Immunology and Inflammation Quiz

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Questions and Answers

Which of the following accurately describes the role of bradykinin in inflammation?

Inhibits the effects of histamine and prevents platelet aggregation.

Decreases vascular permeability and promotes smooth muscle relaxation.

Enhances pain sensation while increasing clotting factors.

Increases vascular permeability and causes contraction of smooth muscles. (correct)

What is the primary consequence of prolonged use of systemic glucocorticoids?

Excessive secretion of adrenal glucocorticoids.

Risk of Cushing’s syndrome due to overtreatment. (correct)

Enhanced inflammatory response in acute conditions.

Decreased risk of withdrawal symptoms upon stoppage.

Which statement about leukotrienes is correct?

Leukotrienes have milder effects compared to histamine.

They mainly act to reduce vascular permeability.

Leukotrienes are only produced by the liver.

They cause slow and sustained bronchioconstriction. (correct)

How should glucocorticoids be administered to minimize withdrawal symptoms?

Gradually taper off the dosage under a physician's supervision. Signup and view all the answers

What is a key mechanism through which Sulfasalazine exerts its effects in treating inflammatory bowel disease?

Blocking arachidonic acid metabolites Signup and view all the answers

Which of the following statements is true regarding the complement system during inflammation?

It enhances phagocytosis and causes vasodilation. Signup and view all the answers

Which type of immune response is primarily involved in the pathophysiology of asthma?

Humoral immunity with IgE production and mast cell degranulation Signup and view all the answers

What primarily triggers mast cell degranulation in asthmatic patients?

Crosslinking of IgE receptors on mast cells Signup and view all the answers

What distinguishes acute inflammation from chronic inflammation?

Acute inflammation typically involves a more pronounced immune response. Signup and view all the answers

What type of drug is most commonly used as a first-line treatment for acute asthma attacks?

Systemic glucocorticoids Signup and view all the answers

Which therapy is primarily utilized for acute treatments with glucocorticoids?

Systemic steroids for immediate response. Signup and view all the answers

In terms of anti-inflammatory medication, which of the following is a common side effect of NSAIDs?

Gastrointestinal disturbances. Signup and view all the answers

Which of the following is a common side effect of Sulfasalazine?

Photosensitivity Signup and view all the answers

What is the primary inflammatory mediator involved in bronchoconstriction during an asthmatic reaction?

Histamine Signup and view all the answers

How do 1st generation antihistamines primarily differ from 2nd generation antihistamines in terms of their mechanism of action?

1st generation antihistamines produce more sedation due to central nervous system penetration Signup and view all the answers

In asthma, which type of response is characterized as life-threatening?

Severe airway hyperreactivity with systemic involvement Signup and view all the answers

What is the primary role of cytokines such as IL-1, IL-6, and TNF-α during the acute phase response?

To stimulate liver production of acute-phase proteins Signup and view all the answers

Which of the following describes the systemic manifestation known as Systemic Inflammatory Response Syndrome (SIRS)?

Dysregulation of inflammatory response with high cytokine levels Signup and view all the answers

What effects does histamine have on blood vessels during inflammation?

Dilation and increased permeability Signup and view all the answers

Which of the following accurately distinguishes between asthma and anaphylaxis?

Anaphylaxis includes systemic reactions whereas asthma is primarily respiratory Signup and view all the answers

How does the mechanism of action for first-generation antihistamines differ from second-generation antihistamines?

Second-generation antihistamines cross the blood-brain barrier less effectively Signup and view all the answers

Which statement best compares osteoarthritis and rheumatoid arthritis?

Osteoarthritis primarily affects joints due to wear and tear, while rheumatoid arthritis is inflammatory and systemic Signup and view all the answers

What is a common side effect of NSAIDs compared to paracetamol (Tylenol)?

Gastrointestinal irritation Signup and view all the answers

What is the cellular response during the inflammation process characterized by?

Leukocyte migration toward the injury site Signup and view all the answers

Study Notes

Inflammatory Diseases, Tissue Integrity & Wound Healing

This presentation reviews acute inflammatory processes, chronic inflammation, tissue repair, wound healing, factors affecting healing, and disorders of immune response.
Acute inflammation is the body's initial protective response to injury, aiming to contain the injury, stimulate the immune response, remove debris, and promote healing to prevent infection.
Signs of acute inflammation include redness, swelling, heat, pain, and loss of function.

Acute Inflammation

The vascular phase involves small blood vessels near the injury site. It begins with temporary vasoconstriction followed by vasodilation (increasing blood flow), causing heat and redness.
Increased vascular permeability allows fluid (exudate) to leak into the extracellular space, causing swelling (edema), pain, and impaired function. This exudate also contains clotting factors to prevent the spread of infection throughout the body.
The cellular phase involves the delivery of leukocytes (primarily neutrophils) to the injury site for phagocytosis. This includes activation, adhesion, margination, transmigration, and chemotaxis of the leukocytes towards the injury site.
Leukocytes migrate to the site of injury and remove bacteria and cellular debris by phagocytosis.

Systemic Manifestations of Inflammation

Acute-phase response is mediated by cytokines (IL-1, IL-6, TNF-α) that stimulate the liver to produce acute-phase proteins (fibrinogen, CRP, etc.).
This response communicates with the hypothalamus to trigger a fever and metabolic changes, such as protein breakdown into amino acids for immune system or tissue repair.
Systemic inflammatory response syndrome (SIRS) is a dysregulation of the inflammatory response caused by large amounts of microorganisms in the blood, releasing high amounts of cytokines. This leads to vasodilation, increased vascular permeability, intravascular fluid loss, and circulatory shock.

Exudates

Serous exudate is watery fluid low in protein, often seen in blisters, and is a normal part of the healing process.
Fibrinous exudate contains a lot of fibrinogen, forming a thick and sticky meshwork.
Hemorrhagic exudate, also known as sanguineous exudate, results from significant tissue injury and damage to blood vessels, causing leakage of red blood cells (RBCs) into the tissues.

Inflammatory Mediators

Inflammatory mediators are various molecules (both plasma-derived and cell-derived) involved in the inflammatory process. These mediators come from different sources, including mast cells, basophils, platelets, leukocytes, endothelial cells, macrophages, lymphocytes, and nerve fibers.

Key Inflammatory Mediators

Histamine causes blood vessel dilation, smooth muscle contraction, tissue swelling, and itching.
Arachidonic acid metabolites, such as prostaglandins which increase capillary permeability, attract white blood cells (WBCs) to sites of inflammation, cause pain, and promote platelet aggregation. Leukotrienes have similar effects but are more potent and cause sustained bronchoconstriction.
Plasma proteins including clotting factors, complement components, and bradykinin influence vascular permeability and smooth muscle contraction.

Wound Healing

Primary intention involves approximating wound edges with minimal tissue loss, leading to minimal scarring (e.g., sutured surgical wounds).
Secondary intention is healing from inside out, involving greater tissue loss and contamination; this process leads to slower healing and more significant scar formation (e.g., large surface wounds, burns).

Tissue Repair and Wound Healing

Tissue regeneration replaces injured tissue with cells of the same type. Different tissue types regenerate differently.
Fibrous tissue repair replaces damaged tissue with connective tissue, forming granulation tissue to provide a scaffold for new tissue. Fibrogenesis involves the production of extracellular matrix components.
During healing, the number of fibroblasts and blood vessels decrease, eventually forming scar tissue. Although the scar tissue fills the gap, it may not structurally replace the functional tissue.

Stages of Wound Healing

Inflammatory phase removes the injurious agent and prepares the wound for healing. This includes hemostasis (clotting), vascular changes, and the migration of phagocytes.
The proliferative phase involves the proliferation of fibroblasts, angiogenesis, and the formation of granulation tissue. Epithelial cells grow to cover the wound surface.
The remodeling/maturation phase involves collagen remodeling and strengthening of the scar tissue, with a decrease in vascularization; this eventually makes the scar less prominent.

Factors Affecting Wound Healing

Adequate blood flow and oxygen delivery, nutritional status (proteins, carbs, vitamins), and healthy age-appropriate immune responses in neonates, children and adults are essential.
Impaired inflammatory and immune responses (e.g., corticosteroids, immunocompromise, or ongoing infection) can impede healing.

Chronic Inflammation

Acute inflammation typically lasts less than 10 days, but chronic inflammation can persist for weeks, months, or even years.
Chronic inflammation often results from persistent irritants resistant to phagocytosis.
Chronic inflammation causes tissue destruction due to recurring inflammatory cascades.
Macrophages and lymphocytes are more prominent than neutrophils.
Scar tissue formation, with decreased vascularity, replaces connective tissue. Fibrosis occurs. Repeated cycles of inflammation damage tissues and result in dysfunctions and unusual growths (neoplasms).

Inflammatory Diagnoses

Allergic rhinitis, dermatitis, psoriasis, arthritis, inflammatory bowel disease, asthma, and chronic obstructive pulmonary disease (COPD) are examples of inflammatory diagnoses.

Allergic Rhinitis

Allergic rhinitis is an inflammatory response to inhaled allergens.
It triggers seasonal or occasional symptoms such as rhinitis, conjunctivitis (eyes), headache, nasal congestion.
Common treatment options include corticosteroids, antihistamines, and desensitization.

Atopic Dermatitis

Atopic dermatitis, also known as eczema, is a chronic inflammatory skin disorder triggered by an IgE (allergic) response.
Signs include intense itching, skin barrier impairment, and potential superinfection.
Treatments focus on moisturizing, topical glucocorticoids, antihistamines, and antibiotics/antivirals for potential infections.

Psoriasis

Psoriasis is a chronic inflammatory skin disorder with possible autoimmune components.
Common triggers include genetics, stress, or medications..
Symptoms typically are reddish, patchy, hyperkeratotic, dilated dermal papillae scaling dry skin; itching (though sometimes non-pruritic).
Treatment may include topical and/or systemic corticosteroids and topical moisturizing creams.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder that affects joints.
The disease is characterized by inflammation of connective tissue caused by the immune system attacking healthy joints.
Proliferation of inflammatory cells, including WBCs, and fibroblasts within the tissue, leads to pannus formation and destruction of surrounding tissues (bone and cartilage).
Symptoms include swelling, stiffness (worse in the morning), pain, and generalized symptoms (fever or malaise). Treatment includes rest, NSAIDs, glucocorticoids, and immunomodulators.

Osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease (wear-and-tear).
The disease is characterized by cartilage degradation and bone changes. Aging, gender, and increased mechanical stress are factors increasing risk.
Cartilage degradation and loss frequently involve pro-inflammatory mediators like cytokines and prostaglandins.
Treatment includes management with NSAIDs and appropriate corticosteroid applications.

Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD), categorized as Crohn's disease or ulcerative colitis, is a chronic inflammatory condition affecting the gastrointestinal tract.
IBD frequently involves chronic inflammation of the gastrointestinal tract. Symptoms include diarrhea, blood in stool, fatigue, abdominal pain, and weight loss.
Treatment varies by disease and severity but includes glucocorticoids, potentially 5-ASA (mesalamine) drugs.

Asthma

Asthma is a chronic inflammatory disorder of the airways.
Triggered by environmental factors (allergens or environmental particles), stress, infection, and other irritants.
Symptoms involve chronic inflammation leading to airway obstruction and hypersensitivity.
Symptoms include wheezing, shortness of breath, chest tightness, and cough; exacerbations worsen the symptoms.
Treatments involve both maintenance and rescue drugs.

Status Asthmaticus

Characterized by a severe asthma attack requiring emergency room (ER) intervention.
Treatment includes oxygen therapy, bronchodilators, corticosteroids, and potentially magnesium sulfate.

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Description

Test your knowledge on key concepts of immunology and inflammation. This quiz covers bradykinin's role, effects of glucocorticoids, and the mechanisms of various immune responses. Explore important aspects of inflammation management and medication usage.