Inflammation: Acute and Chronic Responses

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Questions and Answers

What defines metabolic acidosis?

An increase in CO2 and a decrease in pH

A primary deficit of bicarbonate and a decrease in pH (correct)

A loss of acids and an increase in pH

An increase in bicarbonate and a decrease in pH

Which condition results from an increase in bicarbonate retention?

Respiratory alkalosis

Respiratory acidosis

Metabolic alkalosis (correct)

Metabolic acidosis

What initiates the primary event in acid-base disorders?

An attempt to correct pH changes

Inadequate respiratory function

The metabolic process itself

The primary-initiating event (correct)

Which of the following is a consequence of respiratory acidosis?

Decreased pH due to increased carbonic acid Signup and view all the answers

What is a common cause of respiratory alkalosis?

Panic attacks Signup and view all the answers

What type of hypersensitivity is characterized by T cells attacking antigens?

Type 4 hypersensitivity Signup and view all the answers

Which condition is NOT an example of a Type 3 immune complex-mediated reaction?

Pneumonia Signup and view all the answers

What is the primary difference between HIV and AIDS?

HIV is an infection while AIDS is a disease caused by HIV Signup and view all the answers

Which of the following best describes the hyperacute reaction in transplantation?

Immediate reaction following transplantation Signup and view all the answers

What is the role of cations and anions in the body?

They maintain fluid balance and function Signup and view all the answers

What triggers edema in the body?

Increased filtration at capillaries Signup and view all the answers

Which of the following is NOT considered an opportunistic infection associated with AIDS?

Common cold Signup and view all the answers

What is Starlings law of the capillaries primarily concerned with?

Volume of fluids exchanged across capillaries Signup and view all the answers

What characterizes the cellular phase of inflammation?

Movement of leukocytes to the site of injury Signup and view all the answers

What is the role of nitric oxide in inflammation?

Induces vasodilation and regulates leukocyte movement Signup and view all the answers

Which leukocytes are primarily involved in the acute inflammatory response?

Neutrophils and eosinophils Signup and view all the answers

Which type of exudate is characterized by watery fluids low in protein content?

Serous exudate Signup and view all the answers

What is the primary purpose of vasodilation during inflammation?

Enhance fluid accumulation in tissue spaces Signup and view all the answers

What is chemotaxis?

Direct migration of a cell in response to a chemical stimulus Signup and view all the answers

Which of the following indicates a chronic inflammation process?

Infiltration by mononuclear cells Signup and view all the answers

Which of the following is NOT a plasma-derived mediator?

Leukotrienes Signup and view all the answers

What is a common systemic sign of inflammation?

Fever Signup and view all the answers

What type of inflammation is associated with foreign bodies and specific microorganisms?

Granulomatous inflammation Signup and view all the answers

What type of response occurs immediately after minor tissue injury?

Immediate transient response Signup and view all the answers

What is one of the five steps of phagocytosis?

Chemotaxis Signup and view all the answers

Which fever pattern remains above normal but fluctuates more than 1 degree in 24 hours?

Remittent fever Signup and view all the answers

What role do inflammatory mediators play during inflammation?

Cause vasodilation and increased vascular permeability Signup and view all the answers

Which of the following factors is NOT involved in the body's protective response?

Oxygen transport Signup and view all the answers

What can a 1 degree increase in body temperature lead to?

An extra 15 beats per minute of the heart Signup and view all the answers

What is the primary regulator of water intake in the body?

Thirst Signup and view all the answers

Which type of diabetes insipidus occurs due to a defect in the synthesis or release of ADH?

Central diabetes insipidus Signup and view all the answers

What is the primary function of sodium in the body?

Maintains serum osmolality and cell integrity Signup and view all the answers

What is hypervolemic hypotonic hyponatremia characterized by?

Addition of a hypertonic solution containing sodium and water Signup and view all the answers

Which condition is characterized by low sodium levels in the body?

Hyponatremia Signup and view all the answers

What does the kidney primarily regulate in the context of sodium levels?

Arterial pressure Signup and view all the answers

Which type of hyponatremia is commonly associated with excess sweating, vomiting, or diarrhea?

Hypovolemic hypotonic hyponatremia Signup and view all the answers

Which disorder results from the failure of the negative feedback system regulating ADH?

SIADH Signup and view all the answers

Study Notes

Inflammation

A vascularized tissue's response to cell damage
Characteristics: Inflammatory mediators, fluid, and leukocytes move from blood to extravascular tissue
Purpose: Minimize damage, remove damaged tissue, promote new tissue growth
Causes: Trauma, surgery, infection, hypoxia, ischemia

Acute Inflammation

Short duration and self-limited
Neutrophils are the first cells to arrive

Chronic Inflammation

Lasts for weeks, months, or years
Characterized by mononuclear cells, lymphocytes, and fibroblasts

Vascular Phase of Acute Inflammation

Hemodynamic changes in the small blood vessels at the site of injury
Vasodilation: Increased capillary pressure, fluid outflow, swelling, pain, and functional impairment
Vasoconstriction: Minimizes blood loss, maintains blood flow, and blood pressure
Vascular Changes:
- Immediate transient response: Minor injury
- Immediate sustained response: More severe injury, lasts several days, damages vessels
- Delayed hemodynamic response: Increased capillary permeability, 4 to 24 hours after injury (e.g., sunburn)

Cellular Phase

White blood cell activation
Two types of leukocytes in acute inflammation:
- Granulocytes: Neutrophils, basophils, and eosinophils
- Monocytes: Largest white blood cell type

Phagocytosis

Five steps:
- Chemotaxis: Cell migration towards chemical stimulus
- Adherence and Opsonization: Attachment to and recognition of foreign material
- Ingestion: Receptor activation, engulfment of targeted material
- Digestion: Fusion with lysosomes, breakdown of engulfed material
- Intracellular Killing: Removal of foreign material

Cardinal Signs of Inflammation

Rubor (redness)
Tumor (swelling)
Calor (heat)
Dolor (pain)
Functio laesa (loss of function)

Systemic Signs of Inflammation

Fever
Malaise (feeling unwell)

Inflammatory Mediators

Increase body's response to injury
Chemotaxis: Direct migration of a cell in response to a chemical stimulus

Plasma-Derived Mediators

Kinin system: Causes pain
Clotting system: Forms clots to prevent infection spread and stop bleeding
Complement system: Causes vasodilation

Chemical Mediators

Histamine: Released in response to trauma and immune reactions
Serotonin: Similar actions to histamine

Arachidonic Acid Metabolites

Prostaglandins: Induce inflammation, similar effects to histamine
Leukotrienes: Similar functions to histamine

Nitric Oxide

Produced by various cells, plays a role in inflammation
Relaxes smooth muscle in vessel walls
Regulates leukocyte movement

Inflammatory Exudates

Serous exudate: Watery fluid, low protein content, plasma entering the site
Hemorrhagic exudate: Severe tissue injury, blood vessel damage
Membranous exudate: Forms on mucus membrane surfaces
Purulent exudate: Contains pus
Fibrinous exudate: Contains large amounts of fibrin

Granulomatous Inflammation

Associated with:
- Foreign bodies (splinters, sutures)
- Microorganisms causing tuberculosis, syphilis, and deep fungal infections

Body's Protective Response

Involves:
- Inflammatory reaction
- Immune response
- Tissue repair

Manifestations of Inflammation

Increased plasma proteins
Increased skeletal muscle breakdown
White blood cell alterations
Fever

Fever Patterns

Intermittent: Normal temperature between fevers
Remittent: Temperature remains above normal, fluctuates more than 1 degree in 24 hours
Sustained: Temperature remains above normal, fluctuates less than 1 degree in 24 hours
Neurogenic: Caused by brain and spinal cord trauma

Dangers of Fever

1-degree increase leads to a 15-beat-per-minute increase in heart rate

Body Organ and Tissue Structure

Parenchymal tissue: Contains the functioning cells of an organ or body part
Stromal tissue: Supports connective tissue, blood vessels, and nerve fibers

Two Types of Healing

Regeneration- replacement of injured cells with cells of the same type
Repair - replacement of lost cells with connective tissue

Types of Hypersensitivity

Type I - Immediate, IgE-mediated, mast cells degranulate, histamine release, examples: allergic reations, anaphylaxis,
Type II - Antibody dependent cytotoxic, antibodies (IgM,IgG) attack antigens, examples: Rh disease, drug reactions, involves neutrophils, macrophages and IgG,IgM
Type III - Immune complex medicated, antigen is not attached to cells, inflammatory response produces the damage, examples: lupus, serum sickness, Arthur's reaction
Type IV - Cell-mediated hypersensitivity, T cells attack antigen, examples: Tuberculin test, allergic contact dermatitis

Transplant Reaction Types

Hyperacute reactions: Occur immediately after transplantation
Acute rejection: Occurs within a few months after transplantation

HIV and AIDS

HIV: The virus
AIDS: Manifestations of the infection
Diagnosis:
- ELISA: Initial screening test
- Western blot: Confirmation test

Opportunistic Infections

Respiratory diseases: Tuberculosis, pneumonia
GI diseases: Thrush, protozoal infections, diarrhea
Nervous system: AIDS dementia, Toxoplasmosis (neurological dysfunction)
Malignancies: Kaposi's sarcoma (affects blood vessel lining)
Wasting syndrome: Involuntary weight loss, weakness, fever

Ions

Negative: Anions
Positive: Cations

Body Fluid Functions

Transport gases, nutrients, and waste
Metabolic processes
Maintain body function

Body Fluid Distribution

Intracellular compartment: Inside the cell, 2/3 of body water, high potassium concentration
Extracellular compartment: Outside the cell, 1/3 of body water, high sodium concentration

Fluid Exchange at Capillaries

Four forces control water movement between capillaries and interstitial spaces
Starling's Law of Capillaries: The volume reabsorbed equals the volume filtered

Edema (Fluid Accumulation)

Occurs when filtration exceeds reabsorption
Concerns: Increased diffusion distance, impaired function, blood vessel compression
Common sites: Stomach, lungs, heart

Water Gain and Loss

2500 ml intake, 2500 ml output

Physiological Mechanisms Regulating Body Water

Thirst: Primary regulator of water intake
ADH (Antidiuretic Hormone): Regulates water output

Ways to Lose Water

Insensible loss: Sweat, respiration
Measurable loss: Urine, vomit, diarrhea

Sodium Regulation

Kidney: Main regulator, monitors arterial pressure, retains sodium when pressure is low, eliminates it when pressure is high

Thirst Triggers

Osmoreceptors in the hypothalamus

Types of Thirst

Hypodipsia: Inability to sense thirst
Polydipsia: Excessive thirst

Disorders of ADH Expression

Diabetes insipidus: Excessive water loss in urine
SIADH (Syndrome of Inappropriate Antidiuretic Hormone): Impaired negative feedback system regulating ADH release

Types of Diabetes Insipidus

Central or neurogenic: Defect in ADH synthesis or release
Nephrogenic: Kidneys do not respond to ADH

Disorders of Sodium and Water Balance

Changes can be proportional (isotonic) or disproportionate (hypertonic or hypotonic)

Isotonic Fluid Volume Deficit (Hypovolemia)

Water and electrolytes lost in equal proportions
Causes: High salt intake
Manifestations: Increased thirst, dry mucous membranes

Isotonic Fluid Volume Excess (Hypervolemia)

Disproportionate intake or retention of water and sodium

Sodium Needs

500 mg per day

Importance of Sodium

Maintains serum osmolality
Acid-base balance
Electrical impulse transmission
Cell integrity (sodium-potassium pump)

Hyponatremia

Low sodium levels

Types of Hyponatremia

Hypertonic hyponatremia: Osmotic water shift due to high blood glucose
Hypovolemic hypotonic hyponatremia: Most common, ECF loss due to sweating, vomiting, diarrhea
Normovolemic hypotonic hyponatremia: Associated with SIADH, post-operative, high ADH levels
Hypervolemic hypotonic hyponatremia: Least common

Hypernatremia

High sodium levels
Causes: Excessive sodium intake or water loss
Euvolemic: Water from ICF shifts to ECF
Hypovolemic: Water loss exceeds sodium loss
Hypervolemic: Addition of hypertonic solution containing sodium and water

Potassium Distribution and Regulation

Key role in muscle contraction and nerve impulse transmission
Regulation:
- Renal excretion: Main regulator, influenced by aldosterone
- Cellular uptake, shifting between ICF and ECF

Disorders of Potassium Balance

Hypokalemia: Low potassium levels
Hyperkalemia: High potassium levels

Acid-Base Balance

Normal pH: 7.35-7.45
Regulation:
- Buffers
- Respiratory system (lungs)
- Renal system (kidneys)

Acid-Base Disorders

Primary: Initiating event
Compensatory: Attempting to correct pH change

Types of Acid-Base Disorders

Metabolic: Involves bicarbonate (HCO3-)
Respiratory: Involves carbon dioxide (CO2)

Metabolic Acidosis

Primary deficit of bicarbonate, decreased pH

Causes of Metabolic Acidosis

Decreased kidney function
Increased bicarbonate loss

Manifestations of Metabolic Acidosis

Increased respiration
Hyperkalemia

Metabolic Alkalosis

Increased pH due to increased bicarbonate ions

Causes of Metabolic Alkalosis

Loss of acids (e.g., vomiting)
Increased bicarbonate retention

Respiratory Acidosis

Increased CO2, carbonic acid, and decreased pH

Causes of Respiratory Acidosis

Acute: Always accompanied by low oxygen
Acute respiratory failure: Severe drop in pH, minimal change in bicarbonate

Respiratory Alkalosis

Decreased CO2, carbonic acid deficit, and increased pH

Causes of Respiratory Alkalosis

Panic attacks, fever, excessive stress

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Description

This quiz explores the mechanisms of inflammation, focusing on acute and chronic processes. It covers key characteristics, causes, and vascular changes involved in inflammatory responses. Test your knowledge on how the body reacts to cell damage and the role of different cells in inflammation.