ROBBINS BASIC PATHOLOGY 10TH EDITION
COMPREHENSIVE EXAM SCRIPT SOLVED
QUESTIONS GRADED A+
◉ changes in vascular caliber and flow in acute inflammation
Answer: 1- transient vasoconstriction (lasts a few seconds)
2- vasodilation mediated by histamine that first alters the arterioles
and then leads to the opening of new capillary beds in the area.
(the cause of heat and erythema at the site of inflammation)
3- microvasculature permeability increases and exudate leaks out.
4- slower blood flow and increased viscosity of the blood --> stasis.
(engorgement of smalls vessels jammed with slowly moving red
cells --> erythema and vascular congestion)
5- Neutrophils accumulate along endothelium while they express
adhesion molecules --> migration.
◉ mechanisms responsible for the increased vascular permeability:
,Answer: 1- Retraction of endothelial cells: (the immediate transient
response)
--> in response to histamine, bradykinin and other chemical
mediators.
--> rapid (15-30 minutes) and short lived.
--> occurs mainly at the post capillary venules.
2- Endothelial injury:
--> endothelial cell necrosis and detachment that occurs in response
to burns or microbial toxins.
--> rapid (leakage starts immediately after injury) and sustained for
several hours until the damaged vessels are thrombosed or repaired.
--> neutrophils binding to the endothelium may also injure the cells
and amplify the reaction.
3- transcytosis:
--> opening of intracellular channels in response to certain factors
such as vascular endothelial growth factor.
◉ Response of lymphatic vessels and lymph nodes to acute
inflammation
Answer: the lymphatic vessels accumulate to drain the edema fluid,
leukocytes, microbes and cellular debris.
, --> secondary inflamed lymphatics and lymph nodes: lymphangitis
and lymphadenitis; inflamed lymph nodes are enlarged because of
increased cellularity.
--> the presence of red streaks near a wound --> infection --> follows
the course of the lymphangitis and accompanied by painful
enlargement of the draining lymph nodes.
◉ compare neutrophiles and macrophages:
Answer: both are essential in the typical inflammatory reactions.
neutrophils:
--> rapid and short-lived cells (1-2 days) that are continuously
produced from hemopoietic stem cells in the bone marrow.
reaction:
--> rely heavily on degranulation of lysosomal enzymes induced by
cytoskeletal rearrangement to eliminate the offending agent.
--> also induce the formation of reactive oxygen species by assembly
of phagocyte oxidase.
COMPREHENSIVE EXAM SCRIPT SOLVED
QUESTIONS GRADED A+
◉ changes in vascular caliber and flow in acute inflammation
Answer: 1- transient vasoconstriction (lasts a few seconds)
2- vasodilation mediated by histamine that first alters the arterioles
and then leads to the opening of new capillary beds in the area.
(the cause of heat and erythema at the site of inflammation)
3- microvasculature permeability increases and exudate leaks out.
4- slower blood flow and increased viscosity of the blood --> stasis.
(engorgement of smalls vessels jammed with slowly moving red
cells --> erythema and vascular congestion)
5- Neutrophils accumulate along endothelium while they express
adhesion molecules --> migration.
◉ mechanisms responsible for the increased vascular permeability:
,Answer: 1- Retraction of endothelial cells: (the immediate transient
response)
--> in response to histamine, bradykinin and other chemical
mediators.
--> rapid (15-30 minutes) and short lived.
--> occurs mainly at the post capillary venules.
2- Endothelial injury:
--> endothelial cell necrosis and detachment that occurs in response
to burns or microbial toxins.
--> rapid (leakage starts immediately after injury) and sustained for
several hours until the damaged vessels are thrombosed or repaired.
--> neutrophils binding to the endothelium may also injure the cells
and amplify the reaction.
3- transcytosis:
--> opening of intracellular channels in response to certain factors
such as vascular endothelial growth factor.
◉ Response of lymphatic vessels and lymph nodes to acute
inflammation
Answer: the lymphatic vessels accumulate to drain the edema fluid,
leukocytes, microbes and cellular debris.
, --> secondary inflamed lymphatics and lymph nodes: lymphangitis
and lymphadenitis; inflamed lymph nodes are enlarged because of
increased cellularity.
--> the presence of red streaks near a wound --> infection --> follows
the course of the lymphangitis and accompanied by painful
enlargement of the draining lymph nodes.
◉ compare neutrophiles and macrophages:
Answer: both are essential in the typical inflammatory reactions.
neutrophils:
--> rapid and short-lived cells (1-2 days) that are continuously
produced from hemopoietic stem cells in the bone marrow.
reaction:
--> rely heavily on degranulation of lysosomal enzymes induced by
cytoskeletal rearrangement to eliminate the offending agent.
--> also induce the formation of reactive oxygen species by assembly
of phagocyte oxidase.
