Session 3 - Chronic Inflammation

Question 1

What is chronic inflammation?

Answer 1

Prolonged inflammation with associated repair

Question 2

What are 3 ways that chronic inflammation arises?

Answer 2

Takes over from acute inflammation is resolution wasn’t possible
Develops alongside acute inflammation
Arises by itself without preceding acute inflammation

Question 3

What are monocytes?

Answer 3

Macrophages in circulation

Question 4

What are histiocytes?

Answer 4

Macrophages in tissue

Question 5

How do macrophages look like?

Answer 5

Large
Abundant foamy cytoplasm
Slipper shape nucleus

Question 6

Why do macrophages cytoplasms look foamy?

Answer 6

Presence of phagolysosomes

Question 7

What are 2 functions of macrophages?

Answer 7

Phagocytosis - removal of pathogen and present to immune system
Synthesis and release inflammatory mediators - controls and regulates inflammatory response

Question 8

How do lymphocytes look like?

Answer 8

Small, only a bit larger than RBC

Spherical nucleus w very thin rim of cytoplasm

Question 9

What are 2 types of T cells?

Answer 9

Helper and cytotoxic

Question 10

What is the function of helper T cells?

Answer 10

Assist other inflammatory cells

Question 11

What is the function of cytotoxic T cells?

Answer 11

destroy pathogens

Question 12

What is the function of B cells?

Answer 12

Become plasma cells, produce antibodies to neutralize pathogens

Question 13

How do plasma cells look like?

Answer 13

Eccentric nucleus - off centre nucleus
Clock face chromatin
Peri-nuclear clearing - area of cytoplasm just next to nucleus is slightly paler

Question 14

What is the function of plasma cells?

Answer 14

Produce antibodies

Question 15

How do eosinophils look like?

Answer 15

Bi lobed nucleus

Granular cytoplasm stains red

Question 16

What is the function of eosinophils?

Answer 16

Release mediators during hypersensitivity reactions and parasitic infections

Question 17

What do fibroblasts/myofibroblasts do?

Answer 17

Regeneration and repair

Question 18

What are giant cells?

Answer 18

Multinucleated cells that form via fusion of multiple macrophages

Question 19

Why do giant cells form?

Answer 19

Frustrated phagocytosis

Question 20

What are 3 forms of giant cells?

Answer 20

Foreign body
Langhans
Touton

Question 21

How do foreign body giant cells look like?

Answer 21

Nuclei randomly scattered

Question 22

How do Langhans giant cells look like?

Answer 22

Nuclei arranged around peripheral, horse shoe shaped

Question 23

When can Langhans giant cell be seen?

Answer 23

Tuberculosis

Question 24

How do Touton giant cells look like?

Answer 24

Nuclei lined up in circle centrally

Question 25

When can Touton giant cells be seen?

Answer 25

Fat necrosis

Question 26

What kind of cells mainly appear in rheumatoid arthritis?

Answer 26

Plasma cells

Question 27

What kind of cells mainly appear in chronic gastritis?

Answer 27

Lymphocytes

Question 28

What kind of cells mainly appear during Leishmaniasis protozoal infection?

Answer 28

Macrophages

Question 29

What are 4 effects of chronic inflammation?

Answer 29

Fibrosis Impaired function Atrophy Stimulation of immune response

Question 30

What are 2 examples of fibrosis due to chronic inflammation?

Answer 30

Chronic cholecystitis - fibrosis of gall bladder wall | Liver cirrhosis

Question 31

What are 2 examples of loss of function due to chronic inflammation?

Answer 31

Crohn’s and ulcerative colitis causes abdominal pain, altered bowel motion, weight loss and rectal bleeding bc bowel lost its function

Question 32

What are 5 differences between Crohn’s disease and ulcerative colitis?

Answer 32

Crohn’s affect all of GI tract, ulcerative colitis only large bowel Crohn’s have skip lesions, ulcerative colitis continuous Crohn’s affect full thickness of bowel wall, ulcerative colitis mucosa and submucosa Crohn’s can sometimes find granulocytes, ulcerative colitis no Crohn’s less likely to have rectal bleeding, ulcerative colitis more likely

Question 33

What is liver cirrhosis?

Answer 33

Fibrosis and attempted regeneration during end stage damage to liver

Question 34

What are 4 possible causes of liver cirrhosis?

Answer 34

Alcohol Hepatitis Drugs and toxins Fatty liver

Question 35

What is granulomatous inflammation?

Answer 35

Chronic inflammation and granuloma

Question 36

What is a granuloma?

Answer 36

Collection of epithelioid histiocytes which are macrophages that resemble epithelial cells with surrounding lymphocytes

Question 37

What are 2 types of granuloma?

Answer 37

Foreign body and immune mediated

Question 38

What is the function of foreign body granuloma?

Answer 38

Destruct and remove foreign material

Question 39

What is the function of immune mediated granuloma?

Answer 39

Destruction and removal of bacteria or fungi

Question 40

What is the difference between foreign body and immune mediated granuloma?

Answer 40

Few lymphocytes in foreign body granuloma, many in immune mediated

Question 41

What kind of bacteria causes granulomatous inflammation?

Answer 41

Mycobacterium

Question 42

What are 2 examples of mycobacterium?

Answer 42

Mycobacterium tuberculosis | Mycobacterium leprae

Question 43

Why do mycobacterium cause granulomatous inflammation?

Answer 43

They are difficult to destroy due to thick cell wall and mycolic acids

Question 44

What is mycobacterium granuloma?

Answer 44

Epithelioid histiocytes surrounded by lymphocytes with caseous necrosis in the middle

Question 45

What are 5 questions or ask when interpreting a histological specimen?

Answer 45

``` Is this correct tissue for the site of biopsy? Is it normal? Is it inflammatory or neoplastic? Is it benign or malignant? Is it primary or secondary? ```

Question 46

What are the differences between benign and malignant?

Answer 46

``` Localized / spread No invasion / invasion No metastasis / metastasis Slow growth / rapid growth Compresses tissue / invades and destroys tissue ```

Question 47

What does primary malignant growth mean?

Answer 47

It originates from that tissue

Question 48

What does secondary malignant growth mean?

Answer 48

It spread from a primary tumor elsewhere