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Gen path test II
material for test 2
165
Pathology
Graduate
10/25/2014

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Cards

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
Inflammatory modifiers
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
cytokines are made by:
Definition
lymphocytes and macrophages
Term
cytokine functions
Definition
1. active inflammation
2. control the movement of inflammatory cells
3. stimulate hematopoiesis
Term
Master cytokines
Definition
IL-1 and TNF
Term
what cytokines control movement of inflammatory cells?
Definition
chemokines
Term
what chemokine is responsible for recruiting neutrophils?
Definition
IL-8
Term
what chemokine is responsible for recruiting eosinophils?
Definition
eotaxin
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
leukotrienes
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
anti-parasitic
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
true
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
proliferate
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
acute
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
circulating monocytes
Term
T/F - macrophages are found in circulation
Definition
false - macrophages are only found in tissues
Term
function of macrophages
Definition
-phagocytosis
-coordinate the inflammatory resposnses
Term
when do macrophages arrive at the site of inflammation?
Definition
24-48 hrs
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
Types I, II and III
Term
define hypersensitivity
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
IgE
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
describe a lymphocyte
Definition
small, dense round nucleus, scant basophilic cytoplasm
Term
lymphocyte functions
Definition
immune surveillance
secrete cytokines to coordinate response to chronic inflammation
Term
lymphocyte sub sets:
Definition
T cells and B cells
Term
when do lymphocytes arrive at site of damage/
Definition
24-48 hours
Term
why do lymphocytes accumulate in the tissue
Definition
chronic inflammation
Term
where do plasma cells come from?
Definition
B cells
Term
describe a plasma cell
Definition
large withe dense round, eccentric nucleus (clock face look. Basophilic cytoplasm wiht a perinuclear clearing
Term
plasma cell functions
Definition
make IgG, IgM, IgA, and IgE
Term
What is a plasma cell wiht distended (constipated) RER called?
Definition
Mott cell
Term
why do plasma cells accumulate in the tissue?
Definition
chronic inflammation
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
drugs (e.g. penicillin)
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
respiratory tract
Term
what is the most common hypersensitivity in dogs and cats?
Definition
flea allergy
Term
what region of the skin is most commonly affected in flea allergy hypersensitivities?
Definition
dorsal lumbosacral
Term
which 2 types of hypersensitivity are involved in flea allergies?
Definition
type I and IV
Term
what is the most common cell type seen with a flea allergy skin biopsy?
Definition
eosinophils
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
type I
Term
T/F - eosinophils are numerous in circulation with atopy
Definition
true
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
redness and heat
Term
what is RRR?
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
IL-1, TNF, and histamine
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
edema
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
becomes fibrin
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
stringy tan fragile net
Term
define diapedesis
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
integrins
Term
define chemotaxis
Definition
migration of leukocytes followed by inflammatory mediators to the site of injury
Term
define chemotaxins
Definition
chemicals released at site of injury to attract or repel leukocytes
Term
steps of phagocytosis
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
- jersey
- guernsey
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
IgG & IgM
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
IgG
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
autoantibodies
Term
what receptor is targeted with myasthenia gravis?
Definition
acetylcholine receptor
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
T helper cells
Term
what cells are associated with CD 8?
Definition
cytotoxic T cells
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
define immunodeficiency
Definition
congenital lack of immune competence (PRIMARY) OR secondary loss of immune competence (SECONDARY)
Term
are primary or secondary immunodeficiencies more common?
Definition
secondary (acquired)
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
frustrated phagocytosis
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
what causes abscesses?
Definition
bacteria
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
Weeks to years
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
pyogranuloma
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
-regeneration
-repair
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
requirements for repair
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
3-5 days
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
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