Acute Inflammation and Wound Healing

Question 1

Histopath difference between Acute and Chronic Inflammation

Answer 1

Acute: Vascular changes, edema, neutrophilic infiltration

Chronic: Mononuclear cells (macrophages, lymphocytes, plasma cells), tissue destruction, attempts at healing (angiogenesis and fibrosis)

Question 2

Functions and respective chemical and biological mediators secreted by Macrophages

Answer 2

Microbicidal: ROS, NO and lysosomal enzymes
Inflammation: IL-1, IL-2, IL-23, chemokines

Tissue repair and fibrosis: Growth factors and TGFbeta
Anti-inflammation: IL-10 and TGFbeta

Question 3

Diapedesis of Leukocytes and their relevant bio and chem mediators

Answer 3

Leukocyte with low affin Integrin and modified glycoprotein–>

[blood flow “stasis”]–>

Leukocytes move to periphery “Margination–>

[TNF and IL-1 upregulate ligands for Lselectin, Eselectin, Pselectin]–>

“Rolling” on endothelium–>

[Integrin Ligands VCAM-1 and ICAM-1 upregulated]–>

High affinity integrins help bind leukocytes–>

Leukocyte cytoskeleton rearranges–>

[bacterial peptides and IL-8, C5a, Arachidonic metabolites (leukotriene B4) stimulate g protein cascade and increased Ca, kinases, and Rac/Rho/cdc42]–>

actin polymerization and movement toward inflammatory stimulus

Question 4

Patients at risk for aspiration pneumonia?

Answer 4

dementia, older, alcoholics

Question 5

common microorganisms responsible for clinical diseases in otherwise healthy patients and what is this pneumonia called?

Answer 5

This is called community-acquired pneumonia and it is commonly cause by Streptococcus pneumoniae, E. Coli in older adults, Staph Aureus in IV drugs users and other gram negative bacteria

Question 6

Why are anti-microbials important for acute-phase pneumonia?

Answer 6

the anti-microbials will assist in cleaning up the infection,. if the infection persists, the macrophages could begin inducing fibrosis and wound repair, scarring the lungs.

Question 7

What type of inflammatory cell would react acutely to a Staph aureus infection in the lung?

Answer 7

neutrophils

Question 8

When you see multiple bacterial lesions in the lung would this be aspiration related microbial attack or hematogenous?

Answer 8

Hematogenous because they at not localized.

Question 9

Why would antibiotics not work as expected in a patient with HIV who needs to be treated for a Staph Aureus infection in the lungs?

Answer 9

CD4 reduced Antibiotics would not kill alone. Innate and Adaptive immunity need to be up to the job, Anti-retroviral therapy would be needed to completely control the infection.

Question 10

What isn’t working if the serum albumin level is low?

Answer 10

low liver function (liver makes albumin)

Question 11

Why would prothrombin time be slow when the liver is not functioning?

Answer 11

Liver isn’t making proteins and clotting factors

Question 12

Esophageal varisces associated with alcoholism would cause what during vomiting?

Answer 12

esophageal bleeding from portal hypertension which causes vasodilation

Question 13

What do you notice in a cirrhotic liver?

Answer 13

• fat
• bile ducts proliferated to compensate for poorly functioning scarred bile ducts
• scarring from inflammation that damages extracell matrix.
• Mallory Hyaline indicative of malformed protein
• Collagen surrounding nodules

Question 14

What is volume resuscitation?

Answer 14

give fluid

Question 15

What is the main microbe of PID?

Answer 15

nisseria gonorrheae

chlamydia

Question 16

What are the risks with PID?

Answer 16

ectopic pregnancy leading to tubal ruptal and bleeding.