Chronic Inflammation

Question 1

Why would chronic inflammation take over from acute inflammation?

Answer 1

If the original damage is too severe to be resolved within a few days, such as a burn which becomes infected

Question 2

What are the reason chronic inflammation may occur de novo?

Answer 2

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

Question 3

When might acute irritation occur alongside chronic infection?

Answer 3

In Severe or persistent infections

Question 4

What are the 3 ways in which chronic inflammation occurs?

Answer 4

• May take over from a acute inflammation
• May arise de novo
• May develop alongside acute inflammation

Question 5

How is chronic inflammation characterised?

Answer 5

By what it looks like mainly at a microscopic level and what cells are present.

Question 6

What are macrophages derived from?

Answer 6

Blood monocytes

Question 7

What are the functions. Of macrophages?

Answer 7

• 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

Question 8

What are the function of lymphocytes?

Answer 8

• 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.

Question 9

What kind of nucleous do plasma cells have?

Answer 9

A clock face nucleous

Question 10

Which other cells other than lymphocytes and macrophages are involved in the inflammatory response?

Answer 10

• Plasma cells- which are Differentiated antibody-producing B lymphocytes.
• eosinophils- allergic response, some parasite infections and some cancers
• fibroblasts/myofibroblasts

Question 11

What are the 3 types of giant cells?

Answer 11

Langhan cells

Touton cells

Foreign body cells

Question 12

What are giant cells?

Answer 12

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.

Question 13

What are langhans cells most commonly associated with?

Answer 13

TB

Question 14

What are touton cells most commonly associated with?

Answer 14

Fat necrosis

Question 15

Briefly describe a foreign body giant cell:

Answer 15

Disorganised giant cell

Question 16

How can you distinguish between the different types of chronic inflammation?

Answer 16

Morphology of most chronic inflammation reactions is non-specific but there are different numbers of each cell type in different conditions

Question 17

What is the main cell type present in rheumatoid arthritis?

Answer 17

Mainly plasma cells

Question 18

What is the main cell type present in chronic gastritis?

Answer 18

Mainly lymphocytes

Question 19

What are rh effects of chronic inflammation?

Answer 19

1. Fibrosis
2. Impaired function
3. Atrophy
4. Stimulation of immune response- the macrophage-lymphocyte interaction

Question 20

What is a granuloma?

Answer 20

A cohesive group of epithelioid macrophages

Question 21

When do granuloma s arise?

Answer 21

Due to persistent, low grade antigenic stimulation, and hypersensitivity

Question 22

What are the main causes of granuloma formation in inflammation?

Answer 22

• Mildly irritant for eight material
• infections from mycobacterium such as TB and leprosy
• Unknown causes such as sarcoidosis and Crohn’s disease

Question 23

What type of necrosis may happen in TB?

Answer 23

Caseus necrosis

Question 24

What happens in chronic cholecystitis?

Answer 24

There is repeated obstruction by gallstones, repeated acute inflammation leads to chronic inflammation which leads to eventual fibrosis of gall bladder wall

Question 25

Is gastric ulceration a type of fibrosis?

Answer 25

Yes

Question 26

Why may ulceration occur?

Answer 26

Due to an imbalance of acid production and mucus defence system

Question 27

What is an ulcer?

Answer 27

A lesion which erodes the mucous membrane

Question 28

What disease would produce a cobble stone mucosa appearance?

Answer 28

Crohn’s disease

Question 29

Does ulcerative cloisters affect the superficial laters of the GIT or the deep layers?

Answer 29

The superficial layers

Question 30

In what disease do strictures and fistulae appear in?

Answer 30

Crohn’s disease

Question 31

What disease causes anal lesions?

Answer 31

Crohn’s disease

Question 32

What is cirrhosis of the liver caused by?

Answer 32

Chronic inflammation with fibrosis, which causes disorganisation of the cellular architecture

Question 33

What kind of chronic inflammatory disease can cause an increase in function?

Answer 33

Thyrotoxicosis

Question 34

Briefly describe rheumatoid arthritis:

Answer 34

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.

Question 35

What are the outcomes of TB:

Answer 35

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

Question 36

What is miliary TB?

Answer 36

Lots and lot of bacteria causing TB

Question 37

Define chronic inflammation:

Answer 37

Chronic response to injury with associated fibrosis