chronic inflammation

Question 1

define Inflammation

Answer 1

a protective response involving host cells and proteins

Question 2

what is the purpose of inflammation

Answer 2

remove the cause of injury
remove necrosis
initiate repair

Question 3

what are the major differences between acute and chronic inflammation

Answer 3

chronic inflammation has a slow onset (days), subtle signs (autoimmune disease symptoms and mimic diseases
severe prognosis.

Question 4

what are the main immune cells involved in acute inflammation

Answer 4

neutrophils

Question 5

what are the main immune cells involved in chronic inflammation

Answer 5

macrophages and lymphocytes and plasma cells.

Question 6

what primary causes can cause chronic inflammation

Answer 6

infections, endogenous material, some autoimmune, exogenous material, primary granulomatous disease.

Question 7

what infections causes chronic inflammation

Answer 7

TB, leprosy and some viruses.

Question 8

what endogenous material cause chronic inflammation

Answer 8

necrotic adipose tissue, uric acid crystals

Question 9

what Autoimmune conditions cause chronic inflammation

Answer 9

rheumatoid arthritis, SLE, pernicious anaemia

Question 10

what is a granuloma

Answer 10

collections of inflammatory cells

Question 11

what conditions which involve granulomatous form cause chronic inflammation

Answer 11

crohns, sarcoidosis

Question 12

what inflammation due recurrent acute inflammation lead to

Answer 12

chronic inflammation

Question 13

abscess form in acute inflammation and if they are deep enough the walls what do they for,

Answer 13

granulation and fibrous tissue

Question 14

what are the main morphological features

Answer 14

infiltration with mononuclear cells (macrophages, lymphocytes and plasma cells)
tissue destruction
healing and fibrosis

Question 15

what are the macroscopic features of chronic inflammation

Answer 15

fibrous tissue extends through wall
Chronic abscess cavity
Granulomatous

Question 16

what are the microscopic features of acute inflammation

Answer 16

Cellular infiltrate of lymphocytes, plasma cells and macrophages.
Production of new fibrous tissue from granulation tissue.
Cells in the connective tissue include: macrophages, mast cells and plasma cells (immune cells).

Question 17

what is the function of macrophages

Answer 17

engulf and digest cellular debris and microbes

Question 18

what is another name for granulocyte

Answer 18

Polymorphonuclear leukocytes

Question 19

what granulocyte produces histamine

Answer 19

basophil

Question 20

what molecule do injured basophils release and what is the function of this molecule

Answer 20

release prostaglandins

and increase blood flow to the site of infection

Question 21

what is the main function of eosinophils

Answer 21

good antigen presenting cells.

Question 22

what system are macrophages part of

Answer 22

reticuloendothelial system

Question 23

what are macrophages in the blood called

Answer 23

monocytes

Question 24

what is recruitment of macrophages

Answer 24

Macrophages already at sight of damage release cytokines which signal to monocytes
Monocytes enter damaged tissue from endothelium of blood vessel (leukocyte extravasion

Question 25

what is the main role of macrophages

Answer 25

phagocytosis of bacteria and damaged tissue- causes tissue injury

Question 26

what does low oxygen in inflamed tissue stimulate macrophages to do

Answer 26

induce angiogenesis, they also induce cells to re-epithelialise the wound and create granulation tissue.

Question 27

what are 2 examples of bacteria that macrophages cannot kill so it holds them instead

Answer 27

M. tuberculosis and M. leprae.

Question 28

what is granulation tissue made up from

Answer 28

Angiogenesis Fibroblasts deposit collagen Inflammatory cells

Question 29

where does granulation tissue begin to grow from - the base or the apex of the wound.

Answer 29

The base.

Question 30

define fibrosis

Answer 30

Formation of excess fibrous connective during repair of damaged tissue Scarring

Question 31

define a granuloma

Answer 31

aggregate of epitheliod histocytes and other cells, lymphocytes and histocytic giant cells.

Question 32

define a histolytic giant cell

Answer 32

horseshoe arrangement of peripheral nuclei.

Question 33

define a foreign body giant cells

Answer 33

large cells with randomly scattered nuclei seen in relation to foreign body material.

Question 34

name 2 diseases which are granulomatous

Answer 34

TB and leprosy.

Question 35

when does histolytic giant cells form

Answer 35

where material is indigestible to macrophages They’re multinucleate giant cells. May have >100 nuclei. Develop when 2+ macrophages try to engulf the same particle

Question 36

Are histolytic giant cells phagocytic

Answer 36

No

Question 37

Examples of granulomatous diseases

Answer 37

``` Bacterial = TB, leprosy Parasitic = schistosomiasis Fungal = cryptococcus Synthetic materials = silicosis Unknown = Sarcoidosis, crohn’s disease. ```

Question 38

can macrophages be considered the same as histiocytes when in tissues

Answer 38

Yes

Question 39

what organ does Tb typically effects and what it's symptoms

Answer 39

Lungs | cough, haemoptysis, night sweats weight loss.

Question 40

what organs does leprosy effect and what are it's symptoms

Answer 40

nerve, respiratory tract, skin and eyes, loss of pain sensation and subsequent injuries, weakness. Poor eyesight.

Question 41

define epithelioid histiocytes

Answer 41

large vesicular nuclei and eosinophilic cytoplasm (stain pink)

Question 42

define silicosis

Answer 42

occupational lung disease from inhaling silica dust, forms scarring and granulomas

Question 43

where do the granulomas form in silicosis and why is the the reason it is often mistaken for TB

Answer 43

upper lobes of lungs | this is where TB causes granulomas

Question 44

define sarcoidosis

Answer 44

granulomas form in multiple organs, often lungs and lymph nodes but anywhere can be affected, usually self limiting

Question 45

what are common symptoms of sacoidosis.

Answer 45

Fatigue weight loss joint aches and pains, cough, non specific symptoms.

Question 46

which condition has caseating granulomas and which condition has non caveating granulomas TB and crohsn

Answer 46

crohns non caseating | TB caseating.

Question 47

what 2 factors stimulate granuloma formation in TB

Answer 47

Alveolar macrophages in lung release cytokines to recruit more macrophages. Dendritic cells present antigens to T cells in lymph nodes to mount a T cell response.

Question 48

define caseating

Answer 48

there is necrosis, epithelioid macrophages surround necrotic region that has a T cell rim.

Question 49

what 2 cytokines are important in granuloma formation

Answer 49

TNF alpha and INF gamma

Question 50

what can be seen histologically in a granuloma

Answer 50

Langhans giant cell -lots of nuclei Caseous necrosis Epithelioid macophages

Question 51

what cells are involve in MS inflammation and where are they found

Answer 51

plasma cells and T lymphocytes are seen in white matter where macrophages break down myelin

Question 52

what 2 factors mainly predispose you to chronic inflammation and give and example for each

Answer 52

Persistence of Infection- H pylori. Prolonged exposure to toxic agents-Autoimmune Disease E.g rheumatoid arthritis, Systemic lupus- inflammation anywhere.