Inflammation Flashcards
Rubor
redness
- vasodilation via relaxation of arteriolar smooth muscle
- histamine/PGs/bradykinin-mediated
Tumour
swelling
- edema via leakage from post-capillary venule -> interstitial space
- histamine and tissue damage-mediated
Calor
heat
- vasodilation via relaxation of arteriolar smooth muscle
- histamine/PGs/bradykinin-mediated
Dolor
pain
- sensitization of sensory nerve endings
- bradykinin and PGE2-mediated
Fever
- pyrogens stimulate macrophages to release IL-1, TNF -> increase COX in perivascular cells of the hypothalamus -> increases PGE2 -> raises temperature set point
Factors of the extrinsic pathway (of the coagulation cascade)
III (Thromboplastin)
VII
IIa (Thrombin)
*Note: activated VII (VIIa) can convert IX to IXa
Factors of the intrinsic pathway (of the coagulation cascade)
XII (Hageman factor)
XI
IX
VIII
IIa (Thrombin)
*Activated XI (XIa) converts IX to IXa
Factors of the common pathway (of the coagulation cascade)
X V II (Prothrombin) I (Fibrinogen) XIII
IIa (Thrombin)
* the common pathway uses thrombin, and also generates thrombin
Aspirin
COX-1 inhibitor
- prevents formation of thromboxane in platelets
- permanent action on platelets
Heparin
Binds and inactivates thrombin (factor IIa)
Binds and activates antithrombin III
- low molecular weight heparins only bind antithrombin III
Warfarin
Oral anticoagulant
- blocks epoxide reductase in liver -> prevents regeneration of active form of Vitamin K
Streptokinase
Thrombolytic agent
- plasminogen activator
- converts plasminogen -> plasmin
- enables dissolution of clots
Bleeding time
- time taken from initial injury to the formation of the primary hemostatic plug (plug formed prior to incorporation of fibrin)
- indicator of PRIMARY HEMOSTASIS
Prolonged bleeding time indicates:
- low platelet count
- vWF deficiency
- platelet receptor defects
Clotting time
- time taken for the formation of the stable hemostatic plug (incorporation of fibrin into the plug)
Prolonged clotting time indicates:
- defects in coagulation pathway
- specific defects of either the intrinsic or extrinsic pathway are indicated by:
- Prothrombin time (PT)
- Activated partial thromboplastin time (APTT/PTT)
Prothrombin time (PT)
- tests extrinsic and common coagulation pathways
Measures defects in:
- thromboplastin
- VII
- X
- V
- prothrombin (II)
- fibrinogen (I)
- XIII
Activated partial thromboplastin time (APTT)
- tests intrinsic and common pathways
Measures defects in:
- XII
- XI
- IX
- VIII
- X
- V
- prothrombin (II)
- fibrinogen (I)
- XIII
E selectin (what does it bind? what does it facilitate? how is it regulated?)
- endothelial molecule (ELAM-1)
- facilitates ROLLING adhesion
- binds Sialyl-Lewis X-modified proteins on leukocytes
- TNF, IL-1 stimulate DE NOVO synthesis of E selectin
P selectin (what does it bind? what does it facilitate? how is it regulated?)
- endothelial molecule
- facilitates ROLLING adhesion
- binds Sialyl-Lewis X-modified proteins on leukocytes
- histamine stimulates release of P selectin from Weibel-Palade bodies
*Weibel-Palade bodies also contain von Willebrand factor
ICAM-1 (what does it bind? what does it facilitate? how is it regulated?)
- integrin ligand/ endothelial adhesion molecules
- facilitate Adhesion & Emigration
- binds LFA-1 (CD11a/CD18) - integrin
- binds Mac1 (CD11b/CD18) - integrin
- TNF stimulates DE NOVO synthesis of ICAM-1
VCAM-1 (what does it bind? what does it facilitate? how is it regulated?)
- integrin ligand/ endothelial adhesion molecules
- facilitate Adhesion & Emigration
- binds VLA-4 (CD49d/CD29) - integrin
- upregualted by TNF
Chemotactic factors for PMNs
- Bacterial products (i.e. E. coli, Staph. aureus)
- C5a
- LTB4
- IL-8
Chronic Granulomatous Disease
NADPH Oxidase deficiency
- increased infection by catalase + microbes (because they can convert hydrogen peroxide to water, thereby protecting themselves)
Conditions in which you see granulomatous inflammation
- Tuberculosis (Caseating granuloma)
- Cat-scratch disease
- Syphilis
- Fungal
- Protozoan
- Foreign body granuloma
- Rheumatic fever (Aschoff body)
- Rheumatoid arthritis
- Sarcoidosis
- Granuloma annular of skin