Chronic Inflammation Flashcards Preview

Principles of Disease 16 > Chronic Inflammation > Flashcards

Flashcards in Chronic Inflammation Deck (19)
1

List the cell types involved in chronic inflammation.

Lymphocytes
Plasma cells
Macrophages
Fibroblasts

2

List the major causes of chronic inflammation.

Arising from acute inflammation
– Large volume of damage
– Inability to remove debris
– Fails to resolve
Arising as a primary lesion
– No preceding acute phase
– Only see chronic changes

3

Describe the effects of chronic inflammation.

• Granulation tissue is characteristic of organisation
• Results in healing and repair
• Leads to fibrosis and formation of a scar

4

List factors involved in promoting healing and repair.

• Cleanliness
• Apposition of edges (no haematoma)- abrasion of edges to remove debris
• Sound nutrition
• Metabolic stability and normality
• Normal inflammatory and coagulation mechanisms

5

Define the role of angiogenesis in healing and repair.

Promotes wound healing, though must remain checked

6

List the factors that impair healing and repair.

• Dirty, gaping wound, large haematoma
• Poorly nourished, lack of vitamins C, A
• Abnormal CHO metabolism, diabetes, corticosteroid therapy
• Inhibition of angiogenesis

7

What are some triggers of primary chronic inflammation

Autoimmune disease - Autoantibodies directed against own cell and tissue components – autoantigens which damage or destroy organs, tissues, cells, cell components e.g. Thyroiditis, rheumatoid disease, pernicious anaemia (chief/parietal cells), systemic lupus erythematosis (nuclear antigen), autoimmune thyroiditis

Lymphocytes, plasma cells, macrophages, fibrosis

Material resistant to digestion e.g. Mycobacteria, Brucella, viruses with cell wall resistant to enzymes

Exogenous substances
– Sutures, metal and plastic e.g. joint replacements, mineral crystals, glass, which do not provoke immune response

Endogenous substances - Necrotic tissue, keratin, hair which cannot easily be phagocytosed

8

What are some tissue components of chronic inflammation?

Granulation tissue
Collagen

9

What are granulomas?

• Aggregates of epithelioid macrophages in tissue
• 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

10

Describe giant cells

• Granulomas comprise epithelioid histioytes (macrophages)
• ? fusion of macrophages to form larger cells
• Large cytoplasm; multiple nuclei

11

Name 4 different types of giant cell

Langhans type - rim of nuclei on the periphery of the cell
Foreign body type - pigmented, random nuclei, pus
Silicone associated - vacuoles contain leaked silicone
Warthin-Finkeldy type - central cluster of nuclei

12

When are longhand type cells common?

TB patients

13

When are warthin-finkeldy giant cells usually seen?

Measles

14

Name some infectious granulomatous diseases and what causes them

• Tuberculosis – Mycobacterium tuberculosis
• Leprosy – Mycobacterium leprae
• Syphilis – Treponema pallidum

15

What drug combination is used to treat leprosy?

• Dapsone, rifampicin and clofazimine

16

Give some examples of non-infective granulomas

• Rheumatoid disease - tissue specific auto-immune disease,
• Sarcoidosis – granulomas in skin and lungs etc
• Crohn’s disease – chronic inflammatory bowel disease

17

Briefly describe the process of wound healing

• Phase of acute inflammation
• Granulation tissue formation
• Local angiogenesis – new vessels grow
• Fibrosis and scar formation

18

What is a callus?

Callus - an unorganized network of woven bone formed around the ends of a broken bone; it is absorbed as repair is completed (provisional callus), and ultimately replaced by true bone (definitive callus).

19

What stimulates angiogenesis?

Vascular Endothelial Growth Factor (VEGF) released by hypoxic cells stimulates proliferation – important target in some cancer drugs