Acute inflammation 2 Flashcards
What is the suffix for inflammaiton?
- itis
e. g. meningitis (inflammation of meninges)
e. g. Appendicitis (inflammation of appendix)
Whats inflammation of lungs called?
Pneumonia
Whats inflammation of the pluera called?
Pleurisy
What is the function of a neutrophil?
They are mobile phagocytes
How do neutrophils move towards foreign antigens?
By chemotaxis
What do neutrophils use to digest ingested foreign particles?
Granules which contain oxidants & digestive enzymes (e.g. proteases)
What happens to neutrophils after they digest a foreign organism?
They die prodcuing pus made of fluid, cell parts & endogenous proteins.
What two plasma proteins are mainly involved in acute inflammation?
Fibrinogen
Immunoglobulins
What does Fibrinogen do?
Forms fibrin which clots around the area of inflammation, basically localising by blocking off the inflammatory process.
What do immunoglobulins do in acute inflammation?
Antibodies opsonize pathogens so phagocytes can more easily reconise/destroy them.
They also activate the complement system leading to lysis of pathogenic cells.
What are 3 locations/types of acute inflammatory mediators?
- Molecuels on endothelial cell surface
- Molecules in blood plasma
- Molecules released from cells in infalmmatory tissue.
What 5 things do inflammatory mediators cause?
Vasodilation Altered Vascular permeability Chemotaxis Neutrophil adhesion Itch/Pain
What tye of inflammatory mediators cause neutrophil adhesion?
Cell surface mediators - Adhesion molecules
e.g. ICAM-1 helps in pavementing
What inflammatory mediator is released from Mast Cells?
Histamine
Why triggers histamine release?
IgE mediated reactions
What/how does histamine cause?
Vasodilation & increased vascular permability
Acts on H1 receptors on endothelial cells
Where is the inflammatory mediator 5-hydroxytryptamine made?
PLatelets
What is 5-hydroxytryptamine called?
Serotonin
What does serotonin cause & why?
Vasoconstriction to prevent leakage from a damaged vessel.
When is serotonin released? (5-hydroxytryptamine)
When platelets coagulate to reapir a damaged vessel (i.e. degranulate)
What are cytokines & chemokines?
Inflammatory Mediators
Small molecuels produced by endothelium ,macrophages & lymphocytes in response to inflammtory stimuli
Waht do cytokines & chemokines do?
Attract inflamatory cells and trigger action of some of them
What are the 4 enzyme cascades that interact and make up plasma inflammatory mediators?
The blood coagulation pathway
Fibrinolysis
Kinin system
Complement Cascade
What does the blood coagulation pathway do?
Forms fibrin from firbinogen & clots it around exudate to contain inflammation
What does fibrinolysis do?
Breaks down fibrin clots to help maintain blood supply
Products of fibrin breakdwon are vasoactive (affect vessel diameter)
Qhat are the conseueuncecs of the complement cascade?
Activated complement proteins can:
- Increase permeability
- Stimulate chemotaxis
- Phagocytose antigens
- cause cell lysis ofpathogens.
What is pyrexia?
Endogenous pyogenes released from white cells
-> Cause raised temperature
What is malaise?
General feelin of unwell
What symptoms do children with inflmaation show specially?
Abdominal pain
vomiting
Define Neutrophilia:
A high number of neutrophils in the blood
Bone marrow produces more white cells.
What is suppuration?
An outcome of inflammation
Pus formation surrounded by a pyogenic membrane
What is an abscess?
Suppuration under pressure, clumps in one spot then discharges (popping)
Single locale, if pus bursts pyogenic membrane becmes multiloculate
What is it called when pus ends up int he bloodstream?
Pyaemia, when pus is in the blood
What is empyema?
Pus ending up in a hollow viscus (hollow organ)
e.g. gall bladder or pleural cavity
What is organisation?
Formation of granulation tissue followed by fibrosis forming a scar
What makes up granulation tissue?
New capillaries
Fibroblasts & collagen
MAcrophages
What is dissemination?
Spread of the acute inflammatory process to the blood i.e. pateint is septic
Define bacteraemia:
Bacteria in blood
Often happens & ususally cleared harmlessly
Define Septicaemia:
Bacteria growing in the blood
Define Toxaemia:
Toxic products in the blood
e.g. lipopolysaccharides from gram negative bacteria
Define Shock:
The inability to perfuse (deliver blood to capillary beds) tissues,
What are the symptoms of early septic shock?
- Peripheral Vasodilation
- Tachycardia
- Hypotension (Low BP)
- Pyrexia (raised temp)
- Sometimes haemorrhagic skin rash
What does BP stand for?
Blood Pressure
What does CO stand for & how is it calculated?
Cardiac Output
Stroke volume x Heart Rate
What does SV stand for?
Stroke Volume
What does HR stand for?
Heart Rate
What is SVR & how is it calculated?
Systemic Vascular Resistance, the resistance to blood flow offered by systemic vasculature.
SVR = BP/CO
What happens to Stroke volume during shock?
The stroke volume decreases during shock
How is cardiac output maintained during shock?
By increasing heart rate to balance lost stroke volume (CO = SVxHR)
How is pyrexia caused during septic shock?
- Bacterial endotoxin released
- > Interleukin-1 acts on hypothalamus
- > raised temperature (pyrexia)
How is haemorrhagic skin rash caused during septic shock?
Shock causes coagulation
- > fibrin breakdown releases vasoactive chemicals that cause vasodilation
- > Results in haemorrhagic rash
What happnes when heart rate cant be increased enough to maintain cardiac output?
Blood pressure falls
BP = CO x SVR
Whats the effect of falling blood pressure?
Reduced tissue perfusion
- > Tissue Hypoxia
- > Loss of tissue & organ function
What is the outcome of septic shock?
Tissue hypoxia -> cell death
Resulting in haemorrhage & death.
