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MOD > Chapter 3 part 3 > Flashcards

Chapter 3 part 3 Flashcards

1
Q

In what settings does chronic inflammation occur?

A

persistent infections
hypersensitivity diseases
prolonged exposire to toxic agents

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2
Q

Morphologic features of chronic inflammation

A

infiltration with mononuclear cells (macrophages, lymphocytes, plasma cells), tissue destruction, attempts at healing (angiogenesis and fibrosis)

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3
Q

Where are macrophages derived from?

A

hematopoietic stem cells in the bone marrow and from progenitors in embryonic yolk sac and fetal liver during early development

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4
Q

Mononuclear phagocyte system

A

circulating monocytes
macrophages in tissues
specific macrophages based on tissue (e.g. Kuppfer cells in liver)

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5
Q

Classical macrophage activation pathway

A

induced by microbial products which engage TLRs and other sensors and by IFN-y; produce NO and ROS and up regulate lysosomal enzymes
Action: phagocytosis and inflammation

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6
Q

Alternative macrophage activation

A

induced by cytokine other than IFN-y (IL-4 and IL-13); secrete growth factors that promote angiogenesis, activate fibroblasts, and stimulate collagen synthesis
Actions: tissue repair, fibrosis, anti-inflammatory effects

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7
Q

Functions of macrophages that make them central to development and persistence of chronic inflammation

A

1) ingest and eliminate microbes and dead tissues
2) secrete mediators of inflammation
3) display antigens to T lymphocytes and respond to signals from T cells

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8
Q

What do CD4+ T lymphocytes promote?

A

inflammation

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9
Q

3 subsets of CD4+ T lymphocytes and their products

A

1) Th1 cells: IFN-y which activates macrophages by classical pathway
2) Th2 cells: IL-4, IL-5, and IL-13 recruit and activate eosinophils and activate alternative macrophage activation pathway
3) Th17 cells: IL-17 which induces chemokine for recruitment of neutrophils

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10
Q

What are Th1 and Th2 cells involved in defense against?

A

bacteria and viruses

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11
Q

What are Th2 cells important in defense against?

A

helminthic parasites and allergic inflammation

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12
Q

Tertiary lymphoid organs

A

accumulation of lymphocytes, antigen presenting cells, and plasma lymphoid tissue resembling lymph nodes

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13
Q

Function of eosinophils

A

abundant in immune reactions mediated by IgE and in parasitic infections; toxic to parasites and causes lysis of mammalian epithelial cells

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14
Q

Function of mast cells

A

express FceR1 on surface that binds to FC portion of IgE antibody, release histamine and prostaglandins, respond to allergic reaction

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15
Q

In what chronic diseases are neutrophils persistent in?

A

bacterial infection of the bone (osteomyelitis), in lungs from smoking

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16
Q

Define granulomatous inflamation

A

chronic inflammation characterized by activated macrophages and T lymphocytes, sometimes with necrosis

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17
Q

What is a foreign body granuloma?

A

group of macrophages around a foreign body without a T cell-mediated response

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18
Q

What is an immune granuloma?

A

group of macrophages that induce a T cell-mediated response; caused by a persistent microbe or self Ag

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19
Q

What cytokines are involved in immune granuloma formation?

A

IL-2 (from macrophages), IFN-gamma

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20
Q

What is the morphology of a granuloma?

A

activated macrophages resemble epithelia and are surrounded by lymphocytes, contains giant cells, resembles a caseous necrosis grossly

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21
Q

What are giant cells (Langhans giant cells)?

A

consist of large amounts of cytoplasm and many nuclei, derive from the fusion of multiple macrophages

22
Q

What organism causes tuberculosis?

A

Mycobacterium tuberculosis

23
Q

What organism causes leprosy?

A

Mycobacterium leprae

24
Q

What organism causes syphilis?

A

Treponema pallidum

25
Q

What organism causes cat-scratch disease?

A

Gram-negative bacillus

26
Q

What causes Crohn disease?

A

Immune reaction against intestinal bacteria, possibly self Ags

27
Q

What is the tissue reaction of tuberculosis?

A

caseating tubercle with activated macrophages, fibroblasts, lymphocytes, histiocytes and Langhans giant cells

28
Q

What is the tissue reaction of leprosy?

A

non-caseating granulomas with acid-fast bacilli in macrophages

29
Q

What is the tissue reaction of syphilis?

A

Enclosing wall of histiocytes with plasma cell infiltrate and necrotic central cells

30
Q

What is the tissue reaction of cat-scratch disease?

A

Rounded granuloma with granular debris and neutrophils, giant cells unlikely

31
Q

What is the tissue reaction of sarcoidosis?

A

Noncaseating granulomas with many activated macrophages

32
Q

What is the tissue reaction of Crohn disease?

A

Occasional noncaseating granulomas in the intestine with chronic inflammatory infiltrate

33
Q

What cytokines are most commonly involved in an acute-phase reaction?

A

IL-1, IL-6, and TNF, type 1 interferons may also contribute

34
Q

What are the most common clinical and pathologic changes in an acute-phase reaction?

A

Fever, acute-phase proteins, leukocytosis, increased pulse and blood pressure, decreased sweating, shivering and chills, widespread cytokine release

35
Q

What is the temperature change involved in a fever?

A

Increase in body temp by 1 to 4 degrees celsius

36
Q

What are pyrogens?

A

Substances that induce a fever?

37
Q

What molecule causes an increase in body temp and how is it made?

A

Prostaglandins produced in vascular cells of hypothalamus, release is stimulated by leukocytes releasing IL-1 and TNF increasing the amount of prostaglandins present

38
Q

What is the action of PGE2 as it relates to fevers?

A

Causes the production of neurotransmitters that reset the body temp to a higher level.

39
Q

What are the most common acute-phase proteins?

A

CRP, fibrinogen and serum amyloid A

40
Q

What cytokines cause the release of acute-phase proteins?

A

IL-6 causes the release of CRP and fibrinogen, IL-1 or TNF causes the release of serum amyloid a

41
Q

What are the main actions of acute phase proteins?

A

Binding to microbial cell walls to act as opsonins and fix complement, may also bind chromatin and aid in clearing the necrotic cell nuclei

42
Q

What is the action of fibrinogen?

A

Binds red cells and causes them to form rouleaux that sediment more rapidly than regular RBCs

43
Q

What is erythrocyte sedimentation rate?

A

Test used for an inflammatory response

44
Q

What does the presence of hepcidin cause in an inflammatory reaction?

A

elevated plasma concentrations of hepcidin reduce iron level and cause anemia

45
Q

What is leukocytosis?

A

increase of leukocytes to 15-20k cells/mL, may increase to 40-100k cells/mL (leukemoid reaction)

46
Q

What is a left shift?

A

accelerated release of cells and a rise in immature neutrophils

47
Q

Definition of neutrophilia

A

Increase in neutrophils due to bacterial infection

48
Q

Definition of lymphocytosis

A

Absolute increase in number of lymphocytes due to a viral infection

49
Q

Definition of eosinophilia

A

Increase in absolute number of eosinophils due to parasites or allergies

50
Q

Define leukopenia

A

Decrease in number of white blood cells caused by certain infections like typhoid fever, some protozoa and viruses

51
Q

What is the clinical triad of septic shock?

A

intravascular coagulation, hypotensive shock, and metabolic disturbances (insulin resistance and hyperglycemia)

52
Q

What are the main causes of defective inflammation?

A

leukocyte deficiency from bone marrow replacement and suppression of marrow for transplants

MOD (34 decks)

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