inflammation Flashcards

0
Q

Mediators of vascular permeability

A

Swelling
Early mediators: histamine, bradykinin, PAF, thrombin, leukotrienes
Late mediators: IL-1beta, TNF alpha

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1
Q

Mediators of Vascular dilation

A

Redness-

NO, PGI2, PAF, bradykinin

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2
Q

What does increased endothelial permeability cause?

A

swelling
exudate- fibrin (protein) rich, purulent/suppurative (pus)
transudate- cell poor

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3
Q

Patterns of acute inflammatory response

A
  1. Suppurative (pus)
  2. Abscess- liquefactive necrosis w fibrin wall
  3. Ulcerative- ice cream scoop
  4. Pseudomembranous- (ex. c diff)
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4
Q

Most common etiologies of acute inflammatory response?

A

bacteria and cell death

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5
Q

Acute inflammatory response can result in? (2)

A
  • resolution or scarring if stim is destroyed

- necrosis if stim is not destroyed (depends on how frequently affected cell divides)

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6
Q

Types of granulomas

A

Non-caseating: from foreign body, fungus, parasite, immune system
Caseating: TB (usually) or bartonella (cat scratch)
Necrotizing: fungus (ex. histoplasma) or immune

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7
Q

Etiologies of chronic inflammation?

A

bacterial, viral, parasitic, fungal, etc; immune response

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8
Q

What makes up a granuloma?

A
lymphocytes, fibroblasts
activated MAC (by Th1) --> epithelial histiocyte, aggregation --> multinucleated giant cell
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9
Q

Cytopathic changes are associated with what??

A

viral infection

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10
Q

Leukocyte adhesion steps?

A
  1. P-selectin (from weibel palade bodies) go to surface of endothelial cells; bind mucin (PSGL-1, ESL-1) of leukocytes
  2. chemokine dependent activation (TNFa, IL-1): chemokine binds low affinity integrin of leukocyte –> high affinity integrin to surface (VLA4, LFA1); chemokine –> VCAM-1 and ICAM-1 to endothelial surface, bind integrins
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11
Q

Transmigration of leukocyte?

A

Ca2+ influx –> mysoin contraction –> leukocyte transmigration paracellularly
PECAM1 and CD99 help

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12
Q

Chemotactic factors in leukocyte transmigration?

A

C5a, IL-8, LTB4, PAF; guide through ECM

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13
Q

Selectin?

A

Leukocyte adhesion
P-selectin in Weibel palade bodies of endothelial
Sent to surface of endothelial cell
Binds Mucin of leukocytes

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14
Q

Mucin?

A

Leukocyte adhesion
PSGL-1, ESL-1
on leukoctyes
binds selectins of endothelial cells

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15
Q

Weibel Palade bodies?

A

Leukocyte adhesion
contain P-selectin
in endothelial cells

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16
Q

PSGL-1

A

Leukocyte adhesion

Mucin

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17
Q

Integrin

A

Leukocyte adhesion
on leukocytes
cytokines binding to low affinity integrin induces high affinity integrin sent to surface (VLA4, LFA1)

18
Q

ESL-1

A

Leukocyte adhesion

Mucin

19
Q

VLA4

A

Leukocyte adhesion

high affinity integrin

20
Q

VCAM-1

A

Leukocyte adhesion
Sent to endothelial surface with cytokine activation
binds high affinity integrins (VLA4, LFA1)

21
Q

LFA-1

A

Leukocyte adhesion

High affinity integrin on leukocyte

22
Q

ICAM-1

A

leukocyte adhesiion
sent to endothelial surface with cytokine activation
binds high affinity integrins of leukocyte (VLA4, LFA1)

23
Q

PECAM1

A

helps with transmigration

24
Q

CD99

A

helps with transmigration

25
Q

Clinical features of inflammation (4)

A

erythema (red), warmth, swelling, pain

26
Q

Diurnal variation

A

lower body temp in am than in pm

27
Q

Pyrexia v hyperexia v hyperthermia

A

Pyrexia = higher set point
Hyperpyrexia = super high set point (can –> infection and CNS damage)
Hyperthermia=increase in temp (heat stroke)

28
Q

What resets set point? How do they work?

A

Pyrogens

Works on anterior nucleus of hypothalamus –> PGE2 release (via NFkappaB TF) –> cAMP pathway –> increase set point

29
Q

what does CRP target?

A

C-reactive protein
binds PC and LPS of bacteria/fungi
binds PC of damaged cells

30
Q

What are acute phase proteins?

A

CRP and MBL from liver

31
Q

What does MBL target?

A

mannose rich bacteria

32
Q

ESR?

A

erythrocyte sedimentation rate
normal 18mm/hr
increases with infection

33
Q

Leukocytosis

A

increase in # of WBC

34
Q

Neutrophilia? what does path look like?

A

increase neutrophil #

“left sshift” increased immature forms: bands (horshoes) and metamyelocytes (kidneys)

35
Q

Etiology of neutrophilia?

A

bacterial infection, tissue necrosis, prednisone (used to treat inflamm)

36
Q

Leukomoid reaction

A

very high WBC count

similar to leukemia

37
Q

Eosinophilia

A

Increase eosinophil #

38
Q

Eosinophilia etiologies

A

immune response to allergies, psoriasiss eczema, parasitic infection

39
Q

Lymphocytosis

A

Increase lymphocyte #

40
Q

Lymphocytosis etiology

A

viral infection

41
Q

Leukopenia

A

decrease WBC <4000/microL

42
Q

Etiologies of leukopenia

A

bacterial, viral, protozoa