Acute Inflammation

Question 1

Define acute inflammation

Answer 1

Immediate & early response to injury (transient- last short time)

To deliver leukocytes to site of injury

Question 2

What is ‘itis’ vs ‘osis’ at the end of conditions

Answer 2

itis= Inflammation of
osis= Is a disease/condition

Question 3

What are the 5 causes of inflammation

Answer 3

Infections
Hypersensitivity reactions
Physical agents e.g. trauma
Necrosis
Chemicals

Question 4

What are bacterial exotoxins

Answer 4

Chemical released by bacteria stimulating inflammation

Question 5

What are bacterial endotoxins

Answer 5

Associated in cell walls which get released and stimulate inflammation

Question 6

What is hypersensitivity

Answer 6

Excess immune response due to altered immunological state

Question 7

How does physical agents and chemicals cause inflammation

Answer 7

Tissue damage provokes inflammatory response

Question 8

How does tissue necrosis trigger inflammation

Answer 8

Dead tissue releases peptides which trigger inflammatory response

Question 9

What are the Cardinal signs of acute inflammation (diagnostic features)

Answer 9

Redness(rubor)
Heat (calor)
Swelling (tumour)
Pain (dolar)
Loss of function (functio laesa)

Question 10

What is redness and heat caused by in inflammation

Answer 10

Dilation of blood vessels leading to increased blood flow and increased vessel permeability

Question 11

What causes pain in inflammation

Answer 11

Distortion of tissue and release of chemical mediators-
Prostaglandins & Bradykinins

Question 12

What is swelling caused by in inflammation

Answer 12

Accumulation of fluid & increased inflammatory cells migrating to the area

Question 13

What are the 6 stages of inflammation

Answer 13

1. Chemical mediator release
2. Vasodilation
3. Increased vascular permeability
4. Fluid accumulation
5. Cellular recruitment (neutrophils)
6. Phagocytosis

Question 14

What are the 2 major components of early inflammation

Answer 14

Vascular changes (change in vessel calibre)
Cellular events (forms cellular exudate)

Question 15

How does the vascular calibre change in acute inflammation

Answer 15

initial transient constriction then vasodilation occurs

Question 16

What is exudation

Answer 16

Vascular permeability increases which increases net flow of fluid out of the vessels

Question 17

What processes are involved in forming cellular exudate

Answer 17

Margination
Adhesion
Emigration

To accumulate neutrophil polymorphs

Question 18

What is margination

Answer 18

Neutrophils marginate out by inflammation site losing intravascular fluid to slow flow of blood to site

Question 19

What is adhesion

Answer 19

Neutrophils adhere to vascular endothelium
-interaction between paired adhesion molecules on neutrophils and endothelial surface

Question 20

What is emigration

Answer 20

Neutrophils pass between endothelial cells through basil lamina and into the adventitia

Question 21

What are the components of cellular exudate

Answer 21

Cells (endothelial & inflammatory)
Chemical agents (Cytokines, complements, histamine & prostaglandins)

Question 22

What are the early chemical mediators of inflammation

Answer 22

Histamine & Thrombin & Neutrophils

Question 23

What chemical mediators of inflammation are released by cells

Answer 23

Histamine
Lysosomal compounds
Leukotrienes
Prostaglandins
Serotonin
Chemokines

Question 24

What does histamine cause

Answer 24

Vascular dilation and increased permeability

(Released by mast cells)

Question 25

What do lysosomal compounds cause

Answer 25

Increasing vascular permeability and stimulated histamine release from mast cells (released by neutrophils)

Question 26

What do leukotrienes cause

Answer 26

Vasoactive properties (made in neutrophils)

Question 27

What do prostaglandins do

Answer 27

Increase vascular permeability and cause platelet aggregation

Question 28

What does serotonin do

Answer 28

Vasoconstrictor (released by platelets)

Question 29

What do chemokines do

Answer 29

Attract more WBC to site of infection -Common one is Il-8 which attracts neutrophils

Question 30

What are the enzyme cascade systems in plasma

Answer 30

Coagulation system Kinins Fibrinolytic system Complement System

Question 31

What are some Inflammation benefits

Answer 31

Entry of antibodies Dilution of toxins Drug transport Stimulates immune response

Question 32

What are harmful effects of inflammation

Answer 32

Digestion of normal tissue Swelling can compromise airways and cause brain damage Can cause anaphylaxis if inappropriate

Question 33

What are systematic manifestations of acute inflammation

Answer 33

Fever Malaise Loss of appetite Nausea

Question 34

What are outcomes of acute inflammation

Answer 34

Resolution Suppuration Scarring/fibrosis Chronic inflammation

Question 35

What is resolution of acute inflammation

Answer 35

Everything goes back to normal with mininal tissue damage and good vascular drainage to remove fluid & debris

Question 36

What is suppuration

Answer 36

The formation of pus -Mixture of neutrophils (dead & alive), debris & bacteria -Walled off pus forma and abcess

Question 37

What causes scarring/fibrosis

Answer 37

New capillaries lead to more macrophages proliferating more fibroblasts

Question 38

What types of skin healing are there

Answer 38

By primary intention By secondary intention

Question 39

What is healing by primary intention

Answer 39

2 edges of wound brought together an fibrin joins weakly at edges -Over time epidermal re-growth and collagen synthesis makes stronger join

Question 40

What is healing by secondary intention

Answer 40

Tissue defect filled by granulation tissue and epithelial re-growth occurs over surface -Fibrous scar forms contracting over time

Question 41

How does acute inflammation progress to chronic

Answer 41

If causative agent is not removed, cellular exudate changes lymphocytes, plasma cells and macrophages replace neutrophils

Question 42

What are macroscopic signs of chronic inflammation

Answer 42

Chronic ulcer Chronic abscess cavity Fibrosis/tissue thickening

Question 43

what do the cells of chronic inflammation look like

Answer 43

Lymphocytes- Small circular purple dots Plasma cells- fried eggs Macrophages- Big and blobby Eosinophils- Tomato with sunglasses

Question 44

What do lymphocytes do in chronic inflammation

Answer 44

B- turn into plasma cells then produce antibodies T - Killer T cells (CD8+) – cytotoxic function. Helper T cells (CD4+) – Activate killer T and plasma cells

Question 45

What are macrophages good at

Answer 45

Eating things i.e. phagocytosis -Not killed in the process like neutrophils Produce cytokines

Question 46

what do cytokines do in chronic inflammation

Answer 46

Small proteins which enhance cell mediated immunity and antibody response - cell signalling and promote apoptosis

Question 47

What is a granuloma

Answer 47

Collection of histocytes -stationary phagocytic cell present in connective tissue

Question 48

what are giant cells

Answer 48

Macrophages collide (potentially when both trying to eat same particle) producing huge multi-nucleated cells

Question 49

What 3 types of giant cells are there

Answer 49

Foreign body type Langhans Touton type

Question 50

What are foreign body type giant cells

Answer 50

Have random nuclei scattering

Question 51

What are Langhans giant cells

Answer 51

Has a horseshoe nucleus often seen in TB

Question 52

What are touton type giant cells

Answer 52

Lipid breakdown with neat circle of cells