Acute Inflammation

Question 1

5 cardinal signs of inflammation

Answer 1

swelling, redness, heat, pain, loss of function

Question 2

inflammation

Answer 2

coordinated and complex host response to a stimulus (microbes, necrotic tissue) involving soluble mediators, vascular reaction, and cellular and humoral elements resulting in the movement of fluid and leukocytes from the blood to extravascular tissues

Question 3

acute v chronic inflammation

Answer 3

acute- rapid, short duration, edema, neutrophils and macrophages, non-specific immune response

chronic- insidious onset, long duration, fibrosis, vascular proliferation, lymphocytes, plasma cells, macrophages, immunospecific

Question 4

acute inflammation

Answer 4

rapid host response to serve to deliver leukocytes and plasma proteins to injury/infection

• vascular changes (calor, rubor)
• structural changes in microvasculature that permit proteins and leukocytes to leave the circulation (edema)
• emigration of leukocytes from vasculature and accumulation and activation at the site of stimuli (dolor)

Question 5

stimuli for acute inflammation

Answer 5

infection
necrosis
foreign bodies
immune rxn

Question 6

mediators released by necrotic cells

Answer 6

uric acid, ATP, DNA, DNA bp

cause inflammation

Question 7

vascular changes in acute inflammation

Answer 7

transient constriction followed by dilation (mediated by histamine and NO)- causes redness and warmth

increased permeability- causes protein rich exudate (swelling)

hemoconcentration- stasis enabling migration

Question 8

edema

Answer 8

excess of fluid in interstitial tissue or serous cavity

5 types:
increased hydrostatic pressure
decreased oncotic pressure
vascular endothelial retraction or damage**
decreased lymphatic drainage
renal sodium retention

**this is the type that happens in acute inflammation

Question 9

transudate vs exudate

Answer 9

caused by physical changes (increased hydrostatic pressure, decreased oncotic pressure)

fluid doesnt have protein

exudate is a change in permeability, allowing large proteins to flow as well- edema

Question 10

how does edema leave?

Answer 10

lymphatics drain edema and leukocytes

Question 11

what happens if insult isn’t cleared in acute inflammation

Answer 11

leukocytes don’t leave, inflammation starts causing tissue damage

Question 12

most important phagocytes in acute inflammation

Answer 12

macrophages and neutrophils

Question 13

p-selectin/e-selectin

Answer 13

p-selectin expressed by endothelial cells

e selectin expressed by leukocytes-

start the rolling process

Question 14

chemokines and integrins

Answer 14

produced by leukocytes, bind to endothelial cells and activate integrins on leukocytes- VLA-4, LFA-1 are responsible for firm adhesions ICAM on the endothelial cells

Question 15

transmigration

Answer 15

chemokines induce adhesion molecule PECAM-1- enables migration through interendothelial spaces

leukocytes secrete collagenase to cross basement membrane

Question 16

chemotaxis

Answer 16

gradient-mediated attractants

two types- exogenous and endogenous

exo- peptides (n-formyl methionine amino acids)
lipids

endo- cytokines (il8)
complement (c5a)
arachidonic acids metabolites

bind to g proteins on leukocytes and activate actin

Question 17

describe the time sequence of inflammation

Answer 17

0-6 hrs- edema
6-24 hrs- PMNs, eosinophils
24-48 hrs- monocytes, macrophages