Acute inflammation 2

Question 1

What are the outcomes of acute inflammation?

Answer 1

Resolution
Suppuration
Organisation
Dissemination
Chronic inflammation

Question 2

What do you call inflammation at…

• Peritoneal cavity
• Meninges
• Appendix

Answer 2

Peritonitis
Meningitis
Appendicitis

Question 3

What do you call inflammation at the…

• Lungs
• Pleural cavity

Answer 3

Pneumonia

Pleurisy

Question 4

What do neutrophils do?

Answer 4

They are mobile phagocytes which recognise foreign antigens and move towards it- chemotaxis. They adhere to the organism.
The granules released granule contents which contains oxidants (H2O2) and enzymes (proteases). Phagocytosis occurs and the foreign antigen is destroyed.

Question 5

What happens when the granules have been expelled?

Answer 5

The neutrophils die. This produces pus where the infection is. it might extend into other tissues, which progresses the inflammation.

Question 6

What does pus consist of?

Answer 6

Dead tissue, organisms, exudate, neutrophils, fibrin, red cells, debris.
Surrounded by a pyogenic membrane

Question 7

What is the role of plasma proteins in inflammation?

Answer 7

Fibrinogen (coagulation factor) forms fibrin and clots exudates, localises inflammatory response.

Question 8

What are the types of mediators of acute inflammation?

Answer 8

• molecules on endothelial cell surface membrane
• molecules released from cells
• molecules inside cells
• molecules in the plasma

Question 9

What are the collective effects of mediators?

Answer 9

vasodilation
increased permeability, neutrophil adhesion, chemotaxis,
itch and pain

Question 10

what molecules are released from cells?

Answer 10

• histamine
• 5-hydroxytryptamine (serotonin)
• prostaglandin
• cytokines and chemokine
• nitric oxide
• oxygen free radicals ie H2O2, OH, O2

Question 11

What are the immediate systemic effects of inflammation?

Answer 11

Pyrexia- raised temperature
- Endogenous pyrogens from white cells acts centrally
Feel unwell
- Malaise, anorexia, nausea
- Abdominal pain and vomiting in children
Neutrophilia- raised white cell count
- Bone marrow releases/produces

Question 12

What are the longer- term effects of inflammation?

Answer 12

Lymphadenopathy- regional lymph node enlargement
Weight loss- catabolic process
Anaemia

Question 13

What are the outcomes of acute inflammation?

Answer 13

Suppuration
Organisation
Dissemination

Question 14

What is suppuration?

Answer 14

• Pus formation (Dead tissue, organisms, exudate, neutrophils, fibrin, red cells, debris.)
  Pyogenic membrane surrounds the pus

Question 15

What is organisation?

Answer 15

• Granulation tissue is a “universal patch”/repair kit for all damage. It is formed of new capillaries- angiogenesis, fibroblasts and collagen, macrophages.
• Healing and repair
• Leads to fibrosis and formation of a scar

Question 16

What is dissemination?

Answer 16

• Spread to bloodstream- patient “septic”
• Bacteraemia- bacteria in blood
• Septicaemia- growth of bacteria in blood
• Toxaemia- toxic products in blood

Question 17

What is an abscess?

Answer 17

Collection of pus (suppuration) under pressure
Single locule, multiloculated
“points” and discharges
Collapses- healing and repair

Question 18

Where else can Pus be found and how does it occur?

Answer 18

Pus bursts through the pyogenic membrane and forms new cavities.
ISSUE.
- Empyema- in a hollow viscus i.e. gall bladder and pleural cavity
- PYAEMIA- discharge to bloodstream

Question 19

What are the effects of systemic infection?

Answer 19

Shock- inability to perfuse tissues
Clinical picture of early septic shock
-	Peripheral vasodilation
-	Tachycardia- high heart rate
-	Hypotension- low blood pressure