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Principles of Disease 16 > Chronic Inflammation > Flashcards

Flashcards in Chronic Inflammation Deck (19)
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1
Q

List the cell types involved in chronic inflammation.

A

Lymphocytes
Plasma cells
Macrophages
Fibroblasts

2
Q

List the major causes of chronic inflammation.

A
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
Q

Describe the effects of chronic inflammation.

A
  • Granulation tissue is characteristic of organisation
  • Results in healing and repair
  • Leads to fibrosis and formation of a scar
4
Q

List factors involved in promoting healing and repair.

A
  • Cleanliness
  • Apposition of edges (no haematoma)- abrasion of edges to remove debris
  • Sound nutrition
  • Metabolic stability and normality
  • Normal inflammatory and coagulation mechanisms
5
Q

Define the role of angiogenesis in healing and repair.

A

Promotes wound healing, though must remain checked

6
Q

List the factors that impair healing and repair.

A
  • Dirty, gaping wound, large haematoma
  • Poorly nourished, lack of vitamins C, A
  • Abnormal CHO metabolism, diabetes, corticosteroid therapy
  • Inhibition of angiogenesis
7
Q

What are some triggers of primary chronic inflammation

A

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
Q

What are some tissue components of chronic inflammation?

A

Granulation tissue

Collagen

9
Q

What are granulomas?

A
  • 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
Q

Describe giant cells

A
  • Granulomas comprise epithelioid histioytes (macrophages)
  • ? fusion of macrophages to form larger cells
  • Large cytoplasm; multiple nuclei
11
Q

Name 4 different types of giant cell

A

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
Q

When are longhand type cells common?

A

TB patients

13
Q

When are warthin-finkeldy giant cells usually seen?

A

Measles

14
Q

Name some infectious granulomatous diseases and what causes them

A
  • Tuberculosis – Mycobacterium tuberculosis
  • Leprosy – Mycobacterium leprae
  • Syphilis – Treponema pallidum
15
Q

What drug combination is used to treat leprosy?

A

• Dapsone, rifampicin and clofazimine

16
Q

Give some examples of non-infective granulomas

A
  • Rheumatoid disease - tissue specific auto-immune disease,
  • Sarcoidosis – granulomas in skin and lungs etc
  • Crohn’s disease – chronic inflammatory bowel disease
17
Q

Briefly describe the process of wound healing

A
  • Phase of acute inflammation
  • Granulation tissue formation
  • Local angiogenesis – new vessels grow
  • Fibrosis and scar formation
18
Q

What is a callus?

A

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
Q

What stimulates angiogenesis?

A

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