Podcast
Questions and Answers
Which of the following describes chronic inflammation?
Which of the following describes chronic inflammation?
What is a key difference between acute and chronic inflammation?
What is a key difference between acute and chronic inflammation?
Which type of osteomyelitis is primarily characterized by acute hematogenous spread?
Which type of osteomyelitis is primarily characterized by acute hematogenous spread?
Which characteristic defines diffuse suppurative inflammation?
Which characteristic defines diffuse suppurative inflammation?
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What role do chemical mediators play in the inflammatory response?
What role do chemical mediators play in the inflammatory response?
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What role does inflammatory exudate play in the inflammatory response?
What role does inflammatory exudate play in the inflammatory response?
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Which of the following is not a local sign of acute inflammation?
Which of the following is not a local sign of acute inflammation?
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Which mediator is primarily responsible for vasodilatation during the inflammatory process?
Which mediator is primarily responsible for vasodilatation during the inflammatory process?
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Opsonization by C3b enhances which leukocyte function?
Opsonization by C3b enhances which leukocyte function?
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What is a key distinguishing feature of chronic inflammation compared to acute inflammation?
What is a key distinguishing feature of chronic inflammation compared to acute inflammation?
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Which of the following can result from severe bacterial infection as a part of systemic inflammatory response?
Which of the following can result from severe bacterial infection as a part of systemic inflammatory response?
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Which component primarily facilitates leukocyte movement at the site of inflammation?
Which component primarily facilitates leukocyte movement at the site of inflammation?
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What is the primary function of macrophages in the inflammatory response?
What is the primary function of macrophages in the inflammatory response?
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Which type of inflammation is characterized by the presence of clear watery fluid with low protein and cellular content?
Which type of inflammation is characterized by the presence of clear watery fluid with low protein and cellular content?
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What is the primary mechanism through which opsonization by C3b enhances leukocyte function?
What is the primary mechanism through which opsonization by C3b enhances leukocyte function?
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Which of the following factors contributes to the formation of inflammatory fluid exudate?
Which of the following factors contributes to the formation of inflammatory fluid exudate?
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Which type of acute inflammation involves the presence of a necrotizing process and extensive tissue destruction?
Which type of acute inflammation involves the presence of a necrotizing process and extensive tissue destruction?
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Which type of inflammation is associated with a greyish-white, dirty membrane that is loosely attached and can be easily removed?
Which type of inflammation is associated with a greyish-white, dirty membrane that is loosely attached and can be easily removed?
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In which type of inflammation is there an excess of eosinophils present in the exudate?
In which type of inflammation is there an excess of eosinophils present in the exudate?
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Which type of non-suppurative inflammation is known for an appearance resembling 'bread and butter'?
Which type of non-suppurative inflammation is known for an appearance resembling 'bread and butter'?
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What is the predominant characteristic of catarrhal inflammation?
What is the predominant characteristic of catarrhal inflammation?
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Study Notes
Inflammation Overview
- Inflammation is a vital process in which living tissues react to injury as a protective response.
- Its goal is to localize and eliminate the cause of cell injury.
Intended Learning Outcomes (ILOs)
- Define inflammation and recognize clinical manifestations, including systemic effects.
- Explain vascular and cellular events in acute inflammation, describing its morphology.
- Compare and contrast acute and chronic inflammation.
- Recognize different types of acute inflammation and examples of each.
- Recognize pathologic changes in acute and chronic osteomyelitis.
Definition
- Inflammation is a vital process in which living tissues react to injury as a protective response.
- Actions include localizing and eliminating the cause of cell injury.
Types of Inflammation
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Acute Inflammation:
- Rapid onset, short duration (minutes to days)
- Exudative
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Chronic Inflammation:
- Gradual onset, long duration (days to years)
- Productive (granulation tissue)
- Fibrosis
Causes of Inflammation
- Physical: Trauma, heat, cold, irradiation
- Chemical: Acids, alkalies
- Infective: Bacteria, viruses, parasites
Acute Inflammation (Detailed)
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Vascular Changes (Initial):
- Transient vasoconstriction followed by vasodilation.
- Increased vascular permeability (due to chemical mediators on arterioles, capillaries, post-capillary venules). This leads to inflammatory exudate and swelling.
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Leukocyte Emigration:
- Steps of Leukocyte emigration:
- Margination
- Rolling (mediated by selectins)
- Adhesion (mediated by integrins)
- Transmigration
- Chemotaxis
- Phagocytosis
- Steps of Leukocyte emigration:
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Chemotaxis: Substances (chemotaxins) attract immune cells to the site of injury. This includes soluble bacterial products and components of the complement system (like C5a and C3a), as well as products of arachidonic acid metabolism (like leukotriene B4).
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Phagocytosis: Neutrophils and macrophages engulf and destroy bacteria and foreign particles.
- Opsonization: Coating micro-organisms with opsonins (like IgG and C3b) to make them more recognizable and easier to engulf.
- Engulfment: The immune cells engulf the targeted material.
- Killing and Degradation: Killing of micro-organisms through Reactive Oxygen Species (ROS), Reactive Nitrogen Species (particularly NO), and lysosomal enzymes.
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Inflammatory Exudate:
- Fluid rich in fibrinogen (clotting proteins).
- Functions of Inflammatory exudates:
- Diluting bacterial toxins.
- Bringing antibodies to the inflammation area.
- Bacteriolysins (bacteria-killing agents).
- Agglutinins (to clump the organism).
- Opsonins (to coat the organism).
- Fibrinogen → fibrin (to localize infection and facilitate leukocyte movement).
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Chemical Mediators of Inflammation:
- Cell-derived mediators (like histamine, prostaglandins, nitric oxide).
- Plasma-derived mediators (like histamine, serotonin, substance P, bradykinin, C3a, C5a, IL-1, TNF, prostaglandins, and bradykinin).
Signs of Acute Inflammation
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Local:
- Redness
- Heat
- Pain
- Swelling
- Loss of function
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Systemic:
- Fever, anorexia, headache, malaise
- Leukocytosis
- Elevated acute-phase proteins (e.g., CRP, serum amyloid-associated protein, fibrinogen)
- Lymphangitis and lymphadenitis
- Shock (with severe bacterial infection).
Types of Acute Inflammation
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Local Suppurative:
- Abscess: Localized collection of pus
- Boil (Furuncle): Small abscess related to hair follicle or sebaceous gland
- Carbuncle: Multiple abscesses separated by fibrous strands
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Diffuse Suppurative:
- Cellulitis: Diffuse inflammation of subcutaneous tissue.
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Non-Suppurative:
- Serous: Fluid with few proteins and cells (eg., blisters following burns; vesicles of herpes simplex).
- Serofibrinous: Fluid rich in serous fluid and fibrin (e.g., acute fibrinous pericarditis).
- Catarrhal: Excessive mucous secretion (e.g., common cold).
- Membranous (Pseudomembranous): A true membrane forms, firmly attached to underlying tissue (eg. diphtheria). -Allergic: Characterized by excess eosinophils -Haemorrhagic: Blood in the exudate
Complications of Abscesses
- Chronic abscess
- Blood spread (toxemia, septicemia, pyaemia)
- Lymphatic spread (lymphangitis, lymphadenitis)
- Healing complications (ulcer, keloid, sinus, fistula).
Chronic Inflammation
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Persisted inflammation for weeks or months after initial injury.
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Progression from acute inflammation or recurrent episodes of acute inflammation.
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Occurs from chronic inflammation "de novo."
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Types include chronic non-specific inflammation and chronic specific inflammation (granulomas).
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Chronic Osteomyelitis : A specific type of chronic inflammation in bone
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Components of Chronic Osteomyelitis: The key structures affected and observed in chronic osteomyelitis include: Sequestrum (dead bone area), involucrum (new bone growth), and cloaca (a pathway for pus discharge).
Differences between acute and chronic inflammation (summary)
- Acute: Sudden onset, short duration, prominent vascular response, prominent local signs, acute phase proteins, prominent neutrophils, macrophages, healing or progression to chronic.
- Chronic: Gradual onset, long duration, less prominent vascular response, less prominent local signs, chronic phase proteins, chronic lymphocytes, plasma cells, macrophages, fibroblasts, fibrosis.
Fate of Acute Inflammation
- Resolution: Restoration of normal tissue structure.
- Healing/Repair: Tissue destruction and scarring.
- Progression to Chronic: Injury agent persists (e.g., tuberculosis [TB]), interfering with healing.
- Local Complications: Lymphangitis, lymphadenitis, bloodstream spread (bacteremia, septicemia, pyemia).
- Progress to Chronic Inflammation: Involves fibrosis of the affected area.
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Description
This quiz provides an overview of inflammation, a critical biological process in response to injury. It covers definitions, clinical manifestations, and the differences between acute and chronic inflammation. Additionally, you'll explore the pathologic changes associated with osteomyelitis.
