MoD 3 (Chronic Inflammation) Flashcards
(108 cards)
1
Q
Which cells are associated with chronic inflammation?
A
- Macrophages
- Lymphocytes
- Eosinophils
- Fibroblasts/Myofibroblasts
2
Q
Which type of interferon activates macrophages?
A
Gamma Interferon
3
Q
Name the functions of macrophages in chronic inflammation:
A
- Phagocytosis
- Secretion of cytokines, complement, blood clotting factors and proteases
- Antigen presentation (initiation of immune response)
- Stimulation of angiogenesis
- Induce fibrosis
Induce fever, cachexia and acute phase response
4
Q
What are the functions of lymphocytes in chronic inflammation?
A
- Process antigens
- Secrete antibodies
- Secrete cytokines
- Kill cells
5
Q
What type of lymphocytes kill cells?
A
T lymphocytes
6
Q
What type of lymphocytes secrete antibodies?
A
B lymphocytes that have become plasma cells
7
Q
Describe the appearance of eosinophils:
A
- Pink, granular cytoplasm
- Bi-lobed nucleus
(Sun-burnt cell wearing sunglasses)
8
Q
What kind of immune reactions cause the production of large amounts of eosinophils?
A
- Allergic reactions ie Asthma
- Parasitic infections
- Some neoplasms (Hodgkin’s lymphoma)
9
Q
What kind of connective tissue fibres can be secreted from fibroblasts?
A
- Collagen
- Elastic
- Reticulin
- Glycosaminoglycans
10
Q
What name is given to fibroblasts that can contract?
A
Myofibroblasts
11
Q
What cell type recruits fibroblasts in chronic inflammation?
A
Macrophages
12
Q
Neutrophils are the main cell type in what kind of inflammation?
A
Acute inflammation
13
Q
Macrophages, Lymphocytes, Eosinophils and Fibroblasts are all cell types of what kind of inflammation?
A
Chronic inflammation
14
Q
Define ‘giant cell’:
A
Multinucleate cells made by the fusion of macrophages, due to ‘frustrated phagocytosis’
15
Q
When does frustrated phagocytosis occur?
A
When a phagocyte is unable to engulf its target because the target is physically too large to encompass
16
Q
Giant cells form due to the fusion of which cell type?
A
Macrophage fusion
17
Q
Name the 3 types of giant cells:
A
1) Langhans’
2) Foreign body
3) Touton
18
Q
Langhan’s giant cells are made by the fusion of what type of cell?
A
Epithelioid histocytes (activated macrophages resembling epithelial cells)
19
Q
What is an epithelioid histocyte?
A
An activated macrophage resembling an epithelial cell
20
Q
What type of giant cell is formed by the fusion of epithelial histocytes?
A
Langhans’ giant cells
21
Q
Describe the miscroscopic appearance of Langhans’ giant cells:
A
> 15 peripherally placed nuclei arranged in horseshoe formation
eosinophilic cytoplasm
22
Q
Langhans’ giant cells are seen in chronic inflammation caused by what?
A
- Tuberculosis
- Crohn’s disease
- Sarcoidosis
- Late stage syphilis
23
Q
What type of giant cells are seen in a tuberculosis infection?
A
Langhans’ giant cells
24
Q
What type of giant cell is associated with granulomatous conditions?
A
Langhans’ giant cells
25
Describe the microscopic appearance of foreign body giant cells:
- Multiple nuclei scattered throughout cell
| - May contain Ca2+, bone/plastic fragments etc
26
Describe the microscopic appearance of Touton giant cells:
Central ring of nuclei
| Foamy cytosol
27
Why do Touton giant cells have a foamy cytosol?
Due to engulfed lipid
28
When are Touton giant cells seen?
- Fat necrosis
| - Xanthoma
29
Which type of giant cell has a central ring of nuclei?
Touton giant cells
30
Which type of giant cell has a peripheral horseshoe formation of nuclei?
Langhans' giant cells
31
Which type of giant cell has nuclei randomly scattered throughout the cytoplasm?
Foreign body giant cells
32
In which situations does chronic inflammation typically occur?
- After acute inflammation
- Autoimmune conditions
- Chronic persistent infections
- Prolonged exposure to toxic agents
33
Name some possible complications of chronic inflammation:
- Fibrosis
- Atrophy
- Stimulation of immune response
34
How does Rheumatoid Arthritis cause joints to become unstable and deformed?
Causes inflammation and proliferation of synovial membrane, which stretches the joint capsule
35
Which type of arthritis causes symmetrical pain and stiffness of joints?
Rheumatoid arthritis
36
Ulnar deviation of fingers is a sign of which type of arthritis?
Rheumatoid arthritis
37
Describe the distribution of ulcerative colitis:
Continuously proximal inflammation of colon from the rectum
38
What layers of the bowel wall are affected in ulcerative colitis?
Mucosa
| Submucosa
39
Describe the microscopic appearance of ulcerative colitis:
Thinning of bowel wall
Loss of crypt architecture
Ulcer formation
Inflammation limited to mucosa and submucosa
40
What are the symptoms of ulcerative colitis?
- Bloody diarrhoea
- Abdominal pain
- Malaise/lethargy
- Anorexia
41
What is pancolitis?
When the entire colon is affected by ulcerative colitis
42
What are the 2 main types of non-specific inflammatory bowel disease?
1) Ulcerative colitis
| 2) Crohn's disease
43
List some of the complications of ulcerative colitis:
- Increased risk of colon cancer
- Liver disease
- Anaemia
- Bowel perforation
- Osteoporosis (due to treatment)
44
How do corticosteroids cause osteoporosis?
- Inhibit osteoblast function
- Inhibit Ca2+ absorption from GI tract
- Enhance bone resorption
- Increase urine Ca2+ loss
45
Which therapy given for ulcerative colitis can cause osteoporosis?
Corticosteroid therapy
46
Which type of non-specific inflammatory bowel disease is strongly linked with smoking?
Crohn's disease
47
Which type of non-specific inflammatory bowel disease causes discontinuous inflammation?
Crohn's disease
48
Which type of non-specific inflammatory bowel disease causes a 'cobblestone' appearance of the bowel?
Crohn's disease
49
Which layers of the bowel wall can Crohn's disease affect?
Transmural:
- Mucosa
- Submucoa
- Muscle
- Connective tissue
50
Which type of non-specific inflammatory bowel disease can cause transmural inflammation?
Crohn's disease
51
Which type of non-specific inflammatory bowel disease is always contained within the mucosa and submucosa?
Ulcerative colitis
52
Which type of non-specific inflammatory bowel disease can affect the muscular layer of the GI tract?
Crohn's disease
53
What are the symptoms of Crohn's disease?
```
Diarrhoea
Abdominal pain
Weight loss
Lethargy
Nausea
```
54
Name some complications of Crohn's disease:
- Fistula formation
- Stricture formation
- Perforation
- Increased risk of colon cancer
- Anal lesions
55
Define fistulae:
Abnormal connection between 2 epithelial-lined organs
56
Define stricture:
Narrowing or tightening of a hollow tube
57
Describe the microscopic appearance of Crohn's disease:
- smooth muscle hypertrophy
- loss of crypt architecture
- ulcer formation
- often transmural inflammation
- discontinuous inflammation
- often granulomas present
58
Define granuloma:
Mass of granulation tissue formed by epithelioid histocytes, usually surrounded by lymphocytes
- Often in response to infection, inflammation, or foreign bodies
59
Define Granulation tissue:
New connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process
60
What is Chronic cholecystitis?
Continuous or repeated swelling and irritation of gallbladder
61
What is the most common cause of chronic cholecystitis?
Gallstones
62
What is the name given to a chronically inflamed gallbladder?
Chronic cholecystitis
63
What commonly causes chronic gastritis?
- Helicobacter pylori infection
- Autoimmune conditions
- Chronic intake of NSAIDs/ Aspirin
- Biliary reflux
64
What cell type infiltration is seen in chronic gastritis?
- Plasma cell
| - Lymphocyte
65
Name the complications of Chronic gastritis caused by Helicobacter pylori:
- Peptic ulcers
- Increased risk of gastric cancer
- Increased risk of MALT lymphoma
66
What is pernicious anaemia?
Lack of red blood cells due to vitamin B12 deficiency
67
How can chronic gastritis cause pernicious anaemia?
Chronic gastritis causes muscle atrophy and loss of gastric cells. These usually produce intrinsic factor, which allows the body to absorb vitamin B12 in the intestine.
68
List some causes of Cirrhosis:
- Alcoholic Liver Disease
- Hepatitis B
- Hepatitis C
- Autoimmune
- Biliary cirrhosis
- Haemochromatosis
- Granulomatous disease
69
Describe the histological appearance of Cirrhosis:
- Regenerative nodules of hepatocytes
| - Surrounded by fibrous connective tissue/collagen
70
Why might a blood test be performed when cirrhosis/liver disease is suspected?
Alanine aminotransferase and Aspartate aminotransferase are liver function enzymes which are usually raised in liver disease.
Alkaline Phosphatase is also synthesised in the liver, and is raised in liver disease.
71
What are the 2 types of granulomas?
1- Foreign body
| 2- Immune/hypersensitivity
72
What types of cell does a foreign body granuloma contain?
- Epithelioid histocytes
- Foreign body giant cells
- Macrophages
- Fibroblasts
73
What type of cell does a hypersensitivity/immune granuloma contain?
- Epithelioid histocytes
- Macrophages
- Giant cells
- Fibroblasts
- Lymphocytes
74
Which type of granuloma does not contain lymphocytes?
Foreign body granulomas
75
Which type of granuloma is seen in a tuberculosis infection?
Hypersensitivity/Immune granuloma
76
Which type of granuloma is caused by silica?
Foreign body granuloma
77
What causes Tuberculosis?
Mycobacterium tuberculosis infection
78
How does M. tuberculosis gain entry to the body?
Inhaled into alveoli
79
What cell type first engulfs a M.tuberculosis bacterium?
Macrophage
80
What stimulates the formation of a granuloma after M.tuberculosis has gained entry to host?
- Dendritic cell engulfs bacteria and breaks into antigens, which are presented to T-cells in lymph nodes
- Activated T-cell stimulates granuloma formation
81
Describe the granuloma formed in response to an infection with M.tuberculosis:
Hypersensitivity/Immune granuloma:
- Infected macrophages (center of caseous necrosis)
- Surrounded by foamy macrophages
- Surrounded by macrophages
- Surrounded by T-lymphocytes
- Surrounded by fibrous shell (formed by fibroblasts)
82
What is Latent Tuberculosis Infection?
Infection with M. tuberculosis, but not active disease as bacteria are contained within granulomas.
83
What type of necrosis may be seen within granulomas formed due to TB infection?
Caseous necrosis
84
What is a Ghon complex?
Subpleural lesion of caseous necrosis and infected hilar lymph nodes, seen with primary tuberculosis infection (particularly in children)
85
Where are hilar lymph nodes?
Located where the lungs meet the bronchi
86
Describe military tuberculosis:
Tuberculosis infection spreads to other organs via blood with 'millet seed-like' granulomas
87
What is Potts disease?
Spinal tuberculosis which causes progressive bone destruction
88
What is the name of a tuberculosis infection that has spread to the spine?
Potts disease
89
What area of the spine is usually infected with tuberculosis?
Thoraco-lumbar region
90
What name is given to a tuberculosis infection which has spread to the cervical lymph nodes?
Scrofula
91
What is Scrofula?
Tuberculosis infection which has spread to the cervical lymph nodes
92
What are some common symptoms of tuberculosis?
- Severe Cough (may have bloody sputum)
- Fever
- Night sweats
- Fatigue
93
What is a Ranke complex?
A healed and calcified peripheral lung lesion (due to TB infection), with a calcified lymph node
94
What is the most common test for a Latent Tuberculosis Infection?
Mantoux skin test
95
What is the use of a Mantoux skin test?
Allows testing for Latent Tuberculosis Infection
96
What is a positive Mantoux test characterised by?
Skin becomes raised and red after test
97
What stain is used to visualise cultured M.tuberculosis?
Acid-Fast stain
- Ziehl-Nielsson
- Auramine-Rhodamine
etc
98
How could you test a sputum sample for M.tuberculosis?
Culture the bacteria and stain using an acid-fast stain ie Ziehl-Nielsson
99
What can cause Leprosy?
- Mycobacterium leprae
| - Mycobacterium lepromatosis
100
What is Leprosy?
Chronic granulomatous infection
- Poorly-pigmented skin lesions
- Diseased peripheral nerves = damaged skin/eyes/limbs
- Shortened fingers/toes as cartilage is reabsorbed by the body
101
In what part of the world is Leprosy most commonly seen?
Tropical Africa and Asia
102
What are the signs/symptoms of Leprosy?
- Poorly-pigmented skin lesions
- Diseased peripheral nerves = damaged skin/eyes/limbs
- Shortened fingers/toes as cartilage is reabsorbed by the body
103
What bacterium causes Syphilis?
Treponema pallidum
104
How may someone be infected with Treponema pallidum, and what disease will this cause?
May be inherited (congenital) or spread as an STI
| Syphilis
105
What is the 1st stage of Syphilis?
Painless infectious sores develop where the bacteria entered the body
106
What is the 2nd stage of Syphilis?
```
Non-itchy rash (may be patchy or cover body)
Patchy hair loss
Fatigue
Anorexia
Malaise
```
107
What is Sarcoidosis and where does it commonly affect the body?
Chronic granulomatous disease commonly affecting lungs and skin
108
What is Wegener's granulomatosis? (also called granulomatosis with polyangiitis)
Vasculitis: Inflamed, constricted blood vessels and granuloma formation
