chronic and special types of inflammation (W11)

Question 1

4 clinical outcomes of acute inflammation

Answer 1

resolution
organisation
dissemination
chronic inflammation

Question 2

resolution of inflammation - requirements?

Answer 2

elimination of cause of injury
recovery of tissue architecture
chromatin modification

Question 3

anti-inflammatory processes?

Answer 3

efferocytosis
pro-resolving lipids promote clearance
neuroendocrine signals

Question 4

name for macrophages engulfing apoptotic neutrophils

Answer 4

efferocytosis

Question 5

pro-resolving lipids examples

Answer 5

lipoxins, resolvins, protectins

Question 6

chromatin modification (epigenetic)?

Answer 6

changes future innate responses in tissue
boosted (trained immunity), lasts months-years

Question 7

why does scar tissue favour disease progression

Answer 7

difficult to transverse therefore inflammatory cells slow down, get stuck, more likely to be activated

Question 8

what wraps around inflamed intestine to create a contained area of inflammation, eg in late appendicitis

Answer 8

omentum

Question 9

sepsis definition

Answer 9

life threatening organ dysfunction caused by a dysregulated hot response to infection

Question 10

common infections associated with sepsis

Answer 10

pneumonia
abdominal infection
urinary tract infection

Question 11

septic shock?

Answer 11

sepsis with high serum lactate and refractory low blood pressure requiring vasopressors after fluid resuscitation

Question 12

clinical pathology of sepsis

Answer 12

cytokine storm
fluid leak syndromes
coagulopathy
neutrophil NETosis

Question 13

what is NETosis

Answer 13

neutrophil ‘chucks out’ DNA - sticky to bacteria, also toxic (granule proteins).

effective way of trapping microorganisms but dangerous

Question 14

problems with neutrophil NETosis (in sepsis)

Answer 14

fibrin clot blocks some vessels causing ischaemia.
lysis of clot occurs using up bodies platelets and fibrin, patients start to bleed

Question 15

what can fluid leak in sepsis cause

Answer 15

compartment syndrome
intestinal mucosa swelling allows entry of bad microbes
fluid leak in lungs (requires ventilation creating more trauma)

Question 16

sepsis recovery

Answer 16

white cell count plunges, platelet count rises
body tries to restrain inflammation, patients become immunosuppressed for months afterwards

Question 17

monocytes 2 roles

Answer 17

sentinel patrol in vessels to survey epithelium
role in inflammation - enhanced migration, activation proliferation, and some become macrophages

Question 18

why is abnormally persistent inflammation associated with increased risk of cancer

Answer 18

danger of inflammation and requirement to keep regenerating

Question 19

inflammasomes problems?

Answer 19

can cause programmed form of cell death that is leaky - cytokines and inflammasomes leak out of cell becoming red flag for other inflammatory cells. inflammasomes very indigestible and can be produced in conditions unrelated to infection

Question 20

how do scarred tissues become more conductive to inflammation

Answer 20

mechanotransduction
macrophage-myofibroblast stable circuit (new homeostasis).

Question 21

4 special types of inflammation

Answer 21

inflammatory sinus & fistula
erosion & ulcer
abscess
granuloma

Question 22

inflammatory sinus and fistula?

Answer 22

abnormal tract in an epithelial surface lined by granulation tissue
blind ending - sinus
linking 2 epithelial surfaces - fistula

Question 23

ulcer definition

Answer 23

localised loss of full thickness of epithelial surface caused by removal of inflammatory necrotic tissue
(part of epithelium loss = erosion)

Question 24

abscess?

Answer 24

pus in newly formed cavity, granulation tissue surrounds

Question 25

characteristic of staphylococcal pneumonia?

Answer 25

lung abscesses

Question 26

what can occur if abscesses arent surgically trained

Answer 26

rupture creating inflammatory sinus/fistula

Question 27

granulomas?

Answer 27

organised clusters of mature activated macrophages in response to persistent stimuni

Question 28

2 types of granuloma

Answer 28

low turnover (foreign body)
high turnover (immune)