Inflammation and Repair (P) Flashcards
What is inflammation?
1) It refers to the body’s process of fighting against things that harm it (ex. infections, injuries, and toxins in attempt to heal itself)
2) It is the local response of a living tissue vascularized to any injurious agent
What are the characteristics of inflammation?
1) It is non-specific
2) It usually promotes healing
What are the types of inflammation?
1) Acute inflammation
2) Chronic inflammation
Answer the ff questions in connection w/ acute inflammation:
1) When is its onset?
2) What are the cells involved?
3) What are the characteristics of tissue injury?
4) What are the signs (local & systemic)?
1) Rapid (mins / hrs)
2) PMNs / neutrophils
3) Mild and self-limited
4) Very prominent
Answer the ff questions in connection w/ chronic inflammation:
1) When is its onset?
2) What are the cells involved?
3) What are the characteristics of tissue injury?
4) What are the signs (local & systemic)?
1) Slow (days)
2) Lymphocytes, monocytes, and macrophages
3) Severe and progressive in nature
4) Less prominent
What is the Latin word where the word inflammation is derived from?
Inflammare
What is the meaning of inflammare?
To set on fire
Who is Celsus?
He is a roman writer in the 1st century A.D.
What is the contribution of Celsus?
He listed the 4 signs of inflammation
What did Celsus said?
“Rubor et tumor cum calore et dolore”
What are the 4 signs of inflammation listed by Celsus?
1) Rubor
2) Tumor
3) Calor
4) Dolor
What is the meaning of rubor?
Redness
What is the meaning of tumor?
Swelling
What is the meaning of calor?
Heat
What is the meaning of dolor?
Pain
What is the 5th sign of inflammation?
Functio leasa / loss of fxn
The 5th sign of inflammation is added by whom?
Rudolf Virchow
When did Virchow added the 5th sign of inflammation?
19th century
What is the nationality and profession of John Hunter?
He is a Scottish surgeon
What did Hunter said?
“Inflammation is not a disease but just a response”
When did Hunter said that “Inflammation is not a disease but just a response”?
1793
What is the nationality and profession of Elie Metchinkoff?
He is a Russian zoologist
What is the contribution of Metchinkoff?
He discovered the process of phagocytosis
When did Metchinkoff discovered the process of phagocytosis?
1880s
What is acute inflammation?
It is the rapid onset and occurs in a short duration w/c usually lasts for a few hrs / few days
What are the microscopic features of acute inflammation?
1) Protein
2) Fluid rich exudate
What are the 4 major purposes of acute inflammation?
1) Eliminate the injurious agent
2) To prevent the spread of the injurious agent
3) To remove necrotic cells and tissues
4) Initiate the repairing process
What are the hallmarks of acute inflammation?
1) Redness
2) Pain
3) Swelling
4) Warmth
What are the 2 events that comprises acute inflammation?
1) Vascular events
2) Cellular events
Where do vascular events occur?
1) Blood vessels
2) Lymphatics
What are the 2 phases in vascular events of blood vessels?
1) Increase in blood flow at the site of inflammation
2) Increase in vascular permeability
Cellular events are generated by what?
Leukocytes
What are the 3 steps that comprises cellular events?
1) Recruitment of the leukocytes to the site of inflammation from blood
2) Recognition of the offending agent
3) Removal of the offending agent
What are the 3 steps of the step of recruitment of the leukocytes to the site of inflammation from blood?
1) Adhesion of leukocytes to the endothelium
2) Transmigration (diapedesis) of leukocytes into the interstitium
3) Chemotaxis of leukocytes towards the site of inflammation in the interstitial fluid
What must be done in the step of recognition of the offending agent?
Leukocytes must be activated
What are the receptors that are present for the step of recognition of the offending agent?
1) Toll-like receptors
2) GPCR
3) Bacterial products
4) Receptors for opsonins
5) Receptors for cytokines
What are the fxns of toll-like receptors?
These recognizes:
1) Bacterial lipopolysaccharides
2) Bacterial proteoglycans
3) dsRNA (viruses)
What are the fxns of GPCR?
It recognizes:
1) Prostaglandins
2) PLT activating factors
3) Leukotriens
What is the ex of bacterial products (w/c acts as receptor)?
Bacterial peptides
What is the fxn of receptors for opsonins?
These recognize protein w/c *cope microbes (Abs, complement proteins, and lectins)
What are the exs of receptors for cytokines?
1) Microbes
2) IFN-gamma
What are the ways / processes of removing the offending agent?
1) Phagocytosis
2) Intracellular killing
True or False
Leukocytes have several types of receptors to engulf the offending agent
True
What are the types of receptors that the leukocytes have w/c aids / serves to engulf the offending agent?
1) Mannose receptors
2) Scavengers receptor
3) Receptors for opsonin
When the injurious agent is removed, what should be done to the acute inflammatory response?
The acute inflammatory response should terminate
True or False
There are no factors that contribute to cease the inflammatory response (in acute inflammation)
False, because there are several factors that contribute to cease the inflammatory response (in acute inflammation)
In acute inflammation, when the offending agent is eliminated, what happens to the stimulus for acute inflammation?
The stimulus for acute inflammation no longer persist
True or False
The mediators of acute inflammation have long half lives
False, because the mediators of acute inflammation have short half lives
What is the lifespan of neutrophil after leaving the circulation?
Neutrophil live a short duration
*What are the concepts that happen (in connection to mediators of acute inflammation)?
1) Switch of pro inflammatory leukotriens into anti inflammatory lipoxins
2) Liberation of anti-inflammatory cytokine (TGF and IL-10)
3) Production of anti-inflammatory lipid mediators (protectins)
4) Presence of neural impulses
What are the characteristics of exudate?
1) It is present due to increase vascular permeability
2) It has a high protein content
3) It has a high neutrophil content and it is rich in cellular debris
4) It has a high SG
5) It clinically causes as non-pitting edema
What are the characteristics of transudate?
1) It is present due to an imbalance of the hydrostatic and osmotic forces bet the vessels in the interstitial fluid
2) It has a low protein content
3) It has little / no cellular mat at all
4) It has a low SG
5) It is clinically expressed as pitting edema
What is chronic inflammation?
It is a type of inflammation of prolonged duration often for mos, yrs, or even indefinitely
The prolonged course of chronic inflammation is proved by what?
By persistence of the causative agent in the tissues
In chronic inflammation, often the persistent inflammatory changes are combined w/ what?
Combined w/ attempts at healing
What are the 2 major characteristics of chronic inflammation?
1) Ongoing tissue destruction is present
* 2) Attempts at repair by fibrosis (w/ or w/out regeneration of the cell depends on the tissue involved)
What is the other characteristic of chronic inflammation?
1) It may develop soon after an acute inflammatory response
2) It may be insidious in onset
*What are the causes of chronic inflammation?
1) Persistent in infections
2) Persistent in indigestible mat
3) Immune mediated rxns
4) Following an acute inflammatory response
5) Repeated episodes of acute inflammation
What are the principles of persistent in infections (as a cause of chronic inflammation)?
1) Some organisms may be difficult to be eradicated from our body
2) They may persist within cells or tissues for a longer period of time
What are the exs infections that are persistent?
1) MTB w/c causes TB
2) Mycobacterium leprae w/c causes leprosy
3) Treponema pallidum w/c causes syphilis
*What are the 2 types of the cause of chronic inflammation w/c is persistent in indigestible mat?
1) Endogenous
2) Exogenous
What are the exs of endogenous mats (w/c are persistent in indigestible mat)?
1) Necrotic bone
2) Adipose tissue
3) Calcium
4) Uric deposits
What are the exs of exogenous mats (w/c are persistent in indigestible mat)?
1) Silica
2) Asbestos fibers
3) Suture mat
*What are the exs of immune mediated rxns (as a cause of chronic inflammation)?
1) Autoimmune rxns
2) Organ transplant rejections
3) Unregulated immune responses against a particular organism
4) Hypersensitivity rxns
What is the principle of autoimmune rxns?
It is where an immune response that occur is against our own body Ags
What are the exs of autoimmune disorders that causes autoimmune rxns?
1) RA
2) SLE
3) Hashimoto’s thyroiditis
4) Chronic autoimmune gastritis
What is the principle of organ transplant rejections?
It is where the immune response occur against the Ags of the donor organ
*What are the exs of unregulated immune responses against a particular organism?
1) Inflammatory bowel disease
2) Ulcerative colitis
What principle is present in inflammatory bowel disease?
Unregulated immune response to certain commensal bacteria
What are hypersensitivity rxns?
These are inappropriate responses to a generally harmless Ag
*What are the exs (conditions / disorders) w/c can cause hypersensitivity rxns?
1) Chronic bronchial asthma
2) Hypersensitivity pneumonitis
What is the type of hypersensitivity rxn present in chronic bronchial asthma and what is the action of this hypersensitivity rxn?
Type 1 hypersensitivity rxn against various inhaled Ags
What is the type of hypersensitivity rxn present hypersensitivity pneumonitis?
Type 3 hypersensitivity rxn
Persistent abscesses are usually formed during what?
Acute inflammation
What happens to acute inflammatory abscess if it cannot be drained out either via surgically or spontaneously?
It becomes a chronic abscess
Repeated attacks of acute pancreatitis such as in chronic alcohol abusers can cause what?
Development of chronic pancreatitis
Repeated attacks of acute cholecystitis such as in pts w/ gallstone disease can develop to what?
Chronic cholecystitis
What are the macroscopic features present in chronic inflammation due to tissue destruction includes what?
1) Involvement of an epithelial surface may result in the formation of ulcer
2) Parenchymal tissue chronic inflammation may give rise to cavitatory lesions
3) Formation of chronic abscess
4) Formation of sinus
5) Formation of fistula
What are the macroscopic features that are present due to fibrosis in chronic inflammation?
1) In hollow organs, the thickening of the wall such as in chronic gallstone disease
2) Distortion of the organ when fibrous tissue tends to contract due to the presence of myofibroblasts. The main goal of this contraction is to reduce the size of the scar
What are the microscopic features that are present in chronic inflammation?
1) Mononuclear cell infiltration can be seen
2) Tissue necrosis
3) Tissue regeneration
4) Granulation and fibrous tissue
5) Granulomatous inflammation (there may be multinucleated giant cells)
What is granulomatous inflammation?
It is a special type of chronic inflammation w/c is commonly seen in TB
What are the processes in healing?
1) Resolution
2) Regeneration
3) Repair
What is resolution?
1) It is the process of the scavenging of dead tissue and foreign mat by macrophages
2) It is a preliminary to regeneration and repair
What is regeneration?
It is the replacement of lost and dead tissue by tissue similar in type
When do regeneration only occur?
It only occurs when surviving cells of a tissue are capable of cell division
What are the exs of tissues that are capable of regeneration?
1) Epithelial surfaces (ex. epidermis of the skin)
2) Blood capillaries
3) Some supporting tissue (ex. bone)
What is repair?
It is the replacement of lost and dead tissue by tissue of a diff type, usually fibrous tissue
True or False
Healing by repair is inevitable in some tissues when cells are lost (ex. muscle and nerve cells) w/c cannot regenerate
True
What is the principle of healing by repair?
After damage to a tissue, there’s an acute inflammatory rxn in surrounding liver tissues, w/ formation of blood clot if vessels have been damaged
What are the concepts present in healing by repair?
1) Macrophages in the inflammatory exudate scavenge fibrin, dead cells and other mat
2) Newly-formed capillaries grow into the area, accompanied by fibroblasts
3) Fibroblasts do 2 things: they contract, w/c can reduce the extent of the damaged area, and they lay down collagen fibers
4) Finally, most capillaries and cells disappear leaving a mass of collagen (ex. fibrous tissue, or scar)
What is the method of healing for the given tissue?
Given tissue: Heart muscle
Repair
What is the method of healing for the given tissue?
Given tissue: Bone
Regeneration, sometimes repair
What is the method of healing for the given tissue?
Given tissue: Skin
Regeneration of epidermis and repair of dermis
