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ESA2 - Pathological Processes > Chronic Inflammation > Flashcards

Chronic Inflammation Flashcards

1
Q

What is chronic inflammation?

A

Chronic response to injury with associated fibrosis

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2
Q

How does chronic inflammation arise?

A

1) It may ‘take over’ from acute inflammation if damage is too severe to be resolved within a few days
2) May arise de novo
3) May develop alongside acute inflammation in severe persistent/repeated irritation

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3
Q

In which situations can chronic inflammation arise de novo?

A

Some autoimmune conditions (such as rheumatoid arthritis)

Some chronic infections (eg viral hepatitis)

‘Chronic low-level irritation’

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4
Q

What is the most important characteristic of how chronic inflammation looks?

A

The type of cell present

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5
Q

What are the cells of chronic inflammation?

A

Macrophages, lymphocytes, plasma cells, eosinophils, fibroblasts

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6
Q

What are macrophages derived from?

A

Blood monocytes

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7
Q

What are the functions of macrophages?

A

1) Phagocytosis
2) Antigen presentation
3) Synthesis of cytokines, complement, blood clotting factors and proteases
4) Control of other cells by cytokines release

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8
Q

Which are the two types of lymphocytes?

A

B lymphocytes and T lymphocytes

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9
Q

What is the difference between T and B lymphocytes?

A

T = involved in control and some cytotoxic functions

Cell mediated

B = Differentiate to produce antibodies

Humoral

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10
Q

What is a feature of the appearance of plasma cells?

A

Open nucleus - can see cytoplasm, visible golgi

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11
Q

What is a feature of the appearance of eosinophils?

A

Stain pink, bilobe nucleus

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12
Q

What are plasma cells?

A

Differentiated antibody-producing B lymphocytes

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13
Q

What does the presence of plasma cells usually imply?

A

Considerable chronicity - usually lasted a while

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14
Q

In which situations are eosinophils usually involved?

A

Allergic reactions, parasite infestations, some tumours

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15
Q

How are fibroblasts involved in the chronic inflammatory response?

A

Recruited by macrophages, make collagen

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16
Q

What are giant cells?

A

Multinucleate cells made by fusion of macrophages

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17
Q

When are giant cells usually present?

A

Frustrated phagocytosis

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18
Q

What are 3 types of giant cells?

A

Langhans (TB)
Foreign Body Type
Touton (fat necrosis)

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19
Q

What is a feature of the appearance of langhans type giant cells?

A

Horseshoe nuclei

20
Q

What is a feature of the appearance of foreign body type giant cells?

A

Multiple irregular aggregates of nuclei

21
Q

Which cell type is usually present in rheumatoid arthritis?

A

Mainly plasma cells

22
Q

Which cell type is usually present in chronic gastritis?

A

Mainly lymphocytes

23
Q

Which cell type is usually present in leishmaniasis (a protozoan infection)?

A

Mainly macrophages

24
Q

What are some effects of chronic inflammation?

A

Fibrosis, impaired function, atrophy, stimulation of immune response

25
Q

What is an example of a condition where fibrosis is the effect of chronic inflammation?

A

Cirrhosis

26
Q

What is an example of a condition in which impaired function is the effect of chronic inflammation?

A

Chronic inflammatory bowel disease

27
Q

What is an example of a condition in which increased function is the effect of chronic inflammation?

A

Thyrotoxicosis

28
Q

What is cholecystitis?

A

Inflammation of the gallbladder

29
Q

What is one cause of fibrosis of gall bladder wall?

A 
Chronic cholecystitis
(Repeated obstruction by gall stones, repeated acute inflammation leading to chronic inflammation)
30
Q

What is inflammatory bowel disease?

A

Idiopathic inflammatory disease affecting large and small bowel

31
Q

What do patients with inflammatory bowel disease present with?

A

Diarrhoea, rectal bleeding (due to damaged mucosa, ulcers)

32
Q

What is ulcerative colitis?

A

Ulcerative colitis is a long-term condition, where the colon and rectum become inflamed.

33
Q

What is a fistula?

A

Abnormal connection between two epithelium-lined organs

34
Q

True or False:

Ulcerative colitis is superficial thus causing diarrhoea and bleeding

A

True

35
Q

True or False:

Crohn’s disease is transmural thus causing strictures and fistulae

A

True

36
Q

What are some common causes of cirrhosis?

A 
Alcohol
Infection with HBV, HCV
Immunological
Fatty liver disease
Drugs and toxins
Obesity
37
Q

What is thyrotoxicosis?

A

Hyperthyroidism - thyroid produces too much thyroid hormone

38
Q

How do immune diseases cause pathology?

A

Chronic inflammation

39
Q

What is granulomatous inflammation?

A

Chronic inflammation with granulomas

40
Q

What is a granuloma?

A

A mass of granulation tissue, typically produced in response to infection, inflammation, or the presence of a foreign substance.

41
Q

What do granulomas arise with?

A

Persistent, low grade antigenic stimulation and hypersensitivity

42
Q

What are the main causes of granulomatous inflammation?

A

1) Mildly irritant foreign material
2) Infections (eg TB)
3) Sarcoid
4) Crohn’s disease
5) Wegener’s granulomatosis

43
Q

Why are Myobacteria tuberculosis hard to phagocytose?

A

Contain wall lipids (mycosides) that are difficult for phagocytes to digest

44
Q

How do Mycobacteria tuberculosis cause disease?

A

By persistence and induction of cell-mediated immunity (use body’s reaction to cause disease)

So produce no toxins or lytic enzymes

45
Q

What is sarcoidosis?

A

Sarcoidosis is a rare condition that causes small patches of red and swollen tissue, called granulomas, to develop in the organs of the body. It usually affects the lungs and skin.

ESA2 - Pathological Processes (9 decks)

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