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Path Pro 2023 > Chronic Inflammation > Flashcards

Chronic Inflammation Flashcards

1
Q

What is chronic inflammation?

A

prolonged inflammation with associated repair

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2
Q

Features of chronic inflammation

A 
delayed
variable duration
variable appearance
limits damage, initiate repair
cause debilitating symptoms
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3
Q

when can chronic inflammation arise?

A 
After acute (if resolution not possible)
Alongside acute (persistent irritiation)
De novo (by itself, eg. autoimmune conditions)
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4
Q

cells present in chronic inflammation

A 
macrophage
lymphocyte (B and T)
plasma cells
Eosinophils
fibroblasts/myofibroblasts 
giant cells
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5
Q

macrophage name change

A

in blood - monocyte

in tissue - macrophage

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6
Q

macrophage appearance

A

large
lots of foamy cytoplasm
slipper shaped nucleus? (indented)

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7
Q

macrophage function

A

phagocytosis (remove pathogen/debris)
produce inflammatory mediators
antigen presentation

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8
Q

Lymphocyte appearance

A

small (similar little larger than RBC)
spherical nucleus
thin cytoplasm

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9
Q

T cell function

A

helper - assists other inflammatory cells

cytotoxic - destroy pathogens

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10
Q

B cell function

A

mature into plasma cells

produce antibodies

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11
Q

plasma cell appearance

A 
eccentric nucleus (to one side)
nucleus: clock face clumped chromatin (around outside)
peri nuclear clearing (lighter patch around nucleus = golgi for antibodies)
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12
Q

plasma cell function

A

produce antibodies - its a mature B cell

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13
Q

Eosinophil appearance

A

bilobed nucleus
granular pink staining cytoplasm

tomato with sunglasses

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14
Q

eosinophil function

A 
release mediators (granular cytoplasm)
Hypersensitivity reactions (allergies and asthma)
Parasitic (worm) infections
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15
Q

giant cells

A

fused macrophage

same cytoplasm, multinucleated

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16
Q

why do giant cells form?

A

when one macrophage cannot destroy pathogen alone

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17
Q

3 types of giant cells

A

foreign body
Langhan
Touton

18
Q

foreign body giant cells

A

random nuclei distribution

surround foreign body

19
Q

Langhans giant cell

A

usually tuberculosis
Nuclei is arranged around periphery
horse shoe nuclei pattern

20
Q

Touton giant cell

A

Central organised nuclei

fat necrosis

21
Q

What can cells in chronic inflammation indicate?

A

proportion of cells can indicate diagnosis

22
Q

diagnosis for lots of plasma cells

A

Rheumatoid arthritis

23
Q

Diagnosis for lots of lymphocytes

A

chronic gastritis

24
Q

Diagnosis for lots of macrophages

A

Protozoal infection (Leishmaniasis)

25
Q

effects of chronic inflammation

A

Fibrosis (collagen deposition)
Impaired function (rarely increased eg Graves)
Atrophy
Stimulation of immune response

26
Q

Cholelithiasis

A

Repeated obstruction of bile duct from gall stones
Fibrosis (thickened and pale wall of gall bladder)
Repeated bouts of acute inflammation then becomes chronic

27
Q

how does fibrosis appear H&E?

A

pale pin linear strands

28
Q

Idiopathic inflammatory bowel disease effects and names

A 
Crohns disease or Ulcerative colitis 
red and inflamed 
abdominal pain
altered bowel motion 
weight loss
rectal bleeding
29
Q

Crohns disease features

A

Can affect all of GI
Discontinuous inflammation (skip lesions)
Inflammation affects full thickness (transmural) - can cause strictures (narrowing) or fistulae (connect to other tissues)
Granulomata
Less likely rectal bleeding

30
Q

Ulcerative Colitis features

A 
Only affects large bowel
Continuous inflammation
Only affects superficial bowel (mucosa and submucosa)
No granulomata 
More likely rectal bleeding
31
Q

Cirrhosis

A

End stage liver damage

Fibrosis (pale areas) with attempted regeneration (nodules)

32
Q

causes of cirrhosis

A

alcohol
hepatitis
drugs/toxins
fatty liver disease

33
Q

what is granulomatous inflammation?

A

Chronic inflammation with granuloma

34
Q

what is a granuloma?

A

collection of epithelioid histiocytes

with surrounding lymphocytes

35
Q

what is a epithelioid histiocyte?

A

Macrophages that looks like an epithelial cell

light pink and packed

36
Q

types of granuloma

A

Foreign body

Immune mediated

37
Q

Foreign body granuloma

A

destruction and removal of foreign material (surgical thread, implant, shrapnel)
few lymphocytes

38
Q

Immune mediated granuloma

A

Destruction and removal of pathogens (bacteria/fungi)
Central necrosis can occur
can be idiopathic
MANY lymphocytes

39
Q

Infections that often cause granuloma and why

A

Mycobacterium (mycobacterium tuberculosis, mycobacterium leprae)

Difficult destroy due to thick cell wall and mycolic acids (proteins on surface)

40
Q

Specific features of mycobacterium granuloma

A

Epithelioid histiocytes
Central caseous necrosis
Many lymphocytes

41
Q

Causes of granulomatous inflammation

A

Crohns (non caseating)

Sarcoidosis (non caseating) - lungs, skin and lymph
can cause nodules on skin, enlarged lymph nodes and breathlessness

Path Pro 2023 (21 decks)

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