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Pathophysiology and Pharmacology > Chapter 3 Inflammation and Tissue Repair > Flashcards

Chapter 3 Inflammation and Tissue Repair Flashcards

1
Q

What is the first line of defense ?

A

skin and mucous membrane

involves surface and chemical barriers.

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2
Q

What is the second line of defense

A

inflammatory response

waging an inflammatory response is identical regardless of the cause of injury

phagocytes move in to engulf and destroy harmful substances

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3
Q

What is the third line of defense

A

immune response

a specific defense depending on the type of invader

immune cells recognize and destroy harmful substances

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4
Q

What is inflammation ?

A

the intensity of the inflammatory reaction is usually proportional to the extent of tissue injury

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5
Q

What is acute inflammation triggered by?

A

tissue injury and is essential for healing

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6
Q

What is injury?

A

tissue injury and is essential for healing

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7
Q

What is a vascular response?

A

To increase blood flow to the site of an injury

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8
Q

What is a cellular response ?

A

To alert the products of healing to attend to the site of injury

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9
Q

What is acute inflammation

A

occurs rapidly in reaction to cell injury, rids the body of the offending agent, enhances healing, and terminates after a short period, either hours or a few days

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10
Q

What is chronic inflammation?

A

occurs when the inflammatory reaction persists, inhibits, and causes continual cellular damage and organ dysfunction

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11
Q

How long can a vascular response happen

A

vasoconstriction from seconds to 10 minutes and the blood vessels follow vasoconstriction

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12
Q

What does plasma derived involve?

A

Complement System
Kinin System
Clotting System

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13
Q

What is the complement system?

A

Several proteins that comprise 10% - 15% of plasma; produce in liver.
Triggered by the presence of microorganisms.
Once triggered, activates a cascade of inflammatory mediators.

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14
Q

What is the kinin system?

A

Source of highly potent vasoactive inflammatory mediators.
Amplify the inflammatory response by triggering other inflammatory mediators.

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15
Q

What is the clotting system?

A

Promote coagulation through a cascade of clotting factors
Suppresses coagulation when clotting is complete
Various clotting factors produce and release inflammatory mediators.

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16
Q

What are the types of white blood cells in inflammation that are granulocytes?

A

eosinophils

mast cells

basophils

neutrophils

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17
Q

Why are neutrophils, basophils, and eosinophils are referred to as granulocytes

A

they contain cytoplasmic granules that contain important enzymes and inflammatory mediators to fight infection.

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18
Q

What are the types of white blood cells in inflammation that are agranulocytes

A

monocytes-> macrophages

T- lymphocytes

B- lymphocytes -> plasma cells

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19
Q

What are the three steps needed for a successful cellular response?

A

Chemotaxis

cellular adherence

cellular migration

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20
Q

What is histamine?

A

an inflammatory mediator released from basophils, platelets, and mast cells.

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21
Q

What is Histamine Receptor 1

A

smooth muscle cells of the bronchi

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22
Q

What is histamine 2 receptor

A

parietal cell of the stomach mucosa

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23
Q

What is chemotaxis ?

A

process of moving certain cells to the injury site.

Moving certain cells to the injury site

24
Q

What is cellular adherence regulated by:

A

Inflammatory mediators, specifically, chemotactic factors released by endothelial cells

Receptors that bind leukocytes to the surface of endothelial cells near the site of injury

Attraction & binding

25
Q

What is Cellular migration

A

allows leukocytes, erythrocytes, and platelets to go through endothelial to the exact site of injury

26
Q

What are the local manifestations of acute inflammation (cardinal signs)

A

erythema, heat, edema, pain, loss of function

these manifestations are related to vasodilation and fluid accumulation in the tissues as a result of activating inflammatory mediators.

27
Q

What is pyrexia

A

a fever

28
Q

What are systemic manifestations related to the inflammatory response

A

pyrexia, and increased circulating leukocytes and plasma proteins.

29
Q

What two test will signify inflammation is present but neither will identify the exact source or location of the inflammation?

A

CRP or ESR test

CRP is often the preferred test for acute inflammation

ESR deals with the clotting factor, fibrinogen.

30
Q

What are inflammatory mediators?

A

vasoactive inflammatory mediators, facilitate the process of widening and loosening the blood vessels at the site of injury

31
Q

Mast cells can release what kind of inflammatory mediators?

A

Histamine- locally released when injury to cell membrane occurs, vasodilator, alters capillary permeability, stimulates pain perception

Leukotrienes- Potent chemotactic agents (leukocytes)
Increase vascular permeability

Prostaglandins- controls inflammation, blood flow, formation of blood clots

32
Q
A
33
Q

What are the three phases of wound healing?

A

Inflammation

Proliferation

Remodeling

34
Q

What is primary intention

A

Wound close & heals with no skin loss

35
Q

What is secondary intention

A

Some loss of skin at the wound site

36
Q

What is tertiary intention

A

A wound with a large gap of missing tissue that has been contaminated and needs a drainage tube while healing

37
Q

What are the possible complications of a wound healing

A

Keloid- hyperplasia of scar tissue

Contractures- inflexible shrinkage of wound tissue that pulls the edges toward the center of the wound

Evisceration- opening of a wound with extrusion of tissues and organs

Dehiscence- opening of a wounds suture line (increases risk of infection)

38
Q

What causes impaired healing?

A

Malnutrition

Impaired blood flow and oxygen delivery

Age effects

Foreign bodies

Infection

Impaired inflammatory and immune responses

39
Q

What is a first degree burn?

A

thickness burns

damage the epidermis

This radiation-induced injury triggers vasodilation of the dermal blood vessels and increased capillary permeability, causing erythema, pain, and swelling of affected areas

DO NOT RESULT IN CELL NECROSIS OR SCARRING.

40
Q

What is a second degree burn?

A

deep partial thickness burns

damage the epidermis and penetrate into the dermis

41
Q

What is a third degree burn?

A

Full thickness burns

damage the epidermis and dermis and can penetrate subcutaneous layers as well

42
Q

When do you increase your risk for malignant melanoma?

A

intermittent sun exposure

43
Q

You get a paper cut and experience pain at the site. This response is related to:

a. increased perfusion at the site.
b. increased exudate and chemical mediators at the site.
c. bacteria that have entered the wound.
d. vasoconstriction at the site.

A

b. increased exudate and chemical mediators at the site.

44
Q

Inflammation is ultimately needed to:

a. increase inflammatory mediators at the site to vasoconstrict the area.
b. increase platelets at the site for clotting.
c. restore functional cells.
d. prepare the site for healing.

A

d. prepare the site for healing.

45
Q

A wound is 6 cm × 6 cm × 4 cm. A wound with these dimensions needs to heal through:

a. secondary intention.
b. primary intention.
c. tertiary intention.
d. scar tissue formation.

A

a. secondary intention.

46
Q

A major difference between the acute and chronic inflammatory response is that in chronic inflammation:

a. inflammatory mediators are released.
b. neutrophils are much more prominent.
c. granulomas form around certain invaders.
d. granulation tissue is present.

A

c. granulomas form around certain invaders.

47
Q

Which is not a local manifestation of acute inflammation?

a. Edema
b. Redness
c. Loss of function
d. Leukocytosis

A

d. Leukocytosis

48
Q

With burn injuries, it is important to determine the depth of injury. You are in the sun too long without sunscreen and develop redness and blistering on your face, chest, and back. What depth of burn did you experience?

a. Superficial partial-thickness burn
b. Deep partial-thickness burn
c. Full-thickness burn
d. Dermal thickness burn

A

b. Deep partial-thickness burn

49
Q

The hospitalized burn patient wants to know why you need to remove his dressings every day. It is painful and he wants to avoid uncovering his burn injury. You explain that removing the dressings promotes:

a. debridement.
b. Infection.
c. skin function.
d. drying the exudate.

A

a. debridement.

50
Q

What is the one definitive test to diagnose rheumatoid arthritis (RA)?

a. A positive rheumatoid factor (RF).
b. An elevated erythrocyte sedimentation rate (ESR).
c. A positive antinuclear antibody (ANA)
d. One test is not definitive.

A

d. One test is not definitive.

51
Q

Which of the following is the most common cause of acute gastritis?

a. Poor gastric perfusion
b. Too much stomach acid
c. Ingestion of aspirin, alcohol, or other chemicals
d.H. pylori infection

A

c. Ingestion of aspirin, alcohol, or other chemicals

52
Q

Why is Crohn disease more likely to cause intestinal obstruction than ulcerative colitis?

a. Crohn disease is located in the small intestine.
b. Crohn disease causes granulomas to form in the submucosal layer.
c. Crohn disease causes abdominal pain and watery diarrhea.
d. Crohn disease is exacerbated by certain foods, such as spicy foods.

A

b. Crohn disease causes granulomas to form in the submucosal layer.

53
Q

A patient is taking an anti-inflammatory drug for rheumatoid arthritis. What is the most likely action for this drug?

a. Blocks the chemical mediators of inflammation
b. Enhances the body’s immune system
c. Increases blood flow to the tissues
d. Decreases scar formation

A

a. Blocks the chemical mediators of inflammation

54
Q

Which of the following is the most common cause of acute pancreatitis?

a. Cancer
b. Autoimmunity
c. Excess alcohol intake
d. Cystic fibrosis

A

c. Excess alcohol intake

55
Q

Rheumatoid arthritis results in joint immobility as a result of:

a. synovial fluid loss.
b. pannus formation.
c. rheumatoid factor.
d. joint deviation.

A

b. pannus formation.

56
Q

Which of the following meals would you recommend to a patient who has a wound injury to promote healing?

a. Eggs and orange juice
b. Spaghetti and garlic toast
c. Steak and potatoes
d. Tomato soup and grilled cheese

A

a. Eggs and orange juice

Pathophysiology and Pharmacology (11 decks)

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