Inflammation 2 Flashcards

1
Q

What are the events of acute inflammation

A

Stimulus for inflammation
Vascular changes
Cellular events
Termination of acute inflammatory response

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2
Q

What can be the cause of acute inflammation

A

Infectious agents
Trauma
Necrotic tissue
Immune reactions

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3
Q

What are the inflammatory mediators of acute inflammation

A
Vasoactive amines 
Plasma proteases: complement 
Lipid mediators 
Platelet activating factor 
Cytokines 
Chemokines 
Nitric Oxide
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4
Q

What are the vascular changes in acute inflammation

A

Increased vascular flow (hyperemia) and blood vessels

Increased vascular permeability (capillaries and post-capillaries)

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5
Q

What are the cellular events of acute inflmmation

A

Extravasation- deliver of WBC to site of injury

Migration- cytokines
Rolling- selectin/integrin
Activation and Adhesion- integrin and chemokines
Transmigration - P-CAM

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6
Q

The process where WBC emigrate in tissues towards the site of injury

A

Chemotaxis

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7
Q

What are the 3 processes involved in phagocytosis

A

Recognition and attachment of particle

Engulfment with subsequent formation of phagocytic vacuole

Killing or degradation on ingested material

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8
Q

How is the acute inflammatory response terminated

A

Degrade inflammatory mediators
Stop signals
->pro-inflammatory leukotrienes to anti-inflammatory lipoxins from arachidonic acid
-> anti-inflammatory cytokines from macrophages
-> neural impulse inhibits TNF production in macrophages

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9
Q

What are the four outcomes of acute inflammation

A

Complete resolution

Healing by scarring

Abscess formation

Chronic inflammation

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10
Q

What is involved in inflammatory resolution

A

Neutralization of chemical mediators

Return to normal vascular permeability

Stop lymphocytic infiltration and removal of edema

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11
Q

Healing by scarring often occurs in what type of tissue

A

Tissues that do not have the ability to regenerate

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12
Q

How can chronic inflammation arise?

A

Following acute inflammation - persistent stimulus or interference in normal process

Repeated bouts of acute inflammation

Low grade response

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13
Q

Persistent infection by intracellular micro organisms which are low toxicity or prolonged exposure to non-degradable substances usually result in what kind of inflammation

A

Chronic

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14
Q

A small organized collection of modified macrophages (epithelioid cells) surrounded by a rim of lymphocytes

A

Granuloma

Granulomatous inflammation = Chronic!

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15
Q

What are some causes of granulomatous inflammation

A
Insert particles. Eg silica/asbestos 
Lipid resistant to metabolism 
Bacterial resistant to lysosomal degradation 
Systemic fungal agents 
Foreign bodies
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16
Q

What are the cells involved in granulomatous inflmmation

A

Epithelioid cells
Multinucleated giant cells
Lymphocytes

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17
Q

A large, pale-staining, eosinophilic macrophage with a ovoid nucleus, rich with ER, golgi, and vesicles

A

Epithelioid cells

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18
Q

Fusion of macrophages induced by cytokines causes formation of ______________________

A

Multinucleated giant cells

Nuclei are sometimes arranged around the periphery

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19
Q

What are the roles of T lymphocytes

A

To produce lymphokine and interferons
To attract ad activate macrophages
To induce formation of multinucleated giant cells

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20
Q

What are the two patterns of chronic inflammation?

A

Diffuse thickening of affected tissue (eg Johnes disease)

Solid, firm, nodular lesions ->may compress adjacent tissue

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21
Q

The term used when there are significant numbers of neutrophils present in the center of a granulomatous reaction

A

Pyogranulomatous

22
Q

Organized accumulation of machrophage so and epithelioid cells, often rimmed by lymphocytes

A

Simple granuloma

May be diffuse or local

23
Q

Granuloma with a central area of necrosis

A

Complex granuloma

-necrosis may lead to calcification/mineralization

24
Q

What is the sequelae of chronic inflammation ?

A

Persistence of stimuli-> progression of inflammatory rxn -> continuation of disease

25
Q

Process by which lost or necrotic cells are replaced by vital cells

A

Repair

26
Q

What are the two types of repair

A

Paraenchymal regeneration

Fibrosis

27
Q

Injured tissue replaced by identical types of tissue, leaves no residual trace of pervious injury

A

Parenchymal regeneration

28
Q

Parenchymal regeneration can only occur if:

A

Tissue can regenerate

framework of the tissue is maintained

29
Q

Replacement of tissue by fibrous CT

A

Fibrosis

30
Q

Fibrosis results in increased amount of ________ in tissue

A

Collagen

31
Q

What are labile cells

A

AKA continuously dividing cells

Follow the cell cycle from one mitosis to the next; proliferate throughout life

Tissues composed of these cells regenerate after injury

32
Q

What are examples of labile cells?

A

Surface epithelial
Lining mucosa
Columnar epithelium of GI tract, uterus, Fallopian tubes
Transitional epithelium - urinary tract
Spleen, lymphoid, and hematopoietic tissue

33
Q

What are stable cells

A

Aka quiescent cells

Low level of replication

Can undergo rapid division in response to stimuli

34
Q

What are examples of stable cells

A

Epithelium of liver, kidney, lung, pancreas
Smooth muscle
Fibroblast
Vascular endothelium

35
Q

What are permanent cells

A

Aka non-dividing cellls

Cannot undergo mitotic division after postnatal life

36
Q

What are examples of permanent cells?

A

Neurons

Cardiac muscle cells

37
Q

What are the 4 components of fibrosis ?

A

Migrate and proliferation of fibroblasts
Deposit ECM
Form new blood vessel
Maturation and organization of the scar (remodeling)

38
Q

What factors favor fibrosis over regeneration

A

Severe/prolonged tissue injury
Loss of framework (basement membranes)
Large amount of exudate -> body able to eliminate
Lack of renewable cell populations

39
Q

What are the consequences of fibrosis

A

Loss of functional parenchymal tissue
Alteration of physical properties of tissue
-> skin scar prone to tearing
-> pulmonary -> decreased compliance and vital capacity

40
Q

When does granulation tissue form?

A

3-5 days after injury

41
Q

What tissue is pink, soft, and granular on the surface of a wound.

A

Granulation tissue

42
Q

Granulation tissue is composed of what 4 tissue zones?

A

Surface (young) -> deep tissue (old)

Zone of necrotic debris
Zone of macrophage and angiogenesis
Zone of proliferating capillaries and fibroblast
Zone of fibrous CT

43
Q

What is the sequence of events of granulation tissue maturation

A

Bed of granulation tissue matures
Deposits of collagen and ground substance
Granulation bed contracts
Specialization of some fibroblasts into contractile cells

44
Q

What is the difference between and granuloma and granulation tissue

A

Granuloma = chronic inflammation

Granulation tissue= repair process with large amount of fibrous CT and neovascularization

45
Q

Process including CT replacement and regeneration by which restoration of tissue continuity achieved

A

Wound healing

46
Q

Healing by first intention vs second intention

A

First intention: little exudate and tissue edges are close together (little scar)

Second intention : edges of wounds are widely separated (mas scar)

47
Q

What is the general process of skin healing ?

A

Blood clot
Epithelial continuity is restored (24-48hrs)

Epithelial cells lose contact with BM and other cells ->migrate to advancing edge ->mitosis to gradually cover epidermal defect

Inflammatory reaction -> neutrophil infiltration followe by macrophage
Neovascularization
Fibroblast proliferation and laying down of collagen

Devasculrization
Regression of inflammatory cells and fibroblasts

Scar

48
Q

Remaining hepatocytes regenerate and some ECM framework is destroyed resulting in formation of irregular hepatocyte nodes separated by fibrous CT scars

A

Massive hepatic necrosis

49
Q

_______ of the kidney has maximal regenerative capacity while the _____________ has minimal regenerative capacity

A

Renal cortical tubules; renal medullary tubules

50
Q

____________ of the kidney has no regenerative capacity

A

Glomeruli

51
Q

How does the kindey repair by regeneration

A

No rupture of cortical tubule BM

Surviving cells flatten, appear squamoid and migrate to necrotic area