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HistoPathology > [P] Week 2: Inflammation and Repair - Part 1 > Flashcards

[P] Week 2: Inflammation and Repair - Part 1 Flashcards

1
Q

It is fundamentally a protective response of the body to combat offending agents that we encounter in day-to-day life

A

Inflammation

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2
Q

Can inflammation be harmful?

A

YES. The inflammatory process could also damage the normal tissues; may be adjacent
or may also lead to other disease entities like
autoimmune diseases

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3
Q

what is the mechanism of inflammation (just give the overview)

A

a complex reaction between blood vessels and the contents, particularly the WBCs or leukocytes

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4
Q

Inflammation is divided into 2 categories, enumerate

A
  • Acute
  • Chronic
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5
Q

what is the purpose of inflammation?

A

rid the host of both the initial cause of the injury and its consequences

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6
Q

inflammation has been described even in the
Egyptian times by the ____

A

Papyrus

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7
Q

who mentioned the 4 cardinal signs of inflammation? and what are those

A

Celsus

  • Rubor (redness)
  • Calor (warmth)
  • Tumor (swelling)
  • Dolor (pain)
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8
Q

who added the fifth cardinal sign and give the sign

A

Virchow

5th - Function laesa (loss of function)

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9
Q

Match

  1. inflammation is not a disease but a response to an offending stimulus
  2. described phagocytosis
  3. described the concept of chemical substance with chemo attractance
  4. 1st noted an inflamed blood vessel

A. John Hunter
B. julius Cohnheim
C. Elie Metchnikoff
D. Sir Tomas Lewis

A
  1. A
  2. C
  3. D
  4. B
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10
Q

Acute or Chronic

  • Onset: Rapid
  • Short duration
  • There is more prominence of local & systemic signs
A

Acute

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11
Q

Acute or Chronic Inflammation

  • The inflammatory cells are more of mononuclear, macrophages, and
    lymphocytes
  • Associated with response of the tissues
  • Associated with tissue necrosis
A

Chronic

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12
Q

Acute or Chronic Inflammation

  • Usually associated with
    more manifestation (Exudation of fluid and plasma protein)
  • Emigration of leukocyte (neutrophils)
A

Acute Inflammation

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13
Q

Enumerate the Steps of Inflammatory Response

A
  1. Recognition
  2. Recruitment
  3. Removal
  4. Regulation
  5. Resolution / Repair
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14
Q

INFLAMMATORY RESPONSE - Recognition

The body must be able to recognize the?

A

offending agents

im offended. ganon

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15
Q

INFLAMMATORY RESPONSE - Recognition

Engagement of the receptors leads to the production of?

A

mediators of inflammation

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16
Q

INFLAMMATORY RESPONSE - Recognition

enumerate the recognition mechanism of microbes and damaged cells

A
  1. Cellular Receptors
  2. Sensors of cell damage
  3. Other cellular receptors involved in inflammation
  4. Circulating proteins
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17
Q

INFLAMMATORY RESPONSE - Recognition

what are the cellular receptors

A

TLRs or TOLL-like receptors

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18
Q

INFLAMMATORY RESPONSE - Recognition

how does the cellular receptors express their receptors?

A

Cells express receptors in the:
- plasma membrane (for extracellular microbes)
- endosomes (for ingested microbes)
- cytosol (for intracellular microbes)

this enable the cells to sense the presence of foreign invaders in any cellular compartment.

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19
Q

INFLAMMATORY RESPONSE - Recognition

where is the “sensors of cell damage” can be located or present

A

cytosolic receptors which can detect the level of uric acid, ATP, decreased intracellular K+

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20
Q

INFLAMMATORY RESPONSE - Recognition

Cytosolic receptors can activate a multiprotein cytosolic complex
called?

A

INFAMMASOME

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21
Q

INFLAMMATORY RESPONSE - Recognition

Infammasome indusces the production of?

A

cytokine interleukin-1 (IL-1)

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22
Q

INFLAMMATORY RESPONSE - Recognition

All cells have cytosolic receptors, such as?

A

NOD-like receptors (NLRs), that recognize diverse molecules that are liberated or altered as a consequence of cell damage

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23
Q

INFLAMMATORY RESPONSE - Recognition

Many leukocytes (WBCs) express receptors for the ____ of antibodies and for complement proteins

A

Fc tails

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24
Q

INFLAMMATORY RESPONSE - Recognition

Some proteins and Fc portion of antibodies could be ____ or
____ the offending agent

A

taggy or
opsonizing

When opsonized, the WBC can recognize these molecules or offending agents (recall hema)

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25
Q

INFLAMMATORY RESPONSE - Recognition

The ____ reacts against microbes and produces mediators of inflammation

A

Complement system

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26
Q

INFLAMMATORY RESPONSE - Recognition

this circulating proten recognizes microbial sugars and promotes ingestion of the microbes and the activation of the complement system?

A

Mannose-Binding Lectin

Other proteins called COLLECTINS also bind to and combat microbes

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27
Q

INFLAMMATORY RESPONSE

Since blood perfuses every tissue, leukocytes and proteins such as complement can be delivered to any site of microbial invasion or tissue injury.

A

Recruitment

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28
Q

INFLAMMATORY RESPONSE

The inflammatory cells needed to combat the offending agents should go to the area of the offending agents

A

Recruitment

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29
Q

INFLAMMATORY RESPONSE - Removal

Removal of the stimulus for inflammation is accomplished mainly by?

A

phagocytic cells which ingest and destroy
microbes and dead cells

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30
Q

INFLAMMATORY RESPONSE - Removal

this is the process wherein the inflammatory cells are at the location of the offending agents and get rid of them

A

Phagocytosis/killing.

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31
Q

INFLAMMATORY RESPONSE - Regulation

Regulation of the response is important for?

A

terminating the reaction when it has accomplished its purpose

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32
Q

INFLAMMATORY RESPONSE - Regulation

TOF

Inflammation can be harmful

A

True

we want to regulate the presence of these inflammatory cells to minimize damage to normal tissues

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33
Q

INFLAMMATORY RESPONSE

In this process the injured tissue is replaced through regeneration of surviving cells and filling of residual
defects with connective tissue (scarring)

A

Resolution / Repair

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34
Q

INFLAMMATORY RESPONSE - Resolution / Repair

We hope for a complete healing of the injury in that area but the healing may be brought about by repair together with healing of tissues plus _____

A

Fibrosis

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35
Q

Enumerate the Stimuli of Acute Inflammation

A
  • Infections and Microbial toxins
  • Tissue necrosis
  • Foreign Bodies
  • Immune Reaction
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36
Q

What are the three major components of acute inflammation?

A
  1. Alterations in vascular caliber
  2. Increased permeability of the microvasculature
  3. Emigration of leukocytes from the microcirculation
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37
Q

Acute Inflammation

Alterations in vascular caliber leading to an?

A

increase in blood flow

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38
Q

Acute Inflammation

Increased permeability of the microvasculature enabling plasma proteion and leukocytes to?

A

leave the circulation

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39
Q

Acute Inflammation

their accumulation in the focus of injury, and their activation to eliminate the offending agent

A

Emigration of leukocytes from the microcirculation

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40
Q

Acute Inflammation

The vascular reactions of acute inflammation consist of

A
  1. Changes in vascular flow and caliber
  2. Increased vascular permeability
  3. Responses of lymphatic vessels and lymph nodes
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41
Q

Reaction of blood vessels in acute inflammation

denotes an excess of fluid in the interstitial tissue or serous cavities; it can be either an exudate or a
transudate

42
Q

Reaction of blood vessels in acute inflammation

a purulent exudate, is an inflammatory exudate rich in leukocytes (mostly neutrophils), the debris of dead cells, and, in many cases, microbes

43
Q

Exudate or Transudate

The escape of fluid, proteins, and blood cells from the vascular system into the interstitial tissue or body
cavities

44
Q

Exudate or Transudate

essentially an ultrafiltrate of blood plasma that is produced as a result of osmotic or hydrostatic imbalance across the vessel wall without an increase in vascular permeability

A

Transudate

45
Q

Exudate or Transudate

extravascular fluid that has:
- high protein concentration
- high specific gravity
- increase in vascular permeability due to infection

46
Q

Exudate or Transudate

a fluid with:
- low protein content (most of which is albumin)
- little or no cellular material
- low specific gravity

A

Transudate

47
Q

Exudate or Transudate

  1. Associated with changes in pressure (hydrostatic and plasma colloid oncotic pressure)
  2. Associated more with infection
A
  1. Transudate
  2. Exudate
48
Q

Changes in vascular flow and caliber

Vasodilation is induced by the action of several mediators, notably?

49
Q

Changes in vascular flow and caliber

what is the presentation of vasodilation?

A

increased blood flow, which is the cause of he at and redness (erythema) at the site of inflammation

50
Q

Changes in vascular flow and caliber

Vasodilation is quickly followed by

A

increased permeability of the microvasculature

51
Q

Changes in vascular flow and caliber

The loss of fluid and increased vessel diameter lead to ?

A

STASIS:
- slower blood flow
- concentration of red cells in small
vessels
- increased viscosity of the blood

52
Q

Changes in vascular flow and caliber

is seen as vascular congestion andlocalized redness of the involved tissue

53
Q

Changes in vascular flow and caliber

As stasis develops, blood leukocytes,
principally neutrophils accumulate along the vascular endothelium or at the sides of the blood vessels

A

Margination

54
Q

a hallmark of acute
inflammation

A

Increased vascular permeability

55
Q

increased vascular permeability are composed of the foillowing, enumerate

A
  1. Contraction of Endothelial Cells
  2. Endothelial injury
  3. Increased transport of fluids and CHON: transcytosis
56
Q

Increased vascular permeability

resulting in opening of interendothelial gaps is the most common mechanism of vascular leakage.

A

Contraction of endothelial cells

57
Q

Increased vascular permeability

Contraction of endothelial cells is elicited by?

A

histamine, bradykinin,
leukotrienes, and other chemical mediator

58
Q

Increased vascular permeability

Contraction of endothelial cells are called the ____ because it occurs rapidly after exposure

A

immediate transient response

usually short-lives (15 to 30 mins)

59
Q

Increased vascular permeability

In some forms of mild injury, vascular leakage
begins after a delay of

A

2 to 12 hours and lasts for
several hours or even days

may be caused by contraction of
endothelial cells or mild endothelial damage

60
Q

Increased vascular permeability

Endothelial injury resulting in?

A

endothelial cell necrosis
and detachment

61
Q

Increased vascular permeability

Increased transport of fluids and CHON

A

Trancytosis

62
Q

Increased vascular permeability

Trancytosis are induced by?

A

Induced by VEGF (vascular endothelial growth
factor); venules

63
Q

Responses of lymphatic vessels

Lymphatics drain the small amount of ____ ____ that seeps out of capillaries in the healthy state

A

extravascular fluid

64
Q

Responses of lymphatic vessels

In inflammation, lymph flow is?

A

increased and helps drain
edema fluid

65
Q

Responses of lymphatic vessels

with inflmmation, the lymphatics may become? (may sakit)

A
  • secondarily inflamed (lymphangitis)
  • draining lymph nodes (lymphadenitis).
66
Q

Leukocyte Recruitment

Changes in the blood flow and vascular permeability results in?

A

leukocyte extravasation– the leakage of WBC from the veins into the surrounding tissue

67
Q

Leukocyte Recruitment

This ensures that the inflammatory cells will go out and “meet” the offending agent.

A

Leukocyte extravasation

68
Q

Leukocyte Recruitment

what are the wbc capable of phagocytosis

A

neutrophils and the macrophages

the inflammatory cells that are more important are those with the capability of combating the offending
agents

69
Q

Enumerate the steps of “journey of Leukocytes”

A
  1. Margination
  2. Rolling
  3. Adhesion
  4. Migration
  5. offending agent producing the chemotactic stimulu
70
Q

journey of Leukocytes

During stasis, with vasodilation and congestion, there is ____ of leukocytes at the periphery of the
vessel walls

A

MARGINATION

71
Q

journey of Leukocytes

vessel wall, there will be an interaction between the vessel and the white cells. This interaction is termed as ____, which consists of the alternating attachment and detachment of the leukocytes from the vessel

72
Q

journey of Leukocytes

This rolling action will continue until there is a firm ____ to the endothelium

73
Q

journey of Leukocytes

The leukocytes will then ____ across the endothelium and vessel wall

74
Q

journey of Leukocytes

From the vessel wall, the leukocytes will continue to migrate to the tissues, towards the offending agent
producing the ____ ____, or to the site of injury

A

chemotactic stimulus

75
Q

Leukocyte Adhesion to The Endothelium

Stasis occurs, which slows the flow of blood resulting to more?

A

more leukocytes at the periphery or the margination site

76
Q

Leukocyte Adhesion to The Endothelium

Leukocytes bind or adhere to the wall ____, then
detaches

A

Transiently

mabilis lang, short tiome

77
Q

Leukocyte Adhesion to The Endothelium

Rolling is mediated by the following ligands that may be present, such as?

A
  • Leukocyte (L-) selectins
  • Endothelial (E-) selectins
  • Platelet (P-) selectins
78
Q

Leukocyte Adhesion to The Endothelium

this molecule functions for firm adhesion (enumerate the adhesion molecules)

A

Integrins:
- Vascular Cell Adhesion Molecule (VCAM)
- Intercellular Adhesion Molecule (ICAM)

79
Q

ENDOTHELIAL-LEUKOCYTE ADHESION MOLECULES

Match the following

Endothelial:
1. P selectin
2. E selecting
3. GlyCAM-1, CD34
4. ICAM-1
5. VCAM-1

Leukocyte
A. L-selectin
B. Integrin (LFA-1)
C. Sialyl-Lewis X
D. Integrin (VLA-4)

80
Q

ENDOTHELIAL-LEUKOCYTE ADHESION MOLECULES

state the role

  1. P-selectin and Sialyl-Lewis X
  2. E-selectin and Sialyl-Lewis X
  3. GlyCAM-1, CD34 and L-selectin
  4. ICAM-1 and Integrin (LFA-1)
  5. VCAM-1 and Integrin (VLA-4)

A. Rolling (NMT)
B. Ahesion, Arrest, Transmigration (NMT)
C. Adhestion (EMT)
D. Rolling and Adhesion (NMT)
E. Rolling (NM)

81
Q

LEUKOCYTE MIGRATION THROUGH THE ENDOTHELIUM

the exit of the cell
through the vessel wall

pwede rin ata entrance

A

Transmigration or diapedesis occurs

82
Q

LEUKOCYTE MIGRATION THROUGH THE ENDOTHELIUM

It is mediated by what adhesion molecules?

A

Platelet
Endothelial Cell Adhesion Molecule (PECAM-1), or CD31

83
Q

LEUKOCYTE ADHESION DEFICIENCIES

Defect in the biosynthesis of B2 chain

A

Leukocyte Adhesion Deficiency Type 1

84
Q

LEUKOCYTE ADHESION DEFICIENCIES

Absence of Sialyl-Lewis X

A

Leukocyte Adhesion Deficiency Type 2

85
Q

Once the cells are out of the vessels, they will go through?

A

Chemotaxis

86
Q

defined as locomotion along the
chemical gradient toward the site of injury

A

chemotaxis

87
Q

CHEMOTAXIS OF LEUKOCYTES

Both exogenous and endogenous substance can act as?

A

chemoattractants

88
Q

CHEMOTAXIS OF LEUKOCYTES

The most common exogenous factors are?

A
  • bacterial products including peptides with N-formylmethionine
    terminal amino acids
  • some lipids
89
Q

CHEMOTAXIS OF LEUKOCYTES

Endogenous chemoattractants include several chemical mediators such as?

A
  • cytokines–particularly of the
    chemokine family (IL-8)
  • components of the complement system (C5a)
  • arachidonic acid metabolites–mainly leukotriene B4 (LTB4)
90
Q

CHEMOTAXIS OF LEUKOCYTES

All these chemotactic agents bind to this specific receptor?

A

seven (7)
transmembrane G-protein-coupled receptors

91
Q

CHEMOTAXIS OF LEUKOCYTES

TOF

The nature of the plasma cell infiltrate varies with age of inflammatory response and type of stimulus

A

F (not plasma cell, should be LEUKOCYTES)

92
Q

CHEMOTAXIS OF LEUKOCYTES

predominate in most forms of acute
inflammation–during the first 6 to 24 hours, making them
short-lived.

A

Neutrophils

93
Q

CHEMOTAXIS OF LEUKOCYTES

replace neutrophils in cases of chronic inflammation which may last from 24 to 48 hours.

94
Q

CHEMOTAXIS OF LEUKOCYTES

Pseudomonas bacteria, the cellular infiltrate is
dominated by

A

neutrophils for several days

95
Q

CHEMOTAXIS OF LEUKOCYTES

In viral infections

A

lymphocytes may be first to arrive

96
Q

CHEMOTAXIS OF LEUKOCYTES

In some hypersensitivity reactions

A

Lymphocytes,
macrophages, and plasma cells are dominan

97
Q

CHEMOTAXIS OF LEUKOCYTES

In helminthic infections and allergic reactions

A

eosinophils may be the main cell type

98
Q

PHAGOCYTOSIS AND CLEARANCE OF OFFENDING AGENT

The two major phagocytes are

A

neutrophils and
macrophages

99
Q

PHAGOCYTOSIS AND CLEARANCE OF OFFENDING AGENT

Revolves around the recognition of microbes or dead cells which induces several response in leukocytes that are collectively called

A

LEUKOCYTE ACTIVATION

100
Q

LEUKOCYTE ACTIVATION

Results from signaling pathways that are triggered in leukocytes resulting in? enumerate

A
  • Increased cytosolic calcium
  • Activation of enzymes such as protein kinase C and phospholipase A2

HistoPathology (14 decks)

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