05a: Acute Inflammation

Question 1

Time frame of acute inflammation.

Answer 1

Few minutes/hours (resolves within few days)

Question 2

List the leukocytes (from most to least numerous) and star the type that’s hallmark of acute inflammation.

Answer 2

1. Neutrophils*
2. Lymphocytes
3. Monocytes
4. Eosinophils
5. Basophils

Question 3

Normal WBC count.

Answer 3

4,000-11,000/microL blood

Question 4

Which WBC types are granulocytes?

Answer 4

Neutrophils, eosinophils, basophils

Question 5

Neutrophils have (short/long) half-life in blood and (can/cannot) recirculate back into blood after entering tissue site.

Answer 5

Short; cannot

Question 6

Histologically, what’s the sign of inflamed tissue?

Answer 6

Leukocytes present where they’re not normally found

Question 7

(X) leukocyte changes name when it leaves blood and enters peripheral tissues. What are some special names, based on location, for this cell type?

Answer 7

X = monocyte;
(Macrophage in tissue)

Microglia in CNS, Kupffer cell in liver

Question 8

List the four cardinal signs of acute inflammation.

Answer 8

1. Rubor (redness)
2. Tumor (swelling)
3. Calor (heat)
4. Dolor (pain)

Question 9

List the three steps of acute inflammation.

Answer 9

1. Hyperemia (blood vessel dilation)
2. Increased vascular permeability
3. Emigration, accumulation, activation of leukocytes

Question 10

List mediators that increase blood flow in acute inflammation.

Answer 10

1. Vasoactive amines (His, SA)
2. Arachidonic acid metabolites
3. NO
4. PAF (Platelet activating factor)
5. Bradykinin

Question 11

Acute inflammation: (X) are the earliest mediators of hyperemia. Where do they come from?

Answer 11

X = Vasoactive amines (His and SA)

Mast cells and Platelets (pre-formed in cytoplasmic granules)

Question 12

List stimuli for His release from mast cells.

Answer 12

1. Trauma/heat
2. Ab binding
3. C3a, C5a (anaphylatoxins)
4. Neuropeptides (substance P)
5. Cytokines (IL-1, 8)

Question 13

Metabolites of arachidonic acid fall into which categories? Star those that are products of cyclooxygenase pathway.

Answer 13

1. Prostaglandins*
2. Leukotrienes
3. Lipoxins

Question 14

Formation of arachidonic acid from (X) is carried out by (Y). This step is known to be inhibited by (Z).

Answer 14

X = membrane phospholipids
Y = phospholipases
Z = glucocorticoids

Question 15

List products of the cyclooxygenase pathway that are important in inflammation. What’s the role of each?

Answer 15

1. Prostaglandins (vasodilation)
2. Prostacyclins (vasodilation)
3. Thromboxane (vasoconstriction, platelet aggregation)

Question 16

PAF (Platelet activating factor) derived from (X) and is produced by:

Answer 16

X = phospholipids

1. Leukocytes
2. Endothelial and mast cells
3. Platelets

Question 17

PAF main effect is (X). It also causes (vasoconstriction/vasodilation) and low levels and the opposite at high.

Answer 17

X = Platelet aggregation/activation

Vasodilation

Question 18

NO synthesized from (X) by (Y) enzyme. List its effects.

Answer 18

X = L-Arg and oxygen
Y = NO synthase

1. Vasodilation
2. Inhibits cell components (platelet aggr, WBC recruitment)
3. Microbicidal (destructive to microorganisms)

Question 19

iNOS stands for (X), found in (Y) cell types. What does the “i” indicate?

Answer 19

X = inducible NO synthase
Y = macrophages and endothelial

Inducible by cytokines and bacterial breakdown products

Question 20

Bradykinin formed by the proteolytic action of which enzymes?

Answer 20

1. Factor XIIa (forms Kallikrein)

2. Kallikrein (forms Bradykinin)

Question 21

List the actions of Bradykinin.

Answer 21

1. Vasodilation
2. Increased vascular permeability
3. Contraction of nonvascular smooth muscle
4. Pain

Question 22

Transudate has specific gravity (lower/higher) than (X) and exudate (lower/higher) than (X).

Answer 22

Lower;
X = 1.015
Higher

Question 23

Presence of (transudate/exudate) implies that (X) is generally intact and (Y) cannot pass through.

Answer 23

Transudate;
X = endothelial barrier
Y = plasma proteins

Question 24

T/F: Transudate, to a small degree, occurs normally across capillary beds.

Answer 24

True

Question 25

T/F: Transudate has low content of both cells and protein.

Answer 25

True

Question 26

Edema is accumulation of fluid in (X) and is (transudate/exudate).

Answer 26

X = tissue interstitium | Either

Question 27

Effusion is escape of fluid into (X) and is (transudate/exudate).

Answer 27

X = defined (sealed) body cavity | Either

Question 28

(X) exudate contains few cells and is more clear than cloudy. Its presence suggests (Y) injury.

Answer 28

``` X = serous; Y = mild vascular ```

Question 29

(X) exudate is pus; contains large concentration of (Y) cells.

Answer 29

``` X = Purulent Y = inflammatory (esp neutrophils) ```

Question 30

(X) exudate contains RBC, implying (Y) injury/damage.

Answer 30

``` X = hemorrhagic Y = capillary ```

Question 31

(X) exudate has a white layer of (Y) typically deposited on (Z) surfaces.

Answer 31

``` X = fibrinous Y = fibrin Z = serosal (i.e. pleural, pericardial) ```

Question 32

"Bread and Butter" pericarditis gets its name from:

Answer 32

Fibrinous exudate deposited on pericardium

Question 33

List steps of leukocyte recruitment to tissues.

Answer 33

1. Margination 2. Rolling 3. Tight adhesion 4. Migration (across vessel wall)

Question 34

Leukocyte transmigration occurs most prominently in (X) vessels and, to lesser extent, (Y) vessels.

Answer 34

``` X = post-cap venules Y = capillaries ```

Question 35

T/F: Leukocyte transmigration occurs in venules, cap's and arterioles, but not larger vessels.

Answer 35

False - only venules and cap's

Question 36

Vascular leak of plasma proteins is beneficial for which reasons?

Answer 36

Plasma protiens kill invading pathogens and remove necrotic tissue

Question 37

Transmigration of leukocytes: what's the function of margination?

Answer 37

Cells move to bloodstream margin to come into contact with vascular wall

Question 38

Transmigration of leukocytes: initial adherence of cells to endothelium is mediated by (X) receptors on (leukocyte/endothelium).

Answer 38

X = selectin | Endothelium

Question 39

Transmigration of leukocytes: tight adhesion of cells to endothelium is mediated by (X) receptors on (leukocyte/endothelium).

Answer 39

X = integrin | Leukocyte

Question 40

Key points: Inflammation: Principal mediators of vasodilation.

Answer 40

His and prostaglandins

Question 41

Key points: Inflammation: Principal mediators of increased vascular permeability.

Answer 41

1. His, SA 2. C3a, C5a 3. Leukotrienes (C4, D4, E4)

Question 42

Key points: Inflammation: Principal mediators of chemotaxis/recruitment/activation.

Answer 42

1. TNF, IL-1 2. Chemokines 3. C3a, C5a 4. LTB4

Question 43

Key points: Inflammation: Principal mediators of fever.

Answer 43

1. TNF, IL-1, IL-6 | 2. Prostaglandins

Question 44

Key points: Inflammation: Principal mediators of pain.

Answer 44

Bradykinin and Prostaglandins

Question 45

Key points: Inflammation: Principal mediators of tissue damage.

Answer 45

Lysosomal enzymes and ROS

Question 46

List the systemic effects (signs) of acute inflammation.

Answer 46

1. Fever 2. Tachycardia 3. Tachypnea 4. Leukocytosis 5. Acute Phase Reactants

Question 47

Major sources of endogenous pyrognes are (X), released from (Y) cells.

Answer 47

``` X = cytokines (IL-1, 6, TNF-alpa) Y = macrophages ```

Question 48

Neutrophil extracellular nets: composed of (X) that contain (Y).

Answer 48

``` X = chromatin strands Y = antimicrobial peptides ```

Question 49

Neutrophils use which tools/methods to carry out intracellular killing of bacteria?

Answer 49

1. Phagocytosis 2. Phagolysosome 3. Proteases 4. ROS and RNS

Question 50

Tissue injury during acute inflammation is damage done by:

Answer 50

Release of ROS and proteases and/or inappropriate coagulation