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Pathology of inflammation Flashcards

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1
Q

List 5 different types of injury that can cause inflammation

A
  1. Infection
  2. Trauma, radiation
  3. Chemical injury
  4. Autoimmunity
  5. Tumors
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2
Q

Inflammation is a ________ response to eliminate ________ and _____

A
  1. Protective
  2. Infections
  3. Debris
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3
Q

Inflammation sets the stage for ____ and ______

A
  1. Healing

2. Wound repair

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4
Q

T/F Inflammation causes further damage

A

True

*Particularly if severe or persistent

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5
Q

What are the 3 main patterns of inflammation?

A
  1. Acute
  2. Chronic
  3. Granulomatous

*Mixtures of these three are common

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6
Q

Acute inflammation begins almost immediately and lasts ___ to _____

A
  1. Minutes

2. Days

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7
Q

What are the main cells involved in acute inflammation?

A
  1. Neutrophils
  2. Vessels
  3. Mast cells
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8
Q

Chronic inflammation begins at least ______ later

A

6 hours (to days)

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9
Q

What are the major cells involved in chronic inflammation?

A
  1. Lymphocytes
  2. Macrophages
  3. +/- plasma cells
  4. Fibroblasts and new vessels in tissue repair
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10
Q

What is granulomatous inflammation?

A

Variant of chronic inflammation

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11
Q

What are the main cells involved in Granulomatous inflammation?

A

Aggretates of epithelioid histiocytes/macrophages, giant cells, and lymphocytes

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12
Q

Which type of inflammation is mediated by increased vascular permeability resulting in a protein-rich exudate in the tissue?

A

Acute

*According to the notes in his slide

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13
Q

Which clinical signs of inflammation are due to leaky small blood vessels?

A
  1. Rubor
  2. Tumor
  3. Calor
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14
Q

Which Clinical signs of inflammation are due to PgE2, Bradykinin, Substance P?

A

Dolor

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15
Q

Which clinical signs of inflammation are due to pain and tissue damage?

A

Loss of function

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16
Q

In inflammation, small vessels, especially venules, develop _______ and ________

A
  1. Endothelial cell retraction
  2. Pinocytosis

*Plasma seeps through the gaps

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17
Q

The plasma that seeps through the gaps in inflammation can form two types of fluid. What are they?

A
  1. Exudate

2. Transudate

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18
Q

Describe Exudate

A
  1. Fluid rich in proteins (Ig, clotting factors, complement, etc.)
  2. Specific gravity > 1.015
  3. Protein content > 1/2 that of plasma
  4. LDH >163 IU/L
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19
Q

Describe Transudate

A
  1. Lower specific gravity than exudate
  2. Lower protein
  3. Lower LDH
  4. From hemodynamic problems
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20
Q

T/F Vessels also recruit inflammatory cells to the site

A

True

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21
Q

What are 4 laboratory signs of inflammation involving WBC?

A
  1. Leukocytosis with neutrophilia
  2. Leukocytosis with lymphocytosis
  3. Eosinophilia
  4. Thrombocytosis or thrombocytopenia
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22
Q

Leukocytosis with neutrophilia would mainly be seen under what cirucumstances?

A
  1. Acute inflammation
  2. Think bacterial infection
    • Neutrophils can be depleted by severe infections
    • Look for band form neutrophils too
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23
Q

Leukocytosis with lymphocytosis would mainly be seen under what circumstances?

A
  1. Chronic inflammation

- Think viral infection

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24
Q

Eosinophilia would mainly be seen under what circumstances?

A
  1. Parasitic infection
  2. Autoimmune
  3. Asthma/allergic
    • Type II response
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25
T/F >10% bands indicate inflammation.
True *Bandemia
26
T/F Increased sedimentation rate is a laboratory sign of inflammation
True
27
What are 4 things associated with Increased sedimentation rate?
1. Increased plasma fibrinogen, red cells clump, sink faster 2. Fibrinogen is an acute phase reactant made in the liver 3. Nonspecific disease indicator (Infections, autoimmune, tumor) 4. Also an index of activity of a known disease
28
How many mm will red cells sink in one hour in a vertical capillary tube?
Normally <20mm
29
Name 3 other acute phase reactants
1. CRP (C-reactive protein) 2. Procalcitonin (a calcitonin precursor) 3. Other acute phase reactants * SAA (Serum amyloid A protein) * Ceruloplasmin (Copper binding protein)
30
What are 3 things associated with CRP as an acute phase reactant?
a) Becomes abnormal faster than sedimentation rate b) Can increase up to 1,000 fold c) Mild increases in otherwise healthy subjects
31
What are 2 things involved with Procalcitonin as an acute phase reactant?
i. Largely specific or bacterial infection | ii. Can help determine if antibiotics are needed
32
Vasodilation and edema are a result of what?
Vascular changes in inflammation
33
T/F In Vascular changes in inflammation there can be multiple receptors and patterns of response--Immediate vs. delayed
True
34
Vascular changes allow _______ to enter the tissue
inflammatory cells
35
On a macroscopic level, vasodilation causes __________
Erythema
36
What is pulmonary edema?
Fluid in alveolar spaces *Transudate, fluid does not have a lot of protein
37
T/F If you see a plumonary edema with transudate, that is a good indication of inflammation
False, it would be from oncotic or hemodynamic problems, NOT an indication of inflammation
38
What does ARDS stand for and is it a good indication of inflammation?
Acute/adult Respiratory Distress Syndrome * Involves exudate (fluid plus plasma proteins) * This IS an indication of inflammation and injury
39
T/F In ARDS, hyaline membranes are formed
True
40
Mast cells are _______ cells and are often coated with _______
1. Tissue resident | 2. IgE
41
Lymphocytes induce _______ , ______ immunity
1. Chronic | 2. Acquired
42
What are the two major types of lymphocytes?
B and T
43
What is the general function of B cells?
- Make antibody | - Can become plasma cells
44
What are T cells for?
- They direct Chronic immune response. | - There are multiple types
45
Which T cells are for Fungal, mycobacterial, and other infections?
CD4 TH1
46
Which T cells are for parasitic infections and allergies?
CD4 TH2
47
Which T cells are for ongoing neutrophil infiltrates?
TH17
48
Which T cells are involved in direct cytotoxicity and fighting viral infections?
CD8
49
T/F Lymphoctes have a short life span and are seen at limited sites in the body
False, *Can be long lived, present in many sites (esp. lymph nodes, spleen, thyus, and mucosal sites)
50
Give a brief definition of plasma cells and their histological description
1. Differentiated B cells: make immunoglobulin Histologically: * Eccentric, round, clock-faced nuclei * Abundant pink to blue-tinged cytoplasm
51
Which cell involved in Chronic inflammation can also be called a Histiocyte?
Macrophage
52
A granuloma is a cluster of epithelioid _________
Macrophages *Abundant pink cytoplasm, back to back, +/- giant cells
53
What is the main precursor in the blood for macrophages?
Monocytes
54
Name some organs in which a macrphage might reside?
1. Liver 2. Lymph nodes 3. Spleen 4. Lung 5. Intestine 6. Marrow
55
T/F Granulomas can calcify
True *Calcification often develops in an area of necrosis
56
Type II immune responses are in reaction to what?
To parasites and allergies or allergic-like diseases
57
What cells are associated with Type II immune responses?
1. Th2 Lymphocytes 2. Eosinophils 3. Mast cells 4. Basophils
58
Eosinophils respond to _____, _____, and ____
1. IgE 2. Mast Cells 3. TH2 Lymphocytes
59
Eosinophils are prominent in response to _______ infection
parasitic
60
Eosinophils are also involved in pathologic effects in allergic diseases like _______
asthma
61
What is the rarest type of blood cell (0-2% of WBC) and also rare in tissue?
Basophils
62
What does a basophil look like histologically?
Deeply basophilic (blue) granules
63
Like mast cells, Basophils are _____ coated, and involved in ______ and responses to ______
1. IgE coated 2. Alleregies 3. Parasitic infection
64
What type of inflammation would be present in Appendicitis?
Acute inflammation

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