Chronic Inflammation Flashcards
What is a Ghon complex and what disease is it associated with?
A Ghon complex is associated with TB.
A Ghon complex is the combination of hilar lymph nodes with caseation as well as the lung lesion known as the Ghon foxes.
The combination of both the lung seion and the hilar nodes is known as the Ghon Complex.
What is marked in green and red?
Green: Hilar Lymph Nodes
Red: Ghon Complex
Smaller Granlomas, that have not yet undegone caseation, can be seen in the lung between the hilar lymph nodes and the Ghon focus.
Ghon complex is a sign of control with TB. If they are immunosuppressed this would spin out of control. Ghon complex you have TB, but immune system is handling it.
What is the typical structure of granulomas?
Histologically see clusters of epithelioid histiocytes (macrophages, which can coalesce into Langhans Giant cells. The enitre structure is surrounded by small lymphocytes (mainly CD4 cells). As the lesion heals, fibroblasts migrate to the peripher of the lesion and deposit collagen.
Differentiate between primary and primary progressive TB.
Primary TB: Prolonged exposure to Mycobacterium, Night Sweats then asymptomatic. Walled off (granulomatous response). This is controlled.
Primary Progressive TB: Proliferate when infected, leads to disseminated infection, possible CNS infection, ventricles can become occluded
What is the vaccine for TB? What is its usage?
Vaccine is called BCG (Bacillis Calmet Gerrine). Is a live attenuated vaccine.
Given at birth for at-risk children.
Used in Urology with granulomatous responst to tansitional cell carcinoma
Works by attempting to turn primary progressive TB into primary (Adult) form (controlled in granulomas)
Infect them w. attenuated strand to prevent possibility of progressive form.
Describe the process involved in the myocbacterium TB infections prior to activation of a cell mediated imuune response, then describe the initiation and consequences of the cell mediated response
What is secondary progressive TB?
When primary TB infection that goes dormant for a while then begins to actively spread.
-Important that this is reinfection, it is the same strain of TB that affected the first time.
What is milary TB?
Termed used in TB for massive hematogenous dissemianation, spreading of TB from the lungs to other organs most often the liver and the spleen. This is not good.
Describe pathway form infection, to primary compllex, to progressive primary, to progressive secondary and to miliary TB.
What is the way to tell if someone is actively infections with TB?
Sputum stain for acid fast bacilli, also called auromine/rhodamine
What occurs in Sarcoidosis?
Idiopathic Granulomas due to atypical myobacteria
-we do not know what organism is the cause, and we do not know what causes the disease.
What is the treatment for Sarcoidosis?
treatment of choice is immunosuppression with steroids, problem is that you if you treat for sacroidosis without finding the underlying organism, what if its TB which is also hard to find. This would cause TB to disseminate.
- need immunosuppression to avoid granulomas from blocking things like in the brain (avoid hydrocephalus) and from destroying tissue (it is an amped up immune response).
- TNF-alpha is also critical for the formation of sequesting granulomas
What is this?
This is a granuloma of the meninges, present in a patient with sarcoidosis.
What is the significant of the Apgar score?
Predics how baby is going to do. A good clinical utility
How would you characterize or describe the inflammatory response to a virun in the heart?
Lymphocytic
What is this?
This is the heart with Coxsackievirus Myocarditis
What is this?
This is the a granuloma in the brain, an example of the dangerous granulomas that occur in sarcoidosis
Admire this
This is a granuloma that has not yet undergone caseation. The top two arrows point to epitheliod histocytes (macrophages) and at the bottom you can see a Langhans Giant cells.
