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Y2 MECHANISMS OF DISEASE > Abscess > Flashcards

Abscess Flashcards

1
Q

What is the usual result of acute inflammation?

A

It usually resolves entirely

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2
Q

What happens if there is excess exudate in acute inflammation?

A

this leads to suppuration

this is the process of pus formation, leading to abscess formation

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3
Q

What is the definition of an abscess?

A

a collection of pus that is a complication of acute inflammation

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4
Q

Why does acute inflammation happen?

What usually causes it?

A

it is the initial tissue reaction to injury

it is caused by physical, chemical, infectious methods

it can also be immune mediated

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5
Q

What are the 5 signs of acute inflammation?

A
  1. redness (rubor)
  2. heat (calor)
  3. swelling (tumor)
  4. pain (dolor)
  5. loss of function
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6
Q

What are the 3 stages associated with acute inflammation?

A
  1. vascular changes
  2. extravasation of white blood cells
  3. phagocytosis
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7
Q

What is involved in the vascular changes of acute inflammation?

A

There is initial vasoconstriction

This is followed by dilation and increased vascular permeability

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8
Q

What is involved in extravasation of white blood cells?

A

It is an organised sequential process of:

  1. margination
  2. adhesion
  3. transmigration
  4. chemotaxis
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9
Q

What is involved in phagocytosis?

A

Removing the substance that is causing damage in the first place, as well as damaged tissue

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10
Q

What happens after the vessels have undergone vasodilation?

A

Serum, proteins and cells pass from inside to outside the vessel

The fluid that leaves the blood vessel is an exudate

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11
Q

What is margination?

A

the adhesion of white blood cells to the walls of damaged blood vessels

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12
Q

What is transmigration?

A

the passage of blood cells through blood vessel walls

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13
Q

What is chemotaxis?

A

movement of a cell in response to a gradient of increasing or decreasing concentration of a particular substance

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14
Q

What are the three stages in phagocytosis?

A
  1. opsonisation of particles by IgG or C3
  2. engulfment by macrophages
  3. killing
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15
Q

How do phagocytes kill invading pathogens?

A
  1. reactive oxygen species

2. myeloperoxidase (makes HOCl)

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16
Q

What causes redness (rubor)?

A

vasodilation

this increases blood flow to the area

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17
Q

What causes heat (calor)?

A

hyperaemia - increased blood flow going through the tissue

cytokines also increase the temperature

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18
Q

What causes swelling (tumor)?

A

Localised oedema

The exudate also has a mechanical effect to swell

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19
Q

What causes pain (dolor)?

A

Local cytokines (bradykinin, serotonin, prostaglandins)

Physical pressure of the exudate pushing against nerves

20
Q

What causes loss of function?

A

Pain and swelling

The pain then stops the patient from wanting to do things

21
Q

What is suppuration?

A

the formation of pus

22
Q

What is contained within pus?

A
  1. living and dead neutrophils
  2. cell & tissue debris
  3. bacteria
23
Q

What type of bacteria usually cause suppuration?

What colour is pus?

A

Pyogenic bacteria

It is yellow-green in colour

24
Q

What does suppuration form?

A

An abscess

This is a collection of pus in the body

25
Q

Where may an abscess form?

A

in an organ, soft tissue (such as fat) and skin

26
Q

What antibiotics can be used to treat abscesses?

A

Abscesses are not accessible to antibiotics

27
Q

What happens if an abscess is untreated?

A

it can cause an uncontrolled infection around the body

this is septicaemia

28
Q

If there is pain in the right iliac fossa, what does this indicate?

A

there is inflammation/swelling in the appendix

29
Q

What is empyema?

A

a condition where pockets of pus collect inside a body cavity

most commonly in the pleural space

30
Q

What usually causes empyema?

A
  1. complication of surgery
  2. spontaneous
  3. can result from pneumonia, where fluid moves between the lung and chest wall
31
Q

What would empyema look like on an X-ray?

A

Lung is expanded on the normal side

Lung is collapsed and pushed forwards on the infected side

32
Q

What is the technique used to treat an abscess?

A

incision and drainage

33
Q

Why is general anaesthetic used when treating an abscess?

A

local anaesthetic doesn’t work as well around the abscess

34
Q

What is necrotising fasciitis?

A

an infection that results in death of parts of the body’s soft tissue

35
Q

What is the danger of necrotising fasciitis?

A

it is a very serious infection that needs to be treated immediately

36
Q

What are the aims of treating an abscess?

A
  1. to remove all the infected material

2. to encourage healing

37
Q

Why can an abscess not be treated with medical therapy?

A

the pus needs to be drained out of the abscess

38
Q

What is involved in microbiological investigation of abscess?

A
  1. send a sample to the microbiology lab - this can be a swab, pus or tissue
  2. send in a sterile jar
  3. put tissue in saline to stop it drying out
39
Q

What should abscess tissue not be put in?

A

Formalin

This kills the organisms

40
Q

What is done to the sample once it reaches the microbiology lab?

A
  1. spread the material on agar

2. incubate at 37 degrees to culture the bacteria

41
Q

How can the microorganism be identified?

A

From the growth pattern on the agar gel

42
Q

What is the culture and sensitivity test?

A

From the suppression of growth around an antibiotic disc, you can work out what antibiotics the organism is sensitive and resistant to

43
Q

What is granulation tissue?

A

new connective tissue and microscopic blood vessels that form on the surface of wound during the healing process

44
Q

What is contained within granulation tissue?

A

Capillaries, oedema, white cells and fibroblasts

45
Q

What are the benefits of scar formation?

A

it prevents infection

it protects against mechanical trauma

46
Q

What is the drawback of scar formation?

A

it stops regeneration, which can lead to a permanent scar

Y2 MECHANISMS OF DISEASE (36 decks)

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