Inflammation and Repair

Question 1

Four cardinal signs of inflammation

Answer 1

Rubor (redness), Calor (heat), Tumor (swelling), Dolor (pain)

Question 2

Characteristic cells of chronic inflammation

Answer 2

Lymphocytes, plasma cells, and macrophages

Question 3

Chracteristic cells of acute inflammation

Answer 3

Platelets and neutrophils (PMNs)

Question 4

How do arterioles react early in injury?

Answer 4

Transient vasoconstriction followed by vasodilation (hyperemia)

Question 5

What is the primary site at which vasoactive mediators induce endothelial changes?

Answer 5

The post-capillary venule

Question 6

Effusion

Answer 6

Excess fluid in cavities of the body

Question 7

Difference between transudate and exudate

Answer 7

Transudate - low protein content (sg lt 1.015), exudate - high protein content (sg gt 1.015)

Question 8

Give two classes of drugs that inhibit arachidonic acid metabolism

Answer 8

Corticosteroids and NSAIDs

Question 9

How might corticosteroids inhibit arachidonic acid metabolism?

Answer 9

Induction of lipocortin, which inhibits PLA2, thus reducing generation of arachidonic acid

Question 10

Platelet adherence, aggregation, and degranulation occurs when platelets come in contact with what?

Answer 10

Exposed collagen or thrombin

Question 11

Platelet degranulation leads to release of what and what does it do (in this instance)?

Answer 11

Serotonin, a vasoactive mediator of acute inflammation

Question 12

What stimulates histamine release from mast cells?

Answer 12

Anaphylatoxins (eg C3a and C5a)

Question 13

The most important vasoactive mediators produced by endothelial cells

Answer 13

PGI2, NO, Endothelin

Question 14

What causes endothelial cells to secrete increased amounts of procoagulant tissue factor?

Answer 14

Lipopolysaccharide or specific cytokines (e.g. IL-1)

Question 15

How else is prostacyclin written?

Answer 15

PGI2

Question 16

What is arachidonic acid generated from and by what enzyme?

Answer 16

Generated from Phosphatidyl Choline by Phospholipase A2

Question 17

What regulator of vascular permeability do monocytes and macrophages secrete?

Answer 17

Platelet-activating factor (PAF)

Question 18

What activates Hageman Factor (Factor 12)?

Answer 18

Negatively charged surfaces (e.g. basement membranes), proteolytic enzymes, and bacterial lipopolysaccharide

Question 19

What does Hageman activate?

Answer 19

Plasma kallikreins (e.g. bradykinin)

Question 20

What complex is formed by activation of the complement system?

Answer 20

The Membrane Attack Complex

Question 21

What are the pathways which activate the complement system?

Answer 21

Classical, alternative, and high-mannos

Question 22

What triggers the classical complement pathway?

Answer 22

Binding of C1 complex proteins to immune complexes

Question 23

What effects do anaphylatoxins have on smooth muscle and vasculature?

Answer 23

Enhancement of smooth muscle contraction and increase in vascular permeability

Question 24

Opsonization

Answer 24

Process by which a specific molecule binds to the surface of a bacterium

Question 25

What is the purpose of opsonization

Answer 25

Enhances phagocytosis by coating target with an opsonin

Question 26

What are the three mechanisms by which leukocytes accrue at site of injury and what protein moderates each?

Answer 26

Margination (selectins), Emigration (integrins), Chemotaxis (C5a, Chemokines, Bacterial and Mitochondrial products)

Question 27

Examples of things that PMN receptors can bind

Answer 27

Fc portion of IgG and IgM, Complement components, Arachidonic acid metabolites, Chemotactic factors

Question 28

Three reactive oxygen metabolites which are used to kill phagocytosed bacteria

Answer 28

Superoxide anion, Hydrogen peroxide, Hypochlorus acid

Question 29

Oxygen-independent methods for killing phagocytosed bacteria

Answer 29

Lysosomal hydrolases, bactericicdal/permeability-increasing protein, defensins, lysozyme

Question 30

What type of cell responds specifically to parasitic infections and what other type of reaction is it found in?

Answer 30

Eosinophils. Also found in allergic reactions

Question 31

In what types of event is a chronic inflammatory response the first response (ie no acute inflammatory response)

Answer 31

Viral infections, automimmune disease, malignant tumors

Question 32

Principle cells of granulmous inflammation

Answer 32

Macrophages and lymphocytes

Question 33

Three types of granulomas

Answer 33

Foreign body giant granulomas, allergic granulomas, caseous granulomas (tb)

Question 34

Leukocytosis

Answer 34

Increase in number of circulating leukocytes, commonly accompanies acute inflammation

Question 35

Leukopenia

Answer 35

Decrease in circulating white cell count

Question 36

Characteristics of acute phase response

Answer 36

Fever, leukocytosis, decreased appetite, change in levels of acute phase proteins (eg C-reactive protein)

Question 37

What does granulation tissue consist of?

Answer 37

Fibroblasts, myofibroblasts, macrophages, and proliferating capillaries (endothelial cells)

Question 38

How long after injury does vascular proliferation start?

Answer 38

48 to 72 hours

Question 39

What is the rule of thumb for wound strength?

Answer 39

2 weeks = 20% strength

Question 40

What is the predominant collagen found in mature scars?

Answer 40

Type I

Question 41

Why is wound healing inadequate in scurvy?

Answer 41

Because collagen hydroxylation requires vitamin C

Question 42

What type of cell mediates wound contraction

Answer 42

Myofibroblast

Question 43

What protein present in clots can be cross-linked to bridge clots with tissues?

Answer 43

Plasma fibronectin

Question 44

Scar formation following spinal cord injury, which can prevent axon regeneration, is mediated largely by what type of cell?

Answer 44

Vascular pericytes

Question 45

Primary intention

Answer 45

Healing of wounds with apposed edges

Question 46

Secondary Intention

Answer 46

Healing of wounds without apposed edges