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Second Year > Inflammation > Flashcards

Inflammation Flashcards

1
Q

What are the two different types of autopsies?

A

Hospital autopsy- audit, teaching, governance, research

Medico-legal autopsy- coronial and forensic autopsies (main type- 90% of autopsies)

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2
Q

What is the role of an autopsy? 4 questions they ask

A

Who is the deceased?
When did they die?
How did they die?
Where did they die?

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3
Q

Definition: Inflammation

A

A local physiological response to tissue injury

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4
Q

6 Causes of inflammation

A
  1. Microbial infections
  2. Hypersensitivity reactions
  3. Physical agents (burns, trauma etc.)
  4. Corrosive and irritant chemicals
  5. Tissue necrosis (e.g. from a lack of oxygen)
  6. Bacterial toxins
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5
Q

What is the characteristic cell recruited to tissue during inflammation?

A

Neutrophil polymorphs

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6
Q

What are the 4 outcomes of acute inflammation?

A
  1. Suppuration (pus/abscess)- excessive exudate
  2. Organisation- excessive necrosis causes scarring
  3. Resolution (best outcome)
  4. Progession to chronic inflammation- persistent acute
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7
Q

What is the macroscopic appearance of acute inflammation?

A
  1. Redness (rubor)- dilation of small blood vessels
  2. Heat (calor)- due to increased blood flow to region
  3. Swelling (tumor)- due to oedema
  4. Pain (dolor)- due to stretching of tissues and pus under pressure in cavity
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8
Q

4 Cells involved in acute inflammation

A
  1. Neutrophil polymorphs (phagocytosis)
  2. Endothelial cells (allows migration of neutrophils to tissue)
  3. Lymphocytes (produces chemicals to attract other cells)
  4. Tissue macrophages (derived from monocytes)
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9
Q

4 Cells involved in chronic inflammation

A
  1. Lymphocytes (B+T)
  2. Plasma cells
  3. Fibroblasts (form collagen in areas of repair)
  4. Macrophages
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10
Q

4 causes of chronic inflammation

A
  1. Primary chronic inflammation
  2. Transplant rejection
  3. Progression from acute inflammation
  4. Recurrent episodes of acute inflammation
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11
Q

Examples of chronic inflammation

A

Crohn’s, Leprosy, Chronic inflammatory bowel disease

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12
Q

What is a granuloma?

A

An aggregate of epithelioid histiocytes (may contain lymphocytes and other large cells)

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13
Q

3 different types of skin wound healing

A
  1. Abrasion- epithelium divides to replace lost cells- scab
  2. Healing by first intention- surfaces are close so can join back together, area filled with fibrin (e.g. needle injection
  3. Healing by second intention- when surfaces are separate so can’t rejoin, loss of tissue (e.g. stab wound)
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14
Q

When does repair occur instead of resolution?

A

When the cells involved can’t regenerate, or initiating factor is still present

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15
Q

List cells that can regenerate, and can’t regenerate

A

Can: hepatocytes, pneumocytes, blood cells, gut epithelium, skin epithelium, osteocytes

Can’t: neurones, myocardial cells

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16
Q

Definition: Thrombosis

A

Solid mass of blood constituents formed within intact vascular system during life

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17
Q

Causes of a thrombosis (think triad…)

A
  1. Change in vessel wall- epithelial cell injury (smoking)
  2. Change in blood flow- from laminar to turbulent
  3. Change in blood constituents- e.g. a disease which increases the number of platelets
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18
Q

Once a thombus is formed, it can do 1 of 4 things:

A
  1. Resolution (good)
  2. Organisation (scar)
  3. Recanalise (capillaries grow through clot)
  4. Embolise
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19
Q

Definition: embolism

A

The process of a solid mass in the blood being carried through circulation to a place where is gets stuck and blocks the vessel

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20
Q

Definition: ischaemia

A

reduction in blood flow to a tissue without any other implications

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21
Q

How does re-perfusion injury occur?

A

when normal blood flow is restored after ischaemia, and oxygen is restored too quickly, mass influx of reactive oxygen species into cells which kills them

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22
Q

Definition: infarction

A

Reduction in blood flow to a tissue that is so reduced that it cannot support cell maintenance so the cells die

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23
Q

Definition: watershed areas

A

Areas of dual artery supply that receive little supply from either as they are right in the middle

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24
Q

Definition: atherosclerosis

A

A disease in which the inside of an artery narrows due to the build up of plaque (when endothelial cells grow over a thrombus to form plaque)

25
What is in a plaque?
Fibrous tissue Lipids (cholesterol) Lymphocytes (inflammation present)
26
Risk factors of athlerosclerosis
1. Hypertension 2. Smoking 3. Diabetes 4. Hyperlipidaemia
27
Uses of apoptosis
1. Gets rid of 'bad' cells so they don't cause cancer 2. Useful for development- lose necessary cells during development (e.g. lose webbed fingers) 3. Replace cells lost in 'wear and tear'- gut epithelium
28
What causes apoptosis?
Caspases (protease enzymes) BCl2 and Fas ligand/receptor also have roles?
29
Definition: Necrosis
Traumatic cell death- unexpected, caused by trauma, venom, infection, infarction
30
What are congenital abnormalities?
Conditions present at birth (e.g. fetal alcohol syndrome)
31
What are inherited abnormalities?
Conditions caused by an inherited genetic abnormality (e.g. Down's syndrome, Huntington's)
32
What are acquired abnormalities?
Conditions caused by an environmental factor, can be congenital (fetal alcohol syndrome)
33
Definition: hypertrophy
Increase in size of a tissue caused by an increase in size of the constituent cells (think weightlifting)
34
Definition: hyperplasia
Increase in the size of a tissue caused by an increase in number of constituent cells (think benign prostatic hyperplasia
35
Definition: atrophy
Decrease in the size of a tissue caused by a decrease in the number of cells and/or the size (think optic atrophy
36
Definition: metaplasia
Change in differentiation of a cell from one type to another (e.g ciliated columnar to squamous, GORD)
37
Definition: dysplasia
An imprecise term for the morphological changes seen in cells in the progression to becoming cancer
38
Things that happen with age
``` Sarcopenia (loss of muscle) Deafness Dermal elastosis (wrinkles) Osteoporosis Senile dementia Cataracts Ankle oedema Diverticular disease of colon Balding HTN and IHD Prostatic hyperplasia ```
39
What are telomeres and why are they important?
They start DNA replication, they get shorter through life and are linked to ageing as this stops cells reproducing
40
Name a cancer that does not metastasize and therefore can be locally excised to treat
Basal cell carcinoma
41
Name a cancer with generalised symptoms that needs chemotherapy to treat
Leukemia
42
What is the sentinel lymph node?
The first lymph node that a cancer spreads to
43
Which cancers commonly spread to bone?
Breast cancer Prostate cancer Thyroid cancer Kidney cancer
44
Definition: carcinogenesis
The transformation of normal cells to neoplastic cells through permanent genetic alterations or mutations (malignant only)
45
Definition: Neoplasia
The presence or formation of new abnormal growth of tissue
46
Definition: carcinogens
Agents known or suspected to cause cancer | Oncogenic= tumour causing
47
What are the 5 classes of carcinogens?
1. Viral (HPV) 2. Ionising and non-ionising radiation 3. Biological agents (hormones e.g. oestrogen) 4. Chemical (polycyclic aromatic hydrocarbons) 5. Miscellaneous (asbestos, metals)
48
Definition: tumour
Swelling!
49
Definition: neoplasm
A lesion resulting from the AUTONOMOUS ABNORMAL growth of cells which PERSISTS after the initial stimulus is removed. A NEW GROWTH
50
What is a neoplasm made of?
NEOPLASTIC CELLS: growth and synthetic activity related to parent cell STROMA: connective tissue framework that provides mechanical support and nutrition (vascularised)
51
Key features of a malignant neoplasm
``` Invasive Rapidly grows ('down and in') Variable resemblance to normal tissue Increased mitotic activity Necrosis and ulceration common as it grows fast Causes death and illness ```
52
Key features of a benign neoplasm
Localised (non-invasive) Grows slowly ('up and out') Resembles normal tissue Restricted and encapsulated Necrosis and ulceration rare as it grows slowly Can cause death and illness (anxiety, can become malignant, obstructs flow)
53
How to name a benign epithelial neoplasm
PAPILLOMA (benign tumour of non-glandular, non-secretory epithelium)- prefix with cell type of origin, e.g. squamous cell papilloma ADENOMA (benign tumour of glandular or secretory epithelium)- prefix with cell type of origin, e.g. thyroid adenoma
54
How to name a malignant epithelial neoplasm
CARCINOMA prefixed by name of epithelial cell type e.g. transitional cell carcinoma ADENOCARCINOMA for carcinomas of glandular epithelium
55
How to name a malignant connective tissue neoplasm
SARCOMA prefixed by cell type of origin e. g. liposarcoma (adipose tissue) e. g. rhabdosarcoma (striatated muscle)
56
How to name a benign connective tissue neoplasm
Name according to what it looks like: e. g. osteoma- bone e. g. chondroma- cartilage
57
Describe the process of metastasis
1) Grow 2) Invade BM 3) Move through connective tissue (collagenases) 4) Get into lymphatic or blood vessel (collagenases) 5) Travel in vessel without being destroyed 6) Invade through vessel and connective tissue again 7) Grow at distant site (must establish own blood supply once bigger than 1mm- angiogenesis)
58
How do cancer cells evade immune defence?
1) Aggregate with platelets to form a shield 2) Shed surface antigens to confuse immune cells 3) Group together so only the ones on the outside die
59
What are the 3 routes of metastasis?
1) Venous system 2) Colon (GI tumours) 3) Bone (prostate, kidney, thyroid, lung, breast)

Second Year (5 decks)

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