Inflammation - Baker Flashcards
What is inflammation?
Complex biological response of body tissues to harmful stimuli
Protective response
Fx of inflammation is to eliminate the initial cause of cell injury
Unresolved damage causes further injury to tissue
What are clinical conditions associated with inflammation?
Infection
Trauma, radiation
Chemical injury
Autoimmunity
Tumors
Difference b/t acute and chronic inflammation.
Acute
- Pathogens, injury
- PMNs, monocytes, macrophages
- Vasoactive amines, eicosanoids
- IMMEDIATE onset
- Minutes to days
- Resolution, abscess, or can turn into chronic
Chronic
- Persistent acute inflammation, foreign bodies
- Monocytes, macrophages, lymphocytes, fibroblasts
- IFNgamma, growth factors, ROS
- DELAYED onset
- Weeks, months, years
- Tissue destruction, fibrosis
What is granulomatosis?
Variant of chronic inflammation characterized by aggregates of epitheloid histiocytes/macrophages, giant cells and lymphocytes
What are the 5 signs of inflammation?
Rubor
Tumor
Calor
Dolor
Loss of fx
- Red and heat due to vasodilation and increased blood flow
- Swelling due to edema
- Pain due to PGE2, bradykinin, substance P, histamine
What is transudate?
Low protein content, few cells
Decreased colloid osmotic pressure (decreased protein synthesis), increased protein loss
Increased hydrostatic pressure (venous outflow obstruction)
Fluid pushed thru capillary due to high pressure w/in capillary
What is exudate?
High protein content, high cell numbers of white and red cells
- Increased interendothelial spaces and vasodilation and stasis
- Fluid and protein leakage
Fluid that leaks around the cells of the capillaries caused by inflammation
What are the 2 phases of acute inflammation?
Vascular
- Vasodilation
- Edema
Cellular -PMNs** —Chemoattraction —Rolling —Adhesion* —Transmigration -Chemokines also present
What allows the PMN across the endothelium?
PECAM-1
T/F - PMNs actually adhere to the endothelium.
TRUE
Most numerous cells in the blood?
RBC
Platelets
Neutrophil
Lymphocytes
Monocytes
Eosinophils
Basophils
What is neutropenia?
Low PMN amount
What is neutrophilia?
High amount of PMNs
What is leukocytosis?
High WBCs
What is lymphocytosis?
Increase in number of lymphocytes
What is Eosinophilia?
Eosinophil count too high
Thrombocytosis?
Body produces too many platelets
What is leukocytosis with neutrophilia?
Acute inflammation - bacterial infection
What is leukocytosis with lymphocytosis?
Chronic inflammation - VIRAL
Eosinophilia means what?
Parasitic infection, autoimmune, asthma/allergic
T/F - Thrombocytosis or thrombocytopenia can occur during an infection.
TRUE
Faster sedimentation rate would indicate what?
Infection
An increase in band neutrophils typically means what?
Bone marrow has been signaled to release more WBCs and increase production of WBCs
Called left shift
What is an abscess?
Painful collection of pus
Bacterial, parasitic, or foreign substances
What are the 3 important cytokines in the acute phase response?
IL-1beta
IL-6
IFNgamma
*IL-6 signals the liver to release cytokines and CRP to initiate macrophages and other cells
Why is albumin important?
It is used in protein synthesis for the liver to produce acute phase proteins for the acute phase response
What is CRP?
C-reactive protein - an acute phase reactant
-Mild increase in healthy pts indicates risk of atherosclerosis
*Become abnormal faster than sedimentation rate
What is procalcitonin?
A calcitonin precursor
- Bacterial infection specific
- Can help determine if abx are needed
What are other acute phase reactants?
SAA
-Recruiter of immune cells
Ceruloplasmin
-Oxidizes iron
What do mast cells do?
Wound healing, angiogenesis, immune tolerance, defense against pathogens, and BBB fx
What is lobar pneumonia?
Acute exudative inflammation of an entire pulmonary lobe
- Caused by S. Pneumoniae
- 4 stages
What are 3 cells involved in chronic inflammation?
Lymphocytes
Macrophages
Fibroblasts and new vessels in tissue repair
Tell me about lymphocytes.
B - Antibodies, can become plasma cells
T:
- CD4-TH1 - Fungal, mycobacterial, and other infections
- CD4-TH2 - Parasites, allergies
- TH17 - Ongoing PMN infiltrates
- CD8 - Direct cytotoxicity, viral infection
These can be long lived and present in many sites
T/F - Viral pneumonias manifest themselves in the interstitium rather than the alveolar air spaces.
TRUE
- Secondary bacterial superinfection is possible*
- Common viruses - Influenza A and B
What do plasma cells look like?
Eccentric, round, clock-face nuclei
Make immunoglobulins
What is the precursor to macrophages>
Monocytes
Where are macrophages found?
Kupffer cells in liver
Lymph nodes, spleen, lung, intestine, marrow
Granulomas is a cluster of epithelioid macrophages
What are the largest type of leukocytes?
Monocytes
-Can differentiation into macrophages and dendritic cells
What is a granuloma?
Collection of macrophages that form when the immune system attempts to arrest substances it perceives as foreign, but unable to eliminate
What are the 2 types of macrophages?
M1
- Type I inflammation
- Killing of intracellular pathogens
- Tumor resistance
- Marker: iNOS*
M2
- Marker: Arginine*
- Parasites
- Allergy
What are type II immune responses responsive to?
Parasites and allergies
What immune cells are active in the type II immune response?
TH2 lymphocytes, eosinophils, mast cells, and basophils
What do eosinophils respond to?
Ig
Mast cells
TH2 lymphocytes
Prominent in parasitic infections
T/F - Many eosinophils in bronchial mucosa in asthma.
TRUE
What is the difference b/t basophils and mast cells?
ON THE TEST
Both are granulated cells that contain histamine and heparin (anticoagulant)
Basophils - Leave marrow mature
Mast cell - Circulate in an immature form and mature once in a tissue
