Acute Inflammation

Question 1

triggers to acute inflammation (5)

Answer 1

pathogens(bacteria, viruses, parasites) 
physical agents( frost bites, radiation) 
chemical agents(chemical burns, irritants) 
mechanical injury (trauma, crush)
foreign bodies( silica, swallowed bones)

Question 2

purpose of inflammation (5)

Answer 2

1. alert the body
2. limit spread of infection
3. protect injured site from becoming more infected
4. eliminate dead cells
5. create conditions required for healing

Question 3

5 R’s

Answer 3

1. recognition of injury
2. recruitment of leucocytes
3. removal of injurious agent
4. regulation(closure of inflammatory response)
5. resolution/ repair of affected tissue

Question 4

local signs of inflammation (5)

Answer 4

redness
swelling
heat 
pain
loss of function

Question 5

what is pain due to

Answer 5

release of pain mediators

Question 6

what is swelling due to

Answer 6

fluid accumulation in tissue due to increased permeability of vessels

Question 7

what are the systemic changes in acute inflammation

Answer 7

pyrogens
synthesis of neutrophils
acute phase proteins

Question 8

what are some examples of indogenous pyrogens

Answer 8

IL-1

TNF-a

Question 9

what are exogenous pyrogens

Answer 9

microbial components

Question 10

what is neurophilia

Answer 10

neutrophil synthesis

Question 11

which protein does neurophilia occur by

Answer 11

G-CSF

Question 12

examples of acute phase proteins

Answer 12

c-reactive protein
fibrinogen
complement
serum amyloid A protein (SAP)

Question 13

where are acute phase proteins produced

Answer 13

liver

Question 14

what is the acute phase protein production induced by

Answer 14

IL-6
IL-1
TNF-a

Question 15

what will an increase in fibrinogen do

Answer 15

stacking of RBC’s (called rouleaux)

resulting in a faster sedimentation rate

Question 16

3 vascular events

Answer 16

1. vasodilation due to histamine+ serotonin
2. inc blood flow to area(influx of WBC’s, O@, nutrients)
3. blood vessel permeability increases

Question 17

what is the fluid that has leaked out called

Answer 17

inflammatory exudate

Question 18

4 different types of inflammatory exudate

Answer 18

purulent
fibrinous
serous
haemorrhagic

Question 19

what is pus made of

Answer 19

dead cells
neutrophils
pus producing bacteria (pyogenic)
microbes

Question 20

cellular events

Answer 20

1. neutrophils- remove dead/ injured cells
2. phago dead pathogens and tissue
3. monocytes
4. differentiate into macrophages
5. phago
6. release factors that promote tissue repair( TGF-B)

Question 21

4 steps of neutrophil recruitment

Answer 21

1. rolling selectins
2. integrin activation by chemokines resulting in firm adhesion
3. transmigration through endothelium
4. chemotaxis to inflammed site

Question 22

what does transient adhesion mean for leucocytes

Answer 22

detach and reattach as it rolls down endothelium

Question 23

what do selectins do

Answer 23

mediate rolling of neutrophil

Question 24

where are selectins expressed

Answer 24

activated endothelium

Question 25

2 types of selectin

Answer 25

P-selectin- present in preformed granules | E-selectin- actively induced by IL-1 + TNF-a

Question 26

what do selectins bind to

Answer 26

ligands on neutrophils (low affinity interaction)

Question 27

2. integrin activation by chemokines - what produces the chemokines

Answer 27

endothelium

Question 28

2. integrin activation by chemokines - what do the chemokines bind to

Answer 28

receptors on neutrophils

Question 29

2. integrin activation by chemokines - what does the binding of chemokines do

Answer 29

activation of integrin - move upto high affinity configuration

Question 30

what are the integrin ligands called

Answer 30

ICAM-1 | VCAM-1

Question 31

what do neutrophils migrate through

Answer 31

interendothelial spaces

Question 32

once in tissue, what do neutrophils follow

Answer 32

chemoattractant gradient towards site of infection

Question 33

what are some chemoattractant molecules (released by macrophages/microbes)

Answer 33

IL-8 complement components(C5a) bacterial components

Question 34

what detect the neutrophils once in the tissue and release chemokines to alert rest of immune system

Answer 34

sentinel cells (dendritic, macrophages)

Question 35

2 methods of pathogen destruction by neutrophils

Answer 35

release granule content (enzymes which are toxic),phagocytose form nuetrophil extracellular traps (NET's)

Question 36

3 outcomes of acute inflammation

Answer 36

resolution repair chronic inflammation- abcess+pus+scarring

Question 37

what does repair by replacement lead to

Answer 37

fibrosis- scarring

Question 38

what is an abscess

Answer 38

mass of necrotic tissue caused by pyogenic bacteria

Question 39

factors that favour resolution

Answer 39

minimal cell death good regeneration ability fast clearance quick removal of dead tissue

Question 40

factors that prevent healing

Answer 40

``` extensive injury poor vascular supply haemorrhage infection drugs- corticosteroids old age ```