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Year 2 > Chronic Inflammation > Flashcards

Chronic Inflammation Flashcards

1
Q

How do we progress from acute to chronic inflammation

A

If agent causing acute is not removed

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2
Q

How does acute -> chronic happen

A

Alongside organisation

1. lymphocytes, plasma cells and macrophages replace neutrophil polymorphs

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3
Q

What are the systemic effects of inflammation

A

Pyrexia
Weight Loss
Reactive hyperplasia of reticuloendothelial system
Haematological changes
Amyloidosis (deposition of amyloid in various tissues)

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4
Q

How is pyrexia caused

A

Polymorphs and macrophages produce endogenous pyrogens which act on hypothalamus to set the thermoregulatory mechanisms at a higher temperature

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5
Q

Name an endogenous pyrogen

A

IL-2

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6
Q

Why does inflammation cause weight loss

A

Due to negative nitrogen balance

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7
Q

Define hyperplasia

A

Enlargement of organ or tissue due to increased proliferation

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8
Q

Describe three haematological changes caused by inflammation

A

Leucocytosis
Anaemia
Increased erythrocyte sedimentation rate

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9
Q

What are the main causes of chronic inflammation

A
  1. Transplant rejection
  2. Progression from acute
  3. Recurrent episodes of acute
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10
Q

What is the most common scenario in which acute -> chronic

A

Suppurative type

Presence of ingestible material (e.g. keratin) - constant suppuration

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11
Q

How does suppurative cause acute -> chronic

A
  1. If the puss forms an abscess cavity that is deep-seated and drainage is delayed causing abscess to develop thick walls composed of granulation and fibrous tissue
  2. Rigid walls of abscess cavity therefore fail to come together after drainage
  3. Cavity becomes organised by ingrowth of granulation tissue
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12
Q

What type of chronic inflammation is caused by foreign bodies

A

Granulomatous inflammation

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13
Q

What is granulomatous inflammation

A

Macrophages form multi-nucleate giant cells

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14
Q

Example of recurrent acute inflammation

A

Cholecystitis where acute causes wall muscle of gallbladder to be replaced by fibrous tissue

Predominant cell type is lymphocyte rather than neutrophil polymorph

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15
Q

What are the five most common appearances of chronic inflammation

A
  1. Chronic Ulcer (e.g. of the stomach)
  2. Chronic abscess cavity
  3. Thickening of the wall of a hollow viscus by fibrous tissue
  4. Granulomatous inflammation
  5. Fibrosis
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16
Q

Define Fibrosis

A

Thickening of connective tissue

17
Q

What does the cellular infiltrate of chronic inflammation consist of

A 
Lymphocytes (B and T)
Plasma Cells
Macrophages
Eosinophil
Polymorphs (very few)
Granulation tissue forming fibrous tissue
18
Q

What happens to macrophages during delayed-type hypersensitivity responses

A

They die forming large areas of necrosis

19
Q

What is a granuloma

A

Aggregate of epithelioid histiocytes and lymphocytes

20
Q

Characteristics of epithelia histiocytes

A
  1. Large vesicular nuclei
  2. Large eosinophilic cytoplasm
  3. Elongated
21
Q

Are epithelia histiocytes phagocytic

A

Very little

22
Q

What do epithelioid histiocytes secrete

A

ACE

23
Q

What is a marker for systemic granulomatous disease

A

Activity of ACE

24
Q

How can granulomas be characterised

A
  1. Histiocytes become multinucleate giant cells
25
Q

What indicates if granuloma is from a parasitic infection

A

Granulomas associate with eosinophils

26
Q

Where do hisitiocytic giant cells form

A

Where particulate matter is indigestible by macrophages accumulate (e.g. bacterial cell walls)
OR
when foreign particles are too large to be ingested by just one macrophage.

27
Q

Are histiocytic giant cells functional

A

No - very little phagocytic activity

28
Q

When are longhand giant cells seen

A

In TB under granulomatous conditions

29
Q

What are foreign body giant cells

A

Large cells with nuclei randomly scattered through their cytoplasms

30
Q

What are defining features of foreign body giant cells

A

No distinctive features

31
Q

What organ do disease affecting it result in inflammation

A

Heart

32
Q

What are exudates

A

Have high protein contents as they form from increased vascular permeability

33
Q

What are transudates

A

Low protein content from normal permeability of vessels

34
Q

What is a granuloma

A

Aggregate of epithelioid histiocytes

35
Q

What is granulation tissue

A

Component of healing consisting of small blood vessels in a connective tissue matrix with myofibroblasts

Year 2 (155 decks)

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