9: chronic inflammation II

Question 1

pattern of chronic inflammation seen in a limited number of infectious and non-infectious conditions

Answer 1

granulomatous inflammamtion

Question 2

aggregates of activated macrophages having a squamous cell-like epitheliod appearance

Answer 2

granulomatous inflammation

Question 3

granulomatous formation setting

Answer 3

persistent T cell response to certain microbes and fungi leads to macrophage activations (injury); insoluble particles produce cell-mediated response

Question 4

facaol area of granulomatous inflammation

Answer 4

granuloma

Question 5

what does a granuloma contain

Answer 5

microscopic aggregation of macrophages that are transformed into epitheliod cells; epitheliod cells surrounded by a collar of mononuclear leukocytes, prinicpally lymphocytes and occasionally plasma cells

Question 6

epitheliod macrophages, langhans giant cell, peripheral rim of lymphocytes

Answer 6

granuloma

Question 7

granuloma v. granulation tissue:

Answer 7

granulation tissue: proliferation of fibroblast and new thin-walled, delicate capillaries in loose ECM

Question 8

fibroblasts surrounded by abundant extracellular matrix, newly formed blood vesels and scattered macrophages

Answer 8

granulation tissue (think of the picture!!!)

Question 9

epitheliod cells with pale, pink granular cytoplasm;a ggregates of macrophages with collar of lymphocytes, occasionally plasma cells. surrounding rim of fibroblasts and connectie tisseu

Answer 9

granuloma

Question 10

peripheral arrangements of multinucleated giant cells

Answer 10

langans type

Question 11

haphazarrd arrangement of multinucleated giant cells

Answer 11

foreign body type

Question 12

forms when material too large to be phagocytosed by single macrophage

Answer 12

foreign body granuloma

Question 13

granulomatous inflammation with extensive tissue destruction (caseous necrosis) numerous confluent granulomas in lung

Answer 13

TB

Question 14

what is our second line of defense (first is skin)?

Answer 14

lymphatics which filter and police extracellular fluid

Question 15

inflammation of lymphatic channels

Answer 15

lymphangitis

Question 16

“blood poisoning”

Answer 16

red streaks up the arm- this is actually lymphangitis

Question 17

if infection overwhlems LB, may gain access to vascular circulation:

Answer 17

bacteremia –> sepsis

Question 18

inflammation of draining LN

Answer 18

reactive lymphadenitis

Question 19

clincial hallmark of acute phase inflammation

Answer 19

fever because cytokine stimulate PG synthesis in hypothalamic thermoregulatior center and reset body temp.

Question 20

where are plasma proteins synthesized

Answer 20

liver

Question 21

what are teh acute phase proteins

Answer 21

CRP (c reactive prtn)
Fibrinogen
SAA (serum amyloid A protein)

Question 22

what upregulate the synthesis of acute phase prtns

Answer 22

IL1
IL6
TNF alpha

Question 23

what is higher WBC leukocytosis or leukemoid reaction

Answer 23

leukemoid reaction is extrememly high, like leukemia

Question 24

why do you see a shift to the left in WBC as a systemic effect of inflammation?

Answer 24

increase in immature WBC due to accelerated release from bone marrow and increased bone marrow production

Question 25

increase in absolute number of PMN seen in most BACTERIAL infection

Answer 25

neutrophilia

Question 26

increase in absoulte number of lymphs; seen mostily in VIRAL infections

Answer 26

lymphocytosis

Question 27

increase in absolute number of esoinophils seen in asthma hay fever and parasites

Answer 27

eosinophilia

Question 28

DECREASE in absolute number of WBC seen in overwhelming infection

Answer 28

leukopenia

Question 29

systemic inflammation effect on autonomic system

Answer 29

• increase pulse and BP

- decrease sweating

Question 30

behavioral effect of systemic inflammation

Answer 30

shivering, chills, anorexia, somolence, and malaise

Question 31

pathogenesis of sepsis

Answer 31

severe bacterial infections (large number organisms and toxins) lead to large quantities of cytokines TNF and IL-1

• cardiovascular decompensation
• increased TNF leads to DIC, microthrombi
• liver injury due to lack of gluconeogenesis and overproduction of NO

Question 32

septic shock triad

Answer 32

DIC
hypoglycemia
CV failure

net result: multisystem organ dysfunction and death

Question 33

primary cause of tissue injury in allergies and autoimune dieseaes

Answer 33

inflammation

Question 34

association between chronic inflammatory conditions and cancer

Answer 34

STRONG

the longer an inflammation persists the higher the risk of associated carcinogenesis