Intro to Inflammation

Question 1

Name 4 major players in the inflammatory process

Answer 1

• WBCs (leukocytes)
• blood vessels
• CT cells (-blasts)
• ECM

Question 2

name 4 major causes of inflammation

Answer 2

• physical (trauma, thermal, irradiation)
• chemical (corrosives, drugs)
• microbiological (bacterium, viruses, fungi, protozoa)
• immune responses (allergies, immune-mediated diseases)

Question 3

What cells are present in an acute inflammatory response?

Answer 3

Neutrophils and macrophages

Question 4

What is the clinical course of an acute inflammatory response?

Answer 4

Rapid onset, short-lived (under three weeks), symptomology

Question 5

What cells are present in a chronic inflammatory response?

Answer 5

Lymphocytes, fibroblasts, and macrophages

Question 6

What is the clinical course of a chronic inflammatory response?

Answer 6

Slow onset, long-lived, symptoms appear late with pronounced tissue damage

Question 7

What is the hallmark (first) cell of the acute inflammatory response?

Answer 7

Neutrophils (PMNs)

Question 8

What cell is found only in a chronic inflammatory response?

Answer 8

Lymphocytes

Question 9

Which inflammatory response will result in more tissue damage and fibrosis?

Answer 9

Chronic

Question 10

Which cell is responsible for laying down scar tissue in a chronic inflammatory response?

Answer 10

Fibroblasts

Question 11

What are the cardinal signs of inflammation?

Answer 11

Heat (Calor)
Redness (Rubor)
Swelling (Tumor)
Pain (Dolor)
Loss of function (Functio laesa)

Question 12

What is edema?

Answer 12

Accumulation (increase) of fluid within the extravascular compartment and interstitial tissues at the sight of tissue damage

Question 13

What are the two types of edema?

Answer 13

Exudate and transudate

Question 14

What is an exudate?

Answer 14

Edema fluid with a high protein concentration with specific gravity > 1.015 with INFLAMMATORY cells (neutrophils, lymphocytes)

Question 15

What inflammatory reaction/pattern is associated with an exudate?

Answer 15

Acute response produced by mild injuries such as traumatic blisters or sunburns

Question 16

What is an effusion?

Answer 16

Excess fluid in body cavities such as the peritoneum, pleura, or pericardium

Question 17

Where is an effusion most likely to occur?

Answer 17

Peritoneum, pericardium, or pleura (body cavities)

Question 18

What is a transudate edema?

Answer 18

• Edema fluid with a low protein content and specific gravity < 1.015
• Non-inflammatory and involves no increase in vascular permeability

Question 19

What are the different forms of exudate?

Answer 19

Serous, serosanguinous, fibrinous, purulent

Question 20

What are forms of serous exudate?

Answer 20

Serosanguinous and fibrinous

Question 21

What is a serous exudate characterized by?

Answer 21

• Absence of a prominent cellular response with a yellow, straw-like colour
• High specific gravity, high protein concentration, no cells
  ie. Blister fluid, Less injury and a lower WBC count

Question 22

What is a serosanguinous exudate?

Answer 22

A form of serous exudate that contains red blood cells and has a red tinge

Question 23

What is a fibrinous exudate?

Answer 23

• A form of serous exudate with a large amount of fibrin as a result of activation of the coagulation system
• Often seen on skin and SEROSAL surfaces and body cavity linings, with a higher degree of injury
• Greatly increased vascular permeability
  Ie. Pericarditis, pleuritis, peritonitis

Question 24

What are examples of disorders involving a fibrinous exudate?

Answer 24

Fibrinous pericarditis, fibrinous pleuritis, peritonitis

Question 25

What is purulent exudate?

Answer 25

Pus with prominent cellular components associated with pathological conditions - High specific gravity, high protein concentration, and high amounts of cells (PMNs)

Question 26

What is ulcerative inflammation?

Answer 26

Erosion of the surface of a tissue or organ due to shedding of necrotic tissue and resulting inflammation

Question 27

What morphologic pattern of inflammation is always chronic?

Answer 27

Granulomatous

Question 28

What is the main histological difference between serous and purulent exudate?

Answer 28

A serous exudate has low cells (watery) and a purulent exudate has a high amount of cells (pus)

Question 29

What is suppurative inflammation?

Answer 29

A morphological pattern of inflammation presenting with purulent exudate or "pus" accompanied by liquefactive necrosis

Question 30

What three major components comprise the inflammatory response?

Answer 30

Vessel wall permeability changes, vasodilation, and extravasation (leukocyte movement)

Question 31

What are the ordered events of the inflammatory cascade?

Answer 31

Transient vasoconstriction Vasodilation Margination Adhesion/pavementation Emigration/migration via chemotaxis Aggregation Phagocytosis

Question 32

What is transient vasoconstriction?

Answer 32

Autonomic response two to three seconds after a cut or injury where endothelial cells vasoconstrict to prevent hemorrhage

Question 33

What does the vasodilation step of the inflammatory cascade result in?

Answer 33

Increased blood flow to the damaged tissue and increased delivery to cells in the damaged area Increased vascular permeability then follows

Question 34

What are three responses of the body that increase vascular permeability?

Answer 34

Immediate-transient response, immediate-sustained response, and delayed prolonged leakage

Question 35

What is an immediate-transient response regarding vascular permeability?

Answer 35

Vasodilation and increased vascular permeability due to endothelial cell contraction Short lived with "leaky" capillaries Ie. Histamine causing runny nose or watery eyes

Question 36

What response to increase vascular permeability is histamine involved in?

Answer 36

Immediate-transient response

Question 37

What is an immediate-sustained response regarding vascular permeability?

Answer 37

Vasodilation and increased vascular permeability due to endothelial cell damage

Question 38

What is a delayed-prolonged leakage regarding vascular permeability?

Answer 38

Cell undergoes apoptosis hours after sustained injuries occur causing inflammation

Question 39

What is an example of a situation that would cause a delayed-prolonged leakage response?

Answer 39

Sunburn or tanning all day resulting in rubor, calor, dolor by the end of the day

Question 40

What is margination?

Answer 40

Movement of WBCs toward a vascular wall

Question 41

What are selectins?

Answer 41

First molecules expressed by white blood cells during inflammation that slow down the WBC and participate in tethering and rolling

Question 42

What are integrins?

Answer 42

Second molecule expressed by white blood cells during margination that firmly adhere a WBC to a blood vessel wall to stop its movement

Question 43

What molecule expressed by white blood cells assists with transmigration?

Answer 43

Immunoglobulin

Question 44

What step of the inflammatory cascade are selectins and integrins involved in?

Answer 44

Adhesion/pavementation

Question 45

What is transmigration?

Answer 45

Action that occurs with white blood cells where they emigrate through a blood vessel wall with immunoglobulins and travel via diapedesis

Question 46

What is diapedesis? What part of margination does this occur in?

Answer 46

White blood cell moves through a blood vessel using "foot like" processes during transmigration

Question 47

What is chemotaxis?

Answer 47

Movement of WBC along a chemical gradient that allows WBCs to move from low to high concentration to the tissue of injury against the gradient of chemotactic factors

Question 48

What are the three steps of phagocytosis in the inflammation cascade?

Answer 48

Recognition and binding of WBC via opsonization Engulfment via endocytosis Killing via free radicals, lysosomal enzymes, and production of arachidonic acid metabolites

Question 49

What occurs during the recognition phase of phagocytosis?

Answer 49

Opsonization or "tagging" of bacteria with opsin for engulfment via endocytosis and killing

Question 50

What is endocytosis?

Answer 50

Process by which a phagocytic cell "eats" a cell targeted by opsins