Chronic Inflam Flashcards
What are the factors favouring resolution
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
What’s suppurations
Formation fo pus
Which consists of neutrophils ded cellular debris and bac
What is organisation
Is the replacement by granulation tissue
What factors favour organisation
Large amounts of fibrin
Substantial necrosis
Exudative and debris cannot be removed or discharged
What happens in granulation tissues
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
What are the growth factors which stim cell prolif and angiogenesis
TNF EGF FGF
What happens if the agent which caused acute inflam isn’t removed
May progress to chronic organisation of tissue may character of cellular exudate changes
How does chornic inflam occur
Develop form acute inflam
Primary chornic inflam
What are the factors favouring progression of acute to chronic inflammation
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
What are the predominant cells o chornic inflam
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
So,e examples of primary chronic inflam
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)
What is the macroscopic appearance of chronic inflam
Chronic ulcer
Chronic abscess cavity - osteomyelitis
Thickening if wall of a hollow viscus by fibrous tissue
Granulomatous inflam (tb)
What so fibrosis
May eh most prominent in chronic inflam
Most chichi inflam cell infiltrate has subsided
Fibrosis may lead to distortion and stricture formation
What are the ages of macrophages
Bone marrow begins stem cell then promonocyte then monocyte
Monocyte in blood
Tissue kupffer cell alv macrophages osteoclasts giant cell
What do macrophages do in chronic inflam
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
What may happen when mcacrouphages are activated what happens
Increased cell size
Increased lysosomal enzyme levels
Increased metab activty
Increased phagocytic abilities
When does macrophage phagocytosis occur
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
What is a granuloma
Aggregate of epitheliod histoocytes
What is a histoocytes
Macrophage in connective tissue
Little phagocytic activity
Secretory function
What may augment the appearance of granulomas
Caseous necrosis or conversion into histiocytic giant cells
What are some causes of granulomatous inflam
Specific infections - mycobacterium Foreign bodies - endogenous, exogenous Specific Chems Drugs Unknown
What is the most common and imp cause of granulomatous inflam
Tb
How is tb acquired
Inhalation
Cause disease in many organs
Symptoms cough, weight loss night sweats
What are some aspects of mycobacterium
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
What is resolution.
Complete restoration of the tissues to normal after an episode of acute inflam
