Inflammation (Ex2)

Question 1

What are the roles of inflammation?

Answer 1

• dilute, contain, and isolate injury
• destroy invading microorganisms and/or inactivate toxins
• achieve healing and repair

Question 2

What are the outcomes of inflammation?

Answer 2

• Return to normal: elimination of source of injury
• Intense inflammatory response: isolate inflammatory process, formation of wall/capsule
• Failure to eliminate insult: persistence of inflammatory cells, scar formation

Question 3

What is Exudation?

Answer 3

• escape of fluid, proteins, and blood cells from the vascular system into interstitium or body cavities
• implies alteration of permeability of vessels

Question 4

What is exudate?

Answer 4

• inflammatory extravascular fluid
• has a high protein concentration
• much cellular debris
• has a high specific gravity

Question 5

What is transudate?

Answer 5

• an ultrafiltrate of blood plasma
• results from hydrostatic imbalances across vascular endothelium
• has a low protein content
• has a low specific gravity

Question 6

What is pus?

Answer 6

an inflammatory exudate rich in leukocytes and parenchymal cell debris

Question 7

General features of Peracute Inflammation

time, vascular involvement, cells, signs

Answer 7

Time: begins in 0-4 hours
VI: hyperemia, slight edema, hemorrhage
Cells: not many, few leukocytes
Signs: shock, sudden death

Question 8

General features of Acute Inflammation

time, vascular involvement, cells, signs

Answer 8

Time: begins in 4-6 hours
VI: active hyperemia, edema, fibrin thrombi within vessels
Cells: neutrophils predominant, leukocytes variable, sometimes mononuclear cells
Signs: typical inflammation

Question 9

What is Lymphadenitits?

Answer 9

reactive inflammation of lymph nodes

Question 10

What is subacute inflammation?

Answer 10

• a gradual change between acute and chronic

- does not include repair responses

Question 11

General features of Subacute Inflammation

vascular involvement, cells

Answer 11

VI: less hemorrhage, hyperemia, and edema than acute inflammation
Cells: mixed or pleocellular infiltrate
- primarily neutrophils, but infiltration by lymphocytes, macrophages, and plasma cells

Question 12

What is Chronic Inflammation?

Answer 12

• result of persistent inflammatory stimulus in which the host has failed to eliminate the causative agent
• usually accompanied by an immune response
• characterized by host tissue response in terms of repair

Question 13

General features of Chronic Inflammation

vascular involvement, host involvement, cells

Answer 13

VI: proliferation of capillaries and small vessels resulting in hemorrhage and congestion
HI: parenchymal regeneration or repair by fibrosis
C: primarily mononuclear cells, lymphocytes, macrophages, plasma cells, fibroblasts

Question 14

Describe suppurative/purulent exudation

Answer 14

consists of, or contains pus; associated with the formation of pus

Question 15

What is suppuration?

Answer 15

the process by which pus is formed

- implies neutrophils and proteolytic enzymes are present, and that necrosis of host tissue has occurred

Question 16

What is an Abscess?

Gross appearance?

Answer 16

a circumscribed collection of pus

- yellow-white to gray-white and varies from watery to viscous

Question 17

What is the pathogenesis of Fibrinous exudation?

Answer 17

severe injury to endothelium and basement membranes results in leakage of plasma proteins including fibrinogen

Question 18

Describe the gross appearance of fibrinous inflammation

Answer 18

yellow-white or pale, tan, stringy, shaggy meshwork which gives a rough irregular appearance to tissue surfaces
- casts may form in the lumen of tubular organs

Question 19

What is Serous Exudation/Inflammation?

Answer 19

process in which the exudate occurs in tissues in the absence of a cellular response

Question 20

Describe the gross appearance of serous exudate

Answer 20

• yellow, straw-like color, fluid commonly seen in early stages
• ulceration follows rupture of a vesicle

Question 21

What is Granulomatous Inflammation?

Answer 21

• a chronic inflammatory response characterized by the presence of lymphocytes, macrophages, and predominant cell being the macrophage

Question 22

What is a Granuloma?

Simple vs Complex?

Answer 22

macrophages (epithelioid cells) clustered around the causative etiologic agent, necrotic area (complex), or simply as nodules (simple)
- usually surrounded by a rim of lymphocytes

Question 23

Describe the morphology of neutrophils

Answer 23

• multilobed nucleus
• contain cytoplasmic granules, azurophil (large, oval, electron dense) and specific (smaller, less dense, more numerous)

Question 24

What are the functions of neutrophils?

Answer 24

• phagocytosis and secretion of pro-inflammatory substances
• mediate tissue injury via release of oxygen free radicals and lysosomal enzymes
• regulate inflammatory response by releaseing chemical mediators

Question 25

What is Major basic Protein, and what are its functions?

Answer 25

- large secondary granule of eosinophils - toxic to parasites and other cells - cause histamine release from mast cells and basophils

Question 26

What is Eosinophilic cationic protein and what are its functions?

Answer 26

- secondary large granule of eosinophils | - contributes to parasite killing and also shortens coagulation time and alters fibrinolysis

Question 27

What are the functions of Eosinophils?

Answer 27

- modulate hypersensitivity rections (type 1) - defense against helminthic infestations - phagocytic, but not as active as neutrophils

Question 28

Describe the morphology of Lymphocytes

Answer 28

- smaller than neutrophils | - densely staining nucleus and a scant amount of cytoplasm

Question 29

What are the functions of Macrophages?

Answer 29

- phagocytosis - modulation of inflammatory and repair processes - regulation of immune response - production of interleukin-1

Question 30

Describe the morphology of macrophages

Answer 30

- larger than neutrophils - prominent central nuclei, which are folded or bean shaped - have a variable number of azurophilic granules

Question 31

What are the events of acute inflammation?

Answer 31

- stimuli for onset - vascular changes - cellular events - termination of inflammatory response

Question 32

Describe the vascular changes in acute inflammation

Answer 32

- increased vascular flow and caliber of blood vessels | - increased vascular permeability

Question 33

What is extravasation? | What are the events?

Answer 33

- delivery of white blood cells to the site of injury | - margination, rolling, activation and adhesion, and transmigration

Question 34

What is chemotaxis?

Answer 34

- the process where white blood cells emigrate in tissues towards the site of injury

Question 35

What are the four possible outcomes of acute inflammation?

Answer 35

- complete resolution - healing by scarring - abscess formation - progression to chronic inflammation

Question 36

What are some etiologies of Granulomatous Inflammation?

Answer 36

- inert particles - lipids resistant to metabolism - bacteria resistant to lysosomal degradation - systemic fungal agents - foreign bodies

Question 37

Describe Epithelioid cells

Answer 37

- specialized macrophages - abundant eosinophilic cytoplasma - eccentrically located round to oval nucleus

Question 38

Describe Multinucleated Giant Cells

Answer 38

- formed by coalesence and fusion of epithelioid cells | - nuclei sometimes arranged around periphery in horseshoe pattern

Question 39

What are the roles of T lymphocytes in granulomatous inflammation?

Answer 39

- produce lymphokines and interferons - attract and activate macrophages - induce formation of multinucleated giant cells

Question 40

Describe the macroscopic characteristics of chronic inflammation

Answer 40

- diffuse thickening of affected tissue | - or solid, firm, nodular lesions

Question 41

When is the term Pyogranulomatous inflammation used?

Answer 41

if significant numbers of neutrophils are present in the center of a granulomatous reaction