1: Inflammation And Repair

Question 1

Inflammation

Answer 1

A protective response of vascularized tissue to infection and damage that brings cells/moleucles from circulation to sites in tissues where theyre needed to eliminate offending agent

Question 2

Types of immunity related to acute vs chronic inflammation

Answer 2

Acute: innate immunity
Chronic: adaptive immunity

Question 3

Two ways chronic inflammation can arise

Answer 3

From acute inflammation or de novo

Question 4

One of the most prominent manifestations of acute-phase response

Answer 4

Fever

Question 5

Acute phase reactants

Answer 5

Plasma proteins synthesized in liver whose concentrations may increase several hundred-fold due to inflammation

Question 6

Erythrocytes sedimentation rate test

Answer 6

A non-specific test for inflammation - fast sedimentation rate = more likely inflammation is present

Question 7

Secondary amyloidosis deposition in tissues is caused by what?

Answer 7

Prolonged serum AA protein production in chronic inflammation

Question 8

Leukemoid reactions

Answer 8

When leukocytosis reaches extreme levels of 40,000-100,000 cells/mL, similar to what is seen in leukemia

Question 9

High blood levels of cytokines can cause what clinical manifestations?

Answer 9

Disseminated coagulation, hypotensive shock, metabolic disturbances (like insulin resistance) -> this triad is called septic shock

Question 10

What cells are most present in bacterial vs viral vs allergy/parasite infections?

Answer 10

Bacteria: neutrophils
Viral: lymphocytes
Allergy/parasites: eosinophils

Question 11

Leukopenia

Answer 11

Decreased WBCs

Question 12

Exudate vs transudate

Answer 12

Exudate: fluid + high protein, some cells
Transudate: fluid only

Question 13

Condition where transudate may be made instead of exudate

Answer 13

CHF

Question 14

2 cells that produce prostaglandins and leukotrienes

Answer 14

Mast cells + leukocytes

Question 15

What organ produces complement and kinin proteins?

Answer 15

Liver

Question 16

What mostly causes heat and erythema of an inflamed site?

Answer 16

Histamine

Question 17

Stasis

Answer 17

Slowly moving blood

Question 18

Which are longer lived in tissue, neutrophils or macrophages

Answer 18

Macrophages

Question 19

What are lysosomal enzymes tagged with upon synthesis? And why

Answer 19

M6P -> know to deliver to lysosome

Question 20

Antiproteases and the most common example

Answer 20

Control proteases from causing too much damage; a1-antitrypsin

Question 21

Toxic granulation

Answer 21

Changes in Granulocytes where dark, course granules appear on blood smear

Question 22

What condition is toxic granulation commonly seen in?

Answer 22

Sepsis

Question 23

NETs

Answer 23

Extracellular fibrillar networks that provide antimicrobial substances + prevent spread of microbes by trapping them

Question 24

What happens to neutrophils in the process of forming NETs?

Answer 24

Lose nuclei -> death

Question 25

What occurs in the absence of Th17 cells?

Answer 25

Individuals are susceptible to fungal and bacterial infections

Question 26

How do antihistamine drugs work?

Answer 26

Block histamine receptor on endothelium

Question 27

TNF antagonists are used to treat which diseases?

Answer 27

RA, psoriasis, IBD

Question 28

Complication of TNF antagonist therapy

Answer 28

Pts become susceptible to mycobacterium infection

Question 29

How are DAF and CD59 related?

Answer 29

Are both linked to plasma membrane by a GPI anchor

Question 30

Fibrin

Answer 30

A protein involved in blood clotting, formed by thrombin cleaving fibrinogen into fibrin

Question 31

Some settings that may cause chronic inflammation

Answer 31

Persistent infection, hypersensitivity diseases, prolonged exposure to toxic agents

Question 32

6 Specialized tissue macrophages and where theyre found

Answer 32

1. Monocytes: in blood 2. Kupffer cells: liver 3. Sinus histiocytes: spleen and LNs 4. microglial cells: CNS 5. Alveolar macrophages: lungs 6. Langerhans cells: skin

Question 33

Permanent tissues

Answer 33

Terminally differentiated and non-proliferative (neurons and cardiac muscle cells)

Question 34

TGF-a function

Answer 34

Hepatocyte proliferation (and other epithelial cells)

Question 35

Steps of angiogenesis

Answer 35

1. Vasodilation due to NO and VEGF 2. Separation of perictyes from lumen to allow vessel sprout 3. Migration of endothelium towards injury 4. Prolif of endo cells at the tip 5. Remodeling into cap tubes 6. Periendothelial cell recruitment to form mature vessel 7. Suppression of endothelial proliferation

Question 36

Three mediators that orchestrate laying down CT in healing

Answer 36

PDGF, FGF-2, TGF-B

Question 37

What type of leukocyte is most helpful in laying down CT for healing?

Answer 37

M2 macrophages

Question 38

MMP function

Answer 38

Degrade collagens and other ECM components to maintain a balance between synthesis and degradation

Question 39

Most important cytokine for synthesis and degradation of CT proteins

Answer 39

TGF-B

Question 40

TIMPs

Answer 40

Tissue inhibitors of metalloproteinases - inhibit MMPs

Question 41

Things that can affect how well the healing process goes

Answer 41

Infection, DM, nutrition, glucocorticoids, poor perfusion, FBs, extent and location of injury

Question 42

Organs that can be affected by fibrosis which can lead to organ failure

Answer 42

Liver, eye, long, GI, heart, skin

Question 43

Venous leg ulcers

Answer 43

Develop in elderly people due to venous HTN, due to varicose veins or CHF

Question 44

Arterial ulcers

Answer 44

In individuals with atherosclerosis of peripheral arteries, associated with DM

Question 45

Pressure sores

Answer 45

Skin ulceration and necrosis due to prolonged compression of tissue against bone

Question 46

Wound dehiscence

Answer 46

When a wound splits and does not properly heal - causes higher morbidity and mortality post surgery

Question 47

Hypertrophic scar

Answer 47

Scar formed with excess collagen -> raised scar

Question 48

Keloid

Answer 48

Scar tissue that grows beyond boundaries of the original wound and does not regress