions increase margination of neutrophils leading to neutropenia?
What are the 4 steps in neutrophil phagocytosis?
Chemotaxis, adherence, ingestion, digestion
What are the 2 ways neutrophils digest the material they phagocytize?
What are the 4 fxns of eosinophils?
limited phagocytic activity
cytotoxicity of parasites
What term is used for chronic inflammation that has dense infiltration of eosinophils?
What are the 3 idiopathic eosinophilic granulomas in felines?
Where are eosinophilic granulomas usually seen in felines?
abdomen and inner thigh
Where are eosinophilic ulcers usually seen in felines?
Where are Equine collagenolytic granulomas seen?
Where is eosinophilic myositis seen in dogs?
muscles of mastication - special 2m myosin, test for antibodies to this
Where is eosinophilic myositis seen in cattle and sheep?
skeletal and cardiac muscle, allergy to own muscle is suspected
Where are mast cells found?
organs rich in connective tissue
What is the life span of mast cells in tissue?
What do basophils release?
IL4, IL13, and histamine
What immunoglobulin do basophils and mast cells have many receptors for?
What do B lymphocytes differentiate into and are not found in blood circulation?
Where are class 1 MHC molecules expressed?
all nucleated cells
Where are class 2 MHC molecules expressed?
What MHC class do CD4+ T cells react to?
class 2 on surface of APC
What MHC class do CD8+ T cells (CTLs) react to?
What do CD4+T cells differentiate into and do?
effector cells - help other immune cells
What are some reasons that monocytes are not present in large numbers during acute inflammation like neutrophils?
circulating pool is low
production is lower
not as mobile
What can monocytosis indicate?
What 3 things do macrophages secrete?
What conditions are epitheloid cells usually seen?
chronic inflammation - tuberculosis and johnes dz
What are epitheloid cells?
large foamy macrophages
What are giant cells?
2 or more fused macrophages
Where are the nuclei in Langhan's type of giant cell?
Where are the nuclei in foreign body giant cells?
clustered in center or distributed
What are the causes of serous inflammation and where are they found?
serous cavities - infection
joints - trauma
lungs - infection, poison
skin - toxins, trauma, burn
mucous membranes - viral infection
Where does fibrinous inflammation occur?
serous and mucous membranes (same as serous except not skin)
What are the causes of fibrinous inflammation?
same as serous
What is the microscopic appearance of fibrin inflammation?
dirty pink mixed with leukocytes
What are the effects of fibrin inflammation?
protection, chemotactin, regeneration of underlying tissue, organization
Where does the mucus come from in mucus inflammation?
the cells (instead of the blood)
What are the causes of catarrhal or mucus inflammation?
bacteria and low virulence viruses
inhalation of dust/foreign protein
parasite - chronic irritation
what does mucus stain with H&E?
What are the effects of mucus inflammation?
chronic - becomes purulent
Where does hemorrhagic inflammation occur?
organs of rich blood supply - lung, GI
How does hemorrhagic inflammation differ from hemorrhage?
inflammation - blood oozes from inflamed tissue by diapedesis
What are the causes of hemorrhagic inflammation?
microorganisms of high virulence
What is the effect of hemorrhagic inflammation?
if cause is not removed, fatal
Where does purulent inflammation occur?
What are the causes of purulent inflammation?
What color can the pus be in purulent inflammation?
yellow cream to bluish green to black
What is the microscopic hallmark of purulent inflammation?
What is the most effective method of defense against bacteria and fungi?
What happens if abscess ruptures on surface of organ or mucous membranes of respiratory, digestive or repro tract?
What happens if abscess ruptures in blood stream?
What is the definition of an abscess?
encapsulated area of inflammation
How is chronic inflammation different than acute?
infiltration of mononuclear cells, tissue destruction, attempt at repair
Is granulomatous inflammation chronic or acute?
What are the two types of granulomatous lesions?
diffuse and nodular
What does the composition of cells around the granuloma depend on?
What causes lymphocytic inflitration seen in chronic inflammatory lesions?
infections of CNS - perivascular cuffing
portal triad of liver and in cortex of kidney
mucous membranes - lamina propria
bronchi - peribronchial cuffing
effect and significance not clear
What is healing by repair?
damaged cells replaced by OTHER types of cells (connective tissue)
What are the 3 categories of cells being able to regenerate?
labile, stable, permanant
What are labile cells?
continuously dividing cells - epithelial cells, bone marrow, lymphoid organs
What are stable cells?
quiescent - parenchymatous organs such as liver, kidney, pancreas, adrenal, bone, tendon, nerve, smooth muscle (and mesenchymal?)
What does paranchymal mean?
many different types of cells - liver with blood vessels, etc
What are examples of permanent cells?
neurons, cardiac and skeletal muscle cells
What are the two examples of loss of specialized function during repair by connective tissue?
fibrous replacement of kidney
What are the steps of primary healing?
What is the definition of healing by first intention?
healing of a clean wound where tissues are opposed
what are the 3 layers of a secondary union healing?
superficial layer of cell debris
layer of newly formed BV at right angles to lesion
deep layer of fibroblasts with collagen running parallel
What is the term used for large amounts of scar tissue?
What antibody is involved in Type 1 hypersensitivity?
What are the specific features of type 1 hypersensitivites?
need sensitization phase and re exposure
transferable to normal animal
reaction time - 15 to 20 minutes
What does a lick granuloma look like grossly?
circumscribed, hairless, ulcerated
on carpal, metacarpal, metatarsal, tibia or radius areas
What are the 3 different antibody dependent mechanisms for type 2 hypersensitivity?
1. complement dependent reaction
2. antibody dependent cell mediated cytotoxicity (ADCC)
3. antibody mediated cellular dysfunction
What does complement dependent reaction usually involve?
blood cells - transfusion, hemolytic anemia of newborn auto immune hemolytic anemia, thrombo, certain drug rxns
What is antibody mediated cellular dysfunction?
antibodies directed against cell surface receptors impair or dysregulate function
What are characteristics of type 3 hypersensitivities?
What are the two categories of antigens and what are examples?
exogenous - foreign protein, bacteria, viruses
endogenous - nuclear antigen immunoglobulin, tumors
What are localized type 3 sensitivity reactions called?
What is the pathogenesis of immune complex dzs? (type 3 hyper)
formation of antigen/antibody complex
deposition of immune complex
initiation of inflammatory rxn
What are 6 examples of system immune complex diseases
2. systemic lupus erythomatousus
3. immune mediated arthropathies - RA
4. idiopathic poyarthritis
5. periarteritis nodosa,, necrotizing vasculitis
6. immune mediated meningitis
What are examples of localized immune complex diseases?
hypersensitivity pneuomonitis - alveoli deposition
vasculitis - dogs and horses
anterior uveitis - dogs, cats, horses,
What is another name for type 4 DTH?
cell mediated hypersensitivity
What are the features of DTH?
What are examples of type 4 hypersensitivity (DTH)?
flea allergy dermatitis
sweet itch in horses
What charcterisizes flea allergy dermatitis in dogs and cats?
dogs - alopecia, hyperkeratosis
cats - scabs on back
What are 3 examples of failure of normal development?
aplasia, atresia, hypoplasia
What are examples of cellular adaptation to change that results in growth disturbance?
aging, involution of thymus
atrophy, hypertrophy, metaplasia, dysplasia
What are the 3 factors that are stimuli to proliferate cells during repair?
cytokines and wound hormones
What are the 3 systemic factors involved in adequacy of repair?
physioloical condition of animal
What are the local factors affecting adequacy of repair?
mobility of tissues
site of injury
What is aplasia (agenesis)?
organ did not develop fully during embryogenesis
What is atresia?
absence of closure of organ opening
What are the 2 causes of hypoplasia (organ doesnt get full size)?
viral infections in mother
What are examples of viral hypoplasia?
BVD - cerebellar
Blue tongue virus - cerebellar in lambs
canine distemper - enamal
What are some known genetic effects of hypoplasia
familial renal hypoplasia in dogs
pancreatic hypoplasia - dogs and cattle
What is the difference between aplasia and hypoplasia?
hypoplastic structure shows normal architechture
What is atrophy?
decrease in tissue mass after achieving normal growth
What are some causes of atrophy?
physiologic - thymic ,uterine involution, mammary gland
What are the 2 main causes of pathologic atrophy?
What happens during sublethal injury?
What is hypertrophy?
increase tissue size due to increase in individual cell size
What are causes of hypertrophy?
physio - uterus, muscles
pathologic - cardiac, renal, hormone
What is hyperplasia?
much more common than hypertrophy
increase in cell number - reversible
What is metaplasia?
transformation of cell type to another of same germ layer
Where is metaplasia usually seen?
in epithelium and connective tissue
What are some causes of metaplasia?
chronic irritation, vit A def, estrogen, blockage of bile ducts, myeloid
What is dysplasia?
What is dystrophy?
progressive degenerating and atrophic changes
some nutritional, some inherited
What are examples of dystrophy?
osteodystrophies - rickets
muscular - inherited
neuroaxonal - sheep and dogs
What does "malignant" imply?
ability to invade locally
ability for metastasis
What is the suffix for benign?
What is the suffix for malignant?
-carcinoma : epithelial tissue
-sarcoma : mesenchymal tissue
Malignant glandular-epithelium tumor
benign surface protective epithelium tumor
Malignant surface protective epithelium tumor
What layer do carcinomas come from
ANY layer of epithelium
What is a mixed tumor?
arises from cells normally found in the tissue
What can not be part of a mixed tumor?
bone and cartilage
What are teratomas/teratocarcinomas?
germ ccells - contain tissue from all embryonic cell layers
What is anaplasia
tumor cells do not resemble parent tissue (cell differentiation)
Are immature or mature anaplasias more malignant?
Tumors of melanocytes
B - melanocytoma
M - melanoma
Tumors of lymphocytes
both malignant - lymphoma, lymphosarcoma
Tumors of mast cells
B- mast cell tumor
M - mast cell sarcoma, mastocytoma
Tumors of astroglia
both benign and malignant - astrocytoma
Bone marrow tumors
malignant - leukemia
Term for disorganize mass growing around nerve tissue after trauma
Term for hyperplastic mass of mature tissue as a result of anomalous development, normal to location but not a tumor
Term for non neoplastic normal mature tissue that do not occur normally at that site (dermoid)
What is a leiomyoma
smooth muscle tumor
What is the exception that benign tumors grow slowly?
papillomas, hormone dependent mammary tumors in bitch
What are the most important criteria for benign tumors?
How do tumors metastasize in body cavities?
implantation - through serous membrane
What is the "paranchyma" of tumor cells?
the actual neoplastic cells
What is the stroma made of in tumors?
supporting tissue - host derived, ct, bv
What does vessel leakiness allow in tumors?
deposition of fibrin network that promotes formation of collagenous tumor stroma
What causes angiogenesis near tumor cells?
glucocorticoids interfere with angiogenesis
What is the term for fibrous capsule around benign tumors?
What are the non specific host defenses against a tumor
inflammatory (not very protective)
What is a specific mechanism of host defense against tumor?
tumor antigens - antibodies and cytotoxic T lympphos
What are the 2 parts of the innate immune response against tumors?
natural killer cells
What are the parts of adaptive antitumor response?
lymphocytes - CTLs and CD8 T lymphos
B Lymphocytes - ADCC
What does failure of immunosurveilance mean?
if humoral and adaptive immune response fail
How are tumors able to evade the immune response?
no surface molecules, masking of antigens by glycolyx, fibrin or ab, tolerance of antigens, no MHC, immunosuppressive effects, apoptosis in T lymphos
What type of disease is cancer?
non lethal genetic damage
What are protooncogenes?
genes that promote cell grwoth
What antibodies are associated with type 2 hypersensitivity reactions?
IgG and IgM
What determines the extent of tissue damage in type 3 hypersensitivity?
size of immune complex
overload and intrinsc dysfunction of MPS
What bacteria genus is known to cause cancer?
What parasite is known to cause cancer?
What are the local effects of neoplasms?
compression, oobstruction, tissue damage, organ/tissue replacement
What are the systemic effects of tumors?
1. hormonal (indiginous)
2. hormonal - ectopic, (PTH from anal sac adenoma)
What is the term for how tumors suppress appetite,, and cause wasting
What are the molecules that can hide tumor antigens on the surface?
glycalyx, fibrin, or antibodies
What is the term for systemic complications of neoplasia that are remote from the primary tumor?
What are the 2 paraneoplastic syndromes affecting metabolism?
hypercalcemia - lymphosarcoma, anal sac adenocarcinooma, multiple myeloma
hypoglycemia - insulinoma in dogs
What paraneoplastic syndrome affects bones?
hypertrophic (pulmonary) osteopathy
What are the 7 paraneoplastic syndromes affecting costituents of circulation?
Immunoglobulin production, altered coagulability, hyperheparinemia, neutrophilic leukocytosis, eosinophilia, anemia, polycythemia
What are the 2 paraneoplastic syndromes affecting neurologic system?
Peripheral nerve syndrome
What are the 2 paraneoplastic syndromes affecting the skin?
What are the 2 important parts of histological diagnosis of tumors?
grading of tumor - differentiation
staging of tumor - indicates growth and spread
What are the 3 chemical mediators in vasodilation?
Protaglandins - PGD2
What 6 chemical mediators increase vascular permeability?
Complement factors - C5a, C3a
Prostaglandins - PGE2
Leukotriens - LTC4, LTD4, LTE4
Platelet activating factor
What are the 5 chemical mediators of leukocyte activation and chemotaxis?
Complement factors C5a
What are the 4 chemical mediators of fever?
Cytokines IL1, IL6
What are the 2 chemical mediators in nausea?
What are the 2 chemical mediators of pain?