Chronic Inflammation

Question 1

What is chronic inflammation?

Answer 1

It is a chronic response to injury with associated fibrosis.

Question 2

Give the three ways in which chronic inflammation can arise.

Answer 2

It takes over from acute inflammation, it arises with acute inflammation or it happens without any acute inflammation.

Question 3

Name two cell types present in chronic inflammation

Answer 3

Macrophages and lymphocytes

Question 4

What is the name for macrophages when they are in the blood?

Answer 4

Monocytes

Question 5

What happens to monocytes (macrophages) after synthesis in the bone marrow?

Answer 5

They can exist in the blood for up to 6 days and they enter cells where they lie dormant for months but can replicate.

Question 6

What are the roles of macrophages in chronic inflammation?

Answer 6

Phagocytosis, secreting chemicals to activate other cells, inducing fever, inducing fibrosis, presenting cells to the immune system.

Question 7

What can lymphocytes do?

Answer 7

Lymphocytes see not capable of phagocytosis, but they can process antigens, produce antibodies, secrete cytokines and kill cells (natural killer cells)

Question 8

What type of antigens do eosinophils attack?

Answer 8

Large parasites such as worms.

Question 9

What is the role of fibroblasts/ myofibroblasts in chronic Inflamation?

Answer 9

These respond to chemotaxin stimuli to produce fibrous tissue. Myofibroblasts are further differentiated and able to contract which is important in wound healing.

Question 10

What type of giant cell can be categorised by peripherally located nuclei?

Answer 10

Langhans giant cell

Question 11

What is a giant cell?

Answer 11

It is when macrophages fuse to form a single giant cell with multiple nuclei.

Question 12

What type of giant cell is seen when there is hard to digest foreign material?

Answer 12

Foreign body giant cell. The nuclei are arranged randomly. If the foreign material is small then it is phagocytosed. If larger the giant cells stick to the side of the foreign material.

Question 13

What is a touton giant cell?

Answer 13

This is seen in areas of high lipid content such as xanthomas and fat necrosis. Nuclei are arranged in a ring towards the centre and there may also be foam cells present.

Question 14

When does fibrous tissue cause impairment to function?

Answer 14

When it replaces normal parenchymal tissue

Question 15

What is the purpose of excess collagen initially during healing?

Answer 15

It walls off the infected area.

Question 16

What problem can be caused by myofibroblasts?

Answer 16

They can contract which can lead to mis shaping and the tissue not retaining its original shape.

Question 17

What is a granulomatous?

Answer 17

This is the body’s way of dealing with material that is hard to eliminate and so it walls it off from the rest of the body.

Question 18

What is an epitheloid cell?

Answer 18

These are elongated macrophages with eosinophilic cytoplasm which are tightly packed like epithelial cells.

Question 19

What are the main cell types found in a foreign body granulomatous?

Answer 19

Foreign body giant cells, macrophages, a few lymphocytes, fibroblasts and epitheloid cells.

Question 20

What are the two types of granulomatous?

Answer 20

Foreign body or immune type (hypersensitivity)

Question 21

Around what cell type do immune type granulomatous form?

Answer 21

Insoluble, organic particles which cause cell mediated immunity

Question 22

What is sarcoidosis?

Answer 22

This is a condition in which granulomatous are seen spread throughout the body.

Question 23

What type of granuloma contains macrophages, giant cells, epitheloid cells and lymphocytes?

Answer 23

Immune type granuloma (the main difference is the number of lymphocytes.

Question 24

What is chronic cholecystitis? What is a clinical consequence of this?

Answer 24

This is inflammation of the gall bladder. Chronically the walls become thickened with fibrous tissue which removes their ability to distend and so the bile duct can become obstructed by a gall stone.

Question 25

What condition of the GI tract can be caused by helicobater pylori?

Answer 25

Chronic gastritis,

Question 26

What is the difference between Crohn’s disease and ulcerative colitis?

Answer 26

In Crohn’s, there are skip regions of normal bowel tissue. Also the areas affected are much more localised and deeper inter collecting fissuring ulcers. A cobblestone appearance is seen. In ulcerative collitis the ulcers cover a much larger surface area.

Question 27

What is cirrhosis?

Answer 27

This is where fibrous septa form in the liver, dividing the parenchymal tissue into nodules.