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Pathology > Chronic inflammation II > Flashcards

Chronic inflammation II Flashcards

1
Q

What is granulomatous inflammation? What is it characterized by (cell types, appearance etc)?

A

Distinctive pattern of chronic inflammation characterized by aggregates of activated macrophages having a squamous (epithelioid) appearance

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2
Q

What causes granulomatous inflammation as opposed to other forms of inflammation?

A

Isolation of indigestible substance

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3
Q

What are the cells that mediate granulomatous inflammation?

A

Persistent T cell response with macrophage activation

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4
Q

Insolubles substances produce what type of immune response?

A

Cell mediated response

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5
Q

What is the prototypical Granuloma causing agent? Other notable ones?

A

TB/leprosy

Sarcoidosis
Fungal infx
Cat scratch fever

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6
Q

What does a granuloma contain?

A

Aggregation of macrophages that are transformed into epithelioid cells, surrounded by a collar of mononuclear leukocytes (lymphocytes)

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7
Q

What are Lanhans giant cells seen in?

A

Granulomas

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8
Q

What is the difference between a granuloma and granulation tissue?

A

Granuloma = macrophages

Granulation tissue = Walled off via fibroblasts and capillaries

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9
Q

What is granulation tissue?

A

Histological appearance of fibroblasts and a new, thin walled delicate capillaries in a loose ECM

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10
Q

What is the name for the arrangement of giant cells when they are located at the periphery of a granuloma?

A

Langhans-type

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11
Q

For what type of infection/stimulus are multinucleated giant cells arranged in a haphazard manner?

A

Foreign bodies

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12
Q

When are foreign body granulomas formed?

A

When FBs are too large to be phagocytosed

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13
Q

What is caseous necrosis?

A

Cheese-like tissue that forms around bacteria or FBs

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14
Q

What is lymphangitis? How does this appear clinically?

A

Inflammation of lymphatic channels, leukocytes and cell debris

Appears as red streaks

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15
Q

If an infection overwhelms a lymph node, what can happen?

A

Gains access to vascular circulation (bacteremia)

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16
Q

What is SIRS?

A

Systemic inflammatory response system (acute phase response)

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17
Q

What are the clinical symptoms of systemic inflammation?

A

Increased WBCs, cytokine release, fever

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18
Q

What are the two major cytokines released in systemic inflammation? What about the one that bacteria have that causes systemic inflammation?

A

IL-1 and TNF-alpha

Bacteria have LPS

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19
Q

How do IL-1 and TNF alpha promote fever?

A

stimulate PG synthesis (COX pathway converts AA to PG) in hypothalamic thermoregulatory center, resetting the body thermometer

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20
Q

What are the three major acute phase proteins?

A
  1. CRP
  2. Fibrinogen
  3. SAA (serum amyloid protein)
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21
Q

Where are acute phase proteins synthesized? What is their function?

A

Liver

Functions as opsonizers

22
Q

Acute phase proteins can be upregulated by what proteins? (3)

A
  1. IL-1
  2. IL-6
  3. TNFalpha
23
Q

What is a leukemoid reaction?

A

Extremely high WBC (over 40,000/microliter)

24
Q

What happens to band cell production in SIRS?

A

Increases since bone marrow cannot keep up with demand for WBCs

25
Q

What is lymphocytosis?

A

Increase in absolute number of lymphocytes; seen in viral infections (e.g. mononucleosis, mumps, etc)

26
Q

What is leukopenia? What is this seen in?

A

Lower WBCs

Seen in overwhelming infections or debilitated hosts

27
Q

Why is sweating decreased in systemic inflammation?

A

Redirected blood flow from cutaneous to deep vascular tissue to minimize heat loss

28
Q

What bacterial chemical is prone to lead to sepsis?

A

LPS

29
Q

What is the triad for septic shock?

A
  1. DIC
  2. Hypoglycemia
  3. CV failure
30
Q

What is the net result of sepsis?

A

Multisystem organ dysfunction

31
Q

What is defective inflammation?

A

Increased susceptibility to infections and delayed wound healing

32
Q

What is excessive inflammation caused by? (3)

A

Autoimmune disease
CA
atherosclerosis

33
Q

There is a strong relationship between chronic inflammation and what disease?

A

CA

34
Q

What is the etiological agent associated with gastritis? What type of CA does this predispose pts to?

A

H. Pylori

Gastric adenocarcinoma

35
Q

What is the etiological agent associated with Schistosomiasis? What type of CA does this predispose pts to?

A

Schistomes

Bladder, liver, and rectal CA

36
Q

What is the etiological agent associated with cholangitis? What type of CA does this predispose pts to?

A

Liver flukes

Cholangiocarcinoma/colon CA

37
Q

What is the etiological agent associated with cholecystitis? What type of CA does this predispose pts to?

A

Various bacteria/stones

gallbladder CA

38
Q

What is the etiological agent associated with hepatitis? What type of CA does this predispose pts to?

A

Hep B/C

Hepatocellular carcinoma

39
Q

What is the etiological agent associated with PID? What type of CA does this predispose pts to?

A

Gonorrhea/chlamydia/papilloma virus

Ovarian/ cervical CA

40
Q

What is the etiological agent associated with osteomyelitis? What type of CA does this predispose pts to?

A

Various bacterial infx

Skin carcinoma

41
Q

How do granulomas appear?

A

Macrophages with Pale, pink, and granular cytoplasm

42
Q

What is reactive lymphadenitis?

A

Inflammation of a draining lymph node

43
Q

What is chromatolysis?

A

Process involving the cell body following injury, caused by increased protein synthesis in an attempt to repair

44
Q

What are the three characteristics of chromatolysis?

A
  1. Round cellular swelling
  2. Displacement of the nucleus to the periphery
  3. Dispersion of Nissl substance
45
Q

Extravasation of WBC occurs where?

A

Post capillary venules

46
Q

What maintains a granuloma?

A

Th1 cells secreting IFN-gamma, and TNF-alpha from macrophages

47
Q

What are the cell types that surround a granuloma?

A

Macrophages surrounded by Th cells

48
Q

What is the MOA of ASA blocking fever?

A

Inhibits cyclooxygenase and thus prostaglandin synthesis in the hypothalamus.

49
Q

What is ESR and why is it measured in sepsis?

A

Rise in fibrinogen in sepsis = blood sticking together. ESR measures this.

50
Q

What is the cause of hypoglycemia in sepsis?

A

Liver damage decreases gluconeogenesis

Pathology (32 decks)

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