1G Foundations 7 - Inflammation Flashcards

1
Q

What are the characteristics of a cell undergoing apoptosis?

A
  • Cellular shrinkage
  • Nuclear shrinkage (pyknosis)
  • Karyolysis (fading of the nucleus)
  • Apoptotic bodies
  • Membrane blebbing
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2
Q

What are some of the substances that can trigger apoptosis?

A
  • Deprivation of cell signals (growth factors)
  • Cell stress
  • DNA repair process fails –> triggers apoptosis
  • Cytokines (TNF)
  • Cytotoxic T cells can insert Granzyme B into cells
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3
Q

What neural crest derivatives are found in this adult structure? PNS

A
  • ANS
  • Dorsal root ganglia
  • CNs
  • Schwann cells
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4
Q

What neural crest derivatives are found in this adult structure? Ear

A

Bones of the middle ear

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5
Q

What neural crest derivatives are found in this adult structure? Eye

A

Structures of the anterior chamber

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6
Q

What neural crest derivatives are found in this adult structure? Adrenal gland

A

Chromaffin cells in medulla

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7
Q

What neural crest derivatives are found in this adult structure? Mouth

A

Odontoblasts

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8
Q

What neural crest derivatives are found in this adult structure? Heart

A

Aorticopulmonary septum (spiral septum)

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9
Q

What neural crest derivatives are found in this adult structure? Digestive system

A
  • Enteric nervous system
  • Celiac ganglion
  • Enterochromaffin cells
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10
Q

What neural crest derivatives are found in this adult structure? Thyroid

A

Parafollicular cells (C cells)

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11
Q

What neural crest derivatives are found in this adult structure? Skin

A

Melanocytes

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12
Q

Inflammation is characterized by?

A
  • Rubor
  • Dolor
  • Calor
  • Tumor
  • Functio laesa
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13
Q

Acute inflammation: Release of which inflammatory mediators?

A
  • IL-1
  • IL-6
  • TNF-alpha
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14
Q

Acute inflammation: Vasodilation and increased vascular permeability fluid exudation is mediated by?

A
  • Histamine
  • Serotonin
  • Bradykinin
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15
Q

Acute inflammation: Fibrosis. Fibroblasts lay down BLANK and requires BLANK

A

Collagen, vitamin C

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16
Q

Acute inflammation: Tissue remodelling by BLANK which contain BLANK

A

Metalloproteinases, Zinc

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17
Q

Intermediary stage in wound healing. Occurs 3-5 days into the healing process?

A

Granulation tissue

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18
Q

Fibrotic shell that seals inflammatory process off. (body considers this as a success outcome)

A

Abcess

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19
Q

Acute inflammation is mainly mediated by which cell type?

A

Neutrophils

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20
Q

Chronic inflammation is mainly mediated by whuich cell type?

A

Mononuclear cells (like macrophages and lymphocytes)

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21
Q

Multi nucleated giant cells are what?

A

Several macrophages that have connected their plasma membranes and cytoplasms to create one cell

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22
Q

What is a granuloma

A

Nodule of macrophages found in chronically inflamed tissue

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23
Q

Chronically inflamed tissue is characterized by which two processes?

A

Ongoing cycles of tissue damage and tissue repair

24
Q

Meaning of the word extravasation

A

something is leaving the circulation to enter a tissue

25
What cells can be involved in leukocyte extravasation?
- Neutrophils - Polymorphonuclear cells (PMNs) - Granulocytes - Monocytes - Certain types of T-cells
26
Steps in leukocyte extravasation. What's the role of E- and P-selectin?
They are expressed on endothelial cells lining the inside of vasculature and adhere to leukocytes
27
Outcomes of chronic inflammation?
Scarring and Amyloidosis
28
Steps in leukocyte extravasation. Where can you find L-selectin?
On leukocytes
29
Steps in leukocyte extravasation. How is expression of selectins triggered in the endothelium?
By acute-phase cytokines - IL-1 - IL-6 - TNF-alpha
30
Steps in leukocyte extravasation. Tight binding. Surface receptor involved?
ICAM-1
31
Steps in leukocyte extravasation. Tight binding. Leukocyte protein involved?
LFA-1 (an integrin)
32
Steps in leukocyte extravasation. Diapedesis, what is it?
Leukocyte travels between endothelial cells and exits blood vessel
33
Steps in leukocyte extravasation. Diapedesis. Protein involved?
PECAM-1 (on the intercellular junctions between endothelial cells) -Also found on Neutrophils, Monocytes, platelets)
34
Steps in leukocyte extravasation. Migration-inducing signals?
- Chemotactic signals | - Neutrophil chemotactic factors: C5a, IL-8, LTB4, Kallikrein
35
Binding, diapedesis and migration is enhanced by?
Platelet activating factor
36
Leukocyte adhesion deficiency syndrome is characterised by?
- Abnormal integrin molecules - Delayed separation of the umbilicus - Recurrent bacterial infections
37
Describe transudate
- Mostly water - Decreased cells - Decreased protein - Low specific gravity due to: - Increased hydrostatic pressure - Decreased oncotic pressure
38
Describe exudate
- Rich in proteins and cells - Inflammatory cells due to: - Lymphatic obstruction - Inflammation
39
List the three basic forms of inflammation
- Serous - Fibrinous - Suppurative
40
Feature of serous inflammation
Transudate
41
Feature of fibrinous inflammation
Exudate
42
Feature of suppurative (purulent) inflammation
Pus
43
Granuloma?
-Collection of macrophages that make TNF-alpha -- > maintains granuloma
44
What does Infliximab block?
TNF-alpha
45
What does blocking of TNF-alpha lead to (in a granuloma context)?
Breakdown of granuloma
46
Why do you have to be careful before giving anti-TNF-alpha drugs?
It might breakdown latent granulomatous abcesses (i.e. TB) leading to disseminated disease
47
Name granulomatous diseases
- Mycobacterium Tuberculosis (caseating) - Fungal infections (blastomycosis, histoplasmosis, coccidiomycosis) - Sarcoidosis - Granulomatosis with polyangiitis (Wegener's) - Berylliosis (people who work in Beryllium mines get this) - Treponema Pallidum (syphilis) - M. leprae (leprosy) - Bartonella henselae (cat scratch disease) - Crohn's disease - Churg-Strauss syndrome - Silicosis - Listeria - Chronic granulomatous disease - Foreign bodies
48
Is ESR high or low in inflammation?
- Higher (products of inflammation e.g. fibrinogen coat RBC's --> aggregation --> They fall faster) - It's very non-specific
49
Potential causes of elevated ESR ("sed rate")
- Polymyalgia rheumatica - Temporal arteritis - Disease activity in RA and SLE - Infection, inflammation (e.g. osteomyelitis) - Malignancy - Pregnancy
50
How can we classify C-Reactive Protein?
- Acute phase protein synthesised in the liver - Part of the innate immune system - An opsonin as it binds to microbial surfaces (opsonizes and activates complement)
51
Acute phase proteins? | activated during acute inflammation
- ESR - CRP - Fibrinogen - Ferritin
52
In active inflammation you can see?
(Factors mediated by cytokines, non-specific) - Elevated ESR - Elevated CRP - Fever - Leukocytosis - Elevated HR and BP
53
Information about CRP
- Can be secreted from cells within atherosclerotic plaques to activate local endothelial cells to induce a prothrombotic state and increase the adhesiveness of the endothelium to leukocytes - Elevations are a strong predictor of MI, stroke, PAD, and sudden cardiac death - Can be lowered by smoking cessation, exercise, weight loss, and statins
54
Reasons for decreased ESR?
- Sickle cell (altered shape) - Polycythemia (too many) - CHF (unknown)
55
Steps in Leukocyte extravasation and what the steps are mediated by
- Rolling: selectins - Tight binding: Integrins - Diapedesis: PECAM-1 - Migration: IL-8, LTB4, C5a, Kallikrein
56
What cytokine is particularly important in the formation of granulomas?
TNF-alpha
57
What cell type plays a role in inflammation by generating both fibrinogen and C-reactive protein?
Hepatocyte