Acute Inflammation

Question 1

Main cell type involved in acute inflammation

Answer 1

Neutrophils

Question 2

Main Cell types involved in chronic inflammation

Answer 2

Macrophages

Question 3

Signs of acute inflammation

Answer 3

Heat, redness, swelling, pain, loss of function

Question 4

Definition of acute inflammation

Answer 4

A redunant, complex, adaptive adn protective response of vessels, resident cells and leucocytes to noxious stimuli.
It brings cells and molecules of host defense from the circulation to the sites where they are needed, in order to eliminate the offending agents and repair the tissues.

Question 5

How long does acute inflammation last

Answer 5

Hours to days

Question 6

Possible causes of acute inflammation (4)

Answer 6

infections and microbial toxins
Tissue necrosis; ischemia, trauma, physical and chemical injury, irradiation
Foreign bodies (splinters, dirt, dutures); endogenous substances, urate crystals, cholesterol crystals (in atherosclerosis) and lipids
Immune reactions (hypersensitivity)

Question 7

Morphological hallmarks of acute inflammation (3)

Answer 7

Dilation of Blood vessels
Activation and recruitment of leukocytes
Active exudation of fluid in the extravascular tissues

Question 8

Steps of acute inflammation (6 Rs)

Answer 8

Recognition of the injurious agent
Reaction of blood vessels
recruitment of leukocytes
Removal/clearance of the agent
Regulation (control) of the response
Repair (resolution)

Question 9

Mediators in Acute Inflammation

Answer 9

Vasoactive Amines
Inflammatory Lipids
Complement
Cytokines
Others- chemokines, nitric oxide, coagulation cascade…..

Question 10

Examples of vasoactive amines and where are they produced/released

Answer 10

Histamine, serotonin
Released/produced by mast cells, basophils, platelets

Question 11

Examples of inflammatory lipids and where are they produced/released

Answer 11

Prostaglandins, leukotrienes
Produced by mast cells, leukocytes

Question 12

Examples of complement and where are they produced

Answer 12

C5a, C3a
Produced in liver, present in plasma

Question 13

Examples of cytokines and where are they produced

Answer 13

IL-1, TNF, IL-6
Produced by macrophages, endothelial cells, mast cells

Question 14

Which mediators cause vasodilation

Answer 14

Inflammatory lipids (prostaglandins, leukotrienes)

Question 15

Which mediators cause increased vascular permeability

Answer 15

Vasoactive amines
Complement (C5a, C3a)
Inflammatory lipids
Cytokines (IL-1, TNF)

Question 16

Which mediators cause Leukocytes recruitment and activation

Answer 16

Inflammatory lipids
Complement
Cytokines

Question 17

Which mediators cause pain

Answer 17

Inflammatory lipids

Question 18

Which mediators cause tissue damage

Answer 18

Neutrophil granule content
Reactive oxygen species (ROS)

Question 19

3 possible outcomes of acute inflammation

Answer 19

1- Complete resolution
Clearance of the offending agent and regeneration
2- Scarring, or fibrosis
Connective tissue growth into the area of damage or exudate, this occurs after substantial tissue destruction
3- Progression to chronic inflammation
Unresolved inflammatory process due to either the persistence of the injurious agent or some interference with the normal process of healing

Question 20

What is the acute phase response

Answer 20

characterised by different systemic effects of acute inflammation (and other conditions) including pyrexia, leucocytosis and metabolic changes
It also includes changes to the concentrations of plasma proteins, called acute phase proteins (APPs)

Question 21

Example of an exogenous pyrogen (trigger of pyrexia)

Answer 21

Bacteria

Question 22

Examples of endogenous triggers of pyrexia

Answer 22

Phagocytosis, tissue damage, immune complexes

Question 23

Endogenous pyrogens (3)

Answer 23

IL-1
TNF
IL-6

Question 24

How is PGE2 produced and what does it do

Answer 24

Produced in response to endogenous pyrogens
Increases the hypothalamic set point for body temperature

Question 25

How does hypothalamus increase body temperature

Answer 25

vasoconstriction and shivering

Question 26

what drugs target pyrexia pathway

Answer 26

NSAIDs

Question 27

What is a positive Acute Phase Protein

Answer 27

Production is increased in inflammation

Question 28

What is a Negative Acute Phase Protein

Answer 28

Production is decreased in inflammation

Question 29

Examples of positive APPs

Answer 29

C reactive protein (CRP) Serum Amyloid A (SAA)-particularly dogs, cat, horse, cow Haptoglobin- particularly cow Fibrinogen- particularly horses Complement (C3, C4) Pig-Map - In PIGS (pig major acute protein)

Question 30

Examples of Negative APPs

Answer 30

Albumin Transferrin Transthyretin Retinol-binding protein

Question 31

What is a biomarker

Answer 31

a biological molecule that is objectively measure and is an indicator of a normal or abnormal process, or of a condition or disease

Question 32

What is a transudate

Answer 32

Extravascular filtrate of protein and cell poor fluid It is due to increased hydrostatic pressure or decreased colloid osmotic pressure, or combination of both It is accumulated in body cavities and extracellular compartments Fluid appears grossly clear and watery

Question 33

Possible causes of increased hydrostatic pressure

Answer 33

Venous outflow obstruction e.g. congestive heart failure

Question 34

Possible causes of decreased colloid osmotic pressure

Answer 34

Decreased protein synthesis e.g. liver disease increased protein loss e.g. kidney disease

Question 35

What is an exudate

Answer 35

Extravascular fluid that has a high protein concentration and can contain leucocytes Its presence implies the existence of an inflammatory process that has increased the permeability of blood vessels Increased vascular permeability due to inflammation-> leakage of fluid/protein

Question 36

What is serous inflammation

Answer 36

Inflammation with exudation of fluid with low concentration of plasma protein and no to low numbers of leukocytes

Question 37

What is fibrinous inflammation

Answer 37

Inflammation with exudation of fibrinogen and fluid, and formation of thick, friable, loosely adherent fibrin

Question 38

Purulent inflammation

Answer 38

Inflammation with production of pus, viscous to creamy liquid, an exudate consisting of degenerated and necrotic neutrophils, debris and fluid It is typically associated to bacterial infections

Question 39

What is haemorrhagic inflammation

Answer 39

Inflammation with vascular damage, loss of integrity of endothelium and/or extensive tissue necrosis, with leakage of red blood cells Reflects and inciting stimulus

Question 40

Leukocytes Lymphocytes Macrophages

Answer 40

leukocyte- all white blood cells lymphocytes- T&B= adaptive immune response Macrophages= innate immune response- phagocytosis, antigen presenting, tissue remodelling and cytokine production