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Med Path Exam 1 > Inflammation and Repair Part 1 > Flashcards

Inflammation and Repair Part 1 Flashcards

1
Q

Inflammation is defined as _

A

The localized response to infection and injury

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2
Q

The process of repair is initiated by _

A

Inflammation

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3
Q

What are the 4 cardinal signs of inflammation?

A

Calor (Heat / warmth)
Rubor (Redness)
Tumor (Swelling)
Dolor (Pain)

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4
Q

Where are leukocytes and plasma proteins that respond to inflammation stored?

A

They are constantly circulating in the blood

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5
Q

What are the 5 Rs with regar to the Inflammatory response?

A 
Recognition 
Recruitment of leukocytes 
Removal 
Regulation of response 
Resolution (repair)
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6
Q

For the lecture, what are the 3 cell types that recognize the presence of microbes in the tissues and release mediators in response?

A

Macrophages
Dendritic cells
Mast Cells

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7
Q

What are the 3 major types of leukocytes that are recruited as part of the inflammatory response?

A

Monocytes
Neutrophils
Lymphocytes

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8
Q

At the site of inflammation, what is the function of T and B lymphocytes?

A

Mediate antigen specific immune and inflammatory response

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9
Q

At the site of inflammation, what is the function of the neutrophils and the monocytes?

A

Kill bacteria, remove dead cells and debris

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10
Q

What is the difference between a monocyte and a macrophage?

A

Monocyte circulates in blood, becomes macrophage in tissue

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11
Q

Regarding the hallmarks of inflammation, what cell type is associated with acute inflammation and what cell type is associated with chronic inflammation?

A

Acute - Neutrophils

Chronic - Lymphocytes and monocytes

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12
Q

When inflammation completely resolves or results in a healing response with scar formation, this is beneficial or detrimental?

A

Beneficial

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13
Q

What are the 3 examples of detrimental inflammation provided? Why?

A

Acute epiglottis - Airway obstruction
Acute memnigitis - Death
Rheumatoid Arthritis - Joint Destruction

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14
Q

An inflammation that has mainly neutrophils, has mild / limited fibrosis and very prominent local / system inflammation signs is likely [acute/chronic]

A

Acute

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15
Q

An inflammation that has mainly monocytes and macrophages as well as lymphocytes, has severe / progressive fibrosis and very subtle local / system inflammation signs is likely [acute/chronic]

A

Chronic

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16
Q

Acute inflammation is associated with what types of cells? Is this process antigen specific? What is the time line?

A

Neutrophils
Not antigen specific
Minutes to hours

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17
Q

Beyond neutrophils, what other type of lymphocyte may be associated with acute hypersensitivity reactions?

A

Eosinophils

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18
Q

An abcess in inflammed tissue represents _

A

Leukocytes that are phagocytosing and killing bacteria

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19
Q

Arrange the following events in order of occurence

  • Increased vascular permeability
  • Extravasation and deposition of fluid and plasma proteins
  • Increased blood flow
  • Emigration of neutrophils from vessels and accumulation at the site of injury
A
  • Increased blood flow
  • Increased vascular permeability
  • Extravasation and deposition of fluid and plasma proteins
  • Emigration of neutrophils from vessels and accumulation at the site of injury
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20
Q

The physical result of tissue extravasation of liquid and cells is _

A

Edema

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21
Q

A short term (minutes) mechanism by which increased vascular permeability may occur is _. This is chemically mediated by _, among other mediators

A

Retraction of endothelial cells

Histamine

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22
Q

A relatively long term mechanism by which increased vascular permeability may occur is _. This is seen in response to stimuli like _ and situations like _

A

Endothelial injury
Microbial toxins
Tissue Burns

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23
Q

The 2 mechanisms discussed by which vascular permeability can occur are _

A 
Retraction of endothelial cells (transient)
Endothelial injury (longer)
24
Q

What are the 2 forces that determine whether fluid / proteins remain in the blood vessels or go out?

A

Hydrostatic and colloid pressures

25
Q

What is a trasudate? What causes it?

A

A fluid with low protein content, few cells (endothelium not damaged)
Relatively increased hydrostatic pressure

26
Q

What is an exudate? What causes it?

A

A fluid with high protein content, may contain cells (endothelium is leaky)
A leaky endothelium causes it (e.g. inflammation)

27
Q

Which is more likely to cause edema, transudate or exudate?

A

Both can cause edema

28
Q

Which is associated with low protein count, lower specific gravity and predominantly albumin, Transudate or exudate?

A

Transudate

29
Q

Which is associated with high protein count, associated with inflammatory cells and cellular debris and a high specific gravity, transudate or exudate?

A

Exudate

30
Q

Edema caused by increased extravasscular pressure in the absence of any localized injury is likely to be transudate or exudate?

A

Transudate

31
Q

True or false, edema is always going to be detrimental / harmful.

A

False, depends on location. While edema is not good, it doesn’t necessarily have to be detrimental

32
Q

What are the 3 areas provided in the notes where edema is considered harmful?

A

Larynx
Brain
Lung

33
Q

What are the 4 types of exudate? What are their characteristics?

A

Serous - (fluid, few or no cells)
Fibrinous - Have fibrin, other proteins
Sanguinous - Blood
Purulent - Pus

34
Q

What is the difference between a serous exudate and transudate?

A

The mechanism by which it occurs. Both are mainly fluid, serous has few or no inflammatory cells

35
Q

A skin blister (e.g. from a burn) with fluid accumulation between the epidermis and dermis is an example of what type of what type of effusion?

A

Serous exudate / effusion

36
Q

A pericarditis, associated with fibrin deposition on the epicardial surface and fluid in the pericardial space is an example of what type of effusion?

A

Fibrinous exudate

37
Q

A bacterial abcess is an example of what type of effusion?

A

Purulent exudate

38
Q

In an abscess associated with acute inflammation, what is the predominant cell type that you’d expect to see? What is their life span?

A

Neutrophils

Approx 1 day

39
Q

As you increase distance from the site of damage, in what order would you expect to see the following?

  • Granulation tissue
  • Surrounding fibrosis
  • Liquefactive necrosis
A

Liquefactive necrosis
Granulation Tissue
Surrounding fibrosis

40
Q

The 2 aspects of acute inflammation that cause tissue damage as specified in the notes are _

A

Release of proteolytic enzymes

Reactive oxygen species released during frustrated phagocytosis

41
Q

For leukocytes to successfully migrate, adhesion has to occur between the leukocytes and what 2 structures?

A

Apposing Cells

Extracellular matrix

42
Q

What are the 2 types of adhesion that occur during leukocyte migration? What are the mediating proteins? What induces the endothelial adhesion molecules?

A

Rapid / loose / rolling - Selectins
Firm - Integrins
Cytokines

43
Q

Increased integrin affinity is triggered by _

A

Chemokine deposition on endothelial surfaces

44
Q

Transmigration is _. This is mediated by _. Another name for this protein is _

A

Cells squeezing between endothelium
PECAM-1
CD31

45
Q

What do all of the following have in common?
- Complement components (C5A)
Lipooxygenase products (LTB4)
- Cytokines and chemokines

A

They are all endogenous chemoattractants

46
Q

How is a chemokine different from a cytokine?

A

A chemokine is a cytokine that acts as a chemoattractant

47
Q

What is the leukocyte that dominates during the first 6-24 hrs of inflammation? What is the dominant leukocyte in blood? What is the exception where mononuclear cells (lymphocytes) dominate early in the infection?

A

Neutrophils
Neutrophils
Viral Infections

48
Q

What is the leukocyte that dominates during 24-48 hours after infection? In what situation do eosinophils dominate during the 1st 24 hours?

A

Monocytes

Eosinophils dominate during hypersensitivity reactions

49
Q

What is a characteristic of neutrophils that may be observed in a tissue section early during injury?

A

Margination along the blood vessels

50
Q

In a tissue section from an inflammation case where you see a “blue front”. what might this be?

A

A migrating front of neutrophils

51
Q

At 36 hours after inflammation, what are the 2 types of cells that would be present? Why are neutrophils still there?

A

Neutrophils and mononuclear cells

Residual neutrophils still there, but no longer arriving

52
Q

Phagocytosis involves 3 general steps. They are _

A

Recognition
Engulfment
Killing and degradation

53
Q

Fusion of what 2 structures occurs following phagocytosis to kill bacteria? What is the result?

A

Lysosome with enzymes and Phagosome

Phagolysosome

54
Q

Regarding outcomes of inflammation, when the ECM is degraded to the point it is unable to regenerate, what occurs? What can occur if there is no resolution of the acute inflammation?

A

Fibrosis

Chronic inflammaton

55
Q

What are 4 factors that can lead to chronic inflammation?

A

Viral infection
Chronic infection
Persistent Injury
Autoimmune disease

Med Path Exam 1 (4 decks)

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