Chronic Inflammation 2 Flashcards
<p>What is granulomatous inflammation characterised by?</p>
<p>Presence of granulomas in tissues and organs</p>
<p>What is granulomatous inflammation stimulated by?</p>
<p>Indigestable antigen</p>
<p>What can the cause of granulomatous inflammation be described as?</p>
<p>Idiopathic (no known cause)</p>
<p>What does idiopathic mean?</p>
<p>No known cause</p>
<p>What are granulomas composed of?</p>
<p>Aggregates of epitheloid macrophages in tissue</p>
<p>May contain giant cells</p>
<p>May be surrounded by lymphocytes</p>
<p>Contains neutrophils and eosinophils</p>
<p>What may granulomas surround?</p>
<p>Dead tissue</p>
<p>What are granulomas the response to?</p>
<p>Indigestable antigen</p>
<p>What kinds of hypersensitive reaction are many granulomas?</p>
<p>Type IV</p>
<p>What are giant cells?</p>
<p>Fusion of macrophages to form larger cells (larger cytoplasms and multinucleated)</p>
<p>What are different kinds of granulomas?</p>
<p>Langans type</p>
<p>Foreign body type</p>
<p>Silicone associated</p>
<p>Warthin-Finkeldy type</p>
<p>Where are Langhans type granulomas commonly found?</p>
<p>In tuberculosis</p>
<p>What are properties of Langhams type granulomas?</p>
<p>Peripheral rim of nuclei</p>
<p>Large eosinophillic cytoplasm</p>
<p>What do foreign body type granulomas contain?</p>
<p>Neutrophils</p>
<p>Pus</p>
<p>Giant cells</p>
<p>How are the nuclei arranged in foreign body type granulomas?</p>
<p>Scattered around the cytoplasm</p>
<p>What are silicone associated granulomas due to?</p>
<p>Rupture of silicone implants, vacouls contain leaked silicone</p>
<p>Where areWartin-Finkeldy type granulomas found?</p>
<p>Measles</p>
<p>How are the nuclei arranged in Warthin-Finkeldy granuloma?</p>
<p>Clustered in the centre</p>
<p>What are examples of infectious granulomatous diseases?</p>
<p>Tuberculosis (mycobacterium tuberculosis)</p>
<p>Leprosy (mycrobacteria leprae)</p>
<p>Syphilis (treponema pallidum)</p>
<p>What is tuberculosis caused by?</p>
<p>Mycobacterium tuberculosis</p>
<p>What is leprosy caused by?</p>
<p>Mycobacterium leprae</p>
<p>What is syphilis caused by?</p>
<p>Treponema pallidum</p>
<p>What are examples of non-infective granulomas?</p>
<p>Rheumatoid disease (tissue specific autoimmune disease, targets synovial fluid in joints)</p>
<p>Sarcoidosis</p>
<p>Crohn's disease (chronic inflammatory bowel disease)</p>
<p>What is Rheumatoid disease?</p>
<p>Tissue specific autoimmune disease, targets synovial fluid in joints</p>
<p>What is Crohn's disease?</p>
<p>Chronic inflammatory bowel disease</p>
<p>What is the process of wound healing?</p>
<p>1) Phase of acute inflammation</p>
<p>2) Granulation tissue formation</p>
<p>3) Local angiogenesis (new vessels grow)</p>
<p>4) Fibrosis and scar formation</p>
<p>What does ideal surgical wound healing involve?</p>
<p>Healing by primary intention</p>
<p>Minimal gap</p>
<p>Small amount of granulation tissue</p>
<p>Small linear scar</p>
<p>What does healing of larger defects lead to?</p>
<p>Healing by secondary intention</p>
<p>Lots of granulation tissue ingrowth</p>
<p>Contraction and scarring</p>
<p>What is the detailed process of healing?</p>
<p>1) Injury, blood clot, acute inflammation, fibrin formation</p>
<p>2) Many growth factors and cytokines involved</p>
<p>3) Granulation tissue growth - angiogenesis</p>
<p>4) Phagocytosis of fibrin</p>
<p>5) Mycofibroblasts move in and lay down collagen</p>
<p>6) Contraction of scar</p>
<p>7) Re-epithelialisation</p>
<p>What are factors that help wound healing?</p>
<p>Cleanliness</p>
<p>Apposition of edges (no haemotoma)</p>
<p>Sound nutrition</p>
<p>Metabolic stability and normality</p>
<p>Normal inflammatory and coagulation mechanisms</p>
<p>Local mediators</p>
<p>What are things that would impair wound healing?</p>
<p>Dirty, gaping wound, large haematoma</p>
<p>Poorly nourished, lack of vitamines A and C</p>
<p>Abnormal metabolism, diabetes</p>
<p>Inhibition of angiogenesis</p>
<p>How does fracture healing compare to regular tissue healing?</p>
<p>Similar except the addition of repairing bony structures</p>
<p>What are the sequence of events for healing a fracture?</p>
<p>1) Trauma, fracture, haematoma</p>
<p>2) Bits of dead bone and soft tissue</p>
<p>3) Acute inflammation, organisation, granulation tissue, macrophages remove debris</p>
<p>4) Granulation tissue contains osteoblasts as well as fibroblasts</p>
<p>What does the granulation tissue of a healing fracture contain?</p>
<p>Osteoblasts</p>
<p>Fibroblasts</p>
<p>What is a haematoma?</p>
<p>Solid swelling of clotted blood within tissues</p>
<p>What is formed during fracture repairing?</p>
<p>A callus</p>
<p>What is the process of a callus being formed in fracture healing?</p>
<p>1) Osteoblasts lay down woven bone</p>
<p>2) Nodules of cartilage are present</p>
<p>3) Followed by bone remodelling where osteoclasts remove dead bone, progressive replacement of woven bone by lamellar bone and reformation of cortical and trabecular bone</p>
<p>What happens during the bone remodelling when a callus is formed while healing a fracture?</p>
<p>1) Osteoclasts remove dead bone</p>
<p>2) Progressive replacement of woven bone by lamellar bone</p>
<p>3) Reformation of cortical and trabecular bone</p>
<p>What is angiogenesis?</p>
<p>Formation of new blood vessels</p>
<p>What is the process of angiogenesis?</p>
<p>1) Vascular endothelial growth factor (VEGF) release by hypoxic cells stimulation proliferation</p>
<p>2) Enzyme secretion aids process</p>
<p>3) New vessels form</p>
<p>4) Enable blood supply to enter damaged tissue</p>
<p>How does the purpose of angiogenesis differ?</p>
<p>It differs in different situations such as:</p>
<p></p>
<p>Thrombosis</p>
<p>Malignant tumours</p>
<p>Fibrosis and scarring in athlerosclerosis</p>
<p>What is the purpose of angiogenesis in thrombosis?</p>
<p>Limits thrombus propagation</p>
<p>Reinstatement of flow</p>
<p>What is the purpose of angiogenesis in malignant tumours?</p>
<p>Potential for therapeutic control</p>
<p>In malignant tumours what does angiogenesis occur in?</p>
<p>Tumour growth</p>
<p>What is the purpose of angiogenesis in fibrosis and scarring in athlerosclerosis?</p>
<p>Similar to chronic inflammation</p>
