Term
| classic cardinal signs of inflammation |
|
Definition
1. heat
2. redness
3. swelling
4. pain
5. loss of function |
|
|
Term
| morphological descriptors |
|
Definition
1. severity
2. duration
3. distribution
4. inflammatory modifier
5. other anatomic modifiers (optional)
6. organ affected |
|
|
Term
|
Definition
- narcotizing
- suppurative/purulent
- lymphoplamsic
- granulomatous
- ulcerative
- hemorrhagic |
|
|
Term
| origin and actions of histamine |
|
Definition
| mast cells and platelets; vasodilation and increased vascular permeability |
|
|
Term
| origin and action of C3a and C5a |
|
Definition
| complement by-products; vasodilation, increased vascular permeability, and chemotaxis |
|
|
Term
| origin and actions of prostaglandins |
|
Definition
| Arachidonic acid; pathway vasodialtion |
|
|
Term
| origin and actions of leukotrienes |
|
Definition
| Arachidonic acid pathway; vasoconstriction, increased vascular permiability and bronchospasm |
|
|
Term
|
Definition
| lymphocytes and macrophages |
|
|
Term
|
Definition
1. active inflammation
2. control the movement of inflammatory cells
3. stimulate hematopoiesis |
|
|
Term
|
Definition
|
|
Term
| what cytokines control movement of inflammatory cells? |
|
Definition
|
|
Term
| what chemokine is responsible for recruiting neutrophils? |
|
Definition
|
|
Term
| what chemokine is responsible for recruiting eosinophils? |
|
Definition
|
|
Term
| what do phospholipases do? |
|
Definition
| cleave membrane phospholipids into arachidonic acid |
|
|
Term
| how are phospholipases activated? |
|
Definition
| by binding of pro-inflammatory stimuli to receptors on the cell membrane |
|
|
Term
| what inflammatory mediators are involved in creating the symptoms of asthma? |
|
Definition
|
|
Term
| what do neutrophil granules contain? |
|
Definition
- proteases
- myeloperoxidase (MPO)
- cytochrome b
- bactericidal enzymes |
|
|
Term
| what do proteases do? where are they found? |
|
Definition
- digest the extracellular matrix
- neutrophil granules |
|
|
Term
| would the presence of neutrophils represent an acute or chronic inflammatory response? |
|
Definition
| acute inflammatory response |
|
|
Term
| what 2 proteins do eosinophil granules contain? |
|
Definition
1. major basic protein
2. eosinophil cationic protein |
|
|
Term
| eosinophils respond to what 2 conditions? |
|
Definition
1. allergies/analyphalxis
2. parasites |
|
|
Term
| major basic proteins and eosinphil cationic proteins have what main property? |
|
Definition
|
|
Term
| what are the three MAIN pre-formed mediators that mast cell granules contain? |
|
Definition
| 1. histamine 2. proteases 3. eosinophil chemotactic factor |
|
|
Term
| T/F - mast cells normally circulate |
|
Definition
| false - mast cells DO NOT circulate |
|
|
Term
| T/F - mast cells are present in tissues |
|
Definition
|
|
Term
| mast cells degranulate in response to what? |
|
Definition
- cytokines
- physical stimuli
- complement components (C3a, C4a, C5a) |
|
|
Term
| mast cells can ______ in tissues in response to an inflammatory stimuli |
|
Definition
|
|
Term
| what is unique about mast cells and their degranulation? |
|
Definition
| once they degranulate, they can produce more granules |
|
|
Term
| do mast cells trigger an acute or a chronic inflammatory response? |
|
Definition
|
|
Term
| platelets are involved in what 2 processes? |
|
Definition
1. coagulation
2. inflammation |
|
|
Term
| platelets are formed from what kind of cell? where does this occur? |
|
Definition
- megakaryocytes
- bone marrow |
|
|
Term
| what do platelet granules contain? |
|
Definition
- histamine*
- growth factors*
- serotonin, platelet factor 4, fibrinogen, thromboxane A2
*most important |
|
|
Term
| macrophages are derived from what? |
|
Definition
|
|
Term
| T/F - macrophages are found in circulation |
|
Definition
| false - macrophages are only found in tissues |
|
|
Term
|
Definition
-phagocytosis
-coordinate the inflammatory resposnses |
|
|
Term
| when do macrophages arrive at the site of inflammation? |
|
Definition
|
|
Term
| why would macrophages accumulate in the the tissues? |
|
Definition
| chronic inflammation due to continued recruitment and localized proliferation |
|
|
Term
| what are the different types of macrophages |
|
Definition
activated
epithelioid
multinucleated giant cells |
|
|
Term
| what happens to a macrophage when it is turned on? |
|
Definition
| in creases in size, lysosomal enzymes, and ability to phagocytize |
|
|
Term
| which types of hypersensitivity are antibody mediated? |
|
Definition
|
|
Term
|
Definition
| excessive response of the immune system to innocuous antigens |
|
|
Term
| in what species is hypersensitivity most common? least common? |
|
Definition
| dogs > horses & cats > food animals |
|
|
Term
| type I hypersensitivity is mediated by what antibody? |
|
Definition
|
|
Term
| which type of hypersensitivity reaction requires prior exposure to the antigen before the immune system will respond? |
|
Definition
type I
- aka allergies or immediate hypersensitivity |
|
|
Term
| with type I hypersensitivity, the release of inflammatory mediators causes what 5 things? |
|
Definition
1. vasodilation
2. increased vascular permeability
3. smooth muscle contraction
4. mucus secretion
5. recruitment of inflammatory cells |
|
|
Term
| what are the most important cells in a type I hypersensitivity response? |
|
Definition
- eosinophils
- mast cells
- Th2 cells
- basophils |
|
|
Term
| activated macrophages can turn into what type of cell? |
|
Definition
| epithelioid or multinucliated giant cells |
|
|
Term
| how did epitheliod macrophages get their name? |
|
Definition
| they form sheets that resemble an epithelial layer |
|
|
Term
| multinucliated giant cells are formed how? |
|
Definition
| 2 or more activated macrophages combine |
|
|
Term
|
Definition
| small, dense round nucleus, scant basophilic cytoplasm |
|
|
Term
|
Definition
immune surveillance
secrete cytokines to coordinate response to chronic inflammation |
|
|
Term
|
Definition
|
|
Term
| when do lymphocytes arrive at site of damage/ |
|
Definition
|
|
Term
| why do lymphocytes accumulate in the tissue |
|
Definition
|
|
Term
| where do plasma cells come from? |
|
Definition
|
|
Term
|
Definition
| large withe dense round, eccentric nucleus (clock face look. Basophilic cytoplasm wiht a perinuclear clearing |
|
|
Term
|
Definition
| make IgG, IgM, IgA, and IgE |
|
|
Term
| What is a plasma cell wiht distended (constipated) RER called? |
|
Definition
|
|
Term
| why do plasma cells accumulate in the tissue? |
|
Definition
|
|
Term
| what are the steps in inflammation |
|
Definition
1. inciting stimulus
2. vasodialtion
3. increased vascular permiability
4. diapedesis
5. chemotaxis
6. phagocytosis |
|
|
Term
| what stimulus can incite inflammation |
|
Definition
infectious organism
trauma
abnormal cells
necrotic cells
foreign material |
|
|
Term
| what does the stimulus result in? |
|
Definition
| release of cytokines and other mediators |
|
|
Term
| anaphylaxis is classified as what type of hypersensitivity? |
|
Definition
type I
- aka allergies or immediate hypersensitivity |
|
|
Term
| what is the most common cause of anaphylaxis? |
|
Definition
|
|
Term
| what are the main physiologic concerns with anaphylaxis? |
|
Definition
- vasodilation
- smooth muscle contraction |
|
|
Term
| why is widespread vasodilation a problem with anaphylaxis? |
|
Definition
| widespread vasodilation -> hypotension -> shock |
|
|
Term
| why is smooth muscle contraction a problem with anaphylaxis? |
|
Definition
- airways -> dyspnea
- urinary and GIT -> urination, vomiting, diarrhea |
|
|
Term
| what is the primary shock organ for ruminants, horses and cats? |
|
Definition
|
|
Term
| what is the most common hypersensitivity in dogs and cats? |
|
Definition
|
|
Term
| what region of the skin is most commonly affected in flea allergy hypersensitivities? |
|
Definition
|
|
Term
| which 2 types of hypersensitivity are involved in flea allergies? |
|
Definition
|
|
Term
| what is the most common cell type seen with a flea allergy skin biopsy? |
|
Definition
|
|
Term
| what is the most common cause of pruritis in dogs? |
|
Definition
| atopy (K9 atopic dermatitis) |
|
|
Term
| atopy is classified as what type of hypersensitivity? |
|
Definition
|
|
Term
| T/F - eosinophils are numerous in circulation with atopy |
|
Definition
|
|
Term
| in a dog with atopy, would you expect to find eosinophils in a skin biopsy? |
|
Definition
| no - eosinophils are rare in atopy skin biopsies |
|
|
Term
| what causes vasodilation? |
|
Definition
| mast cell degranulation and histamine release |
|
|
Term
| how does histimine release present itself? |
|
Definition
|
|
Term
|
Definition
| red ring of redness; nature highlighter around an area of injury |
|
|
Term
| what is the result of the vasodilation? |
|
Definition
| increased blood flow to the area which causes blood flow through the vessels to slow and circulating leukocytes 'fall out' |
|
|
Term
| what mediators activate endothelial cells |
|
Definition
|
|
Term
| what happens when endothelial cells are activated? |
|
Definition
| they contract and allow fluid and proteins to leak out |
|
|
Term
| leakage of fluid results grossly as? |
|
Definition
|
|
Term
| What is the purpose of edema? |
|
Definition
| to dilute inciting stimulus |
|
|
Term
| what happens when fibrinogen leaks out of the vessels and comes into contact with collagen? |
|
Definition
|
|
Term
| what is the purpose of fibrin? |
|
Definition
| to contain stimulus to prevent spread |
|
|
Term
| what differentiates transudate and exudate? |
|
Definition
| the concentration of leaked protein |
|
|
Term
| how does fibrin present itself grossly? |
|
Definition
|
|
Term
|
Definition
| movement of leukocytes out of vessels |
|
|
Term
| define "roling" in diapedesis |
|
Definition
| loose adhesion to endothelialcells mediated byselectins |
|
|
Term
| what cases strong binding to the endothelial cells |
|
Definition
|
|
Term
|
Definition
| migration of leukocytes followed by inflammatory mediators to the site of injury |
|
|
Term
|
Definition
| chemicals released at site of injury to attract or repel leukocytes |
|
|
Term
|
Definition
recognize and attach
engulf
killing and degredation |
|
|
Term
| what cells types are involved in phagocytosing |
|
Definition
| neutrophils and macrophages |
|
|
Term
| (T/F) phagocytosis only happens in response to and infectious agent |
|
Definition
|
|
Term
| examples of type I hypersensitivity |
|
Definition
1. anaphylaxis
2. flea allergy
3. atopy
4. insect stings/bites
5. food allergy
6. vaccine reactions
7. milk allergy
8. drug reaction |
|
|
Term
| insect stings/bites are usually manifested as what? |
|
Definition
| local urticaria (hives) and edema |
|
|
Term
| vaccines are more likely to cause a reaction if they contain what? |
|
Definition
- fetal calf serum
- gelatin
- casein |
|
|
Term
| what 2 breeds of cattle are susceptible to milk allergy? |
|
Definition
|
|
Term
| what protein is forced into the blood in milk allergies? what causes this? |
|
Definition
- casein
- if the cow isn't milked |
|
|
Term
| type II hypersensitivity is characterized by what two antibodies? |
|
Definition
|
|
Term
| what is the most common mechanism of pathogenesis of type II hypersensitivity? |
|
Definition
| antibodies attach to target cell -> cell destruction via phagocytosis |
|
|
Term
| what is the antibody involved in type III hypersensitivity? |
|
Definition
|
|
Term
| what are the 3 phases of type III hypersensitivity? |
|
Definition
1. immune complex formation
2. tissue deposition
3. complex mediated inflammation & tissue injury |
|
|
Term
| what do deposited Ag-Ab complexes induce? |
|
Definition
- recruitment and activation of phagocytes
- release of chemotactic complement fragments
- inflammation and tissue damage |
|
|
Term
| in type III hypersensitivity, what happens to the immune complexes when Ab > Ag? |
|
Definition
| the complexes are too big and are rapidly phagocytized |
|
|
Term
| in type III hypersensitivity, what happens to the immune complexes when Ag > Ab with slight [Ag]? |
|
Definition
| the complex gets stuck at filtering sites -> complement activated & cells recruited -> complex cannot be phagocytosed -> enzyme release from inflam. cells -> TISSUE DESTRUCTION |
|
|
Term
| what are the examples of type III hypersensitivity? |
|
Definition
- glomerulonephritis
- serum sickness
- equine infectious anemia
- canine adenovirus I
- arthus reaction |
|
|
Term
| what is the mediator of type IV hypersensitivity? |
|
Definition
| previously sensitized T-cells |
|
|
Term
| what are the examples of type II hypersensitivity? |
|
Definition
- IMHA
- drug reaction
- neonatal isoerythrolysis
- transfusion reaction
- myasthenia gravis |
|
|
Term
| in IMHA, immunoglobulins act as __________. |
|
Definition
|
|
Term
| what receptor is targeted with myasthenia gravis? |
|
Definition
|
|
Term
| what happens to the Ag-Ab complexes in type III hypersensitivity if Ag > Ab with high [Ag]? |
|
Definition
| the immune complexes are small and they do not get trapped in the filtering sites |
|
|
Term
| what is serum sickness usually caused by? what type of hypersensitivity is it classified as? |
|
Definition
- injection of antiserum/antitoxin
- type III hypersensitivity |
|
|
Term
| what cells are associated with CD 4? |
|
Definition
|
|
Term
| what cells are associated with CD 8? |
|
Definition
|
|
Term
| what are the examples of type IV hypersensitivity? |
|
Definition
- tuberculin response
- contact hypersensitivity |
|
|
Term
| what are the 3 mechanisms of autoimmune disease? |
|
Definition
1. degradation
2. blockade
3. activation |
|
|
Term
| 4 factors contributing to AID |
|
Definition
1. genetics (more common in purebreeds)
2. hormonal (females predisposed)
3. molecular mimicry
4. neoplasia |
|
|
Term
| what are the 3 conditions that must be met for AID? |
|
Definition
1. immune-mediated
2. not secondary tissue damage
3. no organism identified |
|
|
Term
|
Definition
| congenital lack of immune competence (PRIMARY) OR secondary loss of immune competence (SECONDARY) |
|
|
Term
| are primary or secondary immunodeficiencies more common? |
|
Definition
|
|
Term
| the clinical outcome of hereditary deficiencies depend on what four factors? |
|
Definition
1. cell affected
2. severity
3. low morbidity
4. high mortality |
|
|
Term
| the clinical outcome of acquired deficiencies depend on what four factors? |
|
Definition
1. type of insult
2. severity
3. age of the animal affected
4. variable morbidity and mortality |
|
|
Term
| what are the 3 classes of primary immunodeficiency? |
|
Definition
1. lymphocytic
2. leukocytic
3. mechanical barriers |
|
|
Term
| what happens when Phagocytosis goes wrong |
|
Definition
| enzymes are released into surrounding tissue causing cells to die and extracellular matrix degradation |
|
|
Term
| describe lysosomal suicide |
|
Definition
| phagolysosome bursts intracellularly and degrades the cell from the inside out (cell death) |
|
|
Term
| Premature ejaculation of phagocytosis |
|
Definition
| lysosome prematurely fuses with the phagosome before it fully closes. This results in enzymes escaping and causing damage to surrounding tissue |
|
|
Term
|
Definition
| When the structure is too big to engulf and the phagocyte just spits contents at the offender. Non specific so it also damages surrounding tissue |
|
|
Term
| How do you recognize acute inflammation? |
|
Definition
1. hyperemia
2. exudate
3. edema
4. fibrin
5. neutrophil |
|
|
Term
| Types of acute inflammation |
|
Definition
1. hemorrhagic
2. fibrinous
3. fibrinonecrotic
4. necrotizing
5. suppurative/puruient/py0- |
|
|
Term
| what characterizes fibrinous inflammation |
|
Definition
| primarily fibrin, commonly on serous surfaces, tan/yellow, silly string |
|
|
Term
| what characterizes fibrinonecrotic inflammation |
|
Definition
| primarily fibrin and necrotic material, commonly on mucosal surfaces, you can peel off membrane and expose underlying ulcer |
|
|
Term
| what characterizes necrotizing inflammation |
|
Definition
| presence of necrosis, often neutrophils, physical trauma most of the time |
|
|
Term
| what characterizes suppurative inflammation |
|
Definition
| presence of neutrophils, bacterial cause, pus but may not see immediately if acute |
|
|
Term
| what are the outcomes of inflammation |
|
Definition
1. complete resolution
2. healing by fibrosis
3. abscess formation
4. progression to chronic inflammation |
|
|
Term
| what is required for complete resolution |
|
Definition
1. removal of inciting agent
2. neutralization of inflammatory mediators
3. return of vascular integrity
4. neutrophils die
5. removal of edema and leukocytes
6. healing by regeneration |
|
|
Term
| how can you tell an abscess is chronic |
|
Definition
| it has a fibrinous capsule |
|
|
Term
|
Definition
|
|
Term
| what happens if the neutrophils can't remove or kill stimulus? |
|
Definition
| macrophages arrive 24-48 hours later |
|
|
Term
| what stimuli will cause chronic inflammation |
|
Definition
-persistent infection
-persistent foreign material
-prolonged exposure to irritant
-AID |
|
|
Term
| how long can chronic inflammation last? |
|
Definition
|
|
Term
| what are the key features of chronic inflammation |
|
Definition
-persistent inflammatory stimulus
-neutrophils replaced by macrophages, lymphocytes, and plasma cells
-edema and hyperemia resolved
-attempts at repair |
|
|
Term
| Types of chronic inflammation |
|
Definition
1. histiocytic
2. granulomatous
3. lymphocytic
4. plasmacytic
5. lymphoplasmacytic |
|
|
Term
| what characterizes histicytic inflammation |
|
Definition
-primarily macrophages
-some lymphocytes and plasma cells |
|
|
Term
| what characterizes granulomatous inflammation |
|
Definition
-primarily epithelioid macrophages and/or multinucleated giant cells
-diffuse or nodular |
|
|
Term
| what characterizes lymphocytic inflammation |
|
Definition
-primarily lymphocytes
-some plasma cells and histiocytes
-commonly immune mediated diseases |
|
|
Term
| what characterizes plasmacytic inflammation |
|
Definition
-primarily plasma cells
-some lymphocytes and histiocytes
-may not be grossly apparent |
|
|
Term
| what characterizes lymphoplasmacytic inflammation |
|
Definition
-primarily lymphocytes and plasma cells
-common
-my not be grossly apparent |
|
|
Term
| What is it called when you have a granuloma with foreign material at its center? |
|
Definition
|
|
Term
| What does a chronic lesion not have that an acute lesion will? |
|
Definition
| redness, edema, and fibrin |
|
|
Term
| What are the effects of inflammation |
|
Definition
1. fever
2. hematologic changes
3. sepsis
4. acute phase proteins
5. space occupying lesions
6. immune system disorders
7. neoplasia |
|
|
Term
| what cytokines are involved in producing fever? |
|
Definition
| IL-1, IL-6, prostaglandins |
|
|
Term
| how does fever help in inflammation |
|
Definition
-inhibits bacterial growth
-leukocytes have maximal performance at high temps |
|
|
Term
| what immune disorders can manifest from too much inflammation |
|
Definition
-allergies
-autoimmune diseases |
|
|
Term
| What are the two types of healing/ |
|
Definition
|
|
Term
| what are the requirements for healing by regeneration? |
|
Definition
-intact underlying CT/stromal support
-tissue must have capacity to regenerate (ie not nerves or cardiac tissue |
|
|
Term
|
Definition
-underlying stroma/ CT lost
-tissue has little capacity for regenration |
|
|
Term
| Stages of wound healing by repair |
|
Definition
1. Hemostasis
2. Acute inflammation
3. proliferation of tissue components
4. remodeling |
|
|
Term
| How long does regeneration take? |
|
Definition
|
|
Term
| How long does it take for the remodeling phase to begin and how long does it last? |
|
Definition
| 3-4 weeks post injury and can last up to 2+ years |
|
|
Term
| What is the difference between fibrin and fibrosis |
|
Definition
Fibrin-soft, easily broken, and a component of acute inflammation
fibrosis- chronic and composed of collagen which is not easily broken |
|
|
Term
| what factors can affect healing? |
|
Definition
-type, extent, site of injury
-blood supply
-genetics
-gender
-species
-age
-nutritional status
-concurrent disease
-stress
-repetitive injury
-infection'
-foreign bodies |
|
|
Term
| what can happen when healing goes wrong? |
|
Definition
-deficient scar formation
-hypertrophic scar formation
-exuberate granulation tissue
-excessive wound contraction |
|
|
