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Pathoma Chapter 2 > Chronic Inflammation > Flashcards

Chronic Inflammation Flashcards

1
Q

Chronic Inflammation

A

Histologically characterized by Lymphocytes & Plasma Cells

Delayed Response
More specific (Adaptive Immunity)
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2
Q

Plasma Cells on Histo

A

Nucleus on the side of the cell

Area of glassy clearing between nucleus & cytoplasm

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3
Q

Stimuli for Chronic Inflammation

A 
Persistent Infection (most common)
Viral Infections
Mycobacterial Infections
Parasite Infections
Fungal Infections
Autoimmune Disease
Foreign Material
Some Cancers
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4
Q

T Lymphocytes

A

Born as Progenitor T Cells in bone marrow

Educated in the Thymus

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5
Q

T Lymphocytes in the Thymus

A

Undergo TCR rearrangement into CD4 or CD8

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6
Q

TCR Complex Recognizes

A

Antigens presented on MHC

CD4+ recognize Ag on MHC - II
CD8+ recognize Ag on MHC - I

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7
Q

MHC predominantly expressed on APCs

A

MHC - II

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8
Q

T Cell Activation (General)

A

Bind Ag-MHC Complex

2nd Signal

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9
Q

CD4 Activation

A

APC presents Ag on MHC - II
B7 on APC binds CD28 on CD4 cell (2nd signal)

CD4 differentiates into Th1 or Th2
Secretes cytokines helping inflammation

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10
Q

Th1 Cells Secrete

A

IL-2 (CD8 Activator, T Cell Growth Factor)

IFN-γ (Macrophage Activator)

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11
Q

Th2 Cells Secrete

A

IL-4 (Class Switcher to IgG & IgE)
IL-5 (Eosinophil attractant & activator, B-Cell → Plasma Cell inducer, class switcher to IgA)
IL-10 (Th1 Inhibitor, Induces Inflammation Resolution)

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12
Q

IL-2

A

Activates CD8+ T Cells
T Cell Growth Factor

Secreted by Th1 CD4 Cells

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13
Q

IFN-γ

A

Macrophage Activator

Secreted by Th1 CD4 Cells

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14
Q

IL-4

A

Facilitates class switching to IgG & IgE

Secreted by Th2 CD4 Cells
Involved in maturation of B Cells

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15
Q

IL-5

A

Facilitates Eosinophil Chemotaxis
Facilitates Eosinophil Activation
Facilitates B Cell Maturation into Plasma Cells
Facilitates Class Switching to IgA

Secreted by Th2 CD4 Cells

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16
Q

IL-10

A

Inhibits Th1 Cells
Induces resolution of inflamation

Secreted by Th2 CD4 Cells

17
Q

MCH-I Ag Loading

A

Intracellular Ag loaded

18
Q

CD8 Activation

A

1st Signal: Intracellular Ag Presented on MHC-I

2nd Signal: IL-2 from Th1 CD4 Cell

19
Q

Cytotoxic CD8 Killing Mechanism

A 
Method 1:
Perforins secreted
Granzyme secreted
Caspase Cascade Activated
Apoptosis

Method 2:
FAS-L binds FAS-R (CD95) on target
Caspase Cascade Activated
Apoptosis

20
Q

3 ways to activate Caspases

A

Intrinsic Mitochondrial Pathway (Cytochrome C Leak)
Extrinsic Receptor Pathway (FAS - FASL or TNF)
CD8+ T Cell (Granzyme)

21
Q

B Lymphocytes

A

Immature B cells produced in the bone marrow
Undergo Ig Rearrangement
Naive B Cells express IgM & IgD

22
Q

B Cell Activation

A

Ag binds IgM or IgD → Becomes IgM or IgD-secreting Plasma Cell

OR

B Cell consumes Ag
B Cell presents Ag to Th2 via MHC-II
CD40R on B Cell binds to CD40L on Th2
Th2 secretes IL-4 & IL-5
IgM or IgD switches to IgG, IgE & IgA
Hypermutation
B Cell matures into Plasma Cell
23
Q

Granulomatous Inflammation

A

Characterized by Granuloma
Epithelioid Histiocyte Aggregation
Giant Cells surround it
Rim of Lymphocytes around all else

Caseating (w/ central necrosis) or Non-Caseating

24
Q

Key Cell defining Granulomatous Inflammation

A

Epithelioid Histiocyte

Macrophage w/ pink cytoplasm

25
Q

Normal Macrophages have

A

Foamy clear cytoplasm

26
Q

Caseating Granuloma DDX

A 
TB (Perform AFB)
Fungal Infections (Perform GMS)
27
Q

Non-Caseating Granuloma DDX

A

Foreign Material Reaction (Breast Implants)
Sacroidosis (usually see granulomas in multiple sites of the body, especially lung)
Beryllium Exposure (appears very similar to sarcoid)
Crohn’s Disease
Cat Scratch Disease (usually see stellate-shaepd granulomas in the neck)

28
Q

Histologic Hallmark of Crohn’s Disease

A

Non-Caseating Granulomas

29
Q

Histologic Hallmark of Ulcerative Colitis

A

Crypt Abscesses

30
Q

IL-12

A

Induces CD4 → Th1

31
Q

Steps in Granuloma Formation (both caseating and non-caseating)

A

Interaction between Macrophages & Th1 Cells
Macrophages present Ag via MHC-II to CD4 cells
Macrophages secrete IL-12
CD4 → Th1
Th1 secretes IFN-γ
Macrophage → Eipthelioid histiocytes & Giant Cells

Pathoma Chapter 2 (3 decks)

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