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A client with poor arterial circulation in the lower limbs has developed areas of inflammation and weeping clear serous exudate.
 
  Since chronic inflammation lasts for a long time, it has been associated with which of the following changes in physiological response? Select all that apply.
  A) Formation and development of new blood vessels
  B) The death of one or more cells in the body within a localized area
  C) Release of a number of potent inflammatory mediators, altering adhesive properties
  D) Regulation and modulation of the immune response through synthesis and release of inflammatory mediators
  E) Release of scavenger cells capable of engulfing bacteria through phagocytosis

Ans: A, B
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Chronic inflammation is of a longer duration, lasting for days to years, and is often associated with the proliferation of blood vessels (angiogenesis), tissue necrosis, and fibrosis (scarring). Endothelial cells are also key players in the inflammatory response. They regulate leukocyte extravasation by expression of adhesion molecules and receptor activation and contribute to the regulation and modulation of immune responses through synthesis and release of inflammatory mediators. Activated platelets also release a number of potent inflammatory mediators, thereby increasing vascular permeability and altering the chemotactic, adhesive, and proteolytic properties of the endothelial cells. Neutrophils are scavenger cells capable of engulfing bacteria and other cellular debris through phagocytosis.

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