Acute Inflammation

Question 1

What is inflammation?

Answer 1

Local physiological response to tissue injury

Question 2

What is the difference between acute and chronic inflammation?

Answer 2

Acute: initial and transient reaction to tissue injury

Chronic: subsequent and prolonged reaction to tissue injury

Question 3

Pros and cons of inflammation?

Answer 3

Pro: destruction of micro-organisms

Con: can produce disease, for example abscess in brain

Question 4

What are the steps in the development of acute inflammation?

Answer 4

1. Initial reaction to tissue injury
2. Dilatation of vessels
3. Vascular leakage of protein rich fluid
4. Neutrophil recruitment
5. Outcome: resolution, suppuration, progression to chronic inflammation

Question 5

What is suppuration?

Answer 5

Pus formation

Question 6

List 5 causes of inflammation!

Answer 6

1. Infections
2. Hypersensitivity reactions
3. Physical agents: trauma, ionising radiation
4. Irritant & corrosive agents: acids, alkalis
5. Tissue necrosis: ischaemic infarction

Question 7

What’s the most common cause of inflammation?

Answer 7

Infection

Question 8

How do bacteria lead to inflammation occurring?

Answer 8

They release toxins which synthesise chemicals that initiate inflammation

Also can release chemical irritants that lead directly to inflammation

Question 9

How do viruses lead to inflammation occurring?

Answer 9

They cause cell death by multiplying inside cells.. dying cells = inflammation

Question 10

Which micro-organisms are known to cause hypersensitivity reactions in the body, thus leading to inflammation?

Answer 10

Parasites

Tuberculosis bacteria

Question 11

Describe what is meant by micro-organisms causing a hypersensitivity reaction?

Give an example!

Answer 11

When the immune system produces an inappropriate or excessive reaction to the micro-organism, which causes damage to the body tissues

Example: TB, body tries to fight off bacteria but actually creates granulomas in the process, which affect lung function

Question 12

Give some examples of physical agents that can cause inflammation. How do they do it?

Answer 12

Trauma
Ionising radiation
Excessive heat / cold

Cause tissue damage
Tissue damage leads to inflammation

Question 13

Give some examples of irritants that can cause inflammation.

Answer 13

Acids
Alkalis
Oxidising agents

Question 14

What would you see at the edges of a site of necrotic tissue?

Answer 14

Signs of acute inflammation

Because necrotic tissue releases peptides which causes inflammation

Question 15

List the macroscopic appearances of inflammation!

Answer 15

RUBOR
CALOR
TUMOR
DOLOR

Loss of function
Serous exudate
Suppurative: pus formation

Question 16

What is meant by rubor?

Answer 16

Redness

Due to dilation of blood vessels in the inflamed area

Question 17

What is meant by calor?

Answer 17

Heat
Due to the increased blood flow to the inflamed area

Obviously this is only noticeable in peripheral areas

Question 18

What is meant by ‘tumor’?

Answer 18

Swelling, oedema

Due to accumulation of fluid in extravascular space AND the mass of inflammatory cells that have migrated there

Question 19

What happens if ‘tumor’ is occurring for a long time?

Answer 19

New connective tissue forms that contributes to the initial problem

Question 20

What is meant by dolor?

Answer 20

Pain
Due to stretching and distortion of tissues
Excess pressure
Chemical mediators stimulated which induce pain

Question 21

Why does loss of function occur

Answer 21

Dolor: Movement is inhibited by pain

Tumor: swelling can immobilise tissues

Question 22

What should you look for on a histological slide when diagnosing acute inflammation?

Answer 22

Neutrophils

Purple, wbcs

Question 23

What do neutrophils contribute to the inflammatory process?

Answer 23

Movement, adhesion, destruction of micro-organisms

Phagocytosis

Question 24

What components accumulate in extra-cellular spaces during inflammation (tumor)?

Answer 24

Oedema fluid
Fibrin
Neutrophils

Question 25

Cellular exudate is formed in acute inflammation, true or false?

Answer 25

True!

Question 26

Vessels become less permeable in acute inflammation, true or false?

Answer 26

False! | You get increased vascular permeability

Question 27

Small vessels dilate in acute inflammation, true or false?

Answer 27

True! | To allow everything to get to the site to help

Question 28

Chemical mediators like histamine, bradykinin, NO and many more cause vascular permeability. How quickly do they do so and how long does the response last?

Answer 28

Immediately but transiently

Question 29

Severe direct vascular injury causes increased vascular permeability. How quickly does this happen and how long does it last?

Answer 29

Immediately and sustained

Question 30

Endothelial cell injury causes increased vascular permeability. How quickly does this happen and how long does it last?

Answer 30

Delayed but prolonged

Question 31

What can cause endothelial cell injury?

Answer 31

X-rays | Bacterial toxins

Question 32

Name some chemical mediators that cause immediate, transient increased vascular permeability.

Answer 32

Histamine Bradykinin Nitric oxide

Question 33

What main effect do chemical mediators have that contribute to acute inflammation? How?

Answer 33

They cause the spread of acute inflammation Inflamed tissue releases them and they spread to uninflamed tissue

Question 34

List the effects of the chemical mediators.

Answer 34

``` Vasodilatation Emigration of neutrophils Chemotaxis Increased vascular permeability Itching & pain ```

Question 35

Briefly, what do histamine and thrombin do?

Answer 35

Upregulation of adhesion molecules on the surface of endothelial cells

Question 36

What are plasma factors?

Answer 36

Enzymes found in the plasma They form part of 4 cascade systems that result in the production of inflammatory mediators

Question 37

What do macrophages do?

Answer 37

Ingest pathogens and digest them using enzymes in their lysosomes

Question 38

What is necrotising tissue? | What does it mean if it's gangrenous?

Answer 38

Tissue that's dead as well as inflamed | It is beginning to decompose

Question 39

List and describe the outcomes of acute inflammation.

Answer 39

1. Resolution: everything goes back to normal 2. Suppuration: pus formation 3. Organisation: reorganising a tissue into a scar, a solid structure 4. Progression to chronic inflammation

Question 40

What are the systemic effects of inflammation?

Answer 40

Pyrexia Malaise, anorexia, nausea Weight loss Reactive hyperplasia of reticuloendothelial system: swelling of lymph tissues due to excess production of lymphocytes Increased white cell count Amyloidosis

Question 41

What is amyloidosis?

Answer 41

Deposition of insoluble, abnormally folded proteins which stops organs & tissues working properly

Question 42

What is meant by constitutional symptoms?

Answer 42

Malaise, anorexia, nausea | symptoms to do with how you feel

Question 43

What impact does excessive exudate have on the outcome of acute inflammation?

Answer 43

The outcome will be suppuration, not resolution

Question 44

What impact does excessive necrosis have on the outcome of acute inflammation?

Answer 44

The outcome will be reorganisation (scar formation) rather than resolution

Question 45

What happens when the cause of inflammation is persistent? What is the outcome of acute inflammation?

Answer 45

Progression to chronic inflammation rather than resolution