Inflammation Flashcards
Given a clinical scenario be able to:
—Distinguish between acute and chronic inflammation
Acute Inflammation: early (almost immediate) response to tissue damage. Can last a few minutes –> several days
Red, Warm, Edema, Pain
Chronic:
A 23-year-old female sprained her ankle, which is now swollen, red, warm and painful. To treat the pain, she takes some ibuprofen, a non- steroidal anti-inflammatory drug (NSAID). This works for her because the ibuprofen is most likely inhibiting the formation of:
A. Chemokines B. Histamine C. Lysosomal enzymes D. Prostaglandins E. Leukotrienes
D. Prostaglandins
Match these
A. Chemokines B. Histamine C. Leukotrienes D. Prostaglandins E. TNF, IL-1
Chemotaxis Pain
Recruit and/or activate WBCs Vascular permeability
Vasodilation
A. Chemokines:
Chemotaxis
B. Histamine:
permeability
C. Leukotrienes:
permeability
D. Prostaglandins: Pain
E. TNF, IL-1: Recruit and/or activate
Match these
A. Chemokines B. Histamine C. Leukotrienes D. Prostaglandins E. TNF, IL-1
Chemotaxis Pain
Recruit and/or activate WBCs Vascular permeability
Vasodilation
A. Chemokines:
Chemotaxis
B. Histamine:
permeability
C. Leukotrienes:
permeability
D. Prostaglandins: Pain
E. TNF, IL-1: Recruit and/or activate
A 53-year-old female has a high fever and cough productive of yellowish mucus for the past day. A chest x-ray shows bilateral patchy airspace opacities (white spots that suggest that the airspaces may be filled with microorganisms and pus indicative of pneumonia). Which of the following inflammatory cells is most likely to be seen in greatly increased numbers in the coughed up mucus?
A. Plasma cells B. Macrophages C. Mast cells D. Neutrophils E. T lymphocytes
D. Neutrophils-and it is acute
Describe the role of macrophages and mast cells in starting the inflammatory process.
macrophages are first to response, mast cells cause vasodilation to allow immune cells to target the area
Compare the role of neutrophils and macrophages in acute inflammation.
a. What is the timing of each in acute inflammation?
b. Compare the function of each in acute inflammation?
c. What is the difference between a monocyte and macrophage?
d. When do you find macrophages vs neutrophils in tissue? In general, what is the lifespan of each in tissue?
e. Which immune cell is involved in tissue repair?
a. Neutrophils: leukocytes in blood that enter tissues in response to
inflammatory signals
i. first leukocytes to be recruited at the site of injury because they are
the most abundant leukocyte in blood and can respond faster
ii. major phagocytic cells, polymorphonuclear leukocytes (PMN),
iii. short lifespan! 6-24 hours
1. needs to constantly be replenished à release of mature and
less mature band neutrophils from bone marrow
iv. Activation
1. Microbes, necrotic cell products, inflammatory mediators à
bind to receptors on neutrophils à activate
a. Pathogens have damage associated molecular patterns,
so all are non-specific
2. Once activated: secrete inflammatory mediators (cytokines) to
attract other leukocytes, phagocytosis, kill bacteria and other
microbes, eliminate necrotic tissue and foreign substances
3. Bacteria binds to a receptor on neutrophil à phagocytosis à
fusion of phagocytic vacuole with lysosomes à phagolysosome
contains ROS and Lysosomal enzymes à kill and degrade the
microbe
a. Lysosomal components are also secreted to kill and
degrade extracellular microbes
b. Macrophage: tissue resident, come from monocyte (in blood)
i. Fewer than number of neutrophils, aren’t active until they act as
macrophages in the tissue. Therefore neutrophils enter first, then
monocytes take over! 24-48 hours
1. Macrophages can live for years!
ii. Macrophages always running around in tissues to look for pathogens
à attract neutrophils when activated
iii. Initiate the process of tissue repair by releasing growth factors, etc.
Morphological patterns of acute inflammation
-Serous inflammation
transudate effusion
i. transudate - watery, relatively protein poor fluid
ii. effusion: abnormal collection of fluid within a cavity
iii. Ex: blister – separation of epidermis from dermis, focal collection of
serous effusion
iv. Ex: inflammation of serous membrane that lines body cavities
(pericarditis, peritonitis, pleuritis/pleurisy)
What causes a blister, and what type of fluid does it contain, and where is the fluid located?
A result of acute inflammation!
Separation of the dermis and epidermis which is then filled with serous fluid (transudate effusion) which is..
i. transudate - watery, relatively protein poor fluid
ii. effusion: abnormal collection of fluid within a cavity
Compare the type of fluid that would be in a body cavity when there is serous inflammation, fibrinous inflammation, or purulent (suppurative) inflammation associated with either pleurititis (pleurisy), pericarditis or peritonitis.
Explain the cause and why the type of fluid is different.
Serous is transudate: waterary/protein poor
Fibrinous: from more severe injury and protein rich exudate-fibrinous
Suppurative (purulent) inflammation: full of pus. SO major cellular
component of exudate would be neutrophils
i. Often found in bacterial infections
1. Abscess: puss filled cavity.
Describe how fibrinous inflammation can lead to scarring?
Fibrinous inflammation: from more severe injury, occurs often in body
cavities
i. Releases a protein-rich exudate
- If not resolved (removed by macrophages), can turn into scar
tissue
Describe an abscess - why and where it develops and its composition.
Suppurative (purulent) inflammation:
- Abscess: puss filled cavity. Can develop with extensive acute
inflammation - Center of abscess is dead neutrophils, pus, cell debris, necrotic
tissue - Surrounding tissue is attempted repair tissue with a lot of
fibroblasts to wall it off
Describe the development of an ulcer? Where do they tend to occur?
inflammation occurring on a surface (epidermis, mucosa, etc.) à
necrotic and inflammatory tissue sloughing off
-Define chronic inflammation.
inflammation that lasts 2+ weeks, regardless of the cause.
Where both tissue injury and cell repair coexist because there is time to start the
repair process
What are the predominant immune cells in chronic inflammation?
NO NEUTOPHILS
monocytes and macrophages, plasma cells, T lymphocytes (NOT neutrophils!)
