Chronic Inflammation

Question 1

What are the functions of macrophages?

Answer 1

Phagocytosis
Professional antigen presenting
Synthesis of cytokines, complement components, clotting factors and proteases
Control of other cells

Question 2

Describe the look of plasma cells under a microscope

Answer 2

Clock face ‘lumpy’ chromatin
Cytoplasm usually to one side
Very pink
Semi circular pale areas - Golgi

Question 3

When are eosinophils released?

Answer 3

Allergic reactions
Parasite infestations
Some tumours

Question 4

What are giant cells?

Answer 4

Multinucleate cells made by fusion of macrophages due to frustrated phagocytosis.

Question 5

What are the types of giant cells?

Answer 5

Langhans (TB)
Foreign body type
Touton (fat)

Question 6

Describe the microscopic appearance of Langhans cells

Answer 6

Horseshoe of nuclei around the periphery

Question 7

Describe the microscopic appearance of foreign body cells

Answer 7

Clusters of nuclei with foreign material in the centre

Question 8

Describe the microscopic appearance of Touton cells

Answer 8

Ring of nuclei near the centre, surrounded by foamy cytoplasm

Question 9

What are some of the effects of chronic inflammation?

Answer 9

Fibrosis
Impaired function
Atrophy
Stimulation of immune response

Question 10

Define fistula

Answer 10

An abnormal connection between 2 epithelium-lined, usually hollow organs

Question 11

Define granulomas

Answer 11

Cohesive group of macrophages and other inflammatory cells

Question 12

Why can’t we break down mycobacterium tuberculosis?

Answer 12

The mycosides in the cell wall mean that the bacteria can be taken up by macrophages but cannot be broken down.

Question 13

Describe a TB granulomas

Answer 13

Caseous necrosis in the centre

Langhans cells present

Question 14

How can chronic inflammation arise?

Answer 14

May ‘take over’ from acute
May arise de novo
May develop alongside cute

Question 15

What are the symptoms of tuberculosis?

Answer 15

Weight loss
Night sweats
Cough
Fever
Dyspnoea

Question 16

Which bacteria is most likely to cause chronic gastritis?

Answer 16

Helicobacter pylori

Question 17

Describe ulcerative colitis

Answer 17

Cause unknown 
Inflammatory bowel disease
Affects only colon and rectum
Superficial inflammation only
Crypts often distorted

Question 18

What are some complications of UC?

Answer 18

Anaemia
Liver disease
Malignant change
Perforation 
Haemorrhage

Question 19

Describe Crohn’s disease

Answer 19

Inflammatory bowel disease
Small bowel most commonly affected but can occur anywhere in GI tract
Transmural inflammation with granulomas
‘Cobblestone’ mucosa

Question 20

Define gumma

Answer 20

Soft, benign growth that is a form of granuloma

Question 21

Describe sarcoidosis

Answer 21

Abnormal collections of granulomas
Can form nodules in multiple organs (most often in lungs)
Usually resolves itself

Question 22

What is LTB4?

Answer 22

Leukotriene B4
Induces the adhesion and activation of leukocytes on the endothelium, allowing them to cross into tissues
Induces the formation of ROS in neutrophils

Question 23

What is an eschar?

Answer 23

A piece of dead tissue, cast off from the surface of the skin that contains necrotic tissue.

Question 24

Define sequela

Answer 24

A condition which is the consequence of a previous disease or injury