Chronic inflammation Flashcards Preview

Pathophysiology, exam 1 > Chronic inflammation > Flashcards

Flashcards in Chronic inflammation Deck (25)
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1
Q

Three characteristics of chronic inflammation

A
  • Accumulation of lymphocytes and macrophages
  • Proliferating blood vessels
  • Formation of connective tissues
2
Q

What things can qualify as injurious and are most likely to form acute inflammation?

A

Infarction
Bacterial infections
Toxins
Trauma

3
Q

What things can qualify as injurious and are most likely to form chronic inflammation?

A

Viral infections
Chronic infections
Persistant injury
Autoimmune diseases

4
Q

Why may there be lack of resolution occurring with chronic inflammation? (5)

A
  • Inability to get rid of the pathogen
  • Pathogen resistance to antimicrobials
  • Degradation resistant foreign body
  • Persistant exposure to an autoantigen
  • Genetic inability of the host to mount the appropriate response to the pathogen
5
Q

M1 macrophages

A

“Signature cell” of inflammation. Associated with high levels of pro-inflammatory cytokines

6
Q

What three things do chronic high levels of inflammatory cytokines cause?

A
  • Increased rates of hepatic production of defense proteins
  • Increased hepcidin production, which sequesters iron
  • Increased growth factors for platelets and monocytes
7
Q

M1 vs M2

A

M1: microbicidal actions and inflammation
M2: tissue repair, fibrosis, and anti-inflammatory effects

8
Q

Granulomatous inflammation

A

Distinct form of inflammation associated with persistent, unregulated Th1 cell activation

9
Q

Where are granulomatous inflammation sites commonly found?

A

Persistent microbial intracellular infection or when macrophages uptake poorly degradable foreign bodies

10
Q

Examples of diseases with granuloma formation

A

TB
Sarcoidosis
IBD

11
Q

What types of cells are found in granulomas?

A

Activated macrophages, CD4+ T cells, proliferating fibroblasts, and multinucleated giant cells

12
Q

Describe the layout of a granulomatous formation.

A

There is a central area of caseous necrosis, lined by activated epithelioid macrophages and giant cells, and peripheral accumulation of lymphocytes.

13
Q

What is the benefit of granuloma formation?

A

The infectious organism is “walled off”

14
Q

What is the negative side of granuloma formation?

A

Collateral damage caused by progressive tissue necrosis and fibrosis can be extensive

15
Q

Clinical differences in inflammation are based on . . .

A

Intensity and duration of the injurious stimulus

16
Q

Three things from liver that increase production during inflammation

A

Fibrinogen
Ceruloplasmin
Complement proteins (C3 in particular)

17
Q

Rough estimate of inflammatory process duration

A

Based on albumin levels: rough correlation between decrease in albumin synthesis and duration of inflammatory process

18
Q

What other clinical disorder is noted after chronic inflammation? Why?

A

Anemia; increased hepatic production of hepcidin, which blocks iron uptake, as iron is a common growth factor among microbes

19
Q

What do growth factors do to blood levels?

A

Stimulate marrow to increase leukocyte and platelet production

20
Q

CRP

A

C-reactive protein: stimulated by inflammation and is tightly linked to IL-6 levels. Measures inflammation levels reliably

21
Q

What causes false elevation of CRP?

A

Obesity

22
Q

What is the most useful measure of CRP?

A

When it is normal, it rules out acute inflammation. Very non-specific positive result

23
Q

ESR

A

Erythrocyte sedimentation rate; chronic inflammation causes clinically detectable antibody synthesis expressed as polyclonal increase in IgG and increased fibrinogen that coat and “weigh down” the red blood cells

24
Q

Why is ESR being phased out?

A

“False elevations” can occur when there is IgG increase for non-inflammatory reasons, including myeloma, age

25
Q

Granulation

A

Reactive tissue; a lot of fibrosis and a lot of vessels in it; phase in the process of scar formation. NOT to be confused with granuloma