Inflammation

Question 1

The cell that is first responder in acute inflammation

Answer 1

neutrophil

Question 2

____ is a rapid response to injurious agent that delivers mediators of host defense-especially leukocytes and plasma proteins to the site of injury

Answer 2

acute inflammation

Question 3

The first step of inflammation is recognition of the offending agent-the second is recruitment of WBCs and plasma proteins from circulation to area of injury–what are the 3 steps in recruitment?

Answer 3

1-vasodilation and increased blood flow
2-increased vascular permeability
3-emigration of WBCs from circulation, their accumulation at site of injury and their activation to eliminate offending agent

Question 4

What are the 2 advantages of inflammation?

Answer 4

1-neutralize or remove the offending item

2-take part in healing and repair (required for)

Question 5

What are the disadvantages of inflammation?

Answer 5

calor, rubor, tumor, dolor

Question 6

What are the 4 causes of inflammation?

Answer 6

1-infection and microbial toxins
2-tissue necrosis
3-foreign bodies
4-immune targets including autoimmunity

Question 7

Arterioles first ___ to decrease blood loss but then ____ in response to histamine and nitrous oxide to increase blood flow

Answer 7

vasoconstrict; vasodilate

Question 8

_____ allows the outpouring of protein rich fluid into nearby tissue and concentrates RBCs in small vessels which helps to slow blood flow (stasis)

Answer 8

increased vascular permeability

Question 9

Dolor is from the stimulation of specialized receptors by mediators, especially ____

Answer 9

bradykinin

Question 10

Both endogenous and exogenous chemoattracts signal for ___ to activate and migrate to area of injury

Answer 10

neutrophil

Question 11

____ granules contain bactericidal chemical, free radicals, collagenase, and elastase and are made more destruction

Answer 11

lysosomal

Question 12

____ engulf microbes and/or infected cells and then bind with ____ in order to destruct

Answer 12

phagocytes; lysosomes

Question 13

___ are produced by neutrophils which lose their nuclei and die; they prevent the spread of microbes by trapping them and provide a high concentration of antimicrobial substances

Answer 13

NETs

Question 14

____ carry away the fluid from an inflamed area as well as carry bacteria to a lymph node where it can be filtered out

Answer 14

lymphatics

Question 15

____ and ___ are two major cytokines that are anti-inflammatory mediators involved in termination of inflammation as well as key in wounds and wound healing

Answer 15

TGFbeta and IL-10

Question 16

___ are anti-inflammatory cells released by the Lipoxygenase arachidonic pathway

Answer 16

lipoxins

Question 17

___ are chemotaxic agents that help to get anti-inflammatory cells where they are needed within the body; they are products of the lipoxygenase arachidonic pathway

Answer 17

leukotrienes

Question 18

____ are proteins produced y many cell types that modulate function of other cell types

Answer 18

cytokines

Question 19

___ inflammation happens when cells are poor in fluid and not infected; they tend to be milder inflammation; blisters

Answer 19

serous

Question 20

___ inflammation is due to marked increase in vascular permeability or local procoagulant stimulus allowing fibrinogen to exit circulation; exudate–rich in fibrin; often occurs in the pleura, peritoneum, or pericardium

Answer 20

fibrinous

Question 21

___ inflammation is from pyogenic bacterial infections; involves pus and abscesses

Answer 21

suppurative

Question 22

___ inflammation is from mucous membranes, it is high in mucous content; runny nose

Answer 22

catarrhal

Question 23

___ and ___ are local defects of skin or mucous membranes from shedding of necrotic tissue as a consequence of inflammation

Answer 23

ulcers and erosions

Question 24

___ inflammation is a localized chronic inflammatory response to something the body can’t get rid of

Answer 24

granulomatous

Question 25

A ___ is akin to an abscess but is serous fluid not pus-filled; it normally follows a surgical procedure and is often drained even though it is sterile due to the possibility of infection

Answer 25

seroma

Question 26

____ are a local defect or excavation of the surface of a tissue produced by the shedding of inflamed necrotic tissue; tend not to heal spontaneously; go through basement membrane; often in GI, GU tracts and the skin

Answer 26

ulcers

Question 27

____ is an acute, overwhelming infection without clear borders that spreads along skin or subcutaneous tissues; often caused by Group A strep or staph; there is no abscess formation

Answer 27

cellulitis

Question 28

an ___ is a collection of fluid in a body cavity

Answer 28

effusion

Question 29

____ is caused by increased hydrostatic pressure, it is a clear fluid with low protein content

Answer 29

transudate

Question 30

___ is caused by inflammation and is a cloudy fluid with a high protein content

Answer 30

exudate

Question 31

____ is a purulent effusion--an infected effusion

Answer 31

empyema

Question 32

a ____ effusion is a transudate with mainly edema fluid and few cells; it is usually a yellow fluid

Answer 32

serous effusion

Question 33

a ___ effusion is lymph material, usually yellow-orange, and is often from a ruptured thoracic duct

Answer 33

chylous

Question 34

a ____ effusion has RBC's present but is not hemorrhagic; it is a reddish fluid and is often seen in cancer

Answer 34

serosanguineous

Question 35

a ___ effusion is blood and blood clots due to trauma

Answer 35

hemorrhagic

Question 36

a ___ effusion is greenish yellow and represents cholestrol

Answer 36

pseudochylous

Question 37

What are the 3 outcomes of acute inflammation?

Answer 37

1-complete resolution 2-healing by fibrosis or scarring (form adhesions) 3-progression to chronic inflammation (abscess, ulcers)

Question 38

_____ tissue is a proliferation of local fibroblastic tissue; it provides both healing and sealing functions

Answer 38

granulation

Question 39

granulation tissue removes ___ absorbable tissue such as dead or infarcted tissue

Answer 39

aseptic

Question 40

granulation tissue does not remove ___tissue; that tissue may form an abscess or can create adhesions (organized granulation tissue and organized fibrinous exudate)

Answer 40

septic

Question 41

____ inflammation occurs over weeks to months to years where inflammation, tissue injury, and repair are occurring all at once

Answer 41

chronic

Question 42

Does chronic inflammation require a preceding acute inflammation?

Answer 42

NO

Question 43

What are the 3 common causes of chronic inflammation?

Answer 43

1-persistent infections by microbes that are hard to eradicate 2-hypersensitivity diseases 3-prolonged exposure to toxic agents

Question 44

What are the 6 cell types present in chronic inflammation?

Answer 44

macrophages, T cells, B cells, plasma cells, eosinophils, mast cells

Question 45

When the body attempts to heal chronic inflammation by connective tissue replacement of the damaged tissue, it lays down collagen--this is called

Answer 45

fibrosis

Question 46

Granulomatous inflammation is divided into what 3 types?

Answer 46

1-foreign body type 2-immune/infectious type 3-unknown (non-caseating granulomas)

Question 47

What are the cells responsible for walling off the offending material in granulomatous inflammation?

Answer 47

epithelioid histiocytes

Question 48

Chronic inflammation leading to fibrosis is an outcome of acute inflammation where collagen is produced to fill the damaged space--this is stimulated by ___

Answer 48

fibroblasts

Question 49

a systemic response to insult (SIRS) is defined by what 4 things?

Answer 49

1-temperature >38C or 90bpm 3-respiratory rate >20 4-WBC >12,000 with left shift

Question 50

____ is an invasion of a sterile tissue by organisms

Answer 50

infection

Question 51

____ is presence of microbes in an area without invasion or inflammatory response

Answer 51

colonization

Question 52

____ is bacteria in blood

Answer 52

bacteremia

Question 53

____ is SIRS plus signs of infection

Answer 53

sepsis

Question 54

____ is sepsis and organ dysfunction often with some hypotension

Answer 54

severe sepsis

Question 55

___ is sepsis plus hypotension not responsive to fluids; often have DIC and hypoglycemia

Answer 55

septic shock

Question 56

The acute phase response mediates systemic effects of inflammation by allowing the complex interaction of cytokines, especially ___, ____, ____, and ____

Answer 56

TNF, IL-1, IL-6, and interferon

Question 57

____ proteins are proteins that increase or decrease by 25% in response to inflammatory stimuli, mainly produced by the liver

Answer 57

acute phase

Question 58

____ is an increased white blood cell count

Answer 58

leukocytosis

Question 59

____ is the appearance of less mature neutrophils than normal

Answer 59

left shift

Question 60

_____ produced at the site of infection stimulate production of WBCs by the bone marrow

Answer 60

colony stimulating factors

Question 61

If there is an overwhelming infection and in certain infections the WBC count may decrease which is called ___

Answer 61

leukopenia

Question 62

___ is increased neutrophils seen in most BACTERIAL infections

Answer 62

neutrophilia

Question 63

___ is increased lymphocyte count seen in VIRAL infections

Answer 63

lymphocytosis

Question 64

___ is increased eosinophil count seen in asthma, allergies, and parasitic infections

Answer 64

eosinophilia

Question 65

___ are a family of apolipoproteins that associate with HDL after production; they may influence cholestrol metabolism; may influence adhesion and chemotaxis of inflammatory cells; in chronic conditions they accumulate and become a tissue dysfunction called amyloidosis

Answer 65

serum amyloid A proteins

Question 66

___ is an acute phase protein that binds to phosphocoline and increases recognition of pathogens by immune cells; activates the complement system; has a proinflammatory response in some cases but also anti-inflammatory action

Answer 66

C reactive protein

Question 67

____ is an acute phase protein that influences wound healing by increasing various stages of healing

Answer 67

fibrinogen

Question 68

___ regulates iron and chronic elevation leads to reduction in availability of iron from iron stores

Answer 68

hepcidin

Question 69

____ is a major inhibitor of proteases and its deficiency allows uninhibited action of proteases which causes lung destruction and sometimes in liver

Answer 69

alpha 1 antitrypsin deficiency

Question 70

When acute phase reactants are chronically activated they can cause what 3 things?

Answer 70

1-anemia 2-impaired growth and muscle wasting 3-amyloidosis