Chapter 3: inflammation response and fever

Question 1

What do neutrophils respond to?

Answer 1

bacteria

Question 2

What do eosinophils respond to?

Answer 2

parasites, allergens, and neoplasia

Question 3

What do basophils respond to?

Answer 3

allergens and stress

Question 4

What do mast cells respond to?

Answer 4

allergens

Question 5

What do lymphocytes respond to?

Answer 5

viral and fungal infections

Question 6

What is neoplasia?

Answer 6

abnormal new tissue growth that is a precursor for cancer

Question 7

Explain the difference between acute and chronic inflammation.

Answer 7

ACUTE INFLAMMATION:
short duration, exudation of fluid and plasma proteins

CHRONIC INFLAMMATION:
proliferation of blood vessels, tissue necrosis, and fibrosis

Question 8

What are some things that could cause acute inflammation?

Answer 8

trauma, infection, chemicals

Question 9

What are a few things that are examples of chronic inflammation?

Answer 9

atherosclerosis, rheumatoid arthritis

Question 10

What are the 5 cardinal signs of inflammation

Answer 10

S welling
H eat
L oss of function
R edness
P ain

may also have fever

Question 11

What is the role of leukocytes role in inflammation?

Answer 11

Release interleukins and tumor necrosis factor that….

affect the thermoregulatory center to inc temp (fever)

the increase heat affects CNS resulting in lethargy

Question 12

What role does the liver play in inflammation?

Answer 12

to provide fibrinogen and C-reactive protein to…

1) facilitate clotting
2) bind to pathogens
3) moderate inflammatory responses

Question 13

Describe the 3 parts of the vascular stage of inflammation.

Answer 13

1) vasodilation
2) inc vascular permeability
3) plasma proteins exit and pull water

result in the cardinal signs

Question 14

List and describe the 4 steps of the cellular stage of inflammation.

Answer 14

1) MARGINATION and ADHESION: leukocytes (neutrophils) accumulate at site and release cytokines
2) TRANSMIGRATION: leukocytes move through vessel wall to tissue
3) CHEMOTAXIS: leukocytes follow chemical trail of inflammatory chems
4) ACTIVATION and PHAGOCYTOSIS

Question 15

List the three steps of phagocytosis.

Answer 15

1) RECOGNITION and ADHESION
2) ENGULFMENT
3) INTRACELLULAR KILLING

Question 16

What are the 5 types of exudates and descriptions

Answer 16

SEROUS: clear

HEMORRHAGIC: red, severe dmg that affects vessels

FIBRINOUS: made of fibrin, less clear (cloudy). thick and sticky

MEMBRANOUS: necrotic cells in fibropurulent exudate. on mucous membranes

PURULENT: coloured (pus)

Question 17

Describe the process of chronic inflammation

Answer 17

Macrophages accumulate and release inflammatory mediators

fibroblasts proliferate and create scar tissue

macrophages mass around foreign bodies

CT surrounds and isolates mass

Question 18

List four causes of chronic inflammation.

Answer 18

1) FOREIGN BODIES: asbestos, talc, surgical sutures
2) MICROORGANISMS: viruses, bacteria, fungi, parasites
3) INJURY: tissue around healing fracture
4) OBESITY: adipose tissue is a source of inflammatory mediators therefore inc risk of inflammation

Question 19

What is the core body temperature?

Answer 19

36 - 37.5 degrees

Question 20

What are the core tissues that produce heat?

Answer 20

Muscles and viscera

Question 21

What are the ways to obtain a core temp?

Answer 21

1) rectal
2) oral
3) tympanic
4) esophageal
5) pulmonary artery
6) urinary catheter

Question 22

What part of the brain acts as the thermal control center?

Answer 22

hypothalamus

Question 23

What are the two ways that the body produces heat?

Answer 23

SHIVERING:
hypothalamus impulse (SNS) resulting in inc in muscle tone and oscillating rhythmic tremor

PHYISCAL EXERTION

Question 24

What is the difference in cellular response to acute vs chronic inflammation?

Answer 24

ACUTE: abundant in neutrophils

CHRONIC: abundant in lymphocytes and macrophages

Question 25

What are the two ways that the body attempts to retain heat?

Answer 25

VASOCONSTRICTION: closing of the arteriovenous shunts PILOMOTOR muscle contraction: raises skin hair to trap air and dec surface area avail for heat loss

Question 26

What are the 8 ways that the body loses heat?

Answer 26

``` radiation conduction convection evaporation exhalation urine/feces heat edema increasing HR ```

Question 27

With one degree rise in temp, how much is the HR expected to rise?

Answer 27

15bpm

Question 28

If the HR does not rise with an increase in temp, what might it be a sign of?

Answer 28

medication interference neurological disease aging

Question 29

If the HR rises greater than expected, what might it be a sign of?

Answer 29

hyperthyroidism | pulmonary emboli

Question 30

what is a pyrogen?

Answer 30

any substance that induces or mediates fever

Question 31

Explain the two types of pyrogens

Answer 31

EXOGENOUS: from outside body; bacterial products, toxins, or whole microorganisms ENDOGENOUS: released by cells like phagocytes (interleukens and TNF)

Question 32

list and describe the 4 patterns of pyrexia.

Answer 32

INTERMITTANT: normal temp at least once q24hrs REMITTANT: never returns to norm, but fluctuates SUSTAINED/CONTINUOUS: never returns to norm and fluctuates minimally RECURRANT/RELAPSING: episodes of fever and norm each lasting days

Question 33

What are the 4 stages of pyrexia?

Answer 33

PRODROMAL stage CHILL stage FLUSH stage DEFERVESCENCE stage

Question 34

Describe the symptoms of the prodromal stage of pyrexia

Answer 34

``` headache fatigue aches pain malaise ```

Question 35

Describe the symptoms of the chill stage of pyrexia.

Answer 35

``` chilled vasoconstriction AV shunts close piloerection pale skin rigor ```

Question 36

Describe the symptoms of the flush stage of pyrexia.

Answer 36

vasodilation | AV shunts open

Question 37

Describe the defervescence stage of pyrexia.

Answer 37

Temp dec to norm | sweating

Question 38

What are the 4 manifestations of pyrexia?

Answer 38

Fatigue Anorexia Arthralgia Myalgia

Question 39

What is unique about inflammation and fever in the elderly?

Answer 39

they have an atypical afebrile or blunted response 20-30 per cent of the time

Question 40

What contributes to the unique fever reaction to inflammation in the elderly?

Answer 40

1) dec hypothalamus ability to recognize change in body state 2) altered release of endogenous pyrogens 3) inability to respond to set point change (dec ability to v/c, shiver, etc)