chronic inflamm

Question 1

characterised by what 3 things

Answer 1

mononuclear cell infiltrations tissue destrcution repair involving angiogenesis and fibrosis

Question 2

inflammation + injury + healing can be thought of as what 2 things

Answer 2

unresolved acute inflammation OR primary chronic inflammation

Question 3

what is primary chronic inflammation

Answer 3

injury that involves chronic inflammation without an intial acute inflammatory response

Question 4

what are the 4 types of primary chronic inflammation and give the cause

Answer 4

Perisisent infection - caused by microbes that are difficult to eradicate or establish persisitent infection Immune mediated - caused by excessive or inappropriate immune respose to self antigens (autoimmune) - caused by excessive or inappropriate immune response of unkown origin Toxic agent - caused by endogenuous - caused by exogenenous Primary granunlomatos

Question 5

Chronic inflamm as a consequence of unresolved acute inlfammation

Answer 5

progression from an episode of acute inflammation the cause of the acute inflammation can persist there can be interference with normal healing recurrent episodes of acute inflammation

Question 6

differences between acute and chronic in terms of 1) duration 2) components involved

Answer 6

1) acute is very rapid onset, short duration chronic is insidious onset lasting days to years 2) acute uses neurophilic leukocyte accumulation chronic uses lymphocytes and macrophages

Question 7

what are the main cells involved in chronic

Answer 7

lymphocytes plasma monocyte/macrogpahes

Question 8

what role do eosinophils and mast cells play in chronic inflammation

Answer 8

Eosinophils  Parasitic infection and allergic reactions  Granules release major basic protein toxic to parasites and causes epithelial cell necrosis Mast Cells  Acute and chronic inflammation  Early vascular change in acute inflammation (histamine, leukotrienes)  Allergic reaction (IgE)

Question 9

what role do monocytes play in inflammation

Answer 9

Monocytes are immature mononuclear phagocytes recruited and differentiate into macrophages in response to inflammation

Question 10

what do tissue macrophages initiate

Answer 10

Tissue macrophages initiate acute inflammation Cytokines prolong inflammatory response leading to chronic inflamm

Question 11

Tissue macrophages 1) ingest and eliminate 2) initiate 3) display what 4) die or do what

Answer 11

1) ingest and eliminate microbes and dead tissues 2) initiate the process of tissue repair 3) display antigens to T lymphocytes an respond to signals from T cells 4) Die or wander off in the absence of inflammatory stimulus

Question 12

What are the 2 ways in which tissue macrophages can be activated

Answer 12

M1 and M2 M1 is classical activation by microbial products IFN-Y M2 is alternative activation by other cytokines (IL4 and IL I3) which plays principal role in tissue repair

Question 13

Lymphocytes

1) how are they mobilised
2) recruited into what?
3) B lymphocytes develop into what and secrete what?
4) CD4+ T lymphocytes become what?

Answer 13

1) mobilised by immune stimulus and infection and non infection mediated inflammation
2) recruited into peripheral tissues
3) b lymphocytes develop into plasma cells and secrete antibodies
4) CD4+ T lymphocytes becomes activated and secrete cytokines

Question 14

CD4+ T Lymphocytes

1) name the 3 types
2) name what each type secretes
3) name what each type activates
4) what do these activations defense against

Answer 14

1) TH1, TH2, TH17

TH1
- secretes IFNY, classical macrophage activation, defense against bacteria, viruses and autoimmune disease.

TH2
- secretes IL4, IL5, IL13. Alternative macrophage activation. Defense against helminthic parasites and allergic information

TH17
- Secretes IL17, Leukocyte recruitement

Question 15

Describe the macrophage lymphocyte interactions in chronic inflammation

so talk about the T lymphocytes involved, the macrophages and the mediators etc

Answer 15

Look at diagram

Macrophage > activated macrophage> t lymphocyte> activated t lymphocyte > macrophage etc

Question 16

What are the macroscopic appearances of chronic inflammations

Answer 16

Chronic ulcer, chronic abscess cavity, thickening of the wall of viscus, granulomatous inflammation, fibrosis

Question 17

tree for chronic inflammation

Answer 17

Diffuse and granulomatous

Under gran comes immune and foreign body

under immune comes caseating and noncaseating

Question 18

histological features of chronic inflamm

Answer 18

Infiltration of site by mononuclear cells such as macrophages, lymphocytes, plasma cells and eosinophils.

Tissue destrcution due to mediators, cytokines which are products of inflammatory cells

Repair due to proliferation of fibroblasts and endothelial cells

Fibrosis

Question 19

Histological features of peptic ulcer

Answer 19

Necrotic debris, Nonsepcific inflammation (neutrophils), Granulation tissue such as macrophages, endothelial cells and fibroblasts, then Scar(fibrosis)

So NIGS

Question 20

Granulomatous inflammation

1) aggregates of what cells?,with what appearance
2) What causes the answer from 1
3) describe fibroblasts and CT
4) describe necrosis

Answer 20

1) activated macrophages with epitheloid appearance which is large, pink, flat. Giant cells due to fusion of macrophages
2) T lymphocytes causes activation of macrophages
3) + or - in rim of fibroblasts and CT
4) +or- central zone of necrosis

Question 21

Granulomatous immune caseating

1) infection with
2) describe what is meant by caseous

Answer 21

1) tuberculosis, infection with myobacteriym tuberculosis
2) central mass of necrotic material, usually surrounded by other cells

Question 23

Non caseating granuloma is

1) what disease?
2) describe appearance

Answer 23

1) disease of unkown cause
2) collection of epithelioid and giant cells derived from macrophages cells, rimmed by T cells, fibroblasts

Question 24

Foreign body granuloma

1) too large to be what?
2) doesnt illicit any what?

Answer 24

1) too large to be phagocytosed
2) does noti illicit an inflammatory or specific immune response

Question 25

neoplasia is what?

Answer 25

new growth, cancer

Question 26

Central T cell tolerance

1) mutations in what give rise to human autoimmune disease

Answer 26

1) AIRE, transcription factor that induces exprssion of peripheral tissue antigens in the thymus

Question 27

Peripheral tolerance

1) T cells require how many signals for activation?
2) what are the 2 signals
3) what happens when the T cell encounters self antigen

Answer 27

1) 2 signals
2) recognition of peptie anitgen with self MHC. Binding of CD28 which is on th T cell TO the co stimulatory molecule B7 which is on the APC
3) The co stim molecule B7 is lacking on the APC OR T cell inhibitory receptor CTLA4 competes with CD28 for b7 LEADING TO ANERGY

Question 28

What is anergy

Answer 28

no response to anitgen

Question 29

how does peripheral supression tolerance work?

1) tolerance due to what?
2) express what two things?
3) how does answer from 1 work
4) secretion of what

Answer 29

1) tolerance due to regulatory lymphocytes Treg
2) express CD25 and transcription factor FoxP3
3) Treg cells recognise self antigen in the thymus and inhibit self reactive T cells that recognise the same anitgen in the periphery
4) Secretion of cytoknes that dampen T cell response

Question 30

How does delettion activation induced cell death

1) apoptosis of what
2) engagement of death receptor

Answer 30

1) apoptosis of mature lymphocyctes
2) engagement of death receptor Fas or expression of pro apoptotic members of Bcl family

Question 31

B cell tolerance is less effecient than what and why?

Answer 31

Less tolerance than T cell and relies upon efficient T cell tolerance and the lack of T helper cells specific for many self anitgen