what is the ‘starling’s law’ in regards to movement of fluid?
- movement is a balance of Hydrostatic pressure ( pressure on vessel wall by fluid pushing it away) and the oncotic pressure (exerted by protein drawing fluid in) in vessels and interstitium.
what is Exudate?
protein rich interstitial fluid that delivers protein to area of injury as a response to inflammation when vascular permeability increased.
what is Transudate?
interstitial fluid that move due to increased capillary hydrostatic pressure or reduced oncotic pressure in heart/hepatic/renal failure without change in vascular permeability.
what are the inflammatory mediators at vasodilation in acute inflammation?
- Histamine
- serotonin
- prostaglandins
- Nitric oxide
what are the inflammatory mediators at increase in vaso-permeability in acute inflammation?
- histamine
- bradykinin
- leukotrienes
- C3a & C5a
what are the inflammatory mediators at chemitaxis in acute inflammation?
- C5a
- TNF-a
- IL-1
- Bacterial peptides
what are the inflammatory mediators at systemic fever in acute inflammation?
- Prostaglandins
- IL-1
- IL-6
- TNF-a
what are the inflammatory mediators at body pain in acute inflammation?
- bradykinin
- substance P
- prostaglandin
what are some local complications of acute inflammation?
- swelling/ tumor which may cause compression
- exudate which could compress organs eg:pericarditis
- loss of fluid as exudate evaporates in burns
- pain which encourages healing
what are some systemic complications of acute inflammation?
- fever as mediators act on hypothalamus in increase
- leucocytosis which is the excessive production of white cells shown as high neutrophils in bacterial and high lymphocytes in viral causes.
- acute phase response to induce rest (sleep, less apetite, malaise)
- septic shock which can lead to organ failure.
What type of drugs can be given to battle systemic fever?
non-steroidal anto-inflammatory drugs NSAIDs
- blocks cyclo-oxygenase which is involved in producing prostaglandins.
eg: ibroprufen and aspirin.
what are acute phase proteins?
- important markers in inflammation.
- C-reactive proteins
- fibrinogens
- alpha 1 antitrypsin
what causes appendicitis?
- due to blocked lumen due to faecolith.
- accumulation of bacteria and exudate.
- perforation due to increase in pressure.
what is pneumonia?
- causes : streptococcus pneumoniae, haemophilus influenzae.
- symptoms : SOB, cough, sputum, fever.
- risk factors : pre-existing lung conditions, COPD, asthma, malignancy.
what is bacterial meningitis?
*rapidly fatal.
- inflammation of meninges which is the protective layer between skull and brain.
- causes : group b streptococcus, E.coli, neisseria meningitides.
- symptoms : headache, neck stiff, photophobia, altered mental state.
what is an abscess?
- accumulation of dead and dying neutrophils with associative liquefactive necrosis.
- can cause compression in surrounding strictures.
- pain due to blockage of ducts.
what are the inflammation of serous cavities?
- pleural effusion due to trasudate or exudate in lungs.
- peritoneal space ascites.
- pericardial effusion showing as enlarged cardiac silhouette on chest X-ray.
any known rare acute inflammation disorders?
- hereditary angio-oedema
- alpha-1 antitrypsin deficiency
- chronic granulomatous disease
