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Pathological Processes > S3) Chronic Inflammation > Flashcards

S3) Chronic Inflammation Flashcards

1
Q

What is the definition of chronic inflammation?

A

Chronic response to injury with associated fibrosis

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2
Q

3 ways chronic inflammation can arise

A

Acute inflammation where quick resolution isn’t possible

De novo

Alongside acute inflammation

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3
Q

Give 3 examples of de novo chronic inflammation

A

Autoimmune reactions (RA)

Chronic infections (viral hepatitis)

Chronic low level irritation

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4
Q

4 functions of macrophages

A

Phagocytosis

Antigen presentation

Synthesis of cytokines, complement proteins, clotting factors and proteases

Control of other cells by cytokine release

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5
Q

Which cells are present in chronic inflammation? (6)

A

Macrophages

Lymphocytes

Plasma cells

Eosinophils

Fibroblasts/ myofibroblasts

Giant cells

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6
Q

In what situations are eosinophils recruited? (3)

A

Allergic reactions

Parasite infections

Some tumours

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7
Q

How are giant cells made?

Uni/ multinucleate?

Name three types of giant cells and the conditions which they are seen in

A

Fusion of macrophages

Multinucleate

Langhans - tuberculosis
Touton - fat necrosis
Foreign body type

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8
Q

Which cells are most prevalent in RA?

A

Plasma cells

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9
Q

Which cells are most prevalant in gastritis?

A

Lymphocytes

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10
Q

5 effects of chronic inflammation:

A

Fibrosis eg gall bladder, cirrhosis

Impaired function

Sometimes increased function eg thyrotoxicosis

Atrophy - gastric mucosa and adrenal glands

Stimulation of the immune response

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11
Q

What causes chronic cholecystitis?

What changes does this causes to the organ involved?

A

Repeated obstruction by gall stones leads to repeated acute inflammation, which leads to chronic inflammation

Fibrosis of gall bladder wall

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12
Q

Which parts of the bowl does inflammatory bowel disease affect?

What two conditions cause IBD?

What is the primary difference between these two conditions?

A

Small and large bowel

Ulcerative colitis and Crohn’s disease

Ulcerative colitis is superficial, Crohn’s disease affects the whole organ

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13
Q

What main symptoms are seen in Ulcerative Colitis?

A

Diarrhoea, rectal bleeding

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14
Q

What main symptoms are seen in Crohn’s disease?

A

Strictures - narrowing

Fistulae - abnormal connections between epithelium lined organs

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15
Q

Causes of cirrhosis (5)

A

Alcohol

Infection with HBV or HCV

Immunological

Fatty liver disease

Drugs and toxins

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16
Q

What is a granuloma?

Why does it form?

A

A collection of histiocytes (modified macrophages)

The immune system attempts to wall off substances which it can’t eliminate

17
Q

Causes of granulomatous inflammation (3)

A

Irritant foreign material

Infections eg mycobacteria or fungi

Unknown causes

18
Q

What effect does TB have?

A

Mycobacterial infection which causes persistent cell-mediated immunity

19
Q

How does chronic inflammation present?

A

4 clinical signs are resolved but pain persists

20
Q

Generally, which cells are most dominant in chronic inflammation?

A

Macrophages

21
Q

What are the functions of lymphocytes?

A

Process antigens

B - secrete antibodies

T - secrete cytokines

NK - kill tumour/ virus infected cells

22
Q

How do Langhan cells appear microscopically?

A

Peripheral nuclei

23
Q

How do foreign body giant cells appear microscopically?

A

Randomly arranged nuclei

Seen when indigestible foreign bodies are found

Large foreign bodies stick to the cell surface

24
Q

How do Touton cells appear microscopically?

A

Nuclei arranged in a ring towards the centre of the giant cell

Formed in lesions where there is a high lipid content eg fat necrosis or xanothomas

25
Q

What bacteria cause gastritis?

How does it do this?

A

Helicobacter pylori

Stimulates the production of pro-inflammatory cytokines, directly injures epithelial cells or increases acid secretion

26
Q

Which malignancies are associated with Helicobacter pylori gastritis?

A

Gastric adenocarcinoma

MALT lymphoma

27
Q

What is the function of hypersensitivity / immune type granulomas?

A

Develop around insoluble antigenic particles which causes cell mediated immunity

28
Q

Where are hypersensitivity granulomas seen?

A

TB

Syphillis

Sarcoidosis

Wegeners granulomatosis

Crohn’s disease

29
Q

In what granuloma type does central caseous necrosis occur?

A

Immune type

30
Q

What is sarcoidosis?

A

A rare condition of unknown cause which causes granulomas to develop, especially in the lungs and skin

31
Q

What test screens for TB?

Which vaccine prevents TB?

A

Mantoux

BCG

32
Q

What is a primary complex?

A

A local reaction in the lung parenchyma where organisms lodge and the inflammation reaction of the associated lymph nodes

33
Q

What is meant by:

Ghon focus

A

A calcified TB granuloma in the lung

34
Q

What is meant by:

Ghon complex

A

A calcified TB granuloma in the lung and hilar lymph node

35
Q

What is meant by:

Ranke complex

A

Composed of a ghon focus and an ipsilateral calcified hilar node (seen in healed TB)

36
Q

Where is TB found in:

Miliary TB

Pott’s disease

Scrofula

A

Throughout the body

Vertebrae

Cervical region

Pathological Processes (5 decks)

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