Inflammation Flashcards
rubor
redness
calor
heat
dolor
pain
tumor
edema
functio laesa
loss of function
Cardinal signs of acute inflammation
rubor, calor, dolor, tumor, functio laesa
systemic effects of inflammation
fever, weight loss, systemic lymph node enlargement, amyloidosis (protein build up in tissue)
acute inflammation - 3-4 phases
exudative, necrosis, cellular (principally neutrophilic), reparative
chronic inflammation
macrophages and lymphocytes
Function of Inflammation
biologic defense mechanism
exudative phase
hyperemia due to vasodilation and increased vascular permeability (endothelial gaps due to endothelial cell contraction or cytoskeletal reorganization which is long lived but take awhile)
transudate
ultrafiltrate of plasma (clear and watery)
exudate
larger plasma proteins (fibrinogen) and cells (neutrophils)
–> more viscous
What causes vasodilation?
Histamine, nitric oxide, prostaglandins
phases of vascular permeability
early - histamine and bradykinin
later - IL-1, TNF alpha, IFN gamma, hypoxia, leukotrienes (later ones last longer)
**permeability will increase to all of these
hydrothorax
transudate in thorax
True/False: acute inflammation has fibrin?
True
The acute inflammatory response occurs simultaneously with activation of the _________ immune system.
Innate
Classes of Chemical mediators
vasoactive amines, plasma proteins and proteases, AA metabolites, cytokines, NO, ROS
Vasoactive Amines
Histamine, serotonin, bradykinin, tachykinin
4 things of kinins
1) vasodilation 2) increased vascular permeability 3) pain mediators 4) bronchoconstrictors
True/False: Histamine is 10X more potent than bradykinin.
FALSE: Bradykinin is 10X more potent than histamine
Explain Factor XII
this activates either the kinin cascade or the clotting cascade, your clotting and kinin cascade can produce fibrin or plasmin and activate the complement cascade
Arachidonic acid
20 carbon USFA - released by phopholipases, used for biosynthesis of ecosinoids, creates two pathways: cyclooxygenase pathway and lipoxygenase pathway
1) vasodilation 2) vasoconstriction 3) inhibition or promotion of platelet aggregation 4) increased vascular permeability 5) chemotaxis
What are the major cytokines of inflammation?
IL-1 and TNF alpha
Function of Nitric oxide
vasodilation, decrease platelet aggregation, WBC adhesion
True/False: Basophils contain heparin.
False - they contain histamine
Where do Mast cells come from? Basophils?
both from myeloid lineage in the bone marrow
True/Fasle: Mast cells are normally present in CT and not the blood?
TRUE
True/False: Mast cells only contain histamine and not heparin like basophils?
False, they contain both hisamine and heparin
3 roles of mast cells
1) allergic and anaphylactic reactions (receptors for IgE) 2) defense against parasites 3) extracellular matrix remodeling
Upon binding of IgE, what do mast cells release?
histamine, proteases, chemotactic factors
What are the two cytokines released by basophils?
IL-4 and IL-13
Neutrophil facts
born in bone marrow, short lived, do not recirculate, lots of these in dogs, cats, and people
first inflammatory cells recruited to site of insult, mobile, respond to chemotaxis, phagocytize, release mediators of inflammation
differentiate between oxygen independent vs oxygen dependent killing
you know - dependent (ROS), independent (lysozyme, actoferrin, defensins, BPI)
List some cytoplasmic granules from neutrophils…
myeloperoxidase (potent killer of microbes), defensins, lysozyme, lactoferrin, adhesion molecule receptors, enzymes such as proteases
True/False: the H2O2-myeloperoxidase-haylide system is the most efficient bactericidal system in neutrophils.
TRUE
True/False: macrophages are more efficient than neutrophils at killing bacteria?
False, opposite
We see neutrophilia mainly in acute or chronic inflammation?
acute
Left shift
increased bands in neutrophils
degenerative left shift
bone marrow has more immature neutrophils than mature and releases them early
True/False: Neutrophils are the most abundant granulocyte in the circulation.
True
Eosinophil granules contain…
MBP - major basic protein
eosinophilic cationic protein
enzymes
chemical mediators that neutralize heparin and histamine
Eosinophil function…
1) motility 2) kill helminths and other parasites (MBP) 3) participate in allergic reactions 4) phagocytosis (much less effective than PMNs and macrophages)
You’ll commonly see eosinopenia and neutrophilia concurrently usually without left shift, monocytosis, and lymphopenia. Explain this statement in laymens terms.
If you have low eosinophils, you’ll have high neutrophils, high monocytes, and low lymphocytes. This is called the stress leukogram. Common in sick, small animal patients.
Differentiate between monocytes and macrophages.
Macrophages have more cytoplasmic vacuoles, granules. and ingested debris.
Is a macrophage in the blood?
NO, monocytes are, but become macrophages in the tissue
True/False: Macrophages can live in the tissues for months - years and they are capable of division.
TRUE!!
What are the major components of the mononuclear phagocyte system? MPS
Monocytes, Macrophages, Dendritic cells
Hallmark of Granulomatous inflammation
epithelioid macrophages
Multi-nucleated Giant Cells
fusion of macrophages - occur in granulomatous inflammation
3 main functions of macrophages
1) phagocytosis 2) secretion 3) Ag presentation
How do macrophages contribute to the healing process?
they clean up debris at sites of inflammation which neutrophils do not do
A granuloma is caused by this pathogen.
Mycobacterium sp. - agents that resist phagocytosis
The oxygen dependent bacterial killing system by macrophages is carried out by which ROS?
NO
List the 6 Antioxidants found in serum, tissue fluids, and target cells
1) Ceruloplasmin (copper)
2) Transferrin
3) superoxide dismutase
4) catalse (H2O2)
5) glutathione peroxidase
6) Vitamins A, C, and E
Function of Antioxidants
neutralize ROSes
General Characteristics of Lymphocytes
1) limited motility
2) no phago
3) lymphocytes recirculate
YOU ROCK THIS SHIT
YOU ROCK THIS SHIT
Lymphocyte Function
1) secrete cytokines
2) B lymphocytes differentiate into plasma cells (humoral)
3) NK cells and cytotoxic T cells kill certain virus infectious cells
Lymphocytes are present in both subacute, and chronic phase - True/False
True
What are plasma cells?
terminally differentiated B lymphocytes who secrete immunoglobulins
T/F Plasma cells are capable of division.
False
Are plasma cells in acute or chronic inflammation?
Chronic
What are the main chemical mediators of acute phase response?
IL-1 and TNF alpha
Systemic Inflammatory Response Syndrome
1) DIC (disseminated intravascular coagulation)
2) Heart failure
3) lung damage
4) MOF - multiple organ failure
7 signs of Acute Inflammation
1) fever
2) production of acute phase proteins
3) leukocytosis (increase WBC)
4) anemia
5) thrombocytosis
6) cardiovascular changes
7) anorexia and lethargy
Acute phase proteins - function
1) bind microbial wall for opsonization
2) bind to necrotic cell chromatin - aid in debris removal
3) substrate for fibrin production to aid in hemostasis
What are mononuclear cells?
Lymphocytes, plasma cells, macrophages
T/F: Vascular changes and fluid accumulation are not components of chronic inflammation.
True!
fibrosis - acute or chronic
chronic!! acute - fibrinous
What is a major activator of macrophages?
IFN gamma
what is a granuloma?
a focus of chronic inflammation consisting of epithelioid macrophages surrounded by a collar of lymphocytes and plasma cells
