Pathology - Inflammation

Question 1

What is inflammation?

Answer 1

A local physiological response to tissue injury (not a disease)

Question 2

What are the benefits of inflammation?

Answer 2

Destroy invading micro organisms = prevent spread of infection

Question 3

What is the negative of inflammation?

Answer 3

May produce disease

Question 4

What are 2 causes of chronic inflammation and the cells involved?

Answer 4

Autoimmunity eg. Graves’ disease, MS
Recurrent infection
Macrophages and lymphocytes

Question 5

What are the 6 causes of acute inflammation?
Examples

Answer 5

Microbial infections (pyogenic bacteria & viruses)
Hypersensitivity (parasites)
Physical agents (trauma, ionizing radiation, heat, cold)
Chemicals (corrosives, acids, alkalis)
Bacterial toxins
Tissue necrosis (death of tissue due to lack of O2 or nutrient filled blood)

Question 6

5 physical signs of acute inflammation?
What they mean?

Answer 6

Rubor (redness)
Calor (heat)
Tumor (swelling)
Dolor (pain)
Loss of function

Question 7

Why would you have rubor?

Answer 7

Redness due to dilation of small blood vessels in damaged area (vasodilation)

Question 8

Why would u have calor?

Answer 8

Heat due to hyperaemia = increased vasodilation = increased warm blood to area

Question 9

What causes tumor?

Answer 9

Swelling from oedema - accumulation of fluid in ECF

Question 10

Why would you have dolor?

Answer 10

Pain from stretching/distortion of tissue due to inflammatory oedema
Chemical mediators (bradykinin, prostaglandins and serotonin induce pain)

Question 11

What are the 3 stages of inflammation in detail?

Answer 11

1. Increased vessel calibre - inflammatory cytokines (bradykinin, prostacyclin, NO) mediate vasodilation
2. Fluid exudate - vessels become leaky, protein rich fluid forced out of vessel

3.cellular exudate - neutrophil polymorphs into extra vascular space

Question 12

What is the main cell involved in acute inflammation?

Answer 12

Neutrophils

Question 13

What is a diagnostic histological feature of acute inflammation?

Answer 13

Neutrophil polymorphs into extra vascular space

Question 14

What are the 4 stages in neutrophil action of acute inflammation?

Answer 14

Margination (migrate to edge of BV)

Adhesion (selections bind to neutrophil, cause ‘rolling along BV margins)

Emigration + diapedesis (movement out of BV, thru or in between endothelium & other inflammatory cells follow)

Chemotaxis (site of inflammation)

Question 15

What are the 3 things happening at the site of inflammation?

Answer 15

1. Phagocytosis
2. Phagolysosome and bacterial killing
3. Macrophages clear debris

Question 16

What are the 5 outcomes of acute inflammation?

Answer 16

Resolution- normal

Supporation - pus formation

Organization - granulation tissue + fibrosis (scar tissue)
Note - cardiac tissue + neurons never resolve, most become this fibrotic tissue

Progression - excessive recurrent inflammation becomes chronic + fibrotic tissue

Question 17

What is a granuloma?

Answer 17

Aggregates of an epitheloid histocytes (essentially macrophages)

Question 18

What shape do granulomas form and what disease?

Answer 18

Form a granulomatous ‘horse shoe’ shape
Granulomatous disease

Question 19

What are some examples or granulomatous diseases?

Answer 19

TB, leprosy, crohns, sarcoidosis (granulomas in organs, especially skin and lungs)

Question 20

What is the most common cause of granuloma?

Answer 20

TB

Question 21

What is a feature seen in a granulomatous disease and give an example of which disease?

Answer 21

Central (caseous) necrosis ‘cheese like’
In TB

Question 22

Is there central necrosis in sarcoidosis, leprosy, vasculitis or crohns?

Answer 22

No central necrosis

Question 23

The presence of 2 things indicates a parasitic infection?

Answer 23

Granuloma and eosinophil
(Worms)

Question 24

What do granulomas secrete?
What can this be used as?

Answer 24

ACE
Blood marker