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TT BL and DD Exam1 > DD2 > Flashcards

DD2 Flashcards

1
Q

Extravascular fluid w/ ↑ protein [ ] (exudate) indicates what?

A

increase permeability of small blood vessels due to tissue injury/ inflammation

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2
Q

Is edema due to an excess of fluid in interstitial tissue, serous cavities or the vessels?

A

Interstitial tissue or serous cavities

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3
Q

What is the fluid glucose ratio for transudate?

A

> 1.0

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4
Q

What is the fluid glucose ratio for exudate?

A

<1.0

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5
Q

Does transudate have cells (leukocytes)?

A

No

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6
Q

Where is the source of PMNs in acute inflammation?

A

peripheral blood

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7
Q

Is acute or chronic inflammation a rxn of innate immunity?

A

acute

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8
Q

Main characteristic of acute inflammatory phase

A

exudation of fluid and plasma proteins (edema) and emigration of leukocytes (PMNs)

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9
Q

Is acute or chronic inflammation a rxn of adaptive immunity?

A

chronic

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10
Q

Name 3 cells involved in chronic inflammation repair and what they contribute

A

§ Macrophages → growth factors
§ Fibroblasts → fibrosis/scar
§ Endothelial cells → neovascularization

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11
Q

Where is the source of cells for chronic inflammation?

A

Sentinal/local cells in tissue

or

peripheral blood (like acute)

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12
Q

Can you have chronic inflammation w/o an acute phase?

A

Yes

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13
Q

During inflammation, what purpose do the lymph nodes serve?

A

Aggregation site of lymphocyte : barrier to infection

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14
Q

What are the two infrastructure cells that provide support during inflammation? How?

A

§ Fibroblasts
□ Response to injury: proliferate + produce collagen + other extracellular material
§ Endothelial cells:
□ Line blood vessels
□ Response to injury: proliferate + form new blood vessels

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15
Q

Describe the best outcome of acute inflammation

A
  1. Complete resolution

a. Macrophage clean up necrotic debris → Tissue regeneration →lymphatic drainage decreasing edema

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16
Q

What are the best to worst outcomes of acute inflammation?

A
  1. Complete resolution
  2. Scarring: “patch” not 100% function
  3. Abscess formation: cant get rid of infection → walls off
  4. Progression to chronic inflammation
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17
Q

Which cells are involved in Fibrinopurulent/purulent/suppurtive inflammation?

A

PMNs

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18
Q

Which cells are involved in granulomatous inflammation?

A

Macrophages

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19
Q

Which cells are involved in eosinophilic inflammation?

A

Eosinphils

20
Q

What is your DDX for granulatomatous inflammation?

A

Infections
Inflammatory vascular diseases
Foreign bodies

-materials can be walled off

21
Q

Eosinophils participate in immune rxns mediated by which immunoglobulin?

A

IgE

22
Q

Acute inflammation vascular response

A 
dilation/increased flow
increased permeability (transudate/exudate)
23
Q

Chronic inflammation vascular response

A

variable dilation + leakiness

endothelial cell activated (ready to proliferate)

24
Q

Which phase of inflammation is repair stimulated?

A

Chronic

  • macrophages: cytokines/growth factors
  • fibroblasts: fibrosis/scar
  • endothelial cells: neovascularization

*note: acute mainly neutrophils: phagocytose - no damage

25
Q

5 macroscopic appearance of inflammation

A
  1. Fibrinopurulent/purulent/suppurtive
  2. Abcess
  3. Empyema
  4. Cellulitis
  5. Granuloma
26
Q

Location of abcess

A

w/in parenchyma/confined space

ie: brain, lung, liver cavity

walled off by immune system - prevent infection of neighbors

27
Q

Location of empyema

A

w/in anatomic space or cavity

28
Q

Location of granuloma

A

usually w.in parenchyma (just like abcess)

29
Q

Of the 5 macroscopic appearance of inflammation, all but one have neutrophils being the primary inflammatory cell. Which one?

A

Granuloma - macrophages, lymphocytes, plasma cells

30
Q

What is empyema

A

exudative inflammation (pus) within a body cavity

-commonly lungs

31
Q

What is granuloma

A

collection of immune cells due to inflammation, usually mineralized

walled off by immune system bc it cant eliminate

32
Q

Chronic inflammation show 3 characteristic histologic features:

how does acute inflammation differ?

A
  1. collection of chronic inflammatory cells
  2. destruction of parenchyma
  3. replacement of CT
    ______________
  4. neutrophils (pinker than inflammatory cells) fill spaces and blood vessels congested
33
Q

collateral tissue damage associated with inflammation.

A

Leukocytes do not distinguish between offender and host:

Activated Macrophages release:

  • reactive oxygen and nitrogen species
  • proteases
  • cytokines
  • coagulation factors
  • AA metabolites
34
Q

eating lots of fava beans can cause which anemia?

A

G6PD deficiency

35
Q

Macrophage repair mechanism (not tissue injury)

A

release:

  • growth factors
  • fibrogenic cytokines
  • angiogenic factors
  • remodeling collagenesis
36
Q

Do both neutrophils and macrophages produce microbicidal substances (ROS, NO, lysosomal enzymes) that are released into extracellular space?

A

Yes. Both.

37
Q

Neutrophils survive for how long after migration?

A

1-2 days

38
Q

Lymphatic vessels are involved in acute or chronic inflammation? What does it do?

A

Acute

  • Normally filters and polices extravascular fluid (outside BV)
  • In inflammation-> lymph vessels proliferates-> drains edema accumulated due to vascular permeability -> drains injurious agent
39
Q

What happens if the lymphatic system cannot contain infection during acute inflammation?

A

M.o gains access to blood -> screwed (bacteremia, fungemia, viremia) -> Pt. becomes septic

40
Q

Useful lab tests supporting an inflammatory process (6)

A
  1. hematologic profile
  2. acute phase reactants
  3. DIC related markers
  4. Microbiology and Immunology lab studies
  5. Immunoglobulin quantitation
  6. Chemical mediators
41
Q

Describe this useful lab tests supporting an inflammatory process:
-Hematologic profile

A

WBC

Differential including platelet count

42
Q

Describe this useful lab tests supporting an inflammatory process:
-Acute phase reactant

A

Erythrocyte sedimentation rate

C-reactive protein

43
Q

Describe this useful lab tests supporting an inflammatory process:
-DIC related markers

A 
Fibrin split products (D-DImer)
platelet count (consumption)
44
Q

Describe this useful lab tests supporting an inflammatory process:
-Microbiology and immunology lab studies

A

rapid identification testing (crytococcus, viruses)
culture
serology (IgM vs IgG)

45
Q

Describe this useful lab tests supporting an inflammatory process:
-chemical mediators

A 
Prostaglandins
				Leukotrienes
				Thromboxanes
				Interleukins
"PILT"

TT BL and DD Exam1 (23 decks)

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