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>
What is the process of wound healing?
1) Phase of acute inflammation
2) Granulation tissue formation
3) Local angiogenesis (new vessels grow)
4) Fibrosis and scar formation
What does ideal surgical wound healing involve?
Healing by primary intention
Minimal gap
Small amount of granulation tissue
Small linear scar
What does healing of larger defects lead to?
Healing by secondary intention
Lots of granulation tissue ingrowth
Contraction and scarring
What is the detailed process of healing?
1) Injury, blood clot, acute inflammation, fibrin formation
2) Many growth factors and cytokines involved
3) Granulation tissue growth - angiogenesis
4) Phagocytosis of fibrin
5) Mycofibroblasts move in and lay down collagen
6) Contraction of scar
7) Re-epithelialisation
What are factors that help wound healing?
Cleanliness
Apposition of edges (no haemotoma)
Sound nutrition
Metabolic stability and normality
Normal inflammatory and coagulation mechanisms
Local mediators
What are things that would impair wound healing?
Dirty, gaping wound, large haematoma
Poorly nourished, lack of vitamines A and C
Abnormal metabolism, diabetes
Inhibition of angiogenesis
How does fracture healing compare to regular tissue healing?
Similar except the addition of repairing bony structures
What are the sequence of events for healing a fracture?
1) Trauma, fracture, haematoma
2) Bits of dead bone and soft tissue
3) Acute inflammation, organisation, granulation tissue, macrophages remove debris
4) Granulation tissue contains osteoblasts as well as fibroblasts
What does the granulation tissue of a healing fracture contain?
Osteoblasts
Fibroblasts
What is a haematoma?
Solid swelling of clotted blood within tissues
What is formed during fracture repairing?
A callus
What is the process of a callus being formed in fracture healing?
1) Osteoblasts lay down woven bone
2) Nodules of cartilage are present
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
What happens during the bone remodelling when a callus is formed while healing a fracture?
1) Osteoclasts remove dead bone
2) Progressive replacement of woven bone by lamellar bone
3) Reformation of cortical and trabecular bone
What is angiogenesis?
Formation of new blood vessels
What is the process of angiogenesis?
1) Vascular endothelial growth factor (VEGF) release by hypoxic cells stimulation proliferation
2) Enzyme secretion aids process
3) New vessels form
4) Enable blood supply to enter damaged tissue
How does the purpose of angiogenesis differ?
It differs in different situations such as:
Thrombosis
Malignant tumours
Fibrosis and scarring in athlerosclerosis
What is the purpose of angiogenesis in thrombosis?
Limits thrombus propagation
Reinstatement of flow
What is the purpose of angiogenesis in malignant tumours?
Potential for therapeutic control
In malignant tumours what does angiogenesis occur in?
Tumour growth
What is the purpose of angiogenesis in fibrosis and scarring in athlerosclerosis?
Similar to chronic inflammation
