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EMS MOD > chronic inflammation > Flashcards

chronic inflammation Flashcards

1
Q

what is the difference between innate and adaptive immunity?

A

innate is ready to respond immediately whereas adaptive takes longer and shows memory

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2
Q

what are the characteristics of acute inflammation?

A

quick onset and offset

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3
Q

what is exudation?

A

it occurs in acute inflammation when there is increased blood flow into the area and increased fluid leaving through the permeable vessels

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4
Q

what happens in acute inflammation?

A

releases proteins that are important for the acute immune response such as fibrinogen and cells leak out - usually neutrophils

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5
Q

what are the symptoms acute inflammation?

A

rubor, calor, dolor, tumor

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6
Q

how can you account for the symptoms of acute inflammation?

A

exudation - tumor / swelling
increased blood flow - rubor
blood flow - calor
dolor - swelling

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7
Q

what are the outcomes of acute inflammation?

A

repair or regeneration
repair - organisation occurs through replacement by granulation tissue and a fibrous scar
resolution - phagocytosis of insulting pathogen, fibrinolysis, phagocytosis of debris

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8
Q

what cells are involved in chronic inflammation?

A

lymphocytes, plasma cells and macrophages - mononuclear inflammatory cells

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9
Q

what happens in resolution?

A

resolves situation, remove the foreign agent by breaking down, mainly by macrophages

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10
Q

why does repair occur?

A

it is when there is too much damage for resolution to occur or damage to cells that cannot regenerate

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11
Q

how does repair occur?

A

organisation - replacement by granulation cells - new blood vessels form and collagen deposition by fibroblasts - collagen causes the scar

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12
Q

why does chronic inflammation occur?

A

if there is ongoing damage or it isn’t resolved by acute inflammation

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13
Q

what are the issues of the fibrous scar?

A

it is a defect - can cause issues such as intestine in the abdomen getting caught around the scar

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14
Q

what are the characteristics of innate immunity?

A

it takes hours to days, there is blood vessel dilation and increased permeability, fluid exudation which is rich in proteins such as Ig, and neutrophil recruitment, mast cells and macrophages

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15
Q

what consists chronic inflammation?

A

adaptive and innate immunity - two systems exist together

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16
Q

what happens in chronic inflammation?

A

angiogenesis and fibrosis

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17
Q

what is amyloidosis?

A

it is when proteins misfold and form aggregates - found in various parts of body and damage the tissues they are deposited in

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18
Q

when does cachexia occur and what is it?

A

it is weight loss - the patient will be emaciated and it occurs secondarily to cytokine release from CIR

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19
Q

why does anaemia occur?

A

RBC production decreases and cytokine release affects the way iron is used around the body

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20
Q

what does concomitant mean in chronic inflammation?

A

two events happen at the same time - tissue destruction and repair

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21
Q

what does H. Pylori cause?

A

acute inflammation of the stomach, and gastritis

22
Q

what can cause chronic inflammation?

A

autoimmunity, unknown, repeated episodes of acute inflammation, progression from acute inflammation, asbestos entering the lungs, toxic agents

23
Q

what is chronic cholecystitis?

A

it is repeated inflammation of the gallbladder resulting in chronic inflammation

24
Q

why does persistent infection result in chronic inflammation?

A

the infection is hard to remove so the immune system finds it hard to get rid of bacteria

25
Q

how can we classify toxic agents, and what are examples of each?

A

exogenous - external stimuli such as asbestos fibres

endogenous - if there is a fragment of bone it is hard to break down and will remain in tissue

26
Q

why does asbestos cause chronic inflammation?

A

macrophages cannot break it down so it remains there and fibres cause continual stimuli (same with non-degradable sutures)

27
Q

why does autoimmunity result in chronic inflammation?

A

it is a new reaction to self antigens - the antigens are always there so will continue

28
Q

what is produced in persistent infection that causes chronic inflammation?

A

reactive oxidative species - attempts to remove the infectious agent will also result in injury

29
Q

how do H pylori work?

A

a chronic ulcer is common and destroy all the tissue by perforation

30
Q

what is another example of chronic infection?

A

chronic pyelonephritis

31
Q

what is an example of a condition that occurs due to the prolonged exposure to toxic agents?

A

cirrhosis - exposure to viruses or alcohol

32
Q

what is the basis of cirrhosis?

A

the liver tissue tries to regenerate and forms regenerative nodules, but there is collagen deposition that results in a shrunken liver with poor function

33
Q

how does asbestos affect gas exchange?

A

fibres are very small so get into the alveoli of the lung. There is interstitial fibrosis from collagen deposition int the walls of the alveoli

34
Q

what is deposited in the joint space in RA and what does this result in?

A

deposition of collagen and immune cells - erosion of underlying bones - deformities in joints

35
Q

what cells reside in tissues waiting for infection?

A

mast cells, macrophages and fibroblasts

36
Q

what is the life cycle of macrophages?

A

they start in the bone marrow, then migrate into blood as monocytes and then to tissue as macrophages

37
Q

when are macrophages activated?

A

they are activated in response to cytokine signals from T cells - ingest foreign agents and phagocytose

38
Q

what do lymphocytes do?

A

they emigrate out of the blood vessel to the surrounding tissue. they are mononuclear and go purple on a histology stain

39
Q

how will plasma cells appear down a microscope?

A

they will appear with a clockface nucleus with speckles down

40
Q

what are fibroblasts?

A

they are long thin cells producing collagen that are responsible for producing scars

41
Q

what are eosinophils and mast cells used in?

A

the inflammatory response mediated by IgE which is usually from drugs. they are activated bu IgE

42
Q

what are the characteristics of eosinophils?

A

they are for parasitic infections, and are bactericidal - antiparasitic and allergic reactions

43
Q

how do mast cells appear down a microscope?

A

they are rarely seen down a microscope - they have a granular cytoplasm and are signalling molecules

44
Q

how do cells leave the vessels?

A

they stick to the endothelium of blood vessels as changes to the underling endothelium allow this - follow chemokines to the area of damage

45
Q

what part does the macrophage play and how does this result in process?

A

the macrophage is activated in the tissue and produces cytokines and presents to T cells. These then activate and activate B cells which become plasma cells and ABs - inflammatory mediators from T cells further activate macrophages - cycle of chronic inflammation. Macrophages activate fibroblasts and release factors causing angiogenesis

46
Q

what are B, T and plasma cells?

A

mononuclear leukocytes

47
Q

what are multinucleated giant cells?

A

when macrophages merge together and form giant cell

48
Q

how will caseating necrosis present?

A

there will be no outline of cells just a pale pink merge

49
Q

what is a granuloma and why does it occur?

A

granulomas are collections of activated epitheliod macrophages - pink cytoplasm, indistinct cell membranes and oval nucleus - occur because the macrophages cannot break down so recruit more and accumulate. This will be surrounded by mononuclear leukocytes

50
Q

what causes granuloma?

A

parasitic, fungal, bacterial, unknown, foreign body, or inorganic metals or dust

EMS MOD (28 decks)

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