7 - Chronic Inflammation

Question 1

Acute inflammation signs

Answer 1

Fast onset
Neutrophil presence
Mild, self-limiting tissue injury
Prominent signs

Question 2

Chronic inflammation signs

Answer 2

Slow onset: days
Subtle signs
Macrophages + lymphocytes
Severe progressive

Question 3

Primary chronic causes - infection

Answer 3

TB, Leprosy, some viruses

Question 4

Primary chronic causes - endogenous materials

Answer 4

Necrotic adipose tissue, uric acid crystals

Question 5

Primary chronic causes - exogenous materials

Answer 5

External origin

Asbestos fibres, sutures, implanted prostheses

Question 6

Primary chronic causes - autoimmune

Answer 6

RA
SLE
Pernicious anaemia

Question 7

Primary chronic causes - primary granulomatous

Answer 7

Crohn’s

Sarcoidosis = granulomas collecting in organs

Question 8

Primary chronic causes -

Answer 8

infection
endogenous
exogenous
autoimmune
primary granulomatous

Question 9

Chronic inflammation - morphological features

Answer 9

Infiltration with mononuclear cells (macro, lympho, plasma)
tissue destruction
healing by fibrosis

Question 10

Chronic inflammation - macroscopically

Answer 10

Dependent on the actual disease

Chronic abscess cavity or granulomatous or fibrosis

Question 11

Chronic inflammation - microscopically

Answer 11

cellular infiltrate of lymphocytes, plasma cells and macrophages
exudation if fluid is not prominent
production of new fibrous tissue from granulation tissue

Question 12

Mast cells produce what

Answer 12

Histamine

Question 13

Wound healing involves

Answer 13

Granulation tissue
Angiogenesis
Fibroblasts deposit collagen
Inflammatory cells

Question 14

Granulation tissue is

Answer 14

New connective tissue and blood vessels that form on the surface of a wound during healing

Question 15

Fibrosis is

Answer 15

Formation of excess fibrous connective during repair of damaged tissue

Scarring
Called fibroma if arises from one cell line
Macrophage induced laying down of connective tissue inc. collagen

Question 16

What is a granuloma?

Answer 16

Aggregate (nodule) of epithelioid histiocytes and other cells; lymphocytes and histiocytic giant cells

Question 17

Granulomatous diseases inc.

Answer 17

TB & leprosy

Question 18

What is a histiocytic cell?

Answer 18

Can form where material is indigestible to macrophages e.g. tubercle bacilli which have cell walls resistant to macrophages

Question 19

How do histiocytic cells form?

Answer 19

They’re multinucleate giant cells which develop when 2+ macrophages try to engulf same particle.

Question 20

Do all granulomas have giant cells?

Answer 20

No, solitary giant cells in the absence of epithelioid histiocytes is not a granuloma

Question 21

Granulomatous disease

Answer 21

Bacterial - TB, leprosy
Parasitic - schistosomiasis
Fungal - cryptococcus
Synthetic materials - silicosis
Unknown - sarcoidosis, crohn's

Question 22

Histology of granuloma types

Answer 22

Langhans giant cell
Caseous necrosis
Epithelioid macrophages