Chronic Inflammation

Question 1

chronic differences vs acute

Answer 1

• mononuclear cells: macrophages, lymphocytes, and plasma cells
• tissue destruction vias inflammatory cell products
• repair: angiogenesis (new vessel proliferation) and fibrosis

Question 2

chronic inflammation settings

Answer 2

• persistent infection that are hard to rid
• immune-mediated inflammatory diseases (autoimmune and hypersensitivity diseases)
• prolonged exposure to toxic agents (silicosis in the lungs: long-term lung disease)

Question 3

what is persistent infection associated with

Answer 3

t-cell mediated hypersensitivity

Question 4

what does PPD test for

Answer 4

tests for tuberculosis

Question 5

tuberculosis

Answer 5

• chronic granulomatous condition
• tests positive for delayed (type IV) hypersensitivity and PPD

Question 6

macrophages in chronic inflammation

Answer 6

• ingest and eliminate microbes and dead tissues
• initiate process of tissue repair
• secrete mediators of inflammation
• display antigens to T lymphocytes

Question 7

lymphocytes in chronic inflammation

Answer 7

• activation of B and T lymphocytes in adaptive immune response
• CD4+ T cells secrete cytokines
• T helper cells: activate/recruit leukocytes

Question 8

eosinophils in chronic inflammation

Answer 8

• specific to parasitic infections and allergies
• granulocytes and phagocytes

Question 9

granulomatous inflammation

Answer 9

• specific type of chronic inflammation
• includes syphillis, sarcoidosis, tb, herpes, crohn’s, giant cell arthritis, and Wegner’s
• ocular relevance: iris nodules and keratic precipitates

Question 10

granulomatous conditions

Answer 10

• persistent T cell response
• immune-mediated conditions

Question 11

hilar adenopathy

Answer 11

• inflammation in lung lymph nodes
• used to confirm sarcoidosis

Question 12

granulomatous morphology

Answer 12

• epithelioid cells: activated macrophages that look like epithelial cells
• giant cells: fused, multi activated macrophages
• caseous necrosis: central “cheesy zone” in TB

Question 13

systemic effects of inflammation

Answer 13

• fever: caused by pyrogens releasing cytokines and synthesizing prostaglandins tricking hypothalamus increase temperature
• elevated levels of acute phase-proteins: CRP, fibrinogen, and serum amyloid A
• leukocytosis (increased WBCs): TNF/IL-1 increase release

Question 14

testing for non-specific inflammation

Answer 14

• CPR testing: 0.8-3.0 mg/L normally
• fibrinogen testing: ESR, upper norm for men age/2 and for women age+10/2

Question 15

Mast cells (basophils)

Answer 15

• in the tissue called sentinel cells, which are common in connective tissue

Question 16

Granulomatous keratic precipitates

Answer 16

Located in the back of the cornea and iris. Associated with uveitis and if seen need to be sent to PCP for testing of systemic disease