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Pathological Processes > 3. Chronic inflammation > Flashcards

3. Chronic inflammation Flashcards

1
Q

Which clinical signs are associated with chronic inflammation?

A

Pain and swelling

Redness and heat are resolved

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2
Q

Which is the dominant cell type involved in chronic inflammation?

A

Macrophages

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3
Q

Which 3 ways can chronic inflammation arise?

A
  1. Take over from acute inflammation if damage isn’t resolved in a few days
  2. Without any preceding acute inflammation
  3. Develops alongside acute inflammation
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4
Q

Give examples of chronic inflammation that doesn’t have preceding acute inflammation.

A

Autoimmune conditions - RA

Chronic infections

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5
Q

What type of tissue is often present in chronic inflammation?

A

Granulation tissue

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6
Q

What cells are involved in chronic inflammation?

A

Macrophages, B and T lymphocytes, Eosinophils, Fibroblasts/myofibroblasts.

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7
Q

Outline some functions of macrophages.

A
  • Phagocytosis
  • Processing and presenting antigens
  • Cytokine release…
    stimulate angiogenesis, fever and acute phase reaction.
    Synthesis of cytokines, clotting factors, proteases.
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8
Q

What is the function of fibroblasts/myofibroblasts?

A

Secrete CT substances - collagen, elastin

Myofibroblasts contract - wound healing

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9
Q

What is a giant cell?

A

Fusion of macrophages to form one, large cell with lots of nuclei.

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10
Q

How is a giant cell formed?

A

Frustrated phagocytosis, when macrophages are unable to engulf a foreign body/ microorganism.

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11
Q

What are the 3 types of giant cell?

A
  1. Langhans
  2. Touton
  3. Foreign- body
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12
Q

What does a langhans cell look like and what disease is it associated with?

A

Horse-shoe nuclei

TB

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13
Q

When might a touton giant cell be seen?

A

Lesions with a high lipid content - e.g fat necrosis

Foam cells also present

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14
Q

What are unwanted effects of chronic inflammation?

A
  1. Fibrosis - cirrhosis
  2. Impaired function - excessive fibrous tissue
  3. Atrophy
  4. Immune response - e.g RA autoimmunity
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15
Q

What is granulomatous inflammation?

A

Inflammation with granulomas present

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16
Q

Why does a granuloma form?

A

Granuloma forms around a particle that is poorly soluble and difficult to eliminate. E.g foreign bodies, bacteria (TB)

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17
Q

Which cell types are present in a granuloma?

A

Clusters of macrophages and lymphocytes in its centre

Epitheloid cells

18
Q

What are epitheloid cells?

A

Macrophages modified to look like epithelial cells, elongated and tightly packed together

19
Q

What diseases can present with granulomas?

A 
Crohn's, Sarcoidosis, Wegener's granulomatosis 
BCG granuloma (abnormal reaction)
20
Q

How can you differentiate between sarcoidosis and TB?

A

Sarcoidosis has non-casous granulomas

TB has caseous necrosis within granuloma and langhan giant cells

21
Q

Which inflammatory bowel condition is superficial and affects mucosa only?

A

Ulcerative colitis

22
Q

Which symptoms are common to both UC and Crohn’s disease?

A

Bleeding, diarrhoea, weight loss

23
Q

Are strictures and fistulae associated with UC or Crohn’s?

A

Crohn’s disease

24
Q

What microscopic features would you expect to see in RA?

A

Inflammatory cells in synovial lining- macrophages, lymphocytes, plasma cells
Fibrosis
Hyperplasia of synovial lining
Rheumatoid nodules - giant cell granuloma’s

25
Q

What is cirrhosis?

A

Chronic inflammation with fibrosis

26
Q

Where is cirrhosis commonly seen?

A

End stage liver disease - bands of fibrous tissue, impairing liver function

27
Q

What is chronic cholecystitis?

A

Gallstones

28
Q

UC or Crohn’s: Discontinuous distribution

A

Crohn’s

29
Q

UC or Crohn’s: Affects any part of gastrointestinal system

A

Crohn’s

30
Q

UC or Crohn’s: ‘Cobblestone’ appearance to bowel mucosa.

A

Crohn’s

31
Q

UC or Crohn’s: Granulomas often present

A

Crohn’s

32
Q

UC or Crohn’s: Significant risk of colon cancer.

A

UC

33
Q

UC or Crohn’s: Often most severe in distal colon

A

UC

34
Q

UC or Crohn’s: Continous and superficial

A

UC

35
Q

UC or Crohn’s: Bowel fistulae more common

A

Crohn’s

36
Q

Which patients is sarcoidosis most common?

A

Young adult women

37
Q

What tests can be used to differentiate between TB and sarcoidosis?

A

Acid fast bacilli

38
Q

What is the definition of an ulcer?

A

Ulcer = breach in mucosa to level of submucosa or deeper.

39
Q

How does Helicobacter pylori cause gastritis?

A

By stimulating production of pro-inflammatory cytokines and by directly injuring epithelial cells and increasing acid secretion.

40
Q

Which malignancies are associated with h.pylori gastritis?

A

Gastric adenocarcinoma.

MALT (mucosa associated lymphoid tissue) lymphoma.

41
Q

TB is acid fast. What does acid fast mean?

A

Retains stains even on treatment with mixture of acid and alcohol.

42
Q

What are some clinical examples of chronic inflammation?

A 
Chronic colesystitis 
Inflammatory bowel diseases
Rheumatoid arthritis 
Chronic gastritis 
Cirrhosis

Pathological Processes (12 decks)

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