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Flashcards in Chronic fucking inflammation Deck (46):
1

what is chronic inflammation?

inflammation in which the cell population is especially:
-lymphocytes
-plasma cells
-macrophages
can lead to necrosis/tissue damage and loss of function

2

what is the end result of granulation tissue?

scarring and fibrosis - loss of normal tissue function

3

can chronic inflammation arise from ongoing acute inflammation?

yes

4

what is the clinical presentation of chronic inflammation?

pain often not specific
malaise and weight loss (TB)
loss of function (crohns disease, leprosy)

5

why would chronic inflammation arise from acute inflammation?

large volume of damage
inability to remove debris
acute inflammation fails to resolve and progresses

6

can chronic inflammation arise as a primary lesion only?

yes

7

what is organisation?

an outcome of acute inflammation that results in healing and repair via granulation tissue, leads to fibrosis and scar formation

8

what is the mechanism and function of granulation tissue?

ingrowth of capillaries into the inflammatory mass
allows access of plasma proteins
macrophages from blood and tissue
fibroblasts lay down collagen to repair damaged tissues
collagen replaces inflammatory exudate

this patches tissue defects and replaces dead or necrotic tissue

9

what are some products of granulation tissue?

fibrous tissue -scar

10

why can fibrosis cause a problem?

it can cause loss of function in organs
can progress to chronic inflammation

11

what is autoimmune disease?

autoantibodies directed against self cells and self tissue components - autoantigens

12

what are some effects of autoimmune disease?

damage or destroy organs, tissues, cells, cell components

13

what are some other causes of primary chronic inflammation?

material resistant to digestion
exogenous substances (sutures, metal etc, NO IMMUNE RESPONSE)
endogenous substances (necrotic tissues, keratin)
granulomatous inflammation (common)

14

what is the main role of the lymphocyte?

immune response and immune memory

15

what is the main role of the plasma cell?

antibody production
facilitation of immune response
immune memory
they act with macrophages (presents antigen to immune system)

16

what are some functions of T cells?

production of cytokines
production of interferons
damage and kill (lyse) other cells and destroy antigens

17

what do cytokines do?

attract and hold macrophages
activate macrophages
permeability

18

what is the function of NK cells?

destroy antigens and cells via granule proteins

19

what are the functions of macrophages?

remove debris
antigen presenting cells in the immune system
produced in the bone marrow and present in blood and tissues

20

what are some different types of macrophage?

monocyte
histiocyte
activated macrophage
epitheloid cell
giant cell

21

what are some characteristics of macrophages?

motile phagocyte
long lived
take over from neutrophils
contain enzyme
produce interferons and other chemicals
can influence the progression of chronic inflammation

22

what are some characteristics of fibroblasts?

motile
metabolically active
make and assemble structural proteins such as collagen

23

what are the outcomes of chronic inflammation?

ongoing tissue damage and destruction
insidious loss of function
cellular and stromal response (granulation tissue and angiogenesis)
scarring and fibrosis
granuloma formation

24

what is granulomatous inflammation?

characterised by presence of granulomas in tissues and organs

25

what stimulates granulomatous inflammation?

indigestible antigen

26

what are granulomas?

aggregates of epitheloid macrophages in tissue
may contain giant cells
contain neutrophils and eosinophils

27

what are granulomas a response to?

indigestible antigen

28

how is a giant cell formed?

fusion of macrophages
comprised of epitheliod histiocytes (macrophages)

29

when would you expect to see langhans type giant cells?

TB

30

what are some different classifications of giant cells?

langhans
foreign body type
warthin-finkeldy type

31

what are some examples of infectious granulomatous diseases?

TB
leprosy
syphilis

32

what is caseous necrosis?

dead tissue surrounded by macrophages, giant cells, lymphocytes

33

what are some examples of non infective granulomas?

rheumatoid disease
sarcoidosis
crohns disease

34

what are the phases of clinical wound healing?

phase of acute inflammation
granulation tissue formation
local angiogenesis
fibrosis and scar formation

35

how much granulation tissue would you expect to see in a wound that has been healed by primary intention?

small amount

36

what is healing by secondary intention?

method used for larger defects
lots of granulation tissue ingrowth
contraction and scarring

37

what is the sequence of healing by secondary intention?

injury, clot, acute inflammation, fibrin
granulation tissue ingrowth - angiogenesis
phagocytosis of fibrin
myofibroblasts move in and lay down collagen
contraction of scar
re-epithelialisation

38

what are factors that favour wound healing?

cleanliness
apposition of edges (no haematoma)
good nutrition
stable, normal metabolism
normal inflammatory and coagulation mechanisms

39

what are factors that impair wound healing?

dirty, gaping wound, large haematoma
poor nutrition
abnormal metabolism, corticosteroid therapy
inhibition of angiogenesis

40

what does granulation tissue in fracture healing contain along with fibroblasts?

osteoblasts

41

how is a callus formed?

osteoblasts lay down woven bone
nodules of cartilage present
bone remodelling follows

42

what are the steps in bone remodelling?

osteoclasts remove dead bone
progressive replacement of woven bone by lamellar bone
reformation of cortical and trabecular bone

43

what is angiogenesis?

formation of new vessels

44

what are the steps in angiogenesis?

capillary buds form
vascular endothelial growth factor released by hypoxic cells stimulates proliferation
enzyme secretion aids process

45

what does angiogenesis enable the blood supply to do in relation to damaged tissue?

allows the blood supply to enter it

46

how does angiogenesis present in the case of thrombosis?

limits thrombus propagation and re-instates flow.