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a big ahh document med 1:
| Question | Answer |
|---|---|
| myelinated Aδ specialised nerve fibres | fast sharp, pricking acute pain (mainly mechanical) |
| unmyelinated C fibres | slow dull ache, polymodal (eg mechanical and thermal) |
| specific order of block in local anaesthetics | unmeylinated > small myelinated > large myelinated (pain blocked first) |
| possible outcomes of acute inflammation | resolution repair (fibrosis/ scarring) chronic inflammation abscess formation |
| resolution | replaced with original organised cells (all good all healed) |
| repair | restore some normal structure and function but leave some deficits (involves combination of regeneration and scar formation) |
| labile tissues | replicate throughout life (can resolve eg skin epithelia) |
| stable tissues | non dividing in normal circumstances but capable of regeneration in response to stimuli (capable of regeneration so can resolve or scar eg liver kidney lung etc) |
| permanent tissues | non dividing cells (always scar eg cardiac and skeletal myocytes) |
| example of complete resolution possible | bone after fracture and epithelium after superficial skin wound |
| resolution only occurs in damage to | parenchyma in labile or stable tissues |
| repair only occurs in damage to | parenchyma and stroma (or in brain/muscle) |
| resolution includes | remove damaging stimulus inflammatory cells, mediators and exudate replace injured cells by regeneration to fully restore function minimal absent evidence of damage |
| repair includes | replace damaged tissue with connective tissue formation of granulation tissue formation of scar tissue remodel for strength lacks functional capabilities of undamaged tissue |
| examples of anti inflammatory drugs | NSAIDs selective COX 2 inhibitors (COXIBS) steroids (glucocorticoids) |
| NSAIDs act on which pathway | COX pathway (stop AA acid to PGGs etc but do not stop the leukotriene pathway) |
| steroids act on what | phospholipase A2 (stop of pathway early at aa acid) |
| COX 1 (constitutive) | normally present + active in most cells involved in normal physiological function and generates housekeeping prostaglandins, COX 1 inhibition cause loss of protective effects |
| COX 2 (inducible) | not normally active in most cells so activated in response to inflammatory stimuli and generates pro inflammatory prostaglandins COX2 inhibition reduce inflammation |
| aspirin | non selective (risk of gastrointestinal side effects) |
| most COX 2 selective | celecoxib and etoricoxib |
| main effects of NSAIDs | antipyretic (reduces fever by lowering temp) ant inflammatory analgesic (reduces pain) |
| main side effects of anti inflammatory drugs | NSAIDs: GI disturbances, nephropathy COXIBS: Cardiovascular complications e.g., MI, stroke, hypertension Steroids: infection, hyperglycaemia, growth inhibition in children |
Created by:
kablooey
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