Inflammation , neoplasia and wound healing

Question 1

What is the function of inflammation?

Answer 1

1.To neutralise and eliminate the initial cause of cell injury

2.To clear out necrotic cells and damaged tissue

3. To protect from further injury

4.To initiate healing and tissue repair

Question 2

What are the Cardinal Signs of acute inflammation:

Answer 2

1.Heat (calor)

2. Redness (rubor)
3. Swelling (tumor)

4.Pain (dolor)- loss of function (Pain is the warning sign)

Question 3

What happens in inflammatory exudation?

Answer 3

1.Dilation of arterioles (redness) happens within minutes

2. Heat: Increased blood flow

3.Swelling: Extravasation of plasma fluid and proteins

4. Damage to nerve fibres or irritation from chemicals released from microorganisms

5.Kinins and prostaglandin and local oedema also stimulate pain (The swelling press down on nerves causing pain )

Question 4

What is Oedema?

Answer 4

Fluid accumulating in extravascular space or body cavities

Question 5

what is in the exudate ?

Answer 5

1.Protein-rich fluid containing fibrinogen – clots-

2. Fibrinouse (cloudy, forms adhesions)

3.Serous (bacterial fibrinolysis)

4.Purulent (pus)

5.Figropurulent (pus and fibrin)

Question 6

What is the role of the vessels and the mast cells

Answer 6

Vessels become leaky so the factors can go out
Mast cell release histamine

Question 7

What are the different types of inflammation and what happens?

Answer 7

1. Acute: Immediate and short lived, when successfully concluded, full healing results and the neutrophils dominate and connective tissue proliferation is not usually marked- not an immune response

2.Chronic: Comes from the acute phase when the ‘irritant ’persists and seeks to isolate and partition this so that cannot harm the body further. Macrophages and lymphoid cells predominate. Connective tissue proliferation is prominent . Results in scarring

Question 8

What is the process of pneumonia?

Answer 8

1. Acute congestion-Bacteria invade alveoli, acute response, fibrinous exudation

2.Red hepatisation: Neutrophil emigration and phagocytosis of bacteria happens

3.Grey hepatisation: Macrophages arrive + lymphocytes, more bacterial phagocytosis, fibrin and white blood cells predominate

4.Resolution: re-epithelialisation of reticular scaffold returns to normal

Question 9

Where does appendicitis take place, what are its causes and symptoms

Answer 9

Appendicitis is inflammation in the appendix which is located in the right iliac fossa

Causes: can be caused by bacteria, virus infection etc, inflammatory bowel disease and build up of faecal material

Symptoms: vague pain in the middle abs pain move to the right hip over 24hours then pain with nausea, vomiting and fever

Question 10

What is chronic inflammation and what happens?

Answer 10

1. Last from weeks to months, its effects may persist for a lifetime
   2.Macrophages and lymphoid cells predominate.
2. Connective tissue proliferation is prominent and scaring that can impair function.

Question 11

What do macrophages do?

Answer 11

Ingest a wider range of materials than neutrophils and are long-lived.

They can engulf TB bacteria which will stay alive in it

Question 12

What is granuloma , how do giant cells form in it and what are the other cells in the granuloma?

Answer 12

it is a focal collection of epithelioid cells which giant cells can form in by the fusion of macrophages/ epithelioid cells. Lymphocytes CD4+ cause granulomatous reaction

Question 13

What are the causes of granulomatousinflammation?

Answer 13

1.Bacterial (e.g., Mycobacterium tuberculosis, M.leprae, Treponema pallidum)

2.Parasitic (e.g., schistosomiasis)

3.Fungal (e.g., histoplasmosis, blastomycosis)

4.Inorganic dusts (e.g., silicosis, berylliosis)

5.Foreign body

6.Unknown (for example in sarcoidosis there isformation of small granulomas in lung and skin)

Question 14

What is the inflammation process?

Answer 14

1.Starts with macrophages or mast cells found in the tissue respond to the pamps or damps when there is damage

2.The inflammatory mediators such as histamine and serotonin and cytokines acts on the epithelial cells surrounding the capillaries nearby causing them to separate from each other the macrophages start to eat up the invading pathogens

3.The release of the cytokines causes capillaries to get larger and increases the vascular permeability allowing plasma proteins to leave the circulation

Question 15

What is neoplasia

Answer 15

A new uncontrolled growth of cells when it makes to many it is a tumour

Question 16

What is the benign neoplasm about ?

Answer 16

1. Benign neoplasm does not invade or destroy the surrounding tissue
   2.Does not spread to other parts of the body
   3.Typically grows slowly

Question 17

What is the malignant neoplasm about ?

Answer 17

1.Invades and destroys surrounding tissues
2.Grows quickly
3.May spread around the body: metasatsis
4. Comes back after surgical removal

if it is found in the breast it is harmless but if it is found in the brain it can press down on the brain which can lead to seizures and even death

Question 18

what is the carcinoma in situ about?

Answer 18

1.Malignant cells that have not invaded deeper tissues stay at the most superficial layer of the organ they multiply in and don’t spread around the body

2.May form a tumour can transform into cancer at times

Question 19

How does cancer work?

Answer 19

will have a stimulation of new vascular growth in the area of the injury stimulated by VEGF, and that will allow also if you have got new vessels sprouting that will allow for oxygen and nutrition’s to come to the site of injury and feed the tissue

Question 20

How does scar formation work?

Answer 20

1.Tissue that has limited regenerative capacity first induces inflammation ,which clears dead cells and microbes.

2.This is followed by formation of vascularized granulation tissue

3. and then deposition of extracellular matrix to form the scar

Question 21

What is one the special type of healing?

Answer 21

Bone (fractures) heal by callus formation- this is followed by bone remodelling (new spongy bone appears it coverts to bony call and becomes formed after 2-3 months

Question 22

What is the role of the extracellular matrix

Answer 22

1. Development
   2.Wound healing
2. Cancer invasion

Question 23

What is the difference between granulation tissue and granulomatous inflammation?

Answer 23

Granulation tissue contains new small blood vessels, fibroblasts, and mononuclear cells in an oedematous extracellular matrix- part of the repair response

A granuloma is a circumscribed collection of epithelioid cells, usually surrounded by lymphocytes- a form of chronic inflammation