Corticosteroid and Inflammation Effects

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Questions and Answers

Which of the following is a characteristic of acute inflammation?

More fibrous scar tissue formation

Presence of more lymphocytes and macrophages

Exudation of fluid and plasma protein (correct)

Ongoing tissue destruction

What is the primary role of platelet activation in haemostasis?

To initiate the inflammatory response

To begin the coagulation cascade

To form a platelet plug to stop bleeding (correct)

To remodel the matrix after wound healing

What systemic effect of inflammation is characterized by a feeling of being unwell?

Headache

Low grade fever

Anorexia

Malaise (correct)

Which phase follows haemostasis in the wound healing process?

Inflammation Signup and view all the answers

Which type of inflammation is more likely to involve a severe ongoing tissue destruction?

Chronic inflammation Signup and view all the answers

What is the main function of the coagulation cascade in secondary haemostasis?

To form fibrin from fibrinogen Signup and view all the answers

What is a visible local effect of inflammation?

Pain Signup and view all the answers

Which of the following conditions would most likely occur during chronic inflammation?

Less swelling and exudate Signup and view all the answers

How does inflammation contribute to the healing process?

It removes injurious agents and initiates repair Signup and view all the answers

What is NOT a phase of repair in acute wound healing?

Apoptosis Signup and view all the answers

Which characteristic differentiates necrosis from apoptosis regarding cell size?

Cell size enlarges in necrosis Signup and view all the answers

What is a common feature associated with necrosis but not with apoptosis?

Inflammation is frequent Signup and view all the answers

Which of the following accurately describes nuclear changes in necrosis?

All of the above Signup and view all the answers

In which type of necrosis is the disruption of cellular content a primary characteristic?

Liquefactive necrosis Signup and view all the answers

What is the primary cause of apoptosis?

Physiologic processes Signup and view all the answers

What is a key difference in the plasma membrane behavior between necrosis and apoptosis?

Membrane is disrupted in necrosis Signup and view all the answers

Which type of necrosis is primarily caused by ischemia?

Coagulative necrosis Signup and view all the answers

Which of the following drugs is a long-acting corticosteroid with a half-life of 36-72 hours?

Betamethasone Signup and view all the answers

Which mechanism is employed by glucocorticoids to exert their anti-inflammatory effects?

Inhibit NFkB and increase transcription of anti-inflammatory proteins Signup and view all the answers

Which synthetic corticosteroid is considered intermediate-acting with a half-life of 12-36 hours?

Prednisone Signup and view all the answers

What is the relative potency of prednisolone compared to hydrocortisone?

5X more potent Signup and view all the answers

Which process involves enzymatic digestion of cellular contents?

Liquefactive necrosis Signup and view all the answers

What characteristics does acetaminophen have compared to NSAIDs in terms of its mechanism of action?

Does not affect cyclooxygenase activity Signup and view all the answers

What effect does corticosteroid have on blood sugar levels?

Increases blood sugar Signup and view all the answers

Which of the following is a therapeutic effect of glucocorticoids?

Atrophy of lymphoid tissue Signup and view all the answers

What is one of the side effects related to corticosteroid use?

Reduced immunity Signup and view all the answers

Which of the following correctly describes a phase of acute wound healing?

Inflammation precedes matrix remodelling Signup and view all the answers

What impact do corticosteroids have on calcium absorption?

Decrease calcium absorption Signup and view all the answers

Which of the following effects is NOT associated with corticosteroid treatment?

Decreased blood pressure Signup and view all the answers

Which statement regarding the regulation of metabolism by corticosteroids is true?

They influence both glucose and lipid metabolism Signup and view all the answers

Which of the following phases occurs first in acute wound healing?

Haemostasis Signup and view all the answers

Study Notes

Corticosteroid Effects

Decreases inflammation.
Increases blood sugar.
Retains sodium (Na+).
Regulates metabolism.
Decreases calcium (Ca) absorption.
Decreases serotonin levels.
Decreases immunity.

Glucocorticoid Therapeutic Effects and Side Effects

Atrophy of lymphoid tissue.
Reduced hemopoiesis.
Anxiety.

Acute Wound Healing Phases

Hemostasis: clot formation to stop bleeding. Involves platelet activation and plug formation, and the coagulation cascade converting fibrinogen to fibrin.
Inflammation.
Cell proliferation and matrix deposition.
Matrix remodeling.

Inflammation

Normal protective mechanism.
Aims to eliminate injury cause, necrotic cells and tissues, and initiate repair.
Stops when the injurious agent is removed.
Not the same as infection.

Local vs. Systemic Inflammation Effects

Local:* Redness, heat, swelling, pain.
Systemic:* Low-grade fever, malaise, fatigue, headache, anorexia.

Acute vs. Chronic Inflammation

Acute:* Sudden onset, short duration, exudation of fluid and plasma proteins (edema), leukocyte migration (mainly neutrophils).
Chronic:* Follows acute inflammation with continued tissue destruction, less swelling and exudate, presence of lymphocytes, macrophages, and fibroblasts, more severe ongoing tissue destruction, more collagen and fibrous scar tissue.

Anti-inflammatory Mechanisms of Action

ASA (Aspirin): Irreversibly inhibits COX-1 and COX-2.
Acetaminophen: Exact mechanism unknown; weakly selective COX-2 inhibitor.
NSAIDs (Nonsteroidal anti-inflammatory drugs): Competitive inhibitors of COX-1 and COX-2; some weakly selective to COX-1.
Glucocorticoids: Inhibit NFkB, increasing transcription of anti-inflammatory proteins. Act as IL-1 receptor antagonists and increase IL-10.
COX-2 inhibitors: Competitive COX-2 inhibitors at therapeutic doses.

Common Synthetic Corticosteroids

Cortisone/Hydrocortisone: Short-acting; cortisone is a prodrug converted to hydrocortisone in the liver.
Prednisone/Prednisolone: Intermediate-acting; prednisone is a prodrug converted to prednisolone (the active metabolite) in the liver; Prednisolone is 5x more potent than hydrocortisone.
Dexamethasone: Long-acting; 25x more potent than hydrocortisone.
Betamethasone: Long-acting; used topically and parenterally.

Irreversible Injury: Necrosis vs. Apoptosis

Feature	Necrosis	Apoptosis
Cell size	Enlarged	Reduced
Nucleus	Pyknosis, karyorrhexis, karyolysis	Fragmentation
Plasma membrane	Disrupted	Intact
Cellular content	Enzymatic digestion	Intact, apoptotic bodies
Inflammation	Frequent	No
Causes	Pathologic	Often physiologic, can be pathologic

Necrosis Types

Coagulative: Ischemia.
Liquefactive: Pyogenic bacteria.
Fat necrosis: Acute pancreatitis.
Gangrenous: Ischemia.
Caseous: Mycobacterium or fungal infection.
Necrosis involves rupturing of the cell membrane and nucleus disintegration, leading to lysis of cellular content and inflammation.

NSAIDs/Corticosteroids Summary

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Description

This quiz covers the effects of corticosteroids, including their therapeutic and side effects, as well as the phases of acute wound healing and inflammation. It also distinguishes between local and systemic inflammation effects. Test your knowledge on these important topics in pharmacology and pathology.