Inflammation Quiz
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Questions and Answers

What is the primary purpose of inflammation?

  • To stop blood flow
  • To enhance pain sensation
  • To eliminate the initial cause of cell injury (correct)
  • To promote tumor growth

Which of the following is NOT a recognized cause of inflammation?

  • Tissue necrosis
  • Infections
  • Foreign bodies
  • Excessive exercise (correct)

Which of these definitions correctly describes acute inflammation?

  • Only occurs in response to infections
  • Gradual onset and long duration
  • Rapid onset and short duration (correct)
  • Consistent over months or years

What is a potential side effect of acute inflammation?

<p>Potential tissue necrosis (C)</p> Signup and view all the answers

Which factor is known to trigger inflammation?

<p>Trauma (C)</p> Signup and view all the answers

How does chronic inflammation differ from acute inflammation?

<p>Chronic inflammation occurs over longer durations. (C)</p> Signup and view all the answers

Which term refers to inflammation that is specific and can be long-lasting?

<p>Chronic specific inflammation (C)</p> Signup and view all the answers

What is the main clinical sign of inflammation?

<p>Swelling (B)</p> Signup and view all the answers

What primarily initiates the increase in C-reactive protein in response to inflammation?

<p>Inflammatory stimuli (A)</p> Signup and view all the answers

What happens during the process of leukocytosis in acute inflammation?

<p>Increase in leukocyte numbers (C)</p> Signup and view all the answers

Which of the following factors does NOT modify the outcome of acute inflammation?

<p>Duration of inflammation (D)</p> Signup and view all the answers

What is the primary function of the cellular events in acute inflammation?

<p>Phagocytosis of pathogens (D)</p> Signup and view all the answers

What leads to edema during acute inflammation?

<p>Vascular permeability changes (B)</p> Signup and view all the answers

What defines the resolution of acute inflammation?

<p>Minimal tissue damage and regenerative capability (A)</p> Signup and view all the answers

What is the outcome when there is substantial tissue destruction from inflammation?

<p>Scarring and fibrosis (A)</p> Signup and view all the answers

Which of the following accurately describes the term 'chronicity' in inflammation?

<p>Persistent inflammation due to unaddressed factors (C)</p> Signup and view all the answers

What is the role of chemical mediators during inflammation?

<p>They contract endothelial cells and widen intercellular gaps. (B)</p> Signup and view all the answers

Which of the following correctly describes vascular stasis in acute inflammation?

<p>It causes local slowing of circulation due to increased blood viscosity. (D)</p> Signup and view all the answers

What is the significance of fibrinogen in inflammatory fluid exudate?

<p>It forms a network that helps phagocytic cells move. (A)</p> Signup and view all the answers

What occurs during the arteriolar vasodilatation phase of inflammation?

<p>The inflamed area appears red and warm. (B)</p> Signup and view all the answers

What is a characteristic feature of fibrinous inflammation?

<p>Exudate rich in fibrin with a little fluid component (D)</p> Signup and view all the answers

How does acute inflammation affect lymphatic vessels?

<p>They facilitate the drainage of edema fluid and dead tissue. (C)</p> Signup and view all the answers

What can result from the failure to completely remove fibrin during organization?

<p>Proliferation of fibroblasts and scar formation (C)</p> Signup and view all the answers

What is the primary result of increased vessel permeability during acute inflammation?

<p>Escape of a protein-rich fluid leading to swelling. (D)</p> Signup and view all the answers

Which type of inflammation is exemplified by the presence of bullae in mild burns?

<p>Serous inflammation (A)</p> Signup and view all the answers

What is one of the functions of inflammatory fluid exudate?

<p>It localizes the infection by entangling pathogens. (A)</p> Signup and view all the answers

What defines membranous inflammation?

<p>Formation of a false membrane of necrotic tissue and fibrin (A)</p> Signup and view all the answers

Which process allows leukocytes to migrate to the site of infection?

<p>Vascular stasis allowing for their emigration. (D)</p> Signup and view all the answers

What is the outcome associated with a cellular exudate rich in red blood cells?

<p>Haemorrhagic inflammation (C)</p> Signup and view all the answers

In which situation would one most likely observe an adherent, dense, grey pseudo-membrane?

<p>Diphtheria (A)</p> Signup and view all the answers

Which type of inflammation is primarily driven by an immune reaction rich in eosinophils?

<p>Allergic inflammation (B)</p> Signup and view all the answers

What is a potential consequence of acute non-suppurative inflammation?

<p>Development of chronic inflammation (B)</p> Signup and view all the answers

What is a characteristic feature of a lung abscess?

<p>A central liquefactive necrosis (D)</p> Signup and view all the answers

Which component is NOT typically found in pus?

<p>Living bacteria (A)</p> Signup and view all the answers

What is the fate of a large abscess if it is not surgically incised?

<p>Typically results in spontaneous rupture (B)</p> Signup and view all the answers

What characteristic is associated with the pus that forms during cellulitis?

<p>Thin and slowly forming (C)</p> Signup and view all the answers

Which bacteria is commonly associated with cellulitis?

<p>Streptococcus haemolyticus (A)</p> Signup and view all the answers

What is an unusual characteristic of pus?

<p>It has a foul odor when caused by E. coli (D)</p> Signup and view all the answers

What is the most common site for carbuncles?

<p>Back of neck and scalp (A)</p> Signup and view all the answers

Which process allows for the rapid spread of infection in cellulitis?

<p>Liquefying fibrin by streptokinase (C)</p> Signup and view all the answers

What defines acute suppurative inflammation?

<p>Presence of liquefactive necrosis and pus formation (C)</p> Signup and view all the answers

Which organism is commonly associated with acute suppurative inflammation?

<p>Escherichia coli (A)</p> Signup and view all the answers

In the context of an abscess, which of the following statements is true?

<p>It is characterized by a cavity filled with pus. (C)</p> Signup and view all the answers

What is the primary cause of pus formation during acute suppurative inflammation?

<p>Dying neutrophils and liquefaction of necrotic tissue (A)</p> Signup and view all the answers

Which type of inflammation lacks pus formation?

<p>Non-suppurative inflammation (A)</p> Signup and view all the answers

What is the central zone of necrosis in an abscess primarily composed of?

<p>Necrotic core (A)</p> Signup and view all the answers

Which type of acute inflammation is characterized by a serous fluid exudate?

<p>Serous inflammation (C)</p> Signup and view all the answers

What is the role of neutrophils in acute suppurative inflammation?

<p>To accumulate and release enzymes causing tissue liquefaction (C)</p> Signup and view all the answers

Flashcards

Pus composition

Pus is a thick, alkaline fluid composed of liquefied necrotic tissue, bacteria, toxins, inflammatory exudate (dead neutrophils, neutrophils, macrophages, red blood cells, and fluid).

Pus characteristics

Pus is a thick, alkaline fluid that doesn't clot, and can be yellowish (greenish in some cases) or odourless (offensive in others).

Abscess fate (small)

Small abscesses heal as the body absorbs the pus.

Abscess fate (large)

Large abscesses may point and rupture to heal through fibrosis.

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Carbuncle definition

A carbuncle is a large, deep subcutaneous abscess with multiple openings on the skin.

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Carbuncle risk factors

Carbuncles are commonly found in individuals with reduced immunity, such as diabetics.

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Cellulitis definition

Acute inflammation of loose connective tissue (e.g., orbit, pelvis).

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Cellulitis causative organisms

Cellulitis is often caused by Streptococcus haemolyticus, which spreads readily due to its enzymes.

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Inflammation definition

A protective response to eliminate the initial cause of cell injury and consequences (like dead cells).

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Acute inflammation

Rapid onset, short duration (days to weeks).

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Chronic inflammation

Gradual onset, long duration (months to years).

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Inflammation triggers

Infections, trauma, tissue death, foreign bodies, and immune reactions.

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Vascular events (inflammation)

Blood vessels respond, allowing immune cells to reach the site of injury.

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Cellular events (inflammation)

Immune cells like white blood cells move into the damaged area to fight infection and repair tissue.

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Acute inflammation outcome

Resolution (healing) or progression to chronic inflammation.

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Chronic inflammation types

Specific (e.g., granulomatous) and non-specific.

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Fibrinous inflammation

A type of inflammation characterized by a thick, sticky exudate rich in fibrinogen, which forms a mesh-like structure. It often happens due to injury causing increased blood vessel permeability.

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Serous inflammation

A type of inflammation where the exudate consists mainly of clear fluid with very little fibrin and few inflammatory cells. Often seen in milder injuries, allowing for more fluid to accumulate in the affected area.

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Membranous inflammation

A severe form of inflammation affecting mucous membranes, creating a 'false membrane' composed of dead tissue and fibrin. Often caused by bacteria producing toxins that damage the tissue.

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Allergic inflammation

An immune response characterized by the presence of many eosinophils, a type of white blood cell involved in allergic reactions, both in the blood and tissues.

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Haemorrhagic inflammation

A type of inflammation with significant blood leakage into the affected area due to damage of blood vessels. The inflammatory exudate contains many red blood cells.

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What happens to fibrinous exudate?

It can be broken down by fibrinolysis and removed by macrophages, allowing the tissue to heal completely. Sometimes, the fibrinous exudate is not fully removed, leading to scar formation.

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Where is fibrinous inflammation common?

It is commonly seen in the lining of body cavities, like the pericardium, pleura, and peritoneum. It can also occur in the lungs, especially in conditions like acute lobar pneumonia.

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What are some examples of membranous inflammation?

Bacillary dysentery, where the lining of the intestines is affected, and diphtheria, where the throat is infected, are both examples. Diphtheria is characterized by a thick, grey covering on the tonsils.

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What is acute suppurative inflammation?

Acute inflammation characterized by pus formation due to liquefactive necrosis, usually caused by pyogenic bacteria like Staphylococcus aureus or Streptococcus haemolyticus.

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How does pus form?

Pyogenic bacteria cause significant tissue damage, attracting many neutrophils that eventually die. Their enzymes liquefy the necrotic tissue, creating a creamy mixture of dead neutrophils, fluid, and bacteria called pus.

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Abscess

A localized collection of pus within a cavity, often formed by a pyogenic bacterium like Staphylococcus aureus.

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What makes abscesses localized?

Staphylococcus aureus produces coagulase, an enzyme that causes fibrin deposition, leading to localized inflammation.

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Furuncle

A small abscess related to a hair follicle, often caused by Staphylococcus aureus.

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What are the zones of an abscess?

Early abscesses have a central necrotic zone. Later, they develop a core of necrotic tissue surrounded by a zone of neutrophils and a peripheral zone of inflammation.

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The difference between cellulitis and an abscess?

Cellulitis is a diffuse inflammatory response, while an abscess is localized. Both involve pus formation.

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What causes cellulitis?

Cellulitis is often caused by Streptococcus haemolyticus, which spreads readily due to its enzymes.

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Acute inflammation features

Key signs include fever, increased C-reactive protein (CRP) levels, and increased white blood cells (leukocytosis).

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Resolution (inflammation)

The ideal outcome of acute inflammation where damage is minimal, dead cells are replaced, and the tissue heals.

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Scarring (inflammation)

Occurs when tissue damage is significant and the area can't fully regenerate, leading to fibrous tissue formation.

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Inflammation vascular changes

Blood vessels dilate, increasing blood flow (erythema and warmth) and becoming more permeable, leading to fluid leakage (edema).

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Leukocyte movement (inflammation)

White blood cells move from blood vessels to the inflamed area through steps of margination, rolling, adhesion, transmigration, and chemotaxis.

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Inflammation purpose

It's a protective response to injury or infection, but it can also damage tissues if uncontrolled.

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What are the initial vascular changes in acute inflammation?

The initial vascular response involves a brief vasoconstriction followed by arteriolar vasodilation, leading to increased blood flow and engorged capillaries. This causes redness (erythema) and warmth in the affected area.

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How does increased vascular permeability occur?

Chemical mediators trigger the contraction of endothelial cells, widening the intercellular gaps. This allows a protein-rich fluid (exudate) to escape into the interstitium, increasing osmotic pressure and drawing more water, leading to edema and swelling.

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What is the role of fibrinogen in inflammatory fluid exudate?

Fibrinogen, a key component of exudate, transforms into fibrin, creating a network that helps localize the infection, provides a scaffold for phagocytes and fibroblasts, and aids in tissue repair.

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What is vascular stasis and why is it important?

Vascular stasis refers to the slowing of blood flow in the inflamed area due to increased blood viscosity caused by fluid leakage. This is crucial for leukocyte emigration, allowing immune cells to reach the site of injury.

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How does lymph flow respond to inflammation?

Lymph flow increases, draining oedema fluid, neutrophils, and dead tissue from the extravascular space. This helps clear the inflammation. If bacteria are present in the exudate, it can cause inflammation of the lymphatic vessels (lymphangitis) and lymph nodes (reactive lymphadenitis).

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What are the key functions of inflammatory fluid exudate?

Exudate delivers antibodies to the site of infection, contains fibrinogen for localization and repair, and promotes vascular stasis, aiding leukocyte emigration.

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What are the three cardinal signs of acute inflammation?

The cardinal (primary) signs of acute inflammation include rubor (redness), calor (heat), and tumor (swelling).

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What triggers release of chemical mediators in inflammation?

Microbes and dead cells release unique signals distinct from normal tissue, triggering the release of chemical mediators, initiating the inflammatory response.

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Study Notes

Inflammation Overview

  • Inflammation is a protective response to eliminate the initial cause of cell injury and initiate tissue repair.
  • Causes include infections, trauma, tissue necrosis, foreign bodies, and immune reactions.
  • Key intended learning outcomes include understanding the meaning of inflammation, factors triggering it, clinical signs, vascular and cellular events, advantages and side effects of acute inflammation, its outcome, differences between chronic inflammation (specific and non-specific), and types of granulomatous reactions.

Types of Inflammation

  • Inflammation is categorized as acute or chronic based on duration.
  • Acute inflammation has a rapid onset and short duration (days). Chronic inflammation is prolonged (months to years).

Acute Inflammation

  • Cardinal signs (described by Celsus): Rubor (redness), Tumor (swelling), Calor (heat), Dolor (pain) and Functio laesa (loss of function)
  • Vascular phase involves transient vasoconstriction (insignificant), arteriolar vasodilation increasing blood flow (redness/warmth), and increased vessel permeability leading to fluid exudate (edema/swelling). Vascular stasis is also observed.
  • Cellular phase involves leukocyte recruitment, their function (ingesting, killing, and eliminating necrotic tissues or foreign substances), and their activated functions, including margination, rolling, adhesion, transmigration, and chemotaxis.
  • Types of acute inflammation (suppurative/localized, non-suppurative/diffuse) include Suppurative (pus formation—abscess, cellulitis) and Non-suppurative (no pus—catarrhal, fibrinous, serous, membranous, allergic, haemorrhagic).
  • Fate of acute inflammation can be resolution (tissue heals), scarring and fibrosis.
  • Inflammation can progress to chronic inflammation if the injurious agent cannot be eliminated completely.

Chronic Inflammation

  • Inflammation of prolonged duration.
  • It arises from various causes: failure of defense mechanisms in resolving acute inflammation, or persistent and/or non-degradable antigens/infection (e.g., Mycobacterium tuberculosis, silica particles, autoimmune diseases).
  • Main inflammatory cells are macrophages, lymphocytes, and plasma cells (sometimes eosinophils or mast cells).
  • Macrophages undergo phagocytosis, formation of giant cells (foreign bodies, TB), and secrete cytokines and growth factors.
  • T-helper lymphocytes (CD4+ T cells) play a critical role in chronic inflammation.
  • Chronic inflammation is characterized by infiltration of mononuclear cells (macrophages, lymphocytes, plasma cells), tissue repair by fibrosis, and thick-walled blood vessels.

Granuloma

  • Granulomas are nodular aggregates of macrophages with variable lymphocyte, plasma cell, and sometimes giant cell mix.
  • Macrophages transform into epithelioid cells and giant cells.
  • Central necrosis may be present (e.g., caseous necrosis in tuberculosis).
  • Examples of granulomatous lesions (pathological conditions caused by granulomas) are tuberculosis, leprosy, syphilis, and sarcoidosis.
  • Granuloma formation is stimulated by chronic inflammation with persistent/non-degradable antigens.

Fate of Granuloma

  • Granulomas may persist for a long time.
  • They may slowly resolve and disappear.
  • Granulomas can transform into fibrosis/tissue scarring.
  • Granulomas can coalesce and damage surrounding tissues, causing cavities with necrotic material.

Conclusion

  • Inflammation is a complex response to injury and is crucial for tissue repair.
  • Both acute and chronic inflammation have different characteristics and outcomes with specific cells involved.
  • Understanding the different types of inflammation and their processes can assist in diagnosis and treatment.

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