Inflammation Flashcards
Is a sistemic and local reaction of tissues and microcirculation to a pathogenic insult
inflammation
Mention the 5 key signs of inflammation
Heat Pain Redness Swelling Fuctio Laesa
When the 4 key signs of inflammation combined, that produces a
Temporary loss of function (Functio Laesa)
Goals of inflammation are
Respond to stimuli Restore balance Eliminate the cause Clearing out necrotic cells Tissue repair
Types of trigger factors of inflammation
External or internal factors
Types of external trigger factors of inflammation
Non microbial
Microbial
What are the non microbial external factors of inflammation?
Allergens
Irritants
Toxins
What are the microbial external factors of inflammation?
Virulence factors
PAMPs
PAMPs
Pathogen Associated Molecular Patterns
Help pathogen to colonize tissues and cause and infection
virulence factors
Are recognized by our inmune system and trigger and inflammatory response
PAMPs and DAMPs
DAMPs
Damage Associated Molecular Paterns
DAMPs released when
plasma membrane injured or cell dies
PAMPs and DAMPs are recognized by PRRs as ____ and activate the inflammatory response
Toll Like Receptors (TLRs)
PAMPs could be
Polysaccharide
Peptidoglycan
RNA segment
DAMPs appears when the cell is in
danger
Characteristics of PRRs
Activate cell
Spark inflammatory response
Non specific
Types of leukocytes
Granulocytes
Agranulocytes
Mention the granulocytes
Neutrophil
Eosinophil
Basophil
Mast cells
Mention the agranulocytes
Monocyte
Lymphocyte
Mention the monocytes
Macrophages
Dendritic cells
Are the first cells who phagocyte the pathogens
Neutrophils
Control mechanisms associated with allergy
Eosinophil
Basophils contain
histamine and heparin
Granulocytes that secrete an antibody
Lymphocyte
Eat a pathogen and present to T lymphocyte to activate the adaptive inmune system
Dendritic cells
Granules has inflammatory mediators which are
Histamine
Serotonin
Cytokines
Eicosanoids
Which are the eicosanoids?
Prostaglandins
Leukotrienes
Describe the process of inflammation
The tissue got injured
Macrophages phagocyte the pathogen
The endothelial cells separate and the vascular permeability increased and there is a vasodilation
Vasodilation is produced by an increased in
Nitric oxide
Is when the macrophage squeeze him between endothelium cells and arrive to injured tissue
Extravasation
Complement system are activated in presence of
pathogens
Function of complement system
Attract leukocytes
Help with opsonization
Kill pathogens
In tissue repair growth factors released to _____
angiogenesis
Synthesize collagen and helps with wound healing
Fibroblasts
Is the creation of new blood vessels
Angiogenesis
What happen after the neutrophil phagocyte the pathogen?
the neutrophil die by itself (like suicide)
Mention the 4 steps for the modulation of inflammatory response
- Initiation
- Amplification
- Destruction
- Termination
Is the step for the modulation of inflammatory response where cells are released by trigger factors and circulate inflammatory cells producing an acute inflammation
Initiation
Cells which are released to an inflammatory response
Cytokines
Chemokines
Platelets
Neutrophils
Is the step for the modulation of inflammatory response where leukocytes and macrophages are released to continue the inflammation. Also the system of complement is active
Amplification
Is the step for the modulation of inflammatory response where the enzymatic digestion, phagocytosis and damaged tissue is removed
Destruction
Is the step for the modulation of inflammatory response where the damage to normal cells is prevent
Termination
Principle which explains the pression between extravascular and intravascular space
Starling principle
Components of the Starling Principle
Hydrostatic pressure
Oncotic pressure
Osmotic pressure
Lymph flow
Accumulation of fluid in the extravascular space and interstitial tissues
Edema
Types of edema
Non inflammatory edema
Inflammatory edema
Types of non inflammatory edema
Lymphedema
Thrombosis
Type of edema which disrupt the lymphatic flow
Lymphedema
Obstruction of venous outflow
Thrombosis
Characteristics of an inflammatory edema (triple response)
Transient vasoconstriction of arterioles
Vasodilation of precapillary arterioles
Increase in endothelial cells barriers permeability
Accumulation of fluid in some body spaces
Effusion
Types of effusion
Transudative
Exudative
Effusion that occurs due to increased hydrostatic pressure or low plasma oncotic pressure
Transudative
Effusion that occurs due to inflammation and increased capillary permeability
Exudative
Difference between transudative and exudative
Transudative–>low in protein and LDH
Exudative–>high in protein and LDH
If we have 1 or more of this 3 criteria is an exudate
Serum protein >0.5
Serum LDH >0.6
LDH > 2/3 upper limit normal for serum
Types of exudate
Serous exudate
Serosanguineous
Fibrinous exudate
Suppurative inflammation
Inflammation purulent exudate with significant liquefactive necrosis
suppurative inflammation
Exudate with large amounts of fibrins due to inflammation
Fibrinous exudate
Exudate with an infusion with blood
Serosanguineous
Exudate color white with yelow
Serous exudate
Factor XII is also known as
Hageman Factor
Function of factor XII
Converts plasminogen to plasmic
Activate the Kallikrein
Activation of Coagulation System
There are 2 routes to synthesize arachidonic acid
Phosphatidylcholine
Phosphatidylinositol-P2
Etiology of chronic inflammation
Failure of eliminating
Exposure to irritants
Autoimmune disorder
Oxydative stress
Risk factors associated with chronic inflammation
Age Obesity Diet Smoking Low sex hormones Stress and sleep disorders
Management for chronic inflammation
Low glycemic diet Metformine Reduce intake of fats Statins NSAIDs Corticosteroids
Could the NSAIDs be used in every inflammatory process? Why?
No, because they can interfere delay with the healing process
Which could be the consequences of using NSAIDs during an inflammatory process?
Production of prostaglandins
Increase local blood flow and vascular permeability
The _______ phase is an important part of healing and, without it, healing would not occur
inflammatory
Do NSAIDs interfere with healing?
Yes, inhibiting the COX
When the COX is inhibited, we are also blocking the production of
prostaglandin
NSAIDs have a _____ effect on wound healing
depressant
When do we have to use cold therapy?
Accute pain
Why do we use cold therapy in the first 48 hrs?
To reduce blood flow and slow inflammation
Decrease swelling and pain
When do we have to use heat therapy?
Chronic pain
Why do we use heat therapy for chronic pain?
Will dilate the blood vessels, Promote blood flow
Ice therapy is most effective when applied early and frequently during the first ____ after an acute injury
48 hrs
Cold therapy should not be used for a chronic injury because it can increase
stifness
Is a disorder that causes immunodeficiency, resulting in recurrent bacterial and fungal infections. This patient have granulomas in various tissues
Granulomatous Disease
Pathophysiology of GD
Inability to phagocytes kill microbes caused by several defects in NADPH
Most patients of GD are males who has mutations on the gene coding for
gp91phox
Patients with GD are susceptible to _____ organisms
catalase-positive
Collections of immune cells that cluster when the can’t kill pathogens
granulomas
Mention 2 classical mutations in GD in genes for NADPH oxidase
Autosomal recessive
X-linked recessive
Mention the 2 pathways of arachidonic acid
Cyclooxigenase pathway
5-lipooxygenase pathway
COX1 and COX2 produce
Prostaglandin E2 (PGE2) Prostaciclin (PGI2)
Pathophysiology of Rheumatoid Arthritis
Hyperplasia of synovial membrane
____ and ____ stimulate the expresión of adhesion molecules on endothelial cells and increase the recruitment of neutrophils into the joint is RA
IL-1
TNF-a
Neutrophils release ____ and ____ which degrade proteoglycan in the superficial layer of cartilage in RA
elastase and proteases
Chronic autoimmune inflammatory disease that results in progressive destruction of articular cartilage
Rheumatoid Arthritis
Mention the autoantibodies that produce RA
Rheumatoid factor (RF) Anti CCP
In RA, T cells stimulate B and secrete cytokines such as _______ and macrophages such as ____ which are pro inflammatory cells
INF gamma and IL-17
IL-1 and IL-6