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EMS - Mechanisms of Disease > Acute Inflammation (4) > Flashcards

Acute Inflammation (4) Flashcards

1
Q

Causes

A

Tissue death - Ischaemia, trauma, toxins, chemical insults, thermal injury, radiation

Infection - pus forming (pyogenic) bacterial

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2
Q

What is the purpose?

A
  • Clear away dead tissues
  • Locally protect from infection
  • Allow access of immune system components
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3
Q

Cardinal signs

A 
Calor - heat - vascular dilatation 
Rubor - redness - vascular dilatation
Dolor - pain
Tumor - swelling - inflammatory exudate into surrounding tissues
Function laesa - disturbance of function
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4
Q

Serous inflammation

A

Abundant protein-rich fluid exudate, non-viscous serous fluid

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5
Q

Fibrinous inflammation

A

Exudate of coagulated fibrin

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6
Q

Purulent inflammation

A

Pus formation

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7
Q

Pseudomembranous inflammation

A

Response to a powerful necrotising toxin, formation on a mucosal surface of a false membrane composed of fibrin, necrotic epithelium and inflammatory leukocytes

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8
Q

Vascular reaction

A

Dilatation (rubor), changes in flow

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9
Q

Exudative reaction

A

Formation of inflammatory exudate (tumour)

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10
Q

Exudate

A

Mass of cells and fluid that has seeped out of a blood vessel/organ, especially in inflammation

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11
Q

Cellular reaction

A

Migration of inflammatory cells out of vessels

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12
Q

Pyrexia

A

(Systemic effect of inflammation) Increase body temperature and fever

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13
Q

Acute phase reaction

A

(Systemic effect of inflammation) Changes to the synthesis of certain protein within the serum during an inflammatory response, provides rapid protection for host against microorganisms through non-specific defence mechanisms

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14
Q

Markers of acute phase reaction

A
  • C-reactive protein

- Erythrocyte sedimentation rate

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15
Q

Vascular reaction

A
  • Microvascular dilatation
  • Initially flow increases, then decreases
  • Increased permeability
    (Mediated - histamine, bradykinin, NO, leukotriene B4, complement components)
    (Non-mediated - direct damage to endothelium e.g. toxins, physical agents)
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16
Q

Exudative reaction

A
  • Protein rich (50g/l) - immunoglobulins and fibrinogen
  • Constantly turning over - dilution of noxious agents, transport to lymph nodes, supply to nutrients O2, spread of inflammatory mediators, spread of antibodies, spread of drugs
17
Q

Pericarditis

A

Inflammation of pericardium (fibrous from fibrin in inflammatory exudate)

18
Q

Cellular reaction

A
  • Accumulation of neutrophils in extracellular space

- If Severe > accumulation of neutrophils, cellular debris and bacteria > pus

19
Q

Neutrophils

A
  • Produced in bone marrow
  • Commonest WBC
  • Increase in acute inflammation
  • Motile, amoeboid (crawling-like motion), can move into tissues
  • Directional chemotaxis
  • Short lifespan (hours in tissues)
  • Phagocytotic and microbicidal (destructive to microorganisms)
20
Q

O2 dependent phagocytosis

A

Myeloperoxidase, H2O2, Cl-, O2-, OH-

21
Q

O2 independent phagocytosis

A

Lysozyme, lactoferrin, cationic proteins

22
Q

Neutrophil process

A

1) Margination - align themselves on the wall e.g. selectin
2) Rolling - adhesion
3) Migration - out of vessel
4) Chemotaxis

23
Q

Cell derived mediators of acute inflammation

A
  • Histamine (stored)
  • Prostaglandins (synthesised)
  • Leukotrienes (synthesised)
  • PAF (synthesised)
  • Cytokines (synthesised)
  • NO (synthesised)
  • Chemokines (synthesised)
24
Q

Plasma derived mediators of acute inflammation

A
  • Kinin system
  • Clotting pathway
  • Thrombolytic pathway
  • Complement pathway
25
Q

Mediators of vascular dilatation

A
  • Histamine
  • PGE2/I2
  • VIP
  • NO
  • PAF
26
Q

Mediators of increased permeability

A
  • Histamine
  • Bradykinin
  • NO
  • C5a
  • LTB4
  • PAF
27
Q

Mediators of neutrophil adhesion

A

Upregulation:

  • IL-8
  • C5a
  • LTB4
  • PAF
  • IL-1
  • TNF
28
Q

Mediators of neutrophil chemotaxis

A
  • LTB4
  • IL-8
  • Chemokines
29
Q

Drugs that interfere

A
  • Glucocorticoid steroids
  • NSAIDs
  • LT receptor antagonists
30
Q

Minimal tissue damage

A

Resolution

31
Q

Some tissue damage

A

Fibrosis

32
Q

Marked neutrophil reaction with tissue damage

A

Suppuration - abscess

33
Q

Damaging agent persists

A

Chronic inflammation

EMS - Mechanisms of Disease (21 decks)

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