Chronic Inflamation Flashcards

1
Q

Explain the sequelae of acute inflammation?

A

diagram

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2
Q

What factors favour resolution?

A
  • minimal cell death and tissue damage
  • occurrence in an organ/tissue with regenerative capacity (eg. liver)
  • rapid destruction of the casual agent
  • rapid removal of fluid and debris by good local vascular drainage
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3
Q

What is resolution?

A
  • active process aimed at restoration of tissue and function
  • it involves apoptosis and subsequent clearance of activated inflammatory cells
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4
Q

What is a casual agent?

A

biological pathogen that causes disease

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5
Q

What happens is resolution cannot occur?

A

organisation

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6
Q

What is organisation?

A

replacement of destroyed tissue by granulation tissue

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7
Q

What is granulation tissue?

A

new connective tissue and microscopic blood vessels that form on the surfaces of wounds during the healing process
- light red/pink colour, soft, moist, pulseful, bumpy, painless when healthy

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8
Q

How is granulation tissue formed?

A
Inflammatory exudate replaced by:
- capillaries
- macrophages
- fibroblasts
- collagen
Regulated by growth factors:
-TNF
- EGF
- FGF
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9
Q

What factors favour organisation?

A
  • large amounts of fibrin
  • substancial necrosis
  • exudate and debris cannot be removed or discharged
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10
Q

What causes chronic inflammation?

A
  • primary causes - does not have an acute response (eg. arthritis)
  • progression from acute inflammation
  • recurrent episodes of acute inflammation
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11
Q

What are the factors favouring progression from acute to chronic inflammation?

A
  • indigestible substances eg. glass, suture material - foreign body reaction
  • deep seated suppurative inflammation where drainage is delayed or inadequate - (thick abscess wall - fibrous/granulation tissue - pus becomes organised - forms fibrous scar) - deep seated bone abscesses
  • recurrent episodes of acute inflammation and healing may eventually result in chronic inflamation - macrophages and lymphocytes used instead of neutrophils
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12
Q

What is osteomyelitis

A

chronic bone abscess which is difficult to treat

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13
Q

What are the primary cells of chronic inflammation?

A

macrophages
lymphocytes
plasma cells (activated by lymphocyte)

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14
Q

What are the primary cells of acute inflammation?

A

neutrophils

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15
Q

What does chronic inflammation look like?

A
  • chronic ulcer (mucosa breached, base lined by granulation tissue, fibrous tissue throughout muscle layers)
  • chronic abscess cavity
  • thickening of the wall of a hollow viscus
  • granulomatous inflamation (TB)
  • fibrosis
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16
Q

What does the formation of granulation tissue result in?

A

fibrosis

17
Q

What is special about macrophages?

A

they can communicate with other immune response cells

18
Q

What are the properties of macrophages?

A
  • phagocytic
  • can ingest a wide range of materials
  • relatively large cells
  • ingest viable organisms resistant to lysomal enzymes
  • produce a range of cytokines
  • activated on migration to area of inflamation (by macrophage activation/inhibition factors MAF, MIF)
19
Q

What are lysosomes?

A

membrane-bound vesicles that contain digestiveenzymes,

20
Q

What are cytokines?

A

chemicals that activate other immune cells

21
Q

What is the production/life cycle of a macrophage like?

A

diagram

22
Q

Where do macrophages originate from?

A

haemopoietic stem cell in bone marrow

23
Q

What are macrophages released into the blood as?

A

monocytes

24
Q

What is a granuloma?

A

an aggregate of epithelia histiocytes

25
Q

What is a histiocyte?

A

a macrophage in connective tissue

26
Q

What are the properties of granulomatous inflammation?

A
  • little phagocytic activity
  • secretory function
  • necrotic material in centre of granuloma
  • surrounded by epithelium histiocytes
  • peripheral rim of activated lymphocytes
  • central giant cells
27
Q

What are the causes of granulomatous disease?

A
  • specific infections
  • foreign bodies - endogenous/exogenous
  • specific chemicals
  • drugs
  • unknown
28
Q

How are (Langhans) giant cells formed?

A

histiocytes fuse to form multinucleate giant cells

29
Q

What is the difference between granuloma and granulation?

A

granuloma - aggregate of macrophage like cells

granulation - important healing process with small vessels and connective tissue

30
Q

What is the difference between fibrin and fibrous/

A

fibrin - deposited in acute inflammation

fibrous - typical scar with collagen