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Pathology > Cell Events in Acute Inflammation & Outcomes > Flashcards

Cell Events in Acute Inflammation & Outcomes Flashcards

1
Q

Vasoactive Amines

A
  • Preformed molecs in granules
  • Se from platelets
  • His from mast cells & other cells
  • physical trauma or heat
  • IgE on mast cells
  • complement C3a, C5a
  • leukocyte derived his releasing proteins
  • neuro peptides substance P
  • IL-1, IL-8
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2
Q

Arachidonic Acid metabolites

A
  1. vasodilation- PGI2, PGE1, PGE2, PGD2
  2. vasoconstriction- Thromboxane A2, leukotrienes C4,D4,E4
  3. increased vascular permeability- leukotrienes C4,D4,E4
  4. Chemotaxis, leukocyte adhesion- luekotriene B4
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3
Q

PAF

A
  • mem phospholipid derived mediator
  • aggregate platelets & cause degranulation
  • acetyl glycerol ether phosophrylcholine
  • from neutrophils, monocytes, basophils, endoth cells, & platelets
  • acts on GPCR
  • vasoconstriction & bronchoconstriction
  • 100-1000 more potent than his in inducing vasodilation & increase vascular perm
  • enhanced leukocyte adhesion, chemotaxis, leukocyte degranulation & ox burst
  • stimulates syn of eicosanoids
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4
Q

ROS

A
  • NADPH oxidase pathway makes it
  • from neutrophils & macrophages when killing microbes, immune omplexes, cytokines & other inflamm stimuli
  • ROS are produced w/in lysosomes to destroy microbes & necrotic cells
  • Increase chemokine, cytokine & adhesion molec expression= amplify cascade of inflamm mediators
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5
Q

ROS

A

@ higher levels

  • endoth damage w/ thrombosis & increased perm
  • protease activation & antiprotease inactivation, breakdown of ECM
  • direct injury to cells like tumor cells, RBCs, parenchymal cells
  • antiox protective mech in place= catalase, SOD, glutathione
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6
Q

NO

A
  • regulate NT release in CNS
  • macrophage-cytotoxic metabolite against microbes & tumor cells
  • endoth cells it causes smooth m. relaxation & vasodilation
  • NO syn from L- arg, O2 & NADPH by NOS
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7
Q

NO 3 isoforms

A
  1. type I nNOS- constitutively expressed neuronal NOS
  2. type II iNOS- inducible enz present in macrophages & endoth cells, induced inflamm cytokines & mediators (IL-1, TNF, IFN-g) & bac endotoxin.
  3. Type III eNOS- constitutively syn NOS found w/in endothelium
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8
Q

NO

A
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9
Q

Cytokines

A
  • Polypep products of many cell types that f as mediators
  • some stim bone marrow precursors to produce more leukocytes
  • interleukins b/c mediate b/t leukocytes
  • Many act on leukocytes but not call ILs
  • TNF, IL- & chemokines= acute inflammation
  • IFN-g & IL-2 in **chronic inflammation **
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10
Q

TNF

A

Found in macrophages, mast cells, T lymph

Action:

  • stim expression of endoth adhesion molec
  • secretion of other cytokines
  • systemic effects!
  • acute inflamm
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11
Q

IL-1

A

Found in macrophages, endoth cells, epith cells (some)

Action:

  • similar to TNF
  • greater role in fever
  • acute inflamm
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12
Q

Chemokines

A

Found in macrophages, endoth cells, T lymph, mast cells, other cell types

  • recruite leukocytes to sites of inflamm
  • migration of cells to normal tissues
  • acute inflamm
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13
Q

IL-6

A

Found in macrophgaes, other cells

  • produce systemic effects
  • acute inflamm
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14
Q

IL-12

A

found in dendritic cells, macrophages

Action:

  • increae IFN-g production
  • chronic inflamm
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15
Q

IFN-g

A

Found in T lymph, NK cells

Action:

  • activation of macrophges (increased killing of microbes & tumor cells)
  • chronic inflamm
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16
Q

IL-17

A

Found in T lymphocytes

Action:

  • recruit of neutrophils & monocytes
  • chronic inflamm
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17
Q

Chemokines

A
  • small protein- chemo attractant
  • leukocyte recruitemnt in inflamm & other cells in lymphoid & other tissues
  • activate leukocytes
  • produced constitutively in tissues & responsible for T & B lymphocyte segregation in diff areas of LN & spleen
  • mediate via GPCR
  • CXCR4 & CCR5 are coR for binding & entry of HIV into lymphocytes
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18
Q

Lysosomal Enz of Leukocytes

A
  • neutrophils & monocytes lysosomal granules release molecs
  • acid protease pH optima limit activity only w/in phagolysosomes
  • neutral protease- elastase, collagenase & cathepsin. Active in ECM & degrade matrix proteins
  • Neutral Protease cleaves complement proteins directly to generate C3a & C5a & directly generate bradykinin from kininogen
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19
Q

Antiprotease check damaging effects of lyssomal enz

A
  • a1 antitrypsin- major I of neutrophil elastase & a2 macroglobulin
  • deficiencies of these inhibitors leads to tissue destruction @ sties of luekocyte accumulation
  • a1 antitrypsin def in lung can cause sever panacinar emphysema
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20
Q

Neuropeptides

A
  • substance P, transmit pain signals, reg vessel tone & modulate vascular perm
  • n. fibers secrete neuropeptides prominent in lung & GI
21
Q

Complement Sys

A
  • Found in plasma
  • produced in liver

action:

  • leukocyte chemotaxis, activation, opsonization
  • vasodilation
22
Q

Bradykinin

A
  • found in plasma
  • produced in liver

action:

  • increased vascular perm
  • smooth m. contraction
  • vasodilation
  • pain
23
Q

Proteases activated during coagulation

A
  • found in plasma
  • produced in liver

action

  • endoth activation
  • leukoyte recruitment
24
Q

Complement

A
25
Q

Complement

A
  • complement prot present in circulation
  • classic pathway when Igs are attached
  • Cascade generates C3b which acts like opsonin or C5a (neutrophil attractant)
  • C5-9 complex is known as Mem Attack Complex MAC
  • When MAC attaches, lysis by perforation of cell mem
26
Q

Alternate Pathway

A
  • Generate C3b oR C5a via bacterial products
  • NOT Ig mediated
  • Still create MAC & lyse cell mem by perforation
27
Q

Clotting Cascade

A
28
Q

Phagocytosis & clearance

A
29
Q

Acute inflammation

A
  • resolution
  • exudate- serous, fibrinous, purulent
  • suppurative inflamm
  • abscess
  • ulcer

*neutrophils at first

30
Q

Serous exudate

A

sqamous mucosa separated from dermis

2nd degree burn blister

31
Q

Serous exudate pleural effusion

A
32
Q

Fibrinous exudate

A

contains fibrin

fibrinous pericarditis w/ strangs of fibrin b/t visceral & pareital pericardiaum

Bread & butter pericarditis of uremia

33
Q

Fibrinous exudate

A
34
Q

fibrinous pericarditis- uremia

A
35
Q

Purulent Pericardial Effusion

A
36
Q

Purulent Ascites Abdomen

A
37
Q

Purulent exidate inflammation

A

acute bacterial meningitis

38
Q

Acute meningitis

A
39
Q

Acute bronchopneumonia

A
40
Q

Acute Bronchopneumonia

A
41
Q

Bronchopneumonia

A

productive cough- large amts of purulent sputum

suppurative inflamm (w/ pus)

42
Q

G+ cocci in pneumonia gram stain

A
43
Q

Abscess

A

localized collection of pus

liquefactive necrosis of abascess is apparent b/c purulent contents are draining out to leave a cavity

44
Q

Acute Pneumonia Abscess formation

A

loss of alveolar spaces & liquefactive necrosis

45
Q

acute inflammation ulcer

A

local mucosal defect of surface of organ or tissue

produced by sloughing of necrotic tissue

Found in an ulcer base:

  • fibrin
  • neutrophils
  • active granulation tissue
  • collagen
46
Q

Gastric ulcer

A
47
Q

Gastric ulcer micro

A
48
Q

Skin Ulcer

A
49
Q

Cardinal Signs of Inflammation

A
  1. red- hyperemia (increase BF) & vasodilation (his, PG, NO)
  2. PAIN- swelling from stretch sensory R & inflamm mediators
  3. heat- increased BF to body periph
  4. swelling- due to his, SE, C3a & 5a, bradykinin, leukotrienes, PAF, SP
  5. loss of f- from mech/structural necrosis or healing

Pathology (8 decks)

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