Glossary of 1. Inflammation fundamentals
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- What are 5 clinical features of inflammation?
- Tumor swelling
Functio laesa loss of function
- What are the 4 phases in the biological sequence of inflammatory events?
- 1. Vascular
- What 3 things happen in the vascular phase of inflammation?
- 1. Injury
3. Chemical mediator release
- What happens physiologically when injury occurs?
- a TRANSIENT vasoconstriction
- What happens right after the transient vasoconstriction? Why?
- Vasodilation/permeability increase allows antimicrobial chemicals and cells to extravasate into tissue.
- What 5 chemical mediators appear during the vascular phase?
- 1. Histamine/serotonin
2. Complement - C3
3. Kallekrein-kinin system
4. Coag system products
5. Arachidonic aa. metabolites
- What is the purpose of histamine/serotonin?
- They initially cause vasodilation and increased permeability of vasculature.
- What 2 things do Complement chemical mediators do?
What are their specific names?
- 1. Anaphylatoxins - C3a/C5a; stimulate release of more histamine & smooth muscle contraction.
2. Opsonins - C3b/C5b; enhance phagocytosis.
- What does the coag system do in the vascular phase?
- Increases permeability
- What 2 arachidonic acid metabolites are produced, and what do they do?
- 1. Prostaglandins - stimulate smooth muscle contraction
2. Leukotrienes - same as above, and increase vasoperm/dilation, allow for chemotaxis of PMNs/eosinophils
- What happens to cells in the Cellular Phase of inflammation?
- 1. RBCs undergo stasis and rouleaux, to the middle of vessels.
2. WBCs move to vessel periph.
- What 3 things specifically do WBCs do during cellular phase?
- 1. Margination/pavementing - move to vessel edges.
2. Diapedesis - move through endothelial cells.
3. Chemotaxis - go to injury site.
- After cellular movement, what 3 things finally happen in the cellular phase?
- 1. Transudation of plasma from vessels to tissue.
2. Exudation of plasma and WBCs, creating PUS.
3. Consolidation - fibrin clots form and isolate injury.
- What happens after the cellular phase of inflammation? How?
- -Neutralization of noxious stimuli.
-PMNs and Macrophages
- What four things do Macrophages do in the neutralization phase?
- 1. Phagocytize noxious stimuli.
2. Clear debris with Collagenase and Elastase.
3. Release cytokines
4. Produce angiogenic factors.
- what do angiogenic factors do?
- create new blood vessels.
- What three things happen in the resolution phase of inflammation?
- 1. Fibroblasts proliferate to neutralize mediators.
2. Fibrin clots dissolve
3. Tissue regenerates.
- What is the differense between Acute and chronic inflammation re: tissue regeneration?
- Acute: complete regeneration
Chronic: scarring, abcesses, and granulomas often remain.
- What are 5 systemic manifestations of inflammation?
- 1. Protein/lipid catabolism
2. Hormonal changes
4. Neutrophilia, lymphopenia
5. Serum proteins altered.
- What 4 alterations occur to serum proteins?
- 1. Gammaglobulins increase
2. Cytokines release esp IL6
3. ESR increases
4. APRs are altered
- What is the ESR and what is the ref range in males/females?
- the Distance that RBCs fall in 1 hour. Incrs with more protein.
Male: 0-9 mm/hr
Fmle: 0-15 mm/hr
- What are 6 acute phase reactants?
- 1. C-reactive protein CRP
2. Serum amyloid A SAA
3. a-1 proteinase inhibitor
- What are the 2 negative APRs?
- What 2 APRs are most increased in inflammation?
- CRP and SAA
- What are 3 test methods for CRP detection?
- 1. Nephelometric
3. Latex agglutination
- What is CRP's role in inflammation? (3 things)
- 1. Activates complement cascade.
2. Activates macrophages
3. Binds PMNs to promote phagocytosis.
- On a curve of protein versus time, how does CRP compare to other APRs?
- Rises very fast and falls quickly, to a much greater extent than any other.
SAA is similar.
- What is the reference range for CRP?
- </= 1 mg/dl
</= 10 mg/L
- What are 6 clinical uses for measuring CRP?
- 1. Determines inflam. extent
2. Predicts graft rejection
3. Monitor cancer metasthesis
4. Post-surgical monitoring
5. Depth of burn determinatn
6. Monitor/predict MI
- What is the difference between CRP and hsCRP?
- -CRP normally measures inflammation, and is greatly increased above 1 mg/dl.
-hsCRP is used to measure very low levels of CRP to predict heart disease.
- How, specifially does hsCRP predict myocardial infarct risk?
- <1 mg/L is LOW RISK
1-3 mg/L is AVG risk
>3 mg/L is HIGH risk
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