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Mechanisms Of Disease > Chronic Inflammation > Flashcards

Chronic Inflammation Flashcards

0
Q

What are the functions of macrophages?

A

Phagocytosis and destruction of bacteria and debris
Processing and presenting antigens to the immune system
Synthesis of cytokines and complement proteins
Control and activation of cells by cytokine release

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1
Q

Name the cells involved in chronic inflammation

A 
Macrophages
Plasma cells
Eosinophils
Lymphocytes
Fibroblasts/Myofibroblasts
Giant cells
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2
Q

What do lymphocytes look like?

A

Large nucleus with barely any cytoplasm

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3
Q

Where are T lymphocytes produced and matured?

A

Produced in the bone marrow

Mature in the thymus

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4
Q

Where are B lymphocytes produced and matured?

A

Produced and matured in the bone marrow

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5
Q

What can B lymphocytes differentiate into?

A

Plasma cells or memory cells

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6
Q

What can T lymphocytes differentiate into?

A 
T helper (CD4)
T killer (CD8)
Natural killer cells
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7
Q

Function of T lymphocytes?

A

Control
Cytotoxic functions
Can kill virally infected cells

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8
Q

What do plasma cells look like?

A

Have a clock face nucleus
Pinkish-blue cytoplasm
Pale halo around the nucleus which is the Golgi apparatus

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9
Q

What does the presence of plasma cells imply?

A

That the inflammation is chronic

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10
Q

What do plasma cells do?

A

Produce antibodies

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11
Q

In which situations are eosinophils found in?

A

Allergic reactions
Parasite infestations
Some tumours

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12
Q

How do fibroblasts get there and what do they do?

A

Recruited by macrophages

Secrete collagen

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13
Q

What are giant cells made up of?

A

Giant macrophages

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14
Q

What is the function of giant cells?

A

Frustrated phagocytosis

Phagocytose what macrophages can’t by themselves

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15
Q

What are the types of giant cells?

A

Langhans
Foreign body type
Touton

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16
Q

Which type of giant cell is normally seen in TB?

A

Langhans

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17
Q

Which type of giant cell is described as disorganised aggregates of multiple nuclei?

A

Foreign body type

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18
Q

Which type of giant cell is described as organised nuclei with foamy cytoplasm?

A

Touton

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19
Q

What type of giant cell forms in fat necrosis?

A

Touton

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20
Q

What is chronic inflammation?

A

Chronic response to injury with associated fibrosis

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21
Q

How does chronic inflammation arise?

A

Take over from acute inflammation if not resolved in a few days
De novo- when there has been no preceding chronic inflammation
Develop alongside acute inflammation in severe or repeated irritation

22
Q

What can cause de novo chronic inflammation?

A

Autoimmune diseases eg rheumatoid arthritis
Chronic infections eg viral hepatitis
Chronic low level irritation eg foreign body in tissue

23
Q

What are some possible complications of chronic inflammation?

A

Fibrosis
Impaired function and atrophy
Stimulation of immune response
Carcinoma

24
Q

What are gall stones caused by?

A

Repeated obstruction to the cystic duct causing acute inflammation which leads to chronic inflammtion

25
Q

What damage can gall stones cause?

A

Damage mucosa and damage gall bladder wall

26
Q

Cause of acute gastritis?

A

Alcohol and drugs

27
Q

Cause of chronic gastritis?

A

Helicobacter pylori

28
Q

Why does gastric ulceration occur?

A

Ulceration due to an imbalance of acid production and mucosal defence

29
Q

What can patients present with in IBS?

A

Diarrhoea, rectal bleeding and other symptoms

30
Q

What are strictures?

A

Narrowing

31
Q

What are fistulae?

A

Abnormal connections between two epithelium-lined organs

32
Q

What complication can IBS lead to?

A

Impaired function

33
Q

What complications can gall stones and gastric ulceration lead to?

A

Fibrosis

34
Q

What complication cam cirrhosis lead to?

A

Fibrosis and impaired function

35
Q

What complication can Grave’s disease lead to?

A

Increased function

36
Q

Causes of cirrhosis?

A 
Alcohol
Hep A and B
Immunological
Fatty live disease
Type 2 diabetes
Drugs and toxins
37
Q

What happens in cirrhosis?

A

Nodules of regenerating hepatocytes appear in the liver as it tries to repair itself
Surrounded by bands of collagen

38
Q

What happens in Grave’s disease?

A

Auto-antibodies stimulate TSH receptors causing hyperthyroidism

39
Q

How is Grave’s disease treated?

A

Carbimazole and sometimes surgery

40
Q

Pathology of atrophic gastritis?

A

Lymphocytes and plasma cells produce auto-antibodies which destroy parietal cells
Leads to atrophy of gastric mucosa

41
Q

What can you see in atrophic gastritis?

A

Lots of lymphocytes and fibrous tissue

42
Q

Pathology of rheumatoid arthritis?

A

Local chronic inflammation leads to inflammation of synovial capsule ➡️ joint destruction

43
Q

What is a granuloma?

A

An accumulation of epithelioid histiocytes (macrophages) and lymphocytes

44
Q

What is granulomatous inflammation?

A

Inflammation with granulomas

45
Q

What is granulomatous inflammation caused by?

A

Persistent, low grade irritation such as

  • mildly irritant foreign material
  • unknown causes such as sarcoidosis and Crohn’s disease
46
Q

What is sarcoidosis?

A

An autoimmune disease where there is granulomatous inflammation in tissues

47
Q

What can be seen in the middle of a granuloma?

A

Caseous necrosis

48
Q

Why are mycobacterium tuberculosis difficult for the body to remove?

A

Their cell wall contains lipids and they can survive in the cytoplasm of macrophages

49
Q

What type of necrosis is often seen in TB?

A

Caseous

50
Q

How do Tb bacteria cause disease?

A

Their persistence in the body causing induction of cell meditated immunity. Don’t release any toxins or lytic enzymes.

51
Q

Outcomes of TB?

A

Arrest - stopped by immune system
Progresses - erosion into bronchus. Can spread into GI tract
TB empyema - erodes through plural surface of lung
Erosion into blood

52
Q

What is the difference between miliary TB and single organ TB?

A

Miliary - many bugs

Single organ - few bugs

Mechanisms Of Disease (11 decks)

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