2. inflammation Flashcards
What is the predominant cell type in a pyogenic bacterial infection?
Neutrophil
What granulated cells contain receptors for IgE on its cell surface?
Mast Cells
B lymphocytes and plasma cells are mediators of chronic inflammation and provide what type of immunity to infectious disease?
Antigen-specific
Inflammation of the breast tissue is known as
Mastitis
How does mastitis develop?
bacteria gain access to the breast tissue (through the ducts, through infiltration of secretions, through fissures in the nipples, or through dermatitis involving the nipple)
How does complement activation induce local edema?
Products of complement activation increase permeability of blood vessels
C5a , C3b and C567 are examples of what?
Biologically active fragments or complements (C567) generated by complement proteins
What immunologic processes involve complement proteins?
Oposonization, cytolysis, and chemotaxis
Name the most potent chemotactic factors for leukocytes at the site of injury
Complement Proteins, N-formylated peptides (low molecular weight)/ bacterial and mitochondrial products, Products of arachidonic acid metabolism, and Chemokines
What generates Plasmin?
Hageman Factor (clotting factor XII)
What type of enzyme is Plasmin?
Fibrinolytic.
What doe Hageman Factor activate?
Plasminogen conversion to Plasmin, conversion of prekallikrein to kallikrein, and clot formation through activation of the coagulation system
What is the most significant function of the kinin?
Amplifies the inflammatory response by stimulating local tissue cells and inflammatory cells to generate additional mediators, prostenoids,, cytokines, NO , and tachykinins
What is the function fo PMNs (neutrophils)?
clear debris and begin the process of wound healing
What is the role of fibroblasts a macrophages at the site of an infarction?
they regulate scar tissue formation
What are the 7 vasoactive mediators in the inflammatory response?
Histamine, Serotonin, Bradykannin, Anaphylatoxins, Leukotrienes/Prostaglandins, Platelet-Activating factor, NO
How does edema develop during acute inflammation?
Increase in the permeability of the endothelial cell barrier.
What response of the arterioles exacerbates fluid leakage?
Vasodilation
During inflammation, how doe s the hydrostatic pressure increase in the capillary bed?
Vasoconstriction of the postccapillary venules
What is the key source of vasoactive mediators?
Hageman Factor (clotting factor XII)
In patients with endotoxic shock, what factor is secreted by monocytes/macrophages when stimulated by Gram - bacteria?
Tumor Necrosis Factor A
What do gram negative bacteria secrete to stimulate monoctyes that will act to release TNF-a?
Lipopolysaccharide
Differentiate between karyorrexis, karyolysis, and pyknosis.
These are all patterns of nuclear changes due to breakdown of DNA and chromatin. Pyknosis: nuclear shrinkage and basophilia, DNA condenses into a solid shrunken mass . This nucleus can unedergo fragmentation so that it becomes karyorrrhexis pattern. Karyolysis is when basophilia of chromatin fade, secondary to Dnase activity.
What physiological change occurs that causes necrosis to occur after periods of ischemia?
Decrease in intracellular pH from the build up of lactate in the cytosol from anaerobic glycolysis
An alteration of injured blood vessels which histologically stains with eosin due to the accumulation of plasma proteins is known as what pathological process?
Fibrinoid Necrosis.
Contrast transudate vs exudate
Transudate (edema fluid with low protein content) and Exudate (edema fluid with high protein content)
A purulent exudate or effusion is characterized by what cellular component?
PMNs
A serous exudate or effusion is characterized by the absence of what prominent cellular response. What color is it?
Yellow
What does a sersoanguineious exudate contain?
RBCs . It has a red tinge.
What type of reactions are associated with Eosinophilia ?
allergic-type reactions and parasitic infestations
Skeletal muscle is typically infiltrated by eosinophils when infected by what organism>?
Trichinella
Muscular Dystrophy patients would show elevations of what molecule in serum?
Creatinine Kinase
What is Polymositis?
An inflammatory myopathy. It along with others are characterized by usually symmetric muscle weakness, initially affecting large muscles of the trunk, neck and limbs. Polymyositis seems to be mediated by CTLs.
Children with a deficiency of NADPH oxidase are susceptible to what disease?
Recurrent bacterial infections because they can ‘t produce HOCL and are vulnerable to Candida
What does Catalase enzyme do?
Convert H2O2 to water and molecular oxygen
What is Wiskott-Aldrich Syndrome?
An X-linked recessive disease characterized by thrombocytopenia, eczema, and vulnerability to recurrent infection. The thymus is initially normal burt there is age-related depletion of T lymphocytes in peripheral blood and lymph nodes, and thus loss of cellular immunity. Patients ars don’t synthesize ABs to polysaccharide antigens and are susceptible to encapsulated, pyogenic bacteria.
What is deficient in Hereditary angioedema? What ‘s the consequent of this deficiency?
C1 inhibitor, thus, C1 keeps on cleaving C4 and C2 excessively
Where is nonpitting edema seen in hereditary angioedema?
soft tissues as a result t of chronic complement activation generating vasoactive peptide from C2. Edema can also form in the larynx which is fatal.
what enzyme deficiency increases susceptibility to infections with Candida?
Myeloperoxidase
What do eosoniphils contain to combat parasitic infections like schistosomiasis?
Esoinophil major basic protein, leukotrienes, platelet-activating factor, and acid phosphatase
What characterizes suppurative inflammation?
A purulent exudate accompanied by liquefactive necrosis. It can also be described as PUS.
In suppurative inflammation, Abscesses filled with pus are surrounded by what?
granulation tissue
What are the 3 main cellular components of chronic inflammation?
Lymphocytes, Plasma cells, and Macrophages
What interactions do na?ve lymphocytes have when a patient has viral myocarditis?
The lymphocytes encounter antigen-presenting cells (macrophages and dendritic cells) in the secondary lymphoid organs and are activated to circulate in the vascular system and head to peripheral tissues
what happens when vasoactive mediators bind to endothelial cell receptors?
Contraction and gap formation. This break leads to the leakage (such as caused by direct injury to endothelial cells) of intravascular fluid into the extravascular space.
What terms refer to a fibrinous exudate occurring on a serosal surface?
Fibrinous pleuritis or fibrinous pericarditis
Exogenous pyrogens stimulate what endogenous pyrigens?
Il-1alpha, IL-1beta and TNF-alpha
What is the function of IL-1 alpha?
It is a protein that stimulates prostaglandin synthesis in the hypothalamic thermoregulatory centers- altering body T.
How does aspirin block the fever response?
It is an inhibitor of cyclooxygenase and it inhibits PGE2 synthesis in the hypothalamus.
What is rigor?
profound chills with shivering and piloerection
What is leukotriene B4?
A chemotactic for neturophils, eosinophils, and monocytes
What is the function of Thromboxane A2?
TXA2 is platelet synthesized and is also an important stimulus for platelet aggregation. It works alongside ADP to forma primary hemostatic plug, an enlarging platelet aggregate.
What enhances phagocytosis?
C3b fragment of complement and immunoglobulins
What inflammation mediators can cause secondary injury to a the alveolar basement membrane and lung parenchyma for a patient suffering from pneumonia?
Lysosomal enzymes
what does lysozyme target In degradation?
bacterial cell wall of gram + organisms
Where is MPO located
Neutrophil granules
What kind of protein is Entactin?
basement membrane protein
What is the first response of arterioles to neurogenic and chemical stimuli?
transient vasoconstriction. Shortly after, vasodilation occurs allowing blood flow to the inflamed area (AKA Hyperemia)
What do Leukotrienes do>?
stimulate contraction of smooth muscle and enhance vascular permeability. It is one of other chemical mediators that stimulate mucus production and bronchoconstriction in asthma. Leukotrienes are slow-reacting substances of anaphylaxis
How does Histamine effect the vascular wall?
They bind to H1 receptors in the vascular wall and they induce endothelial cell contraction, gap formation, and edema
What kind of shock occurs from massive Histamine release?
Anaphylactic
Bradykinin and Hageman factor are derived from where/
plasma
What does the enzyme cyclooxygenase mediate?
the conversion of arachidonic acid to prostaglandins.
When is leukopenia encountered?
Under conditions of chronic inflammation, especially in malnourished patients or those suffering from a chronic debilitating disease
What infections can induce Leukopenia?
Typhoid fever, viral and rickettsial infections
What is pancytopenia?
decreased circulating levels of all formed elements in the blood
what are the primary factors responsible for rubor and calor at an injury site?
vasodilation of precapillary arterioles and hyperemia
How do corticosteroids work? What is the associated side effect?
They induce synthesis of an inhibitor of phospholipase A2 and block the release of arachidonic acid from the plasma membranes of inflammatory cells. ; Atrophy of the adrenal glands
What are acute phase proteins?
proteins synthesized primarily by the liver and are released in the circulation in response to acute inflamm. Challenge. They are mediated by cytokines, IL1 , IL 6 and TNF- alpha. Increased plasma levels of these proteins increase RBC sedimentation rate and thus is used to monitor inflammatory disease activity.
