Acute Inflammation

Reference: Davidson 23rd, Page: 72 , Box : 4.4

ESR is increased disproportionately to CRP in Bacterial endocarditis

Explanation :
Acute phase proteins :
CRP,Ceruloplasmin,Cryoglobulin
Serum amyloid A protein 
Fibrinogen
Ceruloplasmin
Heptoglobin
Ferritin
Lactoferrin

The richest source of histamine is mast cell

Explanation :
Acute inflammatory exudates :
Contains neutrophil
Rich in Fibrinogen 
Have protective function
Due to change in blood vessels

Explanation :
Purulent inflammation is characterized by the production of pus, an exudate consisting of neutrophils, the liquefied debris of necrotic cells, and edema fluid. The most frequent cause of purulent (also called suppurative) inflammation is infection with bacteria that cause liquefactive tissue necrosis, such as staphylococci; these pathogens are referred to as pyogenic (pus-producing) bacteria.
A common example of an acute suppurative inflammation is acute appendicitis.

Explanation -
Preformed chemical mediators :
Histamine 
Serotonin
Lysosomal enzyme 

Explanation :
Causetive agents of pain in acute inflammation :
Prostaglandin 
Bradykinin
Increased K+
Decreased pH
Tissue reaction
5-HT/ serotonin

Leukocyte migration through endothelium is called diapedesis

Explanation :
C-reactive protein (CRP) is a protein made by the liver.
The level of CRP increases when there's inflammation in the body.
Synthesis upregulated by TNF.

Main source of TNF is macrophage

[Robbins 9th 90]

Explanation :
Source of serotonin in acute inflammation -
Platelet 
Neuroendocrine cell

Predominant acute inflammatory cell in first 24 hours is neutrophil

Explanation: In Pregnancy, old age and multiple myeloma, isolated elevation of ESR not CRP.

Explanation :
Effects of complement in acute inflammation :
Vasodilation 
Increased vascular permeability 
Phagocytosis
MAC
Chemotaxis
Leucocyte adhesion

Explanation 
Acute inflammatory oedema is due to -
Increased vascular permeability by endothelial cell contraction
Increased capillary hydrostatic pressure 
Breakdown of large molecules of tissue proteins
Increased fluidity of the tissue ground substance. 

[Robbins 9th 71]

Emigration of leukocyte to the site of injury is called chemotaxis

Cause of redness in acute inflammation is increase in blood flow

The process of coating a particle to target it for ingestion is called opsonization

Explanation :
Contraction of endothelial cells resulting in opening of interendothelial gaps is the most common mechanism of vascular leakage. It is elicited by histamine, bradykinin, leukotrienes, and other chemical mediators. 

Dominant leukocyte in pus is neutrophil

Arachidonic acid derived mediators are called eicosanoids