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Pathology > Lecture 3 Study Guide (Inflammation & Repair) > Flashcards

Lecture 3 Study Guide (Inflammation & Repair) Flashcards

1
Q

The body’s response to injury (eliminate cell entry):

A

Inflammation

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2
Q

Inflammation of the periotoneum:

A

Peritonitis

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3
Q

Inflammation of the lymph node:

A

Lymphadenitis

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4
Q

Inflammation of the Fallopian tube:

A

Salpingitis

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5
Q

Inflammation of the cornea:

A

Keratitis

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6
Q

Inflammation of the glans penis:

A

Balantitis (Reiters syndrome)

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7
Q

Inflammation of the bladder:

A

Cystitis

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8
Q

Comes into play when inflammation is caused by infection:

A

Immunity

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9
Q

Infection may provoke ____ and _____

A

inflammation & immunity

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10
Q

Inflammation may exist:

A

Without infection

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11
Q

Inflammation may be caused by _____ or _____ (give examples)

A

Hypersensitivity (mucositis) or autoimmune disease (mucous membrane pemphigoid or RA)

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12
Q

The body’s first and second line of defenses are considered:

A

Non-specific

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13
Q

The body’s third line of defense is considered:

A

Specific

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14
Q

Describe the body’s first line of defense:

A

BARRIERS- THE MOST IMPORTANT- skin, mucous membranes, secretions (nonspecific)

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15
Q

Describe the body’s second line of defense:

A

Inflammatory response- innate- cells (leukocytes) and molecules (mediators) (nonspecific)

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16
Q

Describe the body’s third line of defense:

A

Immune responses- acquired- antibodies (humoral) and cytotoxic T cells (cellular) (specific)

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17
Q

Skins, mucous membranes & secretions =

A

body’s first line of defense

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18
Q

Cells (leukocytes) & molecules (mediators) =

A

body’s second line of defense

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19
Q

Antibodies (humoral) & cytotoxic T cells (cellular) =

A

body’s third line of defense

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20
Q

List the three main components of inflammatory responses:

A
  1. circulating blood cells & plasma proteins
  2. cells of the blood vessel walls
  3. cells & proteins of the ECM
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21
Q

What are the circulating blood cells and plasma proteins of inflammatory responses?

A
  1. PMNs/neutrophils
  2. lymphocytes
  3. monocytes
  4. eosinophils
  5. basophils
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22
Q

The cells of the blood vessel walls that are components of inflammatory responses include:

A
  1. complement
  2. clotting factors (platelets)
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23
Q

The cells and proteins of the ECM of the inflammatory responses include:

A
  1. mast cells
  2. macrophages
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24
Q

What component of the inflammatory response is characterized by functioning to eliminate microbes and debris?

A

PMNs/neutrophils

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25
Q

What component of the inflammatory response is comprised of T cells, B cells, NK cells and function to produce antibodies?

A

Lymphocytes

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26
Q

What component of the inflammatory response are important for repair?

A

Eosinophils

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27
Q

Lymphocytes (circulating blood cells and plasma proteins of the inflammatory response) are specifically _____ cells and function to:

A

T cells, B cells & NK cells; produce antibodies

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28
Q

The complement & clotting factors (platelets) of the inflammatory response are the source of:

A

cytokines & NO

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29
Q

What cells of the ECM that are components of the inflammatory response produce histamine?

A

Mast cells

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30
Q

Mast cells produce:

A

Histamine

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31
Q

What cells of the ECM that are components of the inflammatory response eliminate debris and are a source of cytokines?

A

Macrophages

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32
Q

Inflammation is the bodies response to:

A

Injury

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33
Q

Most of the defensive elements of inflammation are located in the:

A

Blood

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34
Q

Inflammation is the means by which:

A

Defensive cells and chemicals leave the blood and enter tissue

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35
Q

Inflammation is a ______ to injury

A

Complex reaction

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36
Q

Inflammation is a complex reaction to injury including: (4)

A
  1. vascular responses
  2. cellular responses
  3. systemic reactions
  4. repair
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37
Q

Describe the vascular responses of inflammation:

A

MOST IMPORTANT

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38
Q

What is an example of a systemic reaction of inflammation?

A

Fever

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39
Q

Initially inflammation is _____ however if excessive or prolonged it may become _____

A

Beneficial; harmful

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40
Q

Inflammatory response 5 R’s include:

A
  1. recognition of the injurious agent
  2. recruitment of leukocytes
  3. removal of the agent
  4. regulation (control) of the response
  5. resolution (repair)
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41
Q

What are the cardinal signs of inflammation (5):

A
  1. Color-heat
  2. Rubor-redness
  3. Tumor-swelling
  4. Dolor-pain
  5. Loss of function
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42
Q

inflammation that is characterized by a rapid onset, short duration and is intense:

A

acute

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43
Q

What cells are involved in acute inflammation?

A

Neutrophils

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44
Q

What type of inflammation involves the exudation of fluid and plasma proteins?

A

Acute inflammation

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45
Q

Acute inflammation involves ______ of fluid and plasma proteins

A

exudation

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46
Q

protein rich fluid that filters into a site (can cause swelling):

A

Exudate

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47
Q

Describe the composition of exudate:

A

protein rich

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48
Q

Describe the cellular events of acute inflammation: (7)

A
  1. margination
  2. rolling
  3. adhesion
  4. diapedesis
  5. chemotaxis
  6. phagocytosis
  7. killing
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49
Q

inflammation characterized by a longer duration and considered low grade:

A

chronic inflammation

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50
Q

what cells are involved in chronic inflammation?

A

mononuclear cells- macrophages, lymphocytes, plasma cells

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51
Q

Mononuclear cells of chronic inflammation include: (3)

A
  1. macrophages
  2. lymphocytes
  3. plasma cells
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52
Q

Proliferation of blood vessels and fibroblasts occurs in _____ inflammation

A

chronic

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53
Q

chronic inflammation is typically _____ and associated with fibrosis and scarring

A

non-exudative

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54
Q

chronic inflammation can be described as non-exudative meaning its associated with:

A

fibrosis and scarring

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55
Q

What are the causes of acute inflammation? (4)

A
  1. mechanical, chemical, radiation, or thermal injury
  2. infection
  3. compromise of blood supply
  4. immune injury
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56
Q

what are the morphological patterns of acute inflammation? (4)

A
  1. serous inflammation
  2. fibrinous inflammation
  3. suppurative (purulent) inflammation
  4. ulcerative inflammation
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57
Q

acute inflammation characterized by the accumulation of fluid right under the epithelium:

A

serous inflammation

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58
Q

serous inflammation produces _____ (describe it)

A

transudate (low protein fluid, more watery)

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59
Q

Give examples of conditions involving serous inflammation: (4)

A
  1. friction blisters
  2. poison ivy
  3. thermal burn
  4. herpes
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60
Q

acute inflammation characterized by large molecules (fibrinogen) moving into the extravascular space:

A

fibrinous inflammation

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61
Q

describe fibrinous inflammation:

A

acute inflammation, exudative; lines of mucosal fibrin and CT with inflammatory cells beneath

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62
Q

Fibrinous pericarditis in rheumatic fever is an example of:

A

Fibrinous inflammation

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63
Q

acute inflammation characterized by the production of pus:

A

suppurative (purulent) inflammation

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64
Q

Describe the contents of the pus produced in suppurative (purulent) inflammation:

A

Exudate, rich in neutrophils

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65
Q

Streptococcal meningitis, and submandibular gland abscess and abscess caused by infected tooth are all conditions associated with:

A

Suppurative (purulent) inflammation

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66
Q

acute inflammation characterized by a defect in epithelial continuity:

A

ulcerative inflammation

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67
Q

Describe ulcerative inflammation:

A

Clinically presents as a whiteish, yellowish area surrounded by red halo

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68
Q

Recurrent aphthous stomatitis is an example of:

A

Ulcerative inflammation

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69
Q

Other types acute inflammation (not the morphologic patterns) include:

A
  1. Cellulitis
  2. Catarrhal inflammatino
70
Q

diffuse spread of acute inflammatory process through the fascial planes of soft tissues (not localized):

A

cellulitis

71
Q

Describe the clinical manifestations of cellulitis:

A

produces erythema, edema, warmth, and pain WITHOUT consolidation (its diffuse)

72
Q

Clinical type of exudative inflammation, presenting excess production of mucous:

A

Catarrhal inflammation

73
Q

Catarrhal inflammation only occurs on ______ containing _____ cells such as _____ or _____

A

mucosal surfaces; mucous-secreting cells; nasal or bronchial mucosa

74
Q

List all conditions classified as “defects in neutrophil function” (5)

A
  1. Leukocyte adhesion deficiency (LAD)
  2. Lazy leukocyte syndrome
  3. Chediak-Higashi syndrome
  4. Chronic granulomatous disease of childhood
  5. Myeloperoxidase deficiency (MPO)
75
Q

-defect in neutrophil function
-patients present with periodontal bone loss (exfoliating teeth)
-primary and secondary dentition is affected
-due to failure in adhesion of neutrophil to blood vessel wall
-nothing will stop the progression of this disease (greater risk of bacterial & fungal infections)

A

Leukocyte adhesion deficiency (LAD)

76
Q

-defect in neutrophil function
-impaired chemotaxis due to mutation of contractile proteins

A

lazy leukocyte syndrome

77
Q

-defect in neutrophil function
-rare autosomal recessive condition associated with albinism
-form giant lysosomal inclusions from fused primary granules
-both chemotaxis and phagolysosome formation are defective
-subjected to recurrent infections
-platelet function is abnormal

A

Chediak-higashi syndrome

78
Q

-defect in neutrophil function
-X-linked (2/3) or autosomal recessive (1/3)
-deficient NADPH oxidase in cell membranes of neutrophils and monocytes
-absence of respiratory burst –> no H2O2 produced –> HOCl- (bleach) is NOT synthesized
-catalase negative organisms are killed
-catalase positive organisms are NOT killed

A

Chronic granulomatous disease of childhood

79
Q

-defect in neutrophil function
-common autosomal recessive absence of MPO enzyme in neutrophil and monocyte granules
-respiratory burst is normal and H2O2 is produced
-absence of MPO prevents synthesis of HOCl-
-no great clinical consequences in most people
-diabetics may develop candidiasis (and additional problems)

A

Myeloperoxidase (MPO) deficiency

80
Q

Immune deficiencies caused by defects in leukocyte function categories include:

A
  1. too few neutrophils
  2. failure in adhesion
  3. slow chemotaxis
  4. failure to phagocytose
  5. failure to kill invader
81
Q

What immune deficiency caused by defects in leukocyte function is due to too few neutrophils?

A
  1. agranulocytosis
  2. cyclic neutropenia
82
Q

What immune deficiency caused by defects in leukocyte function is due to failure in adhesion?

A
  1. leukocyte adhesion deficiency (LAD)
83
Q

What immune deficiency caused by defects in leukocyte function is due to slow chemotaxis?

A
  1. lazy leukocyte syndrome
84
Q

What immune deficiency caused by defects in leukocyte function is due to failure to phagocytose?

A
  1. bruton Agammaglobulinemia
  2. complement deficiency
85
Q

What immune deficiency caused by defects in leukocyte function is due to failure to kill invader?

A
  1. chediak-higashi syndrome
  2. chronic granulomatous disease of childhood
  3. myeloperoxidase deficiency
86
Q

The cell-derived preformed mediators of inflammation and where they come from:

A
  1. histamine
  2. serotonin

Come from secretory granules

87
Q

The source of histamine:

A
  1. mast cells
  2. basophils
  3. platelets
88
Q

The source of serotonin:

A

platelets

89
Q

The newly synthesized mediators of inflammation include:

A
  1. prostaglandins
  2. leukotrienes
90
Q

The source of prostaglandins:

A
  1. all leukocytes
  2. platelets
  3. EC
91
Q

The source of leukotrienes:

A

all leukocytes

92
Q

Both histamine and serotonin are both ____ chemical mediators of inflammation

A

Preformed (in secretory granules)

93
Q

Both prostaglandins and leukotrienes are _____ chemical mediators of inflammation

A

Newly synthesized

94
Q

Arachidonic acid metabolites=

A

eicosanoids

95
Q

When take drugs for an inflammatory process this is where the drugs act:

A

Arachidonic acid metabolite (eicosanoids)

96
Q

______ act on phospholipase preventing arachidonic acid

A

steroids

97
Q

_____ act on cyclooxygenase preventing prostaglandins

A

aspirins/NSAIDs

98
Q

What do steroids act on? What does this prevent?

A

Phospholipases; arachidonic acid

99
Q

What do aspirins/NSAIDs act on? What does this prevent?

A

Cyclooxygenase; prostaglandind

100
Q

Cell membranes phospholipids produce arachidonic acid, which forms (2):

A
  1. leukotrienes
  2. prostaglandins
101
Q

Responsible for vasodilation/vasoconstriction, chemotaxis of neutrophils and bronchospasm:

A

Leukotrienes

102
Q

Responsible for vasodilation/vasoconstriction, promotion/inhibitions of platelet aggregations and pain/fever in inflammation:

A

Prostaglandins

103
Q

-persistent infection (example mycobacteria)
-prolonged exposure to toxic agents
-exogenous (example silicosis- exposure to foreign agent)
-endogenous (example atherosclerosis - plaque buildup within blood vessels)
-immune-mediated inflammatory disease
-autoimmune diseases (RA)
-unregulated responses against microbes (example IBS)
-immune responses against environmental substances- allergic disease (example bronchia asthma)

A

Causes of chronic inflammation

104
Q

What are the morphological features of chronics inflammation? (3)

A
  1. mononuclear cell infiltration
  2. tissue destruction
  3. angiogenesis & fibrosis
105
Q

A pattern of chronic inflammation that is non-exudative; aggregates of epithelioid macrophages (activated; histiocytes)

A

Granulomatous inflammation

106
Q

Describe the exudative pattern of granulomative inflammation:

A

Non-exudative

107
Q

The macrophages involved in granulomatous inflammation are considered:

A

Epithelial histocytes

108
Q

Discuss characteristic cells of granulomatous inflammation: (3)

A
  1. aggregates epithelioid macrophages (epithelial histiocytes)
  2. multinucleate giant cells (langhans giant cells)
  3. mononuclear leukocytes (mainly lymphocytes & occasionally plasma cells on periphery)
109
Q

Granulomatous inflammation is a type of _______ inflammation

A

chronic

110
Q

There is a _____ variable in granulomatous inflammation

A

fibrosis

111
Q

What are the two classifications of granulomas?

A
  1. immune granulomas
  2. foreign body granulomas
112
Q

-Coccidioides immitis (fungal organisms inside giant cell) is an example of:

A

immune granuloma

113
Q

-Tuberculosis (bacterial infection that contains necrotizing granulomas) is an example of:

A

immune granuloma

114
Q

-Mycobacterium TB (intracellular pathogen, blocks fusion of phagosome with lysosome) is an example of:

A

immune granuloma

115
Q

-Sarcoidosis (immune-mediated condition) is an example of:

A

immune granuloma

116
Q

-Coccidioides immitis
-Tuberculosis
-Mycobacterium TB
-Sarcoidosis

These are all example of:

A

Immune granulomas

117
Q

Forms when a foreign body (i.e., wood splinter) enters soft tissue and inflammation follows:

A

Foreign body granuloma

118
Q

-reparative tissue (example- pyogenic granuloma)
-contains endothelial cells and fibroblasts
-formation of BVs
-body repairing from some type of injury

A

Granulation tissue

119
Q

Granulation tissue may be considered _____ tissue

A

reparative

120
Q

What type of cells are present in granulation tissue?

A

Endothelial cells and fibroblasts

121
Q

The formation of BVs is characteristic of:

A

Granulation tissue

122
Q

If the body is repairing from some type of injury, what tissue will be seen?

A

Granulation tissue

123
Q

-contains granulomas (very specific type of chronic inflammation)
-the granulomas within consist of epithelial histiocytes, giant multinuclear cells, and mononuclear leukocytes

A

Granulomatous tissue

124
Q

Granulomatous tissue contains _____ and is a very specific type of _____

A

granulomas; chronic inflammation

125
Q

What is within the granulomas of granulomatous tissue?

A

Epithelial histiocytes, giant multinuclear cells, and mononuclear leukocytes

126
Q

A pyogenic granuloma is ____ NOT _____

A

granulation tissue; granulomatous tissue

127
Q

The neutrophilia seen in leukocytosis (a systemic manifestation of acute inflammation) represents a shift:

A

To the left

128
Q

Restoration of tissue architecture and function after an injury:

A

Wound healing and repair

129
Q

Repair of wound may occur by ____ or ____

A

regeneration or healing (scar formation)

130
Q

Growth of cells and tissues to replace lost structures:

A

Regerneation

131
Q

What are the three components of regeneration?

A
  1. continuously dividing tissues (labile)
  2. stabile tissues (quiescent)
  3. permanent tissues (non-dividing)
132
Q

Continuously dividing tissues of regeneration:

A

Labile tissues

133
Q

Stable tissue of regeneration:

A

Quiescent tissues

134
Q

Permanent tissues of regeneration:

A

Non-dividing tissues

135
Q

Consists of variable proportions of two distinct processes- regeneration and scarring (fibrosis):

A

Healing

136
Q

Healing consists of variable proportions of two distinct processes, including:

A
  1. regeneration
  2. scarring (fibrosis)
137
Q

Scarring occurs if: (3)

A
  1. tissue is intrinsically unable to regenerate (heart, brain)
  2. underlying connective tissue scaffolding is disrupted
  3. following extensive exudates (organization)
138
Q

Scarring occurs in tissues that are intrinsically unable to regenerates such as:

A

Heart and brain

139
Q

If the underlying connective tissue scaffolding is disrupted what may occur?

A

Scarring

140
Q

Regeneration: Cell classification

-Labile cells are derived from the division of:

A

Stem cells

141
Q

Regeneration: Cell classification

-Labile cells are derived from the division of stem cells: (4)

A
  1. hematopoietic cells
  2. surface epithelium
  3. stratified squamous epithelium of skin, mouth, pharynx, esophagus, vagina & cervix
  4. GI tract epithelium
142
Q

Regeneration: Cell classification

-Labile tissue can readily regenerate after injury as long as:

A

the pool of stem cells is preserved

143
Q

Regeneration: Cell classification

-the most common forms of cancer arise from:

A

Labile tissues

144
Q

Regeneration: Cell classification

-The most common forms of cancer arise from labile tissues including: (5)

(list tissue and associated cancer)

A
  1. epidermis- skin cancer
  2. bronchial mucosa- lung cancer
  3. oral mucosa- oral cancer
  4. cervical mucosa- cervical cancer
  5. hematopoietic tissue- leukemias
145
Q

Regeneration: Cell classification

-stable tissues

A

Quiescent

146
Q

Regeneration: Cell classification

-stable cells are quiescent and have a:

A

very low rate of turnover

147
Q

Regeneration: Cell classification

-in stable tissues, replacement is carried out by:

A

mitotic division of mature cells

148
Q

Regeneration: Cell classification

-in stable tissues, replacement is carried out by mitotic division of mature cells including: (4)

A
  1. viscera (liver, kidney, pancreas)
  2. endothelial cells
  3. fibroblasts
  4. smooth muscle cells
149
Q

Regeneration: Cell classification

-with the exception of ____, stable tissue have limited capacity to regenerate

A

liver

150
Q

Regeneration: Cell classification

-what tissues have a limited capacity to regenerate?

A

stable tissues

151
Q

Regeneration: Cell classification

-malignant tumors of ____ tissues are among the rarer forms of cancer

A

stable tissues

152
Q

Regeneration: Cell classification

-permanent tissues are considered

A

non-dividing

153
Q

Regeneration: Cell classification

-permanent cells were generated during ____ and:

A

Fetal life; never divide in postnatal life

154
Q

Regeneration: Cell classification

-describe the replacement of permanent tissues

A

Can NOT be replaced if lost

155
Q

Regeneration: Cell classification

-permanent tissues cannot be replaced if lost, these include:

A
  1. neurons
  2. cardiac myocytes
156
Q

Regeneration: Cell classification

-because permanent tissues cannot be replaced if lost, repair is dominated by:

A

Scar formation

157
Q

The objectives of wound healing include: (2)

A
  1. epithelial regeneration
  2. connective tissue repair
158
Q

Wound healing characterized by restoring the integrity of the epithelial surface:

A

epithelial regeneration

159
Q

Wound healing characterized by restoring tensile strength of the sub-epithelial tissue:

A

connective tissue repair

160
Q

Occurs when wound margins are pulled together- suture:

A

Healing by primary intention

161
Q

Example- mucocele - surgeons make incision and remove sac of fluid

Healing occurs by:

A

Primary intention

162
Q

All wound healing involves ______, even without an infection

A

Inflammatory reaction

163
Q

Occurs when the wound margin are NOT pulled together:

A

Healing by secondary intention

164
Q

Example- tumor on hard palate- not a lot of tissue here so can’t close it after biopsy; let open wound fill in with granulation tissue- endothelial cells, fibroblasts, and myofibroblasts

Healing occurs by:

A

Secondary intention

165
Q

Wound contraction by myofibroblasts of granulation tissue is characteristic of:

A

Healing by secondary intention

166
Q

Excessive scar formation formed WITHIN the boundaries of original wound:

A

Hypertrophic scar

167
Q

Excessive scar formation that grows BEYOND boundaries of original wound; common in African Americans:

A

Keloid

168
Q

What may cause a deficiency in wound healing?

A

Vitamin C deficiency (Scruvy)

169
Q

In wound healing, why is vitamin C important?

A

Vitamin C is required for the hydroxylation of proline and lysine (forms collagen)

170
Q
A

Pathology (28 decks)

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