Acute Inflammation

Question 1

what is the ‘starling’s law’ in regards to movement of fluid?

Answer 1

• movement is a balance of Hydrostatic pressure ( pressure on vessel wall by fluid pushing it away) and the oncotic pressure (exerted by protein drawing fluid in) in vessels and interstitium.

Question 2

what is Exudate?

Answer 2

protein rich interstitial fluid that delivers protein to area of injury as a response to inflammation when vascular permeability increased.

Question 3

what is Transudate?

Answer 3

interstitial fluid that move due to increased capillary hydrostatic pressure or reduced oncotic pressure in heart/hepatic/renal failure without change in vascular permeability.

Question 4

what are the inflammatory mediators at vasodilation in acute inflammation?

Answer 4

• Histamine
• serotonin
• prostaglandins
• Nitric oxide

Question 5

what are the inflammatory mediators at increase in vaso-permeability in acute inflammation?

Answer 5

• histamine
• bradykinin
• leukotrienes
• C3a & C5a

Question 6

what are the inflammatory mediators at chemitaxis in acute inflammation?

Answer 6

• C5a
• TNF-a
• IL-1
• Bacterial peptides

Question 7

what are the inflammatory mediators at systemic fever in acute inflammation?

Answer 7

• Prostaglandins
• IL-1
• IL-6
• TNF-a

Question 8

what are the inflammatory mediators at body pain in acute inflammation?

Answer 8

• bradykinin
• substance P
• prostaglandin

Question 9

what are some local complications of acute inflammation?

Answer 9

• swelling/ tumor which may cause compression
• exudate which could compress organs eg:pericarditis
• loss of fluid as exudate evaporates in burns
• pain which encourages healing

Question 10

what are some systemic complications of acute inflammation?

Answer 10

• fever as mediators act on hypothalamus in increase
• leucocytosis which is the excessive production of white cells shown as high neutrophils in bacterial and high lymphocytes in viral causes.
• acute phase response to induce rest (sleep, less apetite, malaise)
• septic shock which can lead to organ failure.

Question 11

What type of drugs can be given to battle systemic fever?

Answer 11

non-steroidal anto-inflammatory drugs NSAIDs

• blocks cyclo-oxygenase which is involved in producing prostaglandins.
  eg: ibroprufen and aspirin.

Question 12

what are acute phase proteins?

Answer 12

• important markers in inflammation.
• C-reactive proteins
• fibrinogens
• alpha 1 antitrypsin

Question 13

what causes appendicitis?

Answer 13

• due to blocked lumen due to faecolith.
• accumulation of bacteria and exudate.
• perforation due to increase in pressure.

Question 14

what is pneumonia?

Answer 14

• causes : streptococcus pneumoniae, haemophilus influenzae.
• symptoms : SOB, cough, sputum, fever.
• risk factors : pre-existing lung conditions, COPD, asthma, malignancy.

Question 15

what is bacterial meningitis?

*rapidly fatal.

Answer 15

• inflammation of meninges which is the protective layer between skull and brain.
• causes : group b streptococcus, E.coli, neisseria meningitides.
• symptoms : headache, neck stiff, photophobia, altered mental state.

Question 16

what is an abscess?

Answer 16

• accumulation of dead and dying neutrophils with associative liquefactive necrosis.
• can cause compression in surrounding strictures.
• pain due to blockage of ducts.

Question 17

what are the inflammation of serous cavities?

Answer 17

• pleural effusion due to trasudate or exudate in lungs.
• peritoneal space ascites.
• pericardial effusion showing as enlarged cardiac silhouette on chest X-ray.

Question 18

any known rare acute inflammation disorders?

Answer 18

• hereditary angio-oedema
• alpha-1 antitrypsin deficiency
• chronic granulomatous disease