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MOD > MOD 7 - Chronic Inflammation > Flashcards

MOD 7 - Chronic Inflammation Flashcards

1
Q

what is inflammation

A

a protective response involving host cells, blood vessels and proteins

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2
Q

what is the purpose of inflammation?

A

remove the cause of injury, remove necrosis, initiate repair

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3
Q

what is the difference in cellular response in acute and chronic inflammation

A

acute - neutrophils, chronic - lymphocytes, plasma cells and macrophages

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4
Q

is granulation & scar tissue more abundant in acute or chronic inflammation ?

A

acute inflammation

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5
Q

what is the common cause of primary chronic inflammation?

A

sequential from acute inflammation

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6
Q

what are the 5 common causes for primary chronic inflammation?

A

infections, primary granulomatous diseases, endogenous materials (have an internal origin eg necrotic adipose tissue) , autoimmune, exogenous materials (external origin, asbestos fibres, suture)

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7
Q

what is the most common outcome for acute inflammation?

A

supporative acute inflammation

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8
Q

what is suppurative acute inflammation?

A

it is pus forming acute inflammation

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9
Q

what happen if the suppurative acute inflammation goes deep enough in the tissue?

A

it will cause the wall of tissue to thicken and then it will be filled with granulomas and fibrous tissue

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10
Q

what happen after recurrent acute inflammation?

A

it will then become chronic inflammation

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11
Q

what is the main cellular morphological features of chronic inflammation?

A

chronic inflammation will have infiltration of mononuclear cells (macrophages, lymphocytes, plasma cells) along with tissue destruction and healing by fibrosis

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12
Q

what is granulation tissue?

A

new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process.

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13
Q

what will granulation tissue form in the later stage of chronic inflammation?

A

production of new fibrosis tissue

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14
Q

what are the 2 types of lymphocytes in chronic inflammation ?

A

B & T lymphocytes

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15
Q

which B & T lymphocytes produce cytokines?

A

T does

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16
Q

what does cytokines d o in chronic inflammation?

A
  • attract macrophages leading to activation and so phagocytoseis
  • attract neurophils (chemotaxis) and factor eg histamine that increase vascular permeability - like in acute inflammation
  • cause perforins - kill invading cells by causing perforation on invading cells
  • produce interferons that activate natural killer cells and macrophages - useful for attacking viruses
17
Q

what does macrophages do in chronic inflammation?

A

increase inflammation, stimulate immune system, carry out recruitment via cytokines

18
Q

what happen next after macrophages send out cytokines for recruitment?

A

monocytes are attracted and enter damaged tissue from blood vessel (this is recruitment)

19
Q

what do macrophages do local in the damaged tissue?

A

they release cytokines, proliferate and become immobilised within tissue

20
Q

what is granulation tissue?

A

new connective tissue and blood vessels

21
Q

what is the process of would healing

A

by forming granulation tissue which grows from the base of the wound upward - angiogenesis is required for the continuation of cells to be delivered, fibroblasts deposit collagen - repair by replacing with fibrosis, inflammatory cells - needed for healing process

22
Q

what is the main aim of wound healing in chronic inflammation?

A

repair by replacement of injured tissue by fibrosis tissues

23
Q

what is fibrosis?

A

formation of excess fibrosu connective tissue during repair of damaged tissue

24
Q

what is the name given for fibrosis raised from 1 cell line?

A

fibroma - 1 cell line of fibrosis tissue

25
Q

what is the role of macrophages in fibrosis?

A

macrophage induced laying down of connective tissue inc collagen

26
Q

what is a granuloma

A

a granuloma = nodule of epithelioid histiocytes & other cells eg lymphocytes & histiocytice giant cells

27
Q

what are epithelioid histiocytes?

A

they are large vesicular nuclei and eosinophilic cytoplasm (eosinophilic stain pink or purple)

28
Q

what are histiocytic giant cells

A

they are cells which are formed when materials is indigestible to macrophages eg tubercle bacilli (have cell walls resistance to macrophages), histiocytic giant cells are multinucleate giant cells

29
Q

what are macrophages known as while in tissue?

A

histiocytes

30
Q

what are some example for granulomatous inflammation?

A

Bacterial = TB, leprosy
Parasitic = schistosomiasis (worm lives in fresh water in tropical area)
Fungal = cryptococcus (hidden sphere in greek)
Synthetic materials = silicosis
Unknown = Sarcoidosis (granuloma develop in the organs of the body. It usually affects the lungs and skin), crohn’s disease.

31
Q

outline the layers of early granuloma

A

macrophages - lymphocytes

32
Q

outline layer of non-caseous epithelioid granuloma

A

macrophages (Langhans-type giant cells present) - lymphocytes & plasm cells - fibroblasts producing collagens

33
Q

outline the layers of caseous epithelioid granuloma

A

caseous necrosis - macrophage (Langhans-type giant cells present) - lymphocytes & plasm cells - fibroblasts producing collagen

34
Q

what particular condition does chronic inflammation involved in cardiovascular system

A

myocardial fibrosis (post MI), formation of atheroma

35
Q

how is atheroma formed?

A

macrophages adhere to epithelium and recruit other cells process lipids that accumulate in plaques

36
Q

what are the clinical outcome of chronic inflammation

A

persistence of infection, prolonged exposure to toxic agents, autoimmune disease

37
Q

an example of persistent of infection due to chronic inflammation?

A

H.Polyri - produces proteases - damage intestinal lining - gastritis - loss of protective layer, enzymes can access stomach wall and cause perforation. (life threatening)

38
Q

An example of what happens in prolonged exposure to toxic agents due to chronic inflammation

A

prolong exposure of toxic in liver can cause cirrhosis (macrophages cause fibrosis)

39
Q

an example of what happens in autoimmune disease due to chronic inflammation

A

rheumatoid arthritis

MOD (19 decks)

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