57-Acute and Chronic Inflammation

Question 1

What is inflammation

Answer 1

Localized response to infection and injury

Designed to be protective but can cause tissue damage

Question 2

What are the goals of inflammation

Answer 2

Eliminate cause of injury, necrotic cells and tissue, repair wound

Question 3

What are the signs of inflammation and what causes it

Answer 3

Warm
Red
Pain
Swelling

Vascular changes and leukocyte recruitment

Question 4

What are the sequence of events in inflammatory reaction

Answer 4

macrophages recognize microbes
Trigger vascular and cellular reactions
Bring defense cells to site of infection

Question 5

What are the leukocytes used in inflammation

Answer 5

monocyte
Neutrophils
lymphocyte

Question 6

What do T and B lymphocytes do

Answer 6

antigen specific immune and inflammatory response

Question 7

What do neutrophils do

Answer 7

Kill bacteria, remove dead cells, part of innate immune system and acute inflammatory

Question 8

What do macrophages do

Answer 8

Phagocytic, chronic and acute inflammation

Question 9

What does inflammatory response depend on

Answer 9

Type and intensity of injury

Question 10

Examples of harmful inflammation

Answer 10

Epiglottis-airway obstruction
Meningitis-swelling
Arthritis-joint destruction

Question 11

Acute inflammation
Onset
Cell infiltrate
Tissue injury
Local and systemic signs

Answer 11

Fast, minutes to hours
Neutrophils
Usually mild
Prominent

Question 12

Chronic inflammation
Onset
Cell infiltrate
Tissue injury
Local and systemic signs

Answer 12

Slow, days
Macrophages
Severe and progressive
Less prominent

Question 13

Characteristics of acute inflammation

Answer 13

Vascular changes and edema
rapid
Neutrophils
Innate immune system
NOT ANTIGEN SPECIFIC

Question 14

Functions of acute inflammation

Answer 14

phagocytose and kill bacteria
Remove necrotic tissue
Begin tissue repair process

Question 15

Sequence of events in acute inflammation

Answer 15

Increased blood flows (congestion)
Increased vascular permeability
extravastion and deposit fluid and proteins
Emigration of neutrophils

Question 16

What are the 2 main vascular reactions for acute inflammation

Answer 16

Vasodilator and increased vascular permeability

Question 17

What is congestion

Answer 17

Vascular expansion, increased blood flow

Causes redness and warmth

Question 18

how is exudate formed

Answer 18

Increased vascular permeability
Movement of protein rich fluid out of vessel
Causes increased osmotic pressure of interstitial fluid so more water moves into tissues

Question 19

How is transudate formed

Answer 19

Increased hydrostatic pressure from reduced venous return

Question 20

What is edema

Answer 20

Fluid accumulation in tissue/extravascular

Question 21

What are exudates

Answer 21

High protein, high specific gravity, inflammatory

Question 22

What are transudates

Answer 22

Low protein, low specific gravity, non inflammatory

Question 23

Edema from increased pressure

Answer 23

Transudate, low protein, from congestive heart failure

Question 24

Consequences of edema

Answer 24

Depends on location
Leg-little effect
Larynx-asphyxia
Brain-herniation
Lung-hypoxia

Question 25

Types of exudates

Answer 25

Serous fibrinous sanguineous purulent

Question 26

What is serous exudate

Answer 26

Fluid with no inflammatory cells | Skin blister between epidermis and dermis

Question 27

What is fibrinous exudate

Answer 27

Fibrin | Inflammation of lining of body cavities, vascular dilation and congestion

Question 28

What is sanguineous exudate

Answer 28

bloody

Question 29

What is prudent exudate

Answer 29

Pus, contains neutrophils

Question 30

What causes serous exudate

Answer 30

From burns or inflammatory skin disease

Question 31

What causes fibrinous exudate

Answer 31

Greater vascular permeability, fibrinogen leaks out

Question 32

What is the sequence of events in acute inflammation

Answer 32

Increased blood flow Increased vascular permeability extravasation of transudate and educate Emigration of neutrophils

Question 33

Leukocyte traffic requires what

Answer 33

adhesion

Question 34

What are the 2 types of adhesion

Answer 34

Loose rolling and firm adhesion

Question 35

What causes loose rolling

Answer 35

Selectins

Question 36

What causes firm adhesion

Answer 36

integrins

Question 37

What do chemokines do during migration of leukocytes

Answer 37

Increase integrin affinity and promote directional migration

Question 38

What do cytokines do during migration of leukocytes

Answer 38

(TNF, IL-1) Promote expression of selections and integrin

Question 39

What is chemotaxis

Answer 39

Locomotion along chemical gradient

Question 40

Cell derived mediators of inflammation are formed where

Answer 40

Preformed in cell or produced at site of inflammation

Question 41

Plasma derived mediators of inflammation are formed where

Answer 41

Derived from circulating inactive precursors and activated at the site of inflammation

Question 42

Major cytokines for acute inflammation

Answer 42

TNF, IL-1, IL-6, chemokines

Question 43

Major cytokines for chronic inflammation are

Answer 43

INF gamma, IL4, IL5, IL12

Question 44

Principle role of TNF and IL1

Answer 44

Endothelial activation

Question 45

Where are TNF and IL1 produced

Answer 45

Activated macrophages

Question 46

What happens when leukocytes enter tissues

Answer 46

lipoxygenase AA products are changed from leukotrienes to lipoxins

Question 47

What are lipoxins

Answer 47

anti inflammatory mediators

Question 48

When are neutrophils seen in inflammation

Answer 48

Acute, first 6-24 hours | Respond rapidly, short lived

Question 49

When are monocytes seen in inflammation

Answer 49

24-48 hours

Question 50

What is margination

Answer 50

leukocyte accumulation at periphery of vessels, early acute inflammation

Question 51

What is the goal of acute inflammation

Answer 51

phagocytose and destroy organisms, remove necrotic tissue

Question 52

What can cause tissue damage during an acute inflammation

Answer 52

Proteolysis enzymes, ROS A COMMON CAUSE OF DISEASE!!

Question 53

What are the outcomes of acute inflammation

Answer 53

Resolution, healing by scarring, chronic inflammation

Question 54

What characterizes a chronic inflammation

Answer 54

macrophages, lymphocytes

Question 55

What is chronic inflammation

Answer 55

``` Prolonged duration Continuing active inflammation Tissue injury Attempts at healing An immune response ```

Question 56

What causes a chronic inflammation

Answer 56

Progression of acute inflammation Persistence of injurious agent Interference with normal healing

Question 57

What is the maturation of a macrophage

Answer 57

Bone marrow-stem cell/monoblast Blood-monocyte Tissue-macrophage

Question 58

What is the classically activated pathway for macrophages

Answer 58

proinflammatory induced by microbes and cytokines (IFN gamma)

Question 59

What is the alternatively activated pathway for macrophages

Answer 59

anti inflammatory induced by IL13 and IL4

Question 60

How do macrophages and lymphocytes interact

Answer 60

Stimulate each other | Release inflammatory mediator that affect each other

Question 61

b cells do what

Answer 61

Develop into Plasma cells that secrete antibodies

Question 62

t cells do what

Answer 62

secrete cytokines to promote inflammation

Question 63

What is a distinctive pattern of chronic inflammation

Answer 63

granulomatous inflammation

Question 64

what is a granuloma

Answer 64

Aggregates of epithelioid macrophages An attempt to wall off the offending agent Long lasting and highly destructive

Question 65

What is an example of cascading granuloma

Answer 65

TB

Question 66

What does a persistent inflammation cause

Answer 66

Tissue damage, scar formation, immune response Autoimmune diseases like thyroiditis (hypothyroidism)