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Y1 - PP > Lecture 5 - Chronic Inflammation > Flashcards

Lecture 5 - Chronic Inflammation Flashcards

1
Q

What is the definition for Chronic Inflammation?

A

Prolonged inflammation with associated repair

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2
Q

Why is acute inflammation referred to as being stereotyped and chronic inflammation being modulated?

A

Acute stereotyped occurs rapidly and responds to any type of injury

Chronic modulated takes over if the injurious agent is not quickly removed

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3
Q

How does Chronic inflammation arise?

A

Takes over from acute Inflammation (if acute inflammation cant resolve)

Develops alongside acute inflammation (at same time, e.g ongoing bacterial infection)

Develops without preceding acute inflammation

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4
Q

Why might chronic inflammation arise without preceding acute inflammation?

A

Chronic infection like TB
Autoimmune conditions (Rheumatoid arthritis)
Prolonged exposure to toxic agents (silica)

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5
Q

What is the main cell involved in acute inflammation?

A

Neutrophil

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6
Q

What cells are involved in chronic inflammation?

A

Macrophages
Lymphocytes + Plasma cells
Eosinophils
Fibroblasts/Myofibroblasts

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7
Q

What is a monocyte?

A

A blood circulating phagocyte

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8
Q

What is a macrophage/histiocyte?

A

A monocyte which his migrated into tissues

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9
Q

What is the appearance of a macrophage?

A

Large
Abundant “foamy” cytoplasm
Slipper shaped nucleus

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10
Q

What causes the foamy cytoplasm look in a macrophage?

A

Abundant phagolysosomes

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11
Q

What is the function of the macrophages?

A

Remove pathogens (degrade)
Antigen presentation
Release mediator controlling inflammation

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12
Q

What is the appearance of a lymphocyte?

A

Small cell (like RBC)
Large spherical nucleus
Very thin rim of cytoplasm

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13
Q

What are the 2 types of lymphocyte?

A

T Cell
B Cell

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14
Q

What is the function of T Cells?

A

Helper T Cells assist other inflammatory cells
Cytotoxic T cells destroy pathogens

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15
Q

What is the function of B Cells?

A

Mature into plasma cells
These produce antibodies that neutralise pathogens

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16
Q

What is the appearance of a plasma cell?

A

Clumped chromatin
Eccentric non central nucleus
Paler peri-nuclear clearing

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17
Q

What causes the paler peri-nuclear region around the nucleus of a plasma cell?

A

The prominent Golgi bodies

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18
Q

What is the function of a plasma cell?

A

Produces antibodies

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19
Q

What is the appearance of an Eosinophil?

A

TOMATO WITH SUNGLASSES

Bi-lobed nucleus
Very granular so cytoplasm stains quite red

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20
Q

What is the function of Eosinophils?

A

Parasitic infections
Hypersensitivity reactions (allergies, asthma etc…)

Release variety of mediators

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21
Q

What is the general function of fibroblasts/myofibroblasts?

A

Lay down collagen to regenerate and repair

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22
Q

What are giant cells?

A

Multinucleated cells formed by the fusion of multiple macrophages

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23
Q

What is meant by frustrated phagocytosis?

A

When a phagocyte fails to engulf a pathogen and so fuses with other macrophages to form a giant cell to be able to engulf the pathogen

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24
Q

What are the 3 types of Giant cells?

A

Foreign body giant cell
Langhans giant cell
Touton giant cell

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25
Q

How are giant cells named/categorised?

A

Depending on the arrangement of the nuclei

26
Q

What is the structure/appearance of a foreign body giant cell?

A

Randomly arranged nuclei

27
Q

What is the appearance/structure of a Langhans giant cell?

A

Nuclei arranged in horseshoe in rim around cell

28
Q

What is the appearance/structure of a Touton giant cell?

A

Central ring of nuclei

29
Q

When a foreign body giant cells usually formed?

A

When body is responding to a foreign body present (like a suture)

30
Q

When are Langhans Giant cells usually present?

A

Usually with TB

31
Q

What type of giant cell can be seen in fat necrosis?

A

Touton giant cell

32
Q

What is the importance of the proportions of cells present in chronic inflammation?

A

Can indicate a diagnosis

33
Q

Which cells are predominantly present in Rheumatoid arthritis?

A

Mainly plasma cells

34
Q

Which cells are mainly present in chronic gastritis?

A

Mainly lymphocytes

35
Q

Which cell is mainly present in Whipple’s disease (bacterial infection of intestines and lymph nodes)?

A

Mainly macrophages

36
Q

What are the effects of chronic inflammation?

A

Fibrosis
Impaired function
Atrophy
Stimulation of immune response

37
Q

What is fibrosis and what is the effect of fibrosis on a tissue?

A

The deposition of collagen

Fibrosis impairs tissue function

38
Q

Why is atrophy a negative effect of chronic inflammation?

A

Reduction in size of tissue (reduced amount of normal functioning tissue)

39
Q

What is Chronic Cholethiasis?

A

Repeated obstruction of bile duct by gall stones

40
Q

How does chronic inflammation occur with Chronic cholethiasis?

A

Blocking of common bile duct causes acute inflammation
Repeat blockage = repeat bouts of acute inflammation = chronic inflammation
Fibrosis of gall bladder wall (thickened and pale)

41
Q

How does a patient with Chronic cholethiasis and chronic inflammation present?

A

Pain in RUQ
Fever
Raised neutrophils

42
Q

Which 2 inflammatory bowel diseases are idiopathic?

A

Chron’s Disease
Ulcerative Colitis

43
Q

What symptoms do patients present with when suffering with Crohn’s disease or Ulcerative Colitis?

A

Abdominal pain
Altered bowel motion
Weight loss
Rectal bleeding

44
Q

Where does Ulcerative colitis affect and where can Crohn’s Disease affect?

A

Ulcerative Colitis = LARGE BOWEL ONLY

Crohn’s Disease can affect all of GI tract

45
Q

Out of Crohn’s Disease and Ulcerative Colitis, which one is most likely to cause rectal bleeding and why?

A

Ulcerative colitis since it causes CONTINUOUS Inflammation

Crohn’s disease = discontinuous patchy inflammation

46
Q

How is the bowel wall affected by inflammation in Crohn’s disease and ulcerative colitis?

A

Crohn’s disease = affects full thickness of wall

Ulcerative colitis = affects superficial wall only

47
Q

Which inflammtory bowel disease (Crohns or ulcerative colitis) can granulomata be found?

A

Crohn’s disease

48
Q

What are the nodules caused by in liver cirrhosis?

A

Hepatocytes regenerating

49
Q

What does fibrosis look like on a liver?

A

Bands of collagen separating the nodules of regenerating Hepatocytes

50
Q

What is Granulomatous inflammation?

A

Chronic inflammation + Granuloma

A specific type of chronic inflammation where at least 1 Granuloma is present

51
Q

What is a Granuloma?

A

Collection of macrophages that look like epithelial cells that may be surrounded by lymphocytes

52
Q

What is the name given to macrophages that look like epithelial cells?

A

Epithelioid Histiocytes

53
Q

What is the difference between a giant cell and a Granuloma?

A

Granuloma = all distinct cells
Giant cell = 1 fused cell

Granulomas can contain giant cells

54
Q

What are the 2 types of Granuloma?

A

Foreign body Granuloma
Immune Mediated Granuloma

55
Q

How are Granulomas classified as either foreign body or immune mediated?

A

Depends on what they destroy

56
Q

What is the role of a foreign body Granuloma and what is the relative levels of lymphocytes?

A

Destruction and removal of foreign material

Few lymphocytes

57
Q

What is the role of Immune Mediated Granuloma and what are the relative levels of lymphocytes?

A

Destruction of pathogens (bacteria/fungi)

Can undergo central necrosis

Many lymphocytes

58
Q

What can cause granulomatous inflammation?

A

Infections like:
Mycobacterium tuberculosis
Mycobacterium leprae (Leprosy)

Thick cell walls hard to destroy

59
Q

What type of necrosis do mycobacterium Granulomas have?

A

Central necrosis usually caseous necrosis

60
Q

How does caseous necrosis of a Granuloma appear on an image?

A

Pale pink centre of Granuloma (lacks any structure)

61
Q

What type of granulomata does sarcoidosis cause?

A

Non-necrotising granulomata

62
Q

What type of granulomata does Crohn’s disease cause?

A

Non-necrotising granulomata?

Y1 - PP (20 decks)

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