Repair & Inflammation

Question 1

What do fibroblasts make?

Answer 1

Extracellular matrix

Ex: Collagen

Question 2

Fibroblasts can differentiate into what?

Answer 2

osteo- chondro- and adipo- cytes

but not epithelial cells

Question 3

What forms scar tissue?

Answer 3

Fibroblasts

Question 4

Name 2 characteristics of scar tissue

Answer 4

Scar lacks specialized function

Scar is actually smaller than the original

Question 5

What signals fibroblasts to injured sites?

Answer 5

Transforming GF-beta, Fibroblast GF-2, and platelet-derived GF. Secreted by marcophages and inflamm cells

Question 6

What is the most abundant white blood cell?

Answer 6

Neutrophil

Question 7

Who is the first responder to injury?

Answer 7

Neutrophil (pus)

Question 8

What effect does corticosteroids do to neutrophils?

Answer 8

Normally, neutrophils are along the vessel walls. Steroids will knock these cells off, which increases serum level readings (don’t mistake that for an infectious response) “Neutrophilia”

Question 9

How many lobes should a normal neutrophil nucleus have?

What if it’s more than that?

Answer 9

2-5.

above 5 is too many indicating megaloblastic anemia due to Vit B12/folate deficiency.

Question 10

What are bands?

Answer 10

Immature neutrophils

Question 11

Bandemia is defined as

Answer 11

With infection, the bone marrow will release its immature neutrophils into the blood hoping that they will fight. They are immature but can still phagocytose.

Question 12

What is the term “left shift?”

Answer 12

When acute infection causes release large amounts of even more immature cells than bands.

Question 13

How long do macrophages live?

Answer 13

One day if they don’t get recruited from the blood into a tissue. Once in the tissue, up to years.

Question 14

Genealogy of a macrophage?

Answer 14

Myeloid Precursor –> Monocyte –> Macrophage

Question 15

What are macrophages called in the: 
Liver
CNS
Lung
Lymphnode/spleen

Answer 15

Liver: Kuppfer cells
CNS: Microglial
Lung: Alveolar Macs
Lymph/spleen: sinus histiocytes

Question 16

What is the dominant player in chronic inflection?

Answer 16

Macrophage

Question 17

What is the role of an M1 activated mac?

Answer 17

Eat everything & release IL-1, 2, & 23 among other CK. This signals other inflammatory cells. Therefore M1 = proinflammatory

Question 18

How is a macrophage activated?

Answer 18

By the microbe

Question 19

What is the role of an M2 activated mac?

Answer 19

Secrete Transforming GF-beta which stimulates tissue repair and fibrosis. Therefore M2 = anti-inflammatory

Question 20

What are hemophages?

Answer 20

Macs with brown cytoplasm right after a hemorrhage due to absorbed hemosiderin

Question 21

What are Pigment-Laden Macs?

Answer 21

Macs after an MI which absorbed lipofuscin released from dead myocytes.

Question 22

T cells carry out which immunity?

Answer 22

Cell-mediated immunity

Question 23

B cells carry out which immunity?

Answer 23

Humeral (Ab) immunity

Question 24

Two causes of lymphocyte inflammation?

Answer 24

Infection & Autoimmune

Question 25

Plasma cells are derived from _____ and produce ________?

Answer 25

activated B cells single specific antibodies in great quantities

Question 26

Eosinophils fight what kinds of pathogens? (2)

Answer 26

Parasitic infections & allergic reactions (asthma) If present in blood, look for these pathogens.

Question 27

Eosinophil responses are mediated by which Ig?

Answer 27

IgE

Question 28

Mast cells hang around which parts of the body?

Answer 28

Vessels, nerves, and skin.

Question 29

What is the mast cell counter part?

Answer 29

Basophil

Question 30

Mast cells and basophils steal which Ig?

Answer 30

IgE

Question 31

Mast cells degranulate under what circumstances?

Answer 31

IgE is present on surface, which then binds to an antigen.

Question 32

Histamine causes?

Answer 32

Vasodilation and endothelial contraction

Question 33

Multinucleated giant cells will be present with acute or chronic inflammation?

Answer 33

Chronic

Question 34

What are the two types of giant cells?

Answer 34

Foreign body type Langhans type

Question 35

What is foreign body type?

Answer 35

When one man can't eat a large particle thus it gangs up with another.

Question 36

What is a granuloma?

Answer 36

Two or more activated macs come together to fight chronic infection

Question 37

Which giant cell type has peripheral nuclei?

Answer 37

Langhans

Question 38

What are labile cells?

Answer 38

Tissue that is continually lost and therefore has high proliferation capabilities. Example would include: skin, lining of mouth, GI tract, bladder, vagina, etc.

Question 39

What are Stable cells?

Answer 39

Cells that can proliferate if damaged or influenced, but don't typically proliferate.

Question 40

What are permanent cells?

Answer 40

Those that do not have proliferation abilities. Unless something strange and unusual occurs.

Question 41

Epidermal Growth Factor (EGF) promotes what type of growth?

Answer 41

fibroblast migration and proliferation

Question 42

Fibroblast Growth Factor stimulates?

Answer 42

Fibroblast migration and proliferation | Monocyte chemotaxis and angiogenesis

Question 43

Platelet derived growth factor (PDGF) promotes?

Answer 43

Same as FGF. Fibroblast mig/prolife. | Monocyte chemotaxis and angiogenesis

Question 44

Transforming GF (TGF) Beta stimulates

Answer 44

Fibroblast migration (MOST IMPORTANT ASSOCIATED WITH FIBROBLASTS)

Question 45

Genetic defects in structural proteins are typically show what kind of inheritance?

Answer 45

Autosomal Dominant

Question 46

Genetic defects in enzymes tend to show what kind of inheritance?

Answer 46

Autosomal recessive

Question 47

What are 4 components to granulation tissue?

Answer 47

1: Angiogenesis 2: Activated Fibroblasts (new collagen) 3: Lymphocytes and Macs 4: Cell Debris

Question 48

What is the most characteristic feature of granulation tissue?

Answer 48

angiogenesis (then new collagen)

Question 49

Organization in pathology means?

Answer 49

Getting healed.

Question 50

Angiogenesis is mediated by which growth factor?

Answer 50

VEGF

Question 51

What factors induce angiogenesis?

Answer 51

Hypoxia, TFG, and PDGF

Question 52

What are the 3 overlapping phases in cutaneous wound healing?

Answer 52

Inflammation Proliferation (granulation tissue) Maturation (wound contraction)

Question 53

Wound contraction is performed by

Answer 53

myofibroblasts

Question 54

Skin strength after 7 days is about ___ of the original. | Skin strength at 4 months is ____ and will remain like this for life.

Answer 54

10% | 75%

Question 55

What is the most important growth factor driving fibroblast migration, proliferation, and collegen synthesis?

Answer 55

TGF-Beta.

Question 56

In general, what determines wound healing rate?

Answer 56

Blood supply

Question 57

What is the most important cause of impaired wound healing?

Answer 57

Infection

Question 58

What is dehiscence?

Answer 58

rupture of surgical wound (most common place is abdomen due to high pressure with vomiting or coughing) or anastomosis (most common in bowels with infection)

Question 59

Hernia is?

Answer 59

Protrusion of a body part where it doesn't belong

Question 60

Keloids are?

Answer 60

hypertrophic scar. Scar is actually still proliferating because fibroblasts are still present.

Question 61

Contracture is?

Answer 61

Abnormal excess wound contraction which results in deformity and loss of function. Common on hands feet and unfortunately, the penis.

Question 62

Fibrosis is?

Answer 62

Excessive interstitial collagen deposition. which inhibits function. Typically makes something stiff and immobile (too much collagen.)