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D&D Unit 2 > Acute and Chronic Inflammation (complete) > Flashcards

Acute and Chronic Inflammation (complete) Flashcards

1
Q

What are the 5 cardinals signs of injury?

A

1) Calor (heat)
2) Rubor (redness)
3) Tumor (swelling)
4) Dolar (pain)
5) Functio Laesa (loss of function)

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2
Q

How can rubor (redness) be explained physiologically?

A

Alteration in vascular caliber aka VASODILATION

causes redness

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3
Q

How can tumor (swelling) be explained physiologically?

A

Vasodilation causes increased intravascular hydrostatic pressure —» decrease intravascular osmotic pressure (stuff leaves vessels eg cells, proteins)
—-»>
net outward flow of H2O and ions

Causes tumor

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4
Q

How can calor (heat) be explained physiologically?

A

Alteration in vascular caliber aka VASODILATION

causes heat

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5
Q

What is the difference between transudate and exudate?

A

Trans etiology: increase hydrostatic pressure/reduced oncotic pressure

Ex etio: inflammation

higher specific gravity: ex
higher total protein: ex
higher fl/ser protein: ex
higher fl/ser LDH: ex
higher fl/ser glucose: trans
Leukocytes? in ex, not trans
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6
Q

What are the organs directly exposed to the outside environment?

A

1) Skin
2) Respiratory system
3) Gut

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7
Q

What are some examples of how organs directly exposed to the outside environment maintain their barriers?

A

1) squamous epithelium (skin, esophagus)
- Surface cells slough w/ foreign objects as they pass
- Turnover, also mucus, lubricant secretion

2) Columnar epithelium
- Mucus secretion
- Turnover

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8
Q

What are the possible outcomes of acute inflammation?

A

1) complete resolution (macros clean up necrotic debris, tissue regen, lymphatic drainage decreases edema)
2) Scarring
3) Abscess formation (wall of infection)
4) Progression to chronic inflammation

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9
Q

What are the acute inflammatory cells?

A

Neutrophils (PMNs)

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10
Q

What are the chronic inflammatory cells?

A

Lymphocytes

Macrophages

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11
Q

Describe neutrophils (primary function, cytoplasmic content)

A

Lots of segments in nucleus

Function: acute inflammatory response, phagocytose bacteria

Content: acid hydrolases, lysozyme, glucuronidase, reactive oxygen metabolites

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12
Q

Describe monocytes/macrophages (primary function, cytoplasmic content)

A

Mononuclear - heart shape

Monocyte - in BM
Macros - in tissue

Function: chronic inflammatory response, phagocytose stuff

Content: lysozymes, cytokines, prostaglandins, reactive oxygen metabs

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13
Q

Describe lymphocytes/plasma cells (primary function, cytoplasmic content)

A

A big ass nucleus, not so much cytoplasm

Function: Chronic inflammatory response

Content: variable

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14
Q

Describe eosinophils (primary function, cytoplasmic content)

A

Bi-segmented nucleus, stained pink

Function: chronic infl response, think parasites

Content: lysozymes, reactive O2 metabs, cytokines

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15
Q

Describe mast cells/basophils (primary function, cytoplasmic content)

A

blue cytoplasm, blobby nucleus

Function: acute or chronic, release histamine

Content: histamine, serotonin, heparin, prostaglandins, cytokines

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16
Q

Describe platelets (primary function, cytoplasmic content)

A

Cleaved from megakaryocytes

Function: thrombosis (clot formation)

Content: acid hydrolases, fibrinogen, serotonin, calcium

17
Q

What are the histologic variants in inflammation?

A

1) Fibrinopurulent
2) Granulomatous
3) Eosinophilic

18
Q

Describe fibrinopurulent (cells involved, histologic features, ddx)

A

Cells: PMNs

Histo: neutrophils, fibrin/blood products, +/- hemorrhage

ddx: Any insult, infectious (bacteria, fungal)

AKA: PUS!

19
Q

Describe granulomatous (cells involved, histologic features, ddx)

A

Cells: macros (GIANT CELLS, macros that come together to form 1)

Histo: mixed chronic inflammatory cells (lymph, macros); +/- central necrosis; +/- foreign material

DDx: Infectious (TB, fungus), inflammatory (collagen vascular disease, rheumatoid arthritis), foreign body

Overall: a rxn to a non-digestible material

20
Q

Describe eosinophilic (cells involved, histologic features, ddx)

A

Cells: eosinophils

Histo: lots of eosinophils

DDX: Infectious (parasites), inflammatory (allergic, asthma)

21
Q

Describe the acute inflammation phase

A

Onset/duration: seconds/mins —> days

Vascular response: vasodilation, ^ blood flow, ^ permeability

Source of cells: peripheral blood

22
Q

Describe the chronic inflammation phase

A

Onset/duration: Days —> weeks/months/years

Vascular response: Endo cell proliferation —> neovascularization, ^ leakiness

Source of cells: sentinel/local cells in tissue/peri blood

Repair: Fibroblasts —> fibrosis/scarring; endo cells —-> neovascularization

23
Q

Describe fibrinopurulent exudate/suppurative inflammation (location, inflammatory cells involved, ddx)

A

Location: anywhere, pus

Cells: neutrophils

DDX: Infectious (bacteria, fungus)

24
Q

Describe abscess (location, inflammatory cells involved, ddx)

A

Location: w/in parenchyma/confined space (e.g. brain, lung, liver)

Cells: neutrophils

DDX: Infectious (bacteria, fungus)

25
Q

Describe empyema (location, inflammatory cells involved, ddx)

A

Location: w/in anatomic space/cavity (e.g. pleural, subdural, appendix, gallbladder, uterus, joints)

Cells: neutrophils (EARLY) —» macros, lymphocytes (LATER)

DDX: Infectious (bacteria, fungus)

26
Q

Describe cellulitis (location, inflammatory cells involved, ddx)

A

Location: skin, fascia, CT

Cells: neutrophils (early), mononuclear cells (later)

DDX: infectious (bacteria), inflammatory

27
Q

Describe granuloma (location, inflammatory cells involved, ddx)

A

Location: parenchyma (lung, lymph node, liver, spleen)

Cells: Macros (giants), lymphocytes, plasma cells

DDX: Infectious (bacteria, fungus), inflammatory

28
Q

Describe the process of collateral tissue damage associated with inflammation

A

Damage to normal tissue during inflammatory process

29
Q

What are clinical examples of collateral tissue damage?

A

Pneumonia: inflammatory response degrades septa

Rheumatoid arthritis: inflammatory response erode through cartilage (ulnar deviation)

30
Q

What is the role of lymphatics?

A
  • Drain fluid accumulated in tissue

- Fluid is filtered in lymph nodes — analyzed by T and B cells

31
Q

What are the potential outcomes if the lymphatic system cannot contain an infection?

A
  • Infection enters into lymphatics
  • Reenters circulation
  • Pt is septic (infection is going allover the body)

EX: bacteremia, fungemia, viremia

32
Q

List clinical exam findings associated with an inflammatory process

A

Local signs: rubor, calor, tumor, dolor, loss of function

Systemic signs: sleepiness, anorexia, fever, elevated WBC, BP alterations (hypotensive, shock)

33
Q

List useful lab test supporting an inflammatory process

A

1) WBC count
2) DIC markers
3) PCR bacteria testing

D&D Unit 2 (10 decks)

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