Acute/Chronic Inflammation

Question 1

when an injury occurs there is acute inflammation - what type of cells are characteristically present here first

Answer 1

neutrophil polymorph (lobed nuclei)

Question 2

what are the physical characteristics of acute inflammation

Answer 2

rubor, calor, tumor, dolor (redness, heat, swelling, pain) and functio laesa (loss of function)

Question 3

what are the three steps of acute inflammation

Answer 3

change sin vessel calibre
formation of fluid exudate
formation of cellular exude

Question 4

what changes occur in vessel calibre

Answer 4

initial vasoconstriction then vasodilation (increases blood to site 10x) - mediated by histamine and NO

Question 5

what happens during formation of fluid exudate

Answer 5

vessels become permeable - protein rich fluid enters tissue

diluts toxins, entry of antibodies, formation of fibrin, nutrients and O2 delivery

Question 6

what happens during cellular exudate

Answer 6

loss of fluid into tissue = slower blood flow and increased viscosity - neutrophils flow near endothelium
marginisation then adhesion and cells migrate into exudate via chemotaxis (eg neutrophils)

Question 7

what is the pus at wound sites

Answer 7

neutrophils

Question 8

what are the general vs harmful effects of acute inflammation

Answer 8

general - pyrexia, lymph node enlargement, nausea

harmful = swelling - obstruction, abscess formation, excess fibrin (dangerous in heart)

Question 9

what are the 4 outcomes of acute inflammation

Answer 9

usual result
excess exudate - suppuration
excessive necrosis - repair and organisation
persistent causal agent - chronic inflammation (lead to fibrosis)

Question 10

what are some causes of chronic inflammation

Answer 10

recurrent acute inflammation
persistent infection causing the inflammation
prolonged exposure to potentially toxic agents
autoimmune condition or unknown reasons

Question 11

what happens to the exudate in chronic inflammation

Answer 11

neutrophils decline - mast cells fibroblasts macrophages and lymphocytes all increase
matrix becomes dense with proteoglycans, collagen and elastin

Question 12

what is the role of macrophages during chronic inflammation

Answer 12

release chemokine which induce angiogenesis and adaptive immunity
activate fibroblast which increase collagen produced
this overall produces granulation tissue and scar

Question 13

what are the main differences between acute and chronic inflammation

Answer 13

A vs C
innate vs adaptive
hours days vs weeks months years
fluid exudate rich in protein vs angiogenesis and fibrosis
neutrophils vs macrophages, lymphocytes mast cells and fibroblasts
RCTD vs chacexia, anaemia of chronic disease

Question 14

what is the mechanism of garnulomatoumous inflammation

Answer 14

chronic inflammation

macrophages try to destroy material and can’t so aggregate to from langerhans type giant cells

clump with epitheliod macrophages - surrounded by lymphocytes and fibroblasts producing collagen

Question 15

what is the risk with granuloma formation in chronic inflammation

Answer 15

caseating (undergoing caseous necrosis in the centre) or non-caseating

Question 16

which diseases are associated with chronic infection and caseous necrosis occur

Answer 16

bacterial infections - TB, leprosy, syphillis 
parasitic infections (schistosomiasis)
fungal infection (crytpococcus) 
silicosis 
UC or sarcoidosis