Inflammation

Question 1

Define inflammation?

Answer 1

Reaction of living vascularised tissue to sub-lethal cellular injury. Evolutionary development to protect against infection and trauma.

Question 2

Name the function of inflammation?

Answer 2

Remove cause of injury and initiate repair

Question 3

Name the causes of inflammation?

Answer 3

Infection tissue destruction- mechanical trauma, chemical injury, radiation

Question 4

Why are vascular changes in inflammation important?

Answer 4

Dilation and increased blood flow to injured area enables rapid delivery of inflmatory cells and mediators.

Question 5

Name the local cardinal signs for Acute inflammation.

Answer 5

RUBOR – redness CALOR – heat TUMOR – swelling DOLOR – pain LOSS OF FUNCTION

Question 6

What causes loss of function in acute inflammation?

Answer 6

Loss of function is due to swelling and pain

Question 7

What are exudates?

Answer 7

What comes out of leaky capillaries fluid, cells, proteins including fibrin, antibodies etc. think of exudes

Question 8

What is the function of exudate?

Answer 8

Fluid dilutes pathogen and allows soluble mediators to spread.

Question 9

What does histamine lead to?

Answer 9

Vasodilation Increased vascular permeability

Question 10

What is formed in an acute inflammation?

Answer 10

Exudate is formed

Question 11

What is the main cell invoved in acute inflammation?

Answer 11

Neutrophils

Question 12

In acute inflammation, what needs to occur for tissue to return back to normal?

Answer 12

Tissue cells need to contain cells that can regenerate to replace lost cells Little structural damage done- cells need a framewrok to build on

Question 13

What happens if tissue loss is too great and cells unable to regenerate?

Answer 13

Replace normal tissue with fibirous scar tissue

Question 14

What hinders repair?

Answer 14

Poor nutrition Protein- needed for collagen production Vitamin C- needed by fibroblasts to make collagen Vitamin A- required for epithelial regeneration Mineral dificiency-Zinc Suppressed inflammation- Diabetes Old age steriods

Question 15

Name the complications of repair for acute inflammation?

Answer 15

Keloid formation Excess collagen deposition contractures

Question 16

Name the histological features of acute inflammation?

Answer 16

Nuetrophils predominate eosinophils and mast cells are there

Question 17

What is chronic inflammation?

Answer 17

Inflammation of prolonged duration in which active inflammation, tissue destruction and attempts at repair occur simultaneously

Question 18

What are the causes of chronic inflammation?

Answer 18

Persistent damage Persistent infection (HCV, TB) Prolonged exposure to toxic agent (uric acid) Autoimmunity (RA, SLE) Foreign body (splinter, silica)

Question 19

Name the cells of chronic inflammation?

Answer 19

Macrophages Lymphocytes and plasma cells

Question 20

Name what can be formed in chronic inflammation?

Answer 20

granulation tissue

Question 21

Histological features of Chronic inflmmation?

Answer 21

presence of granulation tissue, Macrophages Lymphocytes and nuetrophil exudate

Question 22

What is granulomatous inflammation?

Answer 22

Particular form of chronic inflammation showing granuloma formation

Question 23

What is a granuloma?

Answer 23

Cluster of macrophages Involves specific immune reaction T cells

Question 24

What are the causes of granulomatous inflammation?

Answer 24

Infection – TB, fungi Foreign material Reaction to tumours Immune diseases (sarcoid, Crohn’s)

Question 25

How does the liver respond to chronic inflammation anywhere in the body?

Answer 25

The liver produces and releases increased amounts of serum amyloid A protein into the blood

Question 26

What is a harmful effect of chronic inflammation?

Answer 26

Amyloidosis

Question 27

What type of inflammation follows acute inflammation but can occasionally develop straight off?

Answer 27

Chronic inflammation

Question 28

What are the main cell types for chronic inflammation?

Answer 28

Lymphocytes and Macrophages

Question 29

State the differences between acute and chronic inflammation?

Answer 29

Question 30

Name the differences between chronic and acute inflammation?

Answer 30

Question 31

What are the positives for inflammation?

Answer 31

• Removal of causative agent
• Cessation of the inflammatory reaction
• Healing of tissue damage to preserve integrity and function (resolution)

Question 32

Name the unwanted effects of local inflammation?

Answer 32

• Can cause excess local tissue damage and scarring
• Secondary effects on nearby tissue

–E.g. Bronchoconstriction in asthma

Question 33

Name the unwanted effects of systematic inflammation?

Answer 33

•Can evolve into systemic inflammatory reaction and secondary multi-organ failure

–E.g. Septic shock

–Amyloid

Question 34

What is needed if tissue architecture returns to normal?

Resolution- refers to the complete restoration of tissue structure and function.

Answer 34

–Tissue contains cells able to regenerate to replace lost cells

•E.g. Liver

–Little structural damage done – cells need a framework to build on (basement membrane)

•E.g. Lung in lobar pneumonia

Question 35

What has to happen for normal tissue to be replaced with fibrous scar tissue?

Answer 35

•Tissue loss too great, and cells unable to regenerate

Question 36

Name the compllications of repair( tissue loss is to great and cells unable to regenerate)?

Answer 36

•Keloid formation

–Excess collagen deposition

•Contractures

–Fibrous scar tissue contracts as it matures. If scarring occurs across a joint can cause poor joint mobility.

•Impaired organ function

–e.g fibrous scars in the myocardium after a heart attack.

Question 37

Lable the diagram and explain what each lable means?

Answer 37

• Margination–Cells pushed to edges of vessel
• Rolling and Adhesion–Selectins on endothelial cells and leucocytes bind white blood cells to endothelial cells
• Transmigration (diapedisis)–Neutrophil dissolves basement, enter interstitium
• Chemotaxis–Follow chemical gradient followed to site of inflammation