Lifelong Learning - Acute and Chronic Inflammation Flashcards
Acute inflammation is considered an initial response to something like infarct, infection, toxin, or trauma, and it occurs within _____ to _____, lasting for _____ to _____. The main pathological characteristic of acute inflammation is emigration of _____ to the site.
Minutes to hours
Hours to days
Neutrophils
Under normal conditions, ______ pressure drives fluid out of the vasculature and colloid osmotic pressure drives fluid into the vasculature.
Hydrostatic
With immediate or transient exudation, the exudate consistency is very close to water, whereas with prolonged exudation, the consistency is more ______ (S.G. > 1) with fluid and a meshwork of _____.
Fibrinous
Fibrin
Whereas Histamine is preformed and stored, ______ and ______ (both are lipid products) are synthesized by mast cells and leukocytes in response to stimuli. ______ are peptides derived from plasma proteins.
Prostaglandis
Leukotrienes
Kinins
Histamine binds it’s receptors (H1 and H2) on _______ cells, and this is what mediates its action.
Endothelial cells
Phospholipase cleaves _______ acid from cell membrane phospholipids. If it is acted on by _______ it forms prostaglandins. If it is acted on by 5-_______ it forms leukortienes. Steroids inhibit _________, and non-steroidal antiinflammatory drugs typically inhibit _______. Keep in mind prostaglandins are highly involved in increasing vascular permeability and vasodilation, while leukotrienes more highly effect _____ of neutrophils and bronchospasms.
Arachidonic acid
Cyclooxygenase
5-Lipoxygenase
Phospholipase
Cyclooxygenase
Chemotaxis
TNFalpha and IL-1beta act in very much the same way, though IL-1beta also induces ______. IL-6 is mostly involved in activating the _____ phase response (remember where these proteins are produced). IL-17 is produced by __-cells and recruits _____ and monocytes to infection/damage site. When it comes to acute inflammatory response, think TNFalpha, IL-1beta, and IL-6!
Fever
Acute Phase Response
T-cells
Neutrophils
The process of diapedesis is as follows:
Cyotkines upregulate ______ (both P and E) on the lumenal side of endothelial cells. These bind leukoctytes with low affinity to allow for leukocyte “rolling.” Tight or high affinity binding is mediated by ______ on leukocytes binding _____ on endothelial cells. Chemokine binding then facilitates the movement of leukocytes through endothelial junctions lined with ____. The leukocytes follow the chemokine gradient to the source.
Selectins
Integrins on leukocytes
ICAMs on endothelial cells
CD31
Describe the composition of each of the following exudates:
Serous
Fibrinous
Suppurative (Purulent) - e.g. in pyogenic infection
Mixed
Serous - watery (e.g. blister)
Fibrinous - more cellular and more fibrin (e.g. uremic pericarditis)
Suppurative (Purulent) - pus (dead neutrophils)
Mixed - fibinopurulent
Sub-types of acute inflammation:
Within tissues: focal areas of suppuration are called _____, while diffuse or spreading is called _____.
On surfaces: Focal necrosis and inflammations are called _____, while the diffuse versions are called _______.
Abscesses
Cellulitis
Ulcers
Pseudomembranes
Systemic acute inflammation is characterized by what 3 key things?
What is DIC, and why is it significant with systemic inflammation? What does it usually go hand-in-hand with?
FEVER: endogenous pyrogens - IL-1beta, TNFalpha, IL-6
LEUKOCYTOSIS (too many neutrophils especially, and “left shift” –> appearance of less mature neutrophils in the blood.
ACUTE PHASE PROTEINS
DIC = Disseminated Intravascular Coagulation –> significant in systemic inflammation as it can exhaust clotting factors and lead to organ wasting and diffuse internal hemorrhaging. Usually goes hand-in-hand with sepsis.
