Inflammation Flashcards by gopi patel

Nonspecific line of defense -Mast and dendritic cells

Triple response of Lewis -> mast cells release histamine

red, wheal, flare, urticaria

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Natural epithelial barriers

keratinization
acidic surfaces
mucinous surfaces - binds bacteria
if breached then leads to inflammation

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Specific Humoral and cellular immunity

Eczema

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hyperemia

engorgment

excess blood flow

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Diapedesis

passage of blood cells through intact walls of capillaries

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emigration

diapedesis of leukocytes through small blood vessels walls

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margination

adhesion of white blood cells to the walls of damaged blood vessels

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pavementing

neutrophils line up along the endothelial surface of the blood vessel

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transudation

escape of fluid by hydrostatic or osmotic pressure
Plasma ultrafiltrate
low protein content
from normal vascular permeability

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exudation

fluid exiting through pore or wound
from increased vascular permeability
High protein and cell debris

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cachecia

dramatic weight loss and muscle atrophy

wasting syndrome

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purpura

purple or red discolorations on the skin that not do not blanch

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extravasation

movement of white blood cells from capillaries to tissues

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effusion

excess fluid in an area?

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serosanguinous

composed of serum and blood

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purulent

containing or discharging pus

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supprative

formation or discharge of pus

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Purposes of inflammation

To contain, neutralize and remove

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urticaria

hives

in dermis

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Eczema

surface rough

epithelia and dermal reaction

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pt wears tight fitting shoes. Redness at base of nails. Pus developed then red streaks, skin sloughed off and ulcerated. Gangrene ensued and amputated leg. Stump got infected, developed septicemia and died. Bacteria responsible?

Strept - aerobic bacteria and releases alot of enzymes

red streaks meant bacteria in lymphatics

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cardinal signs of inflammation

Calor - Heat - vasodilation 
Rubor - Redness - vasodilation 
Tumor - Edema - vascular permeability 
Dolor - Pain - mediator/release PMNs 
Functio - loss of function

Major components of Acute inflammation

vascular changes
cellular events
chemical mediators of inflammation

Paranechia

inflammation around nails

what vascular changes happens during acute inflammation

transient vasoconstriction - lasts seconds vasodilation of precapillary arterioles - increased blood flow "triple response of lewis" - Red line, flare and wheal blood stasis increased permeability of venules - mintues to days

Urticaria

redness and swelling seen when scratch skin

After vascular changes

there is movement of fluid and cells | Edema and Exudation

Vascular permeability

As protein exits vessels - intravascualar osmotic pressure drops and intravascular hydrostatic pressure increases Endothelial gaps occur at intracellular junctions

Endothelial gaps are a _______ response induced by

immediate transient response | histamine, bradykinin, leukotrienes, substance P

what occurs to handle trauma?

Endothelial retraction direct endothelial injury - immediate sustained response leukocyte mediated endothelial injury

Vasculitis

delayed prolonged leakage - 2-12 hours: lasts hours to days | thermal, xray, UV - "sunburn" , bacterial toxin

During repair, these two events occur

Transcytosis - death of neutrophil and leukocytes? | Angiogenesis

Pt has pain from acute appendicitis. what is causing the pain?

Prostaglandins and bradykinins

Pt pain from acute appendicitis. What mediates the phagocytosis?

Complement C3b and IgG

There is erythemia of the appendix, what are the two chemical mediators?

Histamine and serotonin | these are vasodilators

Pt was acute appendicitis has a fever. What are the two chemical mediators?

IL-1 and TNF

What chemicals cause leukocyte infiltration?

Leukotrienes and HPETE

Pt has surgery. There is a small nodule under the skin at the incision site. What cell type is characteristic of this response?

Giant cells (multinucleated) this is from chronic inflammation this is a foreign body granuloma there is infiltration of a lot of Macrophages and these Macrophages fuse to create Giant multinucleated cells

What induces Macrophages to release ROS?

Lipoxins

What chemical would help clear organisms from lung parenchyma?

Hydrogen peroxide

Pt fractured femoral trochanter, 76 yo, lower leg is now swollen and painful with movement and tenderness to palpation. Strong pulse in arteries. What complication is most likely to occur after these events?

Pulmonary Thromboembolism - from stagnation of blood | Not disseminated intravascular coagulation - would need to see fever and chills

See lung cavitation in pt with chronic cough with fever and weight loss. What caused development of lung lesion?

Macrophage

Noncaseating granulomas lack central necrosis. Caused by

``` Reaction to foreign material Sarcoidosis Beryllium exposure Crohn disease Cat scratch disease ```

Chronic inflammation

inflammation of prolonged duration (weeks or months) in which active inflammation, tissue destruction, and attempts at repair are proceeding simultaneously

When does chronic inflammation occur?

Persistent infections - AFB, fungi, Treponemes -low toxicity, delayed hypersensitivity, Granulomatous inflammation Prolonged exposure to potentially toxic agents -silica and toxic plasma lipids -> atherosclerosis Autoimmunity - RA, Lupus

What is chronic inflammation characterized by?

Infiltration with mononuclear cells - Macs, lymphocytes and plasma cells tissue destruction repair involving angiogenesis and fibrosis Macrophage is the prima donna of chronic inflammation

When do see caseating granulomas?

TB and fungal infections | use Acid fast stain or Silver stain

Key macrophage events

recruitment from circulation local proliferation immobilization differentiation - microglia, kupffer, alveolar macrophage, osteoclasts

Pt has trouble breathing. Afebrile, diminished breath sounds and dullness to percussion bilaterally. 2+ pitting edema present on thighs and has bilateral pleural effusion. what may you see test wise?

Hypoalbuminemia | Low protein in blood allows fluid to escape into the tissue

Pt fevver and dry cough for 3 days and difficult breathing. Diffuse rales are auscultated over lower lung fields. Pleural effusion. Fluid removed is cloudy with cell count 15,500 leukocytes/ul, 98% are neutrophils. What describes the pleural process?

Purulent inflammation

empyema

pus in pleural space

Pt taking aspirin for arthritis for past 4 years. Continuing joint destruction with loss of articular cartilage and joint space narrowing. Pain reduction is most likely to be the result of diminishing what chemical mediator?

Prostaglandin

Expression of what on endothelial cells is most intstrumental in promoting inflammatory reaction and aiding neutrophils to migrate into injured tissue?

E-selectin