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General Surgery > Inflammatory Response > Flashcards

Inflammatory Response Flashcards

1
Q

Inflammation: a pathologic reaction at the tissue level consisting of

A

edema, extravascular fluid extravasation and accumulation of leukocytes

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2
Q

T/F: inflammation is a protective response that kills macrophages, removes necrotic debris and is involved in tissue and organ repair.

A

True

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3
Q
  • The _____MAKES the hormones and they are transported into the pituitary
A
  • The hypothalamus MAKES the hormones and they are transported into the pituitary
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4
Q

CRH release (is produced in response to things pain, fear, anxiety. Things that inhibit its release are

A

CRH release (is produced in response to things pain, fear, anxiety. Things that inhibit its release are endogenous opioids and glucocorticoids).

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5
Q

The release of ANP results in:

A

pain

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6
Q

The release of GABA results in:

A

Fear

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7
Q

The release of substance P results in

A

anxiety and emotional stress

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8
Q

The release of AVP is associated with:

A

endogenous opioids

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9
Q

The release of glucocorticoids and l. arginine subsequently causes the release of:

A

cytokines.

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10
Q

ACTH starts off as ___

A

ACTH starts off as pro-opiomelanocortin

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11
Q

The release of ACTH subsequently causes the release of:

(1) Pro-inflammatory cytokines
(2) oxytocin
(3) CCK/VIP
(4) angiotensin II
(5) All of these

A

(5) All of these

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12
Q

Which of the following regarding cortisol is TRUE?

(1) Cortisol is essential for survival.
(2) Most of it is non-plasma bound and loses its diurnal secretion post injury
(3) Cortisol is elevated for short periods of time only.
(4) If there is hemorrhage, cortisol levels increase when blood volume is restored.

A

(1) Cortisol is essential for survival.

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13
Q

The functions of cortisol:

(1) potentiates metabolic effects of glucagon & epinephrine,
(2) Inhibits proteolysis, lipolysis,
(3) inhibits gluconeogenesis and hyperglycemia

A

(1) Cortisol potentiates metabolic effects of glucagon and epinephrine.

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14
Q

T/F: glucocorticoids increase the cell mediated immune response and increase inflammatory cytokine synthesis.

A

False.

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15
Q
  • Adrenal insufficiency (Addisonian crisis): a life threatening condition in which patients present with
A
  • Adrenal insufficiency (Addisonian crisis): a life threatening condition in which patients present with N/V/F, hyponatremia and hypokalemia.
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16
Q

Adrenal insufficiency (Addisonian crisis) is seen in patients on:

A

high-dose steroids, which is common in organ transplant patients (it suppresses the release of ACTH

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17
Q

To prevent adrenal insufficiency, post op patients should ONLY be put on glucocorticoids for:

A

24 hours post op

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18
Q

Thyroid hormone is released from the hypothalamus. Glucocorticoids, growth hormones and somatostatin have

A

Glucocorticoids, growth hormones and somatostatin have negative feedback effect.

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19
Q

Post injury, the thyroid hormone levels are:

A

T3 and TSH decrease, free T4 remains constant/decreased and a patient develops euthyroid sick syndrome and HIGH rates of mortality.

20
Q

Post injury, thyroid hormone levels of TSH and T3 are decreased, and free T4 remains constant. Decreased free T4 correlates with:

A

high mortality

21
Q

Beta adrenergic stimulation or excess cortisol affects growth factor by

A

beta adrenergic stimulation or excess cortisol reduce growth hormone.

22
Q

Prolactin is inhibited by

A

GnRH and dopamine

23
Q

The type of immunity that estrogens stimulate

A

antibody mediated immunity (estrogens inhibit cell mediated immunity)

24
Q

T/F: androgens are immunosuppressive.

A

True

25
Q

beta adrenergic agonists, hyperglycemia and drops in plasma volume STIMULATE

A

beta adrenergic agonists, hyperglycemia and drops in plasma volume STIMULATE ADH RELEASE.

26
Q

Patients with traumatic amputations for example or patients that have been stabbed will have elevation of ADH for

A

Patients with traumatic amputations for example or patients that have been stabbed will have elevation of ADH for ONE WEEK

27
Q

ADH affects vessels by causing

A

vasoconstriction

28
Q

ADH is made in the:

(1) pituitary glands
(2) hypothalamic neurons

A

ADH is made in the (2) hypothalamic neurons

29
Q

A patient with SIADH presents with:

(1) Patients urinate a high levels.
(2) High levels of ADH
(3) The collecting ducts do not absorb water.

A

A patient with SIADH presents with (1) patients urinate at high levels.

30
Q

Diabetes insipidus presents with ADH levels that are:

A

low ADH levels.

31
Q

T/F: patients with brain pathologies, infections or pituitary adenoma resection may also have temporary issues with ADH secretion.

A

True.

32
Q

Catecholamines: these (norepinephrine) peak ___ after surgery.

A

Catecholamines: these (norepinephrine) peak 24 – 28 hours after surgery.

33
Q

Norepinephrine is released by the

(1) sympathetic nervous system
(2) adrenal medulla

A

Norepinephrine is released by the (1) sympathetic nervous system.

34
Q

Epinephrine is released by the:

(1) sympathetic nervous system
(2) adrenal medulla

A

Epinephrine is released by the (2) adrenal medulla.

35
Q

Which of the following is a function of epinephrine?
(1) Lipogenesis
(2) glyogenolysis, gluconeogenesis
(#) activates insulin, hypoglycemia results.
(4) increased immune response of T-lymphocytes.

A

Epinephrine functions to cause (2) glycogenolysis and gluconeogenesis

36
Q

Aldosterone secretion is initiated by:

A

ACTH being activated by angiotensin II.

37
Q

Hyperkalemia and ACTH cause aldosterone production, as well as release of potassium and hydrogen ions into the tubules. In the injured patient, the most potent stimulus for this secretion is __

A

Hyperkalemia and ACTH cause aldosterone production, as well as release of potassium and hydrogen ions into the tubules. In the injured patient, the most potent stimulus for this secretion is ACTH

38
Q

Beta islets of the pancreas produce insulin: the result is

A

(1) protein synthesis,
(2) glycogenesis,
(3) lipogenesis,
(4) protein synthesis

39
Q

Glucagon is:

(1) anabolic
(2) catabolic

A

Glucagon is (2) catabolic

40
Q

The primary stimuli of glucagon release is

(1) plasma glucose
(2) exercise
(3) All of these

A

(3) All of these

41
Q

Glucagon functions to:

(1) Promote ketogenesis and lipolysis
(2) Promote glycogenolysis
(3) Promote glycolysis

A

Glucagon functions to (1) promote ketogenesis and lipolysis.

42
Q

Post-injury, glucagon levels are the HIGEST at:

(1) immediately post injury
(2) 12 hours post injury
(3) 24 hours post injury

A

Post-injury, glucagon levels are highest (3) 24 hours later and can last up to 3 days.

43
Q

T/F: microbes contain danger-associated molecular patterns (DAMPs).

A

microbes contain danger-associated molecular patterns (DAMPs).

44
Q

Which substance casues hypozincemia, activation of the coagulation cascade, causes pulmonary edema and hepatocellular injury? (IL-1 or TNF)

A

IL-1

45
Q

The substance causes increased platelet count (IL-1 or TNF)

A

TNF

General Surgery (12 decks)

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