Acute Inflammation CC Flashcards
How does an inflamed appendix look compared to a normal one
purple- Vasodilation
Normal looks shiny. Inflamed not as shiny because of fibrinoplurulent exudate
Inflamed larger
The appendix can burst. What can this lead to?
Peritonitis
Apart from peritonitis, what 5 other complications can arise from acute appendicitis
Abcess around the burst appendix Subphrenic abcess (Under the diaphragm) Sepsis Portal vein pyemia (Suppurative inflammation of the portal vein)-->Portal vein thrombosis Liver abcess
What predisposing factors are there to acute appendicitis
Age- 10 to 30
Infection (Esp in Gi system)
trauma
llow fibre diet–>constipation–>faecal impactin in the appendix–>Appendicitis
Adhesions in the bowel–>Blocking of appendicix–>Appendicitis (Can be secondary to trauma)
What can be seen in the sulci of the brain in someone who has meningitis? What effect may this have?
Yellow fluid- Pus/Purulent exudate
Can increase the pressure in the skull–>compression of the brain
What organisms commonly cause meningitis in the following age groups? Neonates Children Young adult older age groups
Neonates: Group B streptococci, Escherichia coli, Listeria monocytogenes
Children: Streptococcus pneumoniae, Neisseria meningitidis (Meningococcus), Haemophilus influenzae type B
Young adults: Neisseria Meningitidis, Streptococcus pneumoniae
Older age groups: Streptococcus pneumoniae, Neiserria meningitidis, Listeria monocytogenes
List some complications related to meningitis
Disseminated Intravascular Coagulation
Encephalitis
Persistent fever
Seizures
Syndrome of inappropriate ADH use–>Fluid build up
Brain damage and everything that encumbers eg. vision loss, hearing loss, epilepsy
Sepsis
Waterhouse-Fredrickson Syndrome: bleeding into the adrenal glands
With acute inflammation what leukocyte would most likely show the most abnormal count and what causes this?
Neutrophils
Because of colony-stimulating factor released by macrophages and endothelial cells stimulating the bone marrow to increase neutrophil production
A man come in who has gallstones for months. Has an abcess in his liver. What Liver function test chemicals would you expect to be raised?
Serum bilirubin, Alanine transaminase, Alkaline phosphatase
Why are the liver function tests raised with the liver abcess?
Because the liver function test chemicals are usually metabolised in the liver. Not so to the same extent now so build up in the blood
Why could gallstones lead to a hepatic abscess?
Blocks the bileduct
Stasis as bile flow stopped
Infection develops that spreads up to the liver
Note an infection of the bile duct is called Ascending cholangitis
What type of bacteria are most often the cause of this ascending cholangitis
Escherichia coli
Klebsella
In general Gram Negative bacteria
Give four other complications of gallstones
bilary colic
Gallbladder cancer as it tries to heal itself
Gallstone ileus- Gallstone gets into ileus, causes obstruction in bowel. Gallstone enters the ileum through a fistula between the gallbladder and ileum
Acute pancreatitis
Difference between lobar and bronchopneumonia
Lobar is acute inflammation of an entire lobe
broncho- Characterized by patchy foci of consolidation (pus in many alveoli and adjacent air passages) scattered in one or more lobes of one or both lungs
What is the most ccommon causative organism of lobar pneumonia?
Streptococcus Pneumoniae
whhat are the 4 stages of evolution of lobar pneumonia if it isnt treated?
- Congestion- Affected lung parenchyma becomes partially consolidated and red-purple
Alveolar lumen contains serous exudate, bacteria and rare leucocytes - Red hepatisation- Lobe appears consolidate, red brown, dry and firm (Like liver)
Fibrin rich exudate accumulates in alveoli as well as bacteeria, erythrocytes and leucocytes
Alveolar walls thicken as well due to capillary congestion and oedema - Grey hepatisation- Uniform grey colour, liver like consistency.
Alveolar lumen fill with suppuative exudate (macrophages, neutrophils to remove the fibrin exudate) - Resolution. Exudate drained through the lymphatics and airways (Ie productive cough)
What complications can arise in pneumonia (8)
Acute resp distress syndrome (Fluid builds up in lungs when damaged-->Can't breath) Empyema Lung abscess Meningitis Pericarditis Pulmonary fibrosis Resp. failure Sepsis
What is hereditary Angiooedema
Autosomal dominant
Episodic swelling of face, exteemities, genitals, most importantly airways too
How does hereditary angiooedema present
Begins around puberty
Recurrent swelling
Sensation of fullness
Not really any pain or itching (Except with abdo swelling- experience acute abdo pain)
What is Chronic granulomatosu disease
immune cells can’t make reactiv eoxygen species–>granuloma formation in many organs
