Chronic Inflammation Flashcards
Why would chronic inflammation take over from acute inflammation?
If the original damage is too severe to be resolved within a few days, such as a burn which becomes infected
What are the reason chronic inflammation may occur de novo?
May be due to autoimmune conditions
May be due to chronic infection such as hepatitis
May be due to chronic low level irritation such as the cement which is added in a joint operation
When might acute irritation occur alongside chronic infection?
In Severe or persistent infections
What are the 3 ways in which chronic inflammation occurs?
- May take over from a acute inflammation
- May arise de novo
- May develop alongside acute inflammation
How is chronic inflammation characterised?
By what it looks like mainly at a microscopic level and what cells are present.
What are macrophages derived from?
Blood monocytes
What are the functions. Of macrophages?
- Phagocytosis
- Processing and presentation of antigens to the immune system
- Synthesis of not only cytokines but also complement components, blood clotting factors and proteases
- Control of other cells by cytokines release
What are the function of lymphocytes?
- Mainly immunological
- b lymphocytes can differentiate to produce antibodies
- t lymphocytes can be involved in control and cytotoxic function, they mature in the thymus gland.
What kind of nucleous do plasma cells have?
A clock face nucleous
Which other cells other than lymphocytes and macrophages are involved in the inflammatory response?
- Plasma cells- which are Differentiated antibody-producing B lymphocytes.
- eosinophils- allergic response, some parasite infections and some cancers
- fibroblasts/myofibroblasts
What are the 3 types of giant cells?
Langhan cells
Touton cells
Foreign body cells
What are giant cells?
They are multi cleats cells made by fusion of macrophages
They are formed by frustrated phagocytosis where one macrophage isn’t enough to to phagocytose something.
What are langhans cells most commonly associated with?
TB
What are touton cells most commonly associated with?
Fat necrosis
Briefly describe a foreign body giant cell:
Disorganised giant cell
How can you distinguish between the different types of chronic inflammation?
Morphology of most chronic inflammation reactions is non-specific but there are different numbers of each cell type in different conditions
What is the main cell type present in rheumatoid arthritis?
Mainly plasma cells
What is the main cell type present in chronic gastritis?
Mainly lymphocytes
What are rh effects of chronic inflammation?
- Fibrosis
- Impaired function
- Atrophy
- Stimulation of immune response- the macrophage-lymphocyte interaction
What is a granuloma?
A cohesive group of epithelioid macrophages
When do granuloma s arise?
Due to persistent, low grade antigenic stimulation, and hypersensitivity
What are the main causes of granuloma formation in inflammation?
- Mildly irritant for eight material
- infections from mycobacterium such as TB and leprosy
- Unknown causes such as sarcoidosis and Crohn’s disease
What type of necrosis may happen in TB?
Caseus necrosis
What happens in chronic cholecystitis?
There is repeated obstruction by gallstones, repeated acute inflammation leads to chronic inflammation which leads to eventual fibrosis of gall bladder wall
Is gastric ulceration a type of fibrosis?
Yes
Why may ulceration occur?
Due to an imbalance of acid production and mucus defence system
What is an ulcer?
A lesion which erodes the mucous membrane
What disease would produce a cobble stone mucosa appearance?
Crohn’s disease
Does ulcerative cloisters affect the superficial laters of the GIT or the deep layers?
The superficial layers
In what disease do strictures and fistulae appear in?
Crohn’s disease
What disease causes anal lesions?
Crohn’s disease
What is cirrhosis of the liver caused by?
Chronic inflammation with fibrosis, which causes disorganisation of the cellular architecture
What kind of chronic inflammatory disease can cause an increase in function?
Thyrotoxicosis
Briefly describe rheumatoid arthritis:
It is an autoimmune disease which can have localised and systemic immune responses.
Localised chronic inflammation can cause joint destruction and systemic immune response can cause other damage in organs such as the skin.
What are the outcomes of TB:
Arrest, fibrosis and scarring of lung tissue
Erosion into the bronchus causing bronchopneumonia and sometimes TB of the GIT if it coughed up and swallowed.
Tuberlocous empyema
Erosion into the blood steam
What is miliary TB?
Lots and lot of bacteria causing TB
Define chronic inflammation:
Chronic response to injury with associated fibrosis
