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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 peritoneum:

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 promote ___ & ___.

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 bodies first and second line of defenses are considered:

A

non-specific

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13
Q

The bodies 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) & molecules (mediators) (nonspecific)

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16
Q

Describe the body’s third line of defense:

A

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

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17
Q

Skin, mucous membranes, and 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 and 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 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 components of the inflammatory response is characterized by functioning to eliminate microbes and debris?

A

PMNs/Neutrophils

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25
Q

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

A

Lymphocytes

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26
Q

What components of the inflammatory response are important for repair?

A

Eosinophils

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27
Q

Lymphocytes (circulating blood cells & 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 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 & chemicals leave the blood & 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 5R’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. Calor- heat
  2. Rubor-redness
  3. Tumor- swelling
  4. Dolor- pain
  5. Loss of function
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42
Q

Inflammation 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 & scarring

A

non-exudative

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54
Q

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

A

fibrosis & 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 bern
  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 feber 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, submandibular gland abscess and abscess of infected tooth are all condition 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 whitish, 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 of acute inflammation (Not the morphologic patterns) include:

A
  1. cellulitis
  2. catarrhal inflammation
70
Q

Diffuse spread of acute inflammatory process through the fascial planes of soft tissue (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 with excess production of mucus:

A

Catarrhal inflammation

73
Q

Catarrhal inflammation only occurs on ____ containing ____ cells such as ___ or ___

A

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

74
Q

List all the 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. myeloperoxidate Deficiency (MPO)
75
Q
  • Defect in neutrophil function
  • Patients present with periodontal bone loss (exfoliating teeth)
  • Primary & secondary dentition is affected
  • Due to failure in adhesion of neutrophils 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 inclusion from fused primary granules
  • Both chemotaxis and phagolysosome formation are defective
  • Subjected to recurrent infection
  • 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 H202 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 deficiency 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

Source of histamine:

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

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 ____ 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

eicosandoids

95
Q

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

A

Arachidonic acid metabolites (Eicosandoids)

96
Q

_____ act on phospholipases preventing arachidonic acid

A

steroids

97
Q

____ on cyclooxegenase preventing prostaglandins

A

Aspirins/NSAIDs

98
Q

What do steroids act on? What does this prevent?

A

Phospholipases; arachidonic acid

99
Q

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

A

cyclooxegenase; prostaglandins

100
Q

Cell membrane 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/inhibition of platelet aggregation and pain & fever in inflammation:

A

Prostaglandins

103
Q
  • Persistant infection (ex. mycobacteria)
  • Prolonged exposure to toxic agents
  • Exogenous (ex. silicosis- exposure to foreign agent)
  • Endogenous (ex atherosclerosis- plaque build up within blood vessels)
  • Immune-mediated inflammatory disease
  • Autoimmune disease (ex. RA)
  • Unregulated immune responses against microbes (ex. IBS)
  • Immune responses against environmental substances- allergic disease (ex. bronchial asthma)
A

Causes of chronic inflammation

104
Q

What are the morphological features of chronic inflammation (3)

A
  1. Mononuclear cell infiltration
  2. Tissues destruction
  3. Angiogenesis & fibrosis
105
Q

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

A

Granulmatous inflammation

106
Q

Describe the exudate pattern of granulomatous inflammation:

A

Non-exudative

107
Q

The macrophages involved in granulomatous inflammation are considered:

A

epithelial histocytes

108
Q

Discuss the characteristic cells of granulomatous inflammation: (3)

A
  1. aggregates of epithelioid macrophages (epithelial histiocytes)
  2. Multinucleated giant cells (Langhans giant cell)
  3. Mononuclear leukocytes (mainly lymphocytes & occasionally plasma cells on periphery)
109
Q

Granulomatous inflammation is 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
  • Coocidiodes Imitis (fungal organism 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
  • Coccidiodies Immitis
  • Tuberculosis
  • Mycobacterium TB
  • Sarcoidosis

These are all examples 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 (ex. 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 cells are present in granulation tissue?

A

endothelial cells & 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, grant 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 to:

A

the left

128
Q

Restoration of tissue architecture and function after an injury:

A

wound healing & 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

regeneration

131
Q

What are the three components of regeneration?

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

Continuously dividing tissues of regeneration:

A

labile tissues

133
Q

Stable tissues of regeneration:

A

Quiescent tissues

134
Q

Permanent tissues of regeneration:

A

non-dividing tissues

135
Q

Consists of variable proportions of 2 distinct processes - regeneration and scarring (fibrosis)

A

Healing

136
Q

Healing consists of variable proportions of 2 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 regenerate such as:

A

heart & brain

139
Q

If the underlying connective tissue scaffolding is disrupted, what will 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, and cervix
  4. GI tract of epithelium
142
Q

Regeneration: Cell Classification

Labile tissues 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 & 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 tissues have limited capacity to regenerate

A

liver

150
Q

Regeneration: Cell Classification

What tissues have 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 post-natal 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, and 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

In wound healing, restoring the integrity of the epithelial surface:

A

epithelial regeneration

159
Q

In wound healing, 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

Ex. 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 margins are NOT pulled together:

A

healing by secondary intention

164
Q

Ex. Tumor on hard palate- not a lot of tissue here so can’t close if after biopsy; let ope 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 the original wound:

A

Hypertrophic scar

167
Q

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

A

keloid

168
Q

What may cause a deficiency in wound healing?

A

Vitamin C deficiency (scurvy)

169
Q

In wound healing, why is vitamin C important?

A

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

170
Q
A

Pathology (24 decks)

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