AED - Inflammation - Week 1 Flashcards

1
Q

List 8 causes of inflammation.

A

Hypoxia
Chemicals/drugs
Physical agents
Microbiological agents
Immunological agents
Genetic defects
Nutritional imbalances
Age

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2
Q

List 4 classic signs of acute inflammation and what they cause.

A

Redness
Heat
Swelling
Pain
They cause loss of function

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3
Q

What two cells are more involved in inflammation due to bacteria or toxins?

A

Neutrophils and pus

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4
Q

What two cells are more involved in inflammation due immunological agents or hypersensitivity?

A

eosinophil and basophils

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5
Q

What kind of response does physical trauma generate more (2)?

A

Oedema and haemorrhage

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6
Q

What three cells are more involved in inflammation due viral infections?

A

Macrophages, NKT cells, T cells

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7
Q

Why does chronic infammation tend to occur (2)?

A

Failure to remove injurous agent or by-products of inflammation

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8
Q

What might be seen with chronic inflammation (2)?

A

Granuloma formation and giant multinucleated cells

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9
Q

True or false
Chronic inflammation tends not to be very heterogenous

A

False

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10
Q

The presence of what three cells is a usually a good indicator of chronic inflammation?

A

Lymphocytes, plasma cells and macrophages

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11
Q

What occurs as a result of healing by repair?

A

Scar formation

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12
Q

List 4 cells that are typical of early phase/acute ocular inflammation.

A

Mast cells
Basophils
Neutrophils
Eosinophils

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13
Q

What condition are mast cells particularly prevalent in?

A

Allergy-driven hypersensitivity

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14
Q

What are mast cells histologically similar to, and how can they be distinguished? What is their characteristic stain colour, and what appearance do they have?

A

Similar to basophils
-Mast cells lack bi-lobed nuclei
Characteristic blue stain
Granular appearance

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15
Q

Which is more common in the eye, basophils or eosinophils?

A

Eosinophils

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16
Q

Are basophils involved in acute allergy-driven conjunctivitis?

A

Yes

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17
Q

What is the major cell type of inflammatory responses?

A

Neutrophils

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18
Q

What cell is particularly prevalent in allergy-driven hypersensitivity and parasitic infections, aside from mast cells?

A

Eosinophils

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19
Q

What nucleus shape do eosinophils have?

A

Bi-lobed

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20
Q

What cell is the most prevalent in bacterial infections?

A

Neutrophils (PMN)

21
Q

List two regions of the eye mast cells are resident.

A

Choroid
Conjunctiva

22
Q

Anterior ischaemic optic neuropathy is a disorder of what?

A

Posterior ciliary artery

23
Q

Describe what occurs with anterior ischaemic optic neuropathy (2).

A

Acute oedematous reaction
Haemorrhage of papillary vessels

24
Q

Anterior ischaemic optic neuropathy causes significant loss of what cells? Which retinal layers thins?

A

Loss of RGCs
NFL thinning

25
Q

If acute inflammation occurs to the eye as a result of trauma, would you expect neutrophils following redness and oedema?

A

No, not at this stage, unless it becomes infected

26
Q

Describe how hypopyons form.

A

Neutrophil exudation from iris vessels

27
Q

What does chemical injury to the eye often induce?

A

Neutrophil infiltration

28
Q

What are fibrinous exudates (3), and what do they follow?

A

Comprised of fibrinogen, granulation tissue, and inflammatory cells, following acute inflammation

29
Q

What is direct toxic damage to the eye exacerbated by? What can this contribute to?

A

Proteases released by neutrophils
Can contribute to corneal perforation

30
Q

Distinguish between the true membrane and pseudomembrane in an eye with acute inflammation.
What can this usually be caused by (3) and does it happen often?

A

Pseudomembrane is not firmly attached to the underlying epithelium, the true membrane is.
It is rare, but usually caused by infection, chemical, or immunogenic agents.

31
Q

What can be seen in the initial stages of inflammatory response in anterior uveitis?
What about the later stages?

A

Neutrophil exudation from uveal vessels
Later stages involve largely macrophage response

32
Q

How can the effects of anterior uveitis be experimented on?

A

Immunogenic experimental uveitis is secondary to systemic endotoxin - it runs a course similar to acute anterior uveitis.

33
Q

How can acute and chronic uveitis be differentiated based on cells present (2)?

A

Keratic precipitates differ in size and colour, reflecting different cell types

34
Q

What are keratic precipitates largely composed of in chronic (2) vs acute (1) anterior uveitis?

A

Acute - neutrophils
Chronic - macrophages and lymphocytes

35
Q

What does chronic non-granulomatous inflammation in the iris (anterior uveitis) lead to (3)?
What are the keratic precipitates largely composed of (2)?

A

Ischaemia
Atrophy of the iris stroma and dilator muscle
Keratic precipitates composed of macrophages and neutrophils

36
Q

What is episcleritis and is it usually acute or chronic? Is it quickly self-limiting or not?

A

Inflammation of the episclera - relatively common
Usually acute and self-limiting

37
Q

What are some characteristics of episcleritis that are more consistent with a chronic condition? List them (4).

A

Redness
Oedema
Infiltrate of lymphocyte and plasma cells
Spillover into the conjunctiva

38
Q

Define sarcoidosis.

A

Disease involving abnormal collections of inflammatory lumps known as granulomas

39
Q

List a distinctive histological feature of chronic granulomatous conjunctivitis. Which cells are present?

A

Subepithelial region - epitheloid cells and multinucleated / giant cells surround a fibrous wall of tissue.
Lymphocytes are also present (T cells)

40
Q

What condition can chronic granulomatous inflammation be secondary to?

A

Blocked meibomian gland - chalazion

41
Q

How would a chalazion appear histologically? Explain the characteristic appearance and what initiated inflammation, as well as the cells that would be present (3).

A

A central clear area - which is dissolved lipid
This initiated inflammation, evident by the surrounding giant cells, lymphocytes, and plasma cells

42
Q

What is cobblestone papillae mediated by (the response and disease)?

A

Acute IgE mediated inflammatory response in vernal keratoconjunctivitis.

43
Q

What cells accumulate in cobblestone papillae, and what is it often indicative of?

A

Accumulations of euosinophils and some basophils (or possibly mast cells)
Often indicative of an allergic response

44
Q

How do blood vessels appear in cobblestone papillae (3)?

A

Hard, flat-topped, central vessels

45
Q

Is vernal keratoconjunctivitis an acute or chronic response? Explain.

A

There is evidence of a mised response - lymphocytes can be found in conjunctival biopsies

46
Q

What happens to the cornea following radiation trauma (4)?

A

Local inflammation
Signs of oedema
Inflammatory cell infiltrate
Fibroblast / myofibroblast activation

47
Q

What happens to the cornea after inflammation following radiation trauma (4).

A

Evidence of healing:
-wedge of disorganised collagen
-an acellular region of the stroma
-regrowth of epithelium
-no inflammatory cells present

48
Q

Are signs of inflammation always histologically acute or chronic?

A

No, it can be a mixture of both

49
Q

What is the purest example of the classic acute inflammatory response in the eye?

A

Bacterial keratitis