5. Chronic Inflammation

Question 1

What are the causes of chronic inflammation?

Answer 1

Persistant infection
Autoimmune
Prolonged exposure to toxic agents
Unknown aetiology

Question 2

What are the morphological features of chronic inflammation?

Answer 2

Infiltration of mononuclear cells
Tissue destruction
Attempts at healing (angiogenesis and fibrosis)

Question 3

What is the most important cell in chronic inflammation?

Answer 3

Macrophages

Question 4

What are the functions of macrophages in chronic inflammation?

Answer 4

Secrete cytokines and growth factors
Phagocytosis
Activates T lymphocytes

Question 5

What activates macrophages?

Answer 5

Cytokines and endotoxins

Question 6

What type of inflammation depends on B and T lymphocytes?

Answer 6

Granulomatous

Question 7

What are macrophages in the liver known as?

Answer 7

Kupffer cells

Question 8

What are macrophages in the spleen and lymphatics known as?

Answer 8

Sinus histiocytes

Question 9

What are macrophages in the CNS known as?

Answer 9

Microglia

Question 10

What is contained in the granules of eosinophils?

Answer 10

Major Basic Protein: toxic to parasites

Question 11

What is granulomatous inflammation also known as?

Answer 11

Type 4 hypersensitivity reaction

Question 12

What is a granuloma?

Answer 12

Accumulation of epitheloid macrophages surrounded by lymphocytes

Question 13

Why are macrophages called epitheloid in granulomatous inflammation?

Answer 13

High cytoplasm

Question 14

What is the name given to several epitheloid macrophages fused together?

Answer 14

Giant cell

Question 15

What circumstances cause the formation of a granuloma?

Answer 15

In response to substances that resist lysosomal degradation or induce T cell hypersensitivity
ie. foreign materials and certain micro-organisms

Question 16

What do macrophages present to MHC-II receptors on T cells in a type 4 delayed hypersensitivity reaction?

Answer 16

Ags

Question 17

What type of giant cells are found in type 4 delayed hypersensitivity reaction?

Answer 17

Langhans type giant cells

Nuclei in a U-shape in periphery

Question 18

What are 3 features of sarcoidosis?

Answer 18

Non-caseating naked granuloma
Schaumann bodies
Asteroid bodies

Question 19

What is serous inflammation?

Answer 19

Accumulation of thin fluid from secretion of mesothelium or serum

Question 20

What is fibrinous inflammation?

Answer 20

Accumulation of fluid and fibrin

Question 21

What is suppurative inflammation?

Answer 21

Large amounts of pus produced

May lead to abscess formation

Question 22

What is an ulcer?

Answer 22

Local defect in epithelial surface due to shedding

Question 23

What is an acute ulcer?

Answer 23

Loss of full epithelium thickness

May or may not involve scarring

Question 24

What is a chronic ulcer?

Answer 24

Deep penetration

Always scarring

Question 25

What is a sinus?

Answer 25

Tract lined by granulation tissue from a chronically inflamed cavity to the surface

Question 26

What is a fistula?

Answer 26

Abnormal communication between 2 surfaces

Question 27

Name 5 infectious causes of granulomatous inflammation

Answer 27

``` TB Leprosy Histoplasmosis Toxoplasmosis Syphilis ```

Question 28

What name is given to substances that induce fever?

Answer 28

Pyrogens

Question 29

How do bacterial products induce fever?

Answer 29

Stimulate leukocytes to release cytokines | Increases cyclooxygenase which increases prostaglandins

Question 30

How do NSAIDs lower fever?

Answer 30

Inhibit prostaglandin production

Question 31

Where are acute phase proteins produced?

Answer 31

Liver

Question 32

Name 3 acute phase proteins

Answer 32

CRP SAA Fibrinogen

Question 33

What is leukocytosis?

Answer 33

High leukocyte count in response to inflammation, including immature leukocytes

Question 34

What other response to inflammation are there?

Answer 34

``` Increase HR and BP Decrease sweating Shivering Anorexia and malaise Severe sepsis ```

Question 35

How is granuloma formation different in a defective immune system?

Answer 35

Transformation of macrophages to epitheloid cells is not effective, appear as foamy cells

Question 36

What does a Langhan's giant cell look like?

Answer 36

Giant cell with 20+ nuclei arranged in a U shape