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PATH2220 > 8 - Inflammation (outcomes) > Flashcards

8 - Inflammation (outcomes) Flashcards

1
Q

Suppuration

A

The formation of pus, referred to as suppurative or purulent

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2
Q

Pus

A

An exudate containing dead and living neutrophils, dead and living bacteria, protein, cell fragments etc

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3
Q

Abcess

A

Pus filled cavity

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4
Q

Empyema

A

An accumulation of pus in a naturally occurring body cavity

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5
Q

Evolution of an abscess

A
  • Starts as acute inflammatory exudate with many neutrophils
  • Proteins, bacteria and polymorphs aggregate to form a mass
  • Tissue death (necrosis) ensures
  • Process of organisation
  • Fibroblasts start to lay down scar tissue (collagen)
  • Pus resorbed (if small amount) or can burst onto (‘point’) to external surface (sinus) or adjacent body cavity (fistula) and be
    discharged in this way or enter bloodstream to result in septicaemia
  • Collagen deposition proceeds to formation of mature scar
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6
Q

Granulation tissue (process referred to as organisation)

A

New capillaries and fibroblasts develop at edge of accumulated
material

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7
Q

Examples of acute inflammatory reaction in the lung caused by pyogenic bacteria

A

Bacterial Pneumonia (Lobar pneumonia and Bronchopneumonia)

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8
Q

Cause of lobar pneumonia

A

Streptococcus Pneumoniae

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9
Q

Lobar pneumonia

A
  • Alveolar spaced filled with exudate (meutrophils, fibrin, dead bacteria)
  • Referred to as ‘consolidation’ or ‘hepatisation’
  • Consolidation of entire lobe
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10
Q

Outcomes of pneumonia

A
  • Resolution
  • Abscess formation
  • Empyema
  • Fibrosis and scarring
  • Septicaemia
  • Death
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11
Q

Bronchopneumonia

A

Patchy distribution of consolidation, related to bronchi

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12
Q

Chronic inflammation

A
  • Inflammation enduring longer than acute
  • May be primary (e.g. TB) but often results from acute inflammation when causative agent cannot be removed
  • Neutrophils largely replaced by lymphocytes, plasma cells (and macrophages)
  • Macrophages often fuse to form giant cells
  • Organisation
  • Fibrosis/scarring common
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13
Q

Chronic peptic ulcer

A
  • Chronic ulcer occurring in an area of acid pepsin digestion (stomach, duodenum, oesophagus)
  • Associated with H. pylori infection
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14
Q

Acute gastritis ulceration

A

related to use of non steroidal anti-inflammatory drugs eg aspirin, ibubrufen, naproxen, alcohol, stress

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15
Q

Outcomes of chronic peptic ulcer

A
  • Resolution (rare without appropriate therapy)
  • Haemorrhage
  • Fibrosis (± stenosis)
  • Perforation
  • Penetration (± fistula formation)
  • Malignant transformation (very rare)
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16
Q

Example of chronic inflammatory disease

A

Tuberculosis (Mycobacterium tuberculosis)

17
Q

Primary TB

A

Immune system is unable to defend against the infection. Can effect any organ

18
Q

Secondary TB

A

Reactivation of latent tuberculosis infection

18
Q

Resolution

A
  • Removal of exudate
  • Regeneration of tissue if possible
  • Complete return to normal
18
Q

Repair

A
  • Occurs when resolution
    impossible (severe, ongoing damage, or tissue cannot regenerate)
  • Involves formation of
    granulation tissue
    (organisation)
  • Maturation of granulation
    tissue to scar tissue (fibrosis)
18
Q

When does organisation often occur

A

When exudation or damage is excessive and cannot be removed

19
Q

Healing by primary intention

A
  • Occurs in clean incised
    wounds with apposed
    edges (eg surgical wounds)
  • Results in minimal scarring
  • Occurs in shorter time
  • Strengthening, devascularisation continues longer
20
Q

Healing by secondary intention

A
  • Occurs in open wounds
    (loss of tissue, necrosis or infection)
  • Often results in
    significant scarring (fibrosis)
  • Process may continue for months or years
21
Q

Fibrosis

A

End result of organisation in wound healing and chronic inflammation

22
Q

Process of fibrosis

A
  • Fibrocytes stimulated by polypeptides from surrounding damaged cells
  • Become active fibroblasts. Commence protein synthesis
  • Secretion of ground substance including fibrinonectins
  • Secretion of procollagen
  • Condensation to fine reticulin fibres
  • Further condensation to mature collagen fibres
  • Binding and weaving to form scar tissue
  • Fibroblasts revert to fibrocytes
23
Q

Local factors affecting wound healing

A
  • Poor blood supply
  • Infection
  • Excessive movement or irritation
  • Foreign material
24
Q

General factors affecting wound healing

A
  • Deficiency of Vitamin C (scurvy), essential amino acids, zinc
  • Excess adrenal corticosteroids
  • Intercurrent debilitating chronic disease

PATH2220 (33 decks)

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