Flashcards in Chronic Inflammation 2 Deck (27):
1
What is granulomatous inflammation characterised by?
presence of granulomas in tissues and organ
2
What is granulomatous tissue stimulated by?
indigestible antigen that the body cannot get rid of
3
What does granulomatous inflammation cause?
many serious infections and idiopathic diseases
4
What are granulomas?
-aggregates of epithelioid macrophages in tissues
-may contain giant cells
-may surround dead material
-may be surrounded by lymphocytes
-contain neutrophils, eosinophils
-response to indigestible antigen
-many are type IV hypersensitivity reactions
5
What are giant cells?
-the fusion of macrophages to form larger cells
-large cytoplasm: multiple nuclei
6
What are Langhans type cells?
-classically found in TB
-peripheral rim of nuclei
-large eosinophilic cytoplasm
7
Describe foreign bodies in granulomatous tissue?
-often associated with pyogenic granulation tissue
-acutely inflamed
-neutrophils, pus
-organisation
-giant cells
8
What can vacuoles containing silicone arise from?
ruptured silicone implants
9
When are Warthin-Finkeldy rarely seen?
in measles
10
What are 3 examples of granulomatous diseases?
-Tuberculosis
-Leprosy
-Syphilis
11
What is caseous necrosis?
dead tissue surrounded by macrophages, giant cells, lymphocytes
12
What drug combination kills the pathogen that causes leprosy?
-dapson
-rifampicin
-clofazimine
13
What are 3 examples of condition that involve non-infective granulomas?
-rheumatoid disease
-sarcoidosis
-Crohn's disease
14
Describe the basic mechanism of wound healing?
-phase of acute inflammation
-granulations tissue formation
-local angiogenesis
-fibrosis and scar formation
15
Describe surgical wound healing?
-healing by primary intention
-minimal gap-blood clot forms
-small amount of granulation tissue
-small linear scar
16
Describe healing of larger defects?
-healing by secondary intention
-lots of granulation tissue ingrowth
-contraction and scarring
17
What is the sequence of events from wound to repair?
-injury, blood clot, acute inflammation, fibrin
-many growth factors and cytokines involved
-granulation tissue growth- angiogenesis
-phagocytosis of fibrin
-myofibroblasts move in and lay down collagen
-contraction of scar
-re-epithelialisation
18
What improves wound healing?
-cleanliness
-apposition of edges
-sound nutrition
-metabolic stability and normality
-normal inflammatory and coagulation mechanisms
-local mediator involvement
19
What impairs wound healing?
-dirty,gaping wound with large hematoma
-poorly nourished, lack of vitamin C,A
-abnormal CHO metabolism, diabetes, corticosteroid therapy
-inhibition of angiogenesis
20
How does fracture healing differ from wound healing?
It is a modified situation in bone as there has to be repair of bony structure as well as soft tissue
21
Describe the sequence of events in fracture healing?
-trauma, fracture, hematoma
-bits of dead bone and soft tissue
-acute inflammation, organisation, granulation tissue, macrophages remove debris
-granulation tissue contains osteoblasts as well as fibroblasts
22
Describe callus formation.
-osteoblasts lay down woven bone
-nodules of cartilage present
-followed by bone remodelling
23
What does bone remodelling involve?
-osteoclasts remove dead bone
-progressive replacement of woven bone by lamellar bone
-reformation of cortical and trabecular bone
24
What stimulates proliferation in angiogenesis?
VEGF released by hypoxic cells
25
What does angiogenesis and organisation in thrombosis do?
-limits thrombus propagation
-reinstatement of flow
26
What role does angiogenesis play in malignant tumours?
-angiogenesis occurs as tumour grows
-potential for therapeutic control
27