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Pathology 1 RUSVM > Block 3 > Flashcards

Block 3 Flashcards

1
Q

WHAT IS INFLAMMATION?

A

Ending in “-itis”
Reaction of vascularized living tissues to injury

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2
Q

WHAT IS INFLAMMATION?

What is the goal of inflammation?

A

Defense mechanism that brings immune cells to affected areas,
stimulates repair and inactivates or destroy pathogens

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3
Q

WHAT IS INFLAMMATION?

Is inflammation always beneficial?

A

No. Prolonged inflammation may cause more harm to the tissue
than the inciting agent!
Ex. Crohn’s disease, asthma

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4
Q

WHAT IS INFLAMMATION?

What occurs with inflammation?

A

Accumulation of leukocytes, protein and fluid in the
extravascular tissue
Changes in vascular bed

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5
Q

WHAT IS INFLAMMATION?

5 Cardinal Signs:

A

redness- rubor
swelling-tumor
heat-calor
pain-dolor
loss of funtion

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6
Q

WHAT HAPPENS DURING INFLAMMATION?

Increased vascular permeability!
What happens when vascular permeability increases?

A

Leakage of protein-rich fluid (“exudate”) and leukocytes into the
extravascular space

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7
Q

WHAT HAPPENS DURING INFLAMMATION?

fluid with low protein, low specific gravity, due to hydrostatic/oncotic
pressure imbalances, translucent
(low nucleated cell count)

what is this?

A

Transudate

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8
Q

WHAT HAPPENS DURING INFLAMMATION?

opaque fluid commonly associated with inflammation
- high protein, high specific gravity, high nucleated cell count

what is this

A

Exudate

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9
Q

WHAT HAPPENS DURING INFLAMMATION?

accumulation of excess fluid in the interstitium or in body cavities
- tends to be a transudate: low protein, low specific gravity, low nucleated cell
count
- ex. hydrothorax

A

edema

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10
Q

WHAT HAPPENS DURING INFLAMMATION?

purulent inflammatory exudate
- WBCs, dead cells, and microbe
- (broken down nutrophils and other cells)

A

Pus

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11
Q

ACUTE INFLAMMATION

which cytokines are involved in acute inflamation?

A

TNFa, 1FN1

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12
Q

ACUTE INFLAMMATION

EF’N Acute inflamation refers to:

A
  1. Edema
  2. Fibrin - NOT FIBROSIS
  3. Neutrophils
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13
Q

ACUTE INFLAMMATION

What is fluid with few cells and high protein?

A

Fibrin

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14
Q

ACUTE INFLAMMATION

3 facts about Fibrin formation in extravascular areas

A

-confinces stimulous to an isolated area
-provides leukocytes with target
–framework for fibroblast and endothelial cell migration in wound healing

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15
Q

ACUTE INFLAMMATION

The first stage of acute inflamation is?
what happens?

A

Stages of Acute Inflammation:
1. Vasodilation - Release of histamine from mast cells, hyperemia: increase of arteriole-mediated engorgement of
oxygenated blood

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16
Q

ACUTE INFLAMMATION

what is hyperemia

A

increase of arteriole-mediated engorgement of
oxygenated blood

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17
Q

ACUTE INFLAMMATION

what is the second stages of Acute Inflammation?

A
  1. Increased Vascular Permeability- Leakage of plasma, antibodies and clotting factor
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18
Q

ACUTE INFLAMMATION

what is the third stage of acute inflamation?

A

Emigration of Leukocytes - Margination rolling adhesion migration chemotaxis

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19
Q

ACUTE INFLAMMATION

What is the 4th stage of acute inflammation

A

Phagocytosis - Neutrophils arrive first - engulf inciting agent, fuses with lysosome, produce ROS leading
to oxidative burst

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20
Q

ACUTE INFLAMMATION

What is the 5th stage of acure inflamation?

A

Termination - M2 macrophages central role: normal vascular permeability is restored and lymphatics drain
excess fluid

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21
Q

LEUKOCYTE ADHESION CASCADE

What is the 1st step?

A

Margination - moving towards periphery

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22
Q

LEUKOCYTE ADHESION CASCADE

What is the 2nd step?

A

Rolling - selectins allow for weak binding to
endothelium (slows down the leukocyte in
circulation)
*QB2 Integrins

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23
Q

LEUKOCYTE ADHESION CASCADE

What is the 3rd step?

A

Adhesion - **Integrins on the leukocyte firmly
bind **to ICAM on endothelium

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24
Q

LEUKOCYTE ADHESION CASCADE

What is the 4th step?

A

Emigration -moving through the endothelium

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25
Q

LEUKOCYTE ADHESION CASCADE

What is the 5th step?

A

Chemotaxis - leukocyte uses signals and migrates to
the site of injury

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26
Q

LEUKOCYTE ADHESION CASCADE

What are:
tethering, weak (E,P,L) mostly on the endothelium?

A

selectins

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27
Q

LEUKOCYTE ADHESION CASCADE

What are firmer (B1 and B2 integrins on leuocytes?

A

Integrins

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28
Q

LEUKOCYTE ADHESION CASCADE

what are: ICAM, VCAM, PECAM (on endothelum?

A

Immunoglobulin family

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29
Q

What do neutrophils & monocytes do once they are at the injury
site?

A
  • They express special receptors!
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30
Q

Toll-Like Receptors (TLRs)?

A

recognize microbial products when
activated will produce cytokines

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31
Q

G protein-coupled receptors (GPCRs)?

A

recognize bacterial peptides
and induces migration of more cells from blood & production of
microbicidal substances

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32
Q

Opsonin Receptors?

A

Bind to particles covered by
proteins/opsonins (antibodies, complement proteins) resulting in enhanced
phagocytosis and intracellular killing

33
Q

Cytokine Receptors

A

result in macrophage activation

34
Q

RECEPTOR ACTIVATION

What happens to arachidonit acid when these special receptors are
activated?

A

Production of arachidonic acid (causing pain and fear) metabolites from
phospholipid cell membrane due to activation of
phospholipase

35
Q

RECEPTOR ACTIVATION

What happens to lysosomal enzymes when these special receptors are
activated?

A

Degranulation and secretion of lysosomal enzymes
and oxidative burst

36
Q

RECEPTOR ACTIVATION

What happens to the secretion of cytokines when these special receptors are
activated?

A

Secretion of cytokines will amplify and regulate the
inflammatory response - mostly via activated
macrophages

37
Q

RECEPTOR ACTIVATION

What happens adhesion molecules when these special receptors are
activated?

A

Expression of adhesion molecules on endothelial cells
and leading to increased leukocyte avidity

38
Q

RECEPTOR ACTIVATION

? are usually the first
to arrive

A

Neutrophils are usually the first
to arrive

39
Q

RECEPTOR ACTIVATION

Neutrophils are usually the first
to arrive
Then…

A

Neutrophils engulf and destroy injurious agents via
phagocytosis
-Internalize bacteria, foreign bodies, dead cells,
- Fuse with lysosomes and digest contents
-Oxidative burst produces reactive oxygen species
(ROS - free radicals)

40
Q

TERMINATION

How do we stop an acute inflammatory
response?

How are they controlled by the body?

A

Inflammatory responses are tightly controlled
by the body

41
Q

TERMINATION

How do we stop an acute inflammatory
response?
what about inflammatory mediators?

A

Inflammatory mediators have short half-
lives/produced in very quick bursts… so they do

not last long!

42
Q

TERMINATION

How do we stop an acute inflammatory
response?

Eventually there will be a switch in what resulting in what?

A

Eventually there will be a switch in production
of pro-inflammatory mediators to anti-
inflammatory molecules such as lipoxins,
cytokines and neural impulses that limit
macrophage TNF production

43
Q

TERMINATION

What PLAY A CENTRAL
ROLE IN TERMINATION?

A

MACROPHAGES PLAY A CENTRAL
ROLE IN TERMINATION

44
Q

TERMINATION

MACROPHAGES PLAY A CENTRAL
ROLE IN TERMINATION by doing these 3 things:

A

-pinocytose any excess edema fluid and
proteins
-phagocytose necrotic debris
- produce growth factors that initiate repair

45
Q

IMPORTANT INFLAMMATORY CELLS

what release histamine early
response to inflammation

A

Mast cells

46
Q

IMPORTANT INFLAMMATORY CELLS

what aid with coagulation

A

Endothelial cells

47
Q

IMPORTANT INFLAMMATORY CELLS

Monocytes:
where are they located?
what can they form?
they are what kind of presenting cell?
what important role do they play?

A

Monocytes: in the blood (referred to as
“macrophages” when in tissues)
- can fuse and form multinucleated giant
cells - chronic granulomatous inflammation
- antigen presenting cells
- important role in termination and
recovery of inflammation

48
Q

IMPORTANT INFLAMMATORY CELLS

Name 3 GRANULOCYTES
explain

A

Neutrophils: inflammation,
phagocytes, granules that contain
enzymes/ acute inflammation
response to bacteria

Eosinophils: allergies, fungi and
parasitic infections

Basophils: low in numbers -
allergies and histamine

49
Q

WHAT CELL TYPE IS THIS? WHAT ROLE DOES IT PLAY?

A

BASOPHIL:
- very low in numbers
- allergies and histamine
- life span: ~2 weeks
- activated by IL-1, IL-3, TNF, IgE

50
Q

THIS GROSS IMAGE IS SHOWING AN INFLUX OF
WHICH CELL TYPE?

A

NEUTROPHIL:
- first cells to arrive during inflammation
- acute response against bacteria
- major phagocytic role
- contain granules

51
Q

NEUTROPHILS

Neutrophils have what that contain what?

A

Neutrophils have specific granules that contain important enzymes and molecules

52
Q

NEUTROPHILS

what are Lactoferrin

A

Lactoferrin: chelates/binds to iron

*this is b/c bacteria need iron

53
Q

NEUTROPHILS

what breaks down cell calls?

A

Lysozyme

54
Q

NEUTROPHILS

what allows for migration through clots

A

Plasminogen Activation

55
Q

NEUTROPHILS

Neutrophils also have ?
which contain potent enzymes

A

Neutrophils also have primary or azurophilic granules, which contain potent enzymes

56
Q

NEUTROPHILS

Converts H2O2 to HClO (which is extremely toxic against microbes!)

A

Myeloperoxidase

57
Q

NEUTROPHILS

punch holes in cell membranes

A

Defensins

self defense–>punch

58
Q

NEUTROPHILS

bactericidal permeability-increasing protein

A

BPI

59
Q

EOSINOPHILS

Bone marrow production stimulated by ?

A

IL 5/GM-CSF

60
Q

EOSINOPHILS

Attracted by ?

A

eosinophilic chemotactic factor (mast
cells), IgE, histamine

61
Q

EOSINOPHILS

Important in ?

A

allergic and parasitic conditions

62
Q

EOSINOPHILS

Important in ?

A

allergic and parasitic conditions

63
Q

WHAT CELL TYPE IS THIS? WHAT ROLE DOES IT

PLAY IN INFLAMMATION?

A

MONOCYTE:
- monocyte in the blood/macrophage in tissues
- involved in chronic inflammation
- major role in recovery from inflammation
- longer life span

64
Q

WHAT IS PICTURED HERE? WHAT IS ITS

SIGNIFICANCE?

A

MULTINUCLEATED GIANT CELL:
- syncytial cells formed by the fusion of 2+ macrophages
- chronic granulomatous inflammation
- formation requires an assortment of inflammatory cytokines

65
Q

WHAT CELL TYPE IS PREDOMINATING HERE?

WHAT IS THEIR SIGNIFICANCE?

A

LYMPHOCYTES:
- T and B cells: plasma cells, memory cells,
cytotoxic cells
- seen with chronic inflammation
- viral infection

66
Q

WHAT CELL TYPES ARE DISPLAYED HERE? WHAT
ROLE DO THESE CELLS PLAY IN INFLAMMATION?

A

MAST CELLS:
- initiation of inflammation
- release histamine
- vasodilation

67
Q

COMPLEMENT SYSTEM

Inflammatory processes are capable of activating what?

A

Inflammatory processes are capable of activating
complement proteins (ex. C3) that are
circulating in the blood

68
Q

COMPLEMENT SYSTEM

activation stimulated by what 4 things?

A

activation stimulated by antibodies, microbes,
endotoxins, venom

69
Q

COMPLEMENT SYSTEM

How?

A
  • Ag-Ab complexes
  • Contact with microbial surface molecules

complements the ability of antibodies and
phagocytic cells to remove pathogens from an
organism

70
Q

4 TYPES OF ACUTE INFLAMMATION

what are they?

A

Suppurative/Purulent
Fibrinous
Serous
Catarrhal/Mucoid/Mucopurulent

71
Q

4 TYPES OF ACUTE INFLAMMATION

Identify the acute inflamation that:

  • thick fluid with mucus
  • throughout the GI tract or respiratory tract
A

Catarrhal/Mucoid/Mucopurulent

72
Q

4 TYPES OF ACUTE INFLAMMATION

Identify the acute inflamation that:
- fluid with low cells and high protein - fibrin is protein!!
- NOT THE SAME AS “FIBROUS”: this would imply chronic
inflammation

A

Fibrinous

73
Q

4 TYPES OF ACUTE INFLAMMATION

identify the acute inflamation that:

  • transudate
  • low number of cells and protein
A

Serous

74
Q

4 TYPES OF ACUTE INFLAMMATION

Identify the acute inflamation that:
- infiltration of neutrophils
- high protein
- think of gross nasty pus!

A

Suppurative/Purulent

75
Q

WHAT ARE THE POTENTIAL OUTCOMES OF
ACUTE INFLAMMATION?

A

Resolution
- return to normal state

Formation of an abscess

Healing by fibrosis
- scar formation

Progression to chronic inflammation
- failure to eliminate

76
Q

WHICH TYPE OF ACUTE INFLAMMATION IS SEEN

HERE?

A

Type of acute Inflammation: Serous
Transudate or Exudate: Transudate
Pathology Terminology: Hydrothorax
Cells:Low
Protein:Low

77
Q

WHICH TYPE OF ACUTE INFLAMMATION IS SEEN
HERE?

A

Type of acute Inflammation: Suppurative
Transudate or Exudate:Exudate
Pathology Terminology:Encephalitis
Cells:High
Protein:High

78
Q

WHICH TYPE OF ACUTE INFLAMMATION IS SEEN
HERE?

A

Type of acute Inflammation:Fibrinous
Transudate or Exudate:Exudate
Pathology Terminology:Pleuritis
Cells: low
Protein:high

79
Q

WHICH TYPE OF ACUTE INFLAMMATION IS SEEN

HERE?

A

Type of acute Inflammation:Catarrhal/Mucoid
Transudate or Exudate:Exudate
Pathology Terminology:Catarrhal Rhinitis
(MCF)
Cells:High
Protein:High

Pathology 1 RUSVM (7 decks)

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