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Acute Inflammation Major Features
- Vascular changes leading to inc bl flow
- Inc vascular perm
- Emigration, accum, act leukocytes/Mphage
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Acute Inflammation Cellular events
- Leukocyte adhesion/transmigration
- Chemotaxis (chemoattractants)
- Leukocyte activation
- Phagocytosis
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Inflammatory chemical mediators
- Vasoactive amines (Histamine, Serotonin)
- Plasma Proteins (complement, kinins, clotting F)
- Arachidonic acid metabolites
- Platelet act F
- Cytokines/chemokines
- NO
- Free radicals
- Neuropeptides
- Other (hypoxia-induced factor 1a, uric acid)
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Histamine and Serotonin
- Preformed (h: mast cells, basophils, pl) (s: pl,enterochromaffin cells)
- Response to: phys inj, immune rxn, anaphylatoxins, neuropeptides (substance P), IL-1, IL-8
- Vasodilation
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Bradykinin
- Inc vascular permeability
- sm m contraction
- vasodilation
- pain
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Clotting system
- Thrombin (mobilize P-selectin, chemokines, endothelial adhesion molecules, induces COX-2, PAF, NO)
- Plasmin (activates complement, fibrin-split products, Hageman factor)
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NO
- Produced by endothelium, macrophages, some neurons
- sm m relaxation
- microbicidal
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Lysosomal contents
- Primary (myeloperoxidase, lysozyme, acid hydrolases, neutral proteases)
- Secondary (lysozyme, collagenase, lactoferrin, plasminogen activator, histaminase, alk phos)
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Antioxidants
- Ceruloplasmin
- Transferrin
- Superoxide dismutase
- Catalase
- Glutathione
- Vitamin A/E
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Acute Inflammation: Morphologic patterns
- Serous
- Fibrinous (inflamm of linings of cavities)(may resolve or organize)
- Suppurative (abscess of purulent material)
- Ulcers
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Chronic Inflammation
- Eg: TB, syphilis, leprosy
- Mononuclear (not neutrophil) infiltrate
- Ongoing attempted tissue replacement
- Macrocytes all over. Also lymphocytes, plama cells, eosinophils, mast cells
- Granulomatous inflam
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Granulomatous inflammation processes
- TB
- Sarcoidosis
- Cat-scratch
- lymphogranuloma inguinale
- leprosy
- brucellosis
- syphilis
- berylliosis (dust in lung)
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Granulomatous inflammation histologically
- Epithelioid histiocytes
- Giant cells (langhans - peripheral nuclei) (foreign body giant cells - haphazard nuclei)
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Molecular/cellular effects of fever
- Pyrogens (endotoxin, IL-1, TNF)
- Acute-phase reactants (CRP, fibrinogen, serum amyloid A)
- Left shift leukocytes
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