Inflammation Flashcards

1
Q

Acute

A

minutes to a few days

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2
Q

Main causes of acute inflammation

A

Allergic reaction/ hypersensitivity.
Infections
Physical injury
Chemical injury

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3
Q

What happens in the vascular phase of acute inflammation ?

A

Small vessels dilate, Vascular endothelium cells contract thus making spaces between them

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4
Q

What happens in the exudative phase of inflammation ?

A

Fluid and protein leaking through capillary walls and cells through venules.

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5
Q

Exudate meaning

A

Leaky/dilated blood vessels so protein and cells in fluid.

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6
Q

Transudate meaning

A

Passive outflow of fluid when balance of osmotic and hydrostatic pressure change.

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7
Q

Transudate vs Exudate

A

Transudate has low protein content, few cells.
Exudate has high protein content, may contain some white & red blood cells.

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8
Q

Chemokines and IL-1

A

Stimulate adhesion molecules on endothelium and white cells

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9
Q

Tumour necrosis factor

A

Stimulates vascular permeability

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10
Q

Macrophages role

A

Have the role of clearing debris and dead cells

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11
Q

What is the role of neutrophils during inflammation ?

A

Migration into tissues

Recognise bacteria by
- formylmethionine at end of surface protein chains
-coating of antibody or complement (C3b)

Phagocytosis is carried out.

Kill bacteria via lysozyme destroying cell wall and via hydrogen peroxide production

Apoptosis

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12
Q

What is the lifespan of neutrophils ?

A

8-12 hours (short lifespan)

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13
Q

How are basophils/mast cells activated ?

A

By tissue damage
Or antigens interacting with surface IgE

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14
Q

What do mast cells produce ?

A

Histamine
Leukotrienes
Prostaglandins

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15
Q

Histamines role

A

Vascular dilation and permeability

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16
Q

Leukotrienes role

A

Act as a chemoattractant for other white blood cells

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17
Q

Prostaglandins function

A

Vascular dilation and pain

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18
Q

What does the coagulation pathway result in ?

A

Fibrin production to contain infection in a ‘mesh’.

When coagulation factor 12 is activated, bradykinin is produced - vasodilation and sensitises pain receptors.

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19
Q

Abscess

A

Pus enclosed by fibrin and connective tissue

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20
Q

Pus

A

Inflammatory exudate rich in neutrophils, organisms and dead tissue

21
Q

Empyema

A

Pus enclosed in an existing body cavity eg gall bladder, pleura etc.

22
Q

What are some beneficial effects of acute inflammation ?

A

Dilution of toxins

Effector cells and antibodies (and antibiotics) get to the area

Fibrin helps to “wall-off” further spread of infection
Antigens get carried to local and regional lymph nodes- prevents systemic spread and allows antibodies to be made

23
Q

What are some harmful effects of acute inflammation ?

A

Destruction of normal tissues eg colo-vesical fistula.

Swelling within a confined space eg brain.

SEPSIS

Cytokine storm

24
Q

Systemic effects of acute inflammation

A

Monocyte/macrophage derived TNF and IL-1 cause re-setting of temperature control at hypothalamus

25
Q

Results of systemic effects of acute inflammation

A

Production of Granulocyte colony stimulating factor (G-CSF)- increase production and release of neutrophils from marrow

Rise in “acute phase proteins” eg C-reactive protein (CRP)- assists complement binding to microbes

Rise in immunoglobulins (later in acute inflammation)

26
Q

Chronic

A

Goes on for a long time. e.g. months, years

27
Q

What happens in chronic inflammation ?

A

Tissue damage, inflammation, healing going on at same time

28
Q

What types of cells are involved in chronic inflammation ?

A

macrophages, lymphocytes, plasma cells rather than neutrophils

29
Q

Chronic vs Acute inflammation

A

Chronic inflammation goes on for a long time, whereas acute inflammation is resolved quickly.

30
Q

Factors promoting resolution of acute inflammation

A

Minimal cell death and tissue loss

An organ with good regenerative capacity

Rapid destruction of the causative agent

Rapid removal of fluid and debris by good blood supply

Good nutrition and immune function

31
Q

As part of resolution of acute inflammation, what is the damaged/dead tissue organised into ?

A

Granulation Tissue

32
Q

Role of macrophages

A

Digests debris

33
Q

What does granulation tissue contain ?

A

Macrophages
Fibroblasts
New blood vessels

34
Q

Role of fibroblasts

A

Provide scaffolding for repair

35
Q

Role of new blood vessels

A

Allow nutrients for regeneration of tissues

36
Q

What is the end result of using granulation tissue ?

A

Healing, often with some scarring.

37
Q

Primary chronic inflammation examples

A

Leprosy
TB
Asbestosis
Inflammatory Bowel disease
Rheumatoid arthritis

38
Q

Examples of progression from acute to chronic

A

Osteomyelitis, foreign body

39
Q

Causes of chronic inflammation processing from acute inflammation - osteomyelitis

A

Poor blood supply, pus can’t drain away, pools under periosteum, portion of bone dies which stimulates chronic inflammation

40
Q

What are some consequences of chronic inflammation ?

A

Fevers, weight loss, malaise.
Fibrosis and hence distortion of tissues.
Amyloid deposition.
Reduced growth in children.
Anaemia of chronic disease.

41
Q

What can macrophages produce which is bad ?

A

Peroxynitrite and TNF which cause DNA damage.

Via a multi-hit mechanism, accumulated DNA damage and hence mutations leads to cancer

42
Q

What makes TB cells difficult to kill ?

A

Waxy coating on cell walls

43
Q

What is the hallmark of chronic inflammation ?

A

Macrophages

44
Q

What do macrophages produce that can cause DNA damage ?

A

peroxynitrite and TNF

45
Q

What does accumulated DNA damage lead to ?

A

Mutations
Cancer

46
Q

What increases the risk of gastric cancer ?

A

Helicobacter pylori infection

47
Q

What increases the risk of cervical cancer ?

A

Papilloma virus

48
Q

What increases the risk of liver cancer ?

A

Hepatitis B and C

49
Q

What increases the risk of bowel cancer ?

A

Chronic inflammatory bowel disease