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Flashcards in Chronic Inflammation Deck (29)
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Define Chronic Inflammation

Prolonged inflammation with associated repair


How can Chronic Inflammation arise

1. Takes over from acute inflammation
2. “De novo”- Without preceding acute inflammation
3. Alongside acute inflammation


Give 3 examples of when Chronic Inflammation can arise “De Novo”

Autoimmune conditions
Prolonged exposure to toxic agents
Chronic infections


How does Chronic Inflammation appear
What are the 2 predominant cell types
Name 3 others

Variable appearances
Lymphocytes and Macrophages (Histiocytes)

Eosinophils, Fibro/Myofibroblasts
Giant cells (Granulomatous inflammation


Describe the Appearance of a Macrophage in 3 ways

Large cells
Abundant cytoplasm with Phagolysosomes
Can have a Slipper shaped nucleus


Outline the functions of Macrophages

1. Phagocytosis and Antigen presentation
2. Synthesis of mediators
3. Control and regulation of inflammatory response


Describe the Appearance of a Lymphocyte in 2 ways

1. Small cells
2. Large Central nucleus with thin rim of cytoplasm


What are the 2 types of Lymphocyte? How can they distinguished by appearance

Which one has various types and what are the main 2 types. Outline their functions

T and B cells, they can’t

Main 2 T cells are;
- Helper (CD4+): Assist other inflammatory cells
- Cytotoxic (CD8+): Destroy pathogens


What does a B cell mature into
Describe the appearance of this in 4 ways

A plasma cell

1. Eccentric Nucleus (Pushed to one side)
2. Clock-face chromatin (Clumped into spheres at edge of nucleus)
3. Peri-nuclear clearing (Golgi)
4. Slightly larger than a T cell


Outline the function of a Plasma cell
Give an example

Produces antibodies which neutralise pathogens


Regarding its appearance, what does an Eosinophil look like?
In 2 ways explain why

Describe its function, and suggest 2 occasions this happens

1. “Tomato with sunglasses”
2. Bi-lobed nucleus
3. Granular cytoplasm stains red

Releases mediators- Parasitic infestations + Allergic/ hypersensitivity reactions


Describe the function of Fibro/ Myofibroblasts

Regeneration and repair by Producing, Secreting and Laying down collagen


What are Giant cells

Name 3 and give an example for each of when they are present

Multinucleate cells formed from fusion of macrophages

1. Foreign Body Giant Cell: When a foreign body is present
2. Langhans Giant Cell: Tuberculosis
3. Touton Giant Cell: Fat necrosis/ Xanthomas


Describe the Appearance of a Foreign Body Giant Cell

Describe the appearance of a Langhans Giant Cell (What shape oftenly)

Describe the appearance of a Touton Giant Cell

Foreign Body: Randomly arranged nuclei

Langhans: Nuclei around periphery of cell (Horse shoe shape)

Touton: Nuclei arranged in a ring at centre of cell


What are the main cell types present in;

1) Rheumatoid arthritis
2) Chronic Gastritis
3) Leishmaniasis

1) Plasma cells
2) Lymphocytes
3) Macrophages


What are 4 Complications of Chronic Inflammation

1. Fibrosis (Collagen deposition)

2. Impaired function (Rarely= Increased function)

3. Atrophy

4. Immune response stimulated


Give 2 examples of Fibrosis

Give 3 examples for Impaired function

Give 1 example for Atrophy

F: Cirrhosis, Cholecystitis (Gall bladder inflammation)

IF: Ulcerative colitis, Crohn’s disease, Cirrhosis

A: Gastritis


How does Fibrosis of the gall bladder(Cholecystitis) occur in 2 steps

How does the gall bladder appear

Repeated obstruction of bile duct by gall stones
Repeated Acute Inflammation bouts-> Chronic

Thickened and pale


What are 5 symptoms of Inflammatory Bowel Disease

- Abdominal pain
- Altered bowel motion
- Weight loss
- Rectal bleeding
- Diarrhoea


What 2 conditions come under the term, Inflammatory Bowel Disease

Compare them in regards to;

1. Area affected
2. Pattern of inflammation
3. Part of area affected
4. Presence of granulomas
5. Likelihood of rectal bleeding

Crohn’s Disease:

1. Can affect all of GI tract
2. Discontinuous patches of inflammation (Skip Lesions)
3. Transmural (Full thickness of bowel wall affected)
4. Sometimes Granulomas are present
5. Rectal bleeding is less likely

Ulcerative Colitis:

1. Large bowel affected only
2. Continuous
3. Mucosa and Submucosa only
4. No granulomas
5. Rectal bleeding is more likely


What stage of liver damage is Cirrhosis

Name 4 causes

What do the nodules on a Cirrhhosed liver show

End stage damage to liver

Drugs/ Toxins
Fatty Liver disease

Areas of Fibrosis and attempted Regeneration


What is a Granulomatous Inflammation

A type of Chronic inflammation in which Granulomas are seen


What is a Granuloma

A collection of Epithelioid Histiocytes (Elongated macrophages that are packed together tightly) surrounded by lymphocytes


What are 3 causes of Granulomatous Inflammation

- Foreign body presence
- Infection by “tough” bacteria (Hard to destroy)
- Idiopathic infections (Unknown cause)


Name 2 “Tough” bacteria
Why are they hard to destroy (2 reasons)

Mycobacterium tuberculosis
Mycobacterium leprae (Causes leprosy)

- Thick cell wall
- Mycolic acids (Surface proteins, resist phagocytosis)


What is happening in the centre of a Mycobacterium Granuloma

Name 2 Idiopathic causes of Granulomatous Inflammation

Caseous Necrosis

Crohn’s Disease


Describe the histological appearance of Crohn’s disease

Non-caseating Granuloma


Describe the histological appearance of Sarcoidosis

Name 3 organs that are affected and how they present

Multiple Non-caseating granulomas

Lymph nodes- Enlarged
Lungs- Shortness of breath
Skin- Lumps


Name 1 condition where eosinophils count is high

Hodgkin’s lymphoma