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Pathological Processes > PP 3 Chronic Inflamamtion > Flashcards

PP 3 Chronic Inflamamtion Flashcards

1
Q

Define chronic inflammation

A

Prolonged inflammation with associated repair

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2
Q

Features of chronic inflammation

A
  • delayed onset
  • variable duration
  • variable appearances
  • limits damage + initiates repair
  • can cause debilitating symptoms
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3
Q

Ways chronic inflammation can arise

A
  • takes over from acute inflammation
  • develops alongside acute inflammation
  • arrives de novo: without preceding acute inflammation
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4
Q

Examples of chronic conditions which arise de novo

A

Rheumatoid arthritis
Inflammatory bowel disease

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5
Q

Macrophage naming

A

In circulation- monocyte
After entering tissue- macrophage/histiocyte

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6
Q

Describe macrophage

A

Large cell
Abundant foamy cytoplasm

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7
Q

Macrophage functions

A
  • phagocytosis: -removal of pathogens and debris
    -antigen presentation
  • synthesis of cytokines + clotting factors
  • control other cells by cytokine release
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8
Q

Describe a lymphocyte

A

Small cell
Large spherical nucleus
Thin rim of cytoplasm

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9
Q

Two types of lymphocytes

A

T cells
B cells

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10
Q

T cell functions

A
  • helper T cell: assist other inflammatory cells
  • cytotoxic T cell: destroys pathogen
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11
Q

B cell function

A

Neutralises pathogens
Mature into plasma cells > produce antibodies

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12
Q

Describe a plasma cell

A
  • Eccentric nucleus
  • ‘Clock face’ chromatin
  • Peri-nuclear clearing (Golgi)- pale space around nucleus
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13
Q

Plasma cell function

A

Produce antibodies

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14
Q

Describe an eosinophil

A

Bi-lobed nucleus
Granular cytoplasm - stains red

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15
Q

Eosinophil function

A

Release variety of mediators
In parasitic infections
In hypersensitivity reactions - allergic reactions

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16
Q

Fibroblast/myofibroblast function

A

Regeneration and repair
Lay down collagen&raquo_space; scar production

Myofibroblasts - contract and close wound

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17
Q

Describe giant cells

A

Multinucleated cell
Fusion of multiple macrophages due to ‘frustrated phagocytosis’

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18
Q

Types of giant cells

A

Foreign body
Langhans
Touton

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19
Q

Describe foreign body giant cell

A

Nuclei randomly assorted

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20
Q

Describe Langhans giant cell

A

Nuclei in rim round edge
Full or partial

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21
Q

Describe a Touton giant cell

A

Nuclei in ring in middle

22
Q

What cells are mainly in RA?

A

Plasma cells

23
Q

What cells are mainly in chronic gastritis?

A

Lymphocytes

24
Q

What cells are mainly in Whipple’s disease?

A

Macrophages

25
Q

Effects of chronic inflammation

A
  • fibrosis
  • impaired function
  • increased function (rare)
  • atrophy
  • stimulation of immune system
26
Q

Examples of conditions which show the fibrotic effect of chronic inflammation and info

A

Acute cholecystitis
- repeated obstruction of bile duct by gall stone
- repeated bouts of acute inflammation > chronic inflammation
- fibrosis of gall bladder wall

Liver cirrhosis
- chronic damage > fibrosis > scarring > contraction > portal blood flow impaired > portal hypertension > ascites

27
Q

Examples of conditions which show loss of function due to chronic inflammation and info

A

Idiopathic inflammatory bowel disease: Crohn’s disease and Ulcerative colitis
- abnormal pain
- altered bowl motion
- weight loss
- rectal bleeding

28
Q

What effects of chronic inflammation does cirrhosis show?

A

Fibrosis
Impaired function

29
Q

Causes of cirrhosis

A

Alcohol
Hepatitis
Drugs and toxins
Fatty liver disease

30
Q

What is a granuloma?

A

Epithelial histiocyte with surrounding lymphocytes

31
Q

What is an epithelioid histiocyte?

A

Macrophage that look like epithelial cells

32
Q

Types of granuloma

A
  • foreign body: - destruction + removal of foreign
    material (not antigenic)
    - few lymphocytes
  • immune mediated: - destruction + removal of
    pathogens in response to
    bacteria/fungi (antigenic)
    - can be idiopathic
    - can undergo central necrosis
    - many lymphocytes
33
Q

Why is mycobacterium difficult to destroy?

A

Mycolic acids
Thick cell wall - macrophage resistant

34
Q

What can mycobacterium cause?

A

TB - mycobacterium tuberculosis
Leprosy - mycobacterium leprae

35
Q

What do granulomas look like on H+E stain and why?

A

Pink
Many macrophages which have an abundant cytoplasm - stains pink

36
Q

What are granulomas with central necrosis characteristic of?

A

Rheumatoid arthritis

37
Q

Colour of granuloma with central necrosis

A

Central necrosis is pink

38
Q

What is sarcoidosis?

A

A disease characterised by the growth of granulomas

39
Q

Where is sarcoidosis often found?

A

Lungs
Lymph nodes

40
Q

Is sarcoidosis necrotising or not?

A

No necrosis

41
Q

Colour of healthy lymph nodes on H+E stain

A

Purple
Many lymphocytes which have a large nucleus (haematoxylin stains nucleus purple) + thin cytoplasm

42
Q

What condition are Langhans giant cells often seen in?

A

Tuberculosis

43
Q

What condition are Touton giant cells often seen in?

A

Fat necrosis
Xanthomas

44
Q

What condition are Foreign body giant cells often seen in?

A

When macrophage is unable to phagocytose foreign body

45
Q

When are granulomas formed?

A

When there are particles which are difficult to break down but need to be isolated and contained
e..g splinters, mycobacterium tuberculosis

46
Q

What are epithelioid cells?

A

Macrophages which have been modified due to increased activity so look like epithelium

47
Q

What are the most common cell types in chronic inflammation?

A

Macrophages
Lymphocytes

48
Q

What is chronic gastritis?

A

Inflammation of stomach lining most often due to Helicobacter pylori

49
Q

What is an ulcer?

A

A breach in the mucosa to the level of submucosal layer

50
Q

What is a Mantoux test?

A

A screening test for TB

51
Q

Describe what happens when a person inhales mycobacterium tuberculosis

A
  • MTB endocytosed by macrophages
  • MTB replicates within phagosome
  • MTB proliferates in alveolar macrophages + air spaces
  • bacteraemia develops
  • T helper cell response activates macrophages&raquo_space; produce TNF
  • monocytes differentiate into epithelioid histiocyte&raquo_space; granulomas
  • illness contained

Pathological Processes (14 decks)

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