Inflammation 2 Flashcards
What is chronic inflammation?
Chronic response to injury with associated fibrosis
Dominant cell type in chronic inflammation
Macrophage
How does chronic imflammation arise?
1) takes over acute inflamamtion
2) can occur w/ out prior acute inflammation
3) develops along side acute inflammation
4) autoimmune conditions
In what case can chronic inflammation occur w/ out prior acute imflammation?
In some chronic inflammations like:
- Rheumatoid arthritis
- TB
- autoimmune diseases
What does chromic inflammation look like under a microscope?
- Abundance of macrophages
- granulation tissue
Cells involved in chronic inflammation:(4)
FLEM
Fibroblasts/myofibroblasts-make collagen
Lymphocytes-B&T cells
Eosonophils-allergic reaction, defence against parasitic worms
Macrophages
Major functions of macrophages:
--Phagocytosis • Secretion of numerous STUFF • Presenting antigens to the IS • Stimulating angiogenesis • Inducing fibrosis • Inducing fever, acute phase reaction and cachexia.
Functions of fibroblasts and myofibroblasts
Produce connective tissue like collagen, elastin, GAGS.
Differentiate in to myofibroblasts that can contract.
IMPORTANT IN WOUND HEALING (responsible in bringing wounds back together again)
Different types of giant cells &; where r they seen? (3)
~langhans giant cells=TB
~foreign body giant cell=foreign material
~Touton giant cell=fat necrosis
What type of infection r giant cells found in?
Granulomatous infections
What r giant cells & why do they form?
macrophages fuse together to form single cell called a ‘giant cell’
~they form when they cant kill the cell for some reason, so in order to cope with that they fuse. this is called frustrated phagocytosis
Describe the nuclei of the 3 giant cells
Langhans> nuclei r on periphery (horse shoe appearence)
Foreign body giant cell> arranged randomly, disorganised
Touton giant cell> arranged ringlike in the centre
What r foam cells? Where can they be seen?
Macrophages whose cytoplasm appears FOAMY as they have phagoctyosed alot of lipid
In atheresclerosis
How can chronic inflammation be harmful? what r their effect (4) )consequences
Fibrosis amd impaired function
Involvmemt of inappropriate immune response
Atrophy-reduction in tissue size
Impaired fuction
List some major clinical examples of chronic inflammation
- rheumatoid arthritis
- ulcerative colitis
- chron’s disease
- chronic gastritis
- chronic cholecystitis
- cirrhosis
Define a granuloma,
When granulomatous inflammation occurs? Major causes? In which conditions can the appearnce of granulomas be seen? (3)
A granuloma is the bodys way of dealing with particles that r poory soluble or difficult to eliminate. Group of macrophages stuck together.
causes:
infection
MYCOBACTERIUM: TB and leprosy
sarcoidosis, wegners syndrome, chrons disease
What is chronic inflammation?
Chronic response to injury with associated fibrosis
What is atrophy?
Reduction in cell or tissue size
What is a fistula? Give am example where they can form?
Abnormal connection btw 2 epithelail lined organs
In chrons disease
Ulcerative cholitis vs crohn’s disease
U» is superficial> meaning it only effects the muscosa amd not underlyimg tissues
DIARRHOEA, BLEEDING
chrons»transmural» it effects mucosae AND underlying tissue
FISTULAE & STRICTURES
What is liver cirrhosis? What causes it?
ALCOHOL drugs and toxins Fatty liver disease Infection HBV Imuunological
Cirrhosis vs fibrosis
Cirrohisis is chronic inflammation with fibrosis!
-Fibrosisis the first stage ofliverscarring. When scar tissue builds up and takes over most of theliver, this is a more serious problem calledcirrhosis
EFFECTS OF CHRONIC INFLAMMATION (4)
Fibrosis
Impaired fucntion
Atrophy
Stimulaton of immune response
Give an example of a fribrotic case in the body?
Chronic cholecystitis
Repeated attacks of acute inflammation
What is inflammatory bowel diseas? how to oatients present?
Idiopathic inflammatroey disease affecting the large and small bowel
DiheRea
Rectal bleeding
What is thyrotoxicosis
Theyre r anitbodies against TSH, produces too much TSH.
Graves disease
-is an autoimmune disease that affects the thyroid.
-in which the body produces antibodies to the receptor for thyroid-stimulating hormone (TSH).
2 typrs of granulomas?
1) Foreign body granuloma
2) hypersensitvity or immune type granuloma
Patients with ULCERATIVE COLITIS develop complications in organs or tissues other than the gastrointestinal system. Which organs/tissues can be involved and what complications can occur in them?
Sclerosing colingitis» bialry tree become fibrotic
Uc is a autoimmune disease, so think of ankther disease that is autosommjne like
EYES, iritis» inflammation of irus
Skin» erythema nodosum, pyoderma gangrenosum, ulceration on legs (thought to be due to autoimmune attack on skin
What 2 microorganisms cause a bloody diharrea?
Shigella
E coli
What other complications can arise as the result of acute appendicitis?
Fistula» a connection that forms between 2 organs
U can get portal vein thrombosis (thats where blood drains)
Septecemia
Absecc
another name for macrophages
histocytes
what type of inflammation r giant cells seen in?
granulamatous inflammation
what is fibrosis? give an example
excess of fibrous tissue, occurs when fibroblasts r stimulated by cytokines to produce EXCESS COLLAGEN.
eg; interstitial fibrosis of the lung
**if the fibrotic area contain enough myofibroblasts…it can slowly contract and cause more probs.
what cells do u granulomas contain?
epitheloid cells, which r modified macrophages that look like epithelial cells than have an eosoniphilic cytoplasm and appear tightly packed together.
classify foreign body granulomas
contain macrophages, foreign body giant cells, epithelia cells, fibroblasts,
they develop around a material that is not antigenic! ex: surgical thread
Where can granulomas be seen?
In places where the substances r hard to digest.
What is a granuloma
Fustrated Macrophages that stick together to look like epitheloid macrohpage
stick together and look like epithelial cells
Caseous is asscoiated with GRANULOMAS INFLAMMATION
In tb
What is Pilonidal cynas?
When hair in ur bum builds up in the cleft are of ur buttox
what causes TB? how does it cause it? what type of giant cell is present? and type of necrosis?
- Mycobacteria
- it doesn’t really make toxins or lytic enzymes, they just survive, and use body’s reaction (chronic inflamm. to kill da human)
- Langhans
- caseous necrosis
what is sarcoidosis?
Sarcoidosis is a rare condition that causes small patches of red and swollen tissue, called granulomas, to develop in the organs of the body. It usually affects the lungs and skin.
why is chronic inflammation important? what can it lead to?
- fibrosis
- impaired function and atrophy
- stimulation of immune response
what is an ulcer?
a break in skin or mucous membrane with loss of surface tissue, disintegration and necrosis of epithelial tissue, and often pus
what is a range complex?
when goons complex undergoes fibrosis and calcifies»RANKE COMPLEX (scar tissue seen in lung on X-ray)
Describe in eacho f these disprders, which cells r mostly present during chrimic inflammation?
- Rheumatoid athritis
- Chronic gastritis
- Leishmaniasis (a protozoal infection)
Rheumatoid arthritis: Mainly plasma cells. –
Chronic gastritis: Mainly lymphocytes. –
Leishmaniasis (a protozoal infection): Mainly
macrophages.
What is a Strictures? fistulae?
Stricture» fibrous narrowing
Fistula» abnormal connection btw 2 organs
One od the effects of chronic inflamaation, is “increased function” give an example where this may occur
Thyroxitoxicosis
Graves disease
Antibodies against TSH, produces to much TSH,
Explain the what happens after a granuoma forms around the particle
A granuloma forms around the particle, which can be free or phagocytised within the centre of the granuloma, and walls it off whilst concentrating mononuclear cells within its centre with which it hopes to destroy the particle.
