MOD S4 - Chronic Inflammation Flashcards Preview

ESA2 > MOD S4 - Chronic Inflammation > Flashcards

Flashcards in MOD S4 - Chronic Inflammation Deck (23):
0

How may chronic inflammation arise?

May take over from or arise alongside acute inflammation
De novo
Autoimmune conditions
Chronic infections
Chronic low level irritation
In severe, repeated or persistent irritation

1

List the effects of chronic inflammation

Fibrosis
Impaired function
Atrophy
Stimulation of autoimmune response

2

Give some examples of fibrosis in chronic inflammation

Cirrhosis
Chronic peptic ulcers
Chronic cholecystitis

3

Give some examples of impaired function in chronic inflammation

Chronic inflammatory bowel disease
Rarely, increased secretion eg mucus secretion, thyrotoxicosis

4

Give some examples of atrophy in chronic inflammation

Gastric mucosa
Adrenal glands

5

Give an example of stimulation of immune response in chronic inflammation

Macrophage-Lymphocyte interactions

6

List the cells principally involved in chronic inflammation

Macrophages
Lymphocytes
Eosinophils
Fibroblasts/myofibroblasts
Giant cells

7

What is the purpose of macrophage cells in chronic inflammation?

Important acutely and chronically
Levels of activation
Functions:
-Phagocytosis and destruction of debris and bacteria
-Processing and presentation of antigen to immune system
-Synthesis of clotting factors, complement components, cytokines and proteases
-Control of other cells by cytokines release

8

What is the purpose of lymphocyte cells in chronic inflammation?

Sometimes "chronic inflammation cells"
Functions:
-Complex, mainly immunological functions
-B lymphocytes/plasma cells differentiate to form antibodies
-t lymphocytes involved in control (CD4) and some cytotoxic reactions (CD8)

9

What is the purpose of eosinophils in chronic inflammation?

Allergic reactions
Some tumours
Parasite infections

10

What is the purpose of fibroblasts and myofibroblasts in chronic inflammation?

Recruited by macrophages
Make collagen

11

What is the purpose of giant cells in chronic inflammation?

Multinucleate cells
Formed by fusion of macrophages by frustrated phagocytosis
Types:
-Langerhans type (seen in TB)
-Foreign body type
-Touton type (seen in fat necrosis)

12

Describe chronic cholecystitis

Caused by repeated obstruction of gall bladder by gall stones
Repeated acute inflammation leads to chronic inflammation and fibrosis of gall bladder wall
Treated by surgical removal

13

Describe gastric ulceration

Acutely caused by alcohol or drugs
Chronically caused by helicobacter pylori
Occurs due to imbalance between acid production and mucosal defence
H.Pylori treatment is PPI inhibitor eg omeprazole and two antibiotics eg clarithromycin, amoxicillin

14

Give two examples of inflammatory bowel disease and describe general symptoms

Crohn's disease
Ulcerative colitis
Inflammatory disease affecting large and small bowel
Patients present with rectal bleeding and diarrhoea

15

Describe ulcerative colitis

Superficial
Diarrhoea
Bleeding
Treat with immunosuppression
Last resort is colonectomy

16

Describe Crohn's disease

Transmural
Strictures
Fistulae (abnormal connection between two epithelia)
Treat with immunosuppression and lifestyle changes eg diet/hydration

17

Describe liver cirrhosis

Chronic inflammation and fibrosis leading to disorganisation of architecture and attempted regeneration
Irreversible so requires lifestyle changes and possible transplant
Caused by:
-Alcohol
-Infection with HBV/HVC
-Immunological
-Fatty liver disease
-Drugs and toxins

18

Describe thyrotoxicosis

Aka Graves' disease
Autoimmune stimulation of TSH receptors in thyroid follicular cells
Excess T3 and T4 produced
Treated by carbimazole, thyroidectomy, radioactive iodine

19

Describe rheumatoid arthritis

Autoimmune
Localised chronic inflammation leads to joint damage
Systemic immune response - can affect other organs and cause amyloidosis

20

Describe granulomas

When immune system walls off something it is unable to eliminate eg bacteria, fungi and other foreign material
Arise with persistent low grade antigenic stimulation and hypersensitivity

21

What are the main causes of granulomas?

-Mildly irritant foreign material
-Infections:
>Mycobacteria (leprosy and tuberculosis)
>Syphilis
>Some fungi
-Unknown causes:
>Sarcoidosis
>Wegener's granulomatosis
>Crohn's disease

22

Describe tuberculosis

-Caused by mycobacteria
-Produces no toxins or lyric enzymes
-Causes disease by persistence and induction of cell mediated immunity
-Outcomes:
>Arrest, fibrosis, scarring
>Erosion into bronchus
>Tuberculous empyema
>Erosion into bloodstream