Inflammation-Mesa

Question 1

What cells are most involved in acute inflammation?

Answer 1

Neutrophils

Question 2

What is exudate?

Answer 2

• Leakage of proteinaceous fluid

* High specific gravity

Question 3

What is transudate?

Answer 3

• Acellular leakage of fluid close to water

* Low specific gravity

Question 4

Extravasation of PMNs

Answer 4

• Margination - neutrophils go toward walls
• Rolling - tumbling and heaping
• Adhesion
• Transmigration - leukocytes leaving circulatory system

Question 5

What is a PMN?

Answer 5

A fancy ass Neutrophil

Question 6

What are secretins?

Answer 6

Adhesion molecules from endothelial cells

Question 7

What are integrins?

Answer 7

Adhesion molecules from many different cell types

Question 8

What is chemotaxis?

Answer 8

• PMNs go to site of injury after transmigration

* Regulated by chemokines

Question 9

What is leukocyte activation make PMNs do?

Answer 9

• Produce eicosanoids such as:

• Prostaglandin
• Leukotrines
• Lipoxins

Question 10

What are the 9 steps of inflammation?

Answer 10

1. Vasodilation
2. Increased vascular permeability
3. Leakage of exudate
4. Margination, rolling, adhesion
5. Transmigration
6. Chemotaxis
7. PMN activation
8. Phagocytosis
9. Termination

Question 11

Histamine

Answer 11

• Main mediator of inflammation
• IgE on mast cell triggers release
• Made in mast cells, basophils, platelets
• Causes: vasodilation, increased vascular permeability and endothelial activation

Question 12

Serotonin

Answer 12

• Made in platelets
• Evokes NO synthase which generates NO (vasodilator)
• Causes: vasodilation and increased vascular permeability

Question 13

Complement

Answer 13

• Final product results in lysis of membrane of bacteria

Question 14

Kinin System

Answer 14

• Bradykinin is main component

- Causes increased permeability but results in smooth muscle contraction (painful!)

Question 15

Clotting factors

Answer 15

• Production of fibrin (coagulation)

* Fibrinolysis - dissolves the fibrin

Question 16

Prostaglandins

Answer 16

• Made in mast cells and leukocytes
• Actions: pain, fever and clotting
• Aspirin counteracts these

Question 17

Leukotrienes

Answer 17

• Made in mast cells

* Causes: increased vascular permeability, chemotaxis, leukocyte adhesion and activation

Question 18

Lipoxins

Answer 18

• Inhibit chemotaxis and cause vasodilation

* Counteract leukotrienes

Question 19

Platelet-Activating Factor (PAF)

Answer 19

• Made in leukocytes and mast cells

* Causes: vasodilation, increased vascular permeability, leukocyte adhesion, chemotaxis, degranulation, oxidative burst

Question 20

Cytokines/Chemokines

Answer 20

Cytokines
• Proteins produced by many cells
• Usually lymphocytes and macrophages
Chemokines
• Small proteins which are attractants for PMNs

Question 21

What are the 2 most powerful regulating cytokines and what produces them?

Answer 21

TNF-α and IL-2; Macrophages

Question 22

Nitric Oxide (NO)

Answer 22

• Potent vasodilator

* Produced from asinine by NO synthase

Question 23

Lysosomal constituents - Primary granules

Answer 23

• Azurophilic (non-specific)
• Main components:
- Myeloperoxidase
- Lysozyme
- Acid hydrolyses

Question 24

Lysosomal constituents - Secondary granules

Answer 24

• Specific (more mature)
• Main components:
- Lactoferrin
- Lysozyme
- Alkaline
- Phosphatase
- Collagenase

Question 25

Free radicals

Answer 25

• Produced by cells in the inflammatory process | - Very toxic to microbes

Question 26

Neuropeptides

Answer 26

* Produced in CNS | * Not a big role in acute inflammatory process

Question 27

What is Substance P used for?

Answer 27

Mood disorders

Question 28

What is Neurokinin A?

Answer 28

Acts like neurotransmitters

Question 29

What are the 3 possibly outcomes of acute inflammation?

Answer 29

1. Hopefully 100% resolution 2. Sometimes scarring 3. Chronic inflammation

Question 30

What are the morphological patterns of acute inflammation?

Answer 30

* Serous (watery) * Fibrinous (hemorrhagic, rich in fibrin) * Suppurative (pus(sy)) * Ulcerative

Question 31

What are some causes of chronic inflammation?

Answer 31

* Persistence of infection * Prolonged exposure to insult * Auto-immunity

Question 32

Cellular players of chronic inflammation

Answer 32

* Lymphocytes * Macrophages * Plasma cells * Eosinophils * Mast cells

Question 33

What is a granuloma?

Answer 33

A focus of chronic inflammation consisting of a microscopic aggregation of macrophages that are transformed into epithelial-like cells

Question 34

What are the 4 components of a granuloma?

Answer 34

1. Fibroblasts along the outside 2. Lymphs 3. Histiocytes 4. Giant cells (macrophages that fuse together)

Question 35

If there is caseating necrosis in a granuloma what does that mean?

Answer 35

Tuberculosis!

Question 36

What are some clinical manifestations of chronic inflammation?

Answer 36

* Fevers, chills * C-Reactive Protein (CRP) * Acute phase reactants (α1-α2) * Erythrocyte sedimentation rate (ESR) increases * Leukocytes * Increase production of various cytokines

Question 37

Serum protein electrophoresis

Answer 37

* Albumin is the largest peak | * α1 and α2 are elevated in acute inflammation

Question 38

What are the consequences of defective inflammation?

Answer 38

* Results in increased susceptibility to infections | * Associated with delayed wound healing

Question 39

What are the consequences of excessive inflammation?

Answer 39

* The basis for many types of disease * May cause unregulated immune response (allergies) or auto-immune disorders * Plays a role in arteriosclerosis, ischemic heart disease and some neurodegenerative diseases