Ch3 Chronic Inflammation and Tissue Repair EC

Question 1

Primary leukocytes of chronic inflammation

Answer 1

Monocytes/macrophages

Also lymphocytes, plasma cells, eosinophils

Question 2

Granulation tissue

Answer 2

Blood vessels and fibroblasts
Precursor to scar formation
Fibronectin required

Question 3

Fibronectin

Answer 3

Key adhesion glycoprotein of ECM

Chemotactic factor for fibroblasts and endothelial cells

Question 4

Examples of caseating granulomas

Answer 4

TB 
Systemic fungi (histo)

Question 5

Examples of non-caseating granulomas

Answer 5

Sarcoidosis

Crohn’s

Question 6

Cell types in infectious granuloma

Answer 6

Activated macrophages (epitheliod cells - fuse to form multinucleated giant cells)
Th1 CD4 cells 
TNF-alpha necessary for maintenance of granuloma  (TNF-alpha inhibitors can result in systemic TB)

Question 7

Regulation of the G1 to S checkpoint

Answer 7

p53 inhibits Cdk4 phosphorylation of RB, which allows cell to enter S phase

Question 8

How does p53 induce apoptosis in cells in which the DNA is damaged?

Answer 8

Inhibits translocation of BCL-2 (usually antiapoptotic)

Inhibits translocation of MYC (growth promoting)

Question 9

VEGF

Answer 9

Stimulates angiogenesis

Stimulated by TNF and hypoxia

Question 10

FGF

Answer 10

Chemotactic for fibroblasts

Stimulates keratinocyte migration, angiogenesis, and wound contraction

Question 11

EGF

Answer 11

Stimulates keratinocyte migration and granulation tissue formation

Question 12

PDGF

Answer 12

Chemotactic, and angiogenesis

Question 13

TGF-beta

Answer 13

Chemotactic for macrophages, lymphocytes, fibroblasts, and angiogenesis

Question 14

IL-1

Answer 14

Stimulates synthesis of metalloproteinases

Stimulates synthesis and release of acute phase reactant proteins

Question 15

TNF

Answer 15

Activates macrophages

Stimulates release of acute phase reactants

Question 16

What is the initial collagen in wound repair?

Answer 16

Type III collagen -poor tensile strength

Question 17

Function of metalloproteinases

Answer 17

Contain Zinc
Convert Type III collagen to Type I
Wound strength 80% original after 3 months

Question 18

What is the most common cause of impaired healing? What is the most common pathogen?

Answer 18

Infection

S. aureus

Question 19

MRSA mechanism of path

Answer 19

Produce Panton-Valentine leukocidin which accelerates PMN apoptosis

May progress to necrotizing fasciitis

Question 20

How does diabetes mellitus increase susceptibility to infection?

Answer 20

Decreased blood flow

Increased tissue glucose (bug food)

Question 21

How do nutritional deficiencies impair wound healing?

Answer 21

Malnutrition (decreased protein)
Vit. C/ Copper deficiency (decreased collagen cross linking)
Zinc deficiency (defects in removal of type III collagen

Question 22

How do glucocorticoids impair wound healing?

Answer 22

Prevent scar formation by interfering with collagen formation and decrease tensile strength

plastic surgeons inject steroids into wounds to prevent scar formation

Question 23

Keloids

Answer 23

Raised scars extending beyond borders of original wound

bundles in same plane as epidermis

Question 24

Hypertrophic scar

Answer 24

Raised scar remaining in confines of original wound

bundles in same plane as epidermis

Question 25

Collagen bundles

Answer 25

Random and haphazard

keloids and hypertrophic scars in same plane as epidermis

Question 26

Wallerian degeneration

Answer 26

Distal degeneration of the axon

Question 27

Reinnervation in peripheral nerve transection

Answer 27

Schwann cell proliferates from distal stump 2mm/day

Question 28

Skeletal muscle post exercise

Answer 28

Myofiber repair by satellite cells (muscle stem cells)