Chronic Inflammation

Question 1

What does both repair and organisation and chronic inflammation lead to?

Answer 1

Fibrosis

Question 2

What factors favour resolution?

Answer 2

Minimal cell death and tissue damage

Occurrence in an organ or tissue with regenerative capacity

Rapid destruction of casual agent

Rapid removal of fluid and debris by good local vascular damage

Question 3

What is organisation?

Answer 3

Replacement of destroyed tissue by granulation tissue

Question 4

What factors favour organisation?

Answer 4

Large amounts of fibrin

Substantial necrosis

Exudate and debris cannot be removed or discharges

Question 5

What are classic signs of the body moving into chronic inflammation?

Answer 5

Development of capillary loops and macrophages

Question 6

What is redness caused by in a burn?

Answer 6

Outgrowth of capillaries

Question 7

What is the inflammatory exudate replaced with when moving into organisation?

Answer 7

Capillaries

Macrophages

Fibroblasts

Collagen

Question 8

What regulates organisation?

Answer 8

TNF

Epidermal Growth Factor

FGF

Question 9

What is a primary chronic inflammation?

Answer 9

A chronic response that did not develop from an acute inflammatory reponse

Question 10

How can chronic inflammation develop?

Answer 10

Primary

Progression from acute inflammation

Recurrent episodes of acute inflammation

Question 11

What are the 6 origins of primary chronic inflammation?

Answer 11

Resistance of infective agent to phagocytosis and intracellular killing

Foreign body reactions to endogenous materials

Foreign body reactions to exogenous materials

Autoimmune diseases

Unknown aetiology

Primary granulomatous diseases

Question 12

Example of a disease that has resistance of infective agent to phagocytosis and intracellular killing

Answer 12

TB

Leprosy

Question 13

Example of a disease that is caused by a foreign body reaction’s to endogenous materials

Answer 13

Chronic tophaceous gout

Question 14

Example of a disease that is caused by a foreign body reaction’s to exogenous materials

Answer 14

Asbestos

Question 15

Example of chronic inflammatory disease caused by an autoimmune reaction

Answer 15

Rheumatoid arthritis

Question 16

Example of primary chronic inflammation with an unknown aetiology

Answer 16

Ulcerative colitis

Question 17

Example of chronic inflammation caused by primary granulomatous disease

Answer 17

Sarcoidosis

Question 18

What is sarcoidosis?

Answer 18

The build up inflammatory cells indicating a chronic response

Question 19

What factors favour progression from acute to chronic inflammation?

Answer 19

Indigestible substances

Deep seated suppurative inflammation where drainage is delayed or inadequate

Question 20

What causes suppurative inflammation to develop into chronic inflammation?

Answer 20

The thick abscess wall

Fibrous/ granulation tissue beginning to form

Pus becoming organised

Formation of fibrous scar

Question 21

What is osteomyelitis?

Answer 21

Chronic abscess which is extremely difficult to eradicate

Question 22

What is an example of a disease caused by recurrent episodes of acute inflammation?

Answer 22

Chronic cholecystitis

Question 23

What is chronic cholecystitis?

Answer 23

Replacement of wall by fibrous tissue

Question 24

What does chronic ulcer look like?

Answer 24

Mucosa breached

Base lined by granulation tissue

Fibrous tissue throughout muscle layers

Question 25

What does chronic inflammation look like?

Answer 25

Chronic ulcer Chronic abscess Thickening of the all of a hollow viscus Granulomatous inflammation Fibrosis

Question 26

What immune cells are common in chronic inflammation?

Answer 26

Plasma cell Lymphocyte Macrophage Multinucleate giant cell

Question 27

How do macrophages act as the immune cells?

Answer 27

Phagocytic Produce a range of important cytokines

Question 28

What is macrophage migration activated by?

Answer 28

Macrophage activation factor (MAF) Migration inhibition factor (MIF)

Question 29

How can pathogens counteract macrophages?

Answer 29

Be phagocytosed but adapt the internal environment so the pathogen can survive

Question 30

What are macrophages released into the blood as?

Answer 30

Monocytes

Question 31

What are macrophages called in the liver?

Answer 31

Kuppler cells

Question 32

What are the causes of granulomatous disease?

Answer 32

Specific infections Foreign bodies Specific chemicals Drugs Unknown

Question 33

What can granulomatous inflammation cause?

Answer 33

Caseous necrosis Giant cells

Question 34

What is granuloma?

Answer 34

Aggregrate of macrophage like cells

Question 35

What is granulation?

Answer 35

Important healing process with small blood vessels and connective tissue

Question 36

What is fibrin?

Answer 36

Deposited in acute inflammation

Question 37

What is fibrous?

Answer 37

Typical scar tissue with collagen