Exam 2 Flashcards
What vascular and cell processes commonly occur in inflammation?
Increased blood flow
Increased vascular permeability
Leukocytic exudation through vessels
(Margination/rolling, Adhesion and migration, Chemotaxis and activation)
List 5 signs that often accompany inflammation and describe the pathophysiologic basis of these signs.
a. Rubor (redness): increased blood to the area
b. Tumor (swelling)- increased permeability
c. Calor (heat): body temp goes up due to cytokine mediators and increased BF
d. Dolor (pain): stimulation of free nerve endings
e. Functiolaesa (loss of function)
The process of reaction of living vascularized tissue to injury
Inflammation
List 5 chemicals mediators that can mediate an increase in vascular permeability at a site of inflammation?
histamine C3a, C5a Bradykinin, Leukotrienes (C4/D4/E4) Platelet Activating factor (PAF)
List 3 chemical mediators of cells
Vasoactive amines: histamine, serotonin
Prostaglandins and leukotrienes: PGE2, LTB4
Cytokines/chemokines: TNF alpha, IL-1, IL-8, MIP-1
Nitric Oxide
How does C5a contribute inflammatory reactions?
Increase vascular permeability
Chemotactic for neutrophils, eosinophils, and macrophages
Cause mast cell degranulation, smooth muscle contraction, secretion of neutrophil granules
Stimulates oxygen radical production in neutrophils and macrophages, and arachadonic acid metabolism
How do Coagulation/Fibrinolytic products contribute inflammatory reactions?
chemotactic for PMN’s and macrophages through fibrinopeptide formation
What cells release vasoactive amines and arachidonic metabolites and are important in regulating inflammation?
Vasoactive amines: Mast cells, basophils, platelets
AA metabolites:
resident cells, leukocytes, and mast cells (PGE2) and
Neutrophils, Macrophages, eosinophils (leukotrienes)
???
What pathogenic mechanisms are responsible for edema in inflammatory reactions?
Increased vascular permeability and vasodilation allows plasma proteins to leak into the ECM, altering oncotic pressure, allowing fluid to follow
Why are neutrophils often the first inflammatory cells to reach a site of injury during an acute inflammatory reaction?
Highly motile and high phagocytic rate
Respond to a wide variety of chemotactic stimuli, which enables them to respond quickly and efficiently
What properties of macrophages allow for them to function effectively in a chronic inflammatory process?
Much longer life, can phagocytize more than once
effective in destruction and long-term digestion of phagocytosed particulates
C3a’s role in inflammation
increase vascular permeability
What are the 2 vasoactive amines
histamine and serotonin
What is the role of vasoactive amines in inflammation?
vasodilation
Increased venular permeability
Bronchial and other smooth muscle contraction
Source of prostaglandins
resident cells, leukocytes, mast cells
Inflammatory effects of Prostaglandins
- Increase vascular permeability (PGE2)
- Increase blood flow
- Inhibit fibroblast and lympho proliferation
- Increase body temp
- Stimulate pain receptors
Source of leukotrienes
neutrophils, macrophages, and eosinophils
Inflammatory effects of LTB4
chemotactic for neutrophils and eosinophils and chemokinesis for monocytes/macrophages
MOST potent neutrophil chemotactic substance
leukotrienes (LTB4)
Inflammatory effects of LTD4/C4/E4
smooth muscle contraction, increase vascular permeability
What cell surface molecules on leukocytes and endothelial cells play a role in regulating leukocyte rolling and margination?
a. E selectins: endothelial cells (upregulated by TNF alpha and IL 1)
b. P selectins: endothelial cells
c. Sialylated oligosaccharides: leukocytes
List 2 stimuli that can upregulate E selectins and the process of migration and margination of leukocytes
TNF alpha and IL 1
How do neutrophils and macrophages mediate tissue injury during an inflammatory reaction?
Via release of lysosomal enzymes and oxygen radicals
Macrophages, also, release their cytokines which can induce damage
An inflammatory cell that is long-lived, can divide locally in tissue and regulates immune and repair responses:
a) Neutrophil
b) Eosinophil
c) Macrophage
d) Platelet
e) B and C
C
Histamine increases vascular permeability at the level of capillaries and venules through the mechanism of:
a) Endothelial cell contraction
b) Endothelial cell damage
c) Increased transcytosis
d) Induce endothelial proliferation
A
Which cell surface molecules on leukocytes and endothelial cells mediate leukocyte rolling?
E and P selectins on endothelial cells (upregulated by TNF alpha and IL 1)binding to sialylated oligosaccharides on leukocytes
Which cell surface molecules on leukocytes and endothelial cells mediate leukocyte adhesion?
ICAM-1 and VCAM-1 on endothelial cells
Integrins (LFA-1, Mac-1, VLA-4) on leukocytes, which are stimulated by TNF alpha, IL-8 and IL-1
Which cell surface molecules on leukocytes and endothelial cells mediate leukocyte transmigration?
Co expression of PECAM-1 (CD31) on both endothelial cells and leukocytes (homophilic adhesion molecule)
Bovine leukocyte adhesion deficiency is caused by a defect in which gene? How would you detect the abnormality in a carrier animal?
a. CD18 gene
b. Calves have poor neutrophil response to infection by bacteria and common fungi
c. Enteritis and pneumonia
Leukocyte adhesion deficiency in Irish Setter Dogs is associated with a genetic defect in which gene?
CD18 missense mutation
Why do bacterial infections often lead to neutrophil-dominated inflammatory reactions?
Neutrophils are highly motile, high phagocytic capacity, and are the most effective killers of bacteria (strong neutrophil chemotactic factor is the bacterial cell wall)
How do lymphocytes, macrophages, and mast cells amplify or produce inflammatory response?
Release inflammatory mediators (IFN gamma, leukotrienes, interleukins, chemokines, prostaglandins).
Can amplify a reaction by releasing chemicals like oxygen radicals, superoxide anions and lysosomes. This can cause tissue damage too
Neutrophil-Endothelial surface molecules mediating rolling
a) Integrin (CD11/CD18)- selectin
b) Siayl lewis X-selectin
c) Integrin (CD11/CD18)- ICAM-1
d) PECAM-1 (CD31)-PECAM-1 (CD31)
B
Holstein cattle and Irish Setter dogs have mutations in which molecules to develop leukocyte adhesion molecule deficiency
a) Selectin
b) ICAM-1
c) Integrin (CD18)
d) PECAM-1 (CD31)
e) Siayl-Lewis X glycoprotein
C
How are inflammatory reactions commonly classified morphologically?
Duration :acute, sub-acute, chronic
Distribution: focal, multifocal, locally-extensive, diffuse
Type of exudate
Tissue Involved
What are histologic indicators of a chronic inflammatory reaction?
fibrosis
necrotic inflammatory reaction on an epithelial surface down to the basement membrane
erosion
necrotic inflammatory reaction on an epithelial surface that involves LOSS of the basement membrane
ulcer
What pathogenetic events are important in the stimulation of a granulomatous inflammatory reaction?
Inciting stimuli-substances that resist lysosomal degradation and substances that induce T-cell hypersensitivity
Suppurative inflammatory reactions are often induced by? A. Fungi B. Nematode parasites C. Bacteria (non-mycobacterial) D. Mycobacteria E. Toxins
C. Bacteria (non-mycobacterial)
Eosinophilic inflammatory reactions are often induced by a. fungi b. nematode parasites C. Mycobacteria E. Toxins
B
Macrophage dominated inflammatory reactions are often induced by: a. Fungi B. Nematode parasites C. Bacteria (non-mycobacteria) D. Mycobacteria E. Toxins
A and D
Which type of inflammatory cell is often associated with liquefactive necrosis? a. Lymphocyte B. Neutrophil C. Macrophage D. Eosinophil E. Mast cell
B. neut
What role does delayed type hypersensitivity play in the pathogenesis of granulomatous inflammation?
Hypersensitivity is NOT a requirement but CAN accelerate and intensify the inflammation response via lymphokines released from T cells.
True or False
Granulomatous inflammation is almost always a chronic process unless there is a pre-existing T cell hypersensitivity.
TRUE
Inflammatory reaction dominated by macrophages
Granulomatous
Compact and organized collection of mononuclear inflammatory cells dominated by macrophages
granuloma
highly organized fibrovascular tissue that often replaces necrotic cells and areas where poor regeneration has occurred
Granulation tissue
Granuloma with central necrosis +/- calcification
complex granuloma
Inciting stimuli of granulomatous inflammation are?
a) Particulates resisting lysosomal degradation
b) Persisting molecules that stimulate T-cell hypersensitivity
c) Stimuli that are chemotactic for macrophages and neutrophils
d) A, B
e) A, B, C
D
Granulomatous inflammation is almost always:
a) Acute
b) Chronic
B
Inflammatory cells central to granulomatous inflammation
a) Macrophages
b) Epithelial cells
c) Multinucleated giant cells
d) A,B,C
e) A, C
E
process resulting in increase of collagen in tissue; often an important and sometimes necessary component of the repair process
Fibrosis usually results in fibrous connective tissue
Cells that have latent capacity to regenerate; normally quiescent in G0 state; have long life spans and don’t turnover quickly
Stable
epithelial cells in liver, kidney, lung, endocrine glands; smooth muscle cells, fibroblasts, endothelial cells (also skeletal muscle to an extent) are examples of this kind of cell
stable
Cells that continue to multiply throughout life (never leave cell cycle to G0 state) and replenish those lost due to normal turnover
Liable
epidermal/intestinal epithelial cells, lymphoid and hematopoietic cells are examples of these kind of cells
liable
cells w/ no capacity to regenerate additional cells
Permanent or non-dividing cells
neurons and cardiac cells are examples of these kind of cells
permanent
Cell migration along a concentration gradient of chemical mediatory
chemotaxis
Random migration stimulated by a mediator
chemokinesis
What do non-dividing cell do in response to injury
limited capacity to regenerate some cell cytoplasm therefore only repair by scaring
Process by which lost or necrotic cells are replaced by vital cells
repair
replacement of cells by cells of the same type aka good
regeneration
damage cells are replaced by connective tissue
fibrosis aka bad
small chemotactic cytokines produced by macrophages, stroll cells, and epithelial cells
chemokines
Two examples of broad chemokines and their spectrum of biological activities
CXC chemokines- primarily for neutrophils and endothelial cells (e.g. IL8 and factor 4)
CC chemokines- chemotactic for mononuclear cells (lymphs, mono) and eos (MIP1, Rantes, Eotaxin)
4 cytokines that regulate the inflammatory and/or repair process
TNF alpha
IL-1
IFN gamma
Chemokines
Released from macrophages and other inflammatory cells and fibroblasts in response to viral and fungal infections, endotoxins and chemical injury.
Upregulates endothelial adhesion molecules, promotes production of cytokines and mediators and induces acute phase proteins
TNF alpha and IL-1
Has similar actions to TNF alpha and cachexia
IL-1
Produced by T cells and NK cells during Ag driven inflammatory response. Upregulates macrophage function, increases macrophage killing capacity and giant cell fusion
IFN gamma
What general molecular events might explain why transforming growth factor-beta stimulates fibroblast proliferation and inhibits epithelial proliferation and repair?
Both fibroblasts and epithelial cells have TGF beta, but their second messenger systems must differ. Allowing for upregulation in one cell and down in another.
List three cytokines or growth factors that are released from macrophages that modulate fibrosis and angiogenesis
Fibroblast growth factor (FGF)
Vascular endothelial growht factor (VEGF)
Platelet derived growth factor (PDGF)
Once collagen in a scar is formed is it inert to further change and collagen modification?
No, eventually the scar can resolve and the tissue goes back to almost normal. Collagen is degraded and resynthesized over time
What type of injuries and pathologic processes commonly lead to fibrosis?
- Severe/prolonged injury
- Loss of basement membrane
- Large amount of exudate
- Lack of renewable cells (non-dividing cells)
What type of injuries and pathologic processes commonly lead to regeneration?
- Mild/brief injury
- Maintenance of BM/microvascular/tissue framework
- Small amounts of exudate
- Available renewable cells (stem cells)
Which conditions favor tissue repair by fibrosis following injury?
a) Lack of renewable population
b) Prolonged/severe injury
c) Minimal exudate
d) A,B
e) A,B,C
D
Which tissues are highly susceptible to repair by fibrosis or scarring because they lack dividing renewable cell populations?
a) Renal tubular epithelium
b) Myocardial myocytes
c) Cerebral corticol neurons
d) A,B,C
e) B,C
E
Growth factors and cytokines that lead to epithelial proliferation.migration
b-EGF, HGF KGF
basic, Epithelial growth factor
Hepatocyte Growth Factor aka Scatter Factor (HGF)
Keratinocyte growth factor
Give examples of diseases that are dependent on type IV hypersensitivity phenomena?
TB, contact derm, fungal disease, tissue rejection transplants
Which of the following are potent inducers of angiogenesis?
a) VEGF
b) B-FGF
c) HGF
d) A,B
e) A,B,C
ALWAYS ASKS THIS QUESTION
D
Which of the following is a potent inducer of fibrosis?
a) TGF-beta
b) TNF- alpha
c) PDGF
d) A,B
e) A,B,C
E
What is a morphologic diagnosis, and how does it differ from an etiologic diagnosis?
Morphologic- dx purely on morphology
Etiologic- dx that includes the causative agent
What are IL-8 and eotaxin? What are their functions?
IL-8 CXC chemokine, attracts neutrophils to wound
Eotaxin- CCchemokine, attracts eosinophils to wound
LIST two growth factors that are released by macrophages that strongly promote endothelial growth and angiogenesis.
Here is 3
VEGF, beta- FGF, PDGF
List two growth factors / cytokines released by macrophages that strongly promote fibroblast proliferation and collagen synthesis.
There are several:
TGF-beta, PDGF, TNF, collagenase, MMPs
List two mediators released by macrophages that are strongly chemotactic for neutrophils.
IL-8 and LTB4
How do neutrophils contribute to tissue damage in immune complex injuries?
mediate tissue injury via lysosomal enzymes and oxygen radicals
How do complement fragments (C3a and C5a) contribute to immune complex disease?
Type II Hypersensitivity
May lyse cells or the cells are phagocytized and eliminated by cells of the mononuclear phagocyte series
Which of the following inflammatory mediators induces increases vascular permeability, fever and pain? A. LTB4 B. LXA4 C. C5a D. PGE2 E. Histamine
PGE2 (note that in chart it says just vasodilation, but then on his slide it says it causes vascular perm too)
LTB4, C5a, histamine- just perm
LXA4- have no idea what that is
Which of the following inflammatory mediators is strongly chemotactic for neutrophils? A. LTB4 B. LXA4 C. C5a D. PGE2 E. A and C
E. LTB4 and C5a
Which of the following mediators is produced by sensitized lymphocytes and is strongly chemotactic for eosinophils? A. Histamine B. LXA4 C. C5a D. PGE2 E. Eotaxin (CCL11)
Eotaxin
Sensitized- therefore a hypersensitive response
List three growth factors that stimulate epithelial proliferation in repair.
EGF, HGF (aka scatter factor), KGF (FGF-7)
Which of the four types of hypersensitivity diseases according to the classification of Gell and Coombs
are dependent on T-lymphocytes versus immunoglobulin?
Type IV hypersensitivity
Generalized anaphylaxis is dependent upon which inflammatory mediators?
Histamine and serotonin: Increase venular permeability, induce smooth muscle contraction
in pulmonary airways, cause arteriolar dilation
How do neutrophils contribute to tissue damage in immune complex injuries?
Formation of antigen-antibody complex in tissue
Fixation of complement and liberation of chemotactic
fragments
Neutrophils accumulation at site of immune complex deposition and mediation of tissue
injury through release of lysosomal enzymes and toxic oxygen radicals
What form of antigen-antibody complex is necessary for immune complex disease to develop?
Just need excess antigen
How do complement fragments (C3a and C5a) contribute to immune complex disease?
Released during the complement cascade and act as chemotactic factors for neutrophils
How do sensitized T-cells contribute to tissue damage in type IV hypersensitivity disease?
lymphokine mediated effects and CD8 mediated toxicity
3 components of cytotoxic T cell action
- Perforin cell membrane lysis (necrosis)
- Perforin-granzyme induced apoptosis
- FASL-FAS induction of apoptosis
Type I anaphylactic hypersensitivity reactions can be mediated by:
a) IgG
b) IgM
c) IgE
d) A,B
e) A, C
E
Type III hypersensitivity reactions can be mediated by:
a) IgG
b) IgM
c) IgE
d) A,B
e) A,C
D
SAID THIS ONE IS IMPORTANT
Tissue injury type IV hypersensitivity/allergic reactions is mediated via?
a) Immune complex formation
b) T-call induction of granulomatous inflammation
c) Direct- T cell cytotoxicity
d) A, B,C
e) B,C
E
Type III immune complex hypersensitivity reactions occur most commonly in a state of
a) Ag excess
b) Ab excess
c) Ag-Ab equivalence
A !!!!!
Examples of Type I hypersensitivity
anaphylaxis, allergic dermatitis
Mechanism of Type I hyper.
mediator release
Examples of Type II hypersensitivity
autoimmune hemolytic anemia
Examples of Type III hypersensitivity
glomerulonephritis
Mechanism of Type II hyper.
cytotoxic via complement and cells
Mechanism of Type III hyper.
immune complexes
Mechanism of Type IV hyper.
cell mediated immunity
Immunologic mediator for type I hyper
IgE (IgG in dogs)
Immunologic mediator for type II hyper
IgM, IgG
Immunologic mediator for type III hyper
IgM, IgG
Immunologic mediator for type IV hyper
T-lymphocytes
Developmental disturbance that results in Complete absence of an organ and associated primordium
agenesis
Developmental disturbance that results in refers to the absence of an organ due to failure of growth of the existing primordium (have the precursor cells)
aplasia
Absence of an opening, usually of a hollow organ
o Developmental growth disturbance
Atresia (usually GI tract)
Developmental disturbance that results in failure to develop to normal size
• Can be secondary to in utero viral infection
hypoplasia
Development to bigger than normal size
hyperplasia
Increase in cell size (resulting from increased production of cellular proteins)
hypertrophy
Often in response to increased workload (physiologic, e.g. exercise and pathologic, e.g. cardiac hypertrophy)
hypertrophy
Main cellular adaptation in cells incapable or with limited ability for cell division
hypertrophy
Increase in cell number
o Causes: a lot, hormonal, compensatory, irritation, infection, etc.
hyperplasia
Cells must be able to divide in this disturbance of growth
hyperplasia
2 examples we say in class that demonstrated hyperplasia and hypertrophy
Chronic giant hypertrophic gastropathy
• Basenji beagle, boxer, bull terrier
• Cause is unknown
• Weight loss, diarrhea, vomiting, hyoproteinemia
Dogs, adrenal glands, secondary to functional pituitary adenoma→increase ACTH→cortical hypertrophy and hyperplasia
Decreased cell and organ size
Can just be the cell and rest of tissue is fine
atrophy
decreased nutrient supply, disuse (decreased workload or denervation), loss of endocrine stimulation, pressure causes…
atrophy
Is metaplasia classified as reversible or irreversible?
reversible
If persists, can produce malignant transformation
Change in phenotype of differentiated cells
Metaplasia
Metaplasia can be caused by…
chronic irritation
Loss of uniformity of cells and loss of orientation
Dysplasia, usually epithelial cells
variation in size and shape of cells
pleomorphism
Is dysplasia reversible?
Yes, especially if not full thickness and removal of inciting cause
“flirting with neoplasm”
New growth
neoplasia or neoplasm
disorder of cell growth that is triggered by a series of mutations that give the cells a survival and growth advantage that is independent of growth regulation signals (autonomous)
Neoplasia or neoplasm
2 basic components of tumors
parenchyma and stroma
neoplastic cells that constitute the tumor
parenchyma
reactive tissue surrounding neoplastic cells(parenchyma) composed of connective tissue, BV, and +/- cells from the adaptive and innate immune system
stroma
abundant fibrous stroma, carcinomas
Schirrous response or desmoplasia
Gross and microscopic appearance are considered relatively “innocent”
Can have an intact capsule or no capsule
Remain localized
No spread to other sites
Amendable to surgical removal
Can still result in significant morbidity and still be lethal!
Benign neoplasms, location is often key for these
Benign tumor that is derived from glands
adenoma
Epithelial tumor
Benign tumor that is micro or macroscopic fingerlike or warty projections arising from an epithelia surface
papilloma
benign (or malignant) raised projection above a mucosal surface and projects into lumen
polyp
Fibroma and chondroma are what classification of tumor
mesenchymal bengin tumor
List 4 types of injuries or pathologic processes that lead to fibrosis
1) large amounts of exudate
2) loss of basement membrane
3) lack of renewable cell population
4) severe and prolonged tissue injury
List two major pathogenic mechanisms that contribute to the development of granulomatous inflammatory reactions.
1) substances that induce T-cell hypersensitivity
2) substances that resist lysosomal degradation
Which of the following is a chemokine that is a potent chemotactic factor for neutrophils? A. IL-8 B. TNF-α C. IL-14 D. PDGF E. TGF-β
IL-8
Which of the following is a cytokine that promotes macrophage activation and differentiation to giant cells and epithelioid cells in granulomatous inflammation?
A. PDGF B. TNF-α C. Interferon-α D. Interferon-β E. Interferon-γ
E
One of the most reliable indicators of chronicity in an inflammatory reaction is: A. Plasma cells B. Lymphocytes C. Macrophages D. Lack of neutrophils E. Fibrosis
Fibrosis
All of the following events or conditions favor repair by fibrosis, rather than by regeneration:
- Severe and prolonged injury
- Acute neutrophilic inflammatory response
- Loss of basement membranes
- Large amounts of necrotic and/or fibrinous exudates
- Lack of renewable cells
A. 1,2 B. 1,2, 3 C. 1,2,3,4 D. 1,2,3,4,5 E. 1,3,4,5
E
Which of the following are mechanisms that account for neutrophils generally being the first cells to reach an inflammatory site during an acute inflammatory reaction?
- Neutrophils are rapidly motile
- High circulating number of neutrophils in peripheral blood
- Neutrophils are responsive to a wide array of chemotactic substances
- Neutrophils have a 7 to 14 day half life in tissue
A. 1 B. 1,2 C. 1,2,3 D. 1,2,3,4 E. 2,3,4
C
Leukocyte rolling in vessels during an inflammatory cell response is mediated by:
A. Immunoglobulin and complement fragments B. Integrins C. Intercellular adhesion molecules D. Selectins E. B and C
D
Note that integrins only come to play in the later steps
Leukocyte adhesion and migration during an inflammatory cell response is mediated by:
A. Immunoglobulin and complement fragments
B. Integrins
C. Intercellular adhesion molecules
D. Selectins
E. B and C
E
ICAM is intercellular adhesion molecule on endo cells
Integrins are on leuks
Which of the following factors released by macrophages stimulate fibroblast proliferation?
- Vascular endothelial growth factor (VEGF)
- Basic fibroblast growth factor (b-FGF)
- Tumor necrosis factor-alpha (TNF-α)
- Transforming growth factor beta (TGF-β)
- Platelet derived growth factor (PDGF)
A. 1, 2 B. 1,2,3 C. 1,2,3,4, 5 D. 2,3,4,5 E. 3,4,5
D
??
All inflammatory reactions are characterized by:
- Increase blood flow
- Increased vascular permeability
- Fibrin exudation
- Leukocytic exudation
- Parenchymal cell necrosis
A. 1 B. 1,2 C. 1,2,3 D. 1,2,3,4,5 E. 1,2,4
E
Pain in an inflammatory reaction is mediated by release of: A. Bradykinin B. Prostaglandin E2 C. Histamine D. Leukotriene B4 E. A and B
E. Brady and PGE2
Which of the following factors are released by activated neutrophils in an inflammatory reaction to augment recruitment of additional neutrophils?
- Leukotriene B4
- IP-10
- Fibrinogen
- Serum amyloid A
A. 1 B. 1,2 C. 1,2,3 D. 2 E. 2,4
A
Which of the following molecular interactions is responsible for leukocyte adhesion to endothelial cells during an inflammatory reaction?
A. ICAM-1 / Integrin (CD11/CD18)
B. P-selectin / Sialyl Lewis X modified protein
C. Antigen / IgE
D. P-selectin / E-selectin
E. VCAM-1 / P-selectin
A
Which of the following is the best indicator of chronicity when examining inflammatory reactions by light microscopy?
A. Plasma cells in the tissue exudate
B. Macrophage number in the tissue exudate
C. Endothelial cell proliferation and hemorrhage.
D. Fibroblast proliferation and collagen synthesis
E. Epithelial cell proliferation and mucus production
D
Epithelioid cells and multinucleated giant cells in granulomatous inflammatory reactions are derived from: A. Mast cells B. Neutrophils C. Eosinophils D. Lymphocytes E. Macrophages
E
Which of the following cells is considered to be a stable cell capable of contributing to regeneration?
A. Neuron B. Cardiac myocyte C. Nonciliated bronchiolar epithelial cell D. Bone marrow progenitor cell E. Basal epithelial cell in epidermis
C
.Which of the following is a chemokine that is a potent chemotactic factor for monocytes/macrophages? A. LTB4 B. TNF-α C. Macrotactin D. Interferon-γ E. MIP-1α
E
Which of the following is a cytokine that promotes macrophage activation and differentiation to giant cells and epithelioid cells in granulomatous inflammation?
A. PDGF B. TNF-α C. Interferon-α D. Interferon-β E. Interferon-γ
E
The growth factor released from macrophages in chronic inflammatory reactions that has the paradoxical effect of promoting fibroblast proliferation and inhibiting epithelial proliferation is:
A. TGF-β B. TNF-α C. b-FGF D. PGDF E. VEGF
A
Which of the following is commonly generated during thrombosis and is chemotactic for macrophages?
A. C5a B. Leukotriene C4 C. Leukotriene B4 D. Fibrinopeptides E. Plasminogen activator
D
Which of the following are growth factors for endothelial cells that are produced by macrophages?
A. Vascular endothelial growth factor B. Basic fibroblast growth factor C. Tumor necrosis factor D. A and B E. A, B and C
D (was a precious answer) BUT NOT SURE, thinking it may be all. Will check tomorrow
Which of the following are mechanisms that account for neutrophils generally being the first cells to reach an inflammatory site during an acute inflammatory reaction?
- Neutrophils are rapidly motile
- High circulating number of neutrophils in peripheral blood
- Neutrophils are responsive to a wide array of chemotactic substances
- Neutrophils have a 7 to 14 day half life in tissue
A. 1 B. 1,2 C. 1,2,3 D. 1,2,3,4 E. 2,3,4
C
In granulation tissue, blood vessels often are arranged parallel to one another and in which orientation to the exudates surface?
A. Parallel
B. Perpendicular
B
Which of the following is an etiologic diagnosis?
A. Pasteurella multocida
B. Protozoal encephalitis
C. Chronic multifocal suppurative encephalitis
D. Johnes Disease
E. Lymphosarcoma
B
a. is cause, c is morphological, d and e is name of disease
Which of the following is a disease cause?
A. Pasteurella multocida
B. Cutaneous habronemiasis
C. Chronic diffuse eosinophilic and granulomatous dermatitis
D. Johnes Disease
E. Cerebral nematodiasis
A
Which of the following mechanisms is most commonly responsible for edema that occurs at the site of an inflammatory reaction? A. Increased hydrostatic pressure B. Increased vascular permeability C. Decrease oncotic pressure D. Obstruction of lymphatics E. Increased sodium retention
B
Which of the following are growth factors that are produced by macrophages and strongly promote endothelial growth and angiogenesis? A. Interleukin-5 B. Vascular endothelial growth factor C. Transforming growth factor – β D. Fibroblast growth factor E. B and D
E. B and D
Which of the following inflammatory mediators induces vasodilation, fever and pain?
A. LTB4 B. LXA4 C. C5a D. PGE2 E. Histamine
D
Firm binding of neutrophils to endothelial cells prior to migration out of vessels into sites of inflammation is mediated by upregulation of which of the following molecules on neutrophils?
A. VCAM-1 B. ICAM-1 C. Integrins (e.g., CD11/CD18) D. E-selectins E. A and B
C
VCAM and ICAM are responsible for adhesion BUT is on endothelial cells, E-selectin is on endothelial cell during rolling
The histologic hallmark of a chronic inflammatory reaction is: A. Macrophages B. Plasma cells C. Neutrophils D. Fibrinous exudate E. Fibrosis
E
Acute inflammatory reactions are often characterized histologically by accumulation of large numbers of both necrotic and non-necrotic neutrophils due to all of the following EXCEPT:
A. Neutrophils are highly motile
B. Neutrophils respond to a wide array of chemotactic factors
C. Neutrophils have a half life less than 24 hours
D. Neutrophils release chemotactic factors that can recruit other neutrophils
E. None of the above
e???
All of the following cells can be derived from monocytes EXCEPT:
A. Macrophages B. Multinucleated giant cells C. Epithelial cells D. Epithelioid cells E. C and D
c
. C5a contributes to immune complex injury by mediating:
A. Neutrophil chemotaxis B. Increased vascular permeability C. Activation of kallikrein D. A and B E. A, B and C
d
Note kallikrein is activated by Hageman
Which of follow mediators is produced by lymphocytes and strongly chemotactic for eosinophils?
A. Eotaxin B. LXA4 C. C5a D. PGE2 E. Histamine
A
Which of the following mediators is/are released by macrophages and is/are strongly chemotactic for neutrophils?
A. Eotaxin B. LTB4 C. C5a D. PGE2 E. B and C
B?
C5a is chemotactic for neut but not released by macrophages
Type IV (delayed type) hypersensitivity contributes to acceleration or augmentation of granulomatous inflammation mediated largely by lymphocyte production of which of the following?
A. IL-1 B. TNF-α C. Interferon-γ D. MCP-1 E. TGF-β
C
Which of the following cells is highly effective in killing nematode larvae mediated in part by major basic protein? A. Neutrophil B. Macrophage C. Lymphocyte D. Eosinophil E. Mast cell
D
Which of the following is a morphologic diagnosis?
A. Cutaneous acariasis B. Johne’s disease C. Acute multifocal suppurative hepatitis D. Escherichia coli E. A and C
C
A. Cutaneous acariasis – etiological diagnosis (includes causative agent)
B. Johne’s disease - disease
C. Acute multifocal suppurative hepatitis - morph
D. Escherichia coli – cause (agent)
E. A and C
Necrosis in which of the following tissues is most likely to lead to repair by fibrosis? A. Myocardium B. Lung C. Liver D. Epidermis E. Bone marrow
A
Which of the following cells releases both vasoactive amines and arachidonic acid metabolites to regulate inflammation? A. Neutrophil B. Macrophage C. Lymphocyte D. Eosinophil E. Mast cell
E
VA: histamine, serotonin, AA: PGE2, PGD2, COX-2 inhib, leukotriene , LXA
Which of the following cytokines or growth factors stimulates proliferation of fibroblasts and can inhibit division of epithelial cells?
A. IL-1 B. TNF-α C. Interferon-γ D. MCP-1 E. TGF-β
e
Which of the following events promote repair by fibrosis? A. Loss of basement membrane B. Abundant necrotic exudate C. Lack of renewable cell population D. Long duration of tissue injury E. All of the above
E
Which of the following is a small chemotactic cytokine for neutrophils?
A. C5a B. LTB4 C. IL-8 D. A and B E. A, B and C
All are chemotactic for neutr, BUT the only one that is a small cytokine is C
Necrosis of epithelium and associated defect below the basement membrane defines:
A. Erosion B. Ulcer C. Infarct D. Granuloma E. Arthus reaction
b
Activation or enzymatic cleavage of which of the following leads to generation of serum-derived inflammatory mediators?
A. Hageman factor B. Kallikrein C. Fibrinogen D. A and B E. A, B and C
E
A. Hageman factor (activates prok->kallikrein)
B. Kallikrein (becomes bradykinin, plasma md)
C. Fibrinogen (fibrinolytic pdts – plasma md)
Pulmonary tuberculosis in rhesus monkeys is characterized by which of the following inflammatory lesions? A. Granulomatous inflammation B. Simple granulomas C. Complex granulomas D. Caseation necrosis E. All of the above
E (in lab)
Which of the following chemicals mediates pain during an inflammatory reaction? A. Bradykinin B. LTE4 C. TNF-α D. IL-8 E. A and B
A
Which of the following is synthesized and released by macrophages and is chemotactic for neutrophils? A. Eotaxin B. C5a C. IL-1 D. LTB4 E. Histamine
D
Which of the following are released by neutrophils and macrophages during a chronic inflammatory process to mediate cell and tissue damage? A. Superoxide anion B. Hydoxyproline C. Type IV collagen D. Heparin sulfate E. Transforming growth factor beta
A
Which of the following is a cytokine that promotes macrophage activation and differentiation to giant cells and epithelioid cells in granulomatous inflammation? A. PDGF B. TNF-α C. Interferon-α D. Interferon-β E. Interferon-γ
E
Leukocyte adhesion deficiency in Irish Setter Dogs is associated with a genetic defect in which of the following genes? A. CD11 B. CD18 C. ICAM-1 D. CD34 E. PECAM-1
B
Which of the following changes in tissue is the most reliable indicator that an inflammatory reaction is chronic? A. High numbers of lymphocytes B. High number of macrophages C. Endothelial cell hypertrophy D. Low number of neutrophils E. Fibrosis
E
An intestinal mucosal defect characterized by epithelial necrosis and loss is classified as an erosion, rather than an ulcer if it doesn’t go deeper than the A. Mucularis mucosa B. Lamina propria C. Tunica muscularis D. Basement membrane E. Mesenteric plexus
D
Epithelioid cells and multinucleated cells in granulomatous inflammatory reactions derive from:
A. Macrophages B. Lymphocytes C. Neutrophils D. Mast cells E. Eosinophils
A
All of the following events or conditions favor repair by fibrosis, rather than by regeneration:
- Severe and prolonged injury
- Acute neutrophilic inflammatory response
- Loss of basement membranes
- Large amounts of necrotic and/or fibrinous exudates
- Lack of renewable cells
A. 1,2 B. 1,2, 3 C. 1,2,3,4 D. 1,2,3,4,5 E. 1,3,4,5
E
Which of the following molecular interactions is responsible for leukocyte rolling on endothelial cells during an inflammatory reaction?
A. ICAM-1 / Integrin (CD11/CD18)
B. P-selectin / Sialyl Lewis X modified protein
C. Antigen / IgE
D. P-selectin / E-selectin margination/rolling)
B
Which of the following upregulate expression of integrins on leukocytes? A. TGF-β B. IL-1 C. TNF-α D. A, B, C E. B, C
E
. All inflammatory reactions are characterized by: 1. Increase blood flow 2. Increased vascular permeability (plus vascular changes in blood flow, leukocytic events) 3. Fibrin exudation 4. Leukocytic exudation 5. Parenchymal cell necrosis A. 1 B. 1,2 C. 1,2,3 D. 1,2,3,4,5 E. 1,2,4
E
Eosinophils are effective in killing nematode larvae at least in part because they synthesize and release: A. LTC4 B. PGE2 C. Myeloperoxidase D. Superoxide anion E. Major basic protein
e
Which of the following is a morphologic diagnosis?
A. Habronema microstoma
B. Cutaneous habronemiasis
C. Chronic diffuse eosinophilic and granulomatous dermatitis
D. A, B
E. A, B, C
C
A is agent
B is etiological
C is morph
Which of following cells is considered to be a stable cell capable of contributing to regeneration? A. Neuron B. Cardiac myocyte C. Renal tubular epithelial cell D. Bone marrow progenitor cell E. Basal epithelial cell in epidermis
C
Which cell cycle stages are in the correct order beginning at the “start” of the cycle?
a. G1, G2, S, M
b. G1, G2, M, S
c. G1, M, G2, S
d. G1, S, G2, M
e. S, M, G1, G2
D
LIST three cytokines or growth factors that are released from macrophages that modulate fibrosis and/or angiogenesis.
- PDGF (both)
- FGF (both)
- VEGF (angio)
Also: TNF-alpha (fibrosis)
Which of the following mechanisms is most commonly responsible for edema that occurs at the site of an inflammatory reaction? A. Increased hydrostatic pressure B. Increased vascular permeability C. Decrease oncotic pressure D. Obstruction of lymphatics E. Increased sodium retention
B
Which of the following are growth factors that are produced by macrophages and strongly promote endothelial growth and angiogenesis? A. Interleukin-5 B. Vascular endothelial growth factor C. Transforming growth factor – β D. Fibroblast growth factor E. B and D
B
Going to check on this one
Which of the following inflammatory mediators induces vasodilation, fever and pain? A. LTB4 B. LXA4 C. C5a D. PGE2 E. Histamine
D
The histologic hallmark of a chronic inflammatory reaction is: A. Macrophages B. Plasma cells C. Neutrophils D. Fibrinous exudate E. Fibrosis
E
Firm binding of neutrophils to endothelial cells prior to migration out of vessels into sites of inflammation is mediated by upregulation of which of the following molecules on neutrophils? A. VCAM-1 B. ICAM-1 C. Integrins (e.g., CD11/CD18) D. E-selectins E. A andB
C
Acute inflammatory reactions are often characterized histologically by accumulation of large numbers of both necrotic and non-necrotic neutrophils due to all of the following EXCEPT:
A. Neutrophils are highly motile
B. Neutrophils respond to a wide array of chemotactic factors
C. Neutrophils have a half life less than 24 hours
D. Neutrophils release chemotactic factors that can recruit other neutrophils
E. None of the above
E
All of the following cells can be derived from monocytes EXCEPT: A. Macrophages B. Multinucleated giant cells C. Epithelial cells D. Epithelioid cells E. C and D
C
C5a contributes to immune complex injury by mediating: A. Neutrophil chemotaxis B. Increased vascular permeability C. Activation of kallikrein D. A and B E. A, B and C
D
Which of the following mediators is produced by lymphocytes and is strongly chemotactic for eosinophils? A. Eotaxin (CCL11) B. LXA4 C. C5a D. PGE2 E. Histamine
A
Which of the following mediators is/are released by macrophages and is/are strongly chemotactic for neutrophils? A. Eotaxin (CCL11) B. LTB4 C. C5a D. PGE2 E. B and C
B
Note that C5a is chemotactic for neutrophils but not released by macrophages
Type IV (delayed type) hypersensitivity contributes to acceleration or augmentation of granulomatous inflammation mediated largely by lymphocyte production of which of the following? A. IL-1 B. TNF-α C. Interferon-γ D. MCP-1 E. TGF-β
C
Which of the following cells is highly effective in killing nematode larvae mediated in part by major basic protein? A. Neutrophil B. Macrophage C. Lymphocyte D. Eosinophil E. Mast cell
D
Which of the following is a morphologic diagnosis?
A. Cutaneous acariasis
B. Johne’s disease
C. Acute multifocal suppurative hepatitis
D. Escherichia coli
E. A and C
C
Necrosis in which of the following tissues is most likely to lead to repair by fibrosis? A. Myocardium B. Lung C. Liver D. Epidermis E. Bone marrow
A
Which of the following cells releases both vasoactive amines and arachidonic acid metabolites to regulate inflammation? A. Neutrophil B. Macrophage C. Lymphocyte D. Eosinophil E. Mast cell
E
Which of the following cytokines or growth factors stimulates proliferation of fibroblasts and can inhibit division of epithelial cells? A. IL-1 B. TNF-α C. Interferon-γ D. MCP-1 E. TGF-β
E
Which of the following events promote repair by fibrosis? A. Loss of basement membrane B. Abundant necrotic exudate C. Lack of renewable cell population D. Long duration of tissue injury E. All of the above
E
Which of the following is a small chemotactic cytokine for neutrophils? A. C5a B. LTB4 C. IL-8 D. A and B E. A, B and C
C
All are chemotactic for them, but IL8 is the only small cytokine (chemokine)
Necrosis of epithelium and associated defect below the basement membrane defines: A. Erosion B. Ulcer C. Infarct D. Granuloma E. Arthus reaction
B
Activation or enzymatic cleavage of which of the following leads to generation of serum-derived inflammatory mediators? A. Hageman factor B. Kallikrein C. Fibrinogen D. A and B E. A, B and C
E
Pulmonary tuberculosis in rhesus monkeys is characterized by which of the following inflammatory lesions? A. Granulomatous inflammation B. Simple granulomas C. Complex granulomas D. Caseation necrosis E. All of the above
E (was in lab)
An increase in cell number associated with an increase in organ size is? (2 points) A. Hypertrophy B. Atrophy C. Hypoplasia D. Metaplasia E. Hyperplasia
hyperplasia
An increase in cell size associated with an increase in organ size is? A. Hypertrophy B. Atrophy C. Hypoplasia D. Metaplasia E. Hyperplasia
A
A three day old foal with a small thymus might have which thymic disturbance of growth? A. Atrophy B. Hypoplasia C. Metaplasia D. A or B E. A or C
D
Testicular Sertoli cell tumors in dogs occasionally induce which of the following disturbances of growth in prostatic epithelium? A. Hypertrophy B. Atrophy C. Hypoplasia D. Metaplasia E. Hyperplasia
D
Which of the following processes regresses with stimulus removal? (2 points)(p163)
A. Neoplasia
B. Hyperplasia
B
Which of the following is a malignant neoplasm of smooth muscle? (2 points)(p165) A. Hemangioma B. Leiomyoma C. Leiomyosarcoma D. Rhabdomyoma E. Rhabdomyosarcoma
C
All of the following are important diagnostic criteria for benign and malignant tumors EXCEPT? (2
points)(p166)
A. Compression/disturbance of function in surrounding tissue
B. Differentiation / anaplasia
C. Rate of growth
D. Local invasiveness
E. Metastasis
A
A malignant neoplasm of urinary bladder epithelium is called? (2 points)(p165) A. Mesothelioma B. Teratoma C. Cystandenocarcinoma D. Transitional cell carcinoma E. Choriocarcinoma
D
Common mutations in genes associated with cancer include all of the following EXCEPT? (2 points)(p169) A. Apoptosis regulating genes B. Cytochrome P450 expression genes C. Proto‐oncogenes D. Tumor suppressor genes E. DNA repair genes
B
Which of the following are proto‐oncogenes that are commonly mutated in cancer? (2 points)(?) A. RAS B. PDGFB C. ERBB1 (EGFR) D. p53 E. A, B, C
Have to look up, person answered D but technically that is a tumor suppressor gene
Which of the following is highly expressed in malignant neoplastic cells to promote angiogenesis? (2 points)(p173) A. TNF‐alpha B. VEGF C. Collagenase D. p53 E. TGF‐alpha
B
The gene that serves as the “Guardian of the Genome” to block growth of mutated cells and control DNA repair is? (2 points)(p171) A. p53 B. K‐RAS C. Cytochrome c D. VEGF E. Telomerase
A
Which of the following enzymes play a role in tumor cell breakdown of extracellular matrix in
invasion and metastasis? (2 points)(p174)
A. Plasminogen activator
B. Matrix metalloproteases
C. Phospholipases
D. A, B
E. A, B, C
D… (havent gotten to)
Which of the following proteins is broken down in epithelial cells to mediate loosening of
intercellular junctions prior to invasion/metastasis? (2 points)(p174)
A. TP53
B. ICAM‐1
C. CD11
D. E‐cadherin
E. Fibronectin
D
Tumor cells evade immunologic destruction by all of the following mechanisms EXCEPT? (2 points)(p175) A. Produce immunosuppressive molecules B. Upregulate tumor suppressor genes C. Develop antigen negative variants D. Reduce MHC molecule expression E. A, B
B
Hypercalcemia in apocrine gland adenocarcinoma of the anal sac in dogs is mediated by? (2 points)(p178) A. PGE2 B. IL‐1 C. IL‐2 D. PTH E. PTHrP
E.. havent gotten to yet
Which of the following proteins is important in mediating cancer cachexia? (2 points)(p178) A. TNF‐α B. Proteolysis inducing factor C. p53 D. KRAS oncogene protein E. A,B
E
Have not gotten to yet
Chronic inflammatory reactions in most tissues in the body are usually characterized by which of the following processes? (2 points)(p115) A. Neutrophil chemotaxis B. Basophil infiltration C. Mast cell hyperplasia D. Fibrinous response E. Fibrosis
E
One of the mechanisms contributing to effective parasite larval killing by eosinophils is? (2 points)(p102) A. Superoxide anion B. Hydroxyl radical C. Lipid peroxides D. Major basic protein E. Ferrous iron production
d
Macrophages can differentiate into which of the following cells? (2 points)(p102) A. Epithelial cells B. Epithelioid cells C. Multinucleated giant cells D. A, B, C E. B, C
E
Which of the following mediators is strongly chemotactic for lymphocytes? (2 points)(p114) A. CCL3/MIP‐1alpha B. CCL11/Eotaxin C. C5a D. PGE2 E. LTB4
A
Which of the following mediators is strongly chemotactic for neutrophils? (2 points)(p114) A. CCL3/MIP‐1alpha B. CCL11/Eotaxin C. CXCL8/IL‐8 D. LTB4 E. C and D
E
Type IV hypersensitivity reactions contribute to tissue damage via which of the following
mechanisms? (2 points)(p134)
A. Complement fixation and neutrophil chemotaxis and cytotoxicity
B. CD8 T‐cell cytotoxicity
C. Cell mediated immunity with cytokine/lymphokine mediated indirect effects
D. A and B
E. B and C
E
Which of the following growth factors stimulates epithelial proliferation in repair? (2 points)(p129) A. TGF‐beta B. EGF C. PDGF D. A, B, C E. B, C
B
Histamine increases vascular permeability at the level of capillaries and venules via which
mechanism? (2 points)(in-class question)
A. Endothelial cell contraction
B. Endothelial cell damage
C. Increased transcytosis
D. Induces endothelial proliferation
A
Which is an inflammatory cell that is long‐lived, can divide locally in tissue and regulates immune and repair responses? (2 points)(p102) A. Neutrophil B. Eosinophil C. Macrophage D. Platelet E. B and C
C
Which of the following mediate pain in an inflammatory reaction? (2 points)(p114) A. CXCL8/IL‐8 B. C5a C. LTC4 D. PGE2 E. TNF‐alpha
D
Which of the following growth factors stimulates endothelial proliferation in repair? (2 points) A. VEGF B. basic‐FGF C. TNF‐alpha D. A,B E. A,B,C
D
Which of the following cells release vasoactive amines and arachidonic acid metabolites to
upregulate inflammatory reactions? (2 points)(p111 & p 102)
A. Mast cell
B. Neutrophil
C. Lymphocyte
D. Macrophage
E. A and B
A
Leukocyte adhesion deficiency has been described in which of the following? (2 points)(p101) A. Holstein cattle B. Labrador Retriever dogs C. Irish Setter dogs D. A and B E. A and C
E
Which of the following pathogenetic mechanisms of edema contribute most significantly to protein-rich edema fluid in inflammatory reactions? (2 points) A. Increased hydrostatic pressure B. Increased vascular permeability C. Decrease capillary oncotic pressure D. Lymphatic obstruction E. Increased sodium retention
B
Which molecules on leukocytes (L) and endothelial cells (E) respectively mediate leukocyte rolling
on endothelial cells during inflammation? (2 points)(p100)
A. L:integrin (CD11/CD18) and E: ICAM‐1
B. E: integrin (CD11/CD18) and L: ICAM‐1
C. L:Sialy‐Lewis X‐modified glycoprotein and E: E‐selectin
D. E:Sialy‐Lewis X‐modified glycoprotein and L: E‐selectin
E. A and C
C
Which molecules on leukocytes (L) and endothelial cells (E) respectively mediate leukocyte adhesion
on endothelial cells preceding transmigration during inflammation? (2 points)(p100)
A. L:integrin (CD11/CD18) and E: ICAM‐1
B. E: integrin (CD11/CD18) and L: ICAM‐1
C. L:Sialy‐Lewis X‐modified glycoprotein and E: E‐selectin
D. E:Sialy‐Lewis X‐modified glycoprotein and L: E‐selectin
E. A and C
A
Inciting stimuli of granulomatous inflammation are? (2 points)(p115)
A. Particulates resisting lysosomal degradation
B. Persisting molecules that stimulate T‐cell hypersensitivity
C. Stimuli that are chemotactic for neutrophils
D. A, B
E. A, B, C
D
Histamine increases vascular permeability via:
endothelial cell contraction
An inflammatory cell that is long-lived, can divide locally in tissue, and regulates immune and repair responses:
Macrophages
Suppurative inflammatory rxns are often induced by:
Bacteria
Macrophage-dominated (granulomatous) inflammatory rxns are often induced by:
Fungi and mycobacteria
Which type of inflammatory cells is often associated with liquefactive necrosis?
neutrophil
Growth factors and cytokines affecting stages of tissue repair by monocyte/macrophage chemotaxis
Growth factors and cytokines affecting stages of tissue repair
Growth factors and cytokines affecting stages of tissue repair by fibroblast migration/replication and collagen synthesis
PDGF, EGF, FGF, TGF-beta, TNF, IL-1
Growth factors and cytokines affecting stages of tissue repair by epithelial proliferation/migration
EGF, HGF AND KGF
Growth factors and cytokines affecting stages of tissue repair by angiogenesis
VEGF, FGF, PDGF
Growth factors and cytokines affecting stages of tissue repair by connective tissue myofibroblast contraction and remodeling
TGF-beta, PDGF, collagenase, MMPs
Which of the following are potent inducers of angiogenesis?
a. VEGF
b. Beta-FGF
c. HGF
d. A and B
e. A,B,C
D.
Which of the following is a potent inducer of fibrosis?
a. TGF-beta
b. TNF-alpha
c. PDGF
d. A and B
e. A, B, C
E
Type I anaphylactic hypersensitivity rxns can be mediated by: a.IgG b.IgM c.IgE dA,B e.A,C
E
Which of the following inflammatory mediators play a central role in anaphylaxis?
a. Histamine
b. LTC4, LTD4, LTE4
c. C5a
d. A,B
e. A,B,C
D
Tissue injury in a type IV hypersensitivity rxn/allergic rxn is mediated via:
a. Immune complex formation
b. T-Cell induction of granulomatous inflammation
c. Direct T-cell toxicity
d. B,C
D
Type III hypersensitivity reactions can be mediated by:
a. IgG
b. IgM
c. IgE
d. A,B
e. A,C
D
Lab question: From which cells are the epitheloid and multinucleated giant cells derived from?
Monocytes and macrophages
Lab question: what mechanisms can explain the central caseation necrosis in granulomas, and is this sometimes diagnostically useful?
Central necrosis may be due to toxic molecules released by macrophages (superoxide anion and lysosomal enzymes) and hypoxemia. The necrosis may undergo secondary dystrophic calcification to result in radiodense lesions that are readily detectable in radiographs
Lab: what was the etiologic diagnosis for changes present in the stallion penis?
penile habronemiasis
Note the zones of granulation tissue around a hematoma (lab)
center–>outward
fibrin
zone of macrophages, capillaries, and fibroblasts growing inward
zone of proliferating capillaries and fibroblasts
Zone of maturing fibrous connective tissue
LAb wueston: what is the possible stimulus for the granulation tissue to form in the dog hematoma (mast cell was removed and reaction to the sutures)
Persistence of fibrin in the hematoma and failure of fibrinolysis to completely lyse the clot.
Persistence release chemotactic substances and growth factors from fibrin and platelets (fibrinopeptides, PDGF, TGF beta) induces infiltration of macrophages, fibroblasts, and release of other growth factors (VEFE, b-FGF, PDGF, TGF-beta) that promotes granulation tissue and angiogenesis
Lab question: what would have been the likely long-term outcome of the granulation tissue process had the mass not been removed surgically?
cyst would clot and been replaced by dense fibrous connective tissue which would have matured and formed dense scar tissue
Lab question: Organization by granulation tissue occurs in what other processes or types of lesions?
chronic inflammatory process where there is continued generation of necrotic exudate
Large areas of necrosis (e.g. infarct)
Areas of chronic ulceration where there is accumulation of necrotic exudate
Lab question: what mechanisms can account for the influx of macrophages, fibroblasts, and endothelial cells into the thrombus?
fibrinopeptides are chemotactic for macrophages. Then macrophages and platelets release other chemotactic substances for other inflammatory cells and growth factors for endothelial cells and fibrosis
