Inflammation: Acute and Chronic

Question 1

Neutrophil

Answer 1

Phase: Acute
Primary function: Acute Inflammatory Response, Phagocytose bacteria and tissue debris
Damage bugs (and tissue)

Question 2

Monocyte/Macrophage

Answer 2

Phase: Chronic

Some native within tissue: sentinel cells
Phagocytize/neutralize/degrade injurious agents
Regulate inflammatory/immune response
Regulate coagulation/fibrinolytic paths
Initiate repair phase

Question 3

Lymphocyte

Answer 3

Phase: Chronic

Native: sentinel cells

Question 4

Eiosinophil

Answer 4

Phase: Chronic

Function: Some native within tissue: sentinel cells
Type-1 hypersensitivity mediator
Infection defense: parasites
Phagocytosis capability

Question 5

Mast Cell/Basophil

Answer 5

Phase: Chronic

Function: Type-1 hypersensitivity mediator
Some native within tissue: sentinel cells
Binds IgE molecules

Question 6

Acute Inflammation Phase

Answer 6

Cells Involved: Neutrophils

Vascular changes: Vasodilation/increased bloodflow–>redness/erythema (rubor) and warmth (calor)

Fluid changes: Swelling, Increased permeability (transudate and exudate)

Repair changes: N/A, repair is stimulated by chronic inflammation

Question 7

Chronic Inflammation Phase

Answer 7

Cells involved: Macrophages, Lymphocytes, Plasma cells

Vascular changes: Endothelial cell proliferation–> neovascularization

Fluid changes: Variable persistance of “leakiness”

Repair changes: Repair is stimulated by chronic inflammation

Question 8

Repair Phase

Answer 8

Cells involved: Fibroblasts, Macrophases, endothelial cells, epithelial cells/hepatocytes

Vascular changes: Neovascularization from chronic inflammation, re-epithelialization

Fluid changes:

Repair changes: Formation of scar, fibroblasts in background with lots of collagen fibers

Question 9

Transudate

Answer 9

Mostly fluid, little protein, no cells

Question 10

Platelet

Answer 10

Phase: Chronic

Function: Thrombosis–> promotion of clot formation
Permeability regulation
Stimulate proliferation of mesenchymal cells

Question 11

Exudate

Answer 11

Fluid, Proteins (fibrinogen, immunoglobulin, complement), Cells: leukocytes

Question 12

Collateral damage

Answer 12

Damage to normal tissue is a common outcome in the setting of an inflammatory process, via neutrophils and macrophages (ie, both acute and chronic)

Acute examples: Asthma, Septic shock, acute necrotizing bronchopneumonia

Chronic examples: Arthritis, asthma, astherosclerosis, pulmonary fibrosis

Question 13

Describe the acute phase response to inflammation

Answer 13

Early defense system
Initiation: inflammatory cells->inflammatory mediator–> activation of system

Goals:

general: prevent/limit infection/injury
local: initiate inflammation, inactivate and clear pathogens
systemic: activate systemic defenses

Question 14

Organ that produces various proteins for acute phase response

Answer 14

Liver

Question 15

Chemical mediators of acute phase response

Answer 15

IL-1, TNF, Interferons

Question 16

Acute phase response protein that is measured as a marker of systemic response to inflammation

Answer 16

C-reactive protein

Question 17

Clinical examination findings that would suggest an ongoing inflammatory process.

Answer 17

Local:
Rubor
Calor
Swelling
Pain
Foss of function

Systemic:
Fever, fatigue, anorexia, sleepiness

Question 18

Laboratory assessments supporting the hypothesis of an inflammatory process

Answer 18

CBC,

C-reactive protein, erythrocyte sedimentation rate,

DIC-related marker: Fibrin-split products/degradation products, platelet count

Microbiology and Immunology:
Rapid ID testing: strep, cryptococcus, some viruses
Culture(antibiotic/antifungal)
Serology: IgM (acute) vs IgG (chronic) antibodies

Immunoglobulin quantitation