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Pathology block 1 > Cell types, repair and inflammation > Flashcards

Cell types, repair and inflammation Flashcards

1
Q

What are ubiquitous long-lived cells that produce the interstitial ground substance (extracellular matrix) of supporting tissue throughout the body?

A

fibroblasts

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2
Q

What is the main fiber of extracellular matrix (comprising an estimated 25% of the total protein in the body)?

A

collagen

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3
Q

What are the key cellular players in the process of tissue repair?

A

Fibroblasts

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4
Q

In addition to creating extracellular matrix, fibroblasts can differentiate into what?

A

specialized connective tissue cells (osteocytes, chondrocytes, adipocytes), but not epithelial cells

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5
Q

Describe how fibroblasts produce scar tissue (how is it made/functional capacity)

A
  • The fibrous tissue they produce to replace dead tissue is a scar.
  • Scar tissue is generally strong and good at holding things together
  • scars lack the specialized functional capacity of the tissue that it replaces.
  • Scars are generally smaller than the tissue they replace
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6
Q

T/F Wounds contract during the process of healing.

A

true

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7
Q

What are the effector cells of wound contraction?

A

Myofibroblasts

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8
Q

T/F Scars lack the specialized function of tissues they replace and are smaller than the tissues they replace.

A

true

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9
Q

in a site of repair, what are large, metabolically active cells?

A

active fibroblasts

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10
Q

What are the general shapes of fibroblasts?

A
  • generally spindle shaped,
  • elongated, with tapering ends,
  • usually sharply pointed,
  • sometimes bifurcated,
  • sometimes resembling a swallow tail
  • can be stellate (star shaped)
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11
Q

Describe the nuclei and cytoplasm characteristics of fibroblasts

A

nuclei are large, with prominent nucleoli.

cytoplasm tends to be basophilic because it has lots of RNA

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12
Q

Fibroblasts are recruited to and activated at sites of repair by what hormones? What secretes them?

A
  • transforming growth factor-beta (better known as TGF-beta),
  • fibroblast growth factor-2 (FGF-2)
  • platelet-derived growth factor (PDGF)

secreted by inflammatory cells, especially macrophages.

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13
Q

What are inactive fibroblasts? Why are they important?

A

fibrocytes

retired fibroblasts are stable cells

always in reserve and capable to be called up to serve in active duty of repair

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14
Q

What are polymorphonuclear leukocytes (“polys”, “PMNs”, “segs”) are first responder phagocytes?

A

neutrophils

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15
Q

What are the predominant type of white blood cells in the innate immune system response to infection?

A

neutrophils

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16
Q

What are the predominant white blood cell type in acute inflammation?

A

neutrophils

Acute inflammation is essentially neutrophilic inflammation

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17
Q

In addition to responding to infection, polymorphonuclear leukocytes respond to what?

A
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18
Q

Partly because they respond to necrosis, neutrophils can be part of what?

A

chronic inflammation

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19
Q

T/F neutrophils have acute-on-chronic inflammation or chronic suppurative (pus-producing) inflammation.

A
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20
Q

How long do neutrophils live at the site of inflammation?

What are the majority of leukocytes measured in the blood?

A

1-2 days

neutrophils

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21
Q

Corticosteroids cause what wrt to neutrophils?

A
  1. demargination of neutrophils
  2. increase the number of neutrophils measured [up to double]

(make you think a patient has infection if you don’t know they are on steroids).

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22
Q

Increased number of (segmented) neutrophils in the blood is called what?

A

a neutrophilia

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23
Q

T/F neutrophils are granulocytes

A
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24
Q

How can you tell the difference between neutrophils and other granulocytes?

A

Neutrophils have neutral granules (neither red nor blue), hence the name.

other granules that are red or blue in routinely stained tissue sections or peripheral blood smears

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25
Q

What are moderate sized cells with a moderate amount of cytoplasm?

A

neutrophils

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26
Q

Describe the shape/size of neutrophils

A

moderate sized cells with a moderate amount of cytoplasm.

variably shaped nuclei, segmented into 2 to 5 lobes connected by thin filaments

Neutrophils with nuclei segmented into 6 or more lobes are hypersegmented.

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27
Q

Hypersegmented neutrophils are associated with what?

A

megaloblastic anemia due to vitamin B12 or folate deficiency

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28
Q

What are immature (adolescent) neutrophils, normally <5% of blood leukocytes?

A

Bands

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29
Q

Bands are a much higher percentage of the neutrophilic granulocytes where?

A

in the bone marrow

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30
Q

T/F Bands are not quite fully mature, but they are capable of phagocytosis.

A

true

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31
Q

When can bands be counted?

A

When the absolute neutrophil count of infection-fighting cells in the bloodstream is calculated

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32
Q

When a person has a severe infection, the bone marrow releases what into the blood? What is this referred to?

A

bands into the blood in increasing numbers

bandemia

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33
Q

Really severe infection can cause the bone marrow to release even less mature cells than bands, even though they are ineffective phagocytes. What is this referred to?

A

increased numbers of immature leukocytes in the blood is referred to as a left shift

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34
Q

T/F Corticosteroids cause left shift or bandemia

A

False, they do not cause a left shift or bandemia

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35
Q

An abnormally increased percent of neutrophils can be indicative of infection, even when the total number of leukocytes is normal. What is this called?

A

left shift

neutrophilia w/o leukocytosis

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36
Q

The earliest bone marrow precursor cells of granulocytes in general and neutrophils in particular have what type of nuclei?

How does this change during maturity?

A

round-oval nuclei

the nuclei of these precursor cells become flattened on one side and have an indentation

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37
Q

Describe how bands are formed

A
  • As they mature, nuclei of these precursor cells become flattened on one side.
  • flattening becomes an indentation.
  • indentation becomes deeper and deeper until the portions of the nucleus on either side of it are partially segmented.
  • it is a band (imagine the indentation having become a full circumference constricting band, hence the name).
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38
Q

Bands are approximately the same size as fully mature segmented neutrophils. Why is this a problem?

A

automated (machine-generated) counts of the types of leukocytes in a blood sample are based on the sizes of the cells

only way to know the proportion of bands is a labor-intensive counting by a trained human with a microscope (a “manual differential” white blood cell count

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39
Q

Why are band counts not very reliable?

A
  • hard to tell whether a neutrophil has a band nucleus that is folded over on itself
  • showing two distinct lobes lying on top of one another, which would make it a segmented neutrophil

band counts are not very reliable.

40
Q

What are first responder phagocytes crucial in the rapid innate immune system response to acute infection?

A

Neutrophils

41
Q

What are phagocytes derived from blood monocytes?

A

macrophages

42
Q

Describe how long macrophages live in various tissues

A

live only a day in the blood

live months to years if they get recruited to become tissue macrophages

43
Q

Monocytes and macrophages are part of the mononuclear phagocyte system. Name the other cells associated with the correct tissue

A
  • Kupffer cells in the liver,
  • sinus histiocytes in lymph nodes and spleen,
  • microglial cells in the central nervous system
  • alveolar macrophages in the lungs
44
Q

What are the dominant players in chronic inflammation? When do they arrive to the site of damage?

A

macrophages

macrophages arrive after neutrophils

45
Q

Other than consuming bacteria and fungi, what other roles do macrophages play? What type of macrophages are these?

A

activated by microbes or interferon-gamma secrete IL-1, IL-12, IL-23 and chemokines,

summon and direct other inflammatory cells.

classical M1 activated macrophages

46
Q

Macrophages activated by IL-13 and IL-14 are of what type? What is their role?

A

activated M2 macrophages

secrete transforming growth factor-beta and other growth factors that stimulate tissue repair and fibrosis

47
Q

Which type of macrophages are pro-inflammatory vs anti-inflammatory?

A

M1 => pro-inflammatory

M2 => anti-inflammatory

48
Q

Describe the shape of macrophages along with its nuclei

A
  • oval nuclei that can be flattened or indented on one side
  • never segmented
  • abundant cytoplasm with small subtle granules and vacuoles
49
Q

How would you recognize a monocyte in peripheral blood?

A

smears is blue-gray or “sky blue”

50
Q

T/F Macrophages in tissue have variably colored cytoplasm depending on what they have eaten

A

true

51
Q

Macrophages at the site of a recent hemorrhage have what color cytoplasm? why? At this point, what are they called?

A
  • brown cytoplasm
  • from hemosiderin
  • hemophages.
52
Q

Macrophages at the site of a recent myocardial infarction contain what? Why?

A

lipofuscin (wear and tear pigment) released from the dead myocytes in addition to hemosiderin

53
Q

Macrophages in a pneumonia after about the third day and in arterial atheromas have bubbly cytoplasm cleared of lipid debris by tissue processing and are called what?

A

foam cells

54
Q

T/F Macrophages are the dominant players in the multi-cell-type drama of chronic inflammation.

A

true

55
Q

What are the fundamental cellular players in the adaptive immune system?

A

Lymphocytes

56
Q

Which cells carry out cell mediated immunity?

A

T cells

57
Q

What cells carry out humeral immunity?

A

B cells

58
Q

Of the lymphocytes in the bloodstream, Give the avg levels

A

60-70% are T cells

10-20% are B cells

59
Q

What helps B cells make antibodies and help macrophages destroy phagocytosed microbes?

A

CD4 T cells

60
Q

What cells are involved in directly killing virus-infected cells and malignant tumor cells?

A

CD8 T cells

61
Q

What is The importance of the CD4+ helper T lymphocytes in the adaptive immune system?

A
62
Q

What are also the fundamental cellular players in most autoimmune diseases?

A

Lymphocytes

63
Q

Predominantly lymphocytic inflammation can be due to what?

A

nfection or an autoimmune disease

64
Q

A few acute conditions such as aseptic meningitis feature what type of inflammation?

A

lymphocytic rather than neutrophilic inflammation

65
Q

cerebrospinal fluid in a classic case contains what?

A

xclusively mononuclear cells, predominantly lymphocytes

but no neutrophils

66
Q

Describe the shape/size of lymphocytes of nuclei and cytoplasm

A
  • small cells,
  • small round dense nuclei
  • scant cytoplasm.
67
Q

B lymphocytes and T lymphocytes look the same until when?

A

become abnormal or the B cells begin differentiating into plasma cells

68
Q

What are derived from activated B cells and produce large amounts of single-specificity antibody in adaptive humoral immune responses?

A

plasma cells

69
Q

What are terminally differentiated supersubspecialized immunoglobulin factories?

A

plasma cells

70
Q

T/F Plasma cells are not normally present in peripheral blood

A

true

71
Q

What type of cells have nuclear chromatin clumped around the periphery, sometimes in a “clockface” configuration? What else do these cells have?

A

plasma cell

prominent perinuclear Golgi apparatus

72
Q

What are granulocytic leukocytes characteristically found in the inflammation around parasitic infestations and in allergic reactions, especially asthma?

A

eosinophils

73
Q

What type of cells participate most in immune reactions that are mediated by IgE type immunoglobulin?

A

eosinophils

74
Q

eosinophil granules contain what? What is the result?

A

major basic protein

resulting in a highly charged cationic substance toxic to parasites but also to host cells

75
Q

What is the characteristic of eosinophil granules?

A
76
Q

T/F Eosinophil nuclei frequently have only 1 lobe.

A

false, Eosinophil nuclei frequently have only two lobes.

77
Q

Peripheral blood eosinophilia should prompt a search for what?

A

an allergen or a parasite.

78
Q

What are sparsely distributed bone-marrow-derived sentinel cells around blood vessels, nerves and skin?

A

mast cells

79
Q

What type of inflammation do they participate in?

A

both acute and chronic inflammation

80
Q

What has prominent cytoplasmic granules loaded with histamine?

A

mast cells

81
Q

Mast cells have chemotactic factors for what?

A
  • neutrophils and eosinophils,
  • leukotrienes,
  • proteases,
  • platelet-activating factor and
  • cytokines such as tumor necrosis factor-alpha and IL-4.
82
Q

Mast cells and basophils have surface receptors for what?

A

IgE

83
Q

What happens when mast cells and basophils are stimulated by IgE bound to an antigen?

A

they degranulate and release their cornucopia of chemicals

84
Q

What causes vasodilatation and endothelial cell contraction (creating gaps for fluid to extravasate from the blood)? What is the result in this?

A

Histamine (and leukotrienes)

mediating the vascular changes of inflammation

85
Q

Multinucleated giant cells in a site of chronic inflammation generally represent what?

A

a syncytium of macrophages

86
Q

There are multiple morphological types, but the two most common are what of the multinucleated giant cell?

A
  • the foreign body type
  • Langhans type
87
Q

What forms when a single macrophage finds itself unable to engulf and phagocytose a large particle and it coalesces with additional macrophages in an effort to ingest the particle?

A

Foreign body type giant cells

88
Q

What are associated with immune granulomas?

A

Langhans type giant cells

89
Q

What is an aggregate of activated macrophages working together?

A

granuloma

90
Q

What is a distinctive form of chronic inflammation associated with autoimmune and infectious diseases?

A

granuloma

91
Q

What is a response to persistent material too large or undigestible for clearance, including talc and some types of suture?

A

foreign body granuloma

92
Q

What forms when persistent antigen induces a cell-mediated immune reaction in, for instance, tuberculosis or sarcoidosis?

A

immune type granuloma

93
Q

Cells that are not macrophage syncytia occur in multiple types of malignant tumors and in normal placentas are what?

A

Multinucleated giant cells

94
Q

Describe the nuclei of the different multinucleated giant cell

A

Foreign body type giant cells=> haphazardly arranged nuclei.

Langhans type giant cells=> nuclei arranged peripherally in a horseshoe (semicircle).

95
Q

Describe macrophages that form Langhans type giant cells

A

** cytoplasm is smoother and more eosinophilic** than typical macrophages and

referred to as epithelioid.

96
Q

Whenever two or more activated macrophages gather together in the name of chronic inflammation, what is it called?

A

granuloma

97
Q

What are the chronic inflammation players?

A

Macrophages
Lymphocytes
Plasma cells
Eosinophils
Mast cells
Multinucleated giant cells

Pathology block 1 (24 decks)

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