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Principles of Disease BJ > Chronic Inflammation > Flashcards

Chronic Inflammation Flashcards

1
Q

What are the 4 main cell types in chronic inflammation?

A

Lymphocytes
macrophages
Plasma cells (differentiated B cells)
Fibroblasts

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2
Q

When does chronic inflammation arise from acute inflammation?

A

When theres:

  • A larg evolume of damage
  • Debris that cant be removed
  • When it fails to resolve (e.g. repeated infection)
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3
Q

When does chronic inflammation arise as a primary legion?

A

As a result of:

  • An Autoimmune Disorder
  • A material resistant to digestion
  • An exogenous substance
  • An endoenus substance where it shouldnt be
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4
Q

Examples of exogeneous substances that cause chronic inflammation?

A

Glass
Sutures
Plastic/metal joint replacements

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5
Q

Examples of endogenous substances that cause chronic inflammatoin?

A

Hair
Keratin
Necrotic Tissue

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6
Q

What are the clinical presentations of chronic inflammation?

A

Malaise
Weight loss
Loss of function e.g. hypothyroidism in autoimmune thyroiditis

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7
Q

How does granulation occur

A

Angiogenesis occurs so capillaries grow into inflammatory mass
New capilalries give acces for plasma proteins
Macrophages form blood/tissue arrive and clear debris
Granulation tissue made from plasma proteins, macrophages & capillaries fills wound

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8
Q

How does fibrosis occur?

A

Fibroblasts replace inflammatory exudate with collagen
Collagen cross links & contracts or greater strength
Scar forms

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9
Q

Examples of organisms resisitant to destruction that cause chronic inflammation?

A

Mycobacteria
Brucella
Viruses

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10
Q

Why do endogenous substances int he wrong place cause CI?

A

They cant be easily phagocytosed

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11
Q

Function of B cells in chronic inflammation?

A

They form plasma cells which produce antibodies &

present antigens,. The also form memory B cells

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12
Q

Function of T cells in chronic inflammation?

A

Produce cytokine that attract leukocytes & increase vascular permeability
Produce Interferons which are antiviral and attract immune cells
Lysis of pathogenic cells

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13
Q

Function of macrophages in CI:

A

Remove debris
Epithelioid macrophages form granulomas
Antigen presenting

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14
Q

Fibroblasts in CI:

A

Assemble structures most notably collagen for scarring & wound repair

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15
Q

What is granulomatous inflammation?

A

Chronic inflammation involving a granuloma.

Occurs in many serious infections & idiopathic diseases

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16
Q

Why does a granuloma form?

A

To block off an indigestible piece of material that cant be removed from the body

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17
Q

What is a granuloma?

A

An agregate of epithelioid macrophages in tissue.

Also contains neutrphils, eosinophils & lymphocytes

18
Q

What unusual cell type may be found in a granuloma?

A

Giant Cells

19
Q

What type of hypersensitiivity reaction canc ause granulomas?

A

Type 4 hypersensitivity

20
Q

What is Giant cell?

A

An immune cell with a large cytoplasm & multiple nuclei.

There are many types

21
Q

Define Langhans type giant cell

A

Often found in TB
Peripheral rim of nuclei
Large eosinophilic cytoplasm.

22
Q

What are the 4 phases of wound healing?

A
  • Acute inflammation
  • Grandulation tissue formation
  • Local angiogenesis
  • Fibrosis & scar formation
23
Q

What is fibrin and how is it involved in cloting?

A

Fibrin is a derivative of Fibrinogen

It forms the edge of a blood clot

24
Q

What is the sequence of events in wound healing?

A
  • Acute inflammation & clotting
  • granulation tissue grows along with angiogenesis
  • Fibrin is phagocytosed
  • Fibroblasts lay down collagen
  • Contraction of collagen
  • re-epithelialisation
25
Q

What is another name for surgial wound healing?

A

Healing by primary intention

26
Q

How does surgical wound healin occur?

A

Sututes are used to give a minimal gap (apposition of edges)

  • small amount of granulation tissue forms
  • small linear scar forms
27
Q

What is another name for healing a larger defect?

A

Healing by secondary intention

28
Q

Whats different about healing by secondary intention?

A

the gap of the wound is large
So lots of granulation tissue grows in
The tissue contracts and a large messy scar forms

29
Q

List the 6 factors favouring healing?

A
  • Cleanliness
  • Apposition of edges
  • Good nutrition
    Metabolic normality/stability
  • Normal inflammatory & coagulatory mechanisms
  • Normal local mediators
30
Q

List the 5 factors that impair wound healing:

A
  • Dirty, large wounds
  • Large Haematomas (clots)
  • Poor nutrition (mainly low Vitamin C & A)
  • Abnormal metabolism
  • Inhibition of angiogenesis
31
Q

Example of abnormal metabolism that effects healing?

A
  • Abnormal CHO metabolism
  • Cortiocosteroid therapy
  • Diabetes
32
Q

How is angiogenesis stimulated?

A

Hypoxic cells release VEGF

VEGF stimulates formation of new capillary buds

33
Q

What is VEGF?

A

Vascular Endothelial Growth Factor

34
Q

What else aids aniogenesis?

A

Enzyme secretion from hypoxic cells

35
Q

Why would you want to inhibit VEGF?

A

To block angiogeneis in tumours as a therapeutic control of tumour growth.

36
Q

Sumarise the sequence of events in fracture healing?

A
  • Trauma, fracture, haematoma
  • Acute inflammation
  • Organisation
  • Callus formation
37
Q

Whats different about granulation tissue in fracture healing?

A

It contains both fibroblasts to lay down collagen and Osteoblasts to lay down and calcify Hydroxy Apatite crystals.

38
Q

What are the steps of Callus formation?

A
  • Osteoblasts lay down woven bone
  • Osteoclasts remove dead bone
  • Woven bone progressively replaced by lamellar bone
  • Cotrical/trabecular bone reformed.
39
Q

How is angiogenesis involved with malignant tumour?

A

Angiogenesis occurs as the tumor grows.

Potential for therapeutic control by inhibiting VEGF.

40
Q

How is atherosclerosis similar to chronic inflammation?

A

They both involve fibrosis & scarring.

41
Q

What is thrombosis?

A

Local clotting in the circulatory system

42
Q

How are angiogenesis & organisation important in stoppin thrombosis?

A

They limit thrombus propagation & reinstate flow by breaking clots.

Principles of Disease BJ (47 decks)

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