Sem 1 - inflammation and healing

Question 1

components of the acute inflammatory response? (4)

Answer 1

1. vasodilation with hyperaemia (more blood flow).
2. Endothelial activation and increase vascular permeability.
3. Neutrophil infiltration
4. Macrophage infiltration

Question 2

components of the acute inflammatory exudate? (3)

Answer 2

neutrophils, fluid and fibrin

Question 3

An inflammatory exudate characterised by large numbers of neutrophils is known as?

Answer 3

purulent

Question 4

which abnormal laboratory findings would you most expect in a patient with a florid acute inflammatory disease process? (3) and why?

Answer 4

increase neutrophils.
increase CRP (activates complement system).
increase ESR.

Question 5

Components of granulations tissue? (7)

Answer 5

fibroblasts, myofibroblasts, capillaries, macrophages and lymphocytes, oedema (at least early - from leaky newly formed capillaries) and some extracellular matrix(more as time progresses).

Question 6

when is granulation tissue required?

Answer 6

when the injury, infection or acute inflammatory response results in destruction of connective tissue and/or the tissue type is unable to regenerate,

Question 7

characteristic histologic features of plasma cells? (4)

Answer 7

1. amphophilic cytoplasm (takes both up H & E) The 2. Eccentric Nucleus (cytoplasmic machinery pushes the nucleus away from the centre).
2. Clockface ( number of nucleoli in nucleus).
3. Perinuclear hof (pale area adjacent to the nucleus - well dveloped golgi)

Question 8

Which cells (name 2) are characteristic of granulomatous inflammation?

Answer 8

epithelioid macrophages and multinucleate giant cells.

Question 9

what is a myeloblast? name 2 features histologically

Answer 9

a unipotent stem cell that can develop to either neutrophils, macrophages, basophils, eosinophils.

1. Large non-segmented nucleus.
2. Few cytoplasmic granules

Question 10

What does the term ‘left shift” or “shift to the left” mean in relation to the appearance of a blood film and why does it occur? (2 marks)

Answer 10

increase in Immature neutrophils released from the bone marrow in response to severe inflammation including severe infection.

Question 11

What do fibroblasts make?

Answer 11

collagen, elastin and other constituents of extracellular matrix (GAGs)

Question 12

From what protein is fibrin derived and where is this protein made?

Answer 12

from fibrinogen (by the action of thrombin), made in the liver and circulates as a plasma protein.

Question 13

In what 2 main processes is fibrin involved?

Answer 13

acute inflammation and in coagulation of blood.

Question 14

size of a RBC and neutrophil?

Answer 14

RBC 7um. neutrophil 10-14

Question 15

Which type of white blood cell is the most abundant in blood?

Answer 15

neutrophil

Question 16

Why are neutrophils, basophils and eosinophils collectively known as granulocytes?

Answer 16

granules in cytoplasm

Question 17

in lobar pneumonia what differences might you expect to see in the blood vessels compared to normal lung?

Answer 17

dilated and congested

Question 18

What is the general term given to the combined layer of mesothelial cells and its underlying connective tissue that lines body cavities?

Answer 18

serous membrane or serosa

Question 19

What specific abnormality would you expect in the white blood cell count in acute inflammation?

Answer 19

neutrophilia

Question 20

Explain, including relevant cytokines, how this neutrophilia develops. (3 marks)

Answer 20

Cells, predominantly macrophages, in the acute inflammatory response release IL-1, IL-6 and TNF. These circulate systemically and cause the bone marrow to release some of its reserve pool of neutrophils such that more are available for the inflammatory response. In more severe and prolonged acute inflammatory responses it may also increase its production of neutrophils.

Question 21

How does the morphology of the cells in the germinal centres differ from the surrounding cells? What is happening in a germinal centre? (3 marks)

Answer 21

The cells in the germinal centre are generally larger than the surrounding lymphocytes with more cytoplasm and larger paler nuclei. These cells are B cells that are actively dividing and differentiating into plasma cells.

Question 22

how long into the healing process will one see granulation tissue?

Answer 22

1-2 weeks

Question 23

difference b/w healing by primary and secondary intetion

Answer 23

primary: wound edges are brought together.
secondary: edges are not apposed , wound allowed to granulate

Question 24

lifespan of a neutrophil?

Answer 24

1-3 days

Question 25

lifespan of a lymphocyte?

Answer 25

can be more than 20 years