1.2.3 Arthritis and Systemic Inflammation Flashcards
Which of the following substances are most likely to be recognized by toll-like receptors?
A. Antibodies
B. C5a
C. Chemokines
D. HIV gag peptide
E. Lipopolysaccharide
E. LPS
Which of the following molecules is an acute phase reactant?
A. Antibody
B. C-reactive protein
C. IFN-I
D. NKG2D
E. TLR5
B. C-reactive protein
(Acute phase reactants are produced in the liver)
What does ESR stand for? What does it measure?
Eryrthrocyte sedimentation rate; Rate at which RBCs settle in a westergren tube (rate increased by acute phase reactants)
What does CRP stand for?
C-reactive protein
CRP and ESR are both tested to do the presence of what?
Inflammation
Compare the sensitivity/specificity of CRP and ESR in low-grade inflammation.
ESR: More specific, less sensitive
CRP: More sensitive, less specific
Which test is susceptible to alterations in the size/shape/# of RBCs?
ESR
Describe when in the inflammation process would ESR or CRP be the test of choice.
CRP: up to 7 days
ESR: after 7 days

Release of which of the following molecules is most directly responsible for the continued low blood pressure?
A. ICAM-1
B. IFN-I
C. IL-1
D. IL-12
E. TNFα
E. TNFα
(IL-1, according to Dr. Yankee, is mainly involved in traveling to the brain and affecting temperature regulation)
In the example of the elderly woman with a hip replacement, what is the pathway of progression of her infection throughout her body?
Cold -> Lungs -> Systemic -> Hip
What types of signals are recognized by PRRs?
PAMPs and DAMPs
What are some examples of cells that contain PRRs?
Neutrophils, Macrophages, and Dendritic Cells
What is the specialty of macrophages (me)?
Cytokine production - danger signaling
What are some of the cytokines produced by macrophages?
IL-1, TNF-alpha, IL-6
What are two of the effects of TNF-alpha and IL-6?
Vasodilation (endothelial cells) and stimulation of liver to produce acute phase reactants.
What the 4 clinical manifestations of SIRS (systematic inflammatory response syndrome)?
Temp under 36 C or fever above 38 C
HR: over 90 beats/min
RR over 20 or aterial CO2 tension less than 32mm Hg
Abnormal WBC (high or low)
[Can be infectious or non-infectious in origin]
What is sepsis?
Systematic response to infection; It has all the same clinical manifestations as SIRS along with documented/presumed infection, associated w/ organ dysfunction, hypoperfusion or hypotension
What is septic shock?
Sepsis-induced hypotension
Persistent hypotension and perfusion abnormalities despite adequate fluid resuscitation, caused by high levels of TNF-alpha