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Pathology > Chronic Inflammation & Wound Healing > Flashcards

Chronic Inflammation & Wound Healing Flashcards

1
Q

define chronic inflammation

A

when acute inflammatory response fails
after repeated episodes of acute inflammation

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2
Q

how do you characterize chronic inflammation? (what cell types are present)

A

fibroblast - fibrosis
macrophage
lymphocytes
plasma cells
*VERY FEW neutrophils (acute)

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3
Q

fill out the chart in regards to chronic inflammation

A
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4
Q

list the four possible outcomes that occur if conditions do NOT allow full resolution of acute inflammation

A

abscess form
progression to chronic/granulomatous inflammation
healing with increased cellularity
healing by fibrosis

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5
Q

fibrin vs fibrous
which is acute and chronic?

A

fibrin - acute, disorganized, friable
fibrous - chronic, organized, fills within tissues

fibroUS stays with US

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6
Q

fibrin or fibrous?

A

fibrin - acute

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7
Q

fibrin or fibrous?

A

fibrous - chronic

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8
Q

list the main types of chronic inflammation

A

abscess
granuloma (nodular, diffuse)
eosinophilic granuloma (parasites)
lymphocytic to lymphoplasmacytic inflammation

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9
Q

ID the chronic inflammation type

A

abscess

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10
Q

how does abscess form?

A

neutrophils/acute liquify affected tissue/neutrophils to form pus

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11
Q

list the two types of abscess

A

septic - bacterial
sterile - partially degraded foreign body

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12
Q

what is myeloperoxidases role in abscesses?

A

enzyme in neutrophils that contributes to neutrophil necrosis and liquefaction

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13
Q

which abscess type requires lancing to be drained?

A

septic - since forms fibrous capsule, need to lance to allow drugs to be effective

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14
Q

ID the cells in chronic inflammation

A

abscess

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15
Q

ID chronic inflammation type

A

granuloma

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16
Q

define granuloma aka granulomatous inflammation

A

when monocyte-macrophage system is predominant and takes form as macrophages, epithelioid macrophages, and multi nucleated giant cells

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17
Q

describe epithelioid macrophages

A

large macrophages at site of infection
pale eosinophilic cytoplasm
secretes mediators

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18
Q

describe multinucleated giant cells

A

fused macrophages present when pathogen is resistant to elimination
has many nuclei
mediates tissue remodeling

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19
Q

ID the arrows
what type of chronic inflammation is this?

A

granuloma with epithelioid macrophages

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20
Q

describe fibroblasts

A

most common in CT, at outer part of granuloma
elongated cells, aid in integrity of tissue
helps with collagen/ECM synthesis

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21
Q

ID the cells
what type of chronic inflammation?

A

fibroblasts, granuloma

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22
Q

nodular vs diffuse granulomatous inflammation

A

nodular - masses, TH1 biased
diffuse - dispersed in sheets, TH2 biased

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23
Q

describe presentation of nodular granulomas grossly vs microscopically

A

grossly - nodular, gray to white, round, well demarcated

micro - round/oval with central core of granulomatous cells, central necrosis, and fibroblasts on outside

24
Q

list the main examples of nodular granuloma

A

Mycobacterium bovis
Coccidiodes immitis - valley fever

25
Q

ID pathology

A

nodular granuloma

26
Q

describe the three distinctive morphologic areas of granulomas

A

innermost - macrophage, giant cells, some cellular necrosis
middle - macrophage, epithelioid macrophage, giant cells
outermost - lymphocytes, plasma cells, fibroblast with fibrous capsule

27
Q

describe presentation of diffuse granulomas grossly vs microscopically

A

Gross - gray to white, poorly demarcated/delineated from adjacent tissues, firm, widespread distribution

micro- non-caseating aggregates of macrophages, few lymphocytes, and variable fibrosis

28
Q

list the main examples of diffuse granuloma

A

johne’s disease - occurs in lamina propria if ileum/colon

29
Q

ID pathology

A

diffuse granuloma - johne’s disease
*bottom is normal ileum

30
Q

ID pathology

A

johne’s disease - based off presence of epithelioid macrophages

31
Q

define eosinophilic granuloma

A

dense infiltrates of eosinophils with macrophages and some lymphocytes and plasma cells

32
Q

list some examples of eosinophilic granuloma

A

oral eosinophilic granuloma - dog/cat
eosinophilic dermatitis - horse

33
Q

ID the pathology and describe its appearance

A

cat eosinophilic granuloma
oral nodule, ulcer

34
Q

ID pathology

A

eosinophilic granuloma

35
Q

ID the pathology and describe it

A

equine eosinophilic dermatitis
nodular granulomatous and ulcerated areas on skin

36
Q

ID pathology
what’s the arrow?

A

eosinophilic dermatitis
arrow - larvae

37
Q

define lymphocytic to lymphoplasmacytic inflammation

A

B cells conversion to plasma cells - secrete Ig’s to start phagocytosis

38
Q

list the main examples of lymphocytic to lymphoplasmacytic inflammation

A

IBD in dog/cat

39
Q

ID pathology

A

Lymphoplasmacytic enteritis

40
Q

ID the arrows

A
41
Q

define chronic-active inflammation

A

has active part, includes acute inflammation cells - neutrophils, fibrin, plasma proteins

*due to stimulus that has NOT been removed from exudate, repeated episodes of inflammation over time

42
Q

list the main examples of chronic-active inflammation

A

feline infectious peritonitis (FIP)
pancreatitis

43
Q

describe FIP gross vs histological appearance

A

Gross - multifocal, gray-tan, slightly raised foci along vascular structures and coat serosal surface with thick effusion

micro- pyrogranulomatous vasculitis

44
Q

FIP pathogenesis

A

fecal-oral ingestion of coronavirus > replication in enterocytes and peyers patch > mutation and replication in macrophage and blood monocyte > virus infected macrophages dissemination into organs > immune response > pyogranulomatous vasculitis

45
Q

ID pathology

A

FIP

46
Q

what’s the main veterinary example of chronic inflammation becoming neoplastic?

A

feline injection site (fibro)sarcoma

47
Q

explain the possible mechanism of feline injection site (fibro)sarcoma

A

persistent injection site inflammation and genetic predisposition > neoplastic transformation of fibroblasts
**aggressive

48
Q

ID pathology

A

fibrosarcoma

49
Q

list the stages of wound healing

A

hemostasis
acute inflammation
proliferation/granulation
remodeling

50
Q

what’s TGF-beta importance?

A

critical growth factor in wound healing

stimulates healing factors to build

51
Q

describe primary vs second intention wound healing

A
52
Q

define granulation tissue

A

exposed CT that forms in a healing wound
red, hemorrhagic, bleeds easily when bumped

**can overgrow and inhibit healing

53
Q

what is it?

A

granulation tissue

54
Q

what is this?

A

granulation tissue - fibers grow parallel to wound surface

55
Q

describe colors of healthy vs poor granulation tissue

A

top - healthy
bottom - unhealthy

56
Q

pathogenesis of healing via fibrosis

A

necrosis of tissue > dead tissue and acute inflammatory exudate removed by macrophages and phagocytosis > spaced filled with fibrovascular tissues (granulation tissue) > granulation tissue replaced by immature fibrous CT that is poorly collagenized > healing wound forms a scar

Pathology (12 decks)

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