MoD 4 Chronic inflammation Flashcards Preview

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Flashcards in MoD 4 Chronic inflammation Deck (29):
1

How may chronic inflammation arise?

May 'take over' from acute inflammation
May arise de novo
May develop alongside acute inflammation in sever, persistent or repeated irritation

2

When may chronic inflammation arise de novo?

Some autoimmune conditions e.g RA
Some chronic infections e.g viral hepatitis
"Chronic low level irritation"

3

What is chronic inflammation?

Chronic response to injury with associated fibrosis

4

List the effects of chronic inflammation

fibrosis-e.g gall bladder(chronic cholecystitis), chronic peptic ulcers, cirrhosis
impaired function e.g chronic inflammatory bowel disease
atrophy-gastric mucosa, adrenal glands
Stimulation of immune response- macrophage-lymphocyte interactions

5

What is the function of macrophages?

In both acute and chronic inflammation
various levels of activation
phagocytosis and destruction of debris and bacteria
processing and presentation of antigen to immune system
synthesis of cytokines, complement components, clotting factors and proteases
control of other cells via cytokine release

6

What is the function of lymphocytes?

complex mainly immunological
B lymphocytes (plasma cells) differentiate to produce antibodies
T lymphocytes involved in control (CD4+) and some cytotoxic (CD8+) functions

7

What are lymphocytes sometimes called?

chronic inflammatory cells

8

What are the functions or eosinophils?

Allergic reactions
Parasite infections
Some tumours

9

What is the function of fibroblasts/myofibroblasts?

Recruited by macrophages, make collagen

10

What are giant cells?

Multinucleate cells made by fusion of macrophages through frustrated phagocytosis

11

What are the three main types of giant cells and when do they occur?

Langhans-TB
Foreign body type
Touton- fat necrosis

12

What is chronic cholecystitis?

Repeated obstruction of gallbladder with gallstones. Repeated acute inflammation leads to chronic inflammation and fibrosis of the gall bladder wall

13

How is chronic cholecystitis treated?

Surgical removal of the gall bladder

14

What is gastric ulceration (fibrosis)?

Acute caused by alcohol, drugs
Chronic caused by helicobacter
Ulceration occurs due to imbalance between acid production and mucosal defence

15

How is gastric ulceration treated?

PPI inhibitor-e.g omeprazole
2 antibiotics-e.g clarithromycin/amoxicillin

16

What do patients with inflammatory bowel disease present with?

diarhhoea, rectal bleeding and other symptoms

17

What does ulcerative colitis present with and hows it treated?

Superficial
Diarrhoea
Bleeding
Treat with immunosuppression, surgical removal of large bowel (colectomy)

18

What does Crohn's disease present with and how is it treated?

Transmural
Strictures
Fistulae
Treat with lifestyle modifications, diet/ hydration, immunosuppression

19

What are fistulae?

abnormal connections between two epithelia

20

What is liver cirrhosis?

Chronic inflammation with fibrosis leading to disorganisation of architecture and attempted regeneration

21

What are common causes of liver cirrhosis?

Alcohol
Infection with HBV/HCV
Immunological
Fatty liver disease
Drugs and toxins

22

How is liver cirrhosis treated?

Cannot be reversed, lifestyle changes to prevent further damage, and transplantation of a new liver if necessary

23

What disease causes increased function thyrotoxicosis?

grave's disease

24

What is rheumatoid arthritis?

Autoimmune disease with localised and systemic immune response
Localised chronic inflammation leads to joint destruction
The sytemic immune response can affect other organs causing amyloidosis

25

When do granulomas form?

When the immune system walls off something its unable to eliminate e.g bacteria, fungi, other foreign material. Arise with persistent, low grade antigenic stimulation and hypersensitivity.

26

What are the main causes of granulomatous inflammation?

MIldly irritant foreign material
Infections:
Mycobacteria- TB, leprosy
Syphilis
Some fungi
Unknown causes:
Sarcoid
Wegener's granulomatosis
Crohn's disease

27

How does TB cause disease?

Produces no toxins of lytic enzymes but causes disease by persistence and induction of cell-mediated immmunity

28

What are the outcomes of TB?

Arrest, fibrosis, scarring
Erosion into bronchus
Tuberculous emphysema (collection of pus)
Erosion into bloodstream

29

What is a granuloma?

Epithelioid histiocyte core (modified immobile macrophages) surrounded by lymphocytes