Pathoma: Acute Inflammation

Question 1

Explain the purposes and typical situations of acute inflammation.

Answer 1

(1) infection – eliminate and phagocytose pathogen; (2) necrosis – eliminate debris

Question 2

_____ is a classic Toll-like receptor; it is present on the surface of macrophages and recognizes lipopolysaccharide.

Answer 2

CD14 (know this!)

Question 3

TLRs are present on _________.

Answer 3

cells of the innate and adaptive immune systems

Question 4

What enzyme cleave off arachidonic acid?

Answer 4

Phospholipase A2

Question 5

I2, D2, and E2 are types of ______ and mediate vasodilation (at the arteriole) and _______.

Answer 5

prostaglandins; vascular permeability (of the postcapillary venule)

Question 6

PGE2 mediates ___________.

Answer 6

fever (feeeeeeever) and pain

Question 7

There are four kinds of leukotriens: LTB4, LTC4, LTD4, and LTE4. What do they do?

Answer 7

LTB4 activates neutrophils; C4, D4, and E4 mediate vasoconstriction, bronchospasm, and vascular permeability (smooth muscle contraction)

Question 8

Mast cells can be activated by three ways: ____________.

Answer 8

tissue trauma, C3a and C5a, and IgE cross-linking

Question 9

Histamine has two functions: ________.

Answer 9

vasodilation and vascular permeability

Question 10

What attracts neutrophils?

Answer 10

IL-8, C3a, and LTB4

Question 11

In what cell type does the arachidonic acid reaction occur?

Answer 11

Mast cells (late phase IgE response)

Question 12

Hageman factor is produced by the ______ and is activated by _________.

Answer 12

liver; contact with tissue collagen (by seeping through permeable vessels)

Question 13

What three things does Hageman factor do?

Answer 13

Activates the coagulation pathway and fibrinolytic system; activates complement; and activates the kinin system (which mediates pain, vasodilation, and vascular permeability)

Question 14

What three things mediate pain?

Answer 14

Prostaglandin E2, bradykinin, and substance P

Question 15

Describe how fever occurs.

Answer 15

Pathogens cause macrophages to release TNF and IL-1; IL-1 and TNF get to the perivascular cells of the hypothalamus, where they stimulate COX activity; increased COX activity causes increased release of PGE2.

Question 16

What attracts neutrophils?

Answer 16

IL-8, C3a, and LTB4

Question 17

In what cell type does the arachidonic acid reaction occur?

Answer 17

Mast cells (late phase IgE response)

Question 18

Hageman factor is produced by the ______ and is activated by _________.

Answer 18

liver; contact with tissue collagen (by seeping through permeable vessels)

Question 19

What three things does Hageman factor do?

Answer 19

Activates the coagulation pathway and fibrinolytic system; activates complement; and activates the kinin system (which mediates pain, vasodilation, and vascular permeability)

Question 20

What three things mediate pain?

Answer 20

Prostaglandin E2, bradykinin, and substance P

Question 21

Describe how fever occurs.

Answer 21

Pathogens cause macrophages to release TNF and IL-1; IL-1 and TNF get to the perivascular cells of the hypothalamus, where they stimulate COX activity; increased COX activity causes increased release of PGE2.

Question 22

What are the three phases of acute inflammation?

Answer 22

Fluid, neutrophils, and macrophages

Question 23

There are two selectins (__________) on endothelial cells. Which is activated by TNF and IL-1?

Answer 23

P-selectin and E-selectin; E-selectin

Question 24

Which endothelial selectin is mediated by histamine?

Answer 24

P-selectin

Question 25

What do selectins bind on the leukocytes?

Answer 25

Sialyl Lewis X (a tetrasaccharide)

Question 26

What stimulates integrin expression on endothelial cells? On leukocytes?

Answer 26

TNF and IL-1 (on endothelial cells); C5a and LTB4 on leukocytes

Question 27

What are presenting signs of LAD?

Answer 27

Late umbilical cord detachment, neutrophilia, recurrent infections without pus

Question 28

What disorder results from an inability to merge phagosomes with lysosomes?

Answer 28

Chediak-Higashi syndrome, a defect of microtubules that would normally guide these organelles toward one another

Question 29

What are other symptoms of Chediak-Higashi syndrome?

Answer 29

Neutropenia (because these cells lack microtubules needed in mitosis), albinism (because melanocytes cannot distribute melanosomes), peripheral neuropathy (because the nuclei of large nerves needs the “railroad system” of traffickng tubules to keep distant nerves alive), and giant granules

Question 30

What is the bleach pathway?

Answer 30

O2 -> O2-* (by NADPH oxidase); O2-* -> H2O2 (by superoxide dismutase); H2O2 -> HOCl (by myeloperoxidase)

Question 31

Chronic granulomatous disease (CGD) results in _________.

Answer 31

susceptibility to catalase-positive organisms, because those bacteria do not have trace amounts of H2O2 (because they have catalase) which could normally be used as a substrate in the myeloperoxidase-catalyzed reaction

Question 32

What are catalase-positive organisms?

Answer 32

S. aureus, P. cepacia, S. marcescens, Nocardia, and Aspergillus

Question 33

What does the nitro blue tetrazolium test specifically test?

Answer 33

Whether or not there is NADPH present (blue is positive)

Question 34

Those with myeloperoxidase deficiency will have _______ NBT tests.

Answer 34

positive (their defect is further down the pathway)

Question 35

What are some oxygen-independent mechanisms of killing pathogens?

Answer 35

Lysozyme and major basic protein

Question 36

Macrophages mostly utilize _________ killing.

Answer 36

oxygen-independent (lysozyme)

Question 37

IL-8 is produced by _______ and calls in _______.

Answer 37

macrophages; neutrophils