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Goljan High Yield > Inflammation and repair > Flashcards

Inflammation and repair Flashcards

0
Q

Rubor in acute inflammation

+ Calor in acute inflammation

A

Redness - arteriole vasodilation (d/t histamine)

Heat - same as above

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1
Q

Histamine function

A

Key chemical in acute inflammation
Mast cell release
Arteriole vasodilation
Incr venular permeability

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2
Q

Tumor in acute inflammation

A

Swelling; incr vessel permeability

histamine

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3
Q

Dolor in acute inflammation

A

Pain, bradykinin, PGE release

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4
Q

Acute inflammation main cell mediators

A

Neutrophil dominant, Incr in IgM

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5
Q

Initial vessel events in acute inflammation

A

Transient vasoconstriction –> arteriolar vasodilation –> incr venular permeability

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6
Q

Neutrophil margination in acute inflammation:

A

Due to selectins
Integrins –> neutrophil adhesion molecules;

C5a and LTB4 activate –> neutrophil margination
CD11/CD18 - are markers for integrins

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7
Q

Endothelial cell adhesion molecules are activated by:

A

Activated by IL1 and TNF

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8
Q

ICAM

VCAM

A

Intercellular adhesion molecule

vascular cell adhesion molecule

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9
Q

Leukocyte adhesion molecule defect

A

Failure of umbilical cord to separate

- poor wound healing

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10
Q

Causes of Decr activation of neutrophil adhesion molecules

Causes of Incr activation of neutrophil adhesion molecules

A

Neutrophillic leukocytosis; corticosteroids

neutropenia; endotoxins

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11
Q

Chemotaxis directed by

A

Movement directed by C5a and LTB4

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12
Q

Opsonising agents

A

IgG, C3b –> enhance phagocytosis

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13
Q

Neutrophils, monocytes, macrophages have receptors for:

A

IgG, C3b

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14
Q

O2 dependent MPO system

A

Most potent microbicidal system –> in neutrophils and monocytes.

Produces superoxide from O2 via NADPH oxidase with NADPH cofactor; produces respiratory burst

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15
Q

Test for respiratory burst:

Enzyme which converts superoxide to peroxide

A 
Nitroblue tetrazolium (NBT)
Superoxide dysmutase
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16
Q

Chronic granulomatous disease

A

Absent NADPH oxidase –> no respiratory burst
Staphylococcus aureus is NOT killed (catalase positive)
Streptococcus killed (catalase Negative)

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17
Q

Genetic Microbicidal defects:

A

Chronic granulomatous disease of childhood (XR)

Myeloperoxidase deficiency (AR)

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18
Q

Myeloperoxidase

A

Lysosomal enzyme that combines peroxide + Cl to form bleach (HOCl)

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19
Q

Genetic Opsonisation defect:

Phagocytosis defect:

A

Bruton’s agammaglobulinaemia (XR, decr IgG)

Chediak-Higashi - Membrane protein defect in transfering lysosomal enzymes to phagocytic vacuoles. AR and giant lysosomes. also has defect in microtubule polymerisation

20
Q

Actions of Cytokines:

  • PGE2
  • PGI2
  • NO
  • IL1 and TNF
  • IL6
A
  • PGE2 - vasodilation, fever
  • PGI2 - vasodilation, prevent platelet aggregation
  • NO - vasodilator, FR gas from conversion of arginine to citrulline
  • IL1 and TNF - fever, synthesis of acute phase reactants in liver, leukocytosis
  • IL6 - stimulated by IL1, stimulates synthesis of APR
21
Q

Acute phase reactants:

A

Fibrinogen, ferritin, C-reactive protein

22
Q

Bradykinin function

A

Kinin produced in conversion of factor XII to factor XI

mediates pain, vasodilation;
incr vessel permeability,

Iatrogenic association: cough/angioedema ACE inhibitors.

23
Q

Anaphylatoxins

A

C3a and C5a. directly stimulate mast cell release of histamine

24
Q

Prostaglandin I1

A

Synthesised by endothelial cells
Vasodilator
Inhibits platelet aggregation

25
Q

Lipoxygenase pathway
Which drug inhibits lipoxygenase?
Which drugs block lipoxygenase receptor?

A
  • hydroxylation of arachidonic acid pathway
  • Zileuton
  • Zafirlukast, montelukast
26
Q

Effect of LTC4, D4, E4

A

bronchoconstriction

27
Q

Thromboxane A2 function

A

Synthesised by platelets;

Effects: platelet aggregation, vasoconstriction, bronchoconstriction

28
Q

Corticosteroid actions:

A
  • inhibits phospholipase A2
  • inhibits activation of neutrophil adhesion molecules
  • neutrophilic leukocytosis, lymphopenia, eosinopenia
29
Q

Fever effect on body

A

Right shift OBC

- hostile to bacterial/viral replication

30
Q

Pseudomembranous inflammation

A

Toxins from Corynebacterium diptheriae, clostridium difficile

31
Q

Cellulitis pathology

A

Subcutaneous inflammation

- strep pyogenes (hyaluronidase)

32
Q

Suppurative inflammation example:

A

Abscess formation

- staphylococcus aureus (coagulase)

33
Q

Chronic inflammation

A

Monocyte/macrophage mediated
Incr IgG
Repair by fibrosis

34
Q

Granuloma formation pathology

A

Cellular immunity; macrophages interact with Th1 cells - memory cells

35
Q

Collagen fibres function

- types of collagen

A

Triple helix of cross-linked alpha chains.
Cross links at points of hydroxylation – to increase tensile strength
Type 1 collagen: bones, tendons
Type 2: Cartilage
Type 3: Early wound repair (everything else)
Type 4: Basement membrane
Type X: epiphyseal plate

36
Q

Cell cycle key checkpoint

Action of TP53 and RB suppressor gene
Action of BAX gene

A

Key checkpoint from G1 to S phase

  • arrests cell in G1 phase for DNA repair or apoptosis
  • stimulates apoptosis. Is activated by TP53 if too much DNA damage
37
Q

Extracellular matrix formed by:

Complete restoration possible in cells which are:

Scar tissue:

A
  • Basement membrane, interstitial matrix
  • cell capable of duplication, no damage to basement membrane
  • end product of repair by connective tissue
38
Q

Define:
Laminin
Fibronectin
Keloid

A
  • Key basement membrane glycoprotein
  • Key interstitial matrix glycoprotein
  • Excessive type III collagen - common in blacks
39
Q

Angiogenesis in wound repair

Key events in wound repair

A
  • basic fibroblast growth factor + vascular endothelial growth factor
  • Key event: Granulation tissue formation - fibronectin is responsible. BECOMES SCAR TISSUE
40
Q

% normal tensile strength of a healed wound

A

80

41
Q

Inhibition of wound healing (factors):

A

Infection (MCC S.aureus)
Zinc deficiency
DM

42
Q

Ehlers-Danlos syndrome

A

Defects in collagen synthesis and structure; hyperelasticity

43
Q

Scurvy

A

Decr collagen tensile strencth by decreasing cross-links at points of hydroxylation

44
Q

Pyogenic granuloma

A

Exuberant granulation tissue - bleeds when touched

45
Q

Healing by primary intention:

Healing by secondary intention:

A

Clean wound –> appose wound margins with suture

Infected wound - leave wound open –> myofibroblasts are important in healing defect

46
Q

HEALING in liver injury:

  • Lung injury
  • CNS injury
A
  • regenerative nodules; abnormal cytoarchitecture
  • type II pneumocyte repair cell
  • astrocyte and microglial cell repairs cells –> gliosis
47
Q

WBC alterations in acute inflammation:

Effects of ESR
Function of CRP

A

Neutrophilic leukocytosis, left shifts the curve, toxic granulation

  • increased fibrinogen enhances rouleau
  • indicator of acute inflammation and inflammatory atheromatous plaque.
48
Q

Polyclonal gammopathy

A

Diffuse elevation of gamma-globulins

  • Incr IgG
  • chronic inflammation

Goljan High Yield (3 decks)

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