Chronic Inflammation

Question 0

What are the factors affecting Resolution in tissues?

Answer 0

1. Amount Cell Death
2. Regeneration Capacity of the Organ
3. How quickly the casual agent is removed
4. How quickly the fluid/Debris is removed

Question 1

What does Resolution mean?

Answer 1

Resolutions means the complete restoration of the tissue to normal after an episode of acute inflammation

Question 2

What is Suppuration?

Answer 2

Suppuration is the formation of Pus

Question 3

What is pus composed of?

Answer 3

Living Cells,
Dying Cells, 
Neutrophils
Cellular Debris 
Bacteria

Question 4

What is Organisation of Tissues?

Answer 4

This is replacement of tissues by formation of Granulation tissue

Question 5

What factors favour the Organisation of tissues?

Answer 5

Large amounts of Fibrin Formed
Substantial Necrosis
Exudate/Debris cannot be removed

Question 6

What is granulation Tissue?

Answer 6

Granulation tissue is classified by:

Capillaries
Macrophages
Fibroblasts proliferation
Collagen synthesis

Question 7

What are the cells of chronic Inflammation ?

Answer 7

Plasma Cells
Lymphocytes
Macrophages
(Neutrophil polymorphs if it originated from acute inflammation)

Question 8

How does Acute inflammation become chronic inflammation?

Answer 8

When the agent causing acute inflammation is not removed

Question 9

What favours the change from Acute inflammation to Chronic?

Answer 9

1. Indigestible Substances
2. Deep seated Suppurative Inflammation
3. Recurrent episodes of acute inflammation

Question 10

What are the Macroscopic appearances of Chronic Inflammation?

Answer 10

Chronic Ulcer 
Chronic Abscess Cavity 
Thickening of Fibrous Tissue
Granulomatous Inflammation (Caseous necrosis) 
Fibrosis

Question 11

How does monocyte becomes a macrophage?

Answer 11

Stem cell produces Promoncyte
Promoncyte matures into monocyte
Monocyte stays in the blood
When a monocyte moves into the tissues, it is a macrophage

Question 12

What are the uses of a Macrophage?

Answer 12

Phagocytic Cells
Produce a range of important cytokines
Activated on migration to an area of inflammation

Macrophage activation Faction - recruits
Migration Inhibition Factor - Prevents action.

Question 13

What is Granuloma?

Answer 13

A granuloma is aggregate of epitheliod histiocytes

Formed from Granulomatous Inflammation

Question 14

What is a Histiocyte?

Answer 14

A Histiocyte is a macrophage present in connective tissue. They have little phagocytic activity, but a secretory function.

Question 15

What feature of the stimuli generally causes granulomatous inflammation?

Answer 15

Their indigestibility

Question 16

What histocytic giant cells are there?

Answer 16

Langhan’s Giant Cell

Foreign Body Type Giant Cell

Question 17

What causes Granulomatous Disease?

Answer 17

Specific Infections - Myobacteria, Shistosomiasis
Foreign Bodies - Endogenous or Exogenous
Specific Chemicals
Drugs

Question 18

What is the reservoir for M. Tuberculosis?

Answer 18

Humans

Question 19

How is TB spread?

Answer 19

Acquired through Inhalation

Question 20

What is the disease mechanism of TB?

Answer 20

Can cause necrosis of organs - caseous

M Bovis TB initially affects the intestinal/tonsillar lesions

Question 21

What do Mycobacteria induce?

Answer 21

They induce Granulomatous reactions in tissue

Question 22

How can you test for Mycobacteria?

Answer 22

Acid/Alcohol fast at microscopic staining

Question 23

How do Mycobacteria survive?

Answer 23

Mycobacteria can survive and replicated within neutrophils and macrophages

Question 24

What is MAF?

Answer 24

It is Macrophage Activation Factor

Question 25

What is MIF

Answer 25

This is Migration Inhibition Factor - It affects Macrophages

Question 26

What manages the granulation tissue process?

Answer 26

Growth Factors - This stimulates cell regeneration by angiogenesis

Question 27

What can Fibrosis lead to?

Answer 27

Fibrosis can lead to distortion or stricture formation

Question 28

When does Organisation of Tissue occur?

Answer 28

When much of the skin is completely destroyed and underlying tissue is undergoing repair Damage area is being replaced by vascular granulation

Question 29

What is angiogenesis?

Answer 29

Process through which new blood vessel form from pre-existing vessels

Question 30

What is oesteomyelitis?

Answer 30

Inflammation of the bone

Question 31

How does Suppurative Inflammation lead to Chronic Inflammation?

Answer 31

Drainage delayed/inadequate Results in thick wall composed of granulation tissue Rigid walls fail to come together after drainage Pus within cavity becomes organised Results in a fibrous scar

Question 32

What causes Granulomatous Inflammation ?

Answer 32

``` Sarcoidosis Caseous Necrosis Crohn's Disease Mycobacteria Schistosomiasis Foreign Bodes ```