Chronic Inflammation

Question 1

What are the three ways that chronic inflammation can arise?

Answer 1

When it takes over from acute inflammation, when it arises without acute inflammation and it can be seen alongside and superimposed with acute inflammation

Question 2

Name the different cell types that can be seen in chronic inflammation.

Answer 2

Macrophages (giant cells), T and B lymphocytes, eosinophils, fibroblasts/Myofibroblasts.

Question 3

What are the different functions of macrophages?

Answer 3

Phagocytosis (less well than neutrophils), secretion of numerous substances, antigen presentation, induced fibrosis, and stimulation of angiogenesis.

Question 4

What is the primary cell of chronic inflammation?

Answer 4

Macrophages

Question 5

What are macrophages called in the bloodstream?

Answer 5

Monocytes

Question 6

What is the role of b lymphocytes?

Answer 6

Differentiate to produce plasma cells that create antibodies

Question 7

What are T lymphocytes involved in?

Answer 7

Control and some cytotoxic functions

Question 8

What immune responses are eosinophils involved in?

Answer 8

Some tumours, attacking parasites such as worms.

Question 9

What is the difference between fibroblasts and Myofibroblasts?

Answer 9

Myofibroblasts can contract.

Question 10

What do fibroblasts produce?

Answer 10

Collagen, elastin, and some glycosaminoglycans

Question 11

What is a giant cell?

Answer 11

When macrophages fuse together when certain infections are present, are large and contain lots of nuclei

Question 12

What are the three types of giant cell?

Answer 12

Langerhans giant cell, Foreign body giant cells, Touton giant cells

Question 13

Name two features of Langerhans giant cells.

Answer 13

Nuclei arranged around periphary of giant cell, often seen in TB.

Question 14

Name some features of touton giant cells.

Answer 14

Nuclei arranged in a ring towards the centre of the cell, form in lesions with high lipid content

Question 15

Name some features of foreign body giant cells.

Answer 15

Nuclei arranged randomly, large, if the foering body is phagocytosed it may be seen within it,

Question 16

Name some of the unwanted effects of chronic inflammation

Answer 16

Fibrosis, impaired function, artophy, stimulation of inapproiate immune response

Question 17

How can fibrosis lead to impaired function?

Answer 17

Excessive fibrosis can replace parenchymal tissue, and if the area of fibrosis contain Myofibroblasts these can contract and lead to further problems.

Question 18

Name some conditions where Chornic inflammation results in impaired function

Answer 18

Chronic inflammatory bowel disease, cirrhosis, gastric ulceration.

Question 19

Name a condition resulting from excessive fibrosis in chronic inflammation

Answer 19

Chornic cholecytosis and gastric ulceration

Question 20

Where may atrophy be seen as a result of Chornic inflammation

Answer 20

In the gastric mucosa

Question 21

What are the two different types of inflammatory bowel disease

Answer 21

Ulcerative collitis and crohns disease

Question 22

What is the difference between ulcerative collitis and crohns disease

Answer 22

Ulcerative collitis is superficial whereas chrons disease in transmural,

Question 23

How would patients suffering from inflammatory bowel disese present

Answer 23

With diarrhoea, rectal bleeding,

Question 24

Where may increased function as a result of chonric inflammation be seen?

Answer 24

Thyrotoxocysois (graves disease)

Question 25

What are some of the causes of cirrhosis?

Answer 25

Infection with HIV and HBV, alcohol and some drugs and toxins

Question 26

What are some of the features of rheumatoid arthritis?

Answer 26

Autoimmune disease, localised chronic inflammation leads to joint destruction.

Question 27

What is a Granulomatous infection?

Answer 27

A chornic inflammation with granuloms

Question 28

How does a granuloma form?

Answer 28

It is how the body deals with poorly soluble or difficult infection, so a granuloma forms around the particle whih can eb free or phagocytose in the centre, and it walls it off and concentrated mononuclear cells with which it hopes to destroy the particle.

Question 29

What are some of the microscopic features of granulomas?

Answer 29

Contain epitheloid cells, which are cells modified to look like epithelial cells, and have an eospinphilic cytoplasm and appear highly packed together.

Question 30

What are the two types of granulomas?

Answer 30

Foreign body granulomas and hypersensitivity or immune type granulomas.

Question 31

How do foreign body granulomas develop?

Answer 31

Around material that is not antigenic such as surgical thread.

Question 32

What cells do foreign body grnulomas contain?

Answer 32

macrophages, foreign body giant cells, eptholid cells and some fibroblasts.

Question 33

How do hypersensitivity granulomas develop?

Answer 33

Around insoluble but antigenic particles.

Question 34

What do hypersensitivity granulomas contain?

Answer 34

macrophages, giant cells, eptholid cells and lymphocytes

Question 35

Name some grnualmatous infections

Answer 35

Leprosy, syphilis, chornic fungal inefction, xathogranulomatus polynepitiis, sacrodosis and chrons disease

Question 36

Define chronic inflammation

Answer 36

Chronic response to injury with associated fibrosis