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PATHO LEC PRELIMS > CHRONIC INFLAMMATION > Flashcards

CHRONIC INFLAMMATION Flashcards

1
Q

local defect, or excavation, of the surface of an organ or tissue

A

Ulcer

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2
Q

produced by the sloughing (shedding) of inflamed necrotic tissue

A

Ulcer

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3
Q

Response of prolonged duration (weeks or months)

A

Chronic Inflammation

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4
Q

Chronic Inflammation Causes:

A
  1. Persistent infections
  2. Hypersensitivity diseases
  3. Prolonged exposure to toxic agents
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5
Q

Morphologic Features of chronic inflammation

A
  • Infiltration with mononuclear cells
  • Tissue destruction
  • Attempts at healing
    • Angiogenesis
    • Fibrosis
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6
Q

Extravasate through the same
factors involved in NEUTROPHIL
EMIGRATION

A

Blood Monocytes

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7
Q

Principal actions in inflammation of:

IL-12

A

increased production of IFN-y

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8
Q

Principal actions in inflammation of:

IFN-Y

A

activation of macrophages
*increased ability to kill microbes and tumor cells

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9
Q

Principal actions in inflammation of:

IL-17

A

recruitment of neutrophils and monocytes

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10
Q

Ingest and eliminate microbes and dead tissues

A

ACTIVATED Macrophages

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11
Q

Initiate tissue repair

A

ACTIVATED Macrophages

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12
Q

Secrete mediators of inflammation (e.g. TNF, IL-1)

A

ACTIVATED Macrophages

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13
Q

Display antigens to T lymphocytes (feedback loop)

A

ACTIVATED Macrophages

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14
Q

To destroy microbes and promote
the inflammatory response

A

Classically Activated Macrophage (M1)

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15
Q

To terminate inflammation and
promote tissue repair

A

Alternative Macrophage Activation (M2)

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16
Q

abundant in immune reactions
mediated by IgE and in parasitic
infection

A

Eosinophils

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17
Q

participate in both acute and
chronic inflammatory
reactions

A

Mast Cells

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18
Q

absence of T cell– mediated
immune responses

A

Foreign Body Granuloma

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19
Q

persistent T cell–mediated immune
response

A

Immune Granuloma

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20
Q

Restoration of tissue architecture and function after an injury

A

Repair

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21
Q

Two Processes of Repair

A
  1. Regeneration
  2. Scar formation
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22
Q

Replacement of the damaged
components

Return to a Normal State

A

Regeneration

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23
Q

Scar formation

A
  • Connective Tissue Deposition
  • Fibrosis / Collagen Deposition
24
Q

Cell Proliferation:

A
  1. Growth Factors
  2. Extracellular Matrix Integrity
  3. Tissue Stem Cell Maturation
25
Q

most common cells in connective
tissue proper

A

Fibroblasts

26
Q

Fibroblasts synthesize and secrete

A

collagen and elastin

27
Q

targets of growth factors

A

Fibroblasts

28
Q
  • Involved in wound healing
  • have a well-developed contractile
    function
A

Myofibroblasts

29
Q

Three Groups of Tissue Stem Cells

A
  1. Labile (continuously dividing) tissues
  2. Stable Tissues
  3. Permanent Tissues
30
Q

Two Major Mechanisms of Liver
Regeneration

A
  1. After Partial Hepatectomy
  2. From Progenitor Cells
31
Q

Steps in Scar Formation

A
  1. Inflammation
  2. Cell Proliferation
  3. Granulation Tissue
  4. Connective Tissue
32
Q

process of new blood vessel development from
existing vessels

A

Angiogenesis

33
Q

Angiogenesis process

A
  1. Vasodilation
  2. Separation of Pericytes
  3. Endothelial Cell Migration
  4. Endothelial Cell Proliferation
  5. Remodeling of capillary tubes
  6. Periendothelial Cell Recruitment
  7. Suppression of Endothelial
    Proliferation
34
Q

Deposition of Connective
Tissue

A
  1. Migration and Proliferation of
    Fibroblasts
  2. ECM Protein Deposition
35
Q

most important cytokine for the
synthesis and deposition of connective
tissue proteins

A

Transforming Growth Factor – Beta (TGF-β)

36
Q

stimulates fibroblast migration and
proliferation

A

Transforming Growth Factor – Beta (TGF-β)

37
Q

Healing and Scar Maturation Outcomes

A
  1. Fibroblast Proliferation and
    Decreased Angiogenesis
  2. Increased ECM Deposition
  3. Appearance of Myofibroblasts
    – Scar Contraction
38
Q

Responsible for degradation of collagens and
other ECM components

39
Q

Activated by proteases (plasmin) present ONLY AT
SITES OF INJURY

40
Q

Rapidly inhibits active collagenase

41
Q

Factors That Influence Tissue Repair

A
  1. Infection
  2. Diabetes
  3. Nutritional Status
  4. Glucocorticoids
    (steroids)
  5. Mechanical factors
  6. Poor perfusion
  7. Foreign bodies
  8. The type and extent of
    tissue injury
  9. Location of the injury
42
Q

Healing by First Intention

A

epithelial regeneration / primary union

43
Q

Healing by First Intention

Within 24 hours:

A

Activation of coagulation pathway
- Neutrophils

44
Q

Healing by First Intention

Within 24 – 48 hours

A
  • Epithelial cell proliferation
45
Q

Healing by First Intention

(Day 3)

A
  • Macrophages
  • Granulation tissue formation – fibroblasts, angiogenesis, loose
    ECM
46
Q

Healing by First Intention

(Day 5)

A
  • Angiogenesis at peak
  • Continuation of granulation tissue formation
  • Collagen and ECM deposition
47
Q

Healing by First Intention

(week 2)

A
  • Fibroblastic proliferation and Collagen deposition
48
Q

Healing by First Intention

(1 month)

A
  • Scar Formation
49
Q

Healing by Second Intention

A
  • Secondary union
  • Larger wounds
50
Q

Excessive collagen deposition in a
tissue

A

Fibrosis in Parenchymal
Organs

51
Q

Some Fibrotic Disorders:

A
  1. Liver Cirrhosis
  2. Scleroderma
  3. Fibrosing Diseases of the Lungs
  4. End-stage Kidney Disease
  5. Constrictive Pericarditis
52
Q

Defects in Healing

A

Chronic Wounds
-Venous ulcer
-Arterial ulcer
-Pressure Sore
-Diabetic ulcers

53
Q

grows beyond the
boundaries of the
original wound and
does not regress

54
Q

Excessive Collagen Deposition examples

A

Hypertrophic Scar

Keloid

Exuberant granulation

Exuberant Fibroblast Proliferation

Contractures

55
Q
  • “Proud Flesh”
  • which protrudes above the level of the
    surrounding skin
  • blocks reepithelialization
A

Exuberant granulation

56
Q

Exaggeration of wound contracture

A

Contractures

PATHO LEC PRELIMS (4 decks)

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