Inflammation

Question 1

Cardinal signs of inflammation

Answer 1

1. Rubor
2. Tumor
3. Calor
4. Dolor
5. Functio laesa

Question 2

Fates of acute inflammation

Answer 2

1. Complete resolution
2. Healing by connective tissue replacement (scarring or fibrosis)
3. Progression to chronic inflammation

Question 3

Vascular changes in acute inflammation

Answer 3

1. Change in vascular flow and caliber
   i. Vasodilation
   ii. Increased arterial blood flow
2. Increased vascular permeability of the microvasculature
3. Slowing of blood flow or stasis

Question 4

Define phagocytosis

Answer 4

Phagocytosis is the process by which phagocytic cells, mainly neutrophils and macrophages recognize and then engulf and dispose of foreign particles.

Question 5

Steps of phagocytosis

Answer 5

1. Recognition and attachment
2. Engulfment
3. Killing and degradation
   i. Killing
   A. O2 dependent free radical
   mediated mechanism
   a. MPO-halyde-system
   b. MPO-deficient system
   B. O2 independent lysosomal enzyme
   mediated mechanism
   ii. Degradation

Question 6

Outline of O2 dependent mechanism of microbial killing

Answer 6

Phagocytosis > O2 consumption > glycogenolysis > ^ glucose oxidation via HMP shunt > production of reactive oxygen species

1. MPO-halyde-system:
   Formation of superoxide anion
   Conversion of it to H2O2
   MPO in presence of a halide lile Cl- converts H2O2 to HOCl
   HOCl kills microbes by halogenation
2. MPO-deficient system:
   Killed by superoxide, hydroxyl radicals and singlet-oxygen

Question 7

Define granulomatous inflammation

Answer 7

It is a form of chronic inflammation characterized by collections of activated macrophages, often with T Lymphocytes, and sometimes associated with necrosis.

Question 8

5 examples of granulomatous inflammations/diseases

Answer 8

1. TB
2. Leprosy
3. Syphilis
4. Actinomycosis
5. Schistosomiasis
6. Crohn’s disease

Question 9

Define granuloma

Answer 9

A microscopic aggregation of epithelioid cells usually surrounded by a collar of lymphocytes is referred to as granuloma.

Question 10

Etiological classification of granuloma

Answer 10

1. Foreign body granulomas:
2. Immune granulomas

Question 11

Mechanism of immune granuloma

Answer 11

Causative agent of granuloma
‌‌|
Engulfed by macrophage and presented to helper T cell
|
Activated Th1 cells produce cytokines (IL-2 & IF-gamma)
|
Activated macrophages fuse and form multinucleated giant cells
|
Accumulation of lymphocytes, plasma cells and fibroblasts
|
Caseation necrosis may occur
|
Caseating granuloma(TB) if it occurs and non-caseating granuloma if it doesn’t.

Question 12

Morphology of granuloma

Answer 12

See figure on pg 111