INFLAMMATION

Acute inflammation is the bodys stereotypical response to tissue

injury. It is characterised by:
Heat, pain, redness, swelling (calor, dolor, rubor, tumor)
+/- loss of function (functio laesa)
+/- secretions
Chronic inflammation is present where there is active inflammation,
tissue injury and healing at the same time. It is defined by the cells
types present (macrophages and lymphocytes) and typically has a
longer time course than acute inflammation
A granuloma is a collection of epithelioid macrophages.
Granulomatous inflammation is a form of chronic inflammation
characterized by the presence of epithelioid macrophages, called
such as they resemble epithelial cells. These can fuse to form
multinucleate giant cells (Langhans cells) which are sometimes
present in granulomatous inflammation. It can be classified as
caseating (e.g. TB) or non-caseating (e.g. sarcoidosis, Crohns disease)



ASCITES

Ascites is the abnormal accumulation of fluid in the peritoneal cavity
Causes can be split into transudates or exudates. Transudate is
defined as protein content 30g/L. Another commonly used criteria is
the SAAG (Serum-Ascites Albumin Gradient): A high gradient (>1.1
g/dL) indicates the ascites is due to portal hypertension. A low
gradient (<1.1 g/dL) is suggestive of ascites of non-portal
hypertensive aetiology.
These can be split up into those with portal hypertension and those
with hypoalbuminaemia:
Increased portal venous pressure:
Cirrhosis
Right sided cardiac failure
Constrictive pericarditis
Budd Chiari syndrome (occlusion of hepatic veins)
Thoracic duct obstruction
Plasma oncotic changes due to hypoalbuminaemia:
Liver failure
Protein losing enteropathy
Starvation or cachexia
Nephritic and nephrotic syndromes
Renal failure
Causes of ascites classified as exudates:
The main examples are inflammatory causes: these result in protein
leakage
(the 4 Ps)
Peritonitis: bacterial or tuberculosis
Post-irradiation
Peritoneal metastases
Pancreatitis


ATHEROSCLEROSIS

Atherosclerosis is a pathological process of the vasculature in which
an artery wall thickens as a result of the accumulation of fatty
materials such as cholesterol.
Atherosclerosis begins with endothelial dysfunction, resulting in
migration of macrophages, some of which form foam cells and a
lipid core. There is migration of vascular smooth muscle cells to form
a fibrous cap. This process ultimately results in stenosis of the vessel
and rupture of the cap can lead to thrombosis and possible
infarction of the supplied tissue.
Risk factors for atherosclerosis include:
Smoking
Hypertension
Diabetes mellitus types 1 and 2
Family history of atherosclerotic disease
Increased cholesterol (in particular, increased LDL and decreased
HDL)
It can affect:
The aorta
Coronary arteries
Carotid arteries and cerebral vasculature
Popliteal and lower limb vasculature