Chronic inflammation

Question 1

Define chronic inflammation

Answer 1

Inflammation in which the cell population is especially high in lymphocytes, antibodies and macrophages
features tissue/ organ necrosis and loss of function

Question 2

How may chronic inflammation arise

Answer 2

Primary pathology

Follow on from acute inflammation

Question 3

List the cell types involved in chronic inflammation

Answer 3

B-cell mechanism
T-cell mechanism
NK cells
Macrophages
Fibroblasts

Question 4

Describe the mechanism of B cells in chronic inflammation

Answer 4

Differentiate into plasma cells (antibodies)
Facilitate immune responce
Act with macrophages
Create immulogical memory

Question 5

Describe the mechanism of T cells in chronic inflammation

Answer 5

Produce cytokines;
-attract and hold macrophages
-activate immune cells
-alter capillary permeability
Produce interferons (signalling proteins);
-antiviral effects
-attract and stimulate cells
Kill cell and destroy antigen

Question 6

Describe the mechanism of NK cells in chronic inflammation

Answer 6

Destroy antigens and cells

Question 7

Describe the mechanism of macrophages in chronic inflammation

Answer 7

Remove debris

Motile phagocyte in blood

Question 8

Describe the mechanism of fibroblasts in chronic inflammation

Answer 8

Motile cells

Make and assemble structural proteins (collagen)

Question 9

Define granulomas

Answer 9

A group of epitheliod macrophages in tissue

May contain giant cells (large macrophages) , surround dead material or be surrounded by lymphocytes

Question 10

What do granulomas contain

Answer 10

neutrophils and eosinphils

Question 11

What are granulomas a response to

Answer 11

an indigestible antigen

Question 12

Give examples of global scale granulomas inflammation and their casues

Answer 12

TB - mycobacterium tuberculosis
Leprosy - mycobacterium leprae
Syphilis - treponema pallidum

Question 13

Describe theprocess of granulation in organisation

Answer 13

granulation tissue flows into damaged tissue
capillaries grow into inflammatory mass
increased flow of plasma proteins and macrophages
fibroblasts lay down collagen to repair damages tissue (replace exudate)

Question 14

What do fibroblasts and collagen do to damaged tissue

Answer 14

Patch tissue defects and replace dead tissue to pull it together
Produces scar - small blemish on the skin - to heal

Question 15

List the sequence of events in wound healing

Answer 15

Injury > blood clot > acute inflammation > fibrin meshwork
Increased growth factors and cytokines
Granulation tissue growth
Phagocytosis of fibrin
Fibroblasts lay down collagen
Contraction of scar
Re-epithelialisation

Question 16

What is different about granulation tissue in bones?

Answer 16

It contains osteoblasts as well as fibroblasts

Question 17

Describe the process of callus formation

Answer 17

Osteoblasts lay down woven bone with cartilage nodules

Question 18

Describe the process of bone remodelling

Answer 18

Osteoclasts remove dead bone
Replacement of woven bone by lamellar bone
Reformation of cortical + spongy bone (by osteoblasts)

Question 19

List the factors involved in promoting wound healing

Answer 19

Cleanliness
Apposition of edges (no hematoma)
Good nutrition
Metabolic normality
Normal inflammatory and coagulation mechanism

Question 20

List the factors involved in impairing wound healing

Answer 20

Dirty, gaping wound
Large hematoma
Poorly nourished (lack of vit A/C)
Abnormal metabolisms
Inhibition of angiogenesis

Question 21

Define hematoma

Answer 21

an abnormal collection of blood outside of a blood vessel

It occurs because the wall of the vessel has been damaged and blood has leaked into tissues where it does not belong

Question 22

Define the role of angiogenesis in healing and repair

Answer 22

New vessels form capillary buds, enabling blood supply to enter damaged tissue

Question 23

What stimulates the proliferation of new blood vessels

Answer 23

VEGF released by hypoxic cells and enzymes

Question 24

What do cytokines do as part of the T cell mechanism

Answer 24

• attract and hold macrophages
• activate immune cells
• alter capillary permeability

Question 25

What do interferons do as part of the T cell mechanism

Answer 25

• antiviral effects

- attract and stimulate cells