Lecture 15: Inflammation, Exudates Flashcards
what 4 mediators are responsible for vasodilation during signs of inflammation
- Vasoactive amines,
- NO- nitric oxide
- PG- prostaglandin
- PAF- platelet activating factor
what 7 mediators are responsible for increased vascular permeability during signs of inflammation
- Vasoactive amines
- bradykinin
- LT
- PAF
- Substance P
- C5a
- C3a
what 6 mediators are responsible for chemotaxis during signs of inflammation
- LTB4
- LPS
- chemokines
- IL-1
- IL-4
- IL-8
what 2 mediators are responsible for pain during signs of inflammation
- PG- prostaglandin
- Bradykinin
what 3 mediators are responsible for tissue damage during signs of inflammation
- Lysosomal enzymes,
- NO- nitric oxide
- ROS- reactive oxygen species
what 4 mediators are responsible for fever during signs of inflammation
- IL-1
- IL-6
- TNF- tumor necrosis factor
- PG- prostaglandin
What are the 8 types of acute inflammation exudates
- Serous
- Fibrinous
- Fibrinonecrotic
- Mucoid or Catarrhal
- Purulent or Suppurative
- Eosinophilic
- Hemorrhagic
- Necrotizing
What are the 5 types of chronic inflammation exudates
- Lymphocytic / Plasmacytic
- Granulomatous
- Pyogranulomatous
- Fibrosing
- Proliferative
- Serous exudates occur when?
- What type of edema is this called
- Will this happen in an acute or chronic change
- Increased vascular permeability
- protein and fluid leakage into a body cavity or joint
- Called “inflammatory edema”
- Acute early change
Would serous exudate be clear or cloudy
mostly clear with some cloudyness
What type of exudate is this
- What is 1 pointing out
- 2?
- serous exudate
- cloudiness fluid but still can see through
- material on serosal surfaces of abdominal organs
What type of exudate
- serous
- Can see through but not extensively
What is the next step after serous exudate (a type of exudate)
fibrinous exudate
What is the purpose for fibrinous exudates
- Early framework can help in phagocytosis
- Decreased microbial spread via lymphatic
- Scaffold for granulation tissue
explain how fibrinous exudate forms
- Endothelial injury
- fibrinogen exits capillary
- fibrin is formed and polymerizes into a fibrin polymer
- the fibrin polymers are what you can visualize as fibrinous exudate
- is fibrin acute or chronic
- seeing fibrinous exudate what does this imply
- Fibrin is usually acute but can be an ongoing problem (thus chronic)
- Implies a continual need for an inflammatory response, at that site
would you see a lot of cellular infiltrate in a fibrinous exudate
not much
- give a morphologic diagnosis
- What are arrows pointing to?
- serofibrinous peritonitis, acute diffuse
- this is mostly serous but arrows are pointing to fibrin (stringy material)
- What organ?
- what type of exudate
- if you touch it what will happen to exudate?
- Liver
- fibrinous exudate
- If you were to pick up the edge of the material, it would break apart easily
give a MDx
- Fibrous pleuritis, acute, locally extensive to diffuse
- White, friable, shaggy, chalky
- If you could touch it, it would peel off easily
Give a MDx
- Fibrinous peritonitis, acute, locally extensive to diffuse
- Very thin, web-like
- This is what a primary fibrinous exudate looks like.
- Sticky, messy, and really delicate
- What would 2 other names for fibrinonecrotic exudates be?
- Where would you usally see these exudates?
- Pseudomembranous, or Diphtheritic
- mucosal surfaces
- What is usally required for Fibrinonecrotic, Pseudomembranous, or Diphtheritic membrane to occur
- If you were to peel this exudate off what would you usally see under it?
- an ulceration, dead cell debris, inflammatory cells and +/- hemorrhage and fibrin
- ulceration of the underlying mucosa
- What is another name for mucous exudate?
- Where would you usally see it?
- Will it be acute or chronic?
- catarrhal, old term and not used as much
- only on mucus membranes
- respiratry tract
- GI tract
- Reproductive/ urinary tract
- Can be acute or chronic
This is from the GI tract
- What is see at 1?
- 2?
- 3?
- What type of exudate is this?
- Hyperemia
- mucoid exudate
- Tapeworm (cestode)
- Mucous exudate
- What kind of exudate is this?
- What can it interfere with?
- mucous exudate / catarrhal
- interfere with absorption and other GI functions
Give a MDx
treachea: Mucopurulent or catarrhal, tracheitis diffuse acute
What type of exudate
- mucous exudate
- Bovine viral diarrhea/mucosal disease
- Another example of mucous or mucoid exudate overlaying the probably ulcerated mucosal surface
- What is another name for purulent exudate?
- What cell type would you mainly see?
- Is this acute or chronic?
- What kind of agents usally cause this
- Purulent (suppurative)
- Mostly neutrophils
- Acute mostly but can be chronic if there is a persistent agent
- Usually bacterial or fungal agents
Where would purulent (suppurative) exudate usally occur in?
- Focal abscess, or
- Pus-filled
- organ (pyometra)
- structure (bronchiectasis)
- cavity (pyothorax, hypopyon)
- What is hypopyon?
- pyuria?
- Hypopyon is inflammatory cells (pus) in the anterior chamber of eye.
- pyuria- pus filled urine
- What organ is this
- exudate?
- what would you see in this exudate?
- lung
- purulent (suppurative)
- see mostly neutrophils
- What type of exudate would this be?
- What are you mostly seeing in the histological slides?
- Suppurative, bronchopneumonia
- neutrophils in alveolar spaces
What type of distribution is common for bronchopneumonia in 4 legged animals?
Cranial ventral distribution
Name what is happening in this image
- Interpretation: Acute purulent arthritis or synovitis
Note the yellow/green cloudy fluid, this would be purulent exudate
- What kind of exudate
- What would you call what you see in this image (name organ and process)
- Purulent (suppurative) exudate
- Meningitis
Note: Remember that exudates are a fluid, and fluids are always going to go ventral, as they are gravity dependent
So when you see meningitis in an animal that has been sternal, most of that exudate will be in the lower half of the brain and in the meninges
- Give a MDx
- what is the circle highlighting? (hard to tell i think)
- Brain : meningitis, suppurative, focal, acute
- pituitary abscess
this is a pig’s skull, i think, cut in half
- Name what has happened here
Chronic purulent sinusitis
- Because this is a sinus and cannot drain, what will happen to the pus that is seen here?
- What type of necrosis?
- Inspissated pus (has dried out)
- caseous necrosis
If connective tissue or fascial planes is inflammed with purulent exudate what would you call it?
Cellulitis
- Give a MDx
- This is an example of?
- Purulent periesophagitis, acute, focal or locally extensive
- example of Cellulitis
Note:
- Horses with an esophageal rupture
- Bad enough that the esophagus has ruptured (bad surgical sites, don’t heal well), but once you have food exiting the lumen of the esophagus and into the soft tissue surrounding it, now you have a developing cellulitis as well
- Which will put further pressure on the esophagus
What is this an example of?
- Fibrinosuppurative pericarditis, epicarditis and pleuritis
- More neutrophils here than in other examples
- There is an increase in thickness, not as weblite as just fibrin
Name what has happened here
- Fibrinosuppurative peritonitis
- Rupture of GI tract, walled off by fibrin
- Cattle are really good at making fibrin
Give a MDx
- Carpal joint: suppurative synovitis and osteomyelitis, diffuse, subacute, severe
- Carpal joint from a foal
- Articular cartilage should look like: white, smooth, shiny
- Discoloration of the bone as well
- Likely an area of osteomyelitis extending across the physis
What would this be called
- Fibrinosuppurative peritonitis
- secondary to GI rupture
- see Presence of feed material, attached to a surface by fibrin
Is it common to purely see hemorrhagic exudates?
- Not common to have a pure hemorrhagic exudate
- Blood is a major component of exudate
- Often mixed with other exudates
What does necrotizing exudates imply?
- Implies cell loss AND inflammation
- Often mixed with other exudates
- Name what necrotizing and hemorrhagic exudates in a liver would be called
- necrotizing and purulent in the lungs
- Necrohemorrhagic hepatitis, multifocal, acute
- Necropurulent bronchopneumonia, hilar region, acute
- Give a MDx
- What happens if that material breaks off?
- what can this be a result of? (this is a calf)
- Fibrinonecrotic laryngitis, locally extensive, subacute, severe
- This flaky yellow material can break off, can travel into the lungs and cause a pneumonia
- Result of a bacterial infection in a compromised area of mucosa that’s been damaged by trauma or excessive vocalization.
Give an MDx
Fibrinsoupperative perititis, diffuse, acute
