Pathology of inflammation Flashcards
List 5 different types of injury that can cause inflammation
- Infection
- Trauma, radiation
- Chemical injury
- Autoimmunity
- Tumors
Inflammation is a ________ response to eliminate ________ and _____
- Protective
- Infections
- Debris
Inflammation sets the stage for ____ and ______
- Healing
2. Wound repair
T/F Inflammation causes further damage
True
*Particularly if severe or persistent
What are the 3 main patterns of inflammation?
- Acute
- Chronic
- Granulomatous
*Mixtures of these three are common
Acute inflammation begins almost immediately and lasts ___ to _____
- Minutes
2. Days
What are the main cells involved in acute inflammation?
- Neutrophils
- Vessels
- Mast cells
Chronic inflammation begins at least ______ later
6 hours (to days)
What are the major cells involved in chronic inflammation?
- Lymphocytes
- Macrophages
- +/- plasma cells
- Fibroblasts and new vessels in tissue repair
What is granulomatous inflammation?
Variant of chronic inflammation
What are the main cells involved in Granulomatous inflammation?
Aggretates of epithelioid histiocytes/macrophages, giant cells, and lymphocytes
Which type of inflammation is mediated by increased vascular permeability resulting in a protein-rich exudate in the tissue?
Acute
*According to the notes in his slide
Which clinical signs of inflammation are due to leaky small blood vessels?
- Rubor
- Tumor
- Calor
Which Clinical signs of inflammation are due to PgE2, Bradykinin, Substance P?
Dolor
Which clinical signs of inflammation are due to pain and tissue damage?
Loss of function
In inflammation, small vessels, especially venules, develop _______ and ________
- Endothelial cell retraction
- Pinocytosis
*Plasma seeps through the gaps
The plasma that seeps through the gaps in inflammation can form two types of fluid. What are they?
- Exudate
2. Transudate
Describe Exudate
- Fluid rich in proteins (Ig, clotting factors, complement, etc.)
- Specific gravity > 1.015
- Protein content > 1/2 that of plasma
- LDH >163 IU/L
Describe Transudate
- Lower specific gravity than exudate
- Lower protein
- Lower LDH
- From hemodynamic problems
T/F Vessels also recruit inflammatory cells to the site
True
What are 4 laboratory signs of inflammation involving WBC?
- Leukocytosis with neutrophilia
- Leukocytosis with lymphocytosis
- Eosinophilia
- Thrombocytosis or thrombocytopenia
Leukocytosis with neutrophilia would mainly be seen under what cirucumstances?
- Acute inflammation
- Think bacterial infection
- Neutrophils can be depleted by severe infections
- Look for band form neutrophils too
Leukocytosis with lymphocytosis would mainly be seen under what circumstances?
- Chronic inflammation
- Think viral infection
Eosinophilia would mainly be seen under what circumstances?
- Parasitic infection
- Autoimmune
- Asthma/allergic
- Type II response
T/F >10% bands indicate inflammation.
True
*Bandemia
T/F Increased sedimentation rate is a laboratory sign of inflammation
True
What are 4 things associated with Increased sedimentation rate?
- Increased plasma fibrinogen, red cells clump, sink faster
- Fibrinogen is an acute phase reactant made in the liver
- Nonspecific disease indicator (Infections, autoimmune, tumor)
- Also an index of activity of a known disease
How many mm will red cells sink in one hour in a vertical capillary tube?
Normally <20mm
Name 3 other acute phase reactants
- CRP (C-reactive protein)
- Procalcitonin (a calcitonin precursor)
- Other acute phase reactants
- SAA (Serum amyloid A protein)
- Ceruloplasmin (Copper binding protein)
What are 3 things associated with CRP as an acute phase reactant?
a) Becomes abnormal faster than sedimentation rate
b) Can increase up to 1,000 fold
c) Mild increases in otherwise healthy subjects
What are 2 things involved with Procalcitonin as an acute phase reactant?
i. Largely specific or bacterial infection
ii. Can help determine if antibiotics are needed
Vasodilation and edema are a result of what?
Vascular changes in inflammation
T/F In Vascular changes in inflammation there can be multiple receptors and patterns of response–Immediate vs. delayed
True
Vascular changes allow _______ to enter the tissue
inflammatory cells
On a macroscopic level, vasodilation causes __________
Erythema
What is pulmonary edema?
Fluid in alveolar spaces
*Transudate, fluid does not have a lot of protein
T/F If you see a plumonary edema with transudate, that is a good indication of inflammation
False, it would be from oncotic or hemodynamic problems, NOT an indication of inflammation
What does ARDS stand for and is it a good indication of inflammation?
Acute/adult Respiratory Distress Syndrome
- Involves exudate (fluid plus plasma proteins)
- This IS an indication of inflammation and injury
T/F In ARDS, hyaline membranes are formed
True
Mast cells are _______ cells and are often coated with _______
- Tissue resident
2. IgE
Lymphocytes induce _______ , ______ immunity
- Chronic
2. Acquired
What are the two major types of lymphocytes?
B and T
What is the general function of B cells?
- Make antibody
- Can become plasma cells
What are T cells for?
- They direct Chronic immune response.
- There are multiple types
Which T cells are for Fungal, mycobacterial, and other infections?
CD4 TH1
Which T cells are for parasitic infections and allergies?
CD4 TH2
Which T cells are for ongoing neutrophil infiltrates?
TH17
Which T cells are involved in direct cytotoxicity and fighting viral infections?
CD8
T/F Lymphoctes have a short life span and are seen at limited sites in the body
False,
*Can be long lived, present in many sites (esp. lymph nodes, spleen, thyus, and mucosal sites)
Give a brief definition of plasma cells and their histological description
- Differentiated B cells: make immunoglobulin
Histologically:
- Eccentric, round, clock-faced nuclei
- Abundant pink to blue-tinged cytoplasm
Which cell involved in Chronic inflammation can also be called a Histiocyte?
Macrophage
A granuloma is a cluster of epithelioid _________
Macrophages
*Abundant pink cytoplasm, back to back, +/- giant cells
What is the main precursor in the blood for macrophages?
Monocytes
Name some organs in which a macrphage might reside?
- Liver
- Lymph nodes
- Spleen
- Lung
- Intestine
- Marrow
T/F Granulomas can calcify
True
*Calcification often develops in an area of necrosis
Type II immune responses are in reaction to what?
To parasites and allergies or allergic-like diseases
What cells are associated with Type II immune responses?
- Th2 Lymphocytes
- Eosinophils
- Mast cells
- Basophils
Eosinophils respond to _____, _____, and ____
- IgE
- Mast Cells
- TH2 Lymphocytes
Eosinophils are prominent in response to _______ infection
parasitic
Eosinophils are also involved in pathologic effects in allergic diseases like _______
asthma
What is the rarest type of blood cell (0-2% of WBC) and also rare in tissue?
Basophils
What does a basophil look like histologically?
Deeply basophilic (blue) granules
Like mast cells, Basophils are _____ coated, and involved in ______ and responses to ______
- IgE coated
- Alleregies
- Parasitic infection
What type of inflammation would be present in Appendicitis?
Acute inflammation
