pathology of inflammation

Question 1

Symptoms of inflammation: tumor

Answer 1

inflammatory tissue swelling

Question 2

Symptoms of inflammation: rubor

Answer 2

inflammatory hyperemic erythema

Question 3

Symptoms of inflammation: calor

Answer 3

inflammatory heat in the tissue

Question 4

Symptoms of inflammation: dolor

Answer 4

pain in the inflamed area

Question 5

Symptoms of inflammation: Functio laesa

Answer 5

functional impairment of the inflamed organ or tissue

Question 6

Local inflammation

Answer 6

is limited to a circumscribed area

Question 7

Generalized infection

Answer 7

the pathogen spreads diffusely throughout the entire body

Question 8

Metastatic inflammation

Answer 8

the transmission of the inflammatory pathogens into other tissues, where the pathogen can trigger a septico-pyemia (septic metastases)

Question 9

Cells involved in the process of inflammation

Answer 9

• T helper CD4+ cells for humoral immune response
• T cytotoxic CD8+ cells for cellular immune response
• B cells which transform into plasma cells, that produce antibodies

Question 10

What types of cells have granules containing heparin and histamine?

Answer 10

Mast cells and basophils.

Question 11

What additional effect do the substances in the granules of mast cells and basophils have aside from increasing permeability?

Answer 11

they cause platelet aggregation

Question 12

Neutrophils are phagocytic cells, which generate:

Answer 12

lysozyme - unspecific germicide
NO synthase - produces nitrous oxide (a bactericide)
the NADPH oxidase system - uses myeloperoxidase to produce oxygen metabolites, a bactericides

Question 13

Endothelial cells: pro inflammatory cells that generate:

Answer 13

selectins – cause adhesion of lymphocytes and granulocytes
factor VIII activator – activates the complement and kinin cascade → increases permeability

Question 14

Thrombocytes: pro-inflammatory cells that generate

Answer 14

inflammation mediators and PDGF

Question 15

Inflammation Mediators
definition

Answer 15

Chemical substances that trigger certain processes in an inflammatory reaction

Question 16

inflammation mediators Effects:

Answer 16

vasodilatation, increased vascular permeability and chemotaxis.

Question 17

Cell-Derived Mediators

Answer 17

• Histamine (produced by mast cells)
• Serotonin (produced by entero-chromaffin cells)
• Neutrophilic proteases (produced by PMN)
  Interleukins (IL-1, TNF-α)
• Chemokines (produced by macrophages and lymphocytes): link up with CXC-R & CC-R mediated by G-proteins
• Arachidonic acid derivatives (from cell membranes):
  Lipo-oxygenase breaks it down into leukotrienes
  Cyclo-oxygenase breaks it down into prostaglandins
• Platelet activating factor produced by thrombocytes

Question 18

Plasma-Derived Mediators

Answer 18

• Kinin system (activated by necrosis)
• Complement system (from serum)
• C-reactive protein (from hepatocytes)

Question 19

Exudative Inflammatory Reaction definition

Answer 19

Response pattern of acute inflammation, characterized by exudation of blood components and emigration of blood cells.

Question 20

Exudative Inflammatory Reaction - Biologic purpose:

Answer 20

• Increased perfusion due to hyperemia → rapid removal of the noxious agent from the site.
  Exudation of blood serum → rapid dilution of the noxious agent.
• Elimination of pathogens by phagocytosis → rapid destruction of the noxious agent.
• Rapid containment of the noxious agent.

Question 21

Exudative Inflammatory Reaction - Pathogenetic elements:

Answer 21

• Changes in microcirculation
• Increases in permeability
• Leukocyte transmigration

Question 22

Changes in Microcirculation - First phase

Answer 22

A transient arteriolar vasoconstriction lasting a few seconds to a few minutes.

Question 23

Changes in Microcirculation - second phase

Answer 23

Inflammation mediators lead to vasodilatation of the arterioles, capillaries, and post-capillary venules.
This causes exudation of blood serum that leads to inflammatory tissue swelling with stimulation of the nociceptive nerves (pain nerves)
Result: erythema, swelling, and pain in the inflamed area

Question 24

Changes in Microcirculation - third phase

Answer 24

It is brought about by vasodilatation of the capillaries and arterioles and is accompanied by vasoconstriction of the venules.
The circulation slows, filtration pressure elevates, and vascular permeability increases in the inflamed area
The area damaged by the noxious agent is sealed off, paving the way for the “strike force” of leukocytes

Question 25

The biologic purpose of exudation:

Answer 25

• Contaminants are diluted by the protein-rich exudate
• Contaminants are neutralized by antibodies
• Contaminants are fixed and damage is controlled

Question 26

Leukocytes migration
Biologic purpose

Answer 26

The leucocytes travel into the inflamed regions, exiting the blood via the vascular wall, and defend the infected tissue

Question 27

Leukocyte Margination
Normal Travel:
Activation:

Answer 27

Normal Travel: Granulocytes move in the center of the blood vessel.
Activation: Mediators (like histamine, PAF, TNF-a, IL-1, and C5a) cause the endothelium to express adhesion molecules (P-selectin, then E- and L-selectin), making granulocytes roll along the vessel wall.

Question 28

Leukocyte Adhesion

Answer 28

Stable Adhesion: TNF-a and IL-1 stimulate the endothelium to produce sticky molecules (ICAM-1).
Firm Attachment: Granulocytes firmly stick to the endothelium and become activated.

Question 29

Leukocyte Diapedesis

Answer 29

Attraction: Granulocytes move towards the inflamed area, attracted by chemical signals.
Migration: Granulocytes bind to endothelial molecules (ICAM-1, PECAM-1), create gaps in the endothelium, and migrate through these gaps to reach the inflammation site.

Question 30

In humans, TLR have 2 roles:

Answer 30

the recognition of endotoxins in association with CD14 from PMN (e.g.: TLR4 recognizes S lipopolysaccharide)
the recognition of lipoarabinoman from BK wall (e.g.: TLR2)