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ME2019 PART 2 > Chronic Inflammation 2 > Flashcards

Chronic Inflammation 2 Flashcards

1
Q

What is granulomatous inflammation characterised by?

A

Presence of granulomas in tissues and organs

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2
Q

What is granulomatous inflammation stimulated by?

A

Indigestable antigen

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3
Q

What can the cause of granulomatous inflammation be described as?

A

Idiopathic (no known cause)

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4
Q

What does idiopathic mean?

A

No known cause

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5
Q

What are granulomas composed of?

A

Aggregates of epitheloid macrophages in tissue

May contain giant cells

May be surrounded by lymphocytes

Contains neutrophils and eosinophils

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6
Q

What may granulomas surround?

A

Dead tissue

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7
Q

What are granulomas the response to?

A

Indigestable antigen

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8
Q

What kinds of hypersensitive reaction are many granulomas?

A

Type IV

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9
Q

What are giant cells?

A

Fusion of macrophages to form larger cells (larger cytoplasms and multinucleated)

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10
Q

What are different kinds of granulomas?

A

Langans type

Foreign body type

Silicone associated

Warthin-Finkeldy type

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11
Q

Where are Langhans type granulomas commonly found?

A

In tuberculosis

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12
Q

What are properties of Langhams type granulomas?

A

Peripheral rim of nuclei

Large eosinophillic cytoplasm

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13
Q

What do foreign body type granulomas contain?

A

Neutrophils

Pus

Giant cells

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14
Q

How are the nuclei arranged in foreign body type granulomas?

A

Scattered around the cytoplasm

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15
Q

What are silicone associated granulomas due to?

A

Rupture of silicone implants, vacouls contain leaked silicone

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16
Q

Where are Wartin-Finkeldy type granulomas found?

A

Measles

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17
Q

How are the nuclei arranged in Warthin-Finkeldy granuloma?

A

Clustered in the centre

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18
Q

What are examples of infectious granulomatous diseases?

A

Tuberculosis (mycobacterium tuberculosis)

Leprosy (mycrobacteria leprae)

Syphilis (treponema pallidum)

19
Q

What is tuberculosis caused by?

A

Mycobacterium tuberculosis

20
Q

What is leprosy caused by?

A

Mycobacterium leprae

21
Q

What is syphilis caused by?

A

Treponema pallidum

22
Q

What are examples of non-infective granulomas?

A

Rheumatoid disease (tissue specific autoimmune disease, targets synovial fluid in joints)

Sarcoidosis

Crohn’s disease (chronic inflammatory bowel disease)

23
Q

What is Rheumatoid disease?

A

Tissue specific autoimmune disease, targets synovial fluid in joints

24
Q

What is Crohn’s disease?

A

Chronic inflammatory bowel disease

25
Q

What is the process of wound healing?

A

1) Phase of acute inflammation
2) Granulation tissue formation
3) Local angiogenesis (new vessels grow)
4) Fibrosis and scar formation

26
Q

What does ideal surgical wound healing involve?

A

Healing by primary intention

Minimal gap

Small amount of granulation tissue

Small linear scar

27
Q

What does healing of larger defects lead to?

A

Healing by secondary intention

Lots of granulation tissue ingrowth

Contraction and scarring

28
Q

What is the detailed process of healing?

A

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

29
Q

What are factors that help wound healing?

A

Cleanliness

Apposition of edges (no haemotoma)

Sound nutrition

Metabolic stability and normality

Normal inflammatory and coagulation mechanisms

Local mediators

30
Q

What are things that would impair wound healing?

A

Dirty, gaping wound, large haematoma

Poorly nourished, lack of vitamines A and C

Abnormal metabolism, diabetes

Inhibition of angiogenesis

31
Q

How does fracture healing compare to regular tissue healing?

A

Similar except the addition of repairing bony structures

32
Q

What are the sequence of events for healing a fracture?

A

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

33
Q

What does the granulation tissue of a healing fracture contain?

A

Osteoblasts

Fibroblasts

34
Q

What is a haematoma?

A

Solid swelling of clotted blood within tissues

35
Q

What is formed during fracture repairing?

A

A callus

36
Q

What is the process of a callus being formed in fracture healing?

A

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

37
Q

What happens during the bone remodelling when a callus is formed while healing a fracture?

A

1) Osteoclasts remove dead bone
2) Progressive replacement of woven bone by lamellar bone
3) Reformation of cortical and trabecular bone

38
Q

What is angiogenesis?

A

Formation of new blood vessels

39
Q

What is the process of angiogenesis?

A

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

40
Q

How does the purpose of angiogenesis differ?

A

It differs in different situations such as:

Thrombosis

Malignant tumours

Fibrosis and scarring in athlerosclerosis

41
Q

What is the purpose of angiogenesis in thrombosis?

A

Limits thrombus propagation

Reinstatement of flow

42
Q

What is the purpose of angiogenesis in malignant tumours?

A

Potential for therapeutic control

43
Q

In malignant tumours what does angiogenesis occur in?

A

Tumour growth

44
Q

What is the purpose of angiogenesis in fibrosis and scarring in athlerosclerosis?

A

Similar to chronic inflammation

ME2019 PART 2 (45 decks)

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