Inflammation

Question 1

what vascular changes occur in acute inflammation?

Answer 1

increased flow
increased permeability

Question 2

what cellular reactions occur in acute inflammation?

Answer 2

extravasation of leukocytes
migration of leukocytes to target area

Question 3

what is the onset of acute inflammation?

Answer 3

rapid onset

<2 days - mins to days

Question 4

when is acute inflammation terminated?

Answer 4

when stimulus is withdrawn and mediators die down

Question 5

what is the prominent cell type in acute inflammation?

Answer 5

Polymorphonuclear Leukocytes

neutrophils*, eosinophils, basophils

Question 6

what is the pattern of increased flow in acute inflammation?

Answer 6

initial transient vasoconstriction
vasodilation
slows down = stasis = oedema

Question 7

what mediates vasodilation in acute inflammation?

Answer 7

PG12
NO

Question 8

what are the x4 reasons of increased permeability in acute inflammation?

Answer 8

endothelial gap widening
cells damaged
increased transcytosis from endothelium
angiogenesis

Question 9

what is endothelial gap widening in acute inflammation mediated by?

Answer 9

histamine
bradykinin
PAF (platelet activating factor)
leukotrienes
Substance P

Question 10

what vessels are affected in endothelial gap widening?

Answer 10

ONLY VENULES

capillaries + arterioles = unaffected

Question 11

what are x3 conditions where vascular permeability may account for oedema in?

Answer 11

acute anaphylaxis
adult respiratory distress syndrome
serum sickness

Question 12

what are the x2 mediators of arteriolar dilatation in early stages of acute inflammation?

Answer 12

prostocyclin (PG12)
nitric oxide (NO)

Question 13

what are the x2 direct actors which enable leukocytes to pavement/roll along periphery?

Answer 13

induced leukocyte adhesion molecules
endothelial cell adhesion molecules

Question 14

what are examples of induced leukocyte adhesion molecules?

Answer 14

oligosaccharides
intergrins
selectins

Question 15

what are examples of endothelial cell adhesion molecules?

Answer 15

selectins
immnoglobulins

Question 16

name x4 key chemokines?

Answer 16

leukotrine B4
completment C5a
TNF
IL8

Question 17

what are the x2 steps in phagocytosis?

Answer 17

attachment
endocytosis

Question 18

what are the x3 opsonins responsible for attachment in phagocytosis?

Answer 18

IgG (sub-type 1 +3)
C3b
collectins

Question 19

when is opsonisation most effective in endocytosis?

Answer 19

when simultaneous C3 and Fc Fibronectin binding occurs

Question 20

what are the x3 ways bacteria is killed?

Answer 20

oxygen dependent pathway
oxygen independent pathway
acid proteases

Question 21

what is the most powerful killing system?

Answer 21

peroxide-myeloperoxidase-halide system

Question 22

how dos bactericidal permeability increasing protein work?

Answer 22

damages bacterial cell membrane

Question 23

how does lactoferrin work?

Answer 23

Fe binding
deprives bacteria of Fe for metabolism

Question 24

bacteria is killed by 3 processes but what is not guearanteed?

Answer 24

no guarantee that bacteria will die

Question 25

Mechanisms of adhesions between leukocytes and endothelium include what?

Answer 25

increased binding activity of integrins induction of endothelial adhesion molecules redistribution of P-selectin by histamine stimulation

Question 26

phagocytosis of bacteria by granulocytes involves what?

Answer 26

phagocytic vacuole fusing with lysosomes degranulation of the granulocyte frequently requires hydrogen peroxide for destruction

Question 27

what x2 forms of radicals are produced to kill bacteria>

Answer 27

superoxide radicals hydroxyl radicals

Question 28

what are examples of free radical derivative?

Answer 28

hypochlorite ion hydrogen peroxide

Question 29

what are cellular metabolic actions which prevent damage caused by activated oxygen species?

Answer 29

catalase reaction interaction with glutathione peroxidase

Question 30

why does Pneumococcal pneumonia causes inflammation without significant lung necrosis?

Answer 30

because pneumococci induced major chemotaxis but elaborate no major toxins

Question 31

how is Lysosome (N-aceyl muramidase) an effective antibacterial?

Answer 31

because lysosome enzymatically destroys specific components of bacterial cell walls

Question 32

what is chediak-higashi syndrome?

Answer 32

defect in phagocytosis

Question 33

how is inflammation and repair often defective in people with diabetes?

Answer 33

neutrophil reactions + chemotactic stimuli = defective impaired leukocyte-endothelial cell adhesions impaired neutrophil phagocytosis reduced inflammatory vascular reaction microvascular sclerosis

Question 34

where do monocytes originate from and in what form do they enter interstitium?

Answer 34

bone marrow enter interstitium as macrophages

Question 35

what are the mononuclear cells in acute inflammatory exudates?

Answer 35

mainly transformed blood monocytes

Question 36

what do the growth factors released by macrophages do?

Answer 36

control fibroblast proliferation proliferation of myeloid cells, endothelial cells etc.

Question 37

what are monocytes released as epithelioid cells adapted for?

Answer 37

adapted for synthesis NOT phagocytosis

Question 38

what is an example of an epithelioid cell?

Answer 38

angiotensin converting enzyme

Question 39

what are examples of monocyte/macrophages chemotactic agents?

Answer 39

C5a cytokines fibronectin cationic proteins fibropeptides

Question 40

where is histamine and serotonin made?

Answer 40

mast cells platelets

Question 41

what mediators are made on the spot and released?

Answer 41

tissue thromboplastin LTb4 IL2 No

Question 42

what are chemicals which are activated during tissue injury but circulate as inactive plasma precursors?

Answer 42

C3b plasmin bradykinin

Question 43

what is prostacyclin (PG12) an antagonist for?

Answer 43

antagonist of platelet aggregation

Question 44

where is prostacyclin made?

Answer 44

endothelial cells

Question 45

what does prostacyclin promote?

Answer 45

vasodilation

Question 46

what is prostacyclin inhibited by?

Answer 46

aspirin

Question 47

what are x2 activators which induce platelet aggregation?

Answer 47

thromboxane A2 thrombin

Question 48

where is ferritin located and stored?

Answer 48

located in lysosomes stored in mononuclear phagocytic cells

Question 49

what does serum ferritin levels reflect?

Answer 49

stores in iron EXCEPT IN ACUTE INFLAMMATION

Question 50

when is complement activation through 'bypass' mechanism critically important?

Answer 50

in early defence against virulent pyogenic bacteria which has not been previously encountered before

Question 51

what do some sub-groups of immunoglobulins not do when reacting with specific bacterial antigens?

Answer 51

some do not activate by 'classical' pathway

Question 52

what is kinin activated to bradykinin?

Answer 52

kallikrein which in turn is activated by Factor XII

Question 53

what is kinin metabolised by?

Answer 53

ACE kininase

Question 54

what are the actions of bradykinin?

Answer 54

vasodilation increased permeability broncho-constriction pain

Question 55

what do cytokines interact with?

Answer 55

cell surface receptors receptor specific NOT cell type specific

Question 56

IL 1 has an important role in what?

Answer 56

endothelial cell activation hypothalamus mediated fever induction acute inflammation shock T-lymphocyte activation acute phase reaction

Question 57

what are the harmful effects of TNF?

Answer 57

septic shock - hypotension + pyrexia DIC inflammatory symptoms of some autoimmune disease

Question 58

what conditions result in resolution of inflammation with regeneration leading to restoration of normal structure and function?

Answer 58

pneumococcal pneumonia paracetamol induced hepatic necrosis acute viral hepatitis hypovolaemia acute renal tubular necrosis

Question 59

what are some causes of chronic inflammation?

Answer 59

repeated acute inflammation low toxicity organisms prolonged exposure to toxic agents autoimmunity

Question 60

what is the main PMN in chronic inflammation?

Answer 60

macrophages

Question 61

what demonstrates long standing chronic colitis likely to be crohns?

Answer 61

marked submucosal oedema + lymphocytic infiltrate focal epithelioid cell granulomas (mucosal biopsy)

Question 62

what is the main cell found in granulomatous inflammation?

Answer 62

monocytes

Question 63

name some examples of granulomatous inflammation?

Answer 63

TB sarcoidosis brucellosis cat-scratch disease crohns disease, primary biliary cirrhosis

Question 64

what is a granuloma?

Answer 64

focus of chronic inflammation walled off by transformed macrophages

Question 65

what can granulomatous inflammation be composed of?

Answer 65

mass of macrophages + giant cells mass of epithelioid cells + giant cells

Question 66

focal granulomatous lesions resembling those of sarcoidosis are also a characteristic of what?

Answer 66

berylliosis

Question 67

classic immune (epithelioid) granulomas are characteristically seen in what?

Answer 67

sarcoidosis