Systemic features of inflammation chronic inflammation Flashcards
(40 cards)
Fever
hypothalamic thermoregulatory center
- preoptic area of hypothalamus
- “set point”
regulation of temperature
thermoreceptors monitor temperature
-increase in heat loss/conservation of heat/increase in heat production
Nonpyrogenic hyperthermia
NOT fever, overcome bodies ability to keep set point, and body temperature goes up
-physiological mechanism unable to increase heat loss sufficiently to offset increased temperature
what cause non-pyrogenic hyperthermia
high environmental temperature
increased heat production
exercise/seizures/metabolic diseases
malfunctioning regulatory centers (CNS lesions)
Pyrogenic hyperthermia
changes in thermoregulatory set point
causes of Pyrogenic hyperthermia
toxins from bacteria such as endotoxin inflammation immune responses cancer some pharmocological agents
what stimulates a fever?
- stimulation of macrophages by exposure to endotoxin, viruses, inflammation or lymphocyte products
- production of “endogenous pyrogens” from mononuclear cells (monocytes, macrophages, Kupfer cells) IL1/6 TNF
how do endogenous factors start a fever?
endogenous pyrogens (IL-1/6/TNF)-> enter the brain and act directly on hypothalamus to cause local production of PG’s by COX-3-> physiological conservation of heat to raise temperature set point
adverse affects of having a fever?
inactivity, chills, sweats, anorexia, discomfort, seizures
Lymphadenitis
inflammatory mediators, debris and infectious organisms drain into local and regional lymph nodes-> cause hyperplasia of lymph nodes and cause stimulation of immune system
- lymph nodes are tender, not hard and squeeze-able
- inflammation of lymphatic channels-> red streaks
difference between lymphoma and lymphadenitis?
in lymphoma-> lymph nodes are NOT tender and very hard
what are acute phase proteins?
proteins in which appear in plasma early in the inflammation
(not normally present or in small amounts)
-inflammation-> IL-1/6/TNF signal liver to increase production of plasma proteins by liver
positive acute phase proteins?
complement proteins, coagulation, proteases, metal-binding proteins, other proteins
negative acute phase proteins?
albumin
C-reactive protein
is an acute phase protein
- binds surface of cells (Mac, Platelets, and lymphocytes) and results in increased binding of complement proteins/bacteria
- activates alternate complement pathway
what does C-reactive protein indicate?
chronic inflammation
-measures degree of inflammation
serum amyloid A
may be involved in secondary amyloidosis which occurs with chronic disease
with inflammation, why does increased erythrocyte sedimentation rate occur?
red cells fall more quickly with settling of blood due to present of increased fibrinogen as an acute phase protein
-indicator of chronic inflammation
Leukocytosis
release of white cells from marginated pools-> WBC get trapped in places with sinusoids-> spleen and liver (marginated pools)
- requires just a few hours
- primarily released from marginated pool, then released from BM
accompanying an infection, WBC count goes up or down?
Up, increased production of leukocytes
what do IL-1/6/TNF induce early on in leukocytosis?
first induce early release of cell from BM-> early forms of neurtrophils “bands” may be present
- increased synthesis due to CSF released from M and Lymphocytes
- 2-3 fold increase in 72 hours
normal and abnormal Neutrophil values
N: 40-80%, A: < 1,500; >8,000
normal and abnormal band values
0-5%, A: > 5% or 500
normal and abnormal lymphocytes values
N: 15-50%, A: < 1,500, > 5,000
