Chronic Inflam

Question 1

What are the factors favouring resolution

Answer 1

Minimal cell deaths and tissue damage
Occurrence in an organ or tissue with regenerative capacity (liver)
Rapid destruction of causal agent
Rapid removal of fluid and debris by good local vascular drainage

Question 2

What’s suppurations

Answer 2

Formation fo pus

Which consists of neutrophils ded cellular debris and bac

Question 3

What is organisation

Answer 3

Is the replacement by granulation tissue

Question 4

What factors favour organisation

Answer 4

Large amounts of fibrin
Substantial necrosis
Exudative and debris cannot be removed or discharged

Question 5

What happens in granulation tissues

Answer 5

Caps grow in inflam exudate accompanied by macrophages and fibroblasts
Predominant features in repair are angiogenesis followed by fibroblast prolif and collagen syn
Process reg by growth factors

Question 6

What are the growth factors which stim cell prolif and angiogenesis

Answer 6

TNF EGF FGF

Question 7

What happens if the agent which caused acute inflam isn’t removed

Answer 7

May progress to chronic organisation of tissue may character of cellular exudate changes

Question 8

How does chornic inflam occur

Answer 8

Develop form acute inflam

Primary chornic inflam

Question 9

What are the factors favouring progression of acute to chronic inflammation

Answer 9

Indigestible substancs - glass, suture material may result in chronic suppurations

Deep seated suppurative inflammation in which drainage delayed result in thick abscess wall composed of fibrous/granulation tissue

Rigid walls fail to come together after drainage

Osteomyelitis chronic abscess

Recurrent episodes of acute inflam

Question 10

What are the predominant cells o chornic inflam

Answer 10

Inflam process which lymphocytes, plasma cells and macrophages predominate
Usually accomp by formation of granulation tissue resulting in fibrosis
Few eosinophils may be present but neutrophil polymorphs are scarce

Question 11

So,e examples of primary chronic inflam

Answer 11

Resistance to agent in ohagcoytosis and intracellular killing (tb and leprosy)

Foreign body reactions to endogenous materials (gout)

Foreign body reactions to exogenous materials (asbestos)

Some autoimmune diseases ( rheumatoid arthritis )

Specific disease of unknown cause (ulcerative colitis)

Primary granulomatous diseases (sarcoidosis)

Question 12

What is the macroscopic appearance of chronic inflam

Answer 12

Chronic ulcer
Chronic abscess cavity - osteomyelitis
Thickening if wall of a hollow viscus by fibrous tissue
Granulomatous inflam (tb)

Question 13

What so fibrosis

Answer 13

May eh most prominent in chronic inflam
Most chichi inflam cell infiltrate has subsided
Fibrosis may lead to distortion and stricture formation

Question 14

What are the ages of macrophages

Answer 14

Bone marrow begins stem cell then promonocyte then monocyte
Monocyte in blood
Tissue kupffer cell alv macrophages osteoclasts giant cell

Question 15

What do macrophages do in chronic inflam

Answer 15

Phagocytic coabailites
Ingest wide range materials
Restively large cells harbour viable organisms resistant to lysosomal enzymes
Prod wide range important cytokines
Activated on migration to an area of inflam - macrophage activating factor, migration inhib factor

Question 16

What may happen when mcacrouphages are activated what happens

Answer 16

Increased cell size
Increased lysosomal enzyme levels
Increased metab activty
Increased phagocytic abilities

Question 17

When does macrophage phagocytosis occur

Answer 17

Appear late in acute inflam
Lesser Role than neutrophils
Clear away tissue debris
May release lysosomal enzymes by exocytosis or when cells die
Enzymes release aid digestion of inflam exudate

Question 18

What is a granuloma

Answer 18

Aggregate of epitheliod histoocytes

Question 19

What is a histoocytes

Answer 19

Macrophage in connective tissue
Little phagocytic activity
Secretory function

Question 20

What may augment the appearance of granulomas

Answer 20

Caseous necrosis or conversion into histiocytic giant cells

Question 21

What are some causes of granulomatous inflam

Answer 21

Specific infections - mycobacterium 
Foreign bodies - endogenous, exogenous 
Specific Chems
Drugs
Unknown

Question 22

What is the most common and imp cause of granulomatous inflam

Answer 22

Tb

Question 23

How is tb acquired

Answer 23

Inhalation
Cause disease in many organs
Symptoms cough, weight loss night sweats

Question 24

What are some aspects of mycobacterium

Answer 24

Slow growing in culture - subacute, chronic infection
Acid/alcohol fast stain
Resistant to many anti microbial s
Induce granulomatous relations in tissue
Intracellular pathogens able to survive and replicate in neutrophils and macrophages

Question 25

What is resolution.

Answer 25

Complete restoration of the tissues to normal after an episode of acute inflam