Inflammation II

Question 1

What are three mediators in vasodilation?

Answer 1

Prostaglandins, nitric oxide, and histamine

Question 2

C3a and C5a function to increase

Answer 2

Vascular permiability

Question 3

What three mediators function to induce fevers?

Answer 3

IL-1, TNF, and prostaglandins

Question 4

Chronic inflammation can be described by the predominant type of inflammatory cell, i.e

Answer 4

Mononuclear inflammatory cells

Question 5

Parenchymal cell death and tissue destruction that result in growth of new blood vessels and production of connective tissues are examples of

Answer 5

Irreversible tissue damage

Question 6

A dying cell release soluble mediators of inflammation that initiate a response similar to that seen in

Answer 6

Acute inflammation

Question 7

Then, mononuclear emigration replaces neutrophilic emigration. Two new things occur. These are:

Answer 7

Angiogenesis and fibroblast migration

Question 8

As chronic inflammation progresses, we see the development of a transient

Answer 8

Granular tissue

Question 9

A precursor to scar formation

Answer 9

Granulation

Question 10

The process by which new blood vessels are created from preexisting ones

Answer 10

Angiogenesis

Question 11

Occurs at the level of capillaries that consist of a vascular endothelium resting on a basement membrane with an overlay of pericytes

Answer 11

Angiogenesis

Question 12

Angiogenesis is stimulated by

Answer 12

Inflammation and hypoxia

Question 13

Regulate angiogenesis through their receptors leading to the formation of new blood vessels

Answer 13

Chemokines

Question 14

Chemokines indirectly influence endothelial cell behaviors by attracting chemokine receptor-expressing

Answer 14

Leukocytes

Question 15

These subsequently secrete pro-angiogenic factors, such as

-Act on endothelial cells and initate angiogenesis

Answer 15

Vascular Endothelial Growth Factor (VEGF)

Question 16

The coordinated arrangement of endothelial cells in three dimensions to form and maintain a vascular tube requires endothelial cell proliferation, migration, survival, and permeability. These biological responses are mediated mainly by

Answer 16

BEGFA-activated VEGFR2

Question 17

On VEGFA-binding to extracellular Ig-like domains 2 and 3 of VEGFR2, signaling molecules bind to respective

Answer 17

Phosphorylation sites

Question 18

Ultimately, the granulation field becomes relatively accellular, with dense fibrous connective tissue (scar tissue) replacing the

Answer 18

Original architecture

Question 19

The persistent stimulus of chronic inflammation activates macrophages and lymphocytes, leading to the production of growth factors and cytokines, which increase the synthesis of

Answer 19

Collagen

Question 20

Deposition of collagen is enhanced by decreased activity of

Answer 20

Metalloproteinases

Question 21

The principal cells producing the ECM of fibrosis are the myofibroblasts, defined as fibroblasticlike cells that express

Answer 21

Alpha-smooth muscle actin

Question 22

These cells derive from tissue resident mesenchymal cells (fibroblasts and pericytes) following stimulation by various

Answer 22

Cytokines

Question 23

In an MI, the initial infiltrate is replaced by a monocytic response that peaks

Answer 23

One day later

Question 24

Reaches its peak at two weeks of age whereas a full dense scar appears only by several months

Answer 24

Granulation

Question 25

Inflammation of the gallbladder, a condition that can result from gallstones that block the common bile duct

Answer 25

Cholecystisis

Question 26

Gross examination reveals variable thickening of the gallbladder wall. Microscopic exam can reveal chronic inflammation with

Answer 26

Rokitansky-Aschoff sinuses

Question 27

Periportaland receives blood with the highest oxygen concentration -closer to bile duct and hepatic artery

Answer 27

Zone 1 of hepatocyte

Question 28

In micronodular cirrhosis, the regenerative nodules average 3 mm or less in size. The yellow-brown appearance of these nodules is caused by concomitant

Answer 28

Hepatic Steatosis

Question 29

The most common cause of micronodular cirrhosis and steatosis is

Answer 29

Chronic Alcohol abuse

Question 30

A fine reticulin network of type IV collagen is normally present in the liver, but with cirrhosis there is extensive deposition of type

Answer 30

I and III collagen

Question 31

The increased hepatocyte proliferation from nodular regeneration increases the risk for

Answer 31

Hepatocellular cholangiolar carcinoma

Question 32

Liver injury leads to Kupffer cell activation with release of cytokines, such as -stimulate stellate cells in the space of Disse to proliferate into myofibroblasticcells that contribute to the fibrogenesis

Answer 32

Platelet-derived growth factor and TNF

Question 33

In cirrhosis, the flow of blood over hepatocytes from portal triad to central vein is impeded due to the architectural changes resulting from

Answer 33

Fibrosis

Question 34

Achronic inflammatory infiltrate is typically seen in viral pneumonias such as those resulting from

Answer 34

Influenza

Question 35

The final common pathway for various severe lung injuries

Answer 35

Diffuse Alveolar Damage (DAD)

Question 36

In early DAD, hyaline membranes, as seen here, line the alveoli. Later in the first week after lung injury, the hyaline membranes resolve, and we see proliferation of

Answer 36

Macrophages

Question 37

Fibroblasts migrate into the alveolar exudates through defects in the epithelial basement membrane to lay down collagen within the hyaline membranes in the

Answer 37

Organization phase of DAD

Question 38

As epithelial cells grow over the newly formed connective tissue, a new basement membrane is formed, thereby incorporating the collagen into the interstitium, a process known as

Answer 38

Fibrosis by accretion

Question 39

Involvement of the alveolar ducts results in these structures being lined by a ring of

Answer 39

Granulation tissue

Question 40

Less frequently, the organized exudates retain a predominantly intra-alveolar position, resulting in loose buds of granulation tissue similar to those seen in

Answer 40

Pneumonia

Question 41

It is claimed that this intra-alveolar pattern of repair is particularly found when the initial damage is caused by

Answer 41

Generalized sepsis

Question 42

However, interstitial fibrosis is more characteristic of injury caused by

Answer 42

Cytotoxic drugs

Question 43

Fibrotic disease that is often reversible with steroid treatment. Thus there remains a potential of reversibility with fibrosis

Answer 43

BOOP

Question 44

Its appearance within air spaces rather than the interstitium, and likely the better preservation of the alveolar cells themselves, that predisposes to recovery

Answer 44

Boop

Question 45

An example of extensive and irreversible fibrosis

Answer 45

UIP

Question 46

Require stabilizing linkages that extend from the stroma through basement membrane to receptors to cytoskeleton

Answer 46

Skeletal muscle fibers

Question 47

The thin extracellular matrix, consisting largely of basement membrane, is important for maintaining theadjacent

Answer 47

Myofiber

Question 48

A loss of anyone of the linkage proteins can result in a

Answer 48

Muscular dystrophy

Question 49

The most common of these result from X-linked mutations of the gene coding for

Answer 49

Dystrophin

Question 50

Caused by a defective dystrophin gene on the X chromosome that leads to an inability to produce the striated muscle sarcolemmal membrane structural protein dystrophin

Answer 50

Duchenne Muscular Dystrophy (DMD)

Question 51

What is the inheritance pattern of DMD?

Answer 51

X-linked recessive

Question 52

About one third of cases of DMD arise from

Answer 52

Spontaneous new mutations

Question 53

While they can be considered as forms of chronic inflammation, retain the leukocyte characteristics seen in acute inflammation

Answer 53

Abscesses

Question 54

Encapsulated accumulation of pus (usually neutrophils)

Answer 54

Abscess

Question 55

It can be a complication of pneumonia, is seen in aspiration, bronchiectasis, and airway obstruction

Answer 55

Pulmonary Abscess

Question 56

Accumulation of pus in an existing body cavity

Answer 56

Empyema

Question 57

A circumscribed form of chronic inflammation that occurs in response to a localized inciting agent such as a foreign body or certain bacteria that can be sequestered by inflammatory tissue but that cannot be easily removed from the tissue

Answer 57

Granuloma

Question 58

A special type of chronic inflammation characterized by a circumsized collection of macrophages

Answer 58

Granuloma

Question 59

The initiating event of granuloma growth is the growth of

Answer 59

Myobacterium

Question 60

The initial response is that seen in acute inflammation, in which there is

Answer 60

Vasodilation and neutrophilic and mononuclear diapedesis

Question 61

Mononuclear cells surround site of injury and both fuse to form giant cells and adhere to produce

Answer 61

Epithelioid macrophages

Question 62

Then, fibroblasts surround the inflammatory cells and we see the walled-off formation of a

Answer 62

Granuloma

Question 63

One of the most well-studied cases of granulomas is

Answer 63

Tuberculosis

Question 64

The causative organism for tuberculosis stains red with the

Answer 64

Acid fast stain

Question 65

Non-caseating and of uncertain cause and need to be distinguished from those of TB and other infectious diseases

Answer 65

Sarcoid granulomas

Question 66

The most important factors in determining the extent of the inflammatory reaction are (a) whether there is significant amount of cell death and (b) whether there is destruction of the underlying

Answer 66

Basement membrane

Question 67

If the parenchymal cell can rapidly migrate on its basement membrane substrate and re-epithelialize the injured surface, we will see

Answer 67

No irreversible changes

Question 68

On the other hand, if this migration and regeneration is impeded, either because the cells can't divide, or because the underlying basement membrane and stromal architecture is destroyed, then we will see

Answer 68

Irreversible angiogenesis and fibrosis

Question 69

Serves as a good example of a severe and yet self-limiting inflammation reaction

Answer 69

Gout

Question 70

Unlike gout, results in the development of permanent sequelae

Answer 70

Silicosis

Question 71

The result of silicosis is extensive scarring of the

Answer 71

Lung

Question 72

One mechanism by which this may operate is that injured macrophages release the cytokines IL-1 and TNF which initiate angiogenesis, recruit fibroblasts and induce

Answer 72

Collagen and fibronectin synthesis