NURS 5315 ADV PATHO EXAM 2 SET 1|2023/24 UPDATE|GRADED A+

First 5 steps in the inflammatory process 1. mast cell degranulation 2. activation of coagulation cascade 3. activation of kinin cascade 4. release of chemotactic factors 5.Activation of the complement cascade Role/function in the inflammatory process: Complement Form the membrane attack complex bacterial lysis vasodilation Increased vascular permeability triggers mast cell degranulation chemotaxis opsonization - opsonins tag foreign pathogens for elimination by phagocytes Role/function in the inflammatory process: kinin turned into bradykinin which is responsible for pain, chemotaxis and Increased vascular permeability and vasodilation Role/function in the inflammatory process: Coagulation cascade plays role in activating the kinin system Factor XII (Hagemon factor) activates kinin and forms a fibrin mesh to stop bleeding and trap microorganisms Role/function in the inflammatory process: chemotactic factors once released attract neutrophils, eosinophils and monocytes for phagocytosis Role/function in the inflammatory process: Neutrophils show up at the site of injury in 6-8 hours Neutrophils express and release cytokines, which in turn amplify inflammatory reactions by several other cell types. In addition to recruiting and activating other cells of the immune system, neutrophils play a key role in the front-line defense against invading pathogens. Role/function in the inflammatory process: monocytes Show up in 1-7 days become macrophages present antigens to the CD4 cell which leads to Tcell immunity which leads to B cell immunity Releases IL1, IL6, TNF and growth factors Role/function in the inflammatory process: Mast cell degranulation triggers the activation of the acute phase reactants This leads to the release of histamine, cytokines, leukotrienes, platelet activation factor and prostaglandins Role/function in the inflammatory process: Histamine 1 (H1) promotes inflammation smooth muscles, i.e. bronchi - asthma causes bronchoconstriction Role/function in the inflammatory process: Histamine 2 (H2) anti-inflammatory properties gastric mucosa Role/function in the inflammatory process: cytokines IL4 early in the inflammation IL 13 later in inflammation TNF Role/function in the inflammatory process: leukotrienes released when mast cell degranulates cause vasodilation attract neutrophils, monocytes eosinophils Singular impacts leukotrienes Role/function in the inflammatory process: prostaglandins released when the mast cell degranulates produced by the arachidonic pathway cause vasodilation, platelet aggregation, pain and fever Role/function in the inflammatory process: platelet-activating factor derived from fatty acids in the plasma membrane produced by neutrophils, monocytes, endothelial and platelets cause endothelial cell retraction, increases vascular permeability, activates platelets, enhances leukocyte adhesion to endothelial cell Steps in the arachidonic acid pathway Linoleic acid plus phospholipase A2 make arachidonic acid (AA) AA plus COX1 or COX 2 make Prostaglandins Prostaglandins from COX1 maintain homeostasis gastric mucosa platelet aggregation fluid/electrolyte imbalance Prostaglandins from COX2 assist in the inflammatory process via pain, fever help with homeostasis via renal function tissue repair reproduction development Function of arachidonic acid pathway The arachidonic pathway is the biochemical process responsible for the synthesis of prostaglandins (See concept map). It is made from linoleic acid which is part of the phospholipid cell membrane. COX2 note of caution While COX2 inhibitors block the inflammatory function of prostaglandins, they can also impair renal function. NSAIDS inhibit both COX1 and COX2 prostaglandin synthesis Risk: gastric ulcerations, GI bleeds, bleeding, edema, renal impairment Aspirin blocks both COX1 and COX2 also inhibits Thromboxane A2 and prostaglandins Corticosteroids inhibit the action of phospholipase A2 thus preventing the formation of prostaglandins, thromboxane A2 prostacyclin and leukotrienes Phagocytic Cells neutrophils, macrophages, dendritic cells Macrophages derived from monocytes, which leave the blood stream and differentiate in tissues dendritic cells specialized white blood cells that engulf antigens in the epithelia of the skin, GI and respiratory tracts Organs of the immune system bone marrow, thymus gland, spleen, lymph nodes, tonsils, peyer patches Antigen Presenting cells Include dendritic cells, macrophages and B cells. Ingest and process antigens natural killer cells (NK cells) pursue diseased cells (such as those infected by viruses or cancer) T lymphocytes (T cells) cell-mediated immunity CD4 cells (aka T-helper) T4 cells [f] activate macrophages, B-cells, cytotoxic T-cells, other CD$ cells Release lymphokines mediate delayed hypersensitivity reactions (i.e. TB skin test)