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84 Cards in this Set
- Front
- Back
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Pus? |
Exudate |
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Pyogenic |
Involving or relating to the production of pus |
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Purulent |
Consisting of, containing or discharging pus |
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Suppuration |
Conversion into pus |
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Suppurative |
disease that makes pus |
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Fibrin |
Insoluble protein formed from fibrinogen (blood clotting) |
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Fibinous |
presence of fibrin |
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Fibrous |
consisting of or containing fibers |
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Fibrosis |
Thickening and scarring of connective tissue
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Granuloma |
mass granulation tissue - response to infection or inflammation
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Granulomatous |
disease with granulomas |
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Granular tissue |
repair and healing |
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FibrOus = FibrOsis = FibrOus connective tissue = formed by fibrOblasts and collagen =? |
ChrOnic |
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Differential diagnosis for nodules (lumps and bumps)? |
-Neoplasia -Abscess (pus, enclosed in capsule) -Granuloma (chronic inflammatory response) |
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What are the two types cells of inflammatory exudate? |
Polymorphonuclear Leukocytes (granulocytes) Mononuclear cells |
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Types of polymorphonuclear leukocytes |
Neutrophils Eosinophils Basophils and mast cells |
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Types of mononuclear cells |
Lymphocytes and plasma cells Monocytes and macrophages Platelets |
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What are leukocytes a normal inhabitant of? What are the 2 exceptions |
Circulating blood
Except: plasma cells and mast cells |
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Leukocytes cell types each plays ______________ and each cell type enters into the inflammatory response in a ____________ sequence. |
Distinctive role
definite |
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Neutrophils are what? and where do they develop? |
First line of cellular defence (acute) Develop in bone marrow (maturation takes about two weeks) |
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Neutrophils role to eliminate what? |
Microorganisms (bacteria) Tumor cells Foreign material
**phagocytic role with proteolytic enzyme |
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Neutrophils are characterized by... |
-High motility due to rapid amoeboid movement -Response to a wide variety of chemotaxic compounds -phagocytic and bactericidal |
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Neutrophil morphology |
-10-12um diameter -multi lobed nucleus -cytoplasmic granules
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What are the two major classes of granules that are in neutrophils? |
Azurophil Granules: or primary granules. They are large, oval, and electron dense
Specific Granules: or secondary granules. They are smaller, less dense and more numerous |
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What species have heterophils (eosinophilic granules)? |
Rabbits, guinea pigs, rats, reptiles, fish, fish, and birds
**abscesses will not have pus inside rather a rubbery tissue |
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Neutrophil functions |
-phagocytosis (ingest, neutralize, destroy) -secretion of pro-inflammatory substances -regulate inflammatory response |
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How do neutrophils regulate inflammatory response? |
by releasing chemical mediators like leukotrienes and platelet activating factor (PAF) |
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How do neutrophils kill microorganisms? |
-Producing oxygen free radicals -hydrogen peroxide -lysosomal enzymes
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Eosinophils are abundant at sites of inflammation due to? |
Hypersensitivity (allergic reactions) Parasitics (ie helminth worms) |
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Eosinophil Morphology |
-Bigger than a neutrophil -Cytoplasmic granules are pink (esoinophilic)
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Lysosomal granules in Eosinophils contain similar morphology to neutrophils except for what? |
lysozyme and phagocytin |
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Eosinophilic granules types |
Small Primary Large secondary (specific) |
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What are in large secondary (specific) granules in eosinophils? |
-Major basic protein -Eosinophilic cationic protein -Eosinophil-derived neurotoxin -Eosinophil peroxidase |
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Eosinophil Functions |
-modulate hypersensitivity reactions (immediate type) -Defence against helminthic parasites -Phagocytic but less efficient than neutrophils |
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Major basic protein is strongly toxic to what? And what does it cause? |
Toxic to parasites Causes histamine release from mast cells and basophils Neutralizes heparin |
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Eosinophilic cationic protein does what? |
-contributes to parasite killing -Shortens coagulation time -alters fibrinolysis |
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What are 3 examples of eosinophilic infiltration? |
-allergies such as contact dermatitis -Nematode infections -Mast cells tumours |
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Where are basophils and Mast cells located? |
Basophils: rare circulating granulocytes
Mast: perivascular sites (tissues) |
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What are the similarities between basophils and mast cells? |
-Derived from bone marrow precursors -Contain cytoplasmic metachromatic granules with high sulphated mucopolysaccharides like heparin -cytoplasmic granules with histamine and proteases -Main cell sources of histamine and serotonin -Major cellular mediator of immediate hypersensitivity reacts (type I) |
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What are the differences between basophils and mast cells? |
Mast cells: small numbers throughout the connective tissue in most organs -skin, respiratory tract, and gastrointestinal tract -numerous in perivascular sites
Basophils: found in small numbers in the circulation |
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Basophils |
-less than 1% of circulating leukocytes -smaller than neutrophils, but contain metachromatic (blue) granules
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Basophils are recruited into the tissues in.. |
allergic reactions parasitic infections (esp heartworm) |
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Basophil function |
-Induce vascular changes at sites of acute inflammation -Release of mediators to aid in the expulsion of parasites -Histamine may modulate some delayed reactions through receptors on T cells
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Mononuclear Inflammatory cells? |
-Lymphocytes and plasma cells -macrophages |
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Lymphocytes and Plasma cells |
-Both cell types are involved in immune reactions -Antibody production -celluar mediators of both immediate and delayed hypersensitivity |
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Lymphocyte morphology |
Smaller than neutrophils Dense staining of nucleus and scant amount of cytoplasm
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Lymphocytes are divided by molecules on their surface into? |
B and T cells |
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Lymphocyte function |
-Later than neutrophils in inflammatory reactions (subacute and chronic state) |
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B lymphocytes differentiate into….? |
Plasma Cells that produce antibody (humoral immunity) |
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T lymphocytes are responsible for? and Produce? |
Responsible for cell mediated immunity.
Produce lymphokines, which can modulate and expand local inflammatory reactions |
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Macrophages/Monocytes are from what? |
-derived from circulating blood monocytes of bone marrow origin -small portion may originate form immature resident mononuclear phagocytes in the tissue (also bone marrow) |
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Macrophages/monocytes do not have a large reserve pool in the bone marrow, but remain longer in __________ (24-72 hours) |
circulation
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Monocytes require activation under the influence of various ______ before beaching active macrophages |
mediators |
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Once monocyte migrate into tissues and become macrophages what are they called in certain tissues? |
Liver = kupffer cells Spleen and lymph nodes = sinus histiocytes Lungs = alveolar and capillary macrophages CNS = gitter cells |
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Macrophages are sluggish motile and are responsive to? |
Chemotactic influences |
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What is the life span of macrophages and where do they proliferate? |
30-60days (long) Proliferate at sites of inflammation |
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Macrophage functions |
Phagocytosis: macrophages are the major scavengers in the inflammatory response
Modulation: inflammatory and repair
Regulation: of immune response (important effector cells in certain delayed type hypersensitivity responses)
Production of Interleukin-1 (IL-1): major inflammatory mediator - increases vascular permeability, chemotactic, induces fever nausea, etc. |
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Macrophage morphology |
-Larger than neutrophils (15-20um) -central nuclei (folded or bean shaped) -variable azurophilic granules and remnants of digested material |
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What are epithelioid macrophages? Where are they found? |
-large, pale staining activated macrophages that have an ovoid nucleus and resemble epithelial cells. -found in granulomas - become multinucleate giant cells |
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Platelet inflammatory cells functions.. |
-coagulation -primary haemostasis is part of the inflammatory response -Release mediators that increase vascular permeability |
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Platelet characteristics... -___________-like granules -Respond to ___________ injury -Accumulate in vessels adjacent to ___________ -Interact with immune complexes as well as micro-organisms -Initiate the ___________ inflammation -Enzymes can further damage ___________ -Adhesion to ___________ (collagen) -Enhance ___________ and fibrin deposition (early) -promote local ___________ thrombosis |
-lysosomal-like granules -Respond to vascular injury -Accumulate in vessels adjacent to inflamed areas -Interact with immune complexes as well as micro-organisms -Initiate the intravascular inflammation -Enzymes can further damage endothelium -Adhesion to subendothelium (collagen) -Enhance blood coagulation and fibrin deposition (early) -promote local microvascular thrombosis |
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Acute inflammation may have one of what four outcomes? |
1. Complete resolution 2. Healing by scarring (after substantial tissue damage, or when the inflammation occurs in tissue that do not regenerate, or when there is abundant fibrin exudation) 3. Abscess formation (usually in infections with pyogenic organisms) 4. Progression to chronic inflammation |
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IMAGE OF INFLAMMATION |
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Complete Resolution...
Resolution involves what? |
Ideal condition
Resolution involves neutralization of the chemical mediators (return of normal vascular permeability) -cessation of leukocytic infiltration -removal of edema fluid, leukocytes and foreign agents/necrotic debris |
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Healing by formation of a scar |
-fibroblast and collagen form scar |
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Abscess formation |
Fibrous capsule Caseous necrosis or pus (depend on hydration) |
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Chronic inflammation |
-persistent injurious stimuli (weeks or months) -predominantly proliferative rather than an exudative reaction
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What is the hallmark of chronic inflammation? |
Fibrosis |
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Chronic inflammation that originates as a low grade smouldering response includes... |
-persistent infection by intracellular microorganisms (low toxicity but evoke immunological reaction) -prolonged exposure to non degradable but potentially toxic substance (i.e. asbestosis in lung) -Aberrant immune reactions especially those perpetuated against the individuals own tissues (autoimmune) |
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Chronic inflammation is characterized by? |
1. Infiltration by mononuclear cells - macrophages, lymphocytes and plasma cells 2. Proliferation of fibroblasts (and small blood vessels) 3. increase connective tissue (fibrosis) 4. Tissue destruction |
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What is the activation signal for macrophages? |
1.Lymphokines (gamma interferon) secreted by sensitized T lymphocytes 2. bacterial toxins 3. contact with fibronectin coated surfaces and a variety of chemicals generated during acute inflammation |
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Granulomatous Inflammation is? |
-Accumulation of activated macrophages: epithelioid cells, and initiated by a variety of infectious and non infectious agents -diffuse infiltration (Johne's disease) -Nodular type (in tuberculosis)
**focus where inflammation is - macrophages and multinucleate giant cells surround which are surrounded by monocytes |
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Inciting Stimuli/etiology that is resistant to phagocyte killing and degradation will result granulomatous inflammation. Etiology includes? |
-Inert particle (silica, asbestos) -Lipid resistan to metabolism (mineral oil) -Bacterial resistant to lysosomal degradation (Mycobacterium) -Systemic fungal agents (histoplasma sp.) -Foreign bodies (splinters)
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Examples of chronic granulomatous inflammation... |
Lick granuloma in dogs Mycotic infection in dogs sinus Mycotic Airsacculitis (birds) Salmonella pulorum in hens
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What cells are involved in Granulomatous Infection? |
-epithelioid cells (macrophages) -Multinucleated giant cells (macrophages) -Lymphocytes |
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What are epithelioid cells? |
-Specialized macrophages -15-30um -lightly eosinophilic, plump cytoplasm, and eccentrically located round nucleus -rich in ER, golgi apparatus, vesicles, and vacuoles -Specialized for extracellular secretion -Less phagocytic activity than non specialized macrophages
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Multinucleated Giant Cells are formed by ________ and fusion of _____________. This fusion is induced by cytokines. |
-coalescence -epithelioid cells
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Other characteristics of multinucleated giant cells ... |
Other -40-50um with over 50 nuclei -Nuclei arranged around the periphery (horseshoe = longhans giant cells) in TB granulomas -Nuclei may be aggregated in centre = foreign body type giant cells
**function similar to epithelioid cells |
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Where are T-lymphocytes located and what is their role? |
Located in granulomatous inflammatory reactions
Role: produce lymphokines and interferon -attract and activate macrophages -induce formation of multinucleate giant cells |
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What are cells are densely accumulated in chronic inflammation? |
Macrophages, epithelioid, giant cells and lymphocytes -sometimes neutrophils and plasma cells |
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If neutrophils and plasma cells are present in chronic inflammation... |
-present in the centre of granulomatous reaction = pyogranulomatous inflammation -eosinophils = eosinophilic granuloma (parasite migration through tissues) |
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What are they two types of granuloma's |
Simple Granuloma - organized accumulation of macrophages and epithelioid cells, rimmed by lymphocytes, then fibroblasts
Complex granuloma - central area of necrosis that may lead to calcification/mineralization |
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What might complex granuloma necrosis due to? |
-Release of oxygen free radicals -Release of lysosomal enzymes _ischemia |
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What are 2 sequences of chronic/granulomatous inflammation |
Destruction of stimuli -> resolution of inflammation -> REPAIR of tissue
Persistence of stimuli -> progression of inflammatory reaction -> FIBROSIS |
