inflammation Flashcards
What are the classic findings of inflammation?
rubor (redness) dolor (pain) calor (heat) tumor (swelling) loss of function
what is inflammation?
method to REPAIR cell damage
outcomes of acute inflammation
complete resolution: normal structure, function
organization: fibrotic shell walls off inflammation
abscess: fibrotic shell + pus (drain!)
scarring: collagen →↓ function (myocardium can’t contract, no electrical impulses)
progression to chronic inflammation
acute inflammation mediated by:
neutrophils
chronic inflammation mediated by
macrophages + lymphocytes (mononuclear)
acute or chronic inflammation?
granuloma
chronic inflammation
granuloma composed of:
cluster of epithelioid macrophages + multinucleated giant cells (fused macrophages) in chronic inflammation
macrophages make TNFα →maintains granuloma
outcomes of chronic inflammation
scarring
amyloidosis
MOA of infliximab
block TNFα → breakdown of granuloma
test for LATENT TB before starting
granulomatous LUNG diseases (chronic inflammation)
TB: CASEATING granuloma (cheese-like) with caseous necrosis in middle (PINK)
sarcoidosis
fungal: histoplasmosis, blastomycosis
berylliosis
berylium miner
berylliosis
migrant worker with hemoptysis
TB
granulomatous LUNG + KIDNEY disease (chronic inflammation)
granulomatosis with polyangiitis (wegener)
granulomatous GI disease (chronic inflammation)
Chron’s disease (noncaseating, no pink center = caseous necrosis)
bartonella henselae = cat scratch disease causes
granulomatous disease (chronic inflammation)
granulomas are a feature of
granulomatous diseases
M. leprae (leprosy, hansen disease) causes
granulomatous disease (chronic inflammation)
listeria monocytogenes causes
granulomatous disease (chronic inflammation)
chronic granulomatous disease (immunodeficiency disorder) causes formation of
granulomas
foreign body causes
granulomatous disease (chronic inflammation)
transudate extracellular fluid (from vessels) properties
watery:
hypocellular, ↓protein, ↓ specific gravity
exudate extracellular fluid (from vessels) properties
EXudate = EXtra stuff:
cellular (inflammatory cells), ↑protein, ↑specific gravity
exudate caused by
lymphatic obstruction
inflammation/infection
malignancy
transudate caused by
↑hydrostatic pressure (CHF)
↓oncotic pressure (cirrhosis)
Na retention
erythrocyte sedimentation rate (sed rate) is the
rate at which RBCs fall to bottom of tube
fibrinogen (acute phase reactant made by HEPATOCYTES) coats RBCs → aggregation → fall at faster rate within the test tube →↑ ESR
C-reactive protein
a acute phase reactant (like fibrinogen)
made by HEPATOCYTES
bind to bacteria and act as opsonin
can be secreted from cells in athersclerotic plaques: activates endothelial cells to induce a prothrombotic state, ↑adhesiveness of endothelium to leukocytes
↑ ESR occur in
polymyalgia rheumatica
temporal arteritis
monitor disease activity (degree of inflammation) in RA and SLE
infection: osteomyelitis (useful for diagnosis, sometimes xray is negative)
inflammation
malignancy
↑CRP are a strong predictor of
MI risk
stroke
PAD
sudden cardiac death
serous pattern of inflammation
watery fluid in tissues (transudate)
fibrinous pattern of inflammation
fibrinogen exits vessel and enters tissue → forms fibrin matrix in inflamed tissue (exudate)
suppurative/purulent pattern of inflammation
pus (exudate) - in abscess, pleural effusion
dead cells, debris, liquefactive necrosis
type of inflammation with persistent cycles of destruction + repair, start eating healthy tissue
chronic inflammation
acute inflammation causes release of acute phase cytokines (inflammatory mediators):
IL-1
IL-6
TNF-α
during acute inflammation, vasodilation + vascular permeability → fluid exudation into interstium is caused by
histamine
5HT
bradykinin
vitamin C and zinc are required for acute inflammation. they are involved in:
vitamin C: fibroblasts need for laying down collagen for wound healing
zinc: metalloproteinases contain zinc and remodel the ECM
IL-1
IL-6
TNFα cause:
↑expression of select on vessel
disease that causes:
abnormal LFA-1 (integrin) - bad tight binding
delayed separation of umbilical cord in newborn
recurrent bacterial infections later in life
leukocyte adhesion deficiency
