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General Surgery > Inflammation Part 2 > Flashcards

Inflammation Part 2 Flashcards

1
Q

Interferons: innate response to

A

Interferons: innate response to VIRAL INFECTIONS.

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2
Q

INF-gamma is

(1) pro-inflammatory
(2) anti-inflammatory

A

INF-gamma is (2) PRO-inflammatory

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3
Q

The function of interferons

A

differentiation of TH cells into TH-1 cells and secretion of inflammatory cytokines

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4
Q

TNF factor (Cachectin) functions to:

A

It is also an initiator of APOPTOSIS and is inflammatory.

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5
Q

Which of the following is a function of TNF?

(1) Inhibits endothelial cell modulin and protein C.
(2) does not interact with the coagulation cascade.
(3) is contraindicated in sepsis.

A

TNF (1) inhibits endothelial cell thrombomodulin and protein C.

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6
Q

T/F: steroids increase the release of TNF.

A

False.

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7
Q

Infliximab is also a medication used to treat Chron’s and rheumatoid arthritis. IT does so by inhibiting:

A

TNF

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8
Q

a pluripotent cytokine on chromosome 2 that is produced by monocytes, macrophages, NK cells, B & T cells, keratinocytes, dendritic cells, fibroblasts, neutrophils, endothelial cells and enterocytes.

A

IL-1

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9
Q

IL-1 is stimulated by

A

NF, GM-CSF and IL-1 (autocrine manner).

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10
Q

Chronic inflammation (Chron’s disease) is associated with increased secretion of

A

IL-1

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11
Q

has a SHORT HALF LIFE (< 10 MINUTES) and is pro-inflammatory (promotes T lymphocyte proliferation).

*It promotes gut barrier integrity.

A

IL-2

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12
Q

IL-2 production is impaired when

A

production impaired: after injury, cancer, AIDS and perioperative transfusions.

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13
Q

ANTI-INFLAMMATORY and initiates B cells AND the humoral response (IgE, IgE).

A

IL-4

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14
Q

BOTH pro and anti-inflammatory. They are present in patients with burns, major surgery, SEPSIS and septic shock. Its levels are proportional to the degree of tissue injury.

A

IL-6

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15
Q

IL-6 is stimulated by

A

TNF and IL-1, as well as acute injury and infection, and can be present for 10 days.

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16
Q

IL-6 initiates production of:

A

CRP, fibrinogen, haptoglobin and complement. T and B cell maturation when there is fever, and the Hypothalamus-pituitary axis

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17
Q

upregulates the production of ADHESION MOLECULES and the production of reactive oxygen species.

A

IL-8

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18
Q

IL-8 has roles in:

A

It has a role in organ system damage, SEPSIS, ischemia, perfusion injury and ARDS.

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19
Q

The function of IL-8

A

Function: attracts neutrophils, activates degranulation and upregulates expression of surface adhesion molecules

20
Q

Function: attracts neutrophils, activates degranulation and upregulates expression of surface adhesion molecules

A

IL-10

21
Q

IL-12 is implicated in the pathogenesis of:

A

Is implicated in the pathogenesis of IBD.

22
Q

IL-13 functions to

A

is closely related to IL4 and is found on TH2 cells.

*Stimulates: increased production of IL-IRA.

23
Q

The interleukin that is PRO-inflammatory and is related to IL-1beta. It is produced by human peripheral blood monocytes.

A

IL-18

24
Q

The function of TGF-beta

A

TGF-beta: has important roles in wound healing, tissue repair, inflammation and carcinogenesis. It has a pro-inflammatory role during the acute phase response.

25
Q

TGF-beta is activated by

A

IL-6 production

26
Q

Nitric oxide (NO) functions to:

(1) Is a vasoconstrictor
(2) inhibits platelet aggregation
(3) Cannot cause septic shock

A

Nitric oxide (2) inhibits platelet aggregation.

27
Q

Cytokines and ROS stimulate COX production and cause ___ production of prostaglandins

A

Cytokines and ROS stimulate COX production and give increased production of prostaglandins

28
Q

The ebb phase of the metabolic response to inflammation and injury includes:

(1) is late stage inflammatory response.
(2) The body has lost homeostasis and there is a decrease in total body energy.
(3) There is normal blood volume.
(4) There is no enhancement of the neuroendocrine response

A

The ebb phase of the metabolic response to inflammation and injury includes: (2) The body has lost homeostasis and there is a decrease in total body energy.

29
Q

The endocrine response during the ebb phase is:

A

a surge in catecholamines and cortisol.

30
Q

The flow phase:

(1) occurs before the compensatory mechanisms have started.
(2) It is anabolic to provide energy and protein substrates.
(3) catecholamines are mainly responsible for the increase in energy production and consumption.

A

The flow phase (3) catecholamines are mainly responsible for the increase in energy production and consumption.

31
Q

During the catabolic phase of the flow phase:

(1) pro-inflammatory mediators are low.
(2) The phase is affeted by glucose administration.
(3) The patient presents with hyperglycemia.

A

During the catabolic phase of the flow phase, (3) the patient presents with hyperglycemia.

32
Q

Which of the following occurs during catabolic flow phase?

(1) decreased glucose turnover
(2) pro-inflammatory mediators inhibit hepatic gluconeogenesis.
(3) lipolysis liberates glycerol and is turned into glucose in the liver.

A

(3) lipolysis liberates glycerol and is turned into glucose in the liver.

33
Q

T/F The injured patient manifests obligatory increase in REE and nitrogen excretion.

A

True

34
Q

Post operatively there is an inability to efficiently utilize fat and patients are prone to LOSS OF

A

Post operatively there is an inability to efficiently utilize fat and patients are prone to LOSS OF PROTEIN STORES.

35
Q

A patient at rest needs 20 – 25 kg per day, and when injured this is multiplied by

A

A patient at rest needs 20 – 25 kg per day, and when injured this is multiplied by the severity illness factor (e.g., burn patient’s calorie need is multiplied by 2).

36
Q

T/F: Remember that there is a resistance ot insulin post-operatively and fat and proteins will not be used sufficiently;

A

True

37
Q

we use protein stores and the body breaks down skeletal muscle in times of

A

we use protein stores and the body breaks down skeletal muscle in times of surgical stress or severe inflammation

38
Q

A post-op patient is recovering in the hospital. You order labs and note that the nitrogen taken in and excreted equals zero. This indicates that:

A

you are not making progress with the patient.

39
Q

The early anabolic phase occurs around

A

this occurs around days 3 – 8 post elective surgery (in patients with major injury/stress/sepsis, this occurs WEEKS later).

40
Q

The early anabolic phase lasts

A

This process lasts weeks to months as patients may have been intubated for long periods of time and had problems swallowing

41
Q

Early anabolic phase is characterized by

A

It is characterized by a corticoid withdrawal phase and a loss of its diurnal release.

42
Q

In early anabolic phase, cortisol levels and renal insufficiency should be checked because

A

there can be a decrease in nitrogen excretion because the adrenal glands cannot keep up.

43
Q

Anabolic phase ends when a patient experiences

A

Anabolic phase ends when a patient experiences DIURESIS and a renewed interest in PO intake. There is also rapid and progressive weight gain and gain in muscular strength.

44
Q

Nitrogen balance is defined as:

A

maximum of 4 g/dl.

45
Q

T/F: albumin is a good marker to tell if somebody has enough calories and can be checked via blood.

A

True.

46
Q

The late anabolic phase is characterized by:

(1) restoration of protein and lipid stores.
(2) weight gain that is more rapid than in the early anabolic phase.
(3) Calorie intake does not need to be greater than caloric expenditure.
(4) There is a rapid return to normal body weight.

A

The late anabolic phase is characterized by (1) restoration of protein and lipid stores.

General Surgery (12 decks)

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