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Phase 2a > Pathology > Flashcards

Pathology Flashcards

1
Q

What is inflammation

A

A reaction to injury or infection involving cells such as neutrophils and macrophages.

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2
Q

When is inflammation good/helpful

A

When responding to infection to fight off foreign bodies and also in response to injury as it initiates the healing process.

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3
Q

When is inflammation bad /harmful

A

In autoimmune diseases, the body mounts an immune reaction to host cells or when the body over-reacts to a stimulus.

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4
Q

What mediates acute inflammation

A

Neutrophils

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5
Q

Describe acute inflammation

A

Sudden onset, short duration and usually resolves

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6
Q

What are the most abundant cells in acute inflammation

A

Neutrophil polymorphs

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7
Q

What mediates chronic inflammation

A

Macrophages and lymphocytes

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8
Q

Describe chronic inflammation

A

Slow onset or sequel to acute, long duration and may never resolve.

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9
Q

What are the most abundant cells in chronic inflammation

A

Lymphocytes, plasma cells and macrophages (sometimes with granuloma formation).

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10
Q

What is the sequence of acute inflammation

A
  • injury or infection
  • neutrophils arrive and phagocytose and release enzymes
  • macrophages arrive and phagocytose
  • either resolution with clearance of inflammation or progression to chronic inflammation
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11
Q

Give an example of acute inflammation

A
  • examples of acute (neutrophil-mediated) inflammation - acute appendicitis, frostbite, Streptococcal sore throat
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12
Q

What is the sequence of chronic inflammation

A
  • either progression from acute inflammation or starts as ‘chronic’ inflammation such as infectious mononucleosis (thus the better term is macrophage/lymphocyte-mediated
    inflammation)
  • no or very few neutrophils
  • macrophages and lymphocytes, then usually fibroblasts
  • can resolve if no tissue damage (e.g. viral infection like glandular fever) but often ends up with repair and formation of scar tissue
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13
Q

What cells are involved in inflammation

A

Neutrophil polymorphs
Macrophages
Lymphocytes
endothelial cells
fibroblasts

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14
Q

Which cells are first on the scene of acute inflammation

A

Neutrophil polymorphs

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15
Q

What are neutrophil polymorphs

A

They are white blood cells made in the bone marrow and live for 2 or 3 days. They can ‘eat’ debris and bacteria. They are cytoplasmic granules full of enzymes (lysosomes) that kill bacteria and they usually die at the scene of inflammation and are themselves phagocytosed by macrophages. They also draw in other inflammatory cells by releasing chemicals.

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16
Q

Why are they called neutrophil polymorphs

A

They are called polymorphs because they have a polylobed nucleus.

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17
Q

Do neutrophil polymorphs need to have seen the foreign body before they intiate a response

A

No

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18
Q

What are the functions of macrophages

A

Ingest bacteria and debris and may carry debris away and may present antigen to lymphocytes. They also transport material to lymph nodes and may present the material to lymphocytes so a secondary immune reaction is induced.

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19
Q

How long do macrophages live

A

Months to years as they are long-lived

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20
Q

What are the functions of lymphocytes

A

Produce chemicals which attract in other inflammatory cells and involved in controlling inflammation and anitbodies. Have immunological memory for past infections and antigens to allow for quick immune response if repeated infections.

21
Q

How long do lymphocytes live

A

Years - long lived

22
Q

What are the functions of endothelial cells in inflammation

A

They line capillary blood vessels and in areas of inflammation they may become sticky so inflammatory cells can adhere to them. Also become porous to allow inflammatory cells to pass into tissues.

23
Q

How to the precapillary sphincters aid blood flow in inflammation

A

In inflammation the capillary bed opens up through the sphincters to allow more blood to access local site of inflammation.

24
Q

What is a cause of increased blood pressure in sepsis

A

There is uncontrolled opening of the capillary wall leading to increase in bp.

25
Q

What causes swelling in inflammation

A

Swelling is due to the change of pressure meaning more plasma flows out leading to oedema. In acute inflammation, there is a net loss of fluid together with plasma protein molecules into the extracellular space, resulting in oedema.

26
Q

What are the functions of fibroblasts in inflammation

A

Arrive quite late and produce collagen to allow for repair process. They are long-lived cells.

27
Q

Describe the cause and symptoms of acute appendicitis

A

Unknown precipitating factor, neutrophils appear and vessels dilate. Inflammation of serosal surface occurs and pain is felt.

28
Q

What is the treatment for acute appendicitis

A

Appendix either surgically removed or inflammation resolves. Or appendix bursts with generalised peritonitis and possible death.

29
Q

What is an example of chronic inflammation with no intial acute inflammation

A

Tuberculosis

30
Q

What causes tuberculosis

A

Mycobacteria has waxy cell wall which neutrophils don’t pick up on so leads directly to chronic inflammation. Macrophages ingest them but can’t kill them due to cell wall so lymphocytes also appear and fibrosis occurs.

31
Q

What are granulomas

A

Collection of macrophages all together surrounded by lymphocytes

32
Q

Describe the composition of granulation tissue

A

Comprises of small blood vessels in a connective tissue matrix with myofibroblasts. It is an important component of healing.

33
Q

How can ice help with treating inflammation

A

It leads to the closing of capillary sphincters and reduces blood flow to injury.

34
Q

What is a good treatment for insect bites

A

Histamine is a chemical mediator for acute inflammation

35
Q

How do anti-inflammatory work

A

E.g. ibuprofen inhibit prostaglandin synthetase which is an enzyme that makes prostaglandin which is a chemical mediator of inflammation

36
Q

What is a good treatment for skins rashes

A

Steroid creams in a weak form. Corticosteroids are anti-inflammatories that bind to DNA to regulate inhibitors of inflammation.

37
Q

What is resolution of an injury

A

When the initiating factor is removed and the tissue is undamaged or able to regenerate

38
Q

What is repair of an injury

A

The initiating factor is still present and the tissue is damaged or unable to repair. Is replacement of damaged tissue by fibrous tissue

39
Q

What is an example of an organ that can substantially regenerate

A

Liver

40
Q

Why can’t resolution occur in alcoholic liver disease

A

The initiating factor isn’t removed

41
Q

What are resolution and repair of organs dependent on

A

Extent of damage to organs

42
Q

What is the most superficial skin wound known as

A

Abrasion

43
Q

What is healing by first intention

A

Bringing all the edges of the injury together e.g. stitching.

44
Q

How do scars differ from surrounding skin

A

They are stronger in tensile strength

45
Q

What is healing by second intent

A

If you can’t bring edges of wounds together e.g. traumatic wounds which could be due to losing part of the skin.

46
Q

Why does healing by second intent take longer

A

Because cells and epithelium have to grow and also leads to bigger scars as grown up from bottoms instead of bridging a gap.

47
Q

What are cells that can regenerate

A

Hepatocytes, pneuemocytes, blood cells, gut epithelium, skin epithelium and osteocytes

48
Q

What are cells that can’t regenerate

A

Myocardial cells and neurones

49
Q
A

Phase 2a (1 decks)

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