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0

what are the 5 clinical signs of inflammation?

redness
swelling
heat
pain
loss of fxn

1

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

2

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

3

which mechanism of extravasation acts on arterioles?

direct injury to endothelial cells leading to vascular leakage

4

in mild injury, what vessels become permeable?

post capillary venules

5

in moderate injury, what blood vessels become permeable?

capillaries and small venules

6

in severe injury, what vessels become permeable?

venules and arterioles

7

what vessels does the immediate transient response to injury occur?

post capillary venules

8

how long does immediate transient response (monophasic) last?

15 to 30 minutes

9

what vessels are involved in immediate prolonged response (biphasic) and how long did it last?

capillaries and venules
lasts minutes to days

10

what is immediate prolonged response mediated by in the early phase?

kinin

11

what is it called when many rbcs exit bv by diapedesis?

hemorrhagic inflammation

12

which response of vascular permeability lasts the longest?

sustained response - direct injury to endothelial cells

13

what are the 3 causes of slowing down of blood during inflammation?

loss of fluid - high viscosity of blood
passive congestion
stasis of lymph flow

14

what is leukocyte adhesion mostly determined by in margination?

complementary adhesion molecules (cam)

16

what are the 4 different types of adhesion molecules?

selectins
immunoglobins
integrins
mucus like glycoproteins

17

What are the 4 beneficial effects of exudation during inflammation?

dilutes toxin
brings antibodies
fibrin supports leukocyte mobility
fibrin localizes inflammation

18

What species are prone to leukocyte adhesion deficiencies?

Cows and dogs (irish setters)

19

What are the symptoms in cattle that have leukocyte adhesion deficiency?

severe gingivitis, tooth loss
oral and enteric ulcers
abcesses and pneumonia
=lethal

20

What are the 2 vasoactive amines?

histamine and serotonin

21

What are the 2 vasoactive proteases?

plasmin and globulin factors

22

What are the 3 preformed chemical mediators of inflammation?

histamine
serotonin
lysosomal enzymes

23

What are the 2 parts of the plasma chemical mediators in inflammation?

complement activation
hageman factor activation

24

What cells store histamine in their granules?

basophils
mast cells
blood platelets

25

What are the effects of histamine and serotonin in inflammation?

early transient dilation of BV (15-30 mins)
increase permeability of BV

26

What are the 2 functions of plasmin in inflammation?

degrades fibrin
cleaves C3 of complement

27

What cells release heparin during inflammation and what effect does it have?

mast cells
prolongs exudation in acute phase

28

Which prostaglandins are involved in vasodilation?

PGE2 and PGI2

29

What are the 3 ways fibrin is removed?

fibrinolytic enzymes from leukocytes
phagocytic leukocytes
plasmin

30

What is the prostaglandin involved in hyperalgesia?

PGE2

31

What leukotriene is a powerful chemotactic?

Leuko-B4

32

What leukotrienes are involved in vascular permeability?

Leuko-C4, D4, E4

33

What is responsible for vascular dilation after histamine?

kinin system

34

Kinin activates hageman factor which results in what?

amplification mechanism in inflammation

35

What do prostaglandins and leukotrienes do to smooth muscles?

contract

36

What other chemical mediators of inflammation do the prostaglandins and leukotriens enhance?

histamine and kinin

37

What are the 4 ways that oxygen derived free radicals cause cell damage?

peroxidation of cell membrane lipids
cross linking of proteins
damage DNA
cleaving glycoconjugates

38

What are the roles of nitric oxide during inflammation?

vasodilation
inhibits platelets
oxidizes lipids
inhibits mast cells
regulates chemotaxis

39

What do interleukins do?

regulate interactions between lymphocytes and other WBCs

40

What are the three types of cytokines?

interleukins
tumor necrosis factors
interferons

41

What cytokine produced by macrophages stimulates Th2 cells?

interleukin 1

42

What cytokine is produced by macrophages and promotes B cell maturation?

Interleukin 6

43

What cytokine is produced by macrophages and is a co-stimulator of Th1 cells?

interleukin 12

44

What are the major cytokines produced by macrophages?

IL 1, 6, 12, 18, and TNF

45

What 2 cytokines are produced by Th1 cells?

Interleukin 2
Interferon-y (gamma)

46

What are the cytokines produced by Th2 cells?

IL-4,5,9,10, 13

47

What do interferons do?

inhibit virus replication by interfering with viral RNA and protein synthesis

48

What are type 1 interferons?

have antiviral activity, used in pregnancy signaling

49

What is the type 2 interferon?

IFNY

50

What are the 3 properties of neutrophils?

strong amoeboid movement
phagocytic and killing of microbes and tumors
intracellular digestion

51

How long do neutrophils survive in tissue?

1 to 4 days

52

What are the normal neutrophil percentages in different species?

Carnivores - 60-75%
Ruminants - 20-30%
Horse - 50%

53

What are the pHs of the smaller neutrophil granules? large ones?

small - acidic
large - alkaline

54

What does migration of neutrophils stimulate?

colony stimulating factor--> granulopoeisis

55

What is degenerative left shift?

band forms increase but number of mature neutrophils is normal or decreased

56

What are the 3 causes of neutropenia?

acute tissue demand (acute inflammation, sepsis)
decreased marrow production
increased margination

57

What 2 conditions increase margination of neutrophils leading to neutropenia?

anaphylaxis
endotoxemia

58

What are the 4 steps in neutrophil phagocytosis?

Chemotaxis, adherence, ingestion, digestion

59

What are the 2 ways neutrophils digest the material they phagocytize?

respiratory burst
lysosomes

60

What are the 4 fxns of eosinophils?

limited phagocytic activity
cytotoxicity of parasites
inflammatory rxn
allergic rxn

61

What term is used for chronic inflammation that has dense infiltration of eosinophils?

eosinophilic granuloma

62

What are the 3 idiopathic eosinophilic granulomas in felines?

eosinophilic plaque
linear granuloma
eosinophilic ulcer

63

Where are eosinophilic granulomas usually seen in felines?

abdomen and inner thigh

64

Where are eosinophilic ulcers usually seen in felines?

upper lip

65

Where are Equine collagenolytic granulomas seen?

saddle area

66

Where is eosinophilic myositis seen in dogs?

muscles of mastication - special 2m myosin, test for antibodies to this

67

Where is eosinophilic myositis seen in cattle and sheep?

skeletal and cardiac muscle, allergy to own muscle is suspected

68

Where are mast cells found?

organs rich in connective tissue

69

What is the life span of mast cells in tissue?

4-12 weeks

70

What do basophils release?

IL4, IL13, and histamine

71

What immunoglobulin do basophils and mast cells have many receptors for?

IgE

72

What do B lymphocytes differentiate into and are not found in blood circulation?

plasma cells

73

Where are class 1 MHC molecules expressed?

all nucleated cells

74

Where are class 2 MHC molecules expressed?

specialized APC

75

What MHC class do CD4+ T cells react to?

class 2 on surface of APC

76

What MHC class do CD8+ T cells (CTLs) react to?

class 1

77

What do CD4+T cells differentiate into and do?

effector cells - help other immune cells

78

What are some reasons that monocytes are not present in large numbers during acute inflammation like neutrophils?

circulating pool is low
production is lower
different chemotaxis
not as mobile

79

What can monocytosis indicate?

inflammation
tissue necrosis

80

What 3 things do macrophages secrete?

enzymes
pro-inflammatory products
growth factors

81

What conditions are epitheloid cells usually seen?

chronic inflammation - tuberculosis and johnes dz

82

What are epitheloid cells?

large foamy macrophages

83

What are giant cells?

2 or more fused macrophages

84

Where are the nuclei in Langhan's type of giant cell?

periphery

85

Where are the nuclei in foreign body giant cells?

clustered in center or distributed

86

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

87

Where does fibrinous inflammation occur?

serous and mucous membranes (same as serous except not skin)

88

What are the causes of fibrinous inflammation?

same as serous

89

What is the microscopic appearance of fibrin inflammation?

dirty pink mixed with leukocytes

90

What are the effects of fibrin inflammation?

protection, chemotactin, regeneration of underlying tissue, organization

91

Where does the mucus come from in mucus inflammation?

the cells (instead of the blood)

92

What are the causes of catarrhal or mucus inflammation?

bacteria and low virulence viruses
mild chemicals
irritating food
inhalation of dust/foreign protein
parasite - chronic irritation

93

what does mucus stain with H&E?

pale blue

94

What are the effects of mucus inflammation?

protective
chronic - becomes purulent

95

Where does hemorrhagic inflammation occur?

organs of rich blood supply - lung, GI

96

How does hemorrhagic inflammation differ from hemorrhage?

inflammation - blood oozes from inflamed tissue by diapedesis

97

What are the causes of hemorrhagic inflammation?

microorganisms of high virulence
acute poisoning

98

What is the effect of hemorrhagic inflammation?

if cause is not removed, fatal

99

Where does purulent inflammation occur?

ALL TISSUES

100

What are the causes of purulent inflammation?

pyogenic bacteria
fungal infections

101

What color can the pus be in purulent inflammation?

yellow cream to bluish green to black

102

What is the microscopic hallmark of purulent inflammation?

neutrophils

103

What is the most effective method of defense against bacteria and fungi?

purulent inflammation

104

What happens if abscess ruptures on surface of organ or mucous membranes of respiratory, digestive or repro tract?

fatal

105

What happens if abscess ruptures in blood stream?

metastatic abscesses
toxemia/death

106

What is the definition of an abscess?

encapsulated area of inflammation

107

How is chronic inflammation different than acute?

infiltration of mononuclear cells, tissue destruction, attempt at repair

108

Is granulomatous inflammation chronic or acute?

chronic

109

What are the two types of granulomatous lesions?

diffuse and nodular

110

What does the composition of cells around the granuloma depend on?

causative agent

111

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

112

What is healing by repair?

damaged cells replaced by OTHER types of cells (connective tissue)

113

What are the 3 categories of cells being able to regenerate?

labile, stable, permanant

114

What are labile cells?

continuously dividing cells - epithelial cells, bone marrow, lymphoid organs

115

What are stable cells?

quiescent - parenchymatous organs such as liver, kidney, pancreas, adrenal, bone, tendon, nerve, smooth muscle (and mesenchymal?)

116

What does paranchymal mean?

many different types of cells - liver with blood vessels, etc

117

What are examples of permanent cells?

neurons, cardiac and skeletal muscle cells

118

What are the two examples of loss of specialized function during repair by connective tissue?

fibrous replacement of kidney
myocardial infarction

119

What are the steps of primary healing?

clot formation
inflammatory response
fibroblast response
endothelial response
epithelial regeneration
collagen formation

120

What is the definition of healing by first intention?

healing of a clean wound where tissues are opposed

121

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

122

What is the term used for large amounts of scar tissue?

cicatrization

123

What antibody is involved in Type 1 hypersensitivity?

IgE

124

What are the specific features of type 1 hypersensitivites?

need sensitization phase and re exposure
transferable to normal animal
genetic predisposition
reaction time - 15 to 20 minutes

125

What does a lick granuloma look like grossly?

circumscribed, hairless, ulcerated
on carpal, metacarpal, metatarsal, tibia or radius areas

126

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

127

What does complement dependent reaction usually involve?

blood cells - transfusion, hemolytic anemia of newborn auto immune hemolytic anemia, thrombo, certain drug rxns

128

What is antibody mediated cellular dysfunction?

antibodies directed against cell surface receptors impair or dysregulate function

129

What are characteristics of type 3 hypersensitivities?

immune complexes
tissue damage

130

What are the two categories of antigens and what are examples?

exogenous - foreign protein, bacteria, viruses
endogenous - nuclear antigen immunoglobulin, tumors

131

What are localized type 3 sensitivity reactions called?

arthus rxn

132

What is the pathogenesis of immune complex dzs? (type 3 hyper)

formation of antigen/antibody complex
deposition of immune complex
initiation of inflammatory rxn

133

What are 6 examples of system immune complex diseases

1. glomerulonephritis
2. systemic lupus erythomatousus
3. immune mediated arthropathies - RA
4. idiopathic poyarthritis
5. periarteritis nodosa,, necrotizing vasculitis
6. immune mediated meningitis

134

What are examples of localized immune complex diseases?

hypersensitivity pneuomonitis - alveoli deposition
vasculitis - dogs and horses
purpura hemorrhagica
anterior uveitis - dogs, cats, horses,

135

What is another name for type 4 DTH?

cell mediated hypersensitivity

136

What are the features of DTH?

no antibody
cellular reactions
24-48 hours
intracellular organisims
T lymphocytes

137

What are examples of type 4 hypersensitivity (DTH)?

tuberculin test
contact dermatitis
flea allergy dermatitis
sweet itch in horses

138

What charcterisizes flea allergy dermatitis in dogs and cats?

dogs - alopecia, hyperkeratosis
cats - scabs on back

139

What are 3 examples of failure of normal development?

aplasia, atresia, hypoplasia

140

What are examples of cellular adaptation to change that results in growth disturbance?

aging, involution of thymus
atrophy, hypertrophy, metaplasia, dysplasia

141

What are the 3 factors that are stimuli to proliferate cells during repair?

cytokines and wound hormones
chemical stimulants
pressure gradients

142

What are the 3 systemic factors involved in adequacy of repair?

physioloical condition of animal
nutrition
endocrine factors

143

What are the local factors affecting adequacy of repair?

blood supply
infection
mobility of tissues
site of injury

144

What is aplasia (agenesis)?

organ did not develop fully during embryogenesis

145

What is atresia?

absence of closure of organ opening

146

What are the 2 causes of hypoplasia (organ doesnt get full size)?

viral infections in mother
genetic

147

What are examples of viral hypoplasia?

BVD - cerebellar
Blue tongue virus - cerebellar in lambs
canine distemper - enamal

148

What are some known genetic effects of hypoplasia

familial renal hypoplasia in dogs
pancreatic hypoplasia - dogs and cattle

149

What is the difference between aplasia and hypoplasia?

hypoplastic structure shows normal architechture

150

What is atrophy?

decrease in tissue mass after achieving normal growth

151

What are some causes of atrophy?

physiologic - thymic ,uterine involution, mammary gland
pathologic

152

What are the 2 main causes of pathologic atrophy?

disuse atropy
neurogenic
vasculogenic
nutritional
endocrine
inflammatory

153

What happens during sublethal injury?

autophagocytosis

154

What is hypertrophy?

increase tissue size due to increase in individual cell size

155

What are causes of hypertrophy?

physio - uterus, muscles
pathologic - cardiac, renal, hormone

156

What is hyperplasia?

much more common than hypertrophy
increase in cell number - reversible

157

What is metaplasia?

transformation of cell type to another of same germ layer

158

Where is metaplasia usually seen?

in epithelium and connective tissue

159

What are some causes of metaplasia?

chronic irritation, vit A def, estrogen, blockage of bile ducts, myeloid

160

What is dysplasia?

abnormal development

161

What is dystrophy?

progressive degenerating and atrophic changes
some nutritional, some inherited

162

What are examples of dystrophy?

osteodystrophies - rickets
muscular - inherited
neuroaxonal - sheep and dogs

163

What does "malignant" imply?

ability to invade locally
ability for metastasis

164

What is the suffix for benign?

oma

165

What is the suffix for malignant?

-carcinoma : epithelial tissue
-sarcoma : mesenchymal tissue

166

Malignant glandular-epithelium tumor

adenocarcinoma

167

benign surface protective epithelium tumor

papilloma

168

Malignant surface protective epithelium tumor

carcinoma

169

What layer do carcinomas come from

ANY layer of epithelium

170

What is a mixed tumor?

arises from cells normally found in the tissue

171

What can not be part of a mixed tumor?

bone and cartilage

172

What are teratomas/teratocarcinomas?

germ ccells - contain tissue from all embryonic cell layers

173

What is anaplasia

tumor cells do not resemble parent tissue (cell differentiation)

174

Are immature or mature anaplasias more malignant?

immature

175

Tumors of melanocytes

B - melanocytoma
M - melanoma

176

Tumors of lymphocytes

both malignant - lymphoma, lymphosarcoma

177

Tumors of mast cells

B- mast cell tumor
M - mast cell sarcoma, mastocytoma

178

Tumors of astroglia

both benign and malignant - astrocytoma

179

Bone marrow tumors

malignant - leukemia

180

Term for disorganize mass growing around nerve tissue after trauma

neuroma

181

Term for hyperplastic mass of mature tissue as a result of anomalous development, normal to location but not a tumor

hamartoma

182

Term for non neoplastic normal mature tissue that do not occur normally at that site (dermoid)

chriostoma

183

What is a leiomyoma

smooth muscle tumor

184

What is the exception that benign tumors grow slowly?

papillomas, hormone dependent mammary tumors in bitch

185

What are the most important criteria for benign tumors?

rarely invade
never metastasize

186

How do tumors metastasize in body cavities?

implantation - through serous membrane

187

What is the "paranchyma" of tumor cells?

the actual neoplastic cells

188

What is the stroma made of in tumors?

supporting tissue - host derived, ct, bv

189

What does vessel leakiness allow in tumors?

deposition of fibrin network that promotes formation of collagenous tumor stroma

190

What causes angiogenesis near tumor cells?

angiogenic factors
hypoxia
glucocorticoids interfere with angiogenesis

191

What is the term for fibrous capsule around benign tumors?

fibroplasia

192

What are the non specific host defenses against a tumor

inflammatory (not very protective)
phagocytosis

193

What is a specific mechanism of host defense against tumor?

tumor antigens - antibodies and cytotoxic T lympphos

194

What are the 2 parts of the innate immune response against tumors?

natural killer cells
macrophages

195

What are the parts of adaptive antitumor response?

lymphocytes - CTLs and CD8 T lymphos
B Lymphocytes - ADCC

196

What does failure of immunosurveilance mean?

if humoral and adaptive immune response fail

197

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

198

What type of disease is cancer?

non lethal genetic damage

199

What are protooncogenes?

genes that promote cell grwoth

200

What antibodies are associated with type 2 hypersensitivity reactions?

IgG and IgM

201

What determines the extent of tissue damage in type 3 hypersensitivity?

size of immune complex
overload and intrinsc dysfunction of MPS

202

What bacteria genus is known to cause cancer?

Helicobacter spp

203

What parasite is known to cause cancer?

spirocerca lupi

204

What are the local effects of neoplasms?

compression, oobstruction, tissue damage, organ/tissue replacement

205

What are the systemic effects of tumors?

1. hormonal (indiginous)
2. hormonal - ectopic, (PTH from anal sac adenoma)

206

What is the term for how tumors suppress appetite,, and cause wasting

cancer cackexia

207

What are the molecules that can hide tumor antigens on the surface?

glycalyx, fibrin, or antibodies

208

What is the term for systemic complications of neoplasia that are remote from the primary tumor?

paraneoplastic conditions

209

What are the 2 paraneoplastic syndromes affecting metabolism?

hypercalcemia - lymphosarcoma, anal sac adenocarcinooma, multiple myeloma
hypoglycemia - insulinoma in dogs

210

What paraneoplastic syndrome affects bones?

hypertrophic (pulmonary) osteopathy

211

What are the 7 paraneoplastic syndromes affecting costituents of circulation?

Immunoglobulin production, altered coagulability, hyperheparinemia, neutrophilic leukocytosis, eosinophilia, anemia, polycythemia

212

What are the 2 paraneoplastic syndromes affecting neurologic system?

Peripheral nerve syndrome
mysthenia gravis

213

What are the 2 paraneoplastic syndromes affecting the skin?

Alopecia
nodular dermatofibrosis

214

What are the 2 important parts of histological diagnosis of tumors?

grading of tumor - differentiation
staging of tumor - indicates growth and spread

215

What are the 3 chemical mediators in vasodilation?

Nitric Oxide
Histamine
Protaglandins - PGD2

216

What 6 chemical mediators increase vascular permeability?

Leukotriens (LTB4)
Histamine
Complement factors - C5a, C3a
Prostaglandins - PGE2
Leukotriens - LTC4, LTD4, LTE4
Platelet activating factor

217

What are the 5 chemical mediators of leukocyte activation and chemotaxis?

Complement factors C5a
Leukotriens LTB4
Chemokines IL-8
Defensins
Bacterial products

218

What are the 4 chemical mediators of fever?

Cytokines IL1, IL6
TNF
PGE2

219

What are the 2 chemical mediators in nausea?

Cytokine IL-1
TNF

220

What are the 2 chemical mediators of pain?

Bradykinin
PGE2

221

What are the principal mediators of tissue damage?

Neutrophils
macrophages
reactive oxygen species