3. Chronic Inflammation

Question 0

What are the 3 ways that chronic inflammation can arise?

Answer 0

1 Can take over from acute inflammation if the damage is too severe
2 May arise de novo (with some autoimmune conditions, infections (hepatitis) and chronic low level irritation)
3 May develop with acute inflammation in severe persistent or repeated irritation

Question 1

What is chronic inflammation?

Answer 1

Chronic response to injury with associated fibrosis

Question 2

What are the effects of chronic inflammation?

Answer 2

Fibrosis
Impaired function
Atrophy
Stimulation of immune response

Question 3

What cells are typical of chronic inflammation?

Answer 3

Macrophages
Lymphocytes
Eosinophils
Fibroblasts
Giant cells

Question 4

What are the 3 types of giant cell and what do they usually contain?

Answer 4

Langhans - TB
Foreign body type - foreign bodies
Touton - fat necrosis

Question 5

What are giant cells and why do they form?

Answer 5

Multinucleated cells from macrophage fusion

Formed from frustrated phagocytosis

Question 6

What is cholecytitis?

Answer 6

Repeated acute attacks leading to chronic inflammation and fibrosis of gall bladder wall
Leads to obstruction of gall bladder
Treated by removing gall bladder

Question 7

What is gastric ulceration?

Answer 7

Ulceration in the stomach due to imbalance between acid production and mucosal defence
Treated with proton pump inhibitors such as omeprazole
Antibiotics if caused by H.Pylori

Question 8

What are the 2 types of inflammatory bowel disease?

Answer 8

Ulcerative colitis

Crohn’s disease

Question 9

Give 3 features of ulcerative colitis

Answer 9

Superficial
Diarrhoea
Bleeding

Question 10

Give 3 features of Crohn’s disease

Answer 10

Transmural
Strictures
Fistulae

Question 11

How is ulcerative colitis treated?

Answer 11

Immunosuppression

Colectomy

Question 12

How is Crohn’s disease treated?

Answer 12

Lifestyle changes
Diet/staying hydrated
Immunosuppression

Question 13

What is liver cirrhosis?

Answer 13

Chronic inflammation with fibrosis leading to disorganisation of architecture

Question 14

What are the causes of liver cirrhosis?

Answer 14

Alcohol

Hepatitis B/C

Question 15

How is liver cirrhosis treated?

Answer 15

Prevent further damage

Can have liver transplant

Question 16

What is rheumatoid arthritis?

Answer 16

Autoimmune disease
Local chronic inflammation leads to joint destruction
System immune response can affect other organs and cause amyloidosis

Question 17

What is a granuloma?

Answer 17

Where chronic inflammation and immune responses overlap

Immune system walls off something it cannot eliminate

Question 18

What can cause granulomas?

Answer 18

Foreign material
Mycobacterium (tuberculosis/leprosy)
Syphillis
Fungi
Sarcoidosis
Crohn's disease
Wegener's granulomatosis

Question 19

What type of necrosis does TB induce which can be seen in granulomas?

Answer 19

Caseous necrosis