Pathophysiology Infection, Immune & Inflammation

Flashcard maker : Bernice Cooper
the third line of defense
immune response, specific
Response in which there is increased blood flow to the site of an injury
vascular response
Type of response that alerts the products of healing to attend to the site of injury
cellular response
Part of vascular response to accommodate increased blood flow to the site of the injury
dilate
(vascular response) lining of the blood vessel loosens to allow cells to easily move from the vessel into the injured tissue
permeable
Plasma derived chemical mediators
Complement, kinin, clotting systems
Watery fluid that accumulates at the site of injury
exudate
An important inflammatory mediator, a leukocyte that is responsible for the production and immediate inflammatory mediators through a response of degranulation. (\”first responders\”)
Mast cell
When the mast cell breaks apart and releases inflammatory mediators in the form of extracellular granules
Degranulation
A white blood cell that contains granules that acts in the same manner as mast cells
Basophil
mediators released by ________ include histamine, leukotrienes, and prostaglandins
Mast cell
Inflammatory mediators associated with arachidonic acid
Prostaglandins, leukotrienes, thromboxane
A process of moving certain cells to the site of injury – attracts specific types of cells
Chemotaxis
Three steps needed for a successful cellular response
Chemotaxis, cellular adherence, cellular migration
Attraction and binding, essential for effective phagocytosis
Adherence
Process in which cells can move between and through endothelial junctions
Diapedesis
Local manifestations of inflammation
Heat, redness, swelling, pain, loss of function.
Systemic manifestations of inflammation
Fever, fatigue, weight loss, headache, lethargy, inc leukocytes
Infection associated with breakdown of tissues and formation of pus
Abscess
overwhelming infection where pathogenic bacteria gain access to bloodstream
Septicemia
Stimulates inflammation, opsonization, and lysis of foreign cells
The complement system
Three steps in treatment of inflammation
Reduce blood flow, decrease swelling, block the action of chemical mediators
Three steps of healing and tissue repair
Inflammatory, proliferative, remodeling
Covers the wound – first step of healing and tissue repair
Inflammatory phase
Cleans the debris and restores structural integrity – second step of healing and tissue repair
Proliferative phase
Resolution, regeneration, replacement – third step of healing and tissue repair
Remodeling phase
Complication of wound healing. Open lesion of the skin prone to infection
Ulcers
Complication of wound healing. Deficient scar formation, in which the wound splits open, often at a suture line
Dehiscence
Complication of wound healing. Hypertrophic scars that result from excessive collagen production at the site of injury
Keloids
Formation of granulomas and scarring often occur
Chronic inflammation
2nd degree: Blistering occurs in this type of burn
Deep partial burn
3rd Degree: Redness, eschar, edema, and exudate characterize this type of burn
Full thickness burn
Diagnostic criteria used for burns
Rule of nines. Face, hands, feet or groin are MAJOR burns.
Bacterial infection of the blood
Sepsis
A process of mechanically removing debris, including necrotic tissue, from the wound.
Debridement
You get a paper cut and experience pain at the site. This response is related to:
A. Increased perfusion at the site
B. Increased exudate and chemical mediators at the site
C. Bacteria that have entered the wound
D. Vasoconstriction at the site
B
Inflammation is ultimately needed to:
A. Increase inflammatory mediators at the site to vasoconstrict the area
B. Increase platelets at the site for clotting
C. Restore functional cells
D. Prepare the site for healing
D
Type of healing where the wound is closed with all areas of the wound connecting and healing simultaneously (ex. paper cut)
Primary intention
Type of healing where the wound heals from the bottom up. Slower and more involved process (ex. open crater-like wound)
Secondary intention
A major difference between the acute and chronic inflammatory response is that in chronic inflammation:
A. Inflammatory mediators are released
B. Neutrophils are much more prominent
C. Granulomas form around certain invaders
D. Granulation tissue is present
D
Which is not a local manifestation of acute inflammation:
A. Edema
B. Redness
C. Loss of function
D. Leukocytes
D
The hospitalized burn patient want to know why you need to remove his dressings every day. You explain that removing the dressings promotes:
A. Debridement
B. Infection
C. Skin function
D. Drying and exudate
A
Which of the following is the most common cause of acute gastritis?
A. Poor gastric perfusion
B. Too much stomach acid
C. Ingestion of aspirin, alcohol, or other chemicals
D. H. Pylori infection
D
First line of defense
non-specific, mechanical barrier, skin and mucous membranes an secretions
Second line of defense
non-specific, phagocytosis and inflammation.
What are characteristic of the inflammatory response?
1. It is a non-specific response to injury.
2. It is activated when first line of defense is inadequate.
3. It can be initiated by the activation of the complement system.
What leukocyte functions as the first phagocytic responder during the inflammatory process?
neutrophils
WBC Differential shifts
Shift to the left: increase bands % and WBC, neutrophils.
Bands are immature neutrophils.
Inflammatory Exudates
Serous – water, consists of primarily fluid, some proteins, and white blood cells
Sanguinous – bloody
Serosanguinous – mostly serous with some red blood cells present (may be pinkish but still watery)
Fibrinous – thick, sticky, high cell and fibrin content
Purulent – thick, yellow-green, contains more leukocytes, cell debris, and microorganisms
Potential complications of inflammation
infections, deep ulcers, muscle spasms, local complications.
Tissue repair
resolution: Minimal tissue damage, regeneration: Damaged tissue replaced with cells that are functional, and replacement: Functional tissue replaced by scar tissue & Loss of function.
pharmacologic treatment
Acetylsalicylic acid (ASA): Aspirin
Acetaminophen: Tylenol
Non-steroidal anti-inflammatory drugs (NSAIDs): Ibuprofen (Advil, Motrin), Naproxen sodium (Aleve)
Glucocorticoids: Corticosteroids (Prednisone)
Pyrogenics
cytokines and prostagladins

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