Acute & Chronic inflammation Flashcards

1
Q

What is inflammation?

A

The host response to tissue damage

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2
Q

Why does inflammation occur?

A

as a protective response

  • to remove/contain cause
  • initiate repair
  • reinstate useful function
  • it is essential for healing
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3
Q

What are the 5 triggers for inflammation?

A
  • foreign body
  • infection
  • ischaemia/ infarction
  • physical/ chemical injury
  • immune reaction
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4
Q

In acute inflammation what are the vascular changes to maximise movement of plasma proteins to site of injury?

A
  • Vasodilation
  • Increased permeability (leads to OEDEMA)
  • blood stasis (pooling the blood at the site of injury
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5
Q

In acute vasodilation the vascular change of vasodilation leads to…

A
  • increased blood flow
  • causing redness and heat (erythema)
  • endothelial cells of vessel wall contract
  • Transcytosis - increased transport of fluid and proteins
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6
Q

In acute inflammation what are the cellular changes to maximise movement of plasma proteins to site of injury?

A
  • margination - RBCs go to centre of lumen and WBCs go peripherally
  • rolling - increased amount of leucocytes roll along edge of damaged endothelium
  • adhesion - leucocytes stop and adhere to endothelium (cytokines encourage this)
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7
Q

What do the vascular changes in acute inflammation cause?

A
  • cause leakage of intravascular fluid into the extravascular spaces
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8
Q

What is the main aim of inflammation?

A

to recruit leucocytes to area of damage

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9
Q

What do neutrophils and macrophages do ?

A
  • ingest and kill bacteria and necrotic cells

- promote repair

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10
Q

Where are white blood cells recruited from in inflammation?

A

vessel lumens

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11
Q

In the cellular changes of inflammation what happens at the transmigration phase?

A

leucocyte encouraged to pass through endothelium to extravascular space
- chemokines stimulate this

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12
Q

How long does it take for neutrophils to appear and what do they respond to?

A

6-24 hours

chemokines

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13
Q

How long does it take monocytes to appear ?

A

24-48hours

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14
Q

opsonin receptors recognise microbes that have been coated with proteins this targets them for what?

A

phagocytosis

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15
Q

how do leucocytes kill harmful agents?

A
  • attaching to bacteria through opsonin receptors
  • leucocytes engulfs the cell
  • then kills and degrades, removing its harmful effects
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16
Q

What are the outcomes of the process of acute inflammation?

A
  • healing with connective tissue replacement (fibrosis

- if not resolved chronic inflammation or abscess

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17
Q

What are the causes of chronic inflammation?

A
  • persistent infection or inflammation

eg. parasite, TB, toxic agent (asbestos) or when its an auto-immune disease as cant remove are own cells

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18
Q

Neutrophils not normally present in chronic inflammation as others have been recruited such as ..

A

macrophages, lymphocytes and plasma cells

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19
Q

In chronic inflammation you can get granulomas, what are these?

A
  • cells try to contain offending agent
  • strong activation of macrophages and T lymphocytes
  • causes damage to surrounding tissue
20
Q

What examples of conditions may cause granulomas?

A
  • TB
  • rheumatoid arthritis
  • chrones disease
21
Q

What kind of things may cause acute inflammation?

A
  • infarction
  • bacterial infection
  • trauma
  • burn
22
Q

What kind of things may cause chronic inflammation?

A
  • virus
  • autoimmune diease
  • acute inflammation that’s not resolved
  • persistent infection
23
Q

What are the clinical signs of acute inflammation?

A
  • redness (from vasodilation)
  • heat (from vasodilation
  • swelling ( due to vascular permilbilty and fluid moving from intra to extra vascular space)
  • Pain
  • loss of function
24
Q

What can chronic inflammation lead to?

25
What are the medical signs and symptoms of inflammation?
- fever - tachycardia - hypotension - raised white cell count - raised CRP (blood test)
26
What are the signs of chronic inflammation?
- anorexia - general malaise - weight loss - sepsis- large amount of toxins stimulate cytokines, can lead to cardiovascular failure (septic shock)
27
What is the predominate white cell in acute inflammation?
neutrophils
28
What can make inflammatory responses poor?
- immunodeficiency / disease eg. chemotheraphy, steroids - HIV - Hereditary
29
How can are natural inflammatory response be negative?
- asthma - hypersensitivity - allergic reaction
30
What medicines can help with inflammation?
- NSAIDs - anti-histamine - steroids (rheumatoid arthritis) - targeted biologics against immune response proteins
31
What happens if no inflammatory response?
- increased risk of infection - delayed healing of wounds - tissue damage
32
What are examples of inflammation? | *don't need to memorise these
- acute appendicitis - septic arthritis - minor injuries (sprained ankle) - rheumatoid arthritis - peptic ulcers -
33
What are the signs of acute appendicitis?
pyrexia raised heart rate raised white cell count raised CRP
34
What are the symptoms of acute appendicitis ?
- central abdo pain which localises to right iliac fossa - pain is worse on movement - may have nausea and vomiting
35
What is the treatment of acute appendicitis?
appendectomy
36
What are the complications with acute appendicitis?
perforation leading to peritonitis | abscess formation
37
What are the symptoms of septic arthritis?
- red, hot, swollen joint | - unable to move joint
38
What are the signs of septic arthritis?
pyrexia tachycardia raised white cell count raised CRP
39
What are the risk factors for septic arthritis?
``` prosthetic joint recent surgery or trauma to knee age rheumatoid arthritis immunodeficiency ```
40
What are the treatment options for septic arthritis?
joint aspirate IV antibiotics sepsis 6
41
What are the signs and symptoms of a minor injury such as a sprained ankle?
- swelling, pain, heat | - muscle cells are damaged
42
What is the treatment for a sprained ankle?
``` REST - prevent further injury ICE - reverse vasodilation COMPRESS - reduce oedema ELEVATE - prevent blood stasis ANTI-INFLAMMATORY ```
43
What are the signs of rheumatoid arthritis?
- warm, swollen, stiff and painful joints - vessels can become involved leading to vasculitis - chronic inflammatory response
44
What are the treatments for rheumatoid arthritis?
steroids DMARDs biologics
45
how are peptic ulcers developed?
- acute inflammatory response from h.pylori/excess acid - necrotic inflamed mucousa falls away - exposed to stomach acid - leads to chronic inflammation
46
What are people with peptic ulcers at risk of ?
developing a bleed/perforation
47
What are the treatments for peptic ulcers?
PPIs histamine receptor agonist antibiotics