MS II HOST DEFENSE CONFERENCE CELL INJURY AND INFLAMMATION

QUESTIONS FOR DISCUSSION

SCENARIO 1

1. WHY DOES THIS PATIENT HAVE LEUKOCYTOSIS?

2. WHY DOES THIS PATIENT HAVE A FEVER?
3. WHY DOES THIS PATIENT HAVE PAIN?
4. WOULD ASPIRIN HELP HER FEVER AND PAIN?
5. WHICH ARE THE CARDINAL SIGNS OF INFLAMMATION PRESENTED
HERE? WHAT ARE THE OTHER CARDINAL SIGNS OF INFLAMMATION?
6. WHAT CHEMICAL MEDIATORS ARE RESPONSIBLE FOR INCREASING
THE BLOOD FLOW (RUBOR) TO AN AREA OF INFLAMMATION?
7. WHAT IS CAUSING THE “TUMOR” OR SWELLING OF THE APPENDIX?
8. THE SURFACE OF THE APPENDIX IS NOT ONLY RED, BUT ALSO
SOMEWHAT SHAGGY. WHAT IS RESPONSIBLE FOR THE SHAGGY
APPEARANCE?
9. DESCRIBE THIS HISTIOLOGIC SECTION OF THE APPENDIX?
10. HOW DID THE NEUTROPHILS KNOW WHERE TO GO?
11. WHAT STEPS ARE INVOLVED IN THE EXIT OF NEUTROPHILS FROM
THE BLOOD INTO TISSUES?
12. ONCE THE NEUTROPHILS ARE THERE AND IN THE TISSUES, WHAT
NEXT?
13. WHAT MECHANISMS DO NEUTROPHILS USE TO KILL MICROBES
THAT AERE OXYGEN-INDEPENDENT?
14. DO YOU KNOW OF ANY DEFECTS IN NEUTROPHIL KILLING
MECHANISMS?

SCENARIO 2
1. DESCRIBE THE GROSS PICTURE OF THE LUNG?
2. DESCRIBE THIS LESION. WHAT TYPE OF NECROSIS IS IT? HOW
WOULD YOU PROVE THAT THIS PROCESS IS INFECTIOUS?
3. WHAT ARE THE DIFFERENT TYPES OF NECROSIS?
4. MATCH THE NECROSIS PATTERNS.
5. WHAT IS THE CAUSES OF CASEOUS NECROSIS?
6. WHAT CONSTITUTES A GRANULOMA? HOW IS IT FORMED? AND
HOW IS IT DIFFERENT FROM GRANULATION TISSUE?
7. WHAT IS THE DIFFERENCE BETWEEN CASEOUS AND COAGULATIVE
NECROSIS?
8. WHAT ARE THE CAUSES OF GRANULOMATOUS INFLAMMATION?

SCENARIO 3
1. DESCRIBE THE PHYSICAL FINDINGS IN THIS MAN. (2 SLIDES)
2. WHAT IS YOUR DIFFERENTIAL DIAGNOSIS?
3. DESCRIBE THE HISTIOLOGY OF THIS NORMAL LIVER SECTION.
4. DESCRIBE THE FINDINGS OF HIS INITIAL LIVER BIOPSY. IS THIS
CHRONIC INFLAMMATION?
5. WHAT ARE THE MAJOR CAUSES OF CHRONIC HEPATITIS?
6. WHAT IS TYPE OF CELL DEATH ARE THESE HEPATOCYTES
UNDERGOING?
7. MECHANISM GAME.
8. WHAT IS THE BLUE STAINING AND WHY IS IT OCCURING IN HIS
LIVER?
9. DESCRIBE THIS PORTION OF HIS BIOPSY. WHAT ARE THE CLEAR
VACUOLES MADE OF?
10. DESCRIBE THE APPEARRANCE OF THIS EXPLANT. WHAT DO YOU
THINK THE HISTOLOGY WILL SHOW?

SCENARIO 4
1. WHAT IS THE SIGNIFICANCE OF AN ABNORMAL NEUTROPHIL BURST
TEST (NBT)?
2. WHAT IS HIS DIAGNOSIS?
3. EXPLAIN THE MECHANISM BEHIND HIS DIAGNOSIS.
4. MATCH THE TEST WITH THE ABNORMALITY.
5. DESCRIBE THE LUNG BIOPSY? WHAT TYPE OF LESION IS THIS? HAVE
WE SEEN IT BEFORE?
6. WHAT TYPES OF TEST CAN WE DO TO PROVE THAT THIS LESION IS
INFECTIOUS?
7. WHAT ORGANISM IS THIS?
8. WHAT DOES HIS LIVER SHOW, DESCRIBE THE BIOPSY.