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Pathological Processes > Chronic Inflammation > Flashcards

Chronic Inflammation Flashcards

1
Q

What happens after acute inflammation?

A
  1. Complete resolution
  2. Repair with connective tissue ( fibrosis) - this occurs if there has been substantial tissue destruction
  3. Progression to chronic inflammation
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2
Q

What is the definition of chronic inflammation

A

Prolonged inflammation with associated repair.

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3
Q

What are characteristics of chronic inflammation?

A
  • delayed onset
  • variable duration ( days to years )
  • variable appearances
  • limits damage , initiates repair
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4
Q

How does chronic inflammation arise ?

A
  1. Takes over from acute inflammation, if resolution is not possible with acute inflammation.
  2. Develops alongside acute inflammation - this happens where there is repeated stimulated of the acute inflammation.
  3. Arises without preceding acute inflammation. Examples of this would be autoimmune diseases.
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5
Q

What is another name for a macrophage ?

A

Histiocyte

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6
Q

What do macrophages appear like on a microscopic slide ?

A

1) very large cells
2) abundant , foamy cytoplasm,
3) slipper shape nucleus.

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7
Q

What are the functions of macrophages ?

A

1) phagocytosis - which leads to antigen presentation to T cells.
2) Releases inflammatory mediators which controls and regulates inflammatory response.

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8
Q

What does a lymphocyte appear like ?

A

1) small cells , slightly larger than RBC

2) spherical nucleus which occupies most of the lymphocyte.( very thin rim of cytoplasm )

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9
Q

What is the function of lymphocytes

A
  • they are divided into T and B cells.
  • there are many varieties of T cells eg T helper cells which have CD4+ receptors on them - these assist inflammatory cells. Whereas T cytotoxic cells which have CD8+ receptors which destroy pathogens.
  • B cells differentiate into plasma cells which produce antibodies such as immunoglobins which helps to neutralise pathogens.
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10
Q

Can you distinguish between B and T cells by their appearance ?

A

No

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11
Q

Describe the appearance of Plasma cells on a microscopic slide

A

1) eccentric nucleus ( nucleus pushed to the side of the cell)
2) clock face chromatin ( circular around the cytoplasm)
3) peri nuclear clearing : lighter rim around the nucleus which indicates Golgi.

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12
Q

What is the function of plasma cells ?

A

They are fully differentiated B lymphocytes which produce antibodies .

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13
Q

How does an eosinophils appear ?

A

Hi lobed nucleus

  • granular cytoplasm which stains red
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14
Q

What is the function of eosinophils?

A

1) release a variety of mediators
2) they are involved in fighting off parasitic infections
3) involved in hypersentivity reactions : when pollen / gluten enters system they release amounts of chemical mediators

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15
Q

What are fibroblasts / myofibroblasts ?

A

They are involved in regeneration and repair on tissue

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16
Q

What are giant cells ?

A

They are the fusion of multiple macrophages. They are multi nuclear cells.

  • this helps to increase the effectiveness of phagocytosis.
17
Q

How many types of giant cells are there ?

A

3

18
Q

What are the 3 main types of giant cells called ?

A

1) foreign body giant cell
2) langhans giant cell
3) touton giant cell.

19
Q

Describe the appearance of a foreign body giant cell

A
  • dedicated to the destruction of foreign material

- the nuclei are randomly assorted in the cell.

20
Q

Describe the appearance of langhans cells

A
  • the nuclei are lined up at the periphery of the cell.

- often the nuclei around the periphery look like a horse shoe shape.

21
Q

Which disease would you often find langhans cells ?

A

TB

22
Q

Describe the appearance of touton giant cell

A

Nuclei are lined up in a Circle in the middle

23
Q

What cells would be high in concentration in rheumatoid arthritis?

A

Plasma cells

24
Q

What cells would be high in concentration in chronic gastritis?

A

Lymphocytes

25
Q

What cells would be high in concentration in leishmaniasis?( a proposal infection)

A

Mainly macrophages

26
Q

What are the 4 general effects of chronic inflammation ?

A

1) FIBROSIS: deposition of collagen. This occurs in diseases such as cirrhosis
2) IMPAIRED FUNCTION: eg inflammatory bowel disease. In some cases there is actually an increased function for example in Graves’ disease there is an increase in the production of T4/T3 by the thyroid gland.
3) ATROPHY: reduction in the size of the organ.
4) stimulation of an immune response which occurs through antigen presentation.

27
Q

Give an example of fibrosis

A
  • GALL BLADDER FIBROSIS
  • this occurs when there is repeated obstruction of the bile duct by gall stones. This causes repeated bouts of acute inflammation , eventually chronic inflammation occurs in conjunction with acute inflammation.
  • this results in the wall of the gall bladder wall becoming thickened and pale because of fibrosis.
28
Q

What does idiopathic mean ?

A

We don’t know the cause yet

29
Q

Give an example of an organ being impaired to function because of chronic inflammation

A

Inflammatory bowel disease - there are two examples : Crohn’s disease and ulcerative colitis

30
Q

What are common symptoms of inflammatory bowel disease ?

A

Abdominal pain
Altered bowel motion
Weight loss
Rectal bleeding

31
Q

What are the differences between Crohn’s disease and ulcerative colitis

A

C : can affect all GI tract from the mouth to the anus. Whereas with ulcerative colitis, it can only affect the LARGE BOWEL.

  1. With Crohn’s disease , it is often discontinuous patches of inflammation ( patch of inflammation then normal then patch of inflammation). Whereas with ulcerative colitis , there is continuous inflammation.
  2. With Crohn’s disease , inflammation affects full thickness of bowel wall ( from the inside to the outside). Whereas with ulcerative colitis it only affects superficial bowel only ( mucosa and submucosa)
  3. In Crohn’s disease you often find granulomata. Whereas in other ulcerative colitis there is no granulomata.
  4. In Crohn’s disease you are less likely to have rectal bleeding , whereas in ulcerative colitis you are likely to have rectal bleeding.
32
Q

What is granulomatous inflammation

A

A specific type of chronic inflammation which involves the presence of a granuloma

33
Q

What is a granuloma ?

A

A collection of epithelia I’d histiocytic

( a collection of macrophages that look like epithelial cells) .

  • they are surrounded with lymphocytes.
34
Q

What are the 3 causes of granulomatous inflammation ?

A
  1. Foreign body reaction - for example surgery equipment /suturing
  2. Infections - most common is by mycobacterium. For example mycobacterium tuberculosis. And mycobacterium leprae. They are very difficult to destroy because of their thickened cell well..
  3. Idiopathic ( Crohn’s disease - granuloma in the GI tract , sarcoidosis ( multiple granuloma in lymph nodes , lungs , skin ) - we are not sure why these diseases cause granulomatous inflammation. Non-caseating granulomata.
35
Q

How do mycobacterium granuloma differ from a normal granuloma ?

A
  • both have epithelioid histicocytes
  • both surrounded by lymphocytes
  • however their centre is filled with caseous necrosis ( cheese like )

Pathological Processes (13 decks)

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