Acute Inflammation Flashcards

1
Q

characteristics of acute inflamation

A
immediate
short duration
innate
stereotyped
limits damage
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2
Q

causes

A
microbial infections
hypersensitivity reactions
physical agents
chemicals
tissue necrosis
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3
Q

clinical signs

A

Rubor-Redness
Tumor- Swelling
Calor- Heat
Dolor-Pain

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4
Q

what changes occur in the vessels

A
vasoconstriction few seconds
vasodilations few minutes
permeability increased due to increased capillary hydrostatic pressure
oedema formation
red cell stasis
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5
Q

what pressures do we need for optimum flow into the interstitium

A

we need high capillary hydrostatic pressure and high interstitial oncotic pressure

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6
Q

what is stasis, why is it good

A

reduced flow through the vessel

important because allows more time for exudate + transudate formation

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7
Q

what is exudate

A

type of interstitial fluid - protein rich to areas of injury

increased vascular permeability

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8
Q

what is transudate

A

type of tissue fluid when actually being moved out of the vessel into the interstitium
no change in vascular permeability
heart/renal/hepatic failure

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9
Q

mechanisms of increased vascular permeability

A

endothelial contraction (gaps between the endothelial cells)

direct injury - toxins damage the wall

endothelial cytoskeleton reorganisation

leucocyte dependant injury (enzymes and toxic ROCs)

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10
Q

why does blood increase viscosity

A

fluid moves out of vessel
increased concentration of proteins in blood
increased viscosity
reduced flow

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11
Q

stages of neutrophil emigration into the interstitium

A

Margination- stick to the endothelial cell layer
Rolling-roll along the endothelium
Adhesion-stick more avidly to the cell layer
Emigration-through the blood vessel wall

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12
Q

how do the clinical signs relate

A

increased vascular permeability, transudate and exudate formation- TUMOR
increased concentration of RBC in vascular system- RUBOR
reduced flow due to RBC stasis-CALOR

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13
Q

adhesion molecules

A

SELECTINS-on endothelial cell surface, unregulated by chemical mediators

INTEGRINS- on neutrophil surface, bind to receptors on the endothelial surface

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14
Q

functions of the neutrophils

A

chemotaxis- process of entering the interstitium
phagocytosis-immune response
killing of micro-organisms- lysosome contains hydrolytic enzymes

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15
Q

pls explain the chemotaxis process in more detail

A

movement along a chemical gradient of chemoattractants

  • pseudopod
  • neutrophil cytoskeleton rearrangement
  • bacterial peptides
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16
Q

why is inflammation an effective response

A

delivery of nutrients, oxygen, cells, plasma proteins
dilution of toxins
stimulation of immune response
destruction of dead and foreign material
pain and loss of enforcing rest (malaise)

17
Q

Chemical mediators

A

Important in up regulation of adhesion molecules (selectins)

examples: amines, peptides, cytokines and chemokines, exogenous mediators, phospholipid derivatives

18
Q

local complications of inflammation

A

reduced blood supply to normal tissues
swelling causes obstruction of tubes and structures
loss of fluid (exudate and transudate)- blood is left highly viscous
Pain causes by stasis

19
Q

systemic complications of inflammation

A

fever-pyrogens affecting thermoregulatory centre
leucocytosis-WBC production increased
acute phase response- CRP release and malaise
shock- septic overwhelming infection, widespread vasodilation, leads to rapid death

20
Q

what happens after acute inflammation

A

complete resolution
chronic inflammations with some fibrous repair
continued acute inflammation with chronic inflammation
death

21
Q

what happens in complete resolution

A
drainage of the exudate
neutrophils phagocytosed
fibrous repair if architecture preserved
mediators are inhibited
no margination, vessel calibre return to normal
22
Q

how does oedema formation reduce damage

A
dilutes the toxins 
delivers exudate (proteins) to the site of injury- such as immunoglobulins
increased lymphatic draining delivers antigens to the lymph nodes
23
Q

appendicitis

A

blocken lumen, accumulation of bacteria, increased pressure and reduced blood flow

24
Q

pneumonia

A

streptococcus pneumonia, smoking and COPD riskfactors, shortness breath, fever cough, chest pain

25
meningitis
inflammation of the meninges variety of pathogens neck stiffness, fever photophobia rapidly fatal
26
abcess
accumulation of dead and dying neutrophils, with associated necrosis (liquefactive) causes compression of the surrounding structures, pain and blockage of the ducts
27
ascending cholangitis
bacteria entering the bile duct from the duodenum
28
examples of inherited disorders of acute inflammation disorders
hereditary angio-oedema alpha 1 antitrypsin deficiency chronic granulomatous disease