Chapter 3: Chronic Inflammation Flashcards
What causes Chronic inflammation?
An irritant
Describe Chronic inflammation
Active
Describe the action of this irritant
Prolonged
Describe the tissue response
Slow
Describe the onset of the tissue response
Gradual
For how long does the Chronic Inflammation last?
Months to years
What are the 3 systemic manifestations in Chronic Inflammation?
Fever
Weight loss
Anemia
Describe this Fever
Low
Which 3 cells are predominant in Chronic Inflammation and characterize it?
Macrophages
Lymphocytes
Plasma cells
Which cells are also predominant in Chronic Inflammation?
Fibroblasts
What also characterizes Chronic Inflammation?
Fibrosis
What are the 3 courses/outcomes of Chronic Inflammation?
Tissue Destruction
Fibrosis
Necrosis
What are proceeding simultaneously in Chronic Inflammation? (3 points)
Inflammation
Destruction
Attempts
What is destroyed simultaneously in Chronic Inflammation?
Tissue
Which attempts are proceeded simultaneously in Chronic Inflammation?
Repair
What are the 4 causes of Chronic Inflammation?
Infections
Autoimmunity
Exposure to substances
Progression from Acute Inflammation
What causes these infections?
Certain microorganisms
What is an example of these certain microorganisms?
Certain Fungi
Describe the level of toxicity of the certain microorganisms
Low
What do the certain microorganisms evoke?
Hypersensitivity reactions
What type of Hypersensitivity reaction do the certain microorganisms evoke?
Delayed
Describe these infections (2 points)
Persistent
Intracellular
What are 2 examples of these infections?
Tuberculosis
Leprosy
Describe the exposure to substances which causes Chronic Inflammation
Prolonged
Describe these substances
Non-degradable
Describe the toxicity level of these substances
Partial
What are the 2 types of these substances?
Endogenous
Exogenous
What is an example of the Endogenous substances?
Lipid components
What do the lipid components cause?
Atherosclerosis
What are 2 examples of the Endogenous substances?
Silica
Asbestos
What are the 2 examples of an Autoimmune disease that cause Chronic Inflammation?
Rheumatoid Arthritis
Systemic Lupus Erythematosus
From when do these 2 examples of Autoimmune disease cause Chronic Inflammations?
Onset
What are the cells of Chronic Inflammation?
5 points
Macrophages T-Lymphocytes B-Lymphocytes Plasma cells Mast cells
What are the Primary cells in Chronic Inflammation?
Macrophages
What are Macrophages derived from?
Monocytes
What method do Macrophages use to move in various parts of the body?
Diffusion
Describe the occurrence of Macrophages in various parts of the body
Scattered
What are examples of organs where Macrophages are present in? (7 points)
Liver Spleen Lymph nodes Lungs Bone Marrow Brain Skin
What are Macrophages known as in liver cells?
Kupffer cells
What are Macrophages known as in spleen and lymph node cells?
Sinus Histiocytes
What are Macrophages known as in lung cells?
Alveolar Macrophages
What are Macrophages known as in bone marrow and brain cells?
Microglia
What are Macrophages known as in skin cells?
Langerhans cells
What do these cells constitute?
Mononuclear phagocytic system
Describe the products of Macrophages
Active
Describe the variety of these active products
Wide
What is an example of these active products?
Monokines
What can Macrophages be modified into?
Epithelioid cells
During which process can Macrophages be modified into Epithelioid cells?
Granulomatous
What are T-Lymphocytes primarily involved in?
Cellular immunity
Describe the T-Lymphocytes in cellular immunity
Key:
Regulator
Effector
What do T-lymphocytes produce?
Lymphokine
What do B-Lymphocytes and Plasma cells produce?
Antibodies
What are these antibodies directed against?
2 points
Persistent antigen
Tissue components
Where are these persistent antigens found in?
Inflammatory site
Describe these tissue components
Altered
Mast cells and eosinophils appear predominantly to respond to? (2 points)
Parasitic infestations
Allergic reactions
Which cells can be seen in some forms of Chronic Inflammation?
Neutrophils
What are 3 examples of these forms of Chronic Inflammation?
Chronic:
Osteomyelitis
Actinomycosis
Lung diseases
What induces Chronic lung diseases?
Stimuli
What are the stimuli that induce Chronic lung diseases?
Smoking
Others
According to what is the Chronic Inflammation classified into?
Histologic features
What are the 2 types of Chronic Inflammation?
Nonspecific
Specific
What does the Nonspecific Chronic Inflammation inolve?
Macrophages and Lymphocytes accumulation
Describe this accumulation
Diffuse
Which site is this accumulation found in?
Injury
What makes this accumulation productive?
New fibrosis tissue formations
What is an example of Nonspecific Chronic Inflammation?
Chronic Cholecystitis
What is Specific Inflammation known as?
Granulomatous Inflammation
What is Granulomatous Inflammation characterized by?
Granuloma presence
Describe Granuloma
Epithelioid cells aggregation/collection
Describe Epithelioid cells
Activated Macrophage of modified Epithelial-cell like appearance
What do these Epithelioid cells form?
Giant cells
Describe these Giant cells
Multinucleated
What do these Epithelioid cells do in order to form the Multinucleated Giant cells?
Fuse with each other
How many Epithelioid cells fuse with each other to form the Multinucleated Giant cells?
2 or more
Why do the Epithelioid cells fuse with each other in order to form the Multinucleated Giant cells?
For engulfment
What do the Epithelioid cells engulf?
Particle
How many particles do the Epithelioid cells engulf?
Single
What is the Granuloma usually surrounded by?
Lymphocytes
What does the occurrence of these Lymphocytes look like?
A cuff
What can also sometimes surround the Granuloma?
Plasma cells
What are the 2 types of Giant cells?
Foreign body
Langhans
Describe the occurrence of the nuclei of the Foreign body-type Giant cells
Scattered
Describe the scattering of the nuclei of the Foreign body-type Giant cells
Irregular
Describe the occurrence of the nuclei of the Langhans Giant cells
Arranged
Describe the arrangement of the nuclei of the Langhans Giant cells
Peripheral
What does the pattern of the nuclei of the Langhans Giant cells look like?
Horse-shoe
Where are the Langhans Giant cells typically seen in? (2 points)
Tuberculosis
Sarcoidosis
What are the 2 types of Granuloma
Foreign body
Immune
What is Foreign body Granuloma initiated by?
Foreign bodies
Which foreign bodies are initiated by Foreign body Granuloma?
Inert
What are examples of foreign bodies initiated by Foreign body Granuloma? (5 points)
Talc Sutures Fibers Silicosis Asbestosis
Which type of sutures initiate Foreign body Granuloma?
Nonabsorbable
Describe the size of these foreign bodies
Large
What is prevented due to their enough large size?
Phagocytosis
Describe the cell which is prevented from making Phagocytosis
A Single Macrophage
What is not incited by Foreign body Granuloma?
Immune response
Describe Immune Granuloma
Granulomatous Hypersensitivity reaction
Which type of Hypersensitivity reaction is the Immune Granuloma?
IV
Describe this reaction
Protective defense reaction
What makes this reaction?
Host
What does this reaction unfortunately cause eventually?
Tissue destruction
What made this reaction cause tissue destruction?
Antigen persistence
Describe this antigen (2 points)
Poorly digestible/soluble
Inciting
What are the 2 examples of microorganisms of poorly digestible antigens?
Mycobacterium Tuberculosis
M.laprae
What is done with the poorly digestible/soluble inciting antigens?
Engulfed
Which cells engulf the poorly digestible/soluble inciting antigens?
Antigen presenting cells
What type of cell is an antigen presenting cell?
Macrophage
What does this Macrophage do with the antigen?
Presents part of it
What does the Macrophage presents this part of the antigen to?
CD4+ T helper cells
What does the Macrophage also present in accompany with this antigen?
MHC molecules
Which type of the MCH molecules are presented by the Macrophage in accompany with the antigen?
2
What does the Macrophage present the part of the antigen and the MCH molecule type 2 to?
CD4+ T helper cells
How will the of CD4+ T helper cells be affected as a result of this?
Become activated
What will the CD4+ T helper cells then produce?
Cytokines
What is the effect of Cytokines on Granuloma which the Cytokines are implicated in?
(2 points)
Formation
Maintenance
What are the 2 types of Cytokines produced by the CD4+ T helper cells?
IL-2
IFN-γ
What is IFN-γ known as?
Interferon Gamma
What is the function of the Cytokines IL-2?
Activation
Perpetuation
What does the Cytokines IL-2 activate?
Other CD4+ T helper cells
What does the Cytokines IL-2 perpetuates?
The response
What is the function of the Cytokines IFN-γ?
Transformation
What does the Cytokines IFN-γ transfer?
Macrophages
What does the Cytokines IFN-γ transfer Macrophages into? (2 points)
Epithelioid cells then
Multinucleated Giant cells
Which feature of a Macrophage is involved in Immune Granuloma?
Inhibitory factor
What does the Macrophage Inhibitory factor asses in?
Localization
What does the Macrophage Inhibitory factor asses in localizing? (2 points)
Activated Macrophages
Epithelioid cells
What are the 2 examples of Immune Granuloma?
Sarcoidosis
Crohns disease
Describe the etiology of these 2 examples
Unknown
What are the major causes of Granulomatous Inflammation? (7 points)
Bacterial Chlamydial Fungal Protozoal Helminthic Idiopathic Inorganic material
What are the examples of bacterial causes of Granulomatous Inflammation? (5 points)
Tuberculosis Leprosy Syphilis Cat scratch disease Yersinosis
What are the examples of fungal causes of Granulomatous Inflammation? (4 points)
Histoplasmosis
Cryptococcosis
Coccidioidomycosis
Blastomycosis
What is an example of Helminthic causes of Granulomatous Inflammation?
Schistosomiasis
What are the examples of Protozoal causes of Granulomatous Inflammation? (2 points)
Leishmaniasis
Toxoplasmosis
What is an example of Chlamydial causes of Granulomatous Inflammation?
Lymphogranuloma venerum
What is an example of inorganic material causes of Granulomatous Inflammation?
Berylliosis
What are the examples of Idiopathic causes of Granulomatous Inflammation? (3 points)
Acidosis
Cohn’s disease
Primary biliary cirrhosis
