W3- Chronic Inflammation

Question 1

If there is no resolution following acute inflam, what may follow?

Answer 1

Chronic inflam and some form of permanent tissue damage

Question 2

What are the 3 ways that chronic inflam may arise?

Answer 2

Take over from acute inflam, arise de novo, develop alongside acute inflam

Question 3

What is the most important characteristic of chronic inflam?

Answer 3

The type of cell present

Question 4

Which cell type s strongly associated with chronic inflam?

Answer 4

Macrophages

Question 5

Where are macrophages derived from?

Answer 5

Blood monocytes

Question 6

What are the 4 important functions of macrophages in chronic inflam?

Answer 6

Phagocytosis, APC to IS, synthesis of cytokines etc, control of other cells by cytokine release

Question 7

What do lymphocytes do in chronic inflam?

Answer 7

Immunological complex, B lymphocytes produce abs, T lymphocytes involved in control and some cytotoxic functions

Question 8

What are plasma cells?

What do the imply?

Answer 8

Differentiated ab-producing B lymphocytes

Imply considerable chronic inflam

Question 9

During what type of diseases are eosinophils found?

Answer 9

Allergic reactions, parasite infections, some tumours e.g lymphomas

Question 10

What do fibroblats/myofibroblasts do?

What are they recruited by?

Answer 10

Make collages, recruited by macrophages

Question 11

What is a giant cell?

Why are they formed?

Answer 11

Multinucleated cells made by fusion of macrophages.

Formed due to frustrated phagocytosis

Question 12

What are the 3 types of giant cells?

Answer 12

Langhans
Foreign body type
Touton

Question 13

When is a Langhan cell seen?

Answer 13

TB infection- mycobacterium resistant to phagocytosis

Question 14

When do foreign body cells form?

Answer 14

When a foreign body is present

Question 15

When do Touton cells form?

Answer 15

In fat necrosis

Question 16

What cells are mainly seen in rheumatoid arthritis?

Answer 16

Plasma cells

Question 17

What cell type is mainly Seen in chronic gastritis?

Answer 17

Lympocytes

Question 18

What cell type is mainly seen in leishmaniasis (protozoal infection)?

Answer 18

Macrophages

Question 19

What 4 things may be caused by chronic inflam?

Answer 19

Fibrosis, impaired function, atrophy, stimulation of IR

Question 20

What happens in chronic cholecystitis?

What do you get repeated attacks of?

Answer 20

Repeated obstruction by gall stone.

Fibrosis of gall bladder wall.

Repeated attacks of acute inflam leading to chronic inflam

Question 21

What are the causes of acute and chronic gastric ulcers/ gastritis?

Why does ulceration occur?

Answer 21

Acute- alchohol, drugs (NSAIDs)

Chronic- Helicobacter pylori

Ulceration because of imbalance of acid production and mucosal defence

Question 22

What can scarring of the stomach wall in gastritis effect?

Answer 22

The peristaltic function of the stomach

Question 23

What is inflammatory bowel disease and where does it affect?

How do patients present?

What are the two types?

Answer 23

Idiopathic inflam disease affects large and small bowel

Diarrhoea, rectal bleeding, other

Ulcerative colitis and Crohn’s disease

Question 24

What two symptoms characterise UC?

Answer 24

Diarrhoea and bleeding

Question 25

What two features characterise Crohn's disease?

Answer 25

Strictures (fibrosis) and fistulae (abnormal connection between two epithelial-lined organs)

Question 26

What are the 6 common causes of cirrhosis?

Answer 26

Alcohol, infection (HBV, HCV), immunological, fatty liver disease, drugs and toxins

Question 27

What is fibrosis?

Answer 27

Disorganised architecture with attempted regen

Question 28

What disease characterises thyrotoxicosis? What happens?

Answer 28

Graves' disease- abs from plasma cells stimulate TSH R causing excess thyroxine

Question 29

In rheumatoid arthritis, what does localised chronic inflam lead to? What do you see happening at the joints?

Answer 29

Joint destruction Synovitis, articular cartilage erodes

Question 30

What is granulomatous inflammation?

Answer 30

Chronic inflam with granulomas

Question 31

What is a granuloma?

Answer 31

Group of macrphages stuck together

Question 32

What causes granulomas to arise?

Answer 32

Persistent low-grade antigenic stimulation and hypersensitivity

Question 33

What are the main causes of granulomatous inflammation?

Answer 33

Mildly irritant foreign material, infections (TB, leprosy, fungi), sarcoidosis, Crohn's, Wegener's granulomatosis

Question 34

What bacteria causes TB? How does it cause disease/

Answer 34

Mycobacteria esp M.tuberculosis. Causes disease by persistence and induction of cell- mediated immunity

Question 35

What is a key characteristic seen in TB lungs?

Answer 35

Caseous necrosis- white soft cheese like

Question 36

What is miliary TB?

Answer 36

TB that spreads to multiple organs

Question 37

What are the 4 outcomes of TB?

Answer 37

Arrest, firbosis and scarring Erosion into bronchus TB empyema (pus in pleural cavity) Erosion into blood stream

Question 38

Give 2 examples of other granulomatous infections.

Answer 38

Leprosy, syphilis

Question 39

What features characterise sarcoidosis? What places does it involve?

Answer 39

Non-caseating granulomas, giant cells. Involves lymph nodes, lungs

Question 40

What disease is characterised by regional enteritis (patchy full-thickness inflam throughout bowel)?

Answer 40

Crohn's disease

Question 41

What is sarcoidosis?

Answer 41

Formation of collection of inflam cells that can form as nodules in multiple organs

Question 42

What is chronic inflammation?

Answer 42

Chronic response to injury with associated fibrosis