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Principles of Disease 16 > Chronic Inflammation > Flashcards

Flashcards in Chronic Inflammation Deck (19)

List the cell types involved in chronic inflammation.

Plasma cells


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


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


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


Define the role of angiogenesis in healing and repair.

Promotes wound healing, though must remain checked


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


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


What are some tissue components of chronic inflammation?

Granulation tissue


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


Describe giant cells

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


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


When are longhand type cells common?

TB patients


When are warthin-finkeldy giant cells usually seen?



Name some infectious granulomatous diseases and what causes them

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


What drug combination is used to treat leprosy?

• Dapsone, rifampicin and clofazimine


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


Briefly describe the process of wound healing

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


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).


What stimulates angiogenesis?

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