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Veterinary Pathology > Unit 3 - Acute Inflammation > Flashcards

Unit 3 - Acute Inflammation Flashcards

1
Q

The response of living tissue to injury. Involves a well-organized cascade of fluidic and cellular changes:

A

Inflammation

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2
Q

What is the primarily delivery system for inflammatory components?

A

blood

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3
Q

mediated by prostaglandins that are increased in the hypothalamus

A

fever

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4
Q

Which prostaglandins produce fevers?

A

TNF, IL-1, IL-6

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5
Q

What increases cyclooxygenases that convert AA to prostaglandins (PGE2)

A

Cytokines

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6
Q

How do NSAIDs reduce fever?

A

by inhibiting prostaglandin synthesis

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7
Q

Stimultes acute phase protein production by the liver:

A

IL-1, IL-6

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8
Q

List the three common acute phase proteins:

A
  • C-reactive protein
  • SAA
  • Fibrinogen
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9
Q

Predominance of mononuclear cells is characteristic of:

A

chronic inflammation

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10
Q

What are the primary mononuclear cells?

A

macrophages, lymphocytes, plasma cells

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11
Q

The inner wall of an abscess is granulation tissue, called a:

A

pyogenic membrane

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12
Q

Standardized reaction, Early response; Hours to days:

A

acute

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13
Q

Alteration of an inflammatory; weeks to years:

A

chronic

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14
Q

What are the goals of acute inflammation?

A
  1. dilute toxins
  2. isolate
  3. eliminate
  4. repair
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15
Q

Increased _______ often indicates a bacterial infection:

A

neutrophils

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16
Q

Increased ______ are associated with viral infections:

A

lymphocytes

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17
Q

an abnormally high number of circulating white blood cells:

A

leukocytosis

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18
Q

What part of the brain coordinates a fever?

A

hypothalamus

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19
Q

5 Cardinal Signs of Inflammation:

A

Heat, redness, swelling, pain, loss of function

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20
Q

What is the stimulus that triggers inflammation?

A

tissue injury

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21
Q

List three exogenous stimulants of inflammation:

A

microbes, foreign bodies, and injury (chemical, thermal, heat, ischemia)

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22
Q

List the 2 endogenous inflammation stimulants:

A

hypersensitivity, autoreactive

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23
Q

Inflammation activates the:

A

innate immune response

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24
Q

What is the cellular phase of acute inflammation?

A

leukocyte emigration

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25
Q

What is the fluidic phase of acute inflammation?

A

microvascular exudation of electrolutes, fluid, and plasma proteins

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26
Q

How does the body recognize invaders/foreign material?

A
  • cellular receptors
  • cellular sensors
  • circulating proteins
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27
Q

Where are some of the cellular receptors located on immune cells?

A
  • PM (extracellular)
  • cytosol (intracellular)
  • endosome (ingested)
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28
Q

Each TLR recognizes:

A

a different set of microbial molecules

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29
Q

TLR-4 recognizes:

A

LPS

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30
Q

PAMPs associated with:

A

microbial structures

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31
Q

DAMPs associated with:

A

released from necrotic cells

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32
Q

Which cytosolic receptors recognize a diverse set of molecules and active the inflammasome?

A
  • bacterial products
  • crystals
  • K+ efflux
  • reactive O2 species
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33
Q

Inflammasomes induce the production of:

A

IL-1

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34
Q

IL-1 recruits:

A

leukocytes

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35
Q

Receptors located on the plasma membrane that detect fungal glycans and elicit inflammation to fungi:

A

C-type lectin receptors

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36
Q

receptors that recognize antibodies and complement proteins:

A

Fc (recognize opsonized material)

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37
Q

circulating proteins that react against microbes and produces mediators of inflammation:

A

complement

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38
Q

substances that initiate and regulate inflammatory reactions:

A

mediators of inflammation

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39
Q

What are some ways inflammatory mediators are kept in check?

A
  • short half-lives
  • enzymatically destroyed
  • scavenged by antioxidants
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40
Q

One mediator can stimulate the release of:

A

other mediators

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41
Q

What organ constantly secretes inflammatory mediators from plasma proteins?

A

liver

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42
Q

What cell types produce histamine?

A

mast cells, basophils, and platelets

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43
Q

What is the function of histamine?

A

vasodilation

increased vascular permeability

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44
Q

What cell types produce serotonin?

A

mast cells, platelets

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45
Q

What is the function of serotonin?

A

similar to histamine

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46
Q

List the synthesized mediators (3):

A
  • cytokines
  • chemokines
  • arachidonic acid metabolites
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47
Q

Which cells are the primary activators of cytokines?

A

macrophages, lymphocytes, dendritic cells

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48
Q

Which cytokines are responsible for acute inflammation?

A

TNF, IL-1, IL-6

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49
Q

What is the function of cytokines?

A

regulate immune and inflammatory reactions

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50
Q

4 main functions of cytokines?

A
  1. endothelial activation
  2. leukocyte recruitment
  3. leukocyte activation
  4. systemic acute phase response
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51
Q

cytokines that promote leukocyte chemotaxis and migration:

A

chemokines

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52
Q

secreted by activated macrophages, endothelial cells, and others

A

IL-8

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53
Q

Which interleukin causes the chemotaxis of neutrophils?

A

IL-8

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54
Q

What are the lipid mediators produced from arachidonic acid present in membrane phospholipids?

A

prostaglandins, leukotrienes

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55
Q

Prostaglandin function:

A

vasodilation

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56
Q

leukotriene function:

A

vasoconstriction, increased vascular permeability, chemotaxis/leukocyte adhesion

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57
Q

Thromboxane function:

A

vasoconstriction

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58
Q

Collection of soluble proteins and membrane receptors that function in host defense; circulate as inactive form in plasma

A

complement system

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59
Q

deposition of the MAC results in:

A

cell lysis

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60
Q

Which complement cleavage products stimulate inflammation via histamine release?

A

C3a and C5a

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61
Q

Which complement cleavage product is chemotactic for leukocytes?

A

C5a

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62
Q

Which complement cleavage product is useful for opsonization/phagocytosis?

A

C3b

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63
Q

Activates the intrinsic coagulation AND catalyzes the formation of kallikrein:

A

factor 12

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64
Q

Functions of bradykinin:

A
  • increased vasc. permeability
  • vasodilation
  • pain
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65
Q

What is the function of kallikrein?

A

plasminogen –> plasmin

cleaves C3

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66
Q

Synthesized by endothelial cells and macrophages:

A

nitric oxide

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67
Q

3 functions of nitric oxide:

A
  • vasodilation
  • inhibits platelet aggregation and adhesion
  • oxidizes lipids
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68
Q

Platelet activating factor functions in:

A

vasoconstriction and bronchoconstriction

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69
Q

Which principal mediators are responsible for vasodilation?

A

histamine

prostaglandins

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70
Q

Which principal mediators are responsible for increased vascular permeability?

A
  • histamine
  • serotonin
  • C3a, C5a
  • leukotrienes
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71
Q

Which principal mediators are responsible for chemotaxis, leukocyte recruitment, and activation?

A
  • TNF
  • IL-1
  • IL-8 (neutrophil chemotaxis)
  • Chemokines
  • C3a, C5a
  • Leukotrines
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72
Q

Which principal mediators are responsible for fever?

A
  • IL-1
  • TNF
  • Prostaglandins
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73
Q

Which principal mediators are responsible for pain?

A
  • prostaglandins

- bradykinins

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74
Q

Which principal mediators are responsible for tissue damage?

A
  • lysosomal enzymes of leukocytes

- reactive oxygen species

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75
Q

Which phase of acute inflammation functions in dilution and localization of the stimulus?

A

fluidic phase

76
Q

Sequence of vascular events of the fluidic phase:

A
  1. increased blood flow

2. increased permeability of capillaries and postcapillary venules

77
Q

Why does increased vascular permeability mainly occur in venules?

A

high density of histamine receptors

78
Q

What allows for the retraction of endothelial cells?

A

actin/myosin

79
Q

results from increased vascular permeability

A

serous fluid

80
Q

suggests that the injury is rather mild or peracute

A

serous fluid

81
Q

clear watery fluid with low concentration of plasma protein and no/low # of leukocytes

A

serous fluid

82
Q

What are some likely times you will see serous fluid?

A

mild skin injury, allergy (runny nose), serosal surfaces

83
Q

What does the histology of serous fluid typically look like?

A

affected tissues are spread apart by watery fluid

84
Q

Dehydration of serous exudate released from injured vessels:

A

serous crust

85
Q

termed used to describe a PATTERN of acute inflmmation:

A

fibrinous inflmmation

86
Q

Exudate that has leakage of large molecular weight proteins (fibrinogen) that then polymerize to form fibrin:

A

fibrinous inflammation

87
Q

Accumulation of fluid with a high concentration of plasma protein:

A

exudate

88
Q

Where is fibrinous exudate most commonly seen?

A

in serous membranes of body cavity (pleura, pericardium, peritoneum, synovial membrane)

89
Q

What is the gross appearance of fibrinous exudate?

A
  • surface tissue is often hyperemic
  • early - surface may be granular and dull
  • surface covered with fibrin
90
Q

Fibrinous exudate on histopath often involves:

A
  • eosinophilic proteinaceous material - often fibrillary

- rapidly infiltrated by neutrophils

91
Q

If extensive, fibroblasts may migrate in and begin organizing exudate leading to fibrinous adhesions:

A

fibrinous inflammation

92
Q

Delivers leukocutes to the site in order to kill and/or digest the stimulus (neutrophils and macrophages)

A

cellular phase

93
Q

What are the steps of the cellular phase (4)?

A
  1. Margination
  2. Rolling
  3. Adhesion to endothelium
  4. Migration
94
Q

Which cytokines enhance expression of rolling and adhesion?

A

TNF, IL-1

95
Q

Exongenous products that induce chemotaxis:

A
  • bacterial products

- some lipids

96
Q

Endogenous products:

A
  • IL-8
  • complement
  • arachidonic acid
97
Q

Monocytes/macrophages are seen how many hours after injury?

A

24-48

98
Q

Neutrophils are seen how many hours after injury?

A

6-24

99
Q

The first cells to arrive depends on the:

A

stimulus

100
Q

Neutrophils are the first cells to arrive in a:

A

bacterial infection

101
Q

Lymphocytes and plasma cells are the first to arrive in:

A

hypersensitivity reactions

102
Q

Eosinophils are the first to arrive in:

A

allergic reactions

103
Q

Lymphocytes are the first to arrive in:

A

viral infections

104
Q

Which type of inflammation involves a response consisting of an accumulation of fluid with high concentrations of plasma proteins and high number of neutrophils?

A

purulent inflammation

105
Q

Which term is often used synonymously with purulent but often implies that a larger amount of pus is present?

A

suppurative

106
Q

an accumulation of dead neutrophils

A

pus

107
Q

If the purulent exudate is white, it means:

A

neutrophils are predominant component

108
Q

If the purulent exudate is yellow:

A

there is lots of necrotic debris

109
Q

What are the three types of consistencies associated with purulent inflammation?

A
  1. watery
  2. creamy
  3. firm
110
Q

When purulent inflammation is mixed with fibrin:

A

fibrinopurulent

111
Q

on microscopic examination, you will see large numbers of neutrophils, many degenerate neutrophils and mixed with necrotic cellular debris, tissue debris, plasma proteins, and fibrin:

A

purulent inflammation

112
Q

If purulent inflammation progresses to chronic inflammation it becomes:

A

an abscess

113
Q

Mediated by prostaglandins that are increased in the hypothalamus:

A

fever

114
Q

Which cytokines mediate fever?

A

TNF, IL-1, IL-6

115
Q

Increase production of leukocytes by the bone marrow:

A

TNF, IL-1, IL-6

116
Q

stimulate acute phase protein production by the liver:

A

IL-1, IL-6

117
Q

What are the acute phase proteins? (3)

A
  • c-reactive protein
  • SAA
  • fibrinogen
118
Q

Cytokines and acute phase proteins affect (3):

A

heart rate, blood pressure, body temp

119
Q

clinically significant form of bacteremia complicated by toxemia, fever, malaise, and often shock:

A

septicemia

120
Q

Septicemia gross findings:

A

fluid in body cavity, pulmonary edema, petechial hemorrhages, congestion of the liver and intestine

121
Q

Septicemia histologic findings:

A

acute necrosis of renal tubules, centrolobular hepatocytes, and cardiac myocytes

122
Q

What is the major interleukin that recruits neutrophils?

A

IL-8

123
Q

How long do neutrophils live in the tissue?

A

1-2 days

124
Q

How long do neutrophils live in circulation?

A

24 hours

125
Q

List the 2 main functions of neutrophils:

A
  • phagocytosis

- release of granular contents

126
Q

What’s different about cow neutrophils?

A

cytoplasm is more eosinophilic

127
Q

What are two other names for neutrophils?

A

myeloid cells

PMNs

128
Q

What are the important granules released by neutrophils?

A
  • myeloperoxidase

- lysozyme

129
Q

converts hydrogen peroxide (and chloride anions) to hypochlorous acid (toxic to microbes)

A

myeloperoxidase

130
Q

form pores in membranes

A

defensins

131
Q

enzymes released by neutrophils cause liquefaction of the exudate and:

A

accumulation of pus

132
Q

Reptiles and birds have reduced concentration of the enzymes released by neutrophils and thus:

A

cannot liquefy the exudate (and a caseous material forms)

133
Q

extracellular fibrillary networks that provide a high concentration of antimicrobial substances

A

NETs

134
Q

What are NETs composed of?

A

meshwork of nuclear chromatin

135
Q

How long do eosinophils live in circulation?

A

12 hours

136
Q

How long do eosinophils live in the tissue?

A

1 week

137
Q

What are eosinophils attracted by?

A

histamine, eosinophil chemoattractant factor A

138
Q

When do eosinophils enter lesions?

A

during the transition from acute to chronic

139
Q

Gives the muscle a tan-green tinge:

A

large numbers of eosinophils in the CT of muscles

140
Q

Found in all supporting tissues:

A

mast cells/basophils

141
Q

How long do mast cells live?

A

4-12 weeks

142
Q

Have the ability to replicate in tissues:

A

mast cells

143
Q

Which type of cell is distributed in skin, GI, and around blood vessels?

A

mast cells

144
Q

Mast cells express high affinity for which immunoglobulin?

A

IgE

145
Q

Which stain type is used to see the metachromatic granules of mast cells?

A

Giemsa

146
Q

In circulation, monocytes are:

A

short lived

147
Q

In tissues, macrophages are _____-____ are retained the ability to proliferate:

A

long-lived

148
Q

What are the three functions of monocytes/macrophages?

A
  • phagocytosis
  • antigen presentation
  • immune modulation
149
Q

Macrophages of the liver:

A

Kupffer cells

150
Q

Macrophages of the CNS:

A

microglia

151
Q

Macrophages of the lungs:

A

alveolar macrophages

152
Q

Macrophages of the skin:

A

Langerhans cells

153
Q

Macrophages of the bone:

A

osteoclasts

154
Q

Which cell type arrives as a second wave after neutrophils - 12-48 hours - and takes over?

A

macrophages

155
Q

What do platelets arise from?

A

megakaryocyte fragmentation in marrow

156
Q

Which preformed substance do platelets carry?

A

histamine

157
Q

Offending agent is quickly eliminated, little tissue is damaged:

A

complete resolution

158
Q

agent persists, particularly one that is strongly chemotactic for neutrophils:

A

abscess

159
Q

With substantial parenchymal injury and loss, granulation tissue fills in the defects:

A

healing by fibrosis

160
Q
  • hyperemia is typical, often with protein rich fluid exudate
  • neutrophils are the predominant leukocyte
A

acute

161
Q
  • characterized by fibrous and vascular proliferation
  • reduced hyperemia
  • parenchymal proliferation
  • few to no neutrophils
A

chronic

162
Q

What are some chronic modifiers?

A
  • granulomatous (lots of macrophages)
  • lymphocytic
  • lymphoplasmocytic
  • fibrosing
  • proliferative
163
Q

What are some causes of serous inflammation?

A
  • early reaction to many inciting causes
  • trauma to joints
  • burns
164
Q

What is the function of a serous exudate?

A

dilution of offending agent

165
Q

Exudate of accumulation of serum-like fluid

A

serous inflammation

166
Q

Secretion of large amounts of mucus that occurs only in mucous membranes:

A

catarrhal inflammation

167
Q

What can cause catarrhal inflammation?

A
  • mild irritants

- mild/early inflammation

168
Q

What is the gross appearance of catarrhal inflammation?

A

clear film

169
Q

What is the microscopic appearance of catarrhal inflammation?

A
  • pale blue strands of mucus

- may be mixed with inflammatory cells

170
Q

Exudate containing a large amount of fibrin:

A

fibrinous exudate

171
Q

What is the gross appearance of fibrinous exudate?

A

dull granular to thick sheets

172
Q

What is the microscopic appearance of fibrinous exudate?

A

fibrillar eosinophilic material

173
Q

Exudate containing large numbers of neutrophils, necroptic tissue cells, fibrin, and necrotic inflammatory cells:

A

suppurative/purulent exudates

174
Q

collection of pus with a fibrous capsule:

A

abscess

175
Q

Which type of exudate reflects severe vascular injury, arises quickly, and is often fatal?

A

hemorrhagic exudate

176
Q

Hemorrhagic exudate often involves:

A

mucosal surfaces

177
Q

Hemorrhagic exudate gross appearance:

A

deep red and pink to red-tinged fluid is present

178
Q

Which type of exudate can accompany many disease processes?

A

hemorrhagic

179
Q

suggests severe destruction of host tissue (recruits inflammation, calls in fibrins):

A

necrotizing

180
Q

a covering of a mucosal surface by a coagulum of fibrin, mucus, necrotic cells, and leukocytes:

A

pseudomembranes

181
Q

How can you tell if a pseudomembrane is present?

A

when the exudate is peeled away, leaves an ulcerated mucosal surfacce

182
Q

Inflammation of the kidney due to a bacterial infection:

A

pyelonephritis

183
Q

An infection in any part of the urinary system, the kidneys, bladder, or urethra:

A

cystitis

184
Q

What is the pathogenesis for the lay-down of fibrin on an organ?

A

acute inflammation, leakage of protein –> deposition of fibrin

185
Q

If you see whispy material on histo, what most likely are you seeing?

A

fibrin

Veterinary Pathology (14 decks)

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