Inflammation (Slide 24-46) transfer 24–27 to features

1. Milky white fluid in the peritoneal cavity indicates what?

2. Possible cause

3. Edema or effusion?

1. Chylous ascites (milky white due to presence of lipids)

2. Blockage of lymphatic drainage

3. Effusion

1. Identify morphologic pattern of acute inflammation

2. Identify main component of pointed structure

3. This is a result of edema or effusion?

4. Is the accumulated fluid transudate or exudate?

1. Fibrinous Inflammation

2. Fibrin

3. Effusion (in pericardial cavity)

4. Exudate (protein-rich)

1. Identify pointed structure

2. Friction between such structures would produce what auscultatory finding?

1. Fibrin strand

2. Friction rub (creaking or scratching sound, sometimes described as rubbing sandpaper)

1. Predominant (dead) cells in the yellow-green exudate

2. Other components present in the exudate

Condition: inflamed, hyperemic (erythematous) bowel mucosa

1. Neutrophils

2. Fibrin, amorphous debris of dying cells

1. Identify morphologic pattern of acute inflammation

2. What could be the underlying cause of the disease leading to accumulation of the pointed yellowish fluid?

Condition: Purulent pericarditis

1. Purulent (Suppurative) Inflammation

2. Bacterial infection

Purulent pericarditis can have variable components of fibrinous exudate and serous effusion. If the inflammation is severe, it could even become hemorrhagic.

1. Identify morphologic pattern of acute inflammation

2. What could be the underlying cause of the disease leading to accumulation of the pointed fluid?

3. Possible effects on affected individual

4. Preponderant cell if CSF samples are obtained

Condition: Acute meningitis

1. Purulent (Suppurative) Inflammation

2. Bacterial infection (Streptococcus pneumoniae)

3. headache, nuchal rigidity, and changes in mental status

4. Neutrophils (with marked leukocytosis)

1. Identify morphologic pattern of acute inflammation

2. Preponderant cells in the exudate

Condition: Peritonitis

1. Purulent (Suppurative) Inflammation

2. PMNs

1. Predominant cell in the alveolar spaces

2. Describe the microscopic appearance of the surrounding blood vessels

Condition: Acute bronchopneumonia

1. Neutrophils

2. Dilated and congested with RBCs

This exudative process is typical for bacterial infection. The exudate gives rise to a productive cough of purulent yellow sputum. The alveolar architecture is still maintained, which is why even an extensive pneumonia often resolves with minimal residual destruction or damage to the pulmonary parenchyma.

1. Identify pointed cell

2. Physical indicator of the condition on the affected individual

3. What may have been present within the gallbladder to elicit this inflammatory response?

Condition: Acute cholecystitis

1. Neutrophil

2. right upper quadrant abdominal pain with tenderness on palpation

3. Most cases of cholecystitis occur in association with cholelithiasis (gallstones).

Bacterial infection is typically absent from cases of acute and chronic cholecystitis.

1. Consequence of alveolar infiltration

1. Reduced oxygenation

1. Identify morphologic pattern of acute inflammation

1. Abscess

Abscesses are localized collections of pus caused by suppuration buried in a tissue, an organ, or a confined space. They are produced by seeding of pyogenic bacteria into a tissue.

1. Which pattern of tissue necrosis is associated with abscesses?

1. Liquefactive necrosis

The liquefactive necrosis of an abscess is apparent, because the purulent contents are draining out to leave a cavity. On a chest radiograph, the liquefied central contents of an abscess can appear as an "air-fluid level".

1. Identify morphologic pattern of acute inflammation

2. Possible adverse effects of myocarditis

Condition: Myocarditis

1. Abscess (specifically microabscess)

2. fever, chest pain, dyspnea from left-sided heart failure, and peripheral edema from right-sided heart failure; Arrhythmias

1. An abscess is a localized collection of what cells?

2. The irregular dark purple center is a collection of?

1. PMNs

2. bacterial debris

1. Identify morphologic pattern of acute inflammation

2. Preponderant cell in pointed area

1. Abscess

2. Neutrophils

A lung abscess is typically a complication of severe pneumonia, most often from virulent organisms such as Staphylococcus aureus, some pneumococci, and Klebsiella pneumoniae.

1. Identify morphologic pattern of acute inflammation

2. Describe microscopic appearance of affected region

1. Abscess

2. Alveolar walls are no longer visible; adjacent hemorrhage

More virulent bacterial organisms or more severe inflammation with pneumonia can be associated with destruction of lung tissue and hemorrhage.

1. Identify morphologic pattern of acute inflammation

2. Pointed structure is a collection of?

1. Abscess

2. Fuzzy dark purple areas represent clusters of bacterial colonies

The alveoli in that area have been destroyed.

1. Identify morphologic pattern of acute inflammation

2. Possible adverse effects of the pointed defect

3. Possible causes

Condition: Acute gastric ulcer

1. Ulcer

2. hemorrhage, penetration (extension into an adjacent organ), perforation (communication with the peritoneal cavity), and stricture (as a result of scarring)

3. Helicobacter pylori infection; NSAIDs

An ulcer is an area of full-thickness loss of the mucosa (an erosion is a partial-thickness loss).

1. Identify morphologic pattern of acute inflammation

2. Most accurate procedure to determine malignancy

1. Ulcer

2. Biopsy

All gastric ulcers and all gastric masses must undergo biopsy because it is impossible to determine malignancy from their gross appearance. In contrast, virtually all duodenal peptic ulcers are benign.

1. Identify morphologic pattern of acute inflammation

2. Term for ulcers that form on skin over bony prominences in persons who are bedridden for an extended time

1. Ulcer (caused by mechanical forces)

2. "pressure ulcers" or "decubitus ulcers"

According to webpath, this is an ulcer. But, Robbins Atlas says that this is a case of laryngeal erosion. An ulcer is an area of full-thickness loss of the mucosa (an erosion is a partial-thickness loss).

1. Identify pointed tissue

2. Identify clinical condition

3. Identify morphologic pattern of acute inflammation (green circle)

4. Preponderant cells in acute phase of inflammation

5. Preponderant cells in chronic phase of inflammation

6. Most prominent pathologic process if infection persists

1. Stratified squamous epithelium

2. Esophageal acute ulcer

3. Ulceration

4. PMNs

5. lymphocytes, macrophages, and plasma cells

6. fibroblastic proliferation, scarring

An ulcer is a local defect, or excavation, of the surface of an organ or tissue that is produced by the sloughing (shedding) of inflamed necrotic tissue. Ulceration can occur only when tissue necrosis and resultant inflammation exist on or near a surface. Ulcerations are best exemplified by peptic ulcer of the stomach or duodenum, in which acute and chronic inflammation coexist. During the acute stage there is intense polymorphonuclear infiltration and vascular dilation in the margins of the defect.

1. Possible underlying causes of the ulceration

1. Diabetes mellitus leading to marked atherosclerosis with arterial narrowing

1. Identify pattern of cell death

1. Gangrenous necrosis