Chronic inflammation

Question 1

What types of cells are typically involved in a chronic immune response?

Answer 1

Mainly mononuclear cells.

Lymphocytes, plasma cells and macrophages

Question 2

What is the role of CD4+ T cells?

Answer 2

To assist in activating other effector cells such as CD8+ T cells and macrophages. Also play a crucial role in activating naive b cells.

Question 3

What is the role of CD8+ T cells?

Answer 3

Involved as effectors through direct cell death by inducing apoptosis. Also involved in the production of cytotoxic cytokines.

Question 4

What is the role of macrophages? From what cells do they derive?

Answer 4

Macrophages are derived from monocytes. They are normal residents in many tissues in the body. Once promoted they increase in size, motility and phagocytic activity

Question 5

What is a granuloma?

Answer 5

Fusing together of macrophages to form giant cells surrounded by a tough fibrous cap.

Question 6

What is the definition of hyperplasia?

Answer 6

Increase in number of cells

Question 7

What is the definition of hypertrophy?

Answer 7

Increase in size of cells

Question 8

What is the definition of hypoplasia?

Answer 8

Failure to reach full developmental size

Question 9

What is the definition of atrophy?

Answer 9

Decrease in size or number

Question 10

What is the definition of metaplasia? What is Barrett’s oesophagous?

Answer 10

Replacement of one cell type for another.

Replacement of the squamous lining for columnar

Question 11

What is the definition of dysplasia?

Answer 11

Typically a pre-malignant stage of disregulated growth

Question 12

What are the 3 components of the ECM? Which is not present in scar tissue?

Answer 12

1) Collagen fibres
2) Proteoglycans
3) Elastic fibres (not present in scars)

Question 13

What is contained within the dermo-epidermal junction?

Answer 13

Hemidesmosomes, BM and collagen

Question 14

What is the difference between healing by primary and secondary intention?

Answer 14

Primary intention-The act of approximating skin edges so that the skin heals with no intervening tissue. Note that this process can occur non-surgically as well, for example, when a paper cut heals.
Secondary intention- The process by which skin wounds are left to heal without suturing. The tissue that constitutes the gap between skin edges is called granulation tissue. This tissue generally forms the scar after healing is complete.

Question 15

What is the constituent units of granulation tissue found in secondary intention?

Answer 15

Provisional ECM, inflammatory cells, blood vessels, fibroblasts, loose fibroblasts, loose fibrous tissue

Question 16

What are the two key steps to scar formation?

Answer 16

Fibroplasia- production of collagen

Re-epithelialisation- keratinocyte migration, (proliferation is inhibited until migration is complete

Question 17

What are the stages of developing cirrhosis through chronic hepatitis?

Answer 17

Hepatocytes stimulated out of quiescence
New ECM is deposited between hepatocytes
Angiogenesis establishes new sinusoids
Stellate cells in the Space of Disse.
Cirrhosis develops because of nodules of regenerating hepatocytes completely surrounded by fibrous tissue

Question 18

What is Lambert-Eaton syndrome?

Answer 18

Antibodies against the tumour can cross react with synaptic voltage gated calcium channels at the NMJ. This causes severe muscle weakness

Question 19

What is the difference between a carcinoma, sarcoma. and adenocarcinoma?

Answer 19

Carcinoma- Malignant neoplasm of epithelial origin
Sarcoma- Malignant neoplasm of the mesenchyme
Adenocarcinoma- Malignant neoplasm of glandular tissue

Question 20

What is the difference between grade and stage?

Answer 20

Degree of histological resemblance to the parent tissue

Stage- degree of anatomical spread

Question 21

What is Breslow’s thickness?

Answer 21

Used for staging melanoma