Acute Inflammation

Question 1

Define acute inflammation

Answer 1

Protective changes as a response to injury in order to maintain the integrity of a higher organism

Question 2

List the cardinal signs of acute inflammation

Answer 2

Rubor (redness)
Calor (heat)
Tumor (swelling)
Dolor (pain)
Loss of function

Question 3

Give the 6 causes of acute inflammation

Answer 3

Micro-organism (infection)
Mechanical (trauma)
Chemical (pH)
Physical (heat/cold)
Necrosis
Hypersensitivity

Question 4

Name the three processes which give rise to acute inflammation

Answer 4

Vessel radius changes
Permeability changes
Neutrophil movement

Question 5

Describe how changes in vessel radius give rise to acute inflammation

Answer 5

Increased flow of blood is caused by successive arteriolar constriction/dilation followed by smooth muscle relaxation
(Poiseulle’s Law)

Question 6

Describe how changes in permeability give rise to acute inflammation

Answer 6

Swelling is caused by net movement of material (plasma/protein/fibrinogen/immunoglobulin) out of capillaries
Causes an increase in blood viscosity leading to stasis (decreased/low flow rate)

Question 7

Describe how neutrophil movement gives rise to acute inflammation

Answer 7

Loss of normal laminar flow is caused by RBCs gathering in the centre of the blood vessels and neutrophils gathering at the edges near the endothelium
Neutrophil;
Margination (movement to edges)
Pavementing (adherence to endothelium)
Emigration (movement from endothelium to extravascular tissues)

Question 8

How is acute inflammation resolved?

Answer 8

Isolation and destruction of inciting agent
Phagocytosis of debris by macrophages
Epithelial regeneration
Exudate filters away
Normalisation of vascular changes

Question 9

What is meant by the margination of neutrophils?

Answer 9

Movement to edges of blood vessels

Question 10

What is meant by the pavementing of neutrophils?

Answer 10

Adherence to endothelium

Question 11

What is meant by the emigration of neutrophils?

Answer 11

Movement from endothelium to extravascular tissues

Question 12

Give three benefits of acute inflammation

Answer 12

Rapid response (due to cardinal signs - protection)
Neutrophil action
Localisation (by plasma proteins)

Question 13

Give the possible outcomes of acute infection?

Answer 13

Resolution
Suppuration (pus formation)
Organisation
Development of chronic inflammation

Question 14

What suffix is given to conditions of acute inflammation and give some examples

Answer 14

• it is

e. g. meningitis, pancreatitis, appendicitis

Question 15

What is the role of the neutrophil in acute inflammation?

Answer 15

Chemotaxis
Adherence
Release of granule contents
Phagocytosis and destruction of foreign antigens

Question 16

What are the contents of neutrophil granules?

Answer 16

Oxidants and enzymes

Question 17

What happens to neutrophils when they release the contents of their granules?

Answer 17

They die and contribute toward pus formation (suppuration)

Question 18

Name two plasma proteins involved in acute inflammation

Answer 18

Fibrinogen

Immunoglobulins

Question 19

What is the function of fibrinogen in acute inflammation?

Answer 19

Parts cleaved off to form fibrin
Polymerisation to form clots
Hems in the exudate to localise the process

Question 20

What are mediators of acute inflammation?

Answer 20

• on endothelial surface

- released from cells into plasma

Question 21

What are the functions of mediators of acute inflammation?

Answer 21

Vasodilation
Increased permeability
Neutrophil adhesion
Chemotaxis
Itch & Pain

• Gradation/balance exists - not just an on/off mechanism; alternating actions depend on timing/circumstance
• Favour or inhibit the inflammation, depending on bodily need

Question 22

Give some example of mediators of acute inflammation and their functions

Answer 22

Histamine - vasodilation and increased permeability

Serotonin & Prostaglandins - vasoconstriction

Leukotrienes - increased permeability and smooth muscle constriction

Hydrogen peroxide - amplification of other mediators

Question 23

What is the difference between bacteraemia and septicaemia?

Answer 23

The presence of bacteria in the blood versus their growth

Question 24

What is septic shock an example of?

Answer 24

Systemic effect of acute inflammation

Question 25

Give the symptoms of septic shock?

Answer 25

• peripheral vasodilation
• tachycardia
• hypotension
• pyrexia
• haemorrhagic skin rash

Question 26

What causes the tachycardia associated with septic shock?

Answer 26

During vasodilation, systemic vascular resistance decreases
Cardiac output must adjust to the changes in SVR in order to regulate blood pressure

BP = CO X SVR

When CO can no longer cope, the hypotension comes in

Question 27

How is pus organised in acute inflammation?

Answer 27

In an abscess surrounded by a pyogenic membrane

Question 28

What is pyaemia?

Answer 28

Pus in the bloodstream

Question 29

What is empyema?

Answer 29

Pus in a pre-existing hollow cavity

Question 30

Describe organisation as a possible outcome of acute inflammation?

Answer 30

Formation of granulation tissue for healing and repair

Leads to fibrosis and scar tissue formation

Made from;
new capillaries/fibroblasts/collagen/macrophages