Chronic Inflammation Flashcards
Define Chronic Inflammation
Prolonged inflammation with associated repair
How can Chronic Inflammation arise
- Takes over from acute inflammation
- “De novo”- Without preceding acute inflammation
- Alongside acute inflammation
Give 3 examples of when Chronic Inflammation can arise “De Novo”
Autoimmune conditions
Prolonged exposure to toxic agents
Chronic infections
How does Chronic Inflammation appear
What are the 2 predominant cell types
Name 3 others
Variable appearances
Lymphocytes and Macrophages (Histiocytes)
Eosinophils, Fibro/Myofibroblasts Giant cells (Granulomatous inflammation
Describe the Appearance of a Macrophage in 3 ways
Large cells
Abundant cytoplasm with Phagolysosomes
Can have a Slipper shaped nucleus
Outline the functions of Macrophages
- Phagocytosis and Antigen presentation
- Synthesis of mediators
- Control and regulation of inflammatory response
Describe the Appearance of a Lymphocyte in 2 ways
- Small cells
2. Large Central nucleus with thin rim of cytoplasm
What are the 2 types of Lymphocyte? How can they distinguished by appearance
Which one has various types and what are the main 2 types. Outline their functions
T and B cells, they can’t
Main 2 T cells are;
- Helper (CD4+): Assist other inflammatory cells
- Cytotoxic (CD8+): Destroy pathogens
What does a B cell mature into
Describe the appearance of this in 4 ways
A plasma cell
- Eccentric Nucleus (Pushed to one side)
- Clock-face chromatin (Clumped into spheres at edge of nucleus)
- Peri-nuclear clearing (Golgi)
- Slightly larger than a T cell
Outline the function of a Plasma cell
Give an example
Produces antibodies which neutralise pathogens
Immunoglobulins
Regarding its appearance, what does an Eosinophil look like?
In 2 ways explain why
Describe its function, and suggest 2 occasions this happens
- “Tomato with sunglasses”
- Bi-lobed nucleus
- Granular cytoplasm stains red
Releases mediators- Parasitic infestations + Allergic/ hypersensitivity reactions
Describe the function of Fibro/ Myofibroblasts
Regeneration and repair by Producing, Secreting and Laying down collagen
What are Giant cells
Name 3 and give an example for each of when they are present
Multinucleate cells formed from fusion of macrophages
- Foreign Body Giant Cell: When a foreign body is present
- Langhans Giant Cell: Tuberculosis
- Touton Giant Cell: Fat necrosis/ Xanthomas
Describe the Appearance of a Foreign Body Giant Cell
Describe the appearance of a Langhans Giant Cell (What shape oftenly)
Describe the appearance of a Touton Giant Cell
Foreign Body: Randomly arranged nuclei
Langhans: Nuclei around periphery of cell (Horse shoe shape)
Touton: Nuclei arranged in a ring at centre of cell
What are the main cell types present in;
1) Rheumatoid arthritis
2) Chronic Gastritis
3) Leishmaniasis
1) Plasma cells
2) Lymphocytes
3) Macrophages
What are 4 Complications of Chronic Inflammation
- Fibrosis (Collagen deposition)
- Impaired function (Rarely= Increased function)
- Atrophy
- Immune response stimulated
Give 2 examples of Fibrosis
Give 3 examples for Impaired function
Give 1 example for Atrophy
F: Cirrhosis, Cholecystitis (Gall bladder inflammation)
IF: Ulcerative colitis, Crohn’s disease, Cirrhosis
A: Gastritis
How does Fibrosis of the gall bladder(Cholecystitis) occur in 2 steps
How does the gall bladder appear
Repeated obstruction of bile duct by gall stones
Repeated Acute Inflammation bouts-> Chronic
Thickened and pale
What are 5 symptoms of Inflammatory Bowel Disease
- Abdominal pain
- Altered bowel motion
- Weight loss
- Rectal bleeding
- Diarrhoea
What 2 conditions come under the term, Inflammatory Bowel Disease
Compare them in regards to;
- Area affected
- Pattern of inflammation
- Part of area affected
- Presence of granulomas
- Likelihood of rectal bleeding
Crohn’s Disease:
- Can affect all of GI tract
- Discontinuous patches of inflammation (Skip Lesions)
- Transmural (Full thickness of bowel wall affected)
- Sometimes Granulomas are present
- Rectal bleeding is less likely
Ulcerative Colitis:
- Large bowel affected only
- Continuous
- Mucosa and Submucosa only
- No granulomas
- Rectal bleeding is more likely
What stage of liver damage is Cirrhosis
Name 4 causes
What do the nodules on a Cirrhhosed liver show
End stage damage to liver
Alcohol
Hepatitis
Drugs/ Toxins
Fatty Liver disease
Areas of Fibrosis and attempted Regeneration
What is a Granulomatous Inflammation
A type of Chronic inflammation in which Granulomas are seen
What is a Granuloma
A collection of Epithelioid Histiocytes (Elongated macrophages that are packed together tightly) surrounded by lymphocytes
What are 3 causes of Granulomatous Inflammation
- Foreign body presence
- Infection by “tough” bacteria (Hard to destroy)
- Idiopathic infections (Unknown cause)
Name 2 “Tough” bacteria
Why are they hard to destroy (2 reasons)
Mycobacterium tuberculosis Mycobacterium leprae (Causes leprosy)
- Thick cell wall
- Mycolic acids (Surface proteins, resist phagocytosis)
What is happening in the centre of a Mycobacterium Granuloma
Name 2 Idiopathic causes of Granulomatous Inflammation
Caseous Necrosis
Crohn’s Disease
Sarcoidosis
Describe the histological appearance of Crohn’s disease
Non-caseating Granuloma
Describe the histological appearance of Sarcoidosis
Name 3 organs that are affected and how they present
Multiple Non-caseating granulomas
Lymph nodes- Enlarged
Lungs- Shortness of breath
Skin- Lumps
Name 1 condition where eosinophils count is high
Hodgkin’s lymphoma
