Lecture 15: Inflammation, Exudates

Question 1

what 4 mediators are responsible for vasodilation during signs of inflammation

Answer 1

1. Vasoactive amines,
2. NO- nitric oxide
3. PG- prostaglandin
4. PAF- platelet activating factor

Question 2

what 7 mediators are responsible for increased vascular permeability during signs of inflammation

Answer 2

1. Vasoactive amines
2. bradykinin
3. LT
4. PAF
5. Substance P
6. C5a
7. C3a

Question 3

what 6 mediators are responsible for chemotaxis during signs of inflammation

Answer 3

1. LTB4
2. LPS
3. chemokines
4. IL-1
5. IL-4
6. IL-8

Question 4

what 2 mediators are responsible for pain during signs of inflammation

Answer 4

1. PG- prostaglandin
2. Bradykinin

Question 5

what 3 mediators are responsible for tissue damage during signs of inflammation

Answer 5

1. Lysosomal enzymes,
2. NO- nitric oxide
3. ROS- reactive oxygen species

Question 6

what 4 mediators are responsible for fever during signs of inflammation

Answer 6

1. IL-1
2. IL-6
3. TNF- tumor necrosis factor
4. PG- prostaglandin

Question 7

What are the 8 types of acute inflammation exudates

Answer 7

1. Serous
2. Fibrinous
3. Fibrinonecrotic
4. Mucoid or Catarrhal
5. Purulent or Suppurative
6. Eosinophilic
7. Hemorrhagic
8. Necrotizing

Question 8

What are the 5 types of chronic inflammation exudates

Answer 8

1. Lymphocytic / Plasmacytic
2. Granulomatous
3. Pyogranulomatous
4. Fibrosing
5. Proliferative

Question 9

1. Serous exudates occur when?
2. What type of edema is this called
3. Will this happen in an acute or chronic change

Answer 9

1. Increased vascular permeability
   
   • protein and fluid leakage into a body cavity or joint
2. Called “inflammatory edema”
3. Acute early change

Question 10

Would serous exudate be clear or cloudy

Answer 10

mostly clear with some cloudyness

Question 11

What type of exudate is this

1. What is 1 pointing out
2. 2?

Answer 11

• serous exudate

1. cloudiness fluid but still can see through
2. material on serosal surfaces of abdominal organs

Question 12

What type of exudate

Answer 12

• serous
  
  • Can see through but not extensively

Question 13

What is the next step after serous exudate (a type of exudate)

Answer 13

fibrinous exudate

Question 14

What is the purpose for fibrinous exudates

Answer 14

1. Early framework can help in phagocytosis
2. Decreased microbial spread via lymphatic
3. Scaffold for granulation tissue

Question 15

explain how fibrinous exudate forms

Answer 15

1. Endothelial injury
2. fibrinogen exits capillary
3. fibrin is formed and polymerizes into a fibrin polymer
4. the fibrin polymers are what you can visualize as fibrinous exudate

Question 16

1. is fibrin acute or chronic
2. seeing fibrinous exudate what does this imply

Answer 16

1. Fibrin is usually acute but can be an ongoing problem (thus chronic)
2. Implies a continual need for an inflammatory response, at that site

Question 17

would you see a lot of cellular infiltrate in a fibrinous exudate

Answer 17

not much

Question 18

1. give a morphologic diagnosis
2. What are arrows pointing to?

Answer 18

1. serofibrinous peritonitis, acute diffuse
2. this is mostly serous but arrows are pointing to fibrin (stringy material)

Question 19

1. What organ?
2. what type of exudate
3. if you touch it what will happen to exudate?

Answer 19

1. Liver
2. fibrinous exudate
3. If you were to pick up the edge of the material, it would break apart easily

Question 20

give a MDx

Answer 20

• Fibrous pleuritis, acute, locally extensive to diffuse
  
  • White, friable, shaggy, chalky
  • If you could touch it, it would peel off easily

Question 21

Give a MDx

Answer 21

• Fibrinous peritonitis, acute, locally extensive to diffuse
  
  • Very thin, web-like
  • This is what a primary fibrinous exudate looks like.
  • Sticky, messy, and really delicate

Question 22

1. What would 2 other names for fibrinonecrotic exudates be?
2. Where would you usally see these exudates?

Answer 22

1. Pseudomembranous, or Diphtheritic
2. mucosal surfaces

Question 23

1. What is usally required for Fibrinonecrotic, Pseudomembranous, or Diphtheritic membrane to occur
2. If you were to peel this exudate off what would you usally see under it?

Answer 23

1. an ulceration, dead cell debris, inflammatory cells and +/- hemorrhage and fibrin
2. ulceration of the underlying mucosa

Question 24

1. What is another name for mucous exudate?
2. Where would you usally see it?
3. Will it be acute or chronic?

Answer 24

1. catarrhal, old term and not used as much
2. only on mucus membranes
   
   • respiratry tract
   • GI tract
   • Reproductive/ urinary tract
3. Can be acute or chronic

Question 25

This is from the GI tract 1. What is see at 1? 2. 2? 3. 3? 4. What type of exudate is this?

Answer 25

1. Hyperemia 2. mucoid exudate 3. Tapeworm (cestode) 4. Mucous exudate

Question 26

1. What kind of exudate is this? 2. What can it interfere with?

Answer 26

1. mucous exudate / catarrhal 2. interfere with absorption and other GI functions

Question 27

Give a MDx

Answer 27

treachea: Mucopurulent or catarrhal, tracheitis diffuse acute

Question 28

What type of exudate

Answer 28

* mucous exudate * Bovine viral diarrhea/mucosal disease * Another example of mucous or mucoid exudate overlaying the probably ulcerated mucosal surface

Question 29

1. What is another name for purulent exudate? 2. What cell type would you mainly see? 3. Is this acute or chronic? 4. What kind of agents usally cause this

Answer 29

1. Purulent (suppurative) 2. Mostly neutrophils 3. Acute mostly but can be chronic if there is a persistent agent 4. Usually bacterial or fungal agents

Question 30

Where would purulent (suppurative) exudate usally occur in?

Answer 30

* Focal abscess, or * Pus-filled * organ (pyometra) * structure (bronchiectasis) * cavity (pyothorax, hypopyon)

Question 31

1. What is hypopyon? 2. pyuria?

Answer 31

1. Hypopyon is inflammatory cells (pus) in the anterior chamber of eye. 2. pyuria- pus filled urine

Question 32

1. What organ is this 2. exudate? 3. what would you see in this exudate?

Answer 32

1. lung 2. purulent (suppurative) 3. see mostly neutrophils

Question 33

1. What type of exudate would this be? 2. What are you mostly seeing in the histological slides?

Answer 33

1. Suppurative, bronchopneumonia 2. neutrophils in alveolar spaces

Question 34

What type of distribution is common for bronchopneumonia in 4 legged animals?

Answer 34

Cranial ventral distribution

Question 35

Name what is happening in this image

Answer 35

* Interpretation: Acute purulent arthritis or synovitis Note the yellow/green cloudy fluid, this would be purulent exudate

Question 36

1. What kind of exudate 2. What would you call what you see in this image (name organ and process)

Answer 36

1. Purulent (suppurative) exudate 2. Meningitis Note: Remember that exudates are a fluid, and fluids are always going to go ventral, as they are gravity dependent So when you see meningitis in an animal that has been sternal, most of that exudate will be in the lower half of the brain and in the meninges

Question 37

1. Give a MDx 2. what is the circle highlighting? (hard to tell i think)

Answer 37

1. Brain : meningitis, suppurative, focal, acute 2. pituitary abscess

Question 38

this is a pig's skull, i think, cut in half * Name what has happened here

Answer 38

Chronic purulent sinusitis

Question 39

1. Because this is a sinus and cannot drain, what will happen to the pus that is seen here? 2. What type of necrosis?

Answer 39

1. Inspissated pus (has dried out) 2. caseous necrosis

Question 40

If connective tissue or fascial planes is inflammed with purulent exudate what would you call it?

Answer 40

Cellulitis

Question 41

1. Give a MDx 2. This is an example of?

Answer 41

1. Purulent periesophagitis, acute, focal or locally extensive 2. example of Cellulitis Note: * Horses with an esophageal rupture * Bad enough that the esophagus has ruptured (bad surgical sites, don't heal well), but once you have food exiting the lumen of the esophagus and into the soft tissue surrounding it, now you have a developing cellulitis as well * Which will put further pressure on the esophagus

Question 43

What is this an example of?

Answer 43

* Fibrinosuppurative pericarditis, epicarditis and pleuritis * More neutrophils here than in other examples * There is an increase in thickness, not as weblite as just fibrin

Question 44

Name what has happened here

Answer 44

* Fibrinosuppurative peritonitis * Rupture of GI tract, walled off by fibrin * Cattle are really good at making fibrin

Question 45

Give a MDx

Answer 45

* Carpal joint: suppurative synovitis and osteomyelitis, diffuse, subacute, severe * Carpal joint from a foal * Articular cartilage should look like: white, smooth, shiny * Discoloration of the bone as well * Likely an area of osteomyelitis extending across the physis

Question 46

What would this be called

Answer 46

* Fibrinosuppurative peritonitis * secondary to GI rupture * see Presence of feed material, attached to a surface by fibrin

Question 47

Is it common to purely see hemorrhagic exudates?

Answer 47

* Not common to have a pure hemorrhagic exudate * Blood is a major component of exudate * Often mixed with other exudates

Question 48

What does necrotizing exudates imply?

Answer 48

* Implies cell loss AND inflammation * Often mixed with other exudates

Question 49

1. Name what necrotizing and hemorrhagic exudates in a liver would be called 2. necrotizing and purulent in the lungs

Answer 49

1. Necrohemorrhagic hepatitis, multifocal, acute 2. Necropurulent bronchopneumonia, hilar region, acute

Question 50

1. Give a MDx 2. What happens if that material breaks off? 3. what can this be a result of? (this is a calf)

Answer 50

1. Fibrinonecrotic laryngitis, locally extensive, subacute, severe 2. This flaky yellow material can break off, can travel into the lungs and cause a pneumonia 3. Result of a bacterial infection in a compromised area of mucosa that's been damaged by trauma or excessive vocalization.

Question 51

Give an MDx

Answer 51

Fibrinsoupperative perititis, diffuse, acute