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MOD > 3 chronic effects Chronic Inflammation (conditions only) > Flashcards

3 chronic effects Chronic Inflammation (conditions only) Flashcards

1
Q

General effects of chronic inflammation

A
  • fibrosis
  • impaired function
  • atrophy e.g. autoimmune gastritis
  • stimulation of an inappropriate immune response e.g rheumatoid arthritis
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2
Q

In chronic inflammation what cell type may help with diagnosis?

A

giant cell

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3
Q

Examples of fibrosis as an effect of chronic inflammation

A
  • lung fibrosis
  • gall baldder (chronic cholecystitis)
  • chronic peptic ulcers
  • cirrhosis
  • skin scar tissue
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4
Q

Example of impaired function as an effect of chronic inflammation

A
  • chronic inflammatory bowel disease
  • rarely increased function e.g. thyrotoxicosis (grave’s disease), mucus secretion
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5
Q

Chronic cholecystitis:
1. How common ?
2. follows what ?
3. can affect ?

A
  1. very common disease
  2. repeated episodes of acute cholecystitis
  3. both sexes any age
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6
Q

What is the common demographic profile for those most affected by chronic cholecystitis ?

A

“typically” described as female, fat, fertile, forty

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7
Q

leading cause of chronic cholecystitis ?

A

gall stones

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8
Q

Is chronic cholecystitis always symptomatic ?

A

No, it can be asymptomatic

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9
Q

What are some possible syptoms of chronic cholecystitis ?

A
  • biliary colic (intermittent pain in upper right abdomen)
  • indigestion
  • nausea
  • vomiting
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10
Q

What are some possible signs or complications of chronic cholecystitis ?

A
  • episodes of acute cholecystitis
  • obstruction of bile ducts -> leads to jaundice
  • obstruction of pancreatic ducts -> leads to pancreatitis
  • chronic inflammation and scarring of gallbladder wall
  • formation of gallstones
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11
Q

Biliary colic involves episodes of ….1.. pain caused by …2.. temporarily blocking the ..3..

A
  1. severe, crampy abdominal
  2. gallstones
  3. bile ducts
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12
Q

Chronic cholecystitis is associated with malignant transformation to ….?

A

cholangiocarcinoma

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13
Q

Chronic peptic ulcer refers to ulcers found where ?

A

gastric and duodenal ulcer

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14
Q

Example where fibrosis can be observed in a disease pathogenesis is one chronic condition of the stomach known as ?

A

chronic peptic ulcer

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15
Q

Cause of chronic peptic ulcer

A
  • helicobacter pylori (HP gastritis)
  • hyperacidity
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16
Q

Risk factors of chronic peptic ulcer

A
  • Drugs = NSAIDs
  • Genetic
  • alcohol consumption
  • cigarettes
  • steroids
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17
Q

Pathogenesis of chronic peptic ulcer ?

A
  1. excess gastric acid secretion
  2. decreased mucosal defense against gastric acid
  3. ulceration due to imbalance between factors promoting mucosal damage and those mechanisms promoting gastroduodenal defense

can lead to fibrosis = narrowing or pyloric stenosis

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18
Q

Chronic peptic ulcer sites affected ?

A
  • antrum (lowermost part of stomach)
  • first part of duodenum
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19
Q

What type of fibrosis is observed in chronic peptic ulcers (gastric/duodenal) ?

A

narrowing or pyloric stenosis

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20
Q

what is pyloric stenosis ?

A

muscular valve between stomach and small intestine becomes abnormally narrowed

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21
Q

List factors which promote mucosal damage

A
  • gastric acid
  • pepsin
  • H. pylori infection
  • NSAIDs
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22
Q

mechanisms promoting gastroduodenal defense

A
  • prostaglandins
  • mucus
  • bicarbonate
  • muscosal blood flow
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23
Q

Ulceration is due to what ?

A

imbalance of acid and pepsin attack and muscosal defence of the gut

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24
Q

An example where fibrosis can be observed in a disease pathogenesis is one chronic condition of the liver known as ?

A

cirrhosis

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25
Q

A Fat Idiotic Primary Child Hated Banana Cupcakes

Common causes of cirrhosis ?

A
  • alcohol consumption
  • fatty liver disease
  • infection with Hepatitis B/C (HBV/HCV)
  • immunological - primary biliary cirrhosis
  • idiopathic / unknown
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26
Q

Pathogenesis of cirrhosis ?

A
  • chronic inflammation
  • destruction of hepatocytes
  • fibrosis
  • nodular regeneration leading to cirrhosis
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27
Q

Complications associated with cirrhosis ?

A
  • portal hypertension - scar tissue (fibrosis) from cirrhosis obstructs blood flow through liver
  • liver failure - loss of functional liver tissue
  • hepatocellular carcinoma (HCC)
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28
Q

What causes portal hypertension to be a complication of cirrhosis ?

A

increased resistance to blood flow through the scarred liver (scar tissue, fibrosis)

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29
Q

Liver failure is a complication of cirrhosis why ?

A

loss of functional liver tissue and metabolic dysfunction

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30
Q

Hepatocellular carcinoma is a complication of cirrhosis why ?

A

develops due to chronic inflammation , regenerative nodules and genetic mutations

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31
Q

A microscopic slide of liver cirrhosis shows what ?

A
  • inflammation with destruction of hepatocytes
  • fibrosis and nodular regeneration
  • fibrous tissue = blue !
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32
Q

Example where impaired function can be observed in a disease pathogenesis is one chronic condition of the gut known as ?

A

inflammatory bowel disease

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33
Q

Name 3 features that can be observed with inflammatory bowel disease

A
  • oedematous mucosa (mucous membrane becomes swollen due to accumulation of fluid)
  • ulceration
  • scar tissue
34
Q

Cause of inflammatory bowel disease ?

A

idiopathic inflammatory disease affecting the large and small bowel

35
Q

GI and non-GI symptoms of inflammatory bowel disease ?

A

GI
* abdominal pain
* diarrhoea
* rectal bleeding

Non-GI
* sometimes presents with symptoms like uveitis - autoimmune and systemic inflammatory response affecting the eyes

36
Q

Types of inflammatory bowel disease

A
  • ulcerative colitis
  • Crohn’s disease
37
Q

What’s the difference between what is involved with Crohn’s disease and ulcerative colitis ?

A

Crohn’s disease -> may involve any part of the GI tract

Ulcerative colitis -> usually involves large bowel (90% - rectum)

38
Q

Crohn’s disease inflammation is = …1., this causes ..2.. ?

A
  1. transmural
  2. pain, loose stools, malabsorption
39
Q

Crohn’s disease & ulcerative colitis difference in inflammation involved and what each inflammation is ?

A

C: Transmural = affects all layers of bowel wall , intermost mucosa to outermost serosa

U: continuous mucosal inflammation = only mucosal and submucosal layers of colon

40
Q

Crohn’s disease transmural inflammation is a hallmark feature contributing to complications such as what ?

A
  • strictures/ obstruction , narrowing of the bowel
  • fistulas = abnormal connections between different parts of the bowel or other organs
41
Q

In crohn’s disease what leads to the following:
1. …. leads to obstruction
2. …… leads to fistula formation

A
  1. fibrosis
  2. full thickness inflammation
42
Q

Ulcerative colitis:
1. Has no ….. & ….. like in Crohn’s disease
2. a potential serious complication ?

A
  1. skip lesions & granulomas
  2. malignant change (development of colorectal cancer)
43
Q

skip lesions are = areas of ..1.. tissue interspersed with areas of ..2.. tissue

A
  1. diseased
  2. healthy
44
Q

List features that Crohn’s disease has that ulcerative colitis does not ?

A
  • skip lesions (areas of diseased tissue interspersed with areas of healthy tissue)
  • granuloma formation
45
Q

Example where increased function can be observed in a disease pathogenesis is one chronic condition of the thyroid known as ?

A

thyrotoxicosis (grave’s disease)

46
Q

Cause of thyrotoxicosis ?

A

autoimmune disease

47
Q

Thyrotoxicosis involves ..1.. with toxic ..2..

A
  1. hyperthyroidism
  2. goitre
48
Q

Symptoms of thyrotoxicosis ?

A
  • exophthalmos (protruding eyes)
  • thyrotoxic signs (palpitations, tremor)
  • enlarge thyroid (multinodular toxic goitre)
49
Q

Pathogenesis of thyrotoxicosis involves ?

A
  1. autoantibodies - long acting thyroid stimulating antibodies - TSI (thyroid stimulating immunoglobulin)
  2. TSI antibody acts on TSH surface receptor on thyroid epithelium and mimics TSH
  3. Increased T4 and T3 = reduced TSH
  4. hyperactive thyroid (hyperthyroidism)
50
Q

Example where atrophy can be observed in a disease pathogenesis is one chronic condition of the gut known as ?

A

autoimmune gastritis

51
Q

Example where inappropriate immune response can be observed in a disease pathogenesis is one chronic conditions of the joint known as ?

A

rheumatoid arthritis

52
Q

Chronic inflammation overlaps with what response ?

A

immune

53
Q

Immune disease cause pathology by …?

A

chronic inflammation

54
Q

Cause of RA ?

A

autoimmune disease - rheumatoid factor

55
Q

RA ratio female : male ?

A

3: 1

56
Q

RA is : quite ..1.. , ..2.. disease , invariably affects ..3..

A
  1. common
  2. systemic
  3. joints
57
Q

Localised chronic inflammation leads to joint ..1… - especially which joints ?

A
  1. destruction
  2. especially small joints
58
Q

4 examples of systemic immune response associated with RA ?

A
  • rheumatoid nodules
  • splenomegaly
  • amyloidosis
  • pulmonary fibrosis
59
Q

Name 5 examples of atopic disease = …2… characterised by ..1… ?

A
  1. inappropriate immune responses to relatively innocuous (harmless) everyday substances
  2. asthma, hayfever, eczema, food allergies, anaphylaxis
60
Q

What is granulomatous inflammation ?

A

chronic inflammation with granulomas

61
Q

Granuloma = organised collection of …1… which are ….2… often have ..3… nuclei

A
  1. epithelioid cells
  2. modified / activated macrophages
  3. elongated banana-like/slipper-like
62
Q

A granuloma may or may not contain ..1.. / be …2.

A
  1. giant cells
  2. necrotic
63
Q

2 main types of granulomas are ?

A
  • foreign body
  • immune (hypersensitivity)
64
Q

Foreign body granulomas develop around …?

A

material that is not antigenic (e.g. surgical thread)

65
Q

Immune granulomas develop around …?

A

insoluble but antigenic particles = cell-mediated immune response

66
Q

Foreign body granulomas:
1. deal with particles which are … (& an example)
2. deal with organisms which are …. (2 examples)
3. But when the fail, they need to bring in …

A
  1. poorly soluble (foreign bodies)
  2. difficult to eliminate (mycobacterium tuberculosis or mycobacterium leprae)
  3. immune granulomas…
67
Q

Foreign body granulomas & Immune granulomas are either non-caseating / caseating , which one is which ?

A
  • foreign body granulomas = non-caseating
  • immune granulomas = caseating (central necrosis) e.g .TB
68
Q

main causes of granulomatous formation ?

A
  1. midly irritant ‘foreign’ material
  2. infections
  3. unknown causes
69
Q

Examples of infections as main causes of granulomatous formation

A
  • tuberculosis
  • leprosy mycobacterium
70
Q

Examples of unknown causes as main causes of granulomatous formation

A
  • sarcoidosis
  • granulomatosis with polyangiitis (GPA)
  • Crohn’s disease
71
Q

What bacteria causes TB ?

A

mycobacterium tuberculosis

72
Q

what adaptations does this bacterium have to evade immune response ?

A

thick waxy wall of lipids (mycolic acid) that protect against ROS

73
Q

What does tuberculosis produce none of ?

A
  • toxins
  • lytic enzymes
74
Q

tuberculosis causes disease by …?

A

persistence and induction of cell-mediated immunity

75
Q

What is caseating granuloma?

A

central necrosis characteristic of TB and fungal infections

76
Q

Ghon focus…

formation of a ..1.. , or …2… area of bacteria, which is considered the ..3.. in tuberculosis (primary ….4… lesion caused by ..5…)

A
  1. granuloma
  2. walled off
  3. primary lung lesion
  4. subpleural
  5. TB bacilli
77
Q

Latent TB …

  1. symtpom/asymptomatic
  2. …… but infected by TB
  3. results in …… tuberculin skin test/ TB blood test
  4. must be treated regardless
A
  1. asymptomatic
  2. noncontagious
  3. positive
78
Q

List some other granulomatous infections

A
  • leprosy
  • syphilis
  • chronic fungal infections
  • ‘cat-scratch’ disease
79
Q

Sarcoidosis is a …. disease with fibrous lesions forming where ?

A

autoimmune

  • lymph nodes
  • liver
  • skin
  • lungs
  • spleen
  • eyes
  • small bones of hands and feet
80
Q

sarcoidosis is more common in which age group and gender ?

A

young adult women

MOD (22 decks)

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