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General Pathology > Exam #1: Chronic Inflammation > Flashcards

Exam #1: Chronic Inflammation Flashcards

1
Q

What is chronic inflammation?

A

Inflammation that occurs for greater than 2 weeks

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2
Q

What is the most common presentation of chronic inflammation?

A

Insidious low-grade smoldering response without signs of acute inflammation

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3
Q

What are the causes of chronic inflammation?

A

1) Persistent microbial infections
2) Immune related inflammatory disease
3) Prolonged exposure to potentially toxic agents

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4
Q

List the general characteristics/ morphology of chronic inflammmation.

A
  • Infiltration with mononuclear cells (macrophages, lymphocytes, & plasma cells) vs. neutrophils
  • Tissue destruction induced by persistent stimulus or by inflammatory cells
  • Attempts at healing–>connective tissue replacement of damaged tissue, angiogenesis, & fibrosis
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5
Q

Describe the histological characteristics of chronic pancreatitis.

A

Remember if you see islets & ducts= pancreas

  • Inflammatory cells i.e. mononuclear cells
  • Fibrosis= pink substance= collagen deposition
  • Residual ductal structures with fibrosis

*No acinar tissue remaining

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6
Q

Describe the histological characteristics of chronic lung disease.

A

Note that the spaces without cartilage= alveoli i.e you’re looking at the lung

  • Large alveolar spaces b/c endothelial cells have been destroyed
  • Fibrotic deposition (pink)
  • Mononuclear cell infiltration ( looks like tons of black dots)
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7
Q

Describe the histological characteristics of chronic pyelonephritis.

A

Appearance of many black dots= mononuclear

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8
Q

What are the hallmark features of plasma cells? What do you assume if you see plasma cells?

A
  • Nucleus= v. large, dense, & located on a single side
  • Cell is large than the other lymphocyte

*IF you see PLASMA CELLS= CHRONIC INFLAMMATION

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9
Q

What are macrophages derived from?

A
  • Circulating blood monocytes
  • Once the monocyte exits the blood, it is a macrophage

*This is the key cell in chronic & granulomatous inflammation

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10
Q

What is the difference between monocytes & mononuclear cells?

A

Agranulocytes, also known as mononuclear leukocytes, are white blood cells with a one-lobed nucleus. They are characterized by the absence of granules in their cytoplasm, which distinguishes them from granulocytes.

  • 2 categories:
    1) Lymphocytes i.e. T, B & NK cells
    2) Monocytes–>macrophages
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11
Q

What is a Kupffer cell?

A

Liver macrophages

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12
Q

What is an alveolar or pulmonary macrophage?

A

Macrophage in the lung

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13
Q

What is a macrophage in the bone?

A

Osteoclast

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14
Q

What is a macrophage in the brain?

A

Macroglia

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15
Q

When do monocytes emigrate to the site of injury?

A

Within 24-48 hours

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16
Q

Describe the histological features of activated macrophages. How do these differ from non-activated macrophages?

A

Activated=

  • large i.e. increased size
  • Pink
  • Flat or epithelial-like or epitheloid

Non-activated=
- Small

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17
Q

What are the functional features of activated macrophages?

A
  • Increased size
  • increased numbers of lysosomes & lysosomal enzymes

*Activated macrophages have an increased ability to kill organisms

18
Q

Describe the cell lineage of macrophages.

A

Stem cell
Monoblast
Monocyte= blood
Macrophage= tissue

19
Q

What is the predominant cell type of inflammation after 48 hours?

A

Macrophages

20
Q

What are the activation signals for macrophages?

A
  • Cytokines–esp. IFN-gamma–secreted by activated T-cells & NK-cells
  • Gamma interferon is the KEY player in the activation of macrophages, which is specifically secreted by Th1 cells & NK-cells
21
Q

What is an exogenous sources of IFN-gamma production?

A

Bacterial endotoxin i.e. LPS

22
Q

What causes activated macrophages to travel down a path of inflammation & tissue injury mediation vs. repair?

A

Inflammation & Tissue Injury= IFN-gamma

Repair= IL-4

23
Q

What causes activated macrophages to persist in a chronic inflammatory state?

A

Continuous recruitment & local proliferation at the site of inflammation

24
Q

What cytokines produced by macrophages mediate tissue injury?

A

IL-1

TNF-a

25
Q

What are the local effects of IL-1 & TNF-a?

A

Vascular endothelium
Leukocytes
Fibroblasts

See figure 2-13

26
Q

What are the results of chronic inflammation?

A
  • Continued tissue damage/ destruction

- Ongoing tissue destruction can lead to CO-EXISTENCE of both acute & chronic inflammation

27
Q

Why can neutrophils be seen in chronic inflammation?

A

Co-existence of acute and chronic inflammation

*This is referred to as “chronic active inflammation”

28
Q

What are the lifestyle factors that can promote chronic inflammation?

A
  • Smoking
  • Excessive alcohol intake
  • Physical & emotional stress
  • Obesity
  • Lack of exercise
  • Diet
29
Q

Aside from macrophages, what other cells can be activated in chronic inflammation?

A

Lymphocytes (B & T-cells) can be mobilized in response to infections and trauma

30
Q

Describe the reciprocal relationship between T-cells & macrophages in chronic inflammation.

A
  • Macrophages initially activate T-cells
  • Activated lymphocytes (esp. T-cells in chronic inflammation) lead to macrophage activation

*Thus there is a reciprocal relationship between the two; activated macrophages then release cytokines

31
Q

What are Th17 cells?

A

T-cells that secrete:

  • TNF
  • IL-17
  • chemokines
32
Q

What are Th1 cells?

A

T-cells that secrete IFN-gamma

33
Q

What are plasma cells?

A
  • Terminal product of B-cell activation; these are pathognomomic for chronic inflammation
  • Produce antibodies against persistent antigens
34
Q

What is the hallmark of chronic parasitic infections & asthma?

A

Eosinophils

35
Q

What are eosinophils?

A
  • Not mononuclear
  • Contain granules with major basic protein (MBP)
  • MBP is toxic to parasites but also contributes to tissue damage in immune reaction & allergies

*Note that these cells are “pinker” than neutrophils

36
Q

What chemokine is responsible for eosinophil recruitment?

A

Eotaxin

37
Q

What are mast cells?

A
  • IgE arms mast cells
  • Release histamine and PG
  • Central role in anaphylactic reactions
  • Helpful in parasitic infections
38
Q

Are mast cells seen in acute or chronic inflammation?

A

BOTH

39
Q

What are the effects of histamine?

A

Bronchoconstriction

Vasodilation

40
Q

What are the histological features of neutrophils?

A

Lobular nucleus

General Pathology (33 decks)

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