 Hello everybody. Welcome back Andrea here. So let's go through our general pathology quiz. We'll be going through these questions and the answers why the correct answer is the most correct and Rationals behind it. So number one, what is the first cardinal sign of inflammation? The first sign is redness. So if you guys go in your oral pathology notes textbook, however, you want to do it You will notice there's these different signs of inflammation. So if they're present Whether it be one or all of them that is a sign of inflammation in the real world It's more so, you know, if a client comes in and they have swelling on their cheek. Well, that's not normal You can even say to them. Well, you have signs of inflammation Swelling is not normal in the dental office if a client comes in and is calling about an Emergency, their tooth really hurts. The receptionist will likely ask them these things. Do you notice any redness? Heat, swelling, pain. Those are signs of inflammation and an anti-inflammatory May have to be given or antibiotics, but that's a whole nother story for another day So this is where the cardinal signs of inflammation come from. Redness is the first sign They love to ask this on the exam because they want you to know that So redness is the only answer in this case because it's the first sign This is something you would have had to memorize So you can't always just know the signs of inflammation You have to memorize those stages and those steps. Redness is the first sign Now does anybody remember the second sign of inflammation? In fact, I even have to check my notes here because as a dental hygienist This isn't something where we talk about often. Oh, did you know that redness is the first sign? This is the second sign. This is the third. So the first sign, like I said, obviously is redness. The second is the tumor Three is heat and four is pain. So that was easy So these are what you have to know. Another sign of inflammation just so you know is loss of Function. Now that isn't in all of the textbooks, but it's in the newer oral pathology textbooks So you do need to know there's another sign of inflammation and that is loss of function Okay, next one. What is the first cell to? Immigrate to the site of injury so neutrophils are that first cell Meaning neutrophils will be there prominently there that cell That's their most if that makes sense. There are many cells involved but you need to know that that one is the first one there and The most of if that makes sense. So again, you guys, I'm just checking my notes in case you're wondering what I'm doing Just so I don't forget to mention a couple things to you. So D is the best answer. Okay, so just so you guys know hopefully you did figure this out but B for acute that is not a cell Now, do you guys remember what acute would be part of and another Type is chronic acute and chronic Talking about general pathology. So we're not talking about acute or chronic gingivitis or periopurse but just we're talking about general pathology so things can be acute or chronic and Inflammation in general pathology, it means the types of inflammation So is that inflammation acute or is it chronic? So B would not be correct because that's not a cell a C and D are Cells so any of those could have been the correct answer, but we want the first cell So pick out the keyword that would be the neutrophil. So if you guys are kind of I Guess looking through this and thinking oh, I don't remember what the second cell would be or the third cell Definitely restudy this in your general pathology unit. Okay, very very important a quick overview I left some notes for myself here is neutrophils are involved in acute Inflammation, okay, so not chronic, but they're involved in acute Different cells are for different types of inflammation either chronic or acute the second cell Which is the most prominent other than the neutrophil would be the monocyte or the macrophage So you do need to know the different sites I talked about that more in a couple other questions. So I'm not going to go too far into it. Yeah, anyway Number three, what is another cell that emigrates first to the site of injury other than neutrophils? So see how this question might kind of Make you think a little bit because remember how I just mentioned Neutrophils is the first cell the second cell. Do you guys remember what I just said? Do you guys remember? Monocytes or macrophages, but guess what number three is not asking you what the second cell is It's asking you what the other cell is First to the site of injury. So we already established that neutrophils are first. So what's another cell the P? M ends. So this is the correct answer Polly Molecular. Oh gosh, let me check my notes again. See guys. I'm only human too Polymorpho Nuclear leukocyte if you're looking for perfect pronunciations, it's not going to be me In fact, you're all probably laughing at me trying to pronounce that word right now Let's try it again here polymorpho nuclear leukocyte. Oh, that wasn't so bad So that is the other cell that comes first to the site of injury So definitely know this know your sites of I'm sorry know which cells are Starting with inflammation going to that site of injury It's kind of fun to know for the the real world too, you know When you get to talking about gingivitis and perio you can talk about things like It's almost like getting a cut on your arm, you know those neutrophils will start to come first to try to Heal that cut. It's like gingivitis It's like perio where certain cells try to come first to really help to heal But that's why I'm suggesting three month recares three month scalings I should say to clean the teeth because those neutrophils will keep coming back, you know things like that, right? We'll talk about that more in another Topic probably our gingivitis and perio unit, but you get the idea so but for any exam You don't really have to worry about the real world too much I help you guys with that at a later stage So that's why it be is the best answer because that's the only other cell That's with the neutrophils to go to that site of injury first, but then look you guys We have plasma cells. We have lymphocytes and we have phagocytosis Okay, so those are different ones Those are just kind of different cells that I talked about in a little bit I'm not going to go through it too much yet. Just because I will be asking some more questions on that Okay, guys number four What cell is involved in both acute and chronic? Inflammatory reaction so remember how I mentioned before the two of the different types are acute and chronic inflammation, right? so All of these cells are different cells So you would have to know okay, which ones are for acute which ones are for chronic and which ones are for both So I mentioned this to my students all the time, but even as you're going through mock exams Let's say you knew that mass cells was the right answer because you remembered studying that that's involved in both chronic and acute Inflammation, but what about lymphocytes? Do you remember what type of inflammation that is? What about plasma cells? So don't just know the right answer and then move on look at the other answers too and say to yourself lymphocytes darn What was that involved in again or? acute or chronic inflammation if you don't know look it up that's Focused studying and the best type of studying you can do because you'll be kicking yourself if on the exam They ask you What cell is involved in chronic inflammation and lymphocytes is part of the answer But you're like, oh shoot I don't remember what that cell was if you took the time to look it up You will remember it so much easier But you might not have known to look it up unless you had seen this mock exam questions So see how mock exam questions are so important and so helpful. I don't just do it to annoy everybody I do it to really help you. Okay, so lymphocyte. So this is both chronic and immune response So there's different types. It's not involved in acute, but it's involved mostly of chronic So I'm not gonna give you the answers for all of them unless you guys want me to I suppose Should I what do you think? Okay, so I will so math cells we talked about it. This is for acute and chronic Sorry guys, just double checking my notes here Plasma cells I just kind of threw that in there for now That goes ahead with lymphocytes. Okay, so lymphocytes and plasma cells are more so for chronic and immune response The PN sorry PMN Do you guys remember what that is the polymorpho nuclear? Leucocyte, do you guys remember so this would be acute? Inflammation and going back to what we learned Neutrophils and PMNs are the first cells that go to that site of injury and Remember what I just said about PMN PMNs as well. It's involved in acute Inflammation so this is another way to kind of study go. Oh, I've just talked about PMNs What was that in the last question again? I get excited about mock exams, but maybe that's because I'm a teacher and I know the answer So I understand that you guys might not be as excited as I am, but this is truly the best way to help you study Number five. What does stasis stasis? Refer to this is concentration of the red blood cells in small vessels WBC Refers to white blood cells in case you didn't know I'm assuming you did But I just kind of always like to mention that as well. Now. Does anybody have any questions about this one so far now? sepsis I put this in here because I suspect a lot of you will look at stasis and Think I'm referring to sepsis. That's different. So sepsis is a Systemic, you know something that's happening. Not a good thing, you know, your body can go into shock so to speak not good But stasis is different. So specifically the concentration of the red blood cells in small vessels The bacteria infection I literally just threw that in there just to kind of confuse you guys So don't worry about that that really has nothing to do with the question I'm just trying to find my notes everybody. Sorry. Let's see Where did I put that I did want to talk about stasis a little bit more, but it's amazing how You kind of lose your spot for a second. Okay. Here it is. So So just pretty much if you guys didn't know this stasis refers to the blood I mean, I'm sure you guys knew that because it does say concentration of the red blood cells in small vessels But that's basically what it is it's in the small vessels and increased viscosity of Blood that's Basically what that is. Okay. So they talk about this when they're talking about the different cells How they go to the site of injury and kind of how that works Okay, I talk more about the white blood cells in a little bit So I don't want to go through it too much yet But I want you guys to really think about a different term too So this is where they're starting to talk about where the cells are going and how they're traveling So I also just want to make a note of think about leukocytes. Do you guys remember the term? Pavementing Leucocytes and pavementing so also talking about those cells and where they're going This just basically means that those leukocytes are attaching to the endothelium And they will soon migrate Through the wall into the tissues. So just kind of think about how all of that works together But let's move on to the to the next question and then I do talk about it a little bit more So number six, how long do you neutrophils predominate during the first stages of inflammation? So remember neutrophils and PMNs are first cells to the site of injury But guess what? Do you know how long neutrophils are there in the majority of the numbers? It's actually six to 24 hours. That's a long time So you do need to know the different lengths of times as well. Just as a little side note Neutrophils are replaced by monocytes in 24 to 48 hours. Do you guys remember monocytes? That's the second cell that goes to the site of injury So the first ones are the neutrophils and the PMNs six to 24 hours that takes and then what did I just say and Then monocytes come in after 24 hours 24 hours to 48 hours So you do need you do need to know the different timings Okay, what is chemotaxis? So chemotaxis is the chemical attraction of leukocytes to immigrate in tissues So you do need to know all of that Please look at all of these terms and know what they are So it's not always good enough to just know the correct answer I want you guys to look at all of the other answers to and say do I know these ones? This is focused studying and this is how I will get you to pass. I've been doing this now for 15 years I know what I'm doing trust me on this Okay, take the time to go through all of these questions, but because I'm nice I'm gonna tell you guys what they are So I left myself notes because as a dental hygienist, this isn't something you talk about in the real world So do you guys remember those cells attaching to host receptors what that involves? Do you guys remember? So hopefully everybody's kind of confused, right? So we weren't really talking about this and this isn't something that's involved in the other definitions Do you remember? Fagocytes so they eat things up But it has nothing to do with kind of all of this So sometimes and I did this on purpose because sometimes the board exam or any exam will try to trick you So, please keep that in mind now see so neutrophils PMNs are the first cells and then the cells are now Monocytes after 24 hours Next one after phagocytosis What undergoes cell death and are ingested by macrophages? So the correct answer is Neutrophils so remember up here how I kind of said eating of a bad waste cells So you could kind of say that phagocytosis has to do something with that Okay, so hopefully when you were looking at this you're kind of thinking okay So bad cells kind of sounds familiar cells are dying phagocytes phagocytosis. That's a good way of thinking Okay, but back to number eight here. So this is just something this is the best answer The other ones don't really apply to be honest Phagocytes might but that's just not the right answer because imagine how that would sound so after phagocytosis Phagocytes undergo cell death It just doesn't make sense But of course if you had no idea what the answer was you might pick phagocytes because it looks right So this is where you really have to think about things like that Okay, and I'll say it again. Sorry if I sound like a broken record Neutrophils. Oh, sorry, which I just realized I spoke that wrong Neutro let me fix that neutrophils the first cells and then Macrophages are after that, but where are those neutrophils gonna go? Well, the cells die off after they've done their job to that site of injury the cells die off What is normal white blood cell count in the blood? This is always on the exam. Oh my goodness. Like can you tell? 4,000 to 10,000 is just simply normal if it's more than obviously 10,000 That's a lot that's like too much and when you have too many white blood cells You have to kind of think What's going on the body is trying to fight itself Which I think I did actually ask that in the next question. Sorry, I should have stopped myself but so obviously more than 10,000 would be a lot but 40,000 okay, something's really going on. There's something really bad Okay, so white blood cells is our our body's way of trying to heal itself But when there's too many there, that's not good I mean, it's good because it's trying to heal us, but it means something's bad like something's going on Okay, when do fibroblasts begin to form after injury? What do you guys think? Think about it So you do have to know things like You know the different days the different hours I'll be honest. I kind of just threw a bunch of things in here But fibroblasts begin to form three to five days after injury. So you do need to know the different things like Which cell form when does that make sense definitely something to know And I just made a couple notes here for you guys. So Always think site of injury. What's happening? What sells first? So neutrophils and PMNs are first Remember that can take up to 24 hours and after 24 hours you have the macrophages And think about all of the other cells. So fibroblasts three to five days. Well, what's happening? Before that so always think try to connect the dots. So I just left myself some notes here So within 24 to 48 hours. So remember those are now the macrophages That is when a scab starts to form starts to close the wound Within three days As I had kind of mentioned Neutrophils are replaced by macrophages. Notice how it says within three days. So it's after 24 hours But within three days, there's no longer neutrophils. Those cells die off. They're getting eaten basically And then the macrophages form After that by day five the Wound is filled with scar tissue And it's kind of made a note for that During week two This is when the proliferation of collagen and fibroblasts continue But the fibroblasts were obviously happening before then as well By week four, there's a very obvious scar. So kind of know things like that. Okay, and a quick side note Tissues often recover approximately seven to eighty percent of their strength Over three months period compared with intact skin. So skin and tissue is different the way things heal Is a bit different as well Okay, so next one. So within how many days are neutrophils replaced by macrophages So I did mention that were you guys paying attention? So it's three days neutrophils are first with the pm n's and then the macrophages after 24 hours But within what time frame? Okay, guys, so I hope this helped let me know of any questions And keep checking back for more mock exams, and I'll see you guys in the next video