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Flashcards in Chronic Inflammation Deck (20):

What are the factors that favour resolution?

+ Minimal cell death

+ Occurrence in organ or tissue with regenerative capacity e.g liver

+ Rapid destruction of causal agent

+ Rapid removal of exudate and debris by good local vascular drainage


What is "Organisation"

The replacement of destroyed tissue with granulation tissue


What are the factors favouring organisation?

+ Large amounts of fibrin

+ Substantial necrosis

+ Exudate and debris cannot be removed or discharged


What is inflammatory exudate replaced by during organisation?

And which growth factors regulate it?

+ Capillaries
+ Macrophages (inflammatory cells)
+ Fibroblasts (myofibroblasts)
+ Collagen



Give an example of Primary Chronic Inflammation (1/6)

Resistance of infective agent to phagocytosis and intercellular killing

E.g tuberculosis, leprosy, brucellosis, viral infections


Give an example of Primary Chronic Inflammation (2/6)

Foreign body reactions to endogenous materials

E.g gout (may be acute or chronic)


Give an example of Primary Chronic Inflammation (3/6)

Foreign body reactions to exogenous materials

E.g asbestos


Give an example of Primary Chronic Inflammation (4/6

Some autoimmune diseases

E.g rheumatoid arthritis


Give an example of Primary Chronic Inflammation (5/6)

Specific diseases of unknown aetiology

E.g ulcerative colitis


Give an example of Primary Chronic Inflammation (6/6)

Primary granulomatous diseases

E.g sarcoidosis


What are the factors favouring progression from acute Inflammation to Chronic Inflammation?

+ Indigestible substances

+ Deep seated suppurative Inflammation where drainage is delayed or inadequate (thick abscess wall, fibrous/granulation tissue, pus becomes organised, forms fibrous scar)

+ Recurrent episodes of acute inflammation and healing may eventually result in the clinicopathological entity of chronic inflammation


What is osteomyelitis?

A chronic abscess which is extremely difficult to eradicate


What is chronic cholecystitis?

It is the replacement of the wall by fibrous tissue. Lymphocytes > neutrophils


What does chronic inflammation look like?

+ Chronic ulcer
- mucosa breached
- base lined by granulation tissue
- fibrous tissue throughout muscle

+ Chronic abscess cavity e.g osteomyelitis, empyema thoracis

+ Thickening of the wall of a hollow viscus
+ Granulomatous Inflammation e.g TB
+ Fibrosis


Describe the cells of Chronic Inflammation

Chronic Inflammation is an inflammatory process in which lymphocytes, plasma cells and macrophages predominate.

Usually accompanied by the formation of granulation tissue resulting in fibrosis.


List the properties of macrophages.

+ Considerable phagocytise abilities
+ Can ingest a wide range of materials
+ Can harbour viable organisms resistant to lysosomal enzymes e.g mycobacterium tuberculosis, mycobacterium leprae
+ Produce a range of important cytokines
+ Activated on migration to an area of inflammation (MIF, MAF)


Describe features of Granulomatous inflammation?

+ A granulomatous is an aggregate of epithelioid histiocytes

+ A histiocyte is a macrophage in connective tissue

+ Little phagocytic activity

+ Typical granuloma
- central giant cells +/- causation
- surrounded by epithelioid histiocytes
- peripheral rim of activated lymphocytes


What are the causes of Granulomatous disease?

+ Specific infections

+ Foreign bodies
- endogenous
- exogenous

+ Specific chemicals

+ Drugs

+ Unknown


Give an example of Granulomatous Inflammation

Pulmonary Tuberculosis


What may develop with Granulomatous Inflammation?

+ Caseous Necrosis

+ Giant cells