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EMS > Lecture 20: Chronic Inflammation > Flashcards

Lecture 20: Chronic Inflammation Flashcards

1
Q

What is the time period of acute inflammation?

A

Hours - days

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2
Q

What type of immunity is acute inflammation?

A

Innate immunity

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3
Q

What is the time period of chronic inflammation?

A

Weeks-months-years.

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4
Q

What type of immunity is chronic inflammation?

A

Innate & adaptive immunity.

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5
Q

What are 3 outcomes of Acute inflammation?

A
  1. Resolution
  2. Repair
  3. Chronic inflammation
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6
Q

What is granulation tissue?

A

Granulation tissue is reddish connective tissue that forms on the surface of a wound when the wound is healing.

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7
Q

Key features of chronic inflammation?

A

Inflammation of prolonged duration.
Concomitant tissue destruction and repair.
Mononuclear inflammatory cells.
Fibrosis.

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8
Q

What causes chronic inflammation to arise?

A

Progression from acute e.g. helicobacter pylori.

Recurrent episodes of acute e.g. chronic cholecystitis.

Persistent infection by certain microorganisms (difficult to remove).e.g. TB, leprosy

Prolonged exposure to potentially toxic agents (endogenous e.g. bone, exogenous e.g. asbestos fibres, sutures).

Autoimmunity e.g. Hashimoto’s thyroiditis.

Unknown e.g. Crohn’s disease, ulcerative colitis, sarcoidosis

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9
Q

Effects of Chronic inflammation due to prolonged exposure to toxic agents which are difficult to phagocytose?

A

asbestos body
Interstitial fluid

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10
Q

Macrophages’ journey in the body:

A

Bone marrow (Pluripotent stem cell - Myeloid stem cell)
Blood (Monocyte)
Tissues (Macrophage to Microglia, Kupffer cells, Alveolar macrophages, Osteoclasts or Activated macrophages)

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11
Q

how does chronic inflammation affect granulation tissue?

A

New blood vessels (angiogenesis)
Collagen deposition by fibroblasts -> scar

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12
Q

What is granuloma?

A

Granuloma= collection of activated epithelioid macrophages (pink cytoplasm, indistinct cell membranes, oval nucleus)
May also contain multinucleate giant cells

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13
Q

What surrounds granuloma?

A

Surrounded by mononuclear leucocytes

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14
Q

Are granuloma’s caseating or non- caseating?

A

Can be either

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15
Q

6 types of granulomatous inflammation?

A

Bacterial (TB, leprosy, syphilis, cat-scratch)
Parasitic (schistosomiasis)
Fungal (histoplasma, cryptococcus)
Inorganic metals or dust (silicosis, berylliosis)
Foreign body (suture, vascular graft)
Unknown (sarcoidosis, ulcerative colitis)

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16
Q

Give the five key characteristics of inflammation:

A

1) redness (rubor)

2) heat (calor)

3) swelling (tumor)

4) pain (dolor)

5) loss of function

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17
Q

How does repair take place in acute inflammation?

A

organisation using granulation tissue

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18
Q

True or false: chronic inflammation uses both innate and adaptive immune responses

A

True

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19
Q

What three immune cells are most abundant in chronic inflammation?

A

1) macrophages

2) lymphocytes

3) plasma cells

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20
Q

Give 3 common systemic complications associated with chronic inflammation:

A

1) amyloidosis

2) cachexia

3) anaemia

21
Q

What is amyloidosis?

A

deposition of a amyloid protein in organs

22
Q

What is cachexia?

A

extreme wasting and malnutrition

23
Q

What causes fibrosis in chronic inflammation?

A

concomitant tissue destruction and repair

24
Q

Give 5 circumstances where chronic inflammation arises:

A

1) progression from acute inflammation

2) recurrent episodes of acute inflammation

3) persistent infection by microorganisms

4) prolonged exposure to potentially toxic agents

5) autoimmune

25
Q

What shape nuclei do macrophages have?

A

bean shaped

26
Q

What differentiation takes place in bone marrow in the process of forming macrophages?

A

pluripotent stem cells differentiate into myeloid stem cells

27
Q

What do myeloid stem cells differentiate into while in the blood which goes onto form macrophages?

A

monocyte

28
Q

What is the name of a monocyte in tissue?

A

macrophage

29
Q

What kind of nuclei do lymphocytes have?

A

spherical mononucleate

30
Q

What are plasma cells?

A

antibody producing cells

31
Q

What kind of nuclei do plasma cells have?

A

spotty, clock face nuclei

32
Q

How do eosinophils appear under a microscope?

A

like a tomato wearing sunglasses

33
Q

How do macrophages activate T lymphocytes?

A

by presenting it with a specific antigen and with cytokines

34
Q

What do T cells release which recruits more macrophages?

A

INF-gamma

35
Q

How do activated T lymphocytes and macrophages cause further inflammation?

A

they release TNF and other inflammatory mediators

36
Q

What are the two components of granulation tissue?

A

1) angiogenesis

2) collagen deposition by fibroblasts

37
Q

What is a granuloma?

A

A collection of activated epithelioid histiocytes

38
Q

What are epithelioid macrophages?

A

macrophages that have an epithelial shape with pink cytoplasms, indistinct cell membranes and oval nuclei

39
Q

What cells often surround granulomas?

A

mononuclear leukocytes (lymphocytes and plasma cells)

40
Q

What cells other than epithelial macrophages and mononuclear leukocytes are found at the centre of granulomas?

A

multi-nucleate giant cells (fusion of multiple macrophages)

41
Q

What are the two types of granulomas?

A

1) caseating

2) non-caseating

42
Q

What is a caseating granuloma?

A

It is a cheese-like necrosis, typically a feature of a granuloma of TB

43
Q

What makes up the outermost layer of a granuloma?

A

fibroblasts producing collagen

44
Q

Give 3 bacterial diseases associated with granulomatous inflammation:

A

1) tuberculosis

2) leprosy

3) syphilis

45
Q

Give an example of a parasitic disease associated with granulomatous inflammation:

A

schistosomiasis

46
Q

Give 2 fungal disease associated with granulomatous inflammation:

A

1) histoplasma

2) cryptococcus

47
Q

Give an example of a dust that can cause granulomatous inflammation:

A

silica dust causing silicosis

48
Q

Give two examples of foreign bodies associated with granulomatous inflammation:

A

1) sutures

2) vascular grafts

EMS (54 decks)

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