Acute Inflammation

Question 1

Cardinal Signs of Inflammation

Answer 1

Rubor
Calor
Tumour
Dolor
Loss of Function

Question 2

Causes of Acute Inflammation

Answer 2

Micro-organism
Mechanical
Chemical
Physical
Necrosis
Hypersensitivity

Question 3

In microcirculation capillary beds are fed by ______ by ______ and ______ by _______

Answer 3

oxygen and arterioles

drained and venules

Question 4

Starling forces

Answer 4

Control fluid flow across the membrane - Hydrostatic and oncotic pressure

Question 5

Hydrostatic pressure

Answer 5

Increases filtration of fluid out of capillaries

Question 6

Oncotic Pressure

Answer 6

Pulls fluid into capillaries and prevents it from leaking

Question 7

Poiseuille’s Law

Answer 7

Flow is proportional to radius to the power of four

Question 8

Pathogenesis of Acute inflammation

Answer 8

Changes is vessel radius flow
Changes in permeability
Movement of neutrophils from vessel to extravascular space

Question 9

TRIPLE RESPONSE

Answer 9

1. Red- Vasodilation of capillaries and venules
2. Flare- Arteriolar dilation
3. Wheal- increased permeability and exudation

Question 10

Consequences of increased permeability

Answer 10

Imbalance of Starling forces
Exudation = oedema
Fluid loss = increase in viscosity
Decrease in blood flow = decreased in blood pressure

Question 11

Neutrophil flow in inflammation

Answer 11

Margination –> pavementing –> emigration –> extravascular tissue

Question 12

Diapedesis

Answer 12

Passage of blood cells through the intact wall of capillaries during inflammation

Question 13

Benefits of acute inflammation

Answer 13

Non specific response
Neutrophils destroy organism
Plasma protein localises process

Question 14

Outcomes of acute inflammation

Answer 14

Resolution
Organisation
Chronic Inflammation
Suppuration (pus)

Question 15

Inflammation of Peritoneal Cavity

Answer 15

Peritonitis

Question 16

Inflammation of Meninges

Answer 16

Meningitis

Question 17

Inflammation of Appendix

Answer 17

Appendicitis

Question 18

Inflammation of Pleural Cavity

Answer 18

Pluerisy

Question 19

Functions of Neutrophils (8)

Answer 19

Recognise foreign antigens
Chemotaxis
Adhere to organism
Release granules with oxidants and enzymes
Release granule contents
Phagocyte and destroy
Produces pus
Extend inflammation to other tissues

Question 20

Plasma proteins

Answer 20

Fibrinogen

Immunoglobulin

Question 21

Fibrinogen Function

Answer 21

coagulation factor that forms fibrin and clots exudate

Question 22

Immunoglobulin Function

Answer 22

Humoral response

Question 23

Mediators of Acute Inflammation (cells)

Answer 23

Histamine
Serotonin
Prostaglandin
Thromboxane
Nitric Oxide
Oxygen free radicals

Question 24

Mediators of Acute Inflammation (endothelial cell surface membranes)

Answer 24

ICAM-1- helps neutrophil stick

Question 25

Mediators in plasma

Answer 25

Fibrinolysis Kinin Complement cascade

Question 26

Preformed is mast cells besides vessels and released in result of local injury and IgE mediated reaction

Answer 26

Histamine

Question 27

Preformed in platelets and released when platelets degranulate during coagulation and causes vasoconstriction

Answer 27

Serotonin

Question 28

Produced from arachidonic acid via cyclo-oxygenase pathway and increases the effect of histamine

Answer 28

Prostaglandin

Question 29

Promotes platelet aggregation and vasoconstriction

Answer 29

Thromboxane A2

Question 30

Nitric Oxide

Answer 30

Smooth muscle relaxation Anti-platelet Leukocyte recruitment

Question 31

Released by neutrophils in phagocytosis, amplify other mediators

Answer 31

Oxygen free radicals

Question 32

Fibronolysis

Answer 32

Breaks down fibrin and prevents blood clots

Question 33

Kinin system

Answer 33

Bradykinin (pain)

Question 34

Complement cascade

Answer 34

inflammation-immune system

Question 35

Molecules inside cells-signalling

Answer 35

PAMP | Danger associated molecular pattern

Question 36

Intracellular pathways

Answer 36

NF-kB MAPK JAK-STAT

Question 37

Collective effect of mediators

Answer 37

``` Vasodilation Increased permeability Neutrophi adhesion Chemotaxis Itch and pain ```

Question 38

Immediate systemic effects

Answer 38

Pyrexia (pyrogens from WBC) Fell unwell Neutrophilia

Question 39

Longer term effects

Answer 39

Lymphadenopathy Weight loss Anaemia

Question 40

Outcomes of acute inflammation

Answer 40

Granulation Healing and repair Fibrosis and formation of scar

Question 41

Granulation tissue

Answer 41

universal patch forms new capillaries (angiogenesis), fibroblasts, collagen and macrophages

Question 42

Cardiac output

Answer 42

amount of blood pumped by heart in a minute

Question 43

Stroke volume

Answer 43

amount of blood pumped by the left ventricle

Question 44

___ = SV X HR

Answer 44

cardiac output =

Question 45

_____ = CO X systemic vascular resistance

Answer 45

blood pressure =

Question 46

Pathogenesis of Septic Shock

Answer 46

mediators lead to vasodilation and and loss of systemic vascular resistance. Results in catecholamine release, increase in HR to compensate

Question 47

What happens when compensation of increased HR fails to restore SVR

Answer 47

low BP Reduced perfusion of tissues Tissue hypoxia- cell death

Question 48

Causes vasoconstriction

Answer 48

Serotonin