Patho Week 3 Flashcards
The sequence of events of local cellular reaction (5 steps )
1- Margination of leukocytes from central axial cloumn and begin lining endothelial cella due to stasis
2- Firm adhesion of leukocytes to vascular endothelial by integrins
3- Emigration through inter endothelial gaps
4- chemotaxis
5- phagocytosis
4 types of cell derived Mediators
1- Vasoactive amine : histamine, serotonin . From mast cell , cause VD and increase vascular permeability
2- Arachidonic acid : Prostaglandins, leukotrienes . From mast cell , platelets, leukocytes. Cause VD , increased vascular permeability, chemotaxis
3- Cytokines : TNF , IL-1 . From macrophage , lymphocytes. Causes leukocyte migration
4- Lysosomal enzymes: from neutrophils and macrophages. Cause killing of microbes
4 types of plasma protein derived mediators
1- Complement system: C3a , C5a . Cause VD,chemotaxis
2- Coagulative system : change soluble fibrinogen to insoluble fibrin
3- Fibrinolytic system; dissolve fibrin
4- Kinin system: bradykinin . Cause increase vascular permeability
5 Classical or Cardinal signs of Acute inflammation
1- swelling caused by accumulation of inflammatory fluid exudate
2- Redness caused by VD
3- hotness caused by VD
4- pain : irritation of nerve endings
5- loss of function : due to pain
4 systemic or generalized effect of Acute Inflammation
1- Leukocytosis : increase leukocytic count above 10000
2- Fever ( pyrexia ) : pyrogenic substances released from bacteria affect heat regulation center in hypothalamus
3- production of Acute phase reaction
4- Increase Erythrocytic sedimentation rate
4 fate of Acute inflammation
1- Recovery ( resolution ) : complete restoration of inflammed area to normal due to mild to moderate inflammation e.g catarrhal inflammation
2- healing by fibrosis : when there is extensive tissues destruction in tissues that don’t regenerate
3- Transition to chronic inflammation : when causative organism is not completely removed form the body
4- Progression and spread : when the organism overcome the immune system by lymphatic and blood
Mechanism of pus formations
1- the pyogenic organisms cause destruction of tissue by its toxin and strong chemotaxis on polymorph
2- the killed polymorph called pus cells which release proteolytic enzymes lead to liquefaction of the necrotic tissue
3- the liquefied necrotic material mixes with pus cells and other products of inflammation process lead to pus formation
Fate of abscess
Small : the pus is absorped and healing occur by fibrosis
Large abscess : it must surgically evacuated to allow healing ( as pus absorption is very slow
3 complications of abscess
1- spread of infection by lymph or blood
2- Chronicity : due to inadequate drainage
3- Healing complication: chronic ulcer , sinus discharging pus , fistula in hollow organs
What is Carbuncle and mention 2 places and disease predispose it
1- extensive form of abscess in which pus is present in multiple communicating suppurative foci , discharged through several multiple openings
Occurs in back of neck , scalp
Diabetes mellitus is a common predisposing factor
What is furuncle and occur where 3
Small form of abscess related to hair follicle and sebaceous gland
In axilla , face , head
What cause the cellulitis ( the bacteria and 2 enzymes ) and where it happen 4 places and it differ from abscess in what 4 differents
1- streptococcus haemolyticus , streptokinase and hyaluronidase which dissolve fibrin and causes spread of infection
2- in loose CT as subcutaneous tissue and areolar tissue or orbit , scrotum and wall of appendix
3- differ with abscess in
1- excessive necrosis
,2- slow pus formation
3- pus is thin in consistency
4- contain many RBCs
What is Catarrhal inflammation: mention the characteristic feature and 3 examples and the composition of mucoid discharge
Mild acute inflammation of mucous membrane characterized by excess mucous secretions
1- Catarrhal rhinitis ( common cold )
2- Catarrhal bronchitis
3- appendicitis
Mucus , polymorph , inflammatory fluid exudate , shedded epithelial cells
What is characteristic feature of serous inflammation and mention 2 examples
1- Acute non suppurative inflammation characterized by excess serous fluid exudate
2- Examples:
1- inflammatory of serous membrane
2- skin blisters and viral infections
Characteristic feature of fibrinous inflammation and 2 examples and complication
1- ….. characterized with fluid exudate rich in fibrin
2- inflammatory of serous membranes , lobar pneumonia of lung : alveoli are filled with fluid exudate rich in fibrin
3- complication is : failure to remove fibrin lead to fibrosis e.g : organization of fibrinous pericardial lead to obliteration the pericardial space and restrict myocardial function
What is sero-fibrinous inflammation
Acute non suppurative inflammation characterized with fluid exudate rich in fibrinogen
What is pseudo membranous inflammation ( memberanous )
What is the composition of pseudo membrane ( 3 components)
What causes it ( حكاية فيها تلاتة )
2 Examples
1-Severe form of Acute non suppurative inflammation characterized with formation of peuso membrane
2-Formed of : inflammatory cells , necrotic tissue, fibrin
3- bacteria secrete powerful exotoxin effect the mucosa cause patchy necrotic mucosa then diffuse to submucosa cause acute inflammation then absorbed to blood stream cause toxaemia
البكتيريا تفرز سم قوي كل ما يروح حتة يفشخها اولا ال mucosa بعدين فشخت الsubmucosa بعدين فشختblood
4- examples
Mycobacterium diphtheria in palatine tonsil cause diphtheria
Clostridium difficile in mucosa of intestine cause pseudo membranous colitis
example of Ulcerative inflammation
Typhoid intestinal Ulcer
What is Allergic inflammation and 2 examples
Acute inflammation non suppurative caused by hypersensitivity reaction and inflammatory exudate rich in eosinophil
1- Allergic Rhinitis
2- Bronchial Asthma
4 causes of chronic inflammation
1- may follow acute inflammation due to failure of defense mechanisms
2- may start chronic by gradual onset due to
1- persistence of resistant infections : TB, leprosy …
2- prolonged exposure to insult : silicosis , asbestosis
3- Developing of auto- immunity : Rheumatoid arthritis
What is endarteritis obliterans and why happen
Thickening of wall of blood vessels and narrowing of lumen due to proliferation of subintimal CT
The inflammatory cellular exudate of Chronic inflammation may be 3 types
1- diffuse
2- perivascular
3- granulomatous
3 functions of Macrophage
1- phagocytosis
2- formation of giant cell
3- secretion of
1- cytokines
2- enzymes colagenase and estrase
3- Growth promoting factors
4- coagulative factors
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Giant cell : show phagocytic activity
The inflammatory response is associated with attempts at repair from beginning
3 examples of chronic non specific
1- chronic abscess
2- chronic tonsillitis
3- chronic pyelonephritis
3 types of granuloma and examples for each
Infective granuloma
Bacteria: TB, leprosy
Parasite : bilharziasis
Fungal : Actinomycosis, histoplasmosis
Non infective
Silicosis , asbestosis
Granuloma formed around foreign trapped in tissue as pieces of wood , glass around surgical sutures, talk powders
Un known cause
Sarcoidosis, Crohn disease
Effect and clinical significance of Granuloma
1- infective granuloma may be source of spread of infection
2- scarring of organs lead to disturbed function
3- Obstructive effect : urinary bilharziasis of the epididymis can lead to obstructive infertility
4- Any granuloma must be distinguished from other causes of chronic swelling as Malignant
