Types of Inflammation

Question 1

Important roles of inflammation

Answer 1

Delivery of phagocytes and proteins from blood to tissue, set up responses for healing and regeneration, enhanced macrophage activation for antigen presentation

Question 2

Role of Mast cells in inflammation

Answer 2

Release histamine on tissue injury

Question 3

Role of Tissue macrophages in inflammation

Answer 3

Release cytokines, particularly in response to infectious agents

Question 4

Role of endothelial cells in inflammation

Answer 4

Mediate responses between tissue and blood supply

Question 5

Role of parenchymal cells in inflammation

Answer 5

signal inflammation on death or injury

Question 6

Role of platelets in inflammation

Answer 6

Initiate inflammatory signals on activation

Question 7

Review the timeline

Answer 7

Page 3

Question 8

Steps in local vascular events

Answer 8

1. Activation of platelets
2. Vasodilation and increased blood flow
3. Stasis
4. Increased vascular permeability

Question 9

Causes of increase vascular permeability

Answer 9

Inc. hydrostatic pressure, Increased colloid osmotic forces, Activation of endothelial cells, Increased pinocytosis

Question 10

How to distinguish a transudate from an exudate

Answer 10

T – SG under 1.012, under 3% protein, minimal particulate matter
E – SG over 1.020, over 3 percent protein, lots of particulate.

Question 11

Source of immediate transient state of permeability of vessels? How to stop it?

Answer 11

Histamine, Bradykinin, Leukotrienes, Sub P

Block w/ anti-histamines

Question 12

Causes of delayed prolonged leakage?

Answer 12

Prostaglandins and Cytokine production

Question 13

In a clear way, mediators of increased vascular permeability, early, amplification, and maintenence

Answer 13

Early – Histamine, Serotonin
Amplification – Kinin, C3a, C5a (anaphylatoxins)
Maintenance – PGs and Interleukins

Question 14

Timeline for neutrophil and macrophage migration?

Answer 14

Neutrophils days 0-1

Macrophages afterward

Question 15

Steps in the emigration of leukocytes

Answer 15

Margination
Pavement/Adhesion
Transmigration
Chemotaxis

Question 16

What happens in margination

Answer 16

As blood slows, cells move to periphery of the vessel

Question 17

Weak adhesion is caused by interactions between…

Answer 17

Selectins and surface carbohydrates

Question 18

Firm adherance is facilitated by binding of…

Answer 18

endotheliam CAMS with integrins of invading cells

Question 19

Examples of selectins

Answer 19

P-selectin, E selectin

Question 20

Examples of Integrins used in binding

Answer 20

ICAM-LFA1 Integrin (PMN)

VCAM - VLA4 integrin (monocyte)

Question 21

Which adhesion molecules facilitate adhesion

Answer 21

PECAM-1 or CD31

Question 22

____ and ____ are major chemotactic factors for neutrophils

Answer 22

Leukotriene B4 and IL-8

Question 23

In inflamm response – what time should you see PMNs

Answer 23

12-72 hours

Question 24

In inflamm response – what time should you see Mphages.

Answer 24

48+ hours

Question 25

In inflamm response -- what time should you see lymphocytes?

Answer 25

72+ hours

Question 26

Chronic inflammation occurs when..

Answer 26

Persistence of infection Inability to neutralize a toxin Continuos physical injury Persistence of an immune response

Question 27

E selectin expression is stimulated by ____ for what time frame?

Answer 27

IL-1 | Peaks at 4 hours, reversed by 24

Question 28

VCAM expression is enhanced by...

Answer 28

IL-1, TNF, GM-CSF

Question 29

What is serous inflammation?

Answer 29

Extracellular fluid from blood serum associated with mild injury Example -- Blister

Question 30

Difference between fibrinous and fibrosis

Answer 30

Fibrinous -- Fibrin | Fibrosis -- Collagen

Question 31

In a granuloma, macrophages activate T cells with...

Answer 31

IL1, IL12, antigen presentation

Question 32

In a granuloma, what do activated TH1 cells do?

Answer 32

Secrete IFNg, activate macrophages, epithelioid macrophages, multinucleated giant cells

Question 33

What are epithelioid macrophages?

Answer 33

large activated mps, increased phagocytosis, metabolism, and lysosomal enzymes.

Question 34

Two types of giant cells and how to distinguish

Answer 34

Langerhans -- nuc at periphery, immune type granulomas | Foreign body -- nuc at center of cell, response to foreign.

Question 35

What are ulcers?

Answer 35

Local excavation/defect in mucosal surface produced by sloughing of necrotic epithelium

Question 36

Differences seen in acute and chronic ulcers?

Answer 36

Acute -- PMNs, congested BV at margins | Chronic -- Lymphocytes, mps, fibrous connective tissue at base

Question 37

Difference between erosions and ulcers

Answer 37

Erosions -- Superficial only, usually only acute/subacu. | Ulcers -- Loss of mucosal layers to muscularis, ALWAYS assocaited with surrounding chronic inflamm. fibrosis

Question 38

Which types of inflammation are primarily acute? chronic? both?

Answer 38

Acute -- Serous, Suppurative Chronic -- Lymphocytic, Granulomatous Both -- Fibrinous