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Questions and Answers
In the pathogenesis of an abscess, what is the temporal sequence of zonal development following the initial necrotic focus?
In the pathogenesis of an abscess, what is the temporal sequence of zonal development following the initial necrotic focus?
- Mid zone containing pus → Central necrotic core → Pyogenic membrane
- Pyogenic membrane → Central necrotic core → Mid zone containing pus
- Central necrotic core → Pyogenic membrane → Mid zone containing pus
- Central necrotic core → Mid zone containing pus → Pyogenic membrane (correct)
Which enzymatic activity is MOST directly associated with the capacity of Streptococcus haemolyticus to facilitate diffuse spread in cellulitis?
Which enzymatic activity is MOST directly associated with the capacity of Streptococcus haemolyticus to facilitate diffuse spread in cellulitis?
- Proteolytic activity from dead neutrophils
- Hyaluronidase-mediated degradation of extracellular matrix (correct)
- Catalase-mediated detoxification of reactive oxygen species
- Coagulase-mediated fibrin deposition
A patient presents with multiple furuncles in the axillary region. What underlying condition should be MOST strongly considered, given the typical etiology of this presentation?
A patient presents with multiple furuncles in the axillary region. What underlying condition should be MOST strongly considered, given the typical etiology of this presentation?
- Diabetes mellitus
- Underlying streptococcal infection
- Compromised immune system (correct)
- Localized fungal infection
Which of the following is the MOST critical factor in determining whether an abscess will resolve via absorption and healing versus progression to spontaneous rupture?
Which of the following is the MOST critical factor in determining whether an abscess will resolve via absorption and healing versus progression to spontaneous rupture?
In necrotizing inflammation, which of the following mechanisms is MOST directly responsible for the extensive tissue destruction observed?
In necrotizing inflammation, which of the following mechanisms is MOST directly responsible for the extensive tissue destruction observed?
In the context of acute suppurative inflammation, what is the role of coagulase produced by Staphylococcus aureus?
In the context of acute suppurative inflammation, what is the role of coagulase produced by Staphylococcus aureus?
Which of the following best describes the composition of the pyogenic membrane that forms during abscess development?
Which of the following best describes the composition of the pyogenic membrane that forms during abscess development?
During cellulitis, which process directly accounts for both local tissue damage and systemic complications such as septicemia and pyemia?
During cellulitis, which process directly accounts for both local tissue damage and systemic complications such as septicemia and pyemia?
What is the PRIMARY mechanism by which strong pyogenic bacteria induce marked necrosis, leading to substantial pus formation?
What is the PRIMARY mechanism by which strong pyogenic bacteria induce marked necrosis, leading to substantial pus formation?
What is the key differentiating factor at the microscopic level between serous inflammation and serofibrinous inflammation?
What is the key differentiating factor at the microscopic level between serous inflammation and serofibrinous inflammation?
In pseudomembranous inflammation, such as that seen in Shigella bacillary dysentery, what component is MOST responsible for the formation of the characteristic pseudomembrane?
In pseudomembranous inflammation, such as that seen in Shigella bacillary dysentery, what component is MOST responsible for the formation of the characteristic pseudomembrane?
How does the osmotic pressure of pus in a large abscess affect the surrounding tissue?
How does the osmotic pressure of pus in a large abscess affect the surrounding tissue?
Which of the following best characterizes the nature of cellular exudate predominant in allergic inflammation?
Which of the following best characterizes the nature of cellular exudate predominant in allergic inflammation?
Why is chronic non-specific inflammation considered "non-specific"?
Why is chronic non-specific inflammation considered "non-specific"?
What distinguishes cellulitis from a localized abscess in terms of bacterial enzyme activity?
What distinguishes cellulitis from a localized abscess in terms of bacterial enzyme activity?
What role do proteolytic enzymes, primarily from dead neutrophils, play in pus formation during suppurative inflammation?
What role do proteolytic enzymes, primarily from dead neutrophils, play in pus formation during suppurative inflammation?
In the context of wound healing following acute inflammation, which process is considered the 'surest sign of chronicity'?
In the context of wound healing following acute inflammation, which process is considered the 'surest sign of chronicity'?
Which of the following locations is MOST characteristic for the development of a carbuncle?
Which of the following locations is MOST characteristic for the development of a carbuncle?
What is the most significant difference between acute and chronic inflammation regarding the nature of the inflammatory cells involved?
What is the most significant difference between acute and chronic inflammation regarding the nature of the inflammatory cells involved?
Flashcards
Suppurative Inflammation
Suppurative Inflammation
Inflammation associated with pus formation.
Non-Suppurative Inflammation
Non-Suppurative Inflammation
Inflammation NOT associated with pus formation.
Abscess
Abscess
Localized acute suppurative inflammation caused by Staphylococcus aureus, leading to fibrin coagulation.
Furuncle (boil)
Furuncle (boil)
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Carbuncle
Carbuncle
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Cellulitis
Cellulitis
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Fibrinolysin (Streptokinase)
Fibrinolysin (Streptokinase)
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Hyaluronidase
Hyaluronidase
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Serous Inflammation
Serous Inflammation
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Serofibrinous Inflammation
Serofibrinous Inflammation
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Allergic Inflammation
Allergic Inflammation
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Catarrhal Inflammation
Catarrhal Inflammation
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Pseudomembranous Inflammation
Pseudomembranous Inflammation
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Hemorrhagic Inflammation
Hemorrhagic Inflammation
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Necrotizing Inflammation
Necrotizing Inflammation
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Chronic Inflammation
Chronic Inflammation
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Classic Microscopic Feature of Chronic Inflammation
Classic Microscopic Feature of Chronic Inflammation
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Chronic Non-Specific Inflammation
Chronic Non-Specific Inflammation
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Chronic Specific Inflammation
Chronic Specific Inflammation
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Study Notes
Types of Inflammation
- Suppurative inflammation, also known as purulent, septic, or pyogenic inflammation is associated with pus formation
- Non-suppurative inflammation is not associated with pus formation
Acute Suppurative Inflammation
- Localized, caused by Staphylococcus Aureus which produces coagulase, leading to fibrin coagulation and deposition that help localization
- Diffuse, caused by streptococci which produce hyalurinidase and streptokinase (fibrinolysin) that dissolve fibrin and help spread
Mechanism of Suppuration
- Strong pyogenic bacteria like staphylococcus aureus and streptococcus haemolyticus cause marked necrosis
- Neutrophils are attracted in large numbers but die due to the high virulence of bacteria
- Proteolytic enzymes from dead neutrophils and less from necrotic tissue liquefy necrotic tissue and fibrin
- Liquefied material mixes with pus cells and fluid exudate forms pus
Abscess
- Localized suppurative inflammation results in the formation of an irregular pus-containing cavity
- It can occur anywhere, commonly subcutaneous or in deep organs
- Early abscess shows two zones, central necrotic zone surrounded by a zone of acute inflammation with many neutrophils
- Abscess has three zones: central necrotic core, mid zone containing pus (usually formed by 48 hours), and peripheral zone of inflamed tissue called pyogenic membrane
Course and Fate of an Abscess
- Small abscess, pus may be absorbed and followed by healing
- Large abscess, pus is slowly absorbed, its high osmotic pressure absorbs water, increasing size causing throbbing pain
- If not surgically evacuated, pointing and rupture can occur resulting in spontaneous evacuation and forming an ulcer on skin or hollow organs
Complications of an Abscess
- Spontaneous evacuation and non-healing (less repair)
- Healing (much repair)
- If not evacuated it becomes a Chronic Abscess , surrounded by fibrosis, which dries with the addition of cholesterol crystals and dystrophic calcification
Spread of Infection
- Direct spread
- Lymphatic spread
- Blood spread
Furuncle (boil)
- Small abscess related to hair follicle, sebaceous, or sweat gland
- Caused by staphylococci
- Mainly on hairy parts like face and axilla
- Multiple neighboring boils are called furunculosis
Carbuncle
- Acute localized suppurative inflammation forming multiple communicating suppurative foci in the skin and subcutaneous fat, discharging pus through several openings
- Caused by staphylococci
- Common in people with diabetes
- Found in areas where skin and subcutaneous tissue are thick and tough, like the back of the neck, scalp, and buttocks
Diffuse - Cellulitis
- Acute diffuse suppurative inflammation
- Caused by streptococcus hemolyticus which produces two enzymes: fibrinolysin (streptokinase) and hyaluronidase
- Fibrinolysin dissolves fibrin.
- Hyaluronidase dissolves hyaluronic acid, helping spread of bacteria.
- Sites include loose connective tissue like areolar tissue of the orbit, scrotum, and wall of the appendix
- Pus is thin and bloody, contains many sloughs (necrotic debris) due to increased necrosis
- Complications include lymphatic spread, leads to acute lymphangitis and lymphadenitis, and blood spread, leads to septicemia and pyemia
Serous Inflammation
- Acute inflammation with excess watery fluid exudate and low in fibrin
- Skin blister after burn with watery vesicles, or skin vesicles due to viral infection
Serofibrinous Inflammation
- Acute inflammation with excess fluid exudate rich in fibrin
- Found in serous membranes like pleura, peritoneum, and pericardium
Allergic Inflammation
- Acute non-suppurative inflammation with fluid exudate rich in eosinophils
- Occurs in hypersensitivity cases like urticaria, bronchial asthma, allergic rhinitis, contact dermatitis
Catarrhal Inflammation
- Mild acute non-suppurative inflammation of mucous membranes with excess mucous secretion
- Catarrhal rhinitis
Pseudomembranous Inflammation
- Acute inflammation characterized by formation of pseudomembrane consisting of fibrin, desquamated epithelium, and inflammatory cells
- Diphtheria and bacillary dysentery caused by Shigella bacilli
- Toxemia is a common complication, also suffocation by detached membranes as in Diphtheria
Hemorrhagic Inflammation
- Acute inflammation with vascular damage and hemorrhage in the exudate
- As in meningococci
Necrotizing Inflammation
- Acute non-suppurative inflammation with extensive tissue necrosis
- Oral mucosa in debilitated malnourished children
Chronic Inflammation
- Inflammation with lymphocytes, plasma cells, macrophages & giant cells predominate
- Accompanied by fibrosis and End Arteritis Obliterans (EAO)
- Infiltration with mononuclear cells like macrophages, lymphocytes, and plasma cells.
- Thick-walled blood vessels
- Fibrosis is the surest sign of chronicity
Types of Chronic Inflammation
- Chronic non-specific inflammation: follows actue inflammation, produces same lesion with many irritants
- Chronic specific inflammation "Granulma": chronic from start, each irritant produces a specific lesion and the irritant could be detected within the lesion
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