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Block 6 > Inflammation > Flashcards

Inflammation Flashcards

1
Q

What are 4 characteristic features of inflammation? What does it result in? (from the Roman writer Celsus)

A

Rubor (redness)
Tumor (swelling)
Calor (heat)
Dolor (pain)

results in functio laesa (loss of function)

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2
Q

Inflammation is a protective response to rid tissues of ____ _____.

A

cell injury

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3
Q

Inflammation has a dark side. Repair usually does not result in complete ______ of tissue and very likely results in ____.

A

regeneration, scar

Complete function may or may not return to the tissue

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4
Q

What are the 3 types of inflammation?

A

acute
chronic
granulomatous (a subset of chronic)

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5
Q

What type of inflammation is characterized by mobilization of fluid and acute inflammatory cells (neutrophils) into tissues?

A

acute

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6
Q

What are the two steps in the acute inflammatory process?

A

vascular changes

cellular changes

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7
Q

What are the vascular changes? (4)

A
  • immediate vasoconstriction followed by vasodilation
  • increased blood flow to site of injury
  • slowing of circulation to the area by increased microvascular permeability, eventually leading to stasis
  • margination of WBC’s, especially neutrophils
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8
Q

The two major events that occur on the cellular level are what?

A

delivery of WBC’s to site of injury AND phagocytosis

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9
Q

How do WBC’s get to the site of injury? (a sequence of 4 events)

A
  • neutrophils marginate
  • they then roll along the endothelium
  • they migrate across the endothelium (diapedesis)
  • they migrate through the interstitium as a result of a chemotactic response
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10
Q

What endothelial molecule and leukocyte molecule go with the rolling of neutrophils, monocytes, T lymphocytes?

A

Endothelial molecule- P-selectin

Leukocyte molecule- Sialyl-Lewis-X-modified proteins

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11
Q

What endothelial molecule and leukocyte molecule go with rolling and adhesion of neutrophils, monocytes, T lymphocytes?

A

Endothelial molecule- E-selectin

Leukocyte molecule- Sialyl-Lewis-X-modified proteins

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12
Q

What endothelial molecule and leukocyte molecule go with rolling of neutrophils and monocytes only?

A

Endothelial molecule- GlyCam-1, CD34

Leukocyte molecule- L-selectin

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13
Q

What endothelial molecule and leukocyte molecule go with adhesion, arrest, and transmigration of neutrophils, monocytes, and lymphocytes?

A

Endothelial molecule- ICAM-1 (immunoglobin family)

Leukocyte molecule- CD11/CD18(Beta 2) integrins (LFA-1, Mac-1)

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14
Q

What endothelial molecule and leukocyte molecule go with adhesion of eosinophils, monocytes and lymphcytes?

A

Endothelial molecule- VCAM-1 (immunoglobin family)

Leukocyte molecule- VLA-4 (Beta 1) integrin

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15
Q

LAD1 leads to what?

genetic

A

defective leukocyte adhesion because of mutations in Beta chain of CD11/CD18 integrins

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16
Q

LAD2 leads to what?

genetic

A

defective leukocyte adhesion because of mutations in fucosyl transferase required for synthesis of sialylated oligosaccharide (ligand for selectins)

17
Q

Chronic granulomatous disease leads to? X-linked?
Autosomal recessive?

genetic

A
  • decreased oxidative burst
  • phagocyte oxidase (membrane component)
  • phagocyte oxidase (cytoplasmic components)
18
Q

MPO deficiency leads to what? genetic

A

decreased microbial killing because of defective MPO- H2O2 system

19
Q

Chediak-Higashi syndrome leads to what? genetic

A

decreased leukocyte functions because of mutations affecting protein involved in lysosomal membranes traffic

20
Q

What vasodilates the microvascular system but paradoxically constricts larger arteries?

A

histamine

21
Q

What is released from platelets as they aggregate? This acts similar to histamine

A

serotonin

22
Q

Inactive components become activated, several help increased vascular permeability; C5a also aids in chemotaxis of neutrophils

A

complement

23
Q

What initiates the clotting system?

A

activated Hageman factor (factor XIIa)

24
Q

What contributes to pain and fever in the inflammatory response?

A

Prostaglandins

25
Q

What modulates a variety of pathways involved with immunity, neutrophil activation, monocyte activation, and stimulate hematopoiesis?

A

cytokines

26
Q

What accounts for much of tissue injury in the inflammatory response?

A

free radicals

27
Q

What morphologic pattern in inflammation forms effusions?

A

serous

28
Q

What morphologic pattern in inflammation forms fibrinous exudates?

A

fibrinous- duh

29
Q

What morphologic pattern in inflammation forms pus?

A

suppurative (purulent)

30
Q

What are the 4 parts of ulceration?

A
  • necrosis
  • acute and/or chronic inflammation
  • granulation tissue
  • scar
31
Q

What type of inflammation is characterized by infiltration by mononuclear inflammatory cells (lymphocytes, monocytes, plasma cells) along with MACROPHAGES?

A

chronic

32
Q

What is the key player in the chronic inflammatory response?

A

THE MACROPHAGE!

33
Q

Neutrophils are more often involved in ______ infections, lymphocytes/monocytes more often in _____ infections.

A

BACTERIAL

VIRAL

34
Q

This is a distinctive subtype of chronic inflammation that is characterized by ACTIVATED MACROPHAGES (histiocytes).

A

granulomatous inflammation

35
Q

What is in a granuloma? (3)

A
  • ball of histiocytes (may or may not be necrotic)
  • multinucleated giant cells
  • surrounding cuff of lymphocytes
36
Q

What causes a granuloma? (2)

A

immune reaction or foreign body

37
Q

Who is responsible for a granuloma? (the most common)

A
  • necrotizing (caseating) granulomas

- non-necrotizing (non-caseating) granulomas

38
Q

Think TB, fugus (esp. Histoplasma) and cat scratch disease

A

necrotizing (caseating) granulomas

39
Q

Think foreign body, sarcoid, and don’t forget that diseases that have necrotizing granulomas can also be sprinkled with occasional non-necrotizing granulomas (usually the smaller ones are non-necrotic)

A

non-necrotizing (non-caseating) granulomas

Block 6 (16 decks)

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