Pathology Lecture 2: Inflammation and Repair

Question 0

What are the forms of inflammation?

Answer 0

1. Acute inflammation

2. Chronic inflammation

Question 1

Define inflammation

Answer 1

Reaction of vascularized living tissue to cellular injury. Process removes necrotic debris and toxic compounds from injured area and destroyed infectious bacteria.

Question 2

What are characteristics of acute inflammation?

Answer 2

1. Rubor (redness)
2. Tumor (swelling)
3. Calor (heat)
4. Dolor (pain)
5. Functio laesa (loss of function)

Question 3

What are two changes in vascular characteristics that occurs with acute inflammation?

Answer 3

1. Increased vascular flow and caliber

2. Vascular permeability

Question 4

What are the different inflammatory responses to tissue injury?

Answer 4

1. Immediate transient response
2. Immediate sustained response
3. Delayed prolonged response

Question 5

Define immediate transient response

Answer 5

Follows mild tissue injury. Immediately occurs 5-10 minutes after injury and lasts 15-30 minutes.

Question 6

Define immediate sustained response

Answer 6

Follows more severe injury and accompanied by endothelial cell necrosis. Can last for several days and occurs with significant trauma, cellular injury, and infection.

Question 7

Define delayed prolonged response

Answer 7

Initially delayed and may not occur until several hours or days after injury. Occur from burns, X-Ray damage, ultraviolet damage, bacterial toxins, or IV hypersensitivity.

Question 8

What is leukocyte exudation on?

Answer 8

Collection of leukocytes, usually neutrophils, at infection site that phagocytosis bacteria and release debris causing further cellular injury.

Question 9

What are chemical mediators of acute inflammation?

Answer 9

1. Vasoactive amines
2. Plasma proteases ie. complement, kinin, and clotting systems
3. Arachidonic acids metabolites

Question 10

When does chronic inflammation occur?

Answer 10

1. After acute inflammation
2. After repeated episodes of acute inflammation
3. Low grade smoldering inflammatory process without acute inflammation

Question 11

What are cellular constitutes and tissue changes for chronic inflammation?

Answer 11

1. Macrophages, lymphocytes, plasma cells, eosinophils, fibroblasts
2. Tissue destruction, vascular proliferation, fibrosis

Question 12

What are three main steps in chronic inflammation development?

Answer 12

1. Recruitment
2. Local proliferation
3. Survival and immobilization

Question 13

What is chronic granulomatous inflammation?

Answer 13

Chronic inflammation characterized by area containing lymphocytes, plasma cells, macrophages, and multinucleated giant cells forming a granuloma.

Question 14

Define caseating granuloma

Answer 14

Granulomatous process containing a central area of caseation necrosis with a peripheral rim of lymphocytes, macrophages, and langhans giant cells. Classically associated with TB or fungal infections

Question 15

Define non-caseating granuloma

Answer 15

Granulomatous processes lacking central area of caseation necrosis. Includes: sarcoidosis, fungi, brucellosis, leprosy, foreign body reaction, cat scratch disease, syphilis, and parasites

Question 16

What are systemic effects of inflammation?

Answer 16

1. Fever
2. Rigors
3. Appetite suppression
4. Sleep changes
5. Protein degradation
6. Hypotension
7. Hematological effects
8. Release of acute phase proteins

Question 17

What are 3 categories of cellular regeneration cells, their definition, and examples?

Answer 17

1. Labile cells: mitotically divide throughout life. Include epithelial, splenic, lymphoid, and hematopoietic cells
2. Replicated under specific stimuli. Include parachymal, mesenchymal, and vascular endothelial cells
3. Permanent cells: no division, scar tissue formed instead. Include neurons, skeletal muscle, and myocardium.

Question 18

What is granulation tissue formation?

Answer 18

Formed by the regenerative process through which injured or necrotic tissue is gradually replaced and repaired. Not granulomatous inflammation.

Question 19

What occurs with granulation tissue formation?

Answer 19

1. Angiogenesis and neurovascularization
2. Edema
3. Fibroblast proliferation
4. Collagenization
5. Cellular components - increase in macrophages

Question 20

Define collagen formation

Answer 20

Collagen fibers are laid down to increase strength and stability of repaired tissue. Granulation tissue initially contains type III collagen and is remodeled

Question 21

What are non-collagen components?

Answer 21

1. Elastin
2. Laminin
3. Proteoglycans
4. Fibronectin

Question 22

What are two types if wound healing?

Answer 22

1. Primary union (first intention): clean wound with straight, easily approximated margins
2. Secondary union (second intention): large gaping wounds with margins not readily approximated. Needs significant re-epithelialization repair.

Question 23

What is wound dehiscence?

Answer 23

Opening of a partially healed wound

Question 24

What are qualities affecting inflammatory/reparative process?

Answer 24

1. Systemic influences: age, nutritional status, bleeding disorders, systemic disease (ie. diabetes), drugs
2. Local influences: infection, adequacy of blood supply, foreign bodies, type of tissue