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723: Pathophysiology > Acute Inflammation > Flashcards

Acute Inflammation Flashcards

1
Q

What is acute inflammation characterized by?

A

Exudation of fluid and plasma components and emigration of leukocytes, predominantly neutrophils, into the extravascular tissue

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2
Q

Acute inflammation occurs ___ adaptive immunity becomes established

A

before

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3
Q

What triggers acute inflammation?

A
  • infections
  • immune reactions
  • blunt and penetrating trauma
  • physical or chemical agents
  • tissue necrosis
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4
Q

What is the primary phagocyte that arrives early at the site of inflammation, usually within 90 minutes of injury?

A

neutrophil

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5
Q

The neutrophil count in the blood often ______ greatly during an inflammatory process, especially with bacterial infections.

A

increases

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6
Q

Once released from the bone marrow neutrophils have a life span on how long?

A

10 hours

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7
Q

What leukocyte is the largest and constitutes 3-8% of the WBC count?

A

monocytes

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8
Q

Within __ hours, mononuclear cells arrive at the inflammatory site, and by __ hours, monocytes and macrophages are the predominant cell type.

A

24

48

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9
Q

Monocytes and macrophages produce potent vasoactive mediators that promote tissue regeneration. List these 5 mediators

A
  • prostaglandins
  • leukotrienes
  • platelet activating factor (PAF)
  • inflammatory cytokines
  • growth factors
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10
Q

Do monocytes of neutrophils engulf larger and greater quantities of foreign material?

A

monocytes

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11
Q

What 3 cell types produce lipid mediators and cytokines that induce inflammation?

A
  • eosinophils
  • basophils
  • mast cells
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12
Q

When do eosinophils increase in the blood?

A
  • allergic reactions

- parasitic infections

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13
Q

What do the granules of basophils contain?

A

histamine and other bioactive mediators of inflammation

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14
Q

The binding of basophils and mast cells to the antibody IgE triggers what to happen?

A

release of histamine and vasoactive agents from the basophil granules

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15
Q

What 3 things does activation of mast cells result in?

A
  • release of preformed contents of their granules
  • synthesis of lipid mediators derived from cell membrane precursors
  • stimulation of cytokine and chemokine synthesis
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16
Q

What are the 2 components of acute inflammation?

A
  • vascular stage

- cellular stage

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17
Q

What is the vascular stage characterized by?

A

Vasodilation and changes in blood flow followed by increased vascular permeability and leakage of protein-rich fluid into the extravascular tissues

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18
Q

Which comes first, vasodilation or vasoconstriction?

A

Vasoconstriction

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19
Q

Vasodilation is most notably mediated by what?

A
  • histamine

- nitric oxide

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20
Q

This increase in vasodilation is quickly followed by increased permeability of the microvasculature, which results in what?

A

The outpouring of a protein-rich fluid (exudate) into the extravascular spaces

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21
Q

This loss of fluid result in what 3 things?

A
  • an increased concentration of blood constitutes
  • stagnation of flow
  • clotting of blood at the site of injury
22
Q

The loss of plasma proteins _____ the intracapillary osmotic pressure and _____ the osmotic pressure of the interstitial fluid. What does this cause?

A

reduces

increases

Fluid to move into the tissues and produce swelling, pain, and impaired function

23
Q

What is the benefit of exudation of fluid into the tissue spaces?

A

it dilutes the offending agent

24
Q

What causes the increased permeability characteristic of acute inflammation?

A

Binding of the chemical mediators to endothelial receptors causes contraction of the endothelial cells and separation of intercellular junctions

25
Q

What are the 3 vascular response patterns that occur with inflammation?

A
  • immediate transient response
  • immediate sustained response
  • delayed hemodynamic response
26
Q

What is the cellular stage of acute inflammation marked by?

A

Changes in the endothelial cells lining the vasculature and movement of phagocytic leukocytes into the area of injury or infection

27
Q

Describe the sequence of events in the cellular response to inflammation

A

1) leukocyte margination and adhesion to the endothelium
2) leukocyte transmigration across the andothelium
3) chemotaxis
4) leukocyte activation and phagocytosis

28
Q

Define leukocyte margination

A

accumulation and adhesion of leukocytes to the epithelial cells of blood vessel walls at the site of injury in the early stages of inflammation

29
Q

Leukocytes adhere strongly to what on the endothelium?

A

Intercellular adhesion molecules (ICAMs)

30
Q

What does adhesion of the leukocytes cause?

A

The endothelial cells to separate, allowing the leukocytes to extend pseudopodia and transmigrate through the vessel wall

31
Q

The _____ family functions to adhere leukocytes to the endothelial cells

A

selectin

32
Q

What is chemotaxis?

A

The dynamic and energy-directed process of directed cell migration

33
Q

What are chemokines?

A

small proteins that direct the trafficking of leukocytes during the early stages of inflammation or injury

34
Q

What 3 types of leukocytes are activated to engulf and degrade the bacteria and cellular debris?

A
  • monocytes
  • neutrophils
  • macrophages
35
Q

What are the 3 steps of phagocytosis?

A

1) recognition and adherence
2) engulfment
3) intracellular killing

36
Q

What are the signs and symptoms of inflammation produced by?

A

chemical mediators

37
Q

Mediators can originate either from _____ or _____

A

plasma

cells

38
Q

What triggers the production of active mediators?

A

Microbes or host proteins

39
Q

List 6 inflammatory mediators

A
  • histamines
  • arachidonic acid metabolites
  • platelet-activating factor
  • plasma proteins
  • cytokines and chemokines
  • nitric oxide and oxygen-derived free radicals
40
Q

What does histamine do?

A

Causes dilation of arterioles and increases the permeability of venules

41
Q

Release of arachidonic acid by phsopholipases leads to the production of what?

A

eicosanoids

42
Q

What are 2 types of eicosanoids?

A
  • prostaglandins

- leukotrienes

43
Q

What do prostaglandins (PGD2, PGE2, PGF2, and PGI2) do?

A

induce inflammation and potentiate the effects of histamine and other inflammatory mediators

44
Q

What does the prostaglandin thromboxane A2 do?

A

promotes platelet aggregation and vasoconstriction

45
Q

What do leukotrienes (C4, LTD4, and LTE4) do?

A

slow and sustained constriction of bronchioles and are important inflammatory mediators in bronchial asthma and anaphylaxis

46
Q

What are cytokines?

A

Proteins that modulate the function of other cells

47
Q

What are the 2 major cytokines that mediate inflammation?

A

1) Tumor necrosis factor-alpha (TNF)

2) IL-1

48
Q

TNF-alpha and IL-1 are mediators of the acute-phase response. What are the features of these systemic responses?

A
  • fever
  • hypotension
  • increased HR
  • anorexia
  • release of neutrophils into the circulation
  • increased levels of corticosteroid hormones
49
Q

What are chemokines?

A

small proteins that act primarily as chemoattractants to recruit and direct the migration of immune and inflammatory cells

50
Q

What roles does nitric oxide play in the inflammatory response?

A
  • smooth muscle relaxation

- antagonism of platelet adhesion, aggregation and degranulation

51
Q

Characteristically, the acute inflammatory response involves the production of _____

A

exudates

52
Q

What are the 5 types of exudates?

A
  • serous
  • hemorrhagic
  • fibrinous
  • membranous
  • purulent

723: Pathophysiology (13 decks)

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