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Pathological Processes > Acute Inflammation > Flashcards

Acute Inflammation Flashcards

1
Q

What are the clinical features of acute inflammation ?

A 
RUBOR 
TUMOR
CALOR
DOLOR
LOSS OF FUNCTION
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2
Q

What happens to the blood vessels in acute inflammation ?

A

1) transient vasoconstriction of arterioles - few seconds
2) vasodilation of arterioles
3) vasodilation of blood vessels
4) increased permeability
5) STASIS due to increased RBCs + increased viscosity of blood

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3
Q

What cells is histamine released from?

A

Mast cell, basophils, platelets

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4
Q

Which chemical mediator acts immediately in an acute inflammation response and how quickly ?

A

Histamine

Within 30 mins

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5
Q

What does release of histamine do?

A
  • vasodilation
  • increased permeability
  • Pain
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6
Q

What is bradykinin and what does it do?

A

Inflammatory chemical mediator
Peptide
Causes vasodilation = reduced bp

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7
Q

What response do leukotrienes evoke and which condition are leukotrienes particularly troublesome?

A

Bronchiole constriction

Asthma

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8
Q

What are the two types of oedema?

A

Transudate

Exudate

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9
Q

What is the difference between transudate oedema and exudate oedema ?

A

Exudate oedema = high protein content

Transudate oedema = low protein content

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10
Q

Which type of oedema do you get in acute inflammation ?

A

Exudate

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11
Q

What type of oedema would you expect in cardiac failure/ venous outflow obstruction

A

Transudate - oedema due to hydrostatic pressure imbalance

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12
Q

What is polymorphonuclear leucocyte?

A

Neutrophil

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13
Q

What is the primary type of white blood cell involved in acute inflammation?

A

Neutrophil

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14
Q

How do neutrophils infiltrate into the tissue ?

A

Margination - line the endothelium
Rolling - roll along endothelium
Adhesion - stick to endothelium via receptors
Emigration - neutrophils enter blood vessel walls- (cause cells junctions to relax, digest the basement membrane & move in)

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15
Q

Which important protein is found in exudate oedema ?

What is its role in acute inflammation ?

A

Fibrin

Keeps inflammation local and stops it spreading

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16
Q

How do histamines and leukotrienes increase vascular permeability?

A

Cause endothelial contraction - resulting in gaps for protein containing fluid to leak out.

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17
Q

How do cytokines IL-1 & TNF increase vascular permeability?

A

Cytoskeleton reorganisation

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18
Q

What is transcytosis?

What causes this?

A

Fluid moving across wall of non leaky blood vessel

VEGF

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19
Q

What is the commonest type of inflammatory cell?

A

Neutrophil

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20
Q

How many lobes does a neutrophil have?

A

Multiple

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21
Q

What are the 4 stages of neutrophil infiltration ?

A

Migration
Rolling
Adhesion - loose then tight
Emigration

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22
Q

What causes migration of the neutrophils?

A

Stasis of the blood

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23
Q

How do the neutrophils emigrate into the tissue?

A
  • relaxation of the endothelial cell junctions

- digestion of the vascular basement membrane

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24
Q

What is diapedesis?

A

Seen in inflammation - Passage of blood cells through intact capillary walls

25
Q

What are 3 chemotaxins ?

A

C5a
LTB4
Bacterial peptides

26
Q

How do neutrophils move to site of injury ?

A

Chemotaxis

27
Q

What are the steps in chemotaxis ?

A
  • receptor on neutrophils binds to ligand (chemotaxins)
  • causes rearrangement of cytoskeleton
    • production of a pseudopod
  • attracts more neutrophils
28
Q

Once in the tissue what do neutrophils do?

A

Phagocytose

29
Q

Name 2 opsonins

A

Fc (fixed component on all antibodies)

C3b

30
Q

List 3 o2 independant killing mechanisms?

A
  • lysozyme enzymes : eg hydrolases
  • defensins (cationic proteins)
  • BPI (bacterial permeability increasing protein
31
Q

What are 3 families of chemical mediators ?

A

Proteases
Prostaglandins/leukotrienes
Cytokines/chemokines

32
Q

The proteases involved in acute inflammation are found where?

They are produced where?

A

Plasma

Liver

33
Q

Where are plasma proteins produced?

A

Liver

34
Q

What are 3 proteases involved in acute inflammation ?

A

Kinins
Complement
Clotting factors

35
Q

What are the metabolites of arachidonic acid?

A

Prostaglandins

Leukotrienes

36
Q

Name 2 cytokines ?

A

Interleukin 1

TNF alpha

37
Q

What are chemokines ?

A

Smaller cytokines (proteins)

38
Q

Which chemical mediators result in increased blood flow?

A
  • histamine

- prostaglandins

39
Q

Which chemical mediators result in increased vascular permeability ?

A

Histamine

Leukotrienes

40
Q

Which chemical mediators result in neutrophil chemotaxis ?

A

C5a, BPI (BACTERIAL PEPTIDES), LTB4

41
Q

Which chemical mediators are responsible for phagocytosis ?

A

C3b

42
Q

What is the hallmark of acute inflammation?

A
  • exudate of oedema fluid

- infiltration of inflammatory cells

43
Q

What is cardiac tamponade?

A

Compression of heart due to too much fluid in the pericardium

44
Q

What are local complications of acute inflammation?

A
  • swelling
  • exudate
  • loss of fluid
  • pain
  • loss of function
45
Q

What are systemic effects of acute inflammation ?

A 
Fever
Leukocytosis 
Acute phase response 
Acute phase proteins 
Shock
46
Q

What are 5 acute phase proteins

A 
CRP
Alpha 1 antitrypsin 
Haptoglobin 
Fibrinogen 
Serum amyloid A protein
47
Q

Give some examples of the acute phase response ?

A

Loss of appetite
Raised pulse rate
Altered sleep pattern

48
Q

Give 2 examples of endogenous pyrogens?

A

IL-1

TNF alpha

49
Q

WHAT IS SHOCK?

A

circulatory failure

50
Q

What 4 things can happen after development of acute inflammation ?

A
  • resolution
  • abscess
  • chronic inflammation + fibrous repair
  • Death
51
Q

Name 2 inhibitors of acute inflammatory changes

A

Lipoxins

Endothelin

52
Q

Acute inflammation of meninges can lead too..

A

Swelling and compression of brain

Thrombosis and reduced cerebral perfusion

53
Q

Which organism causes lobar pneumonia ?

A

Streptococcus pneumoniae

54
Q

What are 5 clinical features of a patient with lobar pneumonia?

A
  • fever
  • prostration
  • Hypoxaemia
  • Breathlessness
  • dry cough
55
Q

When examining the exudate of a patient with a skin blister would you expect to find inflammatory cells in there?

A

Very few

56
Q

What type of tissue does abscess occur in?

A

Solid

57
Q

In an abscess what type of necrosis is in the centre?

A

Liquefactive

58
Q

What type of problems can you get it exudate pours into serous cavities?

A
  • ascites
  • pleural effusion
  • pericardial effusion
59
Q

which acute inflammatory condition is described as having a bread and butter appearance ?

A

Pericarditis

Pathological Processes (3 decks)

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