AED - Inflammation - Week 1 Flashcards
List 8 causes of inflammation.
Hypoxia
Chemicals/drugs
Physical agents
Microbiological agents
Immunological agents
Genetic defects
Nutritional imbalances
Age
List 4 classic signs of acute inflammation and what they cause.
Redness
Heat
Swelling
Pain
They cause loss of function
What two cells are more involved in inflammation due to bacteria or toxins?
Neutrophils and pus
What two cells are more involved in inflammation due immunological agents or hypersensitivity?
eosinophil and basophils
What kind of response does physical trauma generate more (2)?
Oedema and haemorrhage
What three cells are more involved in inflammation due viral infections?
Macrophages, NKT cells, T cells
Why does chronic infammation tend to occur (2)?
Failure to remove injurous agent or by-products of inflammation
What might be seen with chronic inflammation (2)?
Granuloma formation and giant multinucleated cells
True or false
Chronic inflammation tends not to be very heterogenous
False
The presence of what three cells is a usually a good indicator of chronic inflammation?
Lymphocytes, plasma cells and macrophages
What occurs as a result of healing by repair?
Scar formation
List 4 cells that are typical of early phase/acute ocular inflammation.
Mast cells
Basophils
Neutrophils
Eosinophils
What condition are mast cells particularly prevalent in?
Allergy-driven hypersensitivity
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?
Similar to basophils
-Mast cells lack bi-lobed nuclei
Characteristic blue stain
Granular appearance
Which is more common in the eye, basophils or eosinophils?
Eosinophils
Are basophils involved in acute allergy-driven conjunctivitis?
Yes
What is the major cell type of inflammatory responses?
Neutrophils
What cell is particularly prevalent in allergy-driven hypersensitivity and parasitic infections, aside from mast cells?
Eosinophils
What nucleus shape do eosinophils have?
Bi-lobed
What cell is the most prevalent in bacterial infections?
Neutrophils (PMN)
List two regions of the eye mast cells are resident.
Choroid
Conjunctiva
Anterior ischaemic optic neuropathy is a disorder of what?
Posterior ciliary artery
Describe what occurs with anterior ischaemic optic neuropathy (2).
Acute oedematous reaction
Haemorrhage of papillary vessels
Anterior ischaemic optic neuropathy causes significant loss of what cells? Which retinal layers thins?
Loss of RGCs
NFL thinning
If acute inflammation occurs to the eye as a result of trauma, would you expect neutrophils following redness and oedema?
No, not at this stage, unless it becomes infected
Describe how hypopyons form.
Neutrophil exudation from iris vessels
What does chemical injury to the eye often induce?
Neutrophil infiltration
What are fibrinous exudates (3), and what do they follow?
Comprised of fibrinogen, granulation tissue, and inflammatory cells, following acute inflammation
What is direct toxic damage to the eye exacerbated by? What can this contribute to?
Proteases released by neutrophils
Can contribute to corneal perforation
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?
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.
What can be seen in the initial stages of inflammatory response in anterior uveitis?
What about the later stages?
Neutrophil exudation from uveal vessels
Later stages involve largely macrophage response
How can the effects of anterior uveitis be experimented on?
Immunogenic experimental uveitis is secondary to systemic endotoxin - it runs a course similar to acute anterior uveitis.
How can acute and chronic uveitis be differentiated based on cells present (2)?
Keratic precipitates differ in size and colour, reflecting different cell types
What are keratic precipitates largely composed of in chronic (2) vs acute (1) anterior uveitis?
Acute - neutrophils
Chronic - macrophages and lymphocytes
What does chronic non-granulomatous inflammation in the iris (anterior uveitis) lead to (3)?
What are the keratic precipitates largely composed of (2)?
Ischaemia
Atrophy of the iris stroma and dilator muscle
Keratic precipitates composed of macrophages and neutrophils
What is episcleritis and is it usually acute or chronic? Is it quickly self-limiting or not?
Inflammation of the episclera - relatively common
Usually acute and self-limiting
What are some characteristics of episcleritis that are more consistent with a chronic condition? List them (4).
Redness
Oedema
Infiltrate of lymphocyte and plasma cells
Spillover into the conjunctiva
Define sarcoidosis.
Disease involving abnormal collections of inflammatory lumps known as granulomas
List a distinctive histological feature of chronic granulomatous conjunctivitis. Which cells are present?
Subepithelial region - epitheloid cells and multinucleated / giant cells surround a fibrous wall of tissue.
Lymphocytes are also present (T cells)
What condition can chronic granulomatous inflammation be secondary to?
Blocked meibomian gland - chalazion
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 central clear area - which is dissolved lipid
This initiated inflammation, evident by the surrounding giant cells, lymphocytes, and plasma cells
What is cobblestone papillae mediated by (the response and disease)?
Acute IgE mediated inflammatory response in vernal keratoconjunctivitis.
What cells accumulate in cobblestone papillae, and what is it often indicative of?
Accumulations of euosinophils and some basophils (or possibly mast cells)
Often indicative of an allergic response
How do blood vessels appear in cobblestone papillae (3)?
Hard, flat-topped, central vessels
Is vernal keratoconjunctivitis an acute or chronic response? Explain.
There is evidence of a mised response - lymphocytes can be found in conjunctival biopsies
What happens to the cornea following radiation trauma (4)?
Local inflammation
Signs of oedema
Inflammatory cell infiltrate
Fibroblast / myofibroblast activation
What happens to the cornea after inflammation following radiation trauma (4).
Evidence of healing:
-wedge of disorganised collagen
-an acellular region of the stroma
-regrowth of epithelium
-no inflammatory cells present
Are signs of inflammation always histologically acute or chronic?
No, it can be a mixture of both
What is the purest example of the classic acute inflammatory response in the eye?
Bacterial keratitis
