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Pathology > Human Pathology Inflammation > Flashcards

Human Pathology Inflammation Flashcards

1
Q

What are the five cardinal signs of inflammation?

A 
Rubor=  redness
Calor= Heat
Dolar= Pain
Tumor= Swelling
Functio Laesa= loss of function
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2
Q

What is inflammation?

A

A protective response that attempts to eliminate the initial cause of the cellular injury as well as necrotic cells and tissue.

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3
Q

What are the two components of Inflammation?

A

Vasodialation

Vascular Permeability

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4
Q

What is the goal of the inflammatory reaction?

A

To bring WBC to the site of injury

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5
Q

Where are lymphocytes and leukocytes found?

A

Circulating in the blood

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6
Q

What causes inflammation reaction to progress?

A

Chemical mediators that are produced by the host cells in response to the injurious stimuli.

Inflammation is normally controlled and self limited

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7
Q

Acute Inflammation

A

An immediate and early response to injury and infection

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8
Q

Vasodialation

A

Structural changes resulting in increased vascular permeability

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9
Q

What are the two major events to start inflammation?

A

Vasodialation and emigration of the leukocytes from circulation in the blood to the site of injury

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10
Q

Vascular permeability

A

Allow the protein rich fluid and C proteins to enter into the ECM

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11
Q

Stimuli for Inflammation

A 
Infectious Agents
Toxins
Chemical Agents such as drugs
Immunologic Reactions
Necrotic Tissue
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12
Q

Characteristics of Inflammation

A

Short Duration within 24 hours

Exudation of fluid and proteins

Emigration of neutrophils and WBC

Platelets

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13
Q

Process of Emigration of WBC

A

Diapedisis

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14
Q

What is the duration of chronic inflammation?

A

Months to years

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15
Q

Edema

A

Excess interstitial or serous cavity fluid due to vascular permeability

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16
Q

Purulent Exudate

A

Inflammatory exudate rich in leukocytes and cellular debris

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17
Q

Exudate

A

Inflammatory extravascular fluid with a high protein content and SG of 1.020

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18
Q

Transudate

A

An extravascular fluid with a low protein content and SG less than 1.012

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19
Q

Pattern Recognition Sensors

A

WBC have receptors that are designed to recognize the presence of infectious pathogens as well as substances released from dead cells

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20
Q

What are the 4 major classes of pattern recognition sensors?

A

TLR

NOD like receptors

C type lectin receptors

RIG like receptors for viral nuclei

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21
Q

What do TLR recognize?

A

Microbes and their products

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22
Q

Where are TLR located?

A

Plasma membrane of endosomes

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23
Q

Where are NOD like receptors located?

A

Cytosol

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24
Q

What do NOD like receptors recognize?

A

Products of necrotic cells like uric acid and released ATP.

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25
Q

What type of receptor signals the inflammasome?

A

NOD like Receptor

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26
Q

Inflammasome

A

Multiprotein cytoplasmic complex

Triggering of inflammasome results in activation of caspase 1

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27
Q

Caspase 1

A

Cleaves the precursor forms of the inflammatory cytokine interleukin 1B into its biologically active form

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28
Q

Mediators of leukocyte recruitment

A

TNF and IL-1

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29
Q

What are the steps in the changes of vascular flow with the inflammatory response?

A
  1. Transient vasoconstriction
  2. Vasodialation
  3. Increased Vascular permeability
  4. Slowing circulation
  5. Leukocyte margination
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30
Q

Colloid osmotic pressure

A

at the post capillary venule that reabsorbs the fluid from the interstitial space

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31
Q

Mechanism of Vascular Leakage

A

Endothelial cell contraction with gap formation

Junctional retraction

Direct Endothelial Injury

Leukocyte dependent endothelial injury

Leakage from newly forming blood vessels

Increased transcytosis in which the molecules are transported through the endothelial cell

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32
Q

In inflammation, lymphatic flow is increased.

True or False

A

True

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33
Q

Inflammation of lymphatic vessels

A

Lymphangitis

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34
Q

Inflammation of lymph nodes

A

lymphadenitis

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35
Q

Recruitment

A

Leukocytes flow rapidly in the blood and they must be slowed down and brought to offending agent or site of the injured tissue

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36
Q

Margination

A

Leukocytes adhere to the periphery of the blood vessel

37
Q

Chemotaxis

A

Leukocytes follow a trail of chemokines to tell where the injury is

38
Q

What is the most abundant leukocyte in acute inflammation?

A

Neutrophil

39
Q

What are the chemokines from complement?

A

C5a
C2a
C3a

40
Q

Rolling

A

Leukocytes roll along the vessel wall transiently sticking by selectins and adhesion molecules

41
Q

Where are the P selectins derived from?

A

Waibel Palade bodies activated

42
Q

What activates E selectins?

A

TNF and IL-1

43
Q

What interferon activates ICAM and VCAM?

A

IL-8

44
Q

ICAM and VCAM adhere to?

A

Integrins on the neutrophil

45
Q

P selectin bind to which molecule on the neutrophil?

A

Siayl Lewis X

46
Q

What upregulates selectins on endothelial cells?

A

TNF and IL-1

47
Q

What is the role of selectins?

A

To ensure that the binding of leukocytes is restricted to the endothelium at sites of infections and injury

48
Q

Integrins

A

Transmembrane heterodimeric glycoproteins that also function as cell receptors for ECM.

Present on leukocytes in low affinity until activated by a cytokine

49
Q

Transmigration of the neutrophils is mediated by which adhesion molecule?

A

PECAM CD31

50
Q

VCAM binds

A

VLA-4 Integrin on neutrophil

51
Q

ICAM binds

A

CD11.CD 18 integrin on neutrophil

52
Q

GlyCam 1 binds

A

L -Selectin on neutrophil

53
Q

PECAM CD 31 binds

A

CD 31 on neutrophil

54
Q

What mediators affect upregulation of P selectin?

A

Histamine
Thrombin
PAF = platelet activating growth factor

55
Q

Exogenous chemotactic agents

A

bacterial products

56
Q

Endogenous chemotactic agents

A

components of the complement system in liver

Products of lipoxygenase pathway from cell membrane PLA2

57
Q

What does the lipooxygenase pathway produce?

A

Leukotrienes

58
Q

What starts the cyclooxygenase and lipooxygenase pathways?

A

Arachnodonic Acid

59
Q

How do leukocytes make products to destroy the bacteria?

A

Oxygen Burst

60
Q

Opsonin

A

Tag microbe with C3b

61
Q

Which part of the complement system starts the classical pathway?

A

C1 binds to the antigen antibody complex on the Fc portion of the antibody

62
Q

What is the enzyme that starts the oxygen dependent pathway in the production of ROS?

A

oxidase

63
Q

What enzyme turns hydrogen peroxide back into water?

A

Catalase

Glutathione peroxidase

64
Q

What enzyme makes hydrogen peroxide turn into bleach?

A

MPO and Cl-

65
Q

What does binding the C3b do to the microbe?

A

Tag it for phagocytosis

66
Q

What enzymes does the oxygen independent killing mechanism use?

A

Bacterioacidal permeabiluty increasing protein

Lactoferin

lysozyme

Major Basic protein

Defensins

67
Q

NETS

A

Neutrophil Extracellular Traps

Extracellular fibrillar networks produced by neutrophils in response to infections which contain a framework of chromatin and granule proteins that trap bacteria when the neutrophil dies

68
Q

How does the leukocyte induced tissue injury occur?

A

lysosomal enzymes leak out
ROS
Products of arachidonic acid metabolism

69
Q

What conditions cause a defect in phagocytosis and microbial activity of leukocytes?

A

DM
Sepsis
Anemia
Malnutrition

70
Q

What conditions cause a defect in adhesion and chemotaxis?

A

DM
Chronic dialysis
Sepsis
Malignancy

71
Q

Leukocyte Adhesion Deficiency

A

Defective Leukocyte adhesion due to mutations in the b chain of the CD 11/CD 18 integrins

72
Q

Leukocyte Adhesion Deficiency 2

A

Defective leukocyte adhesion deficiency due to mutation in fucosyl transferase required o make sialyted oligsaccharide

73
Q

Chronic Granulomatous Disease

A

Decreased oxidative burst ( phagocyte oxidase)

Membrane bound X linked
Cytoplasmic autosomal recessive

74
Q

Myeloperoxidase Deficiency

A

Decreased microbial killing due to defective MPO-H2O2 system

75
Q

Stop Signals of Inflammation

A

TGF-B
IL-10
Neural impulses (cholinergic) which inhibit the production of TNF in macrophages

76
Q

Vasoactive amines of the inflammatory response

A

Histamine

Serotonin

77
Q

Histamine

A

Released by Mast Cells, Basophiles and platelets.

Cause dialation of arterioles and increased vascular permeability

78
Q

Serotonin

A

Present in platelets and enterochromaffin cells

79
Q

What releases arachidonic acid from the plasma membrane?

A

phospholipase A2

80
Q

What inhibits phospholipase A2 in arachidonic acid metabolism?

A

Steroids

81
Q

What inhibits cycloxygenase?

A

COX 1

COX 2

82
Q

Prostaglandin GI2

A

Cause vasodialation and inhibit platelet aggregation

83
Q

Thromboxane A2

A

Cause vasoconstriction and promote platelet aggregation

84
Q

PGD2

A

Prostaglandin that promotes vasodialation and vascular permeability

85
Q

PGE2

A

Prostaglandin that promotes vasodialation and vascular permeabilty.

Responsible for fever initiation by influencing the hypothalamus

86
Q

Leukotriene C,D,E

A

Bronchospasm and increased vascular permeability

87
Q

Lipoxin A4 and Lipoxin B4

A

Inhibit neutrophil adhesion and chemotaxis

88
Q

Leukotriene B4

A

Chemotaxis promotion

89
Q

PAF

A

Platelet Activating Factor

Pathology (10 decks)

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