MoD week 2-3 chronic and acute inflammation

Question 1

what is acute inflammation?

Answer 1

response of living tissue to injury

Question 2

what are the clinical signs of acute inflammation?

Answer 2

rubor, color, tumour, dolor, loss of function

Question 3

what is vasodilation in acute inflammation?

Answer 3

increase permeabiity, and hydrostatic pressure to form exudate
gaps in endothelium allows exudation (plasma proteins), adherence, margination and emigration through basement membrane
recruits macro and lymphocytes

Question 4

what are the mediators of acute inflammation?

Answer 4

histamine (stored in mast cells granules), serotonin (stimulate fibroblasts & platelets), prostaglandins (vasodilate, cause pain & fever), leucotrines (permeability), bradykinin (dilator, produce pain), complement (C3a, C4a, C5a), cytokines, endotoxins

Question 5

conditions of acute inflammation

Answer 5

hereditary angiodema
alpha 1 anti trypsin deficiency
CGD (chronic granulomatous disease)

Question 6

what is hereditary angiodema?

Answer 6

C1 esterase inhibitor deficiency
patient has attacks of non-itchy cutaneous angio-oedema
death in larengeal involvement

Question 7

what is a-1 antitrypsin deficiency?

Answer 7

no inhibition of proteases

breaking down lung tissue causing emphysema

Question 8

what is chronic granulomatous disease?

Answer 8

no O2 burst so granulomas formed everywhere
(unable to generate free radicals)
phagocytes can’t kill them and no free radicals leading to chronic infections

Question 9

what causes chronic inflammation

Answer 9

takes over from acute
begins denovo (autoimmune)
alongside acute (abscess) - prolonged exposure to toxic agents
chronic persistent infections (arise denovo)

Question 10

what are the processes of neutrophils working in acute inflammation?

Answer 10

margination - stasis causes neutrophils to line at edge of endothelium
rolling - neutrophils roll along endothelium
adhesion - to endothelium
emigration - of neutrophils out of capillary walls

Question 11

What are the possible complications of chronic inflammation?

Answer 11

granulomas,
excessive fibrosis: fibroblasts stimulated by cytokines (excess collagen production)
impaired function: myofibroblasts contract e.g. blocking flow duct of liver
atrophy: muscle wasting
tissue destruction

Question 12

What are giant cells?

Answer 12

fusion of macrophages due to frustrated phagocytosis

Question 13

What are the 3 types of giant cells?

Answer 13

langans
foreign body
toutons

Question 14

what are langans giant cells?

Answer 14

TB

have a nucleus like horseshoe - periphery

Question 15

What are foreign body giant cells

Answer 15

present if there are foreign bodies

random nuclei

Question 16

what are toutons giant cells

Answer 16

in lesions with high lipid content e.g. fat necrosis + xanthoma
ring nuclei in centre of cell, can see foam cells (macrophage ingest oxidised lipids)

Question 17

what are the principle cells of chronic inflammation?

Answer 17

macrophage
lymphocytes
eosinophils
fibroblasts

Question 18

what is the funciton of macrophage?

Answer 18

phagocytosis, present antigens to immune system

stimulate angiogenesis

Question 19

function of lymphocyte?

Answer 19

B type (plasma cells) produce antibodies
T type (killer cells) + cytotoxic functions, process antigens, secrete cytokines

Question 20

function of eosinophils

Answer 20

allergic rections, parasitic infestations

Question 21

function of fibroblasts

Answer 21

make collagen, elastin + GAG, differentiate into myofibriblasts (cells that can contract)

Question 22

major clinical examples of chronic inflammation

Answer 22

chronic cholecystitis
peptic ulcer
ulcerative colitis
chrons
cirrhosis
grave's
RA

Question 23

what is chronic cholecystitis?

Answer 23

repeated acute inflammation leading to fibrosis of the gall bladder

Question 24

what is peptic ulcer?

Answer 24

helicobacter pylori
imbalance between mucosal defence and acid production
necrosis

Question 25

what is ulcerative colitis?

Answer 25

colon inflammed, superficial, cholectomy

Question 26

what is chron’s disease?

Answer 26

chronic inflammation of all of GI, transmural, treat with removal

Question 27

what is cirrhosis?

Answer 27

fibrosis and impaired function

scarring of liver

Question 28

what is grave’s?

Answer 28

hyperthyroidism

heat intolerance, weight loss, high BMR, tachycardia, anxiety

Question 29

What is rheumatoid arthiritis?

Answer 29

localised autoimmune to joints, symmetrical