Inflammation & Infection

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Inflammation & Infection
2013-02-17 11:48:22
N170 Test

Inflammation & Infection
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  1. 5 Cardinal manifestations of inflammation:
    • warmth
    • redness
    • edema (swelling)
    • pain
    • decreased function
  2. 3 Stages of the Inflammatory Process
    • Vascular Response
    • Cellular Response
    • Tissue Repair
  3. Describe vascular response:
    • initial response to injury causing vasoconstriction to contain the bleeding
    • secretion of chemical mediators signaling WBC's of problem
  4. Describe Cellular Response:
    Exudate stage when leukocytes move in to the area.
  5. Acute cellular response what WBC arrives?
    • granular
    • non granular
  6. Describe Tissue Repair:
    It is the replacement stage that BEGINS at the time of injury.  Fibroblasts arrive to stimulate revascularization, secrete collage and form scar tissue.
  7. Difference between and acute and chronic inflammatory response.
    Acute is short term and is associated with all types of injury. Leukocytes storm the site, but stop migrating after awhile

    Chronic is a response that lasts longer than 2 weeks. Leukocytes are always there causing constant inflammation
  8. 5 common causes of inflammation:
    • trauma
    • surgery
    • infection
    • Extremes of heat and cold
    • Ischemic damage
  9. Describe vascular response to inflammation:
    It is the first response to injury leading to vasoconstriction of venules and vasodilation of arterioles.
  10. Describe cellular response to inflammation:
    It is when WBC's move in to the area to fight any foreign bodies.
  11. Tissue macrophages
    Engulf and digest cellular debris and pathogens
  12. microphages
    small phagocytes
  13. Band is the same as
    Stab....both are neutrophils
  14. neutrophils
    most abundant WBC

    consists of Basophils and Eosinophils
  15. polys=
  16. Bands
    immature neutrophils (or any WBC) that should be in the marrow maturing
  17. Eosinophils
    fights parasites
  18. basophils
    inflammatory rxn
  19. mast cells
    • fights allergies/anaphalyxis
  20. monocytes
    When inflammation occurs these go to the site and divide in to macrophages and dendrites
  21. lymphocytes
    • NK Cells
    • T & B Cells
  22. What is meant by a shift to the left?
    When bands or stabs run at a higher % than normal causing a shift to the left.

    It means the infection is starting to run a muck!!!
  23. phagocytosis
    when a cell ingests and disposes of cellular debris and pathogens
  24. Leukocytosis occurs when?  What is it?
    Acute Inflammation

    Elevated white blood cell count
  25. Leukopenia
    decrease in WBC to below normal value
  26. Pancytopenia
    • decrease in all blood cells...
    • WBC
    • RBC
    • Platelets
  27. Serous
    clear water plasma....blister like
  28. Fibrinous
    thick, sticky mesh.

    Has fibrinogen in it....blood clot
  29. Menbranous
    Develops on the surface of the mucous membrane ....thrush
  30. Purulent
    • pus made of :
    • WBC
    • Proteins
    • Debris
  31. Catarrhal
    cells that produce mucus.  Found in a UTI
  32. Sanguineous Hemorrhage
    Bright RED!!!

    Severe tissue injury where blood vessels and RBC's are damaged
  33. Serosanguenous
    Serous fluid + Hemorrhagic together....
  34. What is fever?
    an abnormal elevation of core body temperature.

    It is a universal response to inflammation and infection
  35. What part of the brain regulates temperature?
  36. What's the set point?
    our body temperature level which is needed for survival

    Fights infection
  37. Pyrogens (Exogenous and Endogenous)
    It is what causes the hypothalamus to raise body temperature and readjust set point
  38. What affects the hypothalamus to change our body temp?
    • breakdown of bacterial and their products
    • breakdown of WBC's
    • chemical mediators (histamines & prostaglandins)
  39. 4 Stages of a fever
    • Prodromal
    • Generalized Shaking/chill
    • Flush
    • De-effervescence
  40. Prodromal
    • Earliest stage
    • Headache, fatigue, malaise, aches and pains

    Feel cold, but hot to touch
  41. Describe generalized shaking/chill stage of a fever
    Occurs as the fever rises in response to the increased set point.

    Shivering to increase heat production as the metabolism and set pt continue to adjust upward.
  42. When do convulsions occur from a fever?
    104 and 40 celsius

    cells are damaged and the hypothalamus can no longer maintain the responses that increase heat loss
  43. How do you intervene during a temperature?
    ice packs on groin and under arm
  44. Describe Flush stage of a fever
    cutaneous vasodilation occurs after shivering has caused the body temp to reach a new set pt at the control center.

    Skin is now warm and flush
  45. De-effervescence
    Fever is breaking.

    maked by initiation of sweating and the fever now diminishes or disappears
  46. Subjective Symptoms of a fever
    Person complains of feeling hot, chilled, headache, malaise, decrease in appetite
  47. Objective signs of a fever
    • flushed 
    • chills
    • tachycardia
    • tachypnea
    • drowsy/confused/disoriented
    • Lab data
  48. Lab Data from Fever
    • Increased WBC and ESR
    • Changes in serum electrolytes
  49. Expected outcome after interventions for fever
    Temp will decrease to a safe level within 1-2 hours
  50. Interventions for Fever:
    • Antipyretics for temps above 38.2 or 100.8
    • Cooling measures
  51. Chemical mediators
    • Histamine
    • Seratonin
    • Prostaglandins
    • Kinins
  52. Histamine
    Capillary dilation and enhances capillary permeability.

    Causes redness and warmth
  53. Seratonin

    Provides protection against further insult, loss of blood or infection
  54. Prostaglandins
    Promotes capillary dilation and enhances capillary permeability

    Causes redness, warmth, fever, pain....contributes to menstural pain
  55. Kinins
    Increases capillary permeability allowing for fluid, fibrin and proteins to escape in to tissues and interstitial spaces.

    Clots and encapsulates area!!!
  56. Margination and pavementing
    provides a route for cells to get to site
  57. diapedesis
    escaping of RBC to injured area
  58. Chemotaxis
    leukocytes moving to area
  59. What is the life span of the neutrophil and why is this important in the inflammatory process?
    12-18 hours.....

    Neutrophils are good for one process only, so we count them and know where we are in an infection/inflammation.  Is it getting away from us?  Or is our body fighting it well?
  60. Left shift occurs with....

    Never viral!!!!
  61. With a left shift with important?
    The % of bands....not the # of them.
  62. Amount of functional loss from an injury is determined by....
    amount of scar tissue
  63. B Cells
    form plasma cells and are concerned with antibody formation
  64. T Cells
    concerned with cell mediated immunity
  65. What does it mean when there is a decrease in Bands?
    You are getting better, antibiotics are working?
  66. does this vary in acute versus chronic inflammation?
    Leukocytes are there in abundance when there is an acute injury. But then it goes down.

    In a chronic situation....leukocytes are always present.
  67. What condition can the ESR diagnose?
    (Erythrocyte Sedimentation Rate)  Explain....
    It is seen in chronic inflammation diseases like arthritis.

    It tells how much inflammation is in the body.  The more sediment there is and the longer it takes to settle.....means more inflammation.
  68. What do dendritic cells do?
    present antigens....allowing a connection between innate and adaptive immunity