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foundation of practice > chronic inflammation > Flashcards

chronic inflammation Flashcards

1
Q

true or false:
1.chronic inflammation is for prolonged period of time and delayed response
2.its the result from imbalance between progressive tissue damage caused by persistent damaging stimulus and attempted eradication of the damaging agent followed by tissue repair
3. chronic inflammation begins insidiously aka ab initial and it preceded by acute inflammation , stimulus can either persists or recurs

A
  • true
  • false , balance
  • true
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2
Q

the cells involved in chronic inflammatory are

A

macrophages and lymphocytes

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3
Q

the chronic inflammation following acute inflammation is the:
1. progression of —-
2. organisation of an —- aka progression of acute osteomyelitis to chronic ostemolytis
3. presence of —- materials as wood implanted into wound and surgical sutures
4. recurrent episode of —– as chronic cholecystitis

A
  • acute inflammation
  • abscess
  • indigestible
  • acute inflammation
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4
Q

chronic inflammation : ab initio includes:
1. persistent —— as:
2. prolonged exposure to —-
3. —— diseases as:
4. diseases of —–

A

1- persistent infection as:
▪ Mycobacterium tuberculosis
▪ Treponema pallidum
▪ Fungi
2. toxic agents as : silica or asbestos
3. autoimmune as SLE and rheaumatoid arthritis
4. unknown aetiology as: inflammatory bowel disease

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5
Q

features of chronic inflammation includes :

A
  1. monuclear cells as macophaes plasma cells and lymphocytes
  2. tissue destruction
  3. reapir granulation tissue as angioagenisis and fibrosis
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6
Q

macrophages are derived from —- and ▪ Kupffer cells (liver)
▪ Sinus histiocytes (spleen and lymph nodes)
▪ Alveolar macrophages (lung)
▪ Micoglia (CNS)
▪ Osteoclasts (bone)
are all known to be —-

A
  • blood monocytes
  • tissue macrophages
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7
Q

the main effector cells in chronic inflammation —- and are extravasion of —– aka adhesion molecules and chemical mediators and they transform into —–

A
  • macrophages
  • monocytes
  • larger macrophages
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8
Q

role of macrophages :
1. they are activated by:
2. involved in —- and are —- presenting
3. releases —– mediators influencing initiating the proegression of inflammation which leads to :
- tissue destruction
- vascular proliferation ( angiogenesis ) and fibrosis

A
  • activated by cytokines and bacterial endotoxins
  • phagosytosis and are antigen presenting
  • inflammatory
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9
Q

products released by macrophages include:

A
  • Tissue destruction
    ▪ Proteases and other enzymes
    ▪ AA metabolites
    ▪ Toxic oxygen metabolites
    ▪ NO
    ▪ Coagulation factors
    ▪ Neutrophil chemotactic factors
  • Vascular proliferation and fibrosis
    ▪ GFs
    ▪ Cytokines
    ▪ Remodelling collagenase and metalloproteinase
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10
Q

1.t lymphocytes are produced in — 2.maturation occurs in —- Ala TCR rearrangement.
3.the activation of the T cells requires binding of ——
4. t lymphocytes release —-

A
  • bone marrow
  • thymus
  • AG/MCH
  • lymphokines
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11
Q

—- are MHC class II
—– are MHC class I

A
  • CD4
  • CD8
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12
Q

true or false:
T cells regulate macrophages activation in recruitment w lymphokines

A

true

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13
Q

b cells are produced in —- and are activated by —- these cells derived from the b cells have encountered —– and are differentiated into —- producing cells and are rich in —- in order to make —-

A
  • bone marrow
  • plasma cells
  • antigen
  • antibody
  • rough er
  • antibodies
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14
Q

estinophils are common in many —- inflammatory reactions and are effective killers of —- .
they mediate tissue damage , MBP aka toxic to parasites and are phagocytic

A
  • allergic
  • parasites
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15
Q

true or false:
1.NK and other lymphocyte subtypes help eliminate
viruses and bacteria

A

true

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16
Q

—- are the least common type of leukocytes in the blood as they migrate into the tissue and become —- , both —– and —- have cell surface — for —- and when stimulated masked cells can release inflammatory mediators including acids mucopolysaccharides, heparin, proteinases

A
  • basophil
  • mast cells
  • mast cells and basophils
  • receptors
  • IgE
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17
Q

—- are derived from bone marrow progenitors and they circulate in the blood , immature precursors , settle in tissue where they differentiate .
- involved in antigen presenting
- are primary cell types that stimulate naive T cells to imitate immune response
- antigens bind to —— and —– and then present antigens to —- and activates them

A
  • dendritic cells
  • MHC class 2 and dendritic cells
  • lymphocytes
18
Q

1.—- is a specific form of chronic inflammation where its caused from aggregation of macrophages have enlarged , epithelium like appearance called ——
2. —– nodular collection of epitheliod macrophages surrounded by a rim of lymphocytes
3. —- large cells w a multiple nuclei aka fusion of macrophages

A
  • granulomatous inflammation
  • epitheliod macrophages
  • granuloma ( aka cluster of wbc )
  • giant cells
19
Q

granulomatous inflammation is seen in response to —- irritating agent which is — digested and/or which imitates a — mediated response aka which are:
it aims to —– or —- damaging agents

A
  • persistent
  • poorly
  • cell mediated response
  • which are: substance resist to lysosomal degradation and substances that induce a T cell hypersensitivity
  • aims to control or remove
    ( check slide 24 )
20
Q

causes of granuloma inflammation:

A
  1. bacteria:
    ▪ Tuberculosis
    ▪ Leprosy
    ▪ Cat scratch
    disease
    2.parasites:
    ▪ Schistosomiasis
    ▪ Toxoplasmosis
    ▪ Leishmaniasis
  2. fungi:
    ▪ Histoplasmosis
    ▪ Blastomycosis
  3. spirochetes : syphilis
21
Q

foreign body type granuloma occurs when in response to —– forge in materials it can be exogenous as:
or endogenous as:

A
  • poorly digestible foreign materials
  • exo : splinter , suture , graft material
  • endo: keratin , hair shafts in pilonidal sinus
22
Q

type IV delayed hypersensitivity is the interaction between —- and —–

A

CD4 helper T cells and macrophages
(* Macrophages present Ags via MHC II to CD4 helper
cells causing their activation
* T cells produce cytokines (IL-2 and IFN-γ)
▪ TB
▪ Fungal infection
▪ Sarcoidosis )

23
Q

microscopic appearance ( important )

A
  1. Foreign body granuloma
    ▪ Macrophages cluster around the foreign material
    ▪ Multinucleated giant cells with haphazardly arranged
    nuclei throughout the cytoplasm
  2. Type IV delayed hypersensitivity :
    ▪ Langhans type giant cells
    ▪ Caseous necrosis in TB
24
Q

true or false:
- tubersulsoris are caused by mycobacterium tuberculosis
- these organisms induce type IV hypersensitivity
- lungs and spleen are main sites of infection

A
  • true
  • true
  • false: lungs and lymph nodes
25
Q

historical features of tb includes:

A

▪ Caseating granuloma
▪ Central necrosis
▪ Epithelioid macrophages and Langhans ’giant cells
▪ T-helper cells (within the granuloma)
▪ Occasional plasma cells
▪ Peripheral rim of suppressor T cells and fibroblasts
▪ ZN stain
* Culture
* Fluorescent staining with auramine
* PCR

26
Q

sarcoidosis is the granulomatous condition of —- which affects — adults and occurs in — more than —- and may affect —- tissues
- histological features include:

A
  • unknown aetiology
  • young adults
  • black more than white
  • any tissue
  • features include:
  • Histological features
    ▪ Non caseating naked granuloma
    ▪ Schaumann bodies - concentric calcification (calcium
    oxalate crystals)
    ▪ Asteroid bodies
27
Q

morphological patterns in acute and chronic inflammation includes:

A
  • Serous inflammation
  • Fibrinous inflammation
  • Suppurative inflammation
  • Ulcers
  • Sinus
  • Fistula
28
Q
  • Accumulation of thin fluid derived from the blood serum
    or secretion of mesothelial lining
    ▪ Effusion
  • Peritoneal
  • Pleural
  • Pericardial
    ▪ Skin blisters
  • Viral infection
  • Burn
    this inflammation is known as —–
A

serous inflammation and the morphological pattern is blister

29
Q

fibrinous inflammation is the accumulation of —–
- contains body cavities
- maybe removed by fibrinolysis ( resolution )
- organisation

A
  • fibrin and fluid
30
Q

suppurative inflammation is characterised by — and can be see associated w certain organism(staphylococcus) and may lead to the formation of —–

A
  • pus
  • abscess
31
Q

—- is the localised formation of pus includes:
▪ Dead and degenerate leucocytes
▪ Dead and degenerate host tissue cells
▪ Oedema fluid
▪ Dead microorganisms

A
  • abscess
32
Q

—- local defect in an epethilal surface produced by the shedding of dead epithelial cells , skin and mucousal surfaces as peptic ulcers and are distinguished from erosions by the — of the tissue loss

A
  • ulcers
  • extent
33
Q

▪ Loss of the full thickness of the epithelium
▪ May or may not be associated with scarring at the
base of the ulcer
are characteristics of —- ulcers

A

acute ulcers

34
Q

▪ Usually deep penetrating
▪ Always associated with scarring at the base of the
ulcer
are characteristics of —- ulcers

A

chronic ulcers

35
Q

sinus:
tract lined by —- tissue leading from — inflamed cavity to a surface
- they are associated w osteomyelitis
- pilondial sinus

A
  • granulation
  • chronically inflamed
36
Q
  • track opened at — ends through which abnormal communication between 2 surfaces is established
  • Gastrointestinal fistula in Crohn’s disease
  • these characterstics are for :
A
  • both ends
  • fistula
37
Q

systemic inflammator response syndrome = ——
inflammatory mediators are produced by —- and —– in repose to infection of injury

A

1- acute phase response
2- leucocytes and hepatocytes

38
Q

pyercxia is a —- réponse by which the bacterial product — stimulates leuocytes to release —- and —- and increases —- which leads to —- and then the neurotransmitters affect the —-
—– inhibits prostaglandin production

A
  • acute phase repose
  • pyrogen
  • IL1and TNF alpha
  • coox
  • prostagladin PGE2
  • hypothalamus
  • NSAIDS
39
Q

acute phase proteins are — proteins produced by the —- which include:

A
  • plasma
  • liver
    ▪ C-reactive protein (CRP)
    ▪ serum amyloid A (SAA)
    ▪ Fibrinogen → binds to RBC→ ↑ESR
    ▪ Iron regulating peptide- hepcidin → Anaemia
40
Q

acute phase response includes:

A
  • Increased pulse and blood pressure
  • Increased sweating and rigors
  • Tendency to sleep
  • Anorexia and malaise
  • Severe sepsis → DIC, hypotension and shock

foundation of practice (59 decks)

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