manifestations

Question 1

two types of manifestations are (2)

Answer 1

local manifestations and systemic manifestations

Question 2

what are local manifestations (4)?

Answer 2

• erythema (redness)
• warmth
• swelling
• pain

Question 3

the 4 local manifestations are also known as..

Answer 3

4 cardinal signs of inflammation

Question 4

what is the possible 5th cardinal sign of inflammation?

Answer 4

loss of function

Question 5

what is not quiiiite a manifestation, however is considered as well

Answer 5

formation of EXUDATES (fluid, proteins, cells)

Question 6

what are the 5 different compositions of exudates?

Answer 6

1. serous exudate
2. purulent/ suppurative
3. hemorrhagic
4. membranous
5. fibrinous

Question 7

what is a serous exudate?

Answer 7

serous- serum

• clear, few proteins or cells
• serum has no clotting factors
• acute inflammation, mild injury (you need leukocytes and proteins at site for more severe)

Question 8

what is a purulent/suppurative exudate?

Answer 8

• proteins, WBC, necrotic debris (pus)
• cloudy, foul odour
• more severe injury, likely a bacteria infection
• common example is a pimple

Question 9

what is hemorrhagic exudate?

Answer 9

severed vessels (RBCs)
-severe injury

Question 10

what is membranous exudate?

Answer 10

necrotic cells in fibro-purulent exudate

-appears membranous

Question 11

what is fibrinous exudate?

Answer 11

abundance of fibrinogen, appears like a sticky mesh

Question 12

what is different about systemic manifestations from local manifestations?

Answer 12

local manifestations are quite specific to that injury, systematic are not.
-do not reveal much information about the injury

Question 13

common examples of systematic manifestations?

Answer 13

• headache
• fever
• malaise (discomfort, not feeling well)

Question 14

what is a FEVER! (what regulates temp, what does it indicate, etc)

Answer 14

• temperature operates by the hypothalamus (usually around 37.5)
• fever is elevated body temperature
• fever generally signals an infection, it is NOT deliberate

Question 15

important benefit of a fever?

Answer 15

decreases growth and reproduction of pathogens, enhances phagocytosis (removing debris) and the immune response

Question 16

pathogenesis of a fever… give the main points

4

Answer 16

1. exogenous pyrogens (chemicals/mediators) released inside the body which triggers formation and release of endogenous pyrogens from our defence cells and other normal cells at the site (interleukins, tumor necrosis factor)
2. these endogenous pyrogens bring along the synthesis of prostaglandin E2 binds
3. prostaglandin E2 binds on the temperature hypothalamus receptor
4. the temperature set point adjusted up via cAMP

Question 17

what is cAMP

Answer 17

helps with receptor binding- aids the binding of PGE2

Question 18

what is CRP (c-reactive protein)?

Answer 18

hepatic protein (synthesized in the liver), produced during inflammation

Question 19

when does CRP get produced more deliberately?

Answer 19

it is always present in blood but when inflammation occurs, the liver produces CRP more deliberately

Question 20

what does CRP aid in?

Answer 20

aids complement with defense

Question 21

is CRP a specific or non-specific serum marker?

Answer 21

non-specific because it does not tell you where the inflammation is, but it tells you the extent

Question 22

pain is due to swelling, and that is what we want to address with inflammation. swelling is due to?

Answer 22

the exudate that is forming because of vasodilation

Question 23

how does applying ice (cold) help with reducing swelling (thus reducing exudate)?

Answer 23

constrict the vessels, which counters the formation of exudate with vasodilation, counters the swelling, counters the pain

Question 24

how does elevating an injured area help?

Answer 24

reduces blood flow to area, reducing blood flow counters formation of exudate, thus counters swelling, which counters pain

Question 25

why would applying pressure to an injured area help?

Answer 25

applying pressure wherever there is bleeding decreases the blood flow (opposes fluids moving out of the capillaries) which is forming exudate, so less exudate and thus less swelling

Question 26

how can applying heat to a injury LATER help?

Answer 26

it can enhance phagocytosis and immune response

Question 27

how can we treat chronic, excessively painful, inflammation? (2)

Answer 27

NSAIDS (nonsteroidal anti inflammatory drugs)
or
Steroidal anti-inflammatory drugs

Question 28

what do NSAIDs do?

Answer 28

inhibit the synthesis of prostaglandin which makes you feel pain, so it decreases the pain

Question 29

what do steroids do?

Answer 29

they are very efficient, however have pressing side effects thus cant be used long term

• they decrease permeability (less exudate, less swelling, less pain)
• they inhibit mediator release
• used when inflammation is no longer beneficial
• also inhibit activity of WBCs and mast cells