CSIM 1.48 Inflammation and Repair 1

Question 1

Define inflammation

Answer 1

A reaction in CT leading to the accumulation of fluid and white blood cells at the site of an injury

Question 2

What are the purposes of inflammation?

Answer 2

• Localise infection
  
  • Eliminate the cause
  • Initiate repair

Question 3

What blood changes are seen during inflammation?

Answer 3

• Increased WBC count
  
  • Increased C-reactive protein
  • Increased erythrocyte sedimentation rate

Question 4

What changes mediate inflammation?

Answer 4

• Vascular dilatation
  
  • Increased permeability of vessels (slows blood flow)
  • Leukocyte migration

Question 5

What are the different macroscopic appearances of inflammation?

Answer 5

• Serous (cavities & joints)
  
  • Suppurative - puss
  • Catarrhal (on mucosal surfaces)
  • Fibrinous

Question 6

What are the two different sequelae after inflammation?

Answer 6

Complete resolution where there is no discernible evidence of previous inflammation
• Minimal damage
• Regenerative tissue
• Debris can be removed

Repair - a combination of regeneration and scarring

Question 7

What does the type of repair depend on?

Answer 7

• Regenerative ability of the cells damaged
  
  • Extent of damage
  • The complexity of the architecture damaged

Question 8

What is organisation?

Answer 8

Scarring - the replacement of specialised tissue by a fibrous scar, via granulation tissue

Question 9

Describe the process of repair

Answer 9

Granulation tissue is formed comprising of
• endothelial cells for angiogenesis
• myofibroblasts which form fibrous tissue and contact the wound
• macrophages which remove debris and coordinate the repaie

Question 10

What pathology can result from repair

Answer 10

• Strictures
  
  • Impaired mobility
  • Keloids/hypertrophic scars (raised scars)

Question 11

Define:

1) Pus
2) Abscess
3) Empyema

Answer 11

1) Exudate, WBCs, organisms, debris
2) Localised collection of pus with pyogenic membrane
3) The collection of pus in a cavity in the body.

Question 12

Which bacteria cause suppuration?

Answer 12

Pyogenic bacteria
• Staph
• Strep

Question 13

What is chronic inflammation?

Answer 13

Prolonged inflammation (weeks+) due to simultaneous:
• persistent tissue injury
• attempted repair.

Question 14

What are the causes of chronic inflammation?

Answer 14

• Persistent Infection
  
  • Poorly degradable materials
  • Autoimmune disease

Question 15

What is inflammatory exudate?

Answer 15

A mass of WBCs and fluid that has seeped out of blood vessels

Question 16

What are granulocytes?

Answer 16

POLYMORPHONUCLEAR CELLS  with secretory granules in its cytoplasm:
  •  Mast cells
  •  Eosinophils
  •  Basophils
  •  Neutrophils

Question 17

What do eosinophils respond to & combat?

Answer 17

Parasites

Question 18

What is a granuloma? Where is it found?

Answer 18

A mass of granulation tissue, formed of epithelioid histiocytes

Found in areas of chronic inflammation along with exudate

Question 19

What is a histiocyte?

Answer 19

a stationary phagocytic cell present in connective tissue.

Question 20

What causes metastatic calcification (calcification of normal tissues at times of hypercalcaemia)?

Answer 20

• Increased PTH
• Destruction of bone e.g. leukaemia
• Hypercalcaemia of malignancy - both the above!

Question 21

What are agranulocytes?

Answer 21

MONONUCLEAR CELLS with NO granules in the cytoplasm:
  •  Lymphocytes
  •  Monocytes 
       > Macrophages
       > Dendritic cells