chronic inflammation

Question 1

what is chronic inflammation and what are its key features

Answer 1

prolonged inflammation with associated repair
delayed onset, during between days and years, variable appearances, limits damage and initiates repair, can cause debilitating symptoms

Question 2

what is a macrophage in circulation

Answer 2

in circulation is a monocyte and then turns into a macrophage when it enters tissue

Question 3

what are the functions of macrophages

Answer 3

phagocytosis-removal of pathogen/necrosis/debris, antigen presentation to immune system
inflammatory mediators -synthesis and release of mediators, controls and regulates inflammatory response

Question 4

how does a macrophage look on histology

Answer 4

foamy bubbly cytoplasm

indented (slipper shaped) nuclei

Question 5

what do lymphocytes look like

Answer 5

small cells but slight;ty larger than rbc

spherical nuclei

Question 6

what are the types of lymphocytes

Answer 6

b and T cells

Question 7

what is the function of T cells

Answer 7

t helper cells assist other inflammatory cells

cytotoxic ones destroy pathogens

Question 8

what is the function fo B cells

Answer 8

mature into plasma cells
produce antibodies
neutralise pathogens

Question 9

plasma cell appearance

Answer 9

eccentric nucleus
clock face chromatin
peri-nuclear clearing (Golgi)

Question 10

function of plasma cells

Answer 10

fully differentiated b lymphocyte

produce antibodies

Question 11

eosinophil appearance

Answer 11

bi-lobed nucleus

granular cytoplasm that stains red

Question 12

function of eosinophil

Answer 12

release of a variety of mediators
hypersensitivity reactions
parasitic infections

Question 13

what is a giant cell

Answer 13

multinucleate cell
fusion of multiple macrophages
‘frustrated phagocytosis’
three types : foreign body giant cell- random scattering of nuclei
langhans giant cell-nuclei arranged outside in horse shoe shape.
Touton giant cell-nuclei in middle in ring shape

Question 14

which cell type is found mostly in rheumatoid arthritis

Answer 14

plasma cells

Question 15

what are the effects of chronic inflammation

Answer 15

fibrosis- deposition of collagen
impaired function- eg ibd. increased function is rare but in grave’s disease
atrophy-progressive degeneration or shrinkage of muscle or nerve tissue
stimulation of immune response-antigen presentation

Question 16

give examples of idiopathic inflammatory bowel disease and symptoms

Answer 16

crohn’s disease and ulcerative colitis

abdominal pain, altered bowel motion, weight loss, rectal bleeding , malabsorption

Question 17

what’s the difference between Crohn’s disease and ulcerative colitis

Answer 17

CD affects all fo the GI tract but UC affects large bowel only.
CD has discontinuous patches of inflammation and UC has continuous inflammation
in CD inflammation affects full thickness of bowel wall but only superficial bowel wall in UC. you can find a granulomata in CD but no granulomata in UC. More likely to have rectal bleeding in UC.

Question 18

what is cirrhosis and what are the causes

Answer 18

end stage damage to liver
caused by: alcohol, hepatitis, drugs & toxins, fatty liver disease.
fibrosis and attempted regeneration

Question 19

what is a granulomatous inflammation

Answer 19

chronic inflammation with a granuloma

Question 20

what is a granuloma

Answer 20

a collection of epithelioid histiocytes with surrounding lymphocytes

Question 21

what are the two types of granuloma

Answer 21

foreign body-destruction and removal of foreign material. few lymphocytes
immune mediated- destruction and removal of pathogens (bacteria/fungi).can undergo central necrosis . can be idiopathic. many lymphocytes

Question 22

what causes a granulomatous inflammation

Answer 22

foreign body reaction
infection- involving mycobacterium. as its difficult to destroy their thick cell wall and mycolic acids
Crohn’s disease- in GI tract
sarcoidosis- in lymph nodes, lungs and skin