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CPAT > Inflammation > Flashcards

Inflammation Flashcards

1
Q

What are the ten reasons why inflammation is important?

A
  • Pathogenic basis of many diseases
  • Roles in triggering immunity
  • A set of processes that keeps us alive
  • Most AI drugs work by preventing formation or actions of mediators
  • Works on a daily basis
  • Deficiency in a segment of inflammation can cause severe diseases
  • Complex relationship inflammation/cancer
  • Dysregulation of inflammation: lethal or chronic, debilitating diseases
  • Problems caused by AI drugs (iatrogenic)
  • Angiogenesis (ageing, tissue remodeling)
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2
Q

What is the ultimate goal after an injury?

A

Stabilization of the tissue

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3
Q

Describe the general pathway for what happens when you are exposed to microorganisms

A

Microorganism may pass epithelial or secretion barriers
Innate immune cells are ready to target anything foreign and will eliminate what they can really quickly
Macrophages may be activated for phagocytosis
The antigen may drain to the lymph node which may cause further exposure to NK cells and macrophages
Adaptive immunity will then kick in later

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4
Q

Define inflammation and list its two categories

A

“Inflammation is the reaction of vascularized living tissues to local injury or infection, characterized by the movement of fluid and leukocytes from the blood into the affected tissue”
2 main categories:
1. Acute
2. Chronic

A coordinated set of processes through which the host attempts to localize and eliminate micro-organisms, damaged cells, inanimate foreign particles, or antigens

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5
Q

List three roles of inflammation

A

Defence against microorganisms
Initiation of the healing process
Elimination of damaged cells, inanimate foreign particles

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6
Q

Acute inflammation has a ____ onset, relatively ____- lived, stereotypic response to injury or infection, characterized by the _______ out of the ____ and into the ____

A 
Rapid onset
Short-lived
Movement of fluid and neutrophils
Blood
Affected tissue
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7
Q

T/F:

Often an acute inflammatory response evolves into a chronic one

A

False
Rarely becomes chronic
Main aim is to fix the problem and not let it get worse

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8
Q

What are some negative aspects about inflammation?

A 
•	Acute inflammation:
o	Appendicitis (possibility of perforation due to excessive pus formation)
o	Meningitis (intra-cranial pressure)

• Chronic inflammation:
o Tuberculosis (impairment of lung function)
o Arthritis (incapacitation)
o Initiation of cancer?

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9
Q

List some cells involved in inflammation

A

Neutrophils
Endothelial cells
Macrophages
Fibroblasts

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10
Q

Select the wrong answer:
Neutrophils kill microorganisms
Endothelial cells regulate movement of protein from blood into the tissue
Macrophages degrade fibrin/debris, kill microorganisms and secrete cytokines (regulatory molecules)
Fibroblasts secrete collagen and express adhesion molecules

A

Fibroblasts secrete collagen BUT DON’T EXPRESS ADHESION MOLECULES

Endothelial cells express adhesion molecules to assist neutrophils to pass into cells

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11
Q

Exudate has ___ protein content

A

High

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12
Q

T/F:

Pus occurs all the time

A

False

Occurs sometimes

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13
Q

List the 4 cardinal signs of inflammation

A

Redness
Heat
Swelling
Pain

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14
Q

T/F:
The heat and redness associated with inflammation occurs because of fluid movement from blood into the tissue (exudation)

A

False
Heat and redness occurs due to increased blood flow (hyperaemia or erythema)

Swelling is caused by fluid movement from blood into tissues

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15
Q

Define pus

A

inflammatory exudate containing viable and dead neutrophils, cell debris, viable and dead micro-organisms, protein, lipid, DNA etc

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16
Q

What is supparation?

A

The formation of pus

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17
Q

What is purulent?

A

Consisting/containing/secreting pus

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18
Q

_____ causes heat and redness

A

Hyperaemia

passage of larger than normal volumes of blood through a tissue

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19
Q

T/F:

Hyperaemia is specific to inflammation

A

False

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20
Q

Hyperaemia is needed for the formation of ____

A

exudate

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21
Q

Explain the role of vasodilation during hyperaemia

A

Vasoactive mediators act on the smooth muscle cells of arterioles
Smooth muscle cells relax and the arterioles dilate= vasodilation
Capillaries that were ‘dormant’ now start to carry blood
More blood is now flowing through the microvascular bed and thus the tissue

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22
Q

For exudation to occur, there must be increased _______

A

Vascular permeability

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23
Q

T/F:

Fluid moving from blood into the affected tissue during exudation results in faster blood flow

A

False

Slower blood flow

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24
Q

During mild/moderate acute inflammation, how does exudate move into the tissue?

A

Through inter-endothelial gaps in post-capillary venules only (contraction of endothelial cells)

(immediate/transient AND delayed/prolonged)

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25
Q

During more severe inflammation, how does exudate move into the tissue?

A

Damage to endothelial cells in all microvesels

immediate/prolonged

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26
Q

What are the two forms of pressure acting on the microcirculation?

A

Colloid osmotic pressure= fluid is moving from the interstitial space into the capillary because there is high concentrations of proteins within the capillaries in comparison to the interstitial space

Hydrostatic pressure= blood in arterioles meeds high resistance of capillaries, drives fluid across the endothelial wall from inside to out

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27
Q

T/F:

During normal conditions, there is generally greater hydrostatic pressure in comparison to colloid osmotic pressure

A

False
They are both fairly equal

During acute inflammation there is an imbalance between the two pressures which causes the movement of fluid/protein from the blood into the tissue

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28
Q

List three reasons for exudation

A

The fluid dilutes the toxins and increases the flow into lymphatics

More plasma proteins are brought into the affected area: antibodies, complement system proteins, fibrin system proteins

Brings in more neutrophils which can destroy micro-organisms

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29
Q

Increased blood flow _____ hydrostatic pressure and can result in ______

A

Increases

Exudate (swelling)

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30
Q

Chemotactic mediators results in the _______ which causes ____ or ______

A

results in the recruitment and stimulation of inflammatory cells

Results in acute or chronic inflammation

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31
Q

Vasoactive mediators causes ______ which results in _____

A

Causes increased blood flow and vascular permeability to proteins

Results in exudate

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32
Q

Where does histamine come from and what is its role

A

Comes from mast cells in tissue and platelets in blood

It is a vasoactive mediator (increases vasodilation in arterioles and vascular permeability to post capillary venules)

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33
Q

List two lipid-derived mediators that are pro-inflammatory mediators acting on blood vessels

A

Prostanoids

Leukotrienes

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34
Q

A2 acts on ____ to form ______

A

acts on the membrane phospholipid to form arachidonic acid

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35
Q

____ and ____ act on arachidonic acid to form ___ and ____. This will induce inflammation by acting on blood vessels.

A

Cyclooxygenases and lipoxygenases

Prostanoids and Leukotrienes

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36
Q

How do corticosteroids inhibit inflammation?

A

Inhibit A2 from acting on the phospholipid membrane thus prevents the inflammation pathway

37
Q

What do NSAIDs and Zileuton do?

A

Non-steroidal anti-inflammatory drugs inhibit cyclyoxygenases
Zileuton inhibits lipoxygenases

38
Q

List 3 vasoactive mediators involved in inflammation

A

Histamine
Lipid-derived mediators (prostanoides and leukotrines)
Plasma derived mediators (complement fragments and kinins)

39
Q

List four vasoactive mediators that result in vasodilation (act on arterioles)

A

Histamine
Kinins
Prostaglandin E2
Prostaglandin I2

40
Q

List four vasoactive mediators that result in increased vascular permeability of post capillary venules

A

Histamine
Kinins
C3a, C5a
Leukotrines B4 and C4

41
Q

_____ can increase your sensitivity to pain

A

Prostaglandins

42
Q

What are the two main roles of neutrophils?

A

Kill microorganisms

Release chemotactins to attract other neutrophils and macrophages

43
Q

Where are neutrophils produced?

A

Bone marrow

44
Q

T/F:

Neutrophils reside in tissues

A

False
They are in the blood
They enter tissues when they have been signalled to do so

45
Q

In what order do these reach their maximum?

Oedema, monocytes/macrophages, neutrophils

A

First oedema
Then neutrophils
Then macrophages/monocytes

46
Q

List the main neutrophil events

A 
Margination in small vessels
Emigration from vessel into tissue
Phagocytosis of micro-organisms
Killing of microorganisms
Death of the neutrophil
47
Q

In what stage does rolling, adhesion and emigration occur for neutrophils

A

First stage

Margination in small vessels- adherence to the endothelium

48
Q

How do neutrophils adhere to the endothelium

A

Both neutrophils and endothelial cells express integrins

49
Q

How do neutrophils emigrate from the vessel into the tissue?

A

Follow a chemogradient towards the target tissue

50
Q

How do neutrophils kill microorganisms?

A

Form a phagosome
Phagosome fuses with granulues to form phagolysosome
Granulues released in phagolysosome to kill microorganism
ROS can be directed into phagolysosome

OR
as neutrophils die they release a NET (neutrophil extracellular trap)
- This consists of DNA and anti-microbial proteins attached
- Kills the microorganism

51
Q

T/F:

Neutrophils don’t have ER or ribosomes

A

False

they don’t have ER and golgi apparatus

52
Q

T/F:

Neutrophils are incapable of proliferation

A

True

53
Q

T/F:

Neutrophils are a long lived cell

A

False

Short-lived

54
Q

What are the general roles of macrophages?

A

Kill microrgansisms
Phagocytose debris/microorganisms
Regulate other cells by producing cytokines

55
Q

Where do monocytes originate from?

A

Originate in bone marrow

Become macrophages later

56
Q

T/F:

macrophages are long lived

A

True

can remain in tissues for months or years

57
Q

T/F:

macrophages have a multi lobed nucleus

A

False

Single lobed

58
Q

T/F:

macrophages are incapable of proliferating and differnetiating

A

False

59
Q

What are the three types of cytokine actions?

A

Autocrine
Paracrine
Systemic (endocrine)

60
Q

What is the role of cytokines?

A

Regulating other cells/pathways
Modify activities of cells
Stimulate or inhibit cellular functions

THEY ARE PROTEINS

61
Q

What is the major source of Interleukin 1 and tumour necrosis factor?

A

Macrophages

62
Q

What is over produced when you have arthritis?

A

TNF and IL-1

63
Q

What are some general roles of TNF and IL-1

A

Make T cells proliferate
Make the hypothalamus give you a fever
Increase the expression of adhesion molecules
Cause stem cells to differentiate into leukocytes

64
Q

What does PAMPs and PRRs stand for?

A

Pathogen Associated Molecular Patterns

Pattern Recognition Receptors

65
Q

What do PRRs recognise?

A

PAMPs:
microbial origin
Lipids, carbohydrates, nucleic acids, proteins

DAMPs:

  • Damage associated molecular patterns
  • Released from damaged cells
  • E.g. ATP, RNA, DNA
66
Q

What is the role of PRRs

A

Activate the adaptive immune response
Detect microbial infection
Trigger anti-microbial host defences

67
Q

T/F:

PRRs are part of the adaptive immune response

A

False

Part of the innate immune response

68
Q

Toll-like receptors are a form of ______

A

pattern recognition receptors (PRRs)

69
Q

What are the 5 possible forms of progression of acute inflammation?

A 
Resolution
Organisation
Suppuration
Chronic Inflammation
Longer Term Healing
70
Q

A granuloma is a nodular inflammatory lesion containing mostly -_____

A

macrophages, lymphocytes, fibroblasts

71
Q

What is fibrinogen?

A

Glycoprotein made by the liver

Converted into fibrin by thrombin during coagulation

72
Q

Describe what must happen for outcome 1 to occur- resolution

A 
Mild stimulus
no tissue damage
Little or no fibrin deposition
Fluid drains away through lymphatics
Tissue stabilized quite rapidly
73
Q

Describe acute healing by fibrosis

A

Copious amounts of fibrin are deposited
Macrophages/capillaries/fibroblasts migrate to the area and form granulation tissue

macrophages will then break down the fibrin
Fibroblasts will deposit collagen

74
Q

T/F:

and abcess is superficial and an ulcer is deep

A

False
Ulcer= superficial
Abcess= deep

75
Q

What can be found in pus?

A

Living/dead neutrophils, fluid, plasma proteins, living/dead microorganisms, cell debris, nucleic acids, myeloperoxidase

76
Q

T/F:

Suppuration is almost always a response to viral infection

A

False

Bacterial infection

77
Q

T/F:
Chronic inflammation is inflammation of prolonged duration (weeks to years) in which active inflammation, tissue destruction and tissue repair are proceeding simulatenously

A

True

78
Q

What are the three major types of chronic inflammation?

A

Suppuration (chronic abcess)
Mixed (rheumatoid arthritis)
Granulomatous (tuberculosis)

79
Q

T/F:

Suppuration occurs during chronic granulomatous inflammation

A

False

80
Q

What are some characteristics of chronic inflammatory lesions?

A

Persistent
Cellular infiltration
Destruction of normal tissue
Formation of fibrous connective tissue

81
Q

Describe chronic suppurative inflammation

A

Characterised by neutrophils

Inolves pus

82
Q

Describe an abcess and what is it an example of

A

An example of chronic suppurative inflammation

Collection of pus within a solid tissue

83
Q

What are the three types of chronic granulomatous inflammation

A

Foreign body granuloma
Chronic granulomatous inflammation of unknown origin
Immune type

84
Q

Giant cells, epithelioid cells and difuse fibrosis are characteristics of _____

A

foreign body chronic granulomatous inflammation

85
Q

Epithelioid cells and langhands giant cells are characteristic of _____

A

unknown origin chronic granulomatous inflammation

86
Q

What is the role of a granuloma?

A

To contain a microorganism/irritant in order to prevent its dissemination
Focuses the immune response against the initiating factor

87
Q

What happens when mice are injected with anti-TNF?

A

No granulomas form
Bacteria persist
Mouse death

88
Q

Briefly describe how granulomas form

A

Chemokines recruit monocytes into an area
Cytokines cause monocytes to differentiate into macrophages or epithelioid cells
Cytokines cause epithelioid cells to fuse together to form giant cells
Growth factors recruit fibroblasts and they form fibrous tissue

89
Q

What are some negative aspects of inflammation?

A

Complications of acute inflammation
Chronic inflammation
Systemic inflammation

CPAT (9 decks)

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