Acute and Chronic Inflammation

Question 1

Define inflammation

Answer 1

The host response to tissue damage. Protective response. Essential for healing.

Question 2

Name the 5 triggers of inflammation.

Answer 2

Infection
Ischaemia/infarction
Physical or chemical injury
Immune reactions
Foreign Body

Question 3

How does acute inflammation occur?

Answer 3

Vasodilation leads to increased blood flow to the area of injury - causing redness and heat.
Increased permeability follows - fluid leaking into extravascular tissue - this leads to oedema.
Together this creates blood stasis - pooling the blood at site of inflammation.

Question 4

What is vascular permeability?

Answer 4

Endothelial cells of wall contract - triggered by histamine/bradykinin. Endothelial injury leads to cell death - extravascular leakage. Transcytosis leads to increased transport of fluids.

Question 5

What is the main aim of inflammation?

Answer 5

To recruit lecuocytes to area of damage. Neutrophils and macrophages ingest and kill bacteria and nectroic cells.

Question 6

What are the functions of the leucocytes?

Answer 6

Their receptors recognise foreign microbes.

Question 7

Define phagocytosis

Answer 7

Leucocyte recognises and attaches itself to bacteria or damaged cell.
It then engulfs the cell.
The leucocyte then kills and degrades the offending agent.

Question 8

What type of tissue replaces the area of damage?

Answer 8

Connective tissue.

Question 9

Define chronic inflammation.

Answer 9

Caused by:
Persistent infection.
Reaction against host tissue leading to auto-immune diseases.
Prolonged exposure to toxic agent.

Question 10

What are granulomas?

Answer 10

Cellular attempt to contain offending agent it cannot eradicate.
Strong activation of macrophages and T lymphocytes - leads to injury of normal tissues.

Question 11

What are the 5 clinical signs of inflammation?

Answer 11

Redness
Heat 
Swelling
Pain
Loss of function

Question 12

What are the signs and symptoms of inflammation?

Answer 12

fever
tachycardia
hypotension
rasied WCC
Raised CRP
anorexia
general malaise
weight loss
sepsis

Question 13

What are the outcomes of acute inflammation?

Answer 13

Complete resolution
Healing by fibrosis
Abscess formation
Chronic Inflammation

Question 14

Which medications can be prescribed to treat inflammation?

Answer 14

NSAIDs
Anti-histamines
Steroids
anti TNF

Question 15

What happens if there is no inflammatory response?

Answer 15

Defective inflammation: increased risk of infection, delayed healing of wounds, tissue damage.

Question 16

What are these symptoms related to? Central abdo pain which localises to right iliac fossa, worse on movement, may have n&v…

Answer 16

Acute Appendicitis

Question 17

What are the complications of an acute appendicitis?

Answer 17

Perforation leading to peritonitis, abscess formation.

Question 18

What are the symptoms of septic arthritis?

Answer 18

Red hot swollen joint, unable to move from pain. Pyrexia, tachycardia, raised WCC and CRP.

Question 19

Risk factors of septic arthritis?

Answer 19

Prosthetic joint, recent surgery/trauma, age, RA, immunodeficiency.

Question 20

What is a peptic ulcer?

Answer 20

acute inflamm. response to h.pylori or excess acid.

necrotic inflammed mucosa falls away and is exposed to stomach acid/h.pylori and does not repair.