Inflammation

Question 1

describe acute inflammation (exudative inflammation) vs. chronic inflammation

Answer 1

• acute
  
  • acute inflammation refers to an inflammatory rxn in which the dominant changes are vascular and exudative (fluids and cells), therefore also = exudative inflammation
    
    • PMNs (neutrophils) dominant
• chronic
  
  • injurious agent persists in the tissues and continues to damage them often for weeks or months
    
    • great amount of proliferation of cells and connective tissues

Question 2

describe the sequence of events in inflammation

Answer 2

1. margination
2. pavementing & rolling
3. adhesion & emigration
4. chemotaxis & activation

Question 3

describe margination (step 1)

Answer 3

• when blood is viscous there is peripheral orientation of WBCs because of sludging of RBCs (rouleaux formation)
  
  • WBCs are pushed to periphery of vessels because they are smaller particles now

Question 4

describe pavementing and rolling (2)

Answer 4

• the group of CAM involved in the rolling phase are L-selectins present on the surface of the phagocyte
• in the endothelial cells, 2 main subclasses of adhesion molecules are described:
  
  • P-selectin
  • E-selectin
  • these increase with cytokines and interact with the phagocytes’ adhesion molecules

Question 5

describe adhesion and emigration (3)

Answer 5

• endothelial adhesion molecules: ICAM-1 and VCAM
  
  • both are up-regulated during inflammation by various cytokines
• phagocyte adhesion molecules: LFA-1 (CD11a/CD18)
  
  • these integrins only adhere to their ligands when the leukocytes are activated by inflammatory chemotactic factors
• after binding occurs, the leukocyte moves between endothelial cell gaps called diapedesis

Question 6

describe chemotaxis and activation (4)

Answer 6

• chemotactic factors for PMN:
  
  • C5a (most important for neutrophils)
  • LTB4
  • IL-8
  • bacterial products (most important for macrophages)

Question 7

describe granulomatous inflammation

Answer 7

a type of chronic inflammation

• formation of granuloma = grain-like nodule
• granuloma is made of: macrophages with rim of lymphocytes and plasma cells
• often macrophages form giant cells (multinucleated)
• examples are: TBC, syphilis, fungal infxn, foreign body, etc.

Question 8

describe what is seen in the image

Answer 8

Question 9

describe what is seen in the image

Answer 9

Question 10

describe what is seen in the image

Answer 10

Question 11

describe what is seen in the image

Answer 11

left = bread and butter pericarditis

Question 12

describe what is seen in the image

Answer 12

Question 13

describe what is seen in the image

Answer 13

Question 14

describe what is seen in the image

Answer 14

Question 15

describe what is seen in the image

Answer 15

Question 16

describe what is seen in the image

Answer 16

Question 17

describe what is seen in the image

Answer 17

Question 18

describe what is seen in the image

Answer 18

Question 19

describe what is seen in the image

Answer 19

Question 20

describe the 4 types of inflammation (based on exudate)

Answer 20

• serous: mild injury, albumin in exudate, blister, ascites, etc.
• fibrinous: more serious leakage (fibrin), serosal surface
• suppurative: pus, liquefactive, necrosis by bacteria
• sanguinous: rich in RBCs, serious vascular injury, tuberculous pleuritis, tumors