Inflammation and Repair

Question 1

Response of vascularized tissues to infections and damaged tissues that brings cells and molecules of host defense from the circulation to the sites where they are needed, in order to eliminate the offending agents.

Answer 1

Inflammation

Question 2

General steps of inflammatory response.

Answer 2

A. Recruitment of leukocytes

B. Regulation of response

C. Recognition of injurious agent

D. Removal of agent E. Resolution

Question 3

Morphologic hallmarks of acute inflammation.

Answer 3

Vasodilation and accumulation of leukocytes and fluid in the extravascular tissue

Question 4

Components of acute inflammation.

Answer 4

1. Dilation of small vessels 2. Increased microvascular permeability 3. Emigration of leukocytes and their activation

Question 5

Most notable mediator that produces vasodilation.

Answer 5

Histamine

Question 6

Most common mechanism of increased microvascular permeability.

Answer 6

Endothelial cell contraction

Question 7

Initial vascular response to injury.

Answer 7

Vasoconstriction

Question 8

An ultrafiltrate of blood, which contains little protein, little or no cellular material, and low specific gravity as a result of osmotic or hydrostatic imbalance across the vessel wall without increase in vascular permeability.

Answer 8

Transudate

Question 9

An extravascular fluid with high protein content; its presence implies an increased vascular permeability, triggered by tissue injury and ongoing inflammatory reaction.

Answer 9

Exudate

Question 10

Steps in leukocyte recruitment.

Answer 10

A. Margination B. Rolling C. Adhesion D. Transmigration

Question 11

The process of leukocyte accumulation at the periphery of blood vessels.

Answer 11

Margination

Question 12

Molecules in the endothelium and leukocyte responsible for rolling.

Answer 12

P and E-selectins on endothelium with Sialyl-Lewis-X on leukocyte; Glycam-1, CD34 on endothelium with L-selectin on leukocyte

Question 13

Molecules responsible for adhesion.

Answer 13

ICAM-1 on endothelium with CD11/CD18 integrins (aka, LFA-1, Mac-1) on leukocyte; VCAM-1 on endothelium with VLA-4 on leukocyte

Question 14

The process of migration of the leukocytes through the endothelium.

Answer 14

Transmigration or diapedesis

Question 15

Molecules in the endothelium responsible for transmigration.

Answer 15

PECAM-1/CD31

Question 16

Process of leukocyte migration toward sites of infection or injury along a chemical gradient.

Answer 16

Chemotaxis

Question 17

Exogenous chemoattractants.

Answer 17

Bacterial products (N-formylmethionine, lipids)

Question 18

Endogenous chemoattractants.

Answer 18

IL-8, C5a, LTB4

Question 19

Type of inflammatory mediators that are normally sequestered in intracellular granules and can be rapidly secreted by granule exocytosis or are synthesized de novo in response to a stimulus; examples: Histamine, Serotonin, Cytokines and Arachidonic acid derivatives

Answer 19

Cell-derived mediators

Question 20

Type of mediators that are produced mainly in the liver and are present in the circulation as inactive precursors that must be activated by proteolytic cleavages to acquire their biologic properties; examples: Complement, coagulation and kinin systems

Answer 20

Plasma-derived mediators

Question 21

Vasoactive amine that results in vasoconstriction; sources include platelets and neuroendocrine cells.

Answer 21

Serotonin

Question 22

Most abundant complement.

Answer 22

C3

Question 23

Complement that acts as an opsonin.

Answer 23

C3b

Question 24

Anaphylatoxins.

Answer 24

C3a, C4a, C5a

Question 25

Membrane attack complex.

Answer 25

C5b, C6-C9

Question 26

Anti-inflammatory cytokines for regulation of the inflammatory response.

Answer 26

Lipoxin, TGF-_, IL-10

Question 27

Inflammatory response of prolonged duration in which inflammation, tissue injury, and attempts at repair coexist, in varying combinations.

Answer 27

Chronic inflammation

Question 28

Two kinds of cells seen in granulomas.

Answer 28

Epithelioid cells (activated macrophages with pink, granular cytoplasm, resembling epithelial cell) and giant cells

Question 29

Type of tissue whose cells can readily regenerate as long as the pool of stem cells is preserved; examples: Bone Marrow, and Vaginal Epithelium

Answer 29

Labile tissues

Question 30

Cells of theses tissues are quiescent and have only minimal replicative activity in their normal state; capable of proliferating in response to injury or loss of tissue mass; examples: Smooth muscles, Endothelium, and Liver Parenchyma

Answer 30

Stable tissues

Question 31

Cells of these tissues are considered to be terminally differentiated and nonproliferative in postnatal life; examples: Neurons, Cardiac muscle

Answer 31

Permanent tissues

Question 32

Type of repair that happens in labile and stable tissues; influenced by growth factors.

Answer 32

Regeneration

Question 33

Type of repair that happens in chronic, severe inflammation, and in permanent tissues.

Answer 33

Connective tissue deposition

Question 34

Steps in healing by connective tissue deposition.

Answer 34

A. Angiogenesis B. Formation of granulation tissue C. Remodeling of the scar

Question 35

Most notable growth factor in angiogenesis.

Answer 35

VEGF

Question 36

Most important cytokine for synthesis and deposition of connective tissue.

Answer 36

TGF-_

Question 37

The pink, soft, granular tissue seen beneath the scab of a skin wound; hallmark of tissue healing; appears by 3-5 days.

Answer 37

Granulation tissue

Question 38

Histologic findings of granulation tissue.

Answer 38

Proliferation of fibroblasts and new, thin-walled, delicate capillaries (angiogenesis) in a loose ECM, often with admixed inflammatory cells, mainly macrophages