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acute inflammation Flashcards

1
Q

Types of inflammation:

Serous inflammation

A

Effusion of thin watery exudate that can be found in the peritoneal, pleural, or pericardial cavities, or be seen as blisters on the skin

No bacteria, it comes from vascular permeability or tissue damage

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2
Q

Types of inflammation:

Fibrinous inflammation

A

Accumulation of fibrin-rich exudate in meninges, pericardium, or pleura. This can either be resolved or lead to scarring.

Ex. Fibrinous pericarditis ass with MI or Rheumatic fever

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3
Q

Types of inflammation:

Purulent (Suppurative) inflammation

A

Production of pus, neutrophils, necrotic tissue, and edema

Ex. Acute pancreatitis

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4
Q

Types of inflammation:

Ulcers

A

Local defect/excavation in the surface of an organ due to necrotic tissue shedding off

common areas are mouth, duodenum, and skin

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5
Q

Types of infection:

Pseudomembranous inflammation

A

Bacterial toxin-induced damage of mucosal linings (causes a shaggy membrane)

Ex clostridium difficile (pseudomembranous colitis) & corynebacterium diphtheriae

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6
Q

Mediators of acute-phase response of inflammation are?

A

TNF
IL-1,6
INFs

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7
Q

Mechanisms of fever are mediated by which pyrogenic cytokines?

A

IL1, 6
TNF
INFs

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8
Q

Liver-made plasma proteins that mediate acute inflammation include:

A

C-reactive protein
Fibrinogen
Hepcidin
Serum amyloid A protein

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9
Q

IL-6 stimulates ______&_____

A

C-reactive protein
&
Fibrinogen

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10
Q

Erythrocyte sedimentation rate is due to which acute-phase protein?

A

Fibrinogen
It binds to RBCs and causes them to form stacks (rouleaux)

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11
Q

Leukocytosis is described as a ______ reaction with leukocyte levels avg ____ -_____

A

Leukemoid reactions showing levels 40,000 to 100,000 leukocyte counts

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12
Q

Neutrophilia

A

increase in neutrophil count usually due to bacterial infections

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13
Q

Lymphocytosis

A

Increase in number of lymphocytes in viral infections

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14
Q

Eosinophilia

A

Allergies & parasitic infections which increase the number of eosinophils

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15
Q

What are the 3 outcomes of acute inflammation?

A

Resolution
Scarring/fibrosis
Chronic inflammation

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16
Q

Myeloperoxidase deficiency

A

Auto REC condition, no HOCL production leads to recurrent fungal infections (candida)

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17
Q

The acquired form of MPO usually happens due to

A

Myelomonocytic leukemia & acute myeloid leukemia

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18
Q

Chediak Higashi Syndrome

A

An AUTO REC
Defect in protein trafficking due to mutated CHS1 gene for Lysosomal transport protein

*Albinism
*Leukocytes with GIANT granules
*Hemostasis
*Impaired phagolysosome (recurrent infections)
*Peripheral neuropathy

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19
Q

Chronic Granulomatous disease

A

Deficient NADPH oxidase
(due to mutated CYBB) absent respiratory burst. It causes deep tissue bacterial and fungal abscesses in macrophage-rich organs (lymph nodes, liver, lungs etc)

Most common are catalase + (S. aureus, Nocardia, Aspergillus, & Candida)

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20
Q

What test is used for CGD and what results indicate what?

A

Nitroublue Tetrazolium dye test

Blue = NADPH okay
Colorless = NADPH is fucked

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21
Q

LAD (Leukocyte Adhesion Deficiency)

A

AUTO REC condition
Caused by deficient B2 integrin

-Delayed umbilical separation
- Hyperleukocytosis (>30,000)
- Poor wound healing
- Severe gingivitis
- Ulcers in genital area

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22
Q

LAD 2

A

AUTO REC
messed up selectin-leukocyte rolling
defective Sialyl-Lewis X glycoproteins

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23
Q

LAD 3

A

AUTO REC
Defective kindlin (which helps activate the ligands affinity of B2 integrins)

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24
Q

Phagocytic receptors:

Mannose receptor

A

A lectin that binds the terminal mannose and fucose residues of glycoproteins and glycolipids on microbial cell walls

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25
Q

Phagocytosis process (3 steps)

A
  1. Recognition/attachment of particle
  2. Engulfment + formation of phagocytic vacuole
  3. Killing/degradation
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26
Q

Chemotactic factors of leukocytes include:

A

IL-8
C5a
LTB4

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27
Q

Leukocyte Recruitment to inflammation steps (5)

A
  1. Margination
  2. Rolling
  3. Adhesion
  4. Transmigration/diapedesis
  5. Migration in interstitial tissue to injury
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28
Q

Steps of leukocyte recruitment:

Margination

A

Fibrinogens cause circulating leukocytes aggregate into rouleaux in the venules aka now marginating leukocytes.

29
Q

Steps of leukocyte recruitment:

Rolling of neutrophils

A

Happens in the venules where selectins on neutrophils and endothelial cells bind to each other “speed bumps.”
L-selectin is on neutrophils (bind GlyCam-1 endo)
P&E-selectin are on endothelium (bind Sialyl-Lewis x-mod glycoprotein neutrophil)

IL-1 & TNF stimulate the expression of selectins

30
Q

Where is P-selectin formed?

A

Wiebel Palade bodies in vascular endothelial cells

31
Q

Steps of leukocyte recruitment:

Adhesion of neutrophils

A

Integrins bind and firmly adhere the neutrophil to the endothelium:

VCAM & ICAM (Vascular endothelium)

MAC-1, LFA-1, & VLA-4 (Neutrophil)

32
Q

Steps of leukocyte recruitment:

Transmigration/Diapedesis

A

Mostly in the post-capillary venules, chemokines help leukocytes move through interendothelial spaces to reach sites of inflammation

PECAM-1 (intercellular junctions)
C5A
LTB4

33
Q

Leukocytes use __________ to breach the basement membrane and enter interstitial tissues

A

collagenases

34
Q
A

Chronic Granulomatous disease

35
Q
A

Pseudomembranous inflammation

36
Q
A

CGD

37
Q
A

Ulcerative inflammation

38
Q
A

Purulent/suppurative inflammation

39
Q
A

Fibrous inflammation

40
Q
A

Chediak Higashi syndrome

41
Q

Selectins:

Selectins are induced by _______ & ________?

A

IL-1 & TNF

42
Q

Selectins:

Describe what L-selectins are?

A

Expressed on neutrophils and bind to endothelial mucin-like molecules like GlyCam-1

43
Q

Selectins:

Describe what E & P Selectins are?

A

These are expressed on endothelial cells and bind to oligosaccharides like Sialyl-Lewis X on leukocytes.

44
Q

Selectins:

Where are P selectins stored?

A

They’re stored in endothelial Weibel-Palade bodies and platelet alpha granules & released y histamine & thrombin

45
Q

Immunoglobin-family adhesion proteins:

Describe where ICAM-1 & VCAM receptors are and what they bind to?

A

They are expressed on endothelial cells and bind to integrins on leukocytes

46
Q

Immunoglobin-family adhesion proteins:

Describe where integrins are and what they bind to?

A

LFA-1, MAC-1, & VLA-4 are all expressed on leukocytes & all bind to the endothelial Ig-family adhesion proteins

47
Q

Acute inflammation:

Describe the vasoactive changes that happen in acute inflammation.

A
  1. First vasoconstriction
  2. Then vasodilation of arterioles, capillaries, & post capillary venules
48
Q

Acute inflammation:

Describe the changes to vascular permeability following the vasoactive changes of acute inflammation

A

After the initial vasoconstriction then dilation causes transudate to leak out of capillaries into the interstitial space (edema)

49
Q

Acute inflammation, cellular response of leukocytes (Margination –> Transmigration)

A
  1. Margination (leukocytes move to the outer margin of blood flow to the vascular endothelium)
  2. Rolling (Selectins L (leukocytes) & P/E (endothelium) loosely bind GlyCam-1 & Sialyl-Lewis X glycoprotein respectively to slow the leukocyte down)
  3. Adhesion (Integrins (leukocyte) bind ICAM & VCAM (endothelium) to firmly adhere the leukocyte to endothelium)
  4. Transmigration (PCAM-1/CD31 mediated the movement of leukocytes across the endothelium membrane)
50
Q

Acute inflammation, Chemotaxis:

What are the chemotactic factors for neutrophils

A
  1. Products from bacteria
  2. Complement proteins C5a
  3. LTB4 (Lipoxygenase), Kallikrein, & HETE (hydroxyeicosatetranoic acid)

direct the leukocyte to the site of injury/infection

51
Q

Chemotactic factors:

Neutrophils

A

C5a
HETE
LTB4
Fibrinogen
PDGF

52
Q

Chemotactic factors:

Eosinophils

A

PAF
Fibronectin

53
Q

Chemotactic factors:

Macrophages

A

PDGF
TGF-B

54
Q

Most important opsonins for phagocytosis are ____ & ____

A

IgG & C3b

55
Q

Vasoconstriction is mediated by

A

TxA2 (platelets)
LTC4, LTD4, LTE4 (Leukotrienes)
PAF (Platelet aggregation factor)

56
Q

Vasodilation is mediated by

A

PGI2, PGE2, PGF2a (Prostaglandins)
Bradykinin
PAF
Nitric oxide

57
Q

Increased vascular permeability is mediated by

A

Histamine
Serotonin
PGE2, PGD2, PGF2 (Prostaglandins)
LTC4, LTD4, LTE4 (Leukotrienes)
Bradykinin
PAF

58
Q

Endogenous mediators, vasoactive amines:

Describe the vasoactive features of histamine

A

It mediates an increase in capillary permeability causing contraction of endothelial cells in postcapillary venules (during mild injuries)

It comes from basophils, mast cells, & platelets

59
Q

Endogenous mediators, vasoactive amines:

Describe the process of how histamine is released from basophils & mast cells ?

A

Histamine is released via degranulation when triggered by:
- Ag binding IgE to a basophil & mast cell
- C3a & C5a bind to receptors on basophils & mast cells
- heat/cold
- IL-1
- Factors from neutrophils, monocytes, & platelets

60
Q

Serotonin (5-hydroxytryptamine) acts similarly to ___________ & it’s derived from ____________

A

similar to histamine & it’s derived from platelets

61
Q

Arachidonic acid metabolites:

What stimulates the release of arachidonic acid from cell membranes?

A

Phospholipase A2

62
Q

Arachidonic acid metabolites:

The cyclooxygenase pathway is catalyzed by two enzymic isoforms _____ & _____, what is the pathway inhibited by?

A

COX-1 & COX-2
&
The pathway is inhibited by aspirin (any anti-inflammatory drugs)

63
Q

The cyclooxygenase pathway yields which two factors?

A

Platelet TxA2 (a powerful vasoconstrictor & platelet aggregate)
&
Endothelial PGI2 (a powerful vasodilator & inhibitor of platelet aggregation)

64
Q

The lipoxygenase pathway yields _____________ & its derivatives ______ in platelets & _____/____ in leukocytes

A

HPETE (Hydroperoxyeicosatetraenoic acid)
12-HPETE
5-HPETE/15-HPETE

65
Q

Describe the properties of 5-HPETE

A
  1. It gives rise to HETE a chemotactic for neutrophils & Leukotrienes LTB4 (chemotactic for neutrophils), LTC4, D4, E4 (Vasoconstrictors, bronchoconstrictors, & increase vascular permeability)
66
Q

interferon-γ are made from ____/___ & activate ______

A

made from t-cells and NK cells and activates monocytes into macrophages

67
Q

Cytokines IL-1 & TNF are secreted by ________

A

monocytes-macrophages

68
Q

IL-1 & TNF induce acute phase systemic effects

A

Path SJSM (26 decks)

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