Acute Inflammation

Question 1

What is Acute Inflammation characterized by?

Answer 1

Neutrophils

Question 2

Definition of inflammation

Answer 2

movements of fluid/leukocytes from tissues->blood

Question 3

What type of immunity is present in acute inflammation?

Answer 3

Innate immunity

Question 4

Hows is the vascular response different between acute and chronic inflammation?

Answer 4

Prominent vascular response in Acute

Question 5

What kind of immunity is present in chronic inflammation?

Answer 5

Cell-mediated

Question 6

What type of leukocyte is predominant in Chronic inflammation?

Answer 6

Mononuclear cell

Question 7

Causes of Acute Inflammation (3)

Answer 7

1) Tissue necrosis
2) Immune hypersensitivity
3) Microbial infections (pyogenic bacteria)

Question 8

Causes of chronic inflammation (3)

Answer 8

1) Autoimmune disorders
2) Primary granulatomous diseases (Chron’s, sarcoidosis)
3) Phagocytosis resistant organisms

Question 9

Signs of inflammation (5)

Answer 9

1) Redness
2) Swelling
3) Heat
4) Pain
5) Loss of Function

Question 10

Major manifestations of Acute Inflammation (6)

Answer 10

1) Rapid vascular response/altered microvasculature
2) Increased vascular permeability
3) Platelet stimulation
4) Chemical mediator activation
5) Neutrophil activity
6) Phagocytosis & intracellular killing

Question 11

What are the 2 most common causes of fibrinous pericarditis?

Answer 11

1) uremia
2) renal failure

Question 12

Define: Effusion

Answer 12

Excess fluid within body cavities

Question 13

Define: Edema

Answer 13

Fluid accumulation within extravascular compartment and interstitium

Question 14

Mechanisms of increased vascular permeability during inflammation (3)

Answer 14

1) Inflammatory mediators cause contraction of endothelial cells –> gaps
2) Direct injury to endothelial cells (arterioles, capillaries, venules usually)
3) Leukocyte dependent injury of endothelial cells

Question 15

Define: Transudate

Answer 15

Edema with low protein content

Question 16

Define: Exudate

Answer 16

Edema with high protein content

Question 17

Types of Exudate

Answer 17

1) Serious - no cellular component
2) Fibrinous - fibrin from coagulation activation
3) Purulent - cellular components , mostly neutrophils
4) Suppurative - Purulent + liquefactive necrosis

Question 18

Vasoactive Mediators of Edema

Answer 18

1. Plasma Derived
   
   • Hageman factor
     
     • Fibrin split products
     • Kinins
   • Complement system
     
     • C3a, C5a
2. Cell Derived
   
   1. Mast cell/basophils –> Histamine
   2. Platelets –> Serotonin
   3. Inflammatory Cells –> prostaglandins/leukotrienes
   4. Endothelium –> NO/prostaglandins

Question 19

What are the anaphylatoxins and what do they do?

Answer 19

• C3a, C4a, C5a
• Part of complement system
• increases vascular permeability by activating Mast Cells (histamine, leukotrienes)
• cause bronchoconstriction, vasoconstriction, edema

Question 20

What makes kinins? and what do kinins do?

Answer 20

• Kallikrenin makes kinin
• Kinin increases vascular permeability

Question 21

Vasoactive Cell Derived Mediators of Edema

Answer 21

1) Arachidonic acid metabolites
2) Platelet Activating Factor
3) Platelet Derived mediators
4) Mast Cell & basophil derived mediators

Question 22

Arachidonic acid metabolites and their functions

Answer 22

1. Thromboxanes (TXA2)
   
   1. Vasoconstrictor, aggregatory, increases PMN response
2. Prostaglandins (PGI2)
   
   1. Vasodilator, anti-aggregatory, decrases PMN responses

Question 23

Actions of Neutrophils during inflammatory resposne

Answer 23

1) Margination of cells along vascular wall
2) Adhereance to endothelium and basement membrane
3) Emigration through vascular wall via diapedesis
4) Chemotaxis - migration through soluble chemotactic agents
5) Haptotaxis - chemotax. along fixed insoluble chemotactic gradient

Question 24

Initial PMN recruitment depends on which two molecules?

Answer 24

1) C5a
2) LTB4

Question 25

Proglonged PMN recruitment depends on what?

Answer 25

Chemotactic cytokines

Question 26

Molecues responsible for leukocyte adhereance and emigration

Answer 26

Rolling - Selectins & addressins

Adhesion - B2 integrins & ICAM 1

Transmigration - PCAM -1

Question 27

Overall process of bacterial phagocytosis

Answer 27

Phagocytosis –> degranulation/NADPH oxidase activation –> bacterial killing and digestion

Question 28

Chediak-Higashi Syndrome

Answer 28

Defective lysosomal granules

Question 29

Chronic granulomatous disease of childhood

Answer 29

NADPH oxidase deficiency

No H2O2

recurrent bacterial infections

Question 30

Myeloperoxidase deficiency

Answer 30

NO HOCl, recurrent fungal infections