MOD 3.1 - Chronic Inflammation Flashcards by Beth Elliott

Give three ways in which chronic inflammation can arise

Permanent tissue damage/ damage not resolved within a few days
Can arise out of nowhere e.g. Autoimmune conditions or chronic infections
Can happen alongside acute inflammation i.e. It’s severely persistent/repeated

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What does chronic inflammation look like?

Very diverse so need to look at microscopic appearance

- Type of cell present is most important

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Which cells are most associated with chronic inflammation? Give two details about them

Macrophages
Lots of granular cytoplasm
Big, digest foreign material

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What do macrophages derive from?

Blood monocytes - have varying levels of activation

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Give three functions of macrophages

Good at phagocytosis
Picking up and presenting of antigens
Synthesis of molecules

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Give four molecules that are synthesised by macrophages

Cytokines
Complements
Proteases
Clotting factors

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What do lymphocytes look like under the microscope?

Lots of blue dots

- Large, round nucleus

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What is the function of lymphocytes?

Differentiate into:

B-lymphocytes (plasma cells) - antibody production
T-Lymphocytes - control and cytotoxic functions

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What do Eosinophils look like under the microscope?

Bright pink circles with a bilobed nucleus

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What are the functions of Eosinophils? (3)

Mediation in response to:

Allergic reactions
Parasite infections
Some tumours

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What is the function of a fibroblast?

Production of collagen after being recruited by macrophages

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What is a giant cell?

Multinucleate cell made by the fusion of macrophages due to frustrated phagocytosis

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When are giant cells formed?

When one macrophage cannot easily phagocytose the foreign material

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What are the three types of giant cell and where can they be found?

Langhans (tuberculosis)
Foreign body type
Touton (Fat necrosis)

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Describe the appearance of a Langhans giant cell

Horseshoe of nuclei

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Describe the appearance of a foreign body type giant cell

Disorganised

- Many little groups of nuclei

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Describe the appearance of Touton giant cells

Horseshoe/circle of nuclei

- Foamy outside of cell

Describe the morphology of chronic inflammation

Mostly non specific

Which condition causes tissue to become rich in plasma cells?

Rheumatoid arthritis

Which condition causes tissue to become rich in mainly lymphocytes

Chronic gastritis

Which condition causes tissue to become rich in mainly macrophages?

Leishmaniasis

Give the effects of chronic inflammation (4)

Fibrosis
Impaired function
Atrophy
Stimulation of immune response

How is scar tissue (fibrosis) formed due to chronic inflammation?

Happens due to multiple episodes of acute inflammation

Describe the occurrence of cirrhosis

Fibrosis and impaired function

- Disorganisation of architecture and attempted regeneration

Give two conditions of chronic inflammation where fibrosis results

- Cholecystitis (swelling of gallbladder due to blockage of cystic duct) - Peptic ulcers

Why do peptic ulcers form?

Form due to an imbalance of acid production and mucosal defence

Give an example of a condition where chronic inflammation has caused impaired function

Inflammatory bowel disease e.g. Ulcerative colitis or Crohn's disease

What is the difference between ulcerative colitis and Crohn's disease?

UC = superficial, crypt abscesses and distorted crypt architecture common C = Transmural, Fistulae and strictures

What is a fistula?

An abnormal connection between two epithelium-lined organs

What is a stricture?

The narrowing of a tubular structure

What is atrophy? Give an example of atrophy that has arisen due to chronic inflammation

- Loss of functional tissue | - Atrophic gastritis = loss of gastric mucosa

Give an example of a condition that arises due to the stimulation of the immune system as a result of chronic inflammation

- Rheumatoid arthritis (can be localised or systemic)

How do localised and systemic rheumatoid arthritis differ?

- Localised = destruction of joints | - Systemic = Other organs are affected and can cause amyloidoses

What is granulomatous inflammation?

Chronic inflammation with granulomas

What is a granuloma?

A cohesive group of macrophages and other immune cells

When does granulomatous inflammation arise?

- Hypersensitivity reactions | - Persistent low grade antigenic stimulation

What are the causes of granulomatous inflammation? (3)

- Mildly irritant foreign material - Infections e.g. Mycobacteria and some fungi - Unknown e.g. Crohn's disease, Sarcoidosis

What are the effects of an infection with mycobacterium tuberculosis? (4)

- Fibrosis - Erosion in bronchioles - Empyema - Erosion in blood

What is the definition of chronic inflammation?

The chronic response to injury with associated fibrosis

What is a foreign body granuloma?

- Granuloma that contains: - Macrophages - Giant cells - Foreign body - Epithelioid cells - Some peripheral fibroblasts - Very few lymphocytes

What are the cell types in a hypersensitivity/immune granuloma?

- Macrophages - Giant cells (usually langhans) - Epithelioid cells (more prominent) - Fibroblasts - Lymphocytes

Give a property of hypersenstivity granulatomas. Where can they normally be found?

- Can undergo central necrosis | - Granulatomas associated with tuberculosis