Pathophysiology of inflammation

Question 1

What are the 5 symptoms of inflammation?

Answer 1

Rubor- redness
Calor- heat
Tumor- swelling
Dolor- pain
Loss of function

Question 2

What are the 5 causes of inflammation?

Answer 2

Microbial infection
Allergy
Physical agents
Chemicals
Tissue necrosis

Question 3

What 3 substances are released after a trigger of inflammation?

Answer 3

Histamine, prostaglandins and leukotrienes

Question 4

What do PAMPs and DAMPs do after being triggered to release?

Answer 4

PAMPs- alert immune cells to destroy intruding pathogens

DAMPs- promote pathological inflammatory response

Question 5

What cells are PAMPs and DAMPs recognised on and what do these cells do?

Answer 5

Sentinel cells

This refers to cells in the body’s first line of defence and patrol the body for the signs of infection

Question 6

What are the 4 types of cytokines and what do they do?

Answer 6

1) Interleukins
Signal between white blood cells
Can be pro-inflammatory and anti-inflammatory

2) Interferons
Interfere with viral replication

3) Chemokines 
Control the migration of white blood cells
Have adhesion molecules
Attract circulating cells
Most chemokines are neutrophils

4) Colony stimulating factors
Stimulate formation of maturing colonies of white blood cells

Question 7

How do white blood cells, cytokines, prostaglandins and histamine contribute to fluid exudate?

Answer 7

White blood cells -> cytokine -> histamine -> fluid exudate

Prostaglandins -> fluid exudate

Question 8

What 3 cascades does fluid exudate directly cause?

Answer 8

1) Coagulation cascade
Prevents blood by clotting by the release of thrombin

2) Fibronolytic cascade
Breaks down the clotting and releases plasmin

3) Kinin cascade
Maintains vascular response
Releases kallikrein-> bradykinin
Bradykinin:
A vasodilator that causes pain and stimulates NO synthesis as NO keeps the blood vessel open

Question 9

What cascade is indirectly activated by fluid exudate?

Answer 9

Complement cascade
  Releases histamine
  Opsonizes
  Activates phagocytic cells
  Contributes to the lysis of bacteria
  Chemotactic- attracts cells

Question 10

What are the steps of phagocytosis?

Answer 10

1) The phagocyte recognises the pathogen due to opsonisation
2) The pathogen interacts with the phagocyte receptor
3) The phagocyte envelopes with the pathogen inside. Lysosomes break down the pathogen due to the presence of proteolytic enzymes and hydrogen peroxide

Question 11

What are some benefits and harms of inflammation

Answer 11

Benefits:
Delivery of antibodies, nutrients and oxygen, drugs such as antibodies
Stimulates adaptive immunity

Harms:
Digestion of normal tissues
Swelling (in airways)
Inappropriate inflammatory to harmless stimulus (hypersensitivity)

Question 12

What are some ways to treat inflammation?

Answer 12

RICE
(rest, ice, compression, elevation)

NSAIDs
These reduce inflammation by stopping production of prostaglandins

Aspiration of fluid

Injection of corticosteroids

Question 13

What are 2 examples of antigen-presenting cells?

Answer 13

Dendritic cells- detect pathogens, antigen presentation, activate adaptive immunity

Macrophages- Engulf tissue debris, dead cells, antigen presentation

Question 14

What are the 2 types of macrophages and what do they do?

Answer 14

M1- pro inflammatory

M2- tissue repair and healing

Question 15

What happens after antigens are processed by APCs?

Answer 15

They are presented with major histocompatibility complex

Major histocompatibility complex: proteins found on surfaces of cells that help the immune sysrem recognise foreign substances

Question 16

Where do the APCs travel to get to the lymphocytes?

Answer 16

In the lymphatic system to the lymphoid tissue to present antigen to lymphocytes

Question 17

What are the 2 types of lymphocytes, where are they formed and what do they do?

Answer 17

B cells- mature in bone marrow, make antibodies

T cells- mature in thymus, cell mediated immunity

Question 18

What are the 2 stages of adaptive immunity?

Answer 18

Induction phase

Effector stage

Question 19

What are the 2 types of effector stages?

Answer 19

Humoral immunity and cell mediated immunity

Question 20

What happens in humoral immunity?

Answer 20

B cells make antibodies

Question 21

What are the 5 types of antibodies and what do they do?

Answer 21

IgG- memory antibody
IgM- first antibody to appear in response to antigen
IgE- mediates allergies
IgA- works on mucous membranes
IgD- makes up 1% of proteins in plasma proteins of B-lymphocytes

Question 22

What happens in cell mediated immunity?

Answer 22

Cytotoxic T cells kill intracellular microorganisms

Activate macrophages

Question 23

What are the four possible outcomes of inflammation?

Answer 23

Complete healing
Abscess formation
Excessive necrosis
Scarring

Question 24

What are the difference in cells in chronic and acute inflammation

Answer 24

Chronic inflammation:
Lymphocytes, plasma cells, macrophages
More granulation and scaring

Acute inflammation:
Mostly neutrophils

Question 25

What are the benefits and harms of inflammation medication?

Answer 25

Benefits:
Relieves symptoms of inflammation
Reduce tissue damage due to chronic inflammation

Harms:
Prevents healing by allowing activity by suppressing pain
Suppresses other inflammatory responses to infections