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70 Cards in this Set
- Front
- Back
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What is inflammation?
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A localized reaction of the living body against an irritant (injurious agent) in an attempt to destroy, dilute, or wall off that irritant.
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Is the inflammation response specific or non-specific?
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relatively non-specific.
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What are the major roles of inflammation?
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clear away dead tissue
protect against local infection allow the immune system access to the damaged area |
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What are the 2 major categories of causes of inflammation?
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Living and non living causes
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What are some living causes of inflammation?
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microbiologic agents. e.g. bacteria, viruses, fungi, protozoa, parasites
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What are some nonliving causes of inflammation?
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physical, chemical, immune, necrosis
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What are some examples of physical nonliving causes of inflammation?
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mechanical, electrical, thermal and radiation injuries
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What are some examples of chemical nonliving causes of inflammation?
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strong acids or alkalis
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What are some examples of immune nonliving causes of inflammation?
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hypersensitivity or autoimmune reactions
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What are some examples of necrotic nonliving causes of inflammation?
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diffusion of necrotic materials stimulates inflammatory reaction in the nearby living tissue
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What are the cardinal manifestations of inflammation?
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rubor (redness), tumor (swelling), calor (temperature), dalor (pain), functio laesa (loss of function)
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Rubor and calor are results of what?
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Vessel dilation and increased blood flow into the inflamed(injured) tissue.
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Tumor is caused by what?
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The accumulation of exudate in the inflamed part.
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Dolor is due to what?
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Pressure on nerve endings from swelling and from chemical mediators which are released to facilitate the inflammatory process.
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Functio laesa is a result of what?
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Swelling and pain.
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What is the pathogenesis of inflammation?
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transient arteriolar vasoconstriction
vasodilation formation of fluid exudate stasis formation of cellular exudate |
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What are the major local manifestation of acute inflammation?
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Vascular dilation causing erythema and warmth
Extravasation of plasma fluid and proteins (edema) Leukocyte emigration and accumulation in site of injury |
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What are the 3 major causes of formation of fluid exudate?
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Increased vascular permeability
Increased intravascular hydrostatic pressure Decreased intravascular and increased extravascular oncotic pressure |
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What are some causes of increased vascular permeability?
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Gaps: endothelial contraction
Gaps: cytoskeletal reorganization Direct injury Leukocyte-dependent injury Angiogenesis |
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Describe increased vascular permeability due to endothelial contractions.
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Endothelial cells contract with an intercellular gap formation.
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What controls the process of endothelial contraction to increase vascular permeability?
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histamine, bradykinin, leukotrienes, and other chemical mediators
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What type of response is endothelial contraction referred to as?
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immediate transient response
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The process of endothelial contraction usually involves what type of vessels ?
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venules
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What can induce cytoskeletal reorganization?
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cytokines(e.g. tumor necrosis factor (TNF), interleukinl (IL-1), gamma interferon (IFN-y))
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Is cytoskeletal reorganization immediate or delayed?
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delayed 4-6 hours
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What is associated with cytoskeletal reorganization?
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hypoxia
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Direct endothelia injury with subsequent necrosis and detachment is referred to as what type of reaction?
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immediate sustained response
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Where does endothelia injury with subsequent necrosis and detachment usually take place?
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Venules, capillaries, arterioles
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Endothelial injury with subsequent necrosis and detachment can be caused by?
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toxins, burns, chemicals
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Leukocyte dependent leakage is caused by what?
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endothelial injury
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Leukocyte dependent leakage mostly occurs where?
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venules and pulmonary capillaries
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What is angiogenesis?
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newly formed capillary loops, these are normally leaky
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Increased intravascular hydrostatic pressure is due to what?
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Increased blood flow
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Decreased intravascular and increased extravascular oncotic pressure is secondary to what?
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Exudation of protein rich fluid into the extravascular compartment
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What are the functions of fluid exudate?
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dilutes the toxins
carries important constituents of plasma to the inflamed area |
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What are some important constituents of plasma?
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complement system components
specific antibodies or antitoxins interferons antibiotics and anti-inflammatory drugs fibrinogen |
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Fibrinogen is converted to ____ creating a _____.
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fibrin threads; meshwork
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Fibrin meshwork is important because?
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blocks the intercellular gaps
decreases lymphatic spread acts as a railway and helps chemotaxis and repair provides a surface against which phagocytosis occurs |
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What is stasis?
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decreased flow
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Stasis is caused by what?
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Hemoconcentration and increased blood viscosity secondary to fluid exudation
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What are the first cells to appear in an area of inflammation?
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polymorphonuclear leukocytes (neutrophil = polymorphs = microphages)
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Polymorphonuclear leukocytes are predominate in the inflammatory infiltrate during what time in the inflammation process?
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First 6-24 hours
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What are polymorphonuclear leukocytes replaced with after the first 24-48 hours?
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larger macrophages
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What are the 6 steps in leukocyte migration?
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Disturbance of axial blood flow and migration
Pavementation of leukocytes along the endothelium Adhesion of leukocytes Insertion of pseudopodia Passage through the the gaps by ameboid movement Passage through the basement membrane |
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What are the adhesion molecules that stimulate adhesion of leukocytes to the endothelium?
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selectins
immunoglobulins integrins |
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What chemical mediators stimulate the adhesion of leukocytes to the endothelium?
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interleukin-1 (ill)
tumor necrosis factor (TNF) complement C5a |
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What does the insertion of pseudopodia cause?
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widening of intracellular gaps
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How is passage through the endothelium membrane accomplished during leukocyte migration?
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mechanical disruption or possibly by enzyme (collagenase) effect
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The movement of leukocytes from outside of the blood vessels into the tissues spaces is known as what?
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transmigration
diapedesis |
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Chemotactic substances do what?
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bind to leukocyte receptors, initiating a stimulus-receptor interaction that leads to activation of intracellular contractile proteins.
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What is chemotaxis?
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E.g. when leukocytes migrate through the venular walls and are attracted to the area of inflammation
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Biological activities resulting from leukocyte activation include what?
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chemotaxis
modulation of adhesion molecules elaboration of arachidonic acid metabolites secretion/degranulation the oxidative burst |
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What are the plasma derived chemotactic mediators?
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Complement derivatives-C5a
Kallikrein Fibrin split products |
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What are the cell derived chemotactic mediators?
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lymphokines (migration inhibitory factor EMIF)
leukotrienes (e.g. leukotriene B4) nitric oxide, which is released from endothelial cells and macrophages and produces vasodilatation and cytotoxicity |
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What are chemotactic mediators that are tissue products?
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Tissue breakdown by collagenases results in release of protein fragments that are chemotactic for leukocytes.
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What are the biologic cellular responses of neutrophils?
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chemotaxis, degranulation, oxygen radical production, and leukotriene B4 production
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What are the biologic cellular responses of mast cells and basophils?
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Degranulation (histamine release) and leukotriene formation.
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What are the biologic cellular responses of platelets?
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aggregation, degranulation (serotonin release), and thromboxane A2 formation
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What are the phagocytic cells?
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microphages (neutrophils)
macrophages (monocytes from the blood or histiocytes from tissues) |
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The process of phagocytosis involves what?
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adhesion
engulfment fusion intracellular microbial killing |
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What is a opsonin?
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A generic term for a protein that coats a particle to be phagocytised resulting in an enhanced phagocytosis.
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What are two major opsonins?
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the Fc fragment of immunoglobulin G (IgC0
C3b, the so called "opsonic fragment of C3" |
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The complement system plays an essential role in host defense against what?
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infectious agents and in the inflammation process
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What are some of the agents that participate in intracellular microbial killing with oxygen derived radicals?
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superoxide anion, singlet oxygen, hydroxyl radicals, hydrogen peroxide.
The most bactericidal moiety is HOCl |
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What are some of the agents that participate in intracellular microbial killing that are oxygen-independent mechanisms?
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lysozymes,lactoferrin which acts as a chelating iron necessary for bacterial growth, bactericidal/permeablity increasing factor (BPIF), major basic protein (MBP) of eosinophils
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How are lysosomal products released?
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reverse endocytosis
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The release of lysosomal products by regurgitation during phagocytosis will lead to what?
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tissue destruction by proteolysis
blood coagulation via Hageman factor (factor XII) increased vascular permeability chemotaxis of leukocytes pyrogenis effect by acting on the hypothalamus |
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What is neutropenia?
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an absolute decrease in the number of circulating neutrophils
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What can neutropenia be caused by?
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drugs
bone marrow aplasia(e.g. irradiation) acute leukemia hypersplenism immune neutropenia |
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What are some chemotactic factor abnormalities?
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decreased production of C3 and C5
depressed chemotactic factor formation and action, as in uremia and cirrhosis chemotactic factor inactivators, as in Hodgkin's disease |
