Acute and Chronic Inflammation

Question 1

Acute inflammation is usually mediated by _____ cells, while chronic inflammation is mediated by _______ cells.

Answer 1

neutrophils; monocytes, macrophages, and lymphocytes

Question 2

Acute inflammation is usually from the _______ immune system, while chronic inflammation is usually from the _______ system.

Answer 2

innate; adaptive

Question 3

Annular means ________.

Answer 3

ring-shaped

Question 4

Acute inflammation can be stimulated by ________.

Answer 4

• infections from bacteria, fungus, parasites (including the toxins from these organisms)
• trauma (mechanical, thermal)
• foreign material

Question 5

List the four broad steps of inflammation.

Answer 5

• recognition of cellular insult
• vascular changes
• calling for back-up
• leukocyte activation

Question 6

Pro-inflammatory receptors can be on __________.

Answer 6

the ECM surface of plasma membranes, endosomes, and in the cytosol

Question 7

Define inflammasome.

Answer 7

The complex of proteins that mediates cellular response, especially in response to stuff from dead or damaged cells. (Example, decreased intracellular K+, decreased ATP, cytosolic DNA.)

Question 8

What are the two major changes involved in the vascular response to inflammation?

Answer 8

Increased blood flow and increased vessel permeability.

Question 9

What type of blood vessels alter in response to inflammation?

Answer 9

Arterioles serving the capillary beds (histamine acting on smooth muscle cells is the main cause)

Question 10

Permeability results from ________ cells contracting.

Answer 10

endothelial

Question 11

What are the four stages of leukocyte recruitment?

Answer 11

Margination/rolling, adhesion, transmigration, and chemotaxis.

Question 12

What is margination?

Answer 12

Margination is the process by which larger material gets pushed to the sides in a laminar flow situation.

Question 13

Name two molecules that participate in rolling and what signals induce them.

Answer 13

P-selectin (histamine) and E-selectin (IL-1)

Question 14

Leukocytes alter ________ to an activated state. Expression of these molecules stops rolling.

Answer 14

integrins

Question 15

What is the endothelial ligand for integrins (CD8/CD11)?

Answer 15

I-CAM

Question 16

Transmigration occurs after __________.

Answer 16

the leukocyte stops rolling

Question 17

Upon transmigration, leukocytes secrete _________.

Answer 17

enzymes (such as collagenase) that break down the basement membrane

Question 18

Chemotaxis is __________.

Answer 18

the process in which leukocytes move down chemical gradients toward site of inflammatory stimulus

Question 19

What are the four things that an activated leukocyte does upon meeting its target?

Answer 19

1) phagocytize material
2) secrete material to kill material
3) produce inflammatory material to amplify response
4) become poised to kill/engulf material

Question 20

What are the two ways a leukocyte can bind to something?

Answer 20

1) binding to the material itself

2) binding to the material through opsonins (such as IgG or C3b)

Question 21

NETs are ________.

Answer 21

neutrophil extracellular traps composed of chromatin with antimicrobial proteins embedded

Question 22

______, _______, and ______ are the three possible outcomes of acute inflammation.

Answer 22

Resolution; scarring; chronic inflammation

Question 23

Pruritis is _______.

Answer 23

itchy skin

Question 24

What causes chronic infection?

Answer 24

• prolonged infection
• auto-immune disease
• allergies
• persistent exposure to toxins

Question 25

Liver monocytes are called ______ cells.

Answer 25

Kupffer

Question 26

What activates macrophages in the classical pathway?

Answer 26

Endotoxin, interferon gamma (from T cells), and foreign material

Question 27

What activates macrophages in the alternative pathway?

Answer 27

IL-4 and IL-13 (from T-cells, eosinophils, and mast cells)

Question 28

The ______ pathway of macrophage activation leads to repair and fibrosis, while the ______ pathway leads to microbe destruction.

Answer 28

alternative; classical

Question 29

Which type of helper T cell recruits neutrophils and monocytes?

Answer 29

Th17

Question 30

Th2 secretes ______.

Answer 30

IL-4, IL-5, and IL-13 (resulting in alternate pathway activation of macrophages)

Question 31

The two situations in which eosinophils are recruited are _______.

Answer 31

parasitic infection and allergic reaction

Question 32

Mast cells become coated with _______ and release ______.

Answer 32

IgE; histamine

Question 33

Granulomas are __________.

Answer 33

monocytes surrounded by lymphocytes

Question 34

Source of granulomas are ___________.

Answer 34

• infections (tuberculosis, fungi, leprosy)
• foreign material (suture)
• autoimmune disease (Crohn’s)
• sarcoidosis

Question 35

The three cytokines that are most responsible for systemic inflammatory effects are ________.

Answer 35

TNF, IL-1, and IL-6

Question 36

Pyrexia is ______.

Answer 36

fever

Question 37

In pyrexia, the hypothalamus stimulates the production of _________, which raise the body temperature.

Answer 37

prostanglandins

Question 38

In response to IL-6, hepatocytes produce two proteins that are used as lab indicators of inflammation: ________.

Answer 38

C-reactive protein (CRP) and Serum Amyloid A (SAA)

Question 39

Under the influence of _______, more leukocytes are released from the bone marrow.

Answer 39

TNF and IL-1

Question 40

Continuous inflammation leads to production of ________, leading to greater production of leukocytes.

Answer 40

Colony Stimulating Factor (CSF)

Question 41

The inflammasome activates _________.

Answer 41

caspase-1 (which then activates IL-1Beta)

Question 42

Which helper T cell activates the classical macrophage pathway?

Answer 42

Th1 (by secreting IFN-gamma)

Question 43

Th17 secretes ______ which recruits _____.

Answer 43

IL-17 (go figure); neutrophils

Question 44

______ and ________ are endogenous pyrogens.

Answer 44

IL-1 and TNF

Question 45

Exudates result from _________.

Answer 45

increased vascular permeability

Question 46

Transudates result from _________.

Answer 46

increased blood pressure (can be cardiac or osmotic)