MOD Chronic Inflammation Flashcards
Which clinical signs resolve and which persist
Rubor and calor resolve
Tumor and floor persist
Differences between acute and chronic
Steroetyped vs modulated
Neutrophils vs macrophages
Immediate vs long time
Instant vs following persistant injury
Macrophage functions
Phagocytosis Antigen presentation Secretion of cytokines and chemical mediators Secretion of clotting factors Angiogenesis stimulation Fibrosis induction Fever induction
Lymphocyte function
B cell differentiates into plasma cell and forms antibodies
T helpers secrete cytokines
Cytotoxic T killers, kill
Fibroblast function
Respond to chemotaxis
Produce extracellular matrix - collagen, elastin, gags
Myofibroblasts in wound contraction
Giant cells are seen in?
Granulomatous inflammation
Give 3 types of giant cell
Langhans
Foreign body
Touton
Describe langhans giant cells and when seen
Peripheral nuclei
Seen in granulomatous infection such as tuberculosis
Describe foreign body giant cells and when seen.
Nuclei randomly arranged
Often seen when there is a foreign body that is difficult to digest
Describe Touton giant cells and when seen
Nuclei in rings towards centre Form in lesions with high lipid content Fat necrosis Xanthelasma Foam cells present
How does chronic inflammation arise
Take over from acute
Begins de novo
Superimposed on acute inflammation
Complications
Tissue destruction
Excessive fibrosis, keloid scar
Impaired function
Atrophy
What is granulomatous inflammation
Chronic inflammation with granulomatous
What is a granuloma
Collection of activated macrophages that forms when the immune system attempts to wall off a substance that is foreign but cannot be eliminated.
What cells do granulomas contain
Macrophages
Epithelioid histiocytes
Giant cells
What do granulomas do
Form around particle, walling it off then causing attack with mononuclear cells to destroy
2 types of granuloma
Foreign body
Hypersensitivity or immune
Describe foreign body granuloma
Macrophages Foreign body giant cells Epithelioid histiocytes Fibroblasts Lymphocytes Develop around non antigenic material
Describe hypersensitivity or immune giant cells
Macrophages Langhans type giant cells Epithelioid histiocytes Fibroblasts Lymphocytes Central necrosis Around insoluble antigenic material
Why do granulomatous inflammation arise
Persistant low grade antigenic stimulation
Hypersensitivity reactions
Differences between ulcerative colitis and crohns
Both IBD idiopathic UC only large intestines Crohns throughout Gi UC no granulomas Chrons granulomas UC cobblestone mucosa, crypt abscesses Crohns Anal lesions Bowel fistulae
What is chronic inflammation
Chronic response to injury with associated fibrosis
