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chronic inflammation Flashcards

1
Q

define Inflammation

A

a protective response involving host cells and proteins

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2
Q

what is the purpose of inflammation

A

remove the cause of injury
remove necrosis
initiate repair

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3
Q

what are the major differences between acute and chronic inflammation

A

chronic inflammation has a slow onset (days), subtle signs (autoimmune disease symptoms and mimic diseases
severe prognosis.

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4
Q

what are the main immune cells involved in acute inflammation

A

neutrophils

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5
Q

what are the main immune cells involved in chronic inflammation

A

macrophages and lymphocytes and plasma cells.

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6
Q

what primary causes can cause chronic inflammation

A

infections, endogenous material, some autoimmune, exogenous material, primary granulomatous disease.

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7
Q

what infections causes chronic inflammation

A

TB, leprosy and some viruses.

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8
Q

what endogenous material cause chronic inflammation

A

necrotic adipose tissue, uric acid crystals

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9
Q

what Autoimmune conditions cause chronic inflammation

A

rheumatoid arthritis, SLE, pernicious anaemia

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10
Q

what is a granuloma

A

collections of inflammatory cells

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11
Q

what conditions which involve granulomatous form cause chronic inflammation

A

crohns, sarcoidosis

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12
Q

what inflammation due recurrent acute inflammation lead to

A

chronic inflammation

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13
Q

abscess form in acute inflammation and if they are deep enough the walls what do they for,

A

granulation and fibrous tissue

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14
Q

what are the main morphological features

A

infiltration with mononuclear cells (macrophages, lymphocytes and plasma cells)
tissue destruction
healing and fibrosis

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15
Q

what are the macroscopic features of chronic inflammation

A

fibrous tissue extends through wall
Chronic abscess cavity
Granulomatous

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16
Q

what are the microscopic features of acute inflammation

A

Cellular infiltrate of lymphocytes, plasma cells and macrophages.
Production of new fibrous tissue from granulation tissue.
Cells in the connective tissue include: macrophages, mast cells and plasma cells (immune cells).

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17
Q

what is the function of macrophages

A

engulf and digest cellular debris and microbes

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18
Q

what is another name for granulocyte

A

Polymorphonuclear leukocytes

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19
Q

what granulocyte produces histamine

A

basophil

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20
Q

what molecule do injured basophils release and what is the function of this molecule

A

release prostaglandins

and increase blood flow to the site of infection

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21
Q

what is the main function of eosinophils

A

good antigen presenting cells.

22
Q

what system are macrophages part of

A

reticuloendothelial system

23
Q

what are macrophages in the blood called

A

monocytes

24
Q

what is recruitment of macrophages

A

Macrophages already at sight of damage release cytokines which signal to monocytes
Monocytes enter damaged tissue from endothelium of blood vessel (leukocyte extravasion

25
Q

what is the main role of macrophages

A

phagocytosis of bacteria and damaged tissue- causes tissue injury

26
Q

what does low oxygen in inflamed tissue stimulate macrophages to do

A

induce angiogenesis, they also induce cells to re-epithelialise the wound and create granulation tissue.

27
Q

what are 2 examples of bacteria that macrophages cannot kill so it holds them instead

A

M. tuberculosis and M. leprae.

28
Q

what is granulation tissue made up from

A

Angiogenesis
Fibroblasts deposit collagen
Inflammatory cells

29
Q

where does granulation tissue begin to grow from - the base or the apex of the wound.

A

The base.

30
Q

define fibrosis

A

Formation of excess fibrous connective during repair of damaged tissue
Scarring

31
Q

define a granuloma

A

aggregate of epitheliod histocytes and other cells, lymphocytes and histocytic giant cells.

32
Q

define a histolytic giant cell

A

horseshoe arrangement of peripheral nuclei.

33
Q

define a foreign body giant cells

A

large cells with randomly scattered nuclei seen in relation to foreign body material.

34
Q

name 2 diseases which are granulomatous

A

TB and leprosy.

35
Q

when does histolytic giant cells form

A

where material is indigestible to macrophages
They’re multinucleate giant cells. May have >100 nuclei.
Develop when 2+ macrophages try to engulf the same particle

36
Q

Are histolytic giant cells phagocytic

A

No

37
Q

Examples of granulomatous diseases

A 
Bacterial = TB, leprosy
Parasitic = schistosomiasis
Fungal = cryptococcus
Synthetic materials = silicosis
Unknown = Sarcoidosis, crohn’s disease.
38
Q

can macrophages be considered the same as histiocytes when in tissues

A

Yes

39
Q

what organ does Tb typically effects and what it’s symptoms

A

Lungs

cough, haemoptysis, night sweats weight loss.

40
Q

what organs does leprosy effect and what are it’s symptoms

A

nerve, respiratory tract, skin and eyes, loss of pain sensation and subsequent injuries, weakness. Poor eyesight.

41
Q

define epithelioid histiocytes

A

large vesicular nuclei and eosinophilic cytoplasm (stain pink)

42
Q

define silicosis

A

occupational lung disease from inhaling silica dust, forms scarring and granulomas

43
Q

where do the granulomas form in silicosis and why is the the reason it is often mistaken for TB

A

upper lobes of lungs

this is where TB causes granulomas

44
Q

define sarcoidosis

A

granulomas form in multiple organs, often lungs and lymph nodes but anywhere can be affected, usually self limiting

45
Q

what are common symptoms of sacoidosis.

A

Fatigue weight loss joint aches and pains, cough, non specific symptoms.

46
Q

which condition has caseating granulomas and which condition has non caveating granulomas
TB and crohsn

A

crohns non caseating

TB caseating.

47
Q

what 2 factors stimulate granuloma formation in TB

A

Alveolar macrophages in lung release cytokines to recruit more macrophages.
Dendritic cells present antigens to T cells in lymph nodes to mount a T cell response.

48
Q

define caseating

A

there is necrosis, epithelioid macrophages surround necrotic region that has a T cell rim.

49
Q

what 2 cytokines are important in granuloma formation

A

TNF alpha and INF gamma

50
Q

what can be seen histologically in a granuloma

A

Langhans giant cell -lots of nuclei
Caseous necrosis
Epithelioid macophages

51
Q

what cells are involve in MS inflammation and where are they found

A

plasma cells and T lymphocytes are seen in white matter where macrophages break down myelin

52
Q

what 2 factors mainly predispose you to chronic inflammation and give and example for each

A

Persistence of Infection- H pylori.
Prolonged exposure to toxic agents-Autoimmune Disease
E.g rheumatoid arthritis, Systemic lupus- inflammation anywhere.

MOD (19 decks)

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