3. Chronic Inflammation Flashcards
What are the 3 ways that chronic inflammation can arise?
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
What is chronic inflammation?
Chronic response to injury with associated fibrosis
What are the effects of chronic inflammation?
Fibrosis
Impaired function
Atrophy
Stimulation of immune response
What cells are typical of chronic inflammation?
Macrophages Lymphocytes Eosinophils Fibroblasts Giant cells
What are the 3 types of giant cell and what do they usually contain?
Langhans - TB
Foreign body type - foreign bodies
Touton - fat necrosis
What are giant cells and why do they form?
Multinucleated cells from macrophage fusion
Formed from frustrated phagocytosis
What is cholecytitis?
Repeated acute attacks leading to chronic inflammation and fibrosis of gall bladder wall
Leads to obstruction of gall bladder
Treated by removing gall bladder
What is gastric ulceration?
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
What are the 2 types of inflammatory bowel disease?
Ulcerative colitis
Crohn’s disease
Give 3 features of ulcerative colitis
Superficial
Diarrhoea
Bleeding
Give 3 features of Crohn’s disease
Transmural
Strictures
Fistulae
How is ulcerative colitis treated?
Immunosuppression
Colectomy
How is Crohn’s disease treated?
Lifestyle changes
Diet/staying hydrated
Immunosuppression
What is liver cirrhosis?
Chronic inflammation with fibrosis leading to disorganisation of architecture
What are the causes of liver cirrhosis?
Alcohol
Hepatitis B/C
How is liver cirrhosis treated?
Prevent further damage
Can have liver transplant
What is rheumatoid arthritis?
Autoimmune disease
Local chronic inflammation leads to joint destruction
System immune response can affect other organs and cause amyloidosis
What is a granuloma?
Where chronic inflammation and immune responses overlap
Immune system walls off something it cannot eliminate
What can cause granulomas?
Foreign material Mycobacterium (tuberculosis/leprosy) Syphillis Fungi Sarcoidosis Crohn's disease Wegener's granulomatosis
What type of necrosis does TB induce which can be seen in granulomas?
Caseous necrosis
