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general pathology- usmlerx bricks

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step 1 general pathology usmle rx bricks

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  • November 24, 2022
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  • 2022/2023
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Acute Inflammation
Last Updated: March 9, 2021
access_time18 min
Learning Objectives (7)

After completing this brick, you will be able to:
● Describe the three roles of inflammation.
● 1

● Identify the cells of innate immunity involved in acute inflammation
and the timeline of when each cell type is involved.
● 2

● Describe the four reactions of blood vessels in acute inflammation.
● 3

● Describe leukocyte recruitment to sites of inflammation.
● 4

● Explain how these processes result in the general clinical
manifestations of acute inflammation.
● 5

● Provide specific examples of acute inflammation.
● 6

● Describe the utility of acute-phase reactants as a marker of
inflammation: erythrocyte sedimentation rate, C-reactive protein,
ferritin, fibrinogen (all increased with inflammation—positive
markers).
● 7



CASE CONNECTION

,You are sitting in the waiting room of your dentist’s office. Twenty-
four hours earlier, you started to feel pain in your lower jaw. You then
noticed swelling and redness over the area. “This is the worst pain I
have ever had,” you said when you called for an appointment. Once
you are in the dentist’s chair, mouth open, your dentist turns to the
assistant and says “Wow, that’s pretty swollen in there. Time for the
Novocain.” To distract yourself from the long needle, you begin to
think about the acute inflammatory process.




How is your body attempting to deal with the dental infection?
Consider your answer as you read, and we’ll revisit at the end of the
brick.




What Is Acute Inflammation?

Have you ever cut your finger, bumped your head, or fallen and
scraped your knee? While you were cursing your clumsiness or bad
luck, your body got straight to work healing the injury, relying on the
wondrous process of acute inflammation. Shortly after your injury,
you most likely experienced some or all of the cardinal signs of acute
inflammation: pain (dolor), redness (rubor), heat (calor), and swelling
(tumor).

,There are two types of inflammation: acute and chronic. Acute
inflammation is an essential part of the body’s defense system and
generally lasts a few days. Chronic inflammation (discussed in detail
in another brick) involves an ongoing low-level inflammation that
lasts for weeks, months, or even years. Unlike acute inflammation,
chronic inflammation is not beneficial; it leads to tissue damage and is
linked to the development of many types of chronic disease, including
diabetes, cancer, and a range of autoimmune disorders.



What Are the Three Major Roles of
Acute Inflammation?

The first role of inflammation is to recruit help in response to
infection or injury. This help arrives via the delivery of effector
molecules and cells to the site of injury or infection. These molecules
and cells specialize in tissue repair and clearing foreign pathogens.
Some effector molecules and cells carry out the second role: causing
blood to clot at the site of injury. This halts the flow of blood out of
the injured area, provides a framework for tissue repair, and creates a
physical barrier that contains the spread of infection. The third role of
inflammation is promoting repair of injured tissue.

, Which Cells Are Involved in Acute
Inflammation?

The main cells involved in acute inflammation are two types of
immune system cells, neutrophils and macrophages. Both of these
cells also play a role in innate immunity.


The first cells to arrive on the scene—the paramedics of acute
inflammation—are neutrophils. Neutrophils are the most abundant
white blood cells (WBCs) in the blood, representing about 60% of the
total WBC count. They are classified as granulocytes because of the
presence of specific granules in their cytoplasm. Neutrophils kill
microorganisms using phagocytosis (engulfing and ingesting them)
and by releasing antimicrobial proteins. Neutrophil response peaks
about 24 hours after injury or infection (Figure 1).

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