Session 3 Flashcards

1
Q

What is chronic inflammation?

A

Chronic response to injury with associated fibrosis

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2
Q

How does chronic inflammation compare to acute inflammation?

A

It is more long term and more variable.

Acute inflammation is rapid and stereotyped.

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3
Q

In what 3 ways can chronic inflammation arise?

A

May ‘take over’ from acute inflammation
May arise de novo
May develop alongside acute inflammation

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4
Q

When may chronic inflammation take over from acute inflammation?

A

When damage is too severe to be resolved within a few days

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5
Q

When may chronic inflammation arise de novo? (3)

A

In some autoimmune conditions
In some chronic infections
Chronic low-level irritation

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6
Q

Give an example of an autoimmune condition and chronic infection that can result in chronic inflammation?

A

Rheumatoid arthritis

Viral hepatitis

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7
Q

When may chronic inflammation develop alongside acute inflammation?

A

In severe, persistent or repeated infection

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8
Q

What sort of appearance does chronic inflammation take under a microscope?

A

A much more variable appearance - the most important characteristic is they type of cells present

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9
Q

Name some cells of chronic inflammation (6)

A
Macrophages
Lymphocytes
Plasma cells 
Eosinophils 
Fibroblasts
Giant cells
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10
Q

Macrophages are derived from __________ and are important in which types of inflammation?

A

Monocytes in the blood

Both acute and chronic

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11
Q

Name 4 functions of macrophages in chronic inflammation

A

Phagocytosis
Antigen presentation
Cytokine synthesis
Cytokine release to control other cells

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12
Q

Macrophages often present with what sort of nucleus under a microscope?

A

Bean shaped nucleus

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13
Q

What are the functions of B lymphocytes?

A

Differentiate into plasma cells to produce antibodies

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14
Q

What are the function of T lymphocytes?

A

Involved in control of the immune response and some cytotoxic function

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15
Q

T lymphocytes are produced in the _________ _________ and mature in the _________

A

Bone marrow

Thymus

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16
Q

How do lymphocytes appear under a microscope?

A

With a large blue nucleus and little cytoplasm

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17
Q

What are plasma cells? What does their presence in a blood film in chronic inflammation imply?

A

Differentiated antibody producing B lymphocytes

Implies considerable chronicity

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18
Q

How do plasma cells appear under a microscope?

A

With an open nucleus and visible pink cytoplasm

Can see abundant golgi (pale areas) due to synthesis of antibodies

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19
Q

Eosinophils are seen in… (3)

A

Allergic reactions, parasite infections and some tumours

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20
Q

How do eosinophils appear under the microscope?

A

With a pink cytoplasm and bilobe nucleus (sunburnt face with glasses)

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21
Q

Fibroblasts/Myofibroblasts are recruited by _____________ and secrete ___________

A

Macrophages

Collagen

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22
Q

What are giant cells? How are they formed?

A

Multinucleate cells made by the fusion of macrophages

As a result of frustrated phagocytosis

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23
Q

Name three types of giant cell

A

Langhans
Foreign Body Type
Touton

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24
Q

In which disease are Langhans giant cells commonly seen?

A

TB

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25
Q

In which disease are Touton giant cells commonly seen?

A

Fat necrosis

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26
Q

How do Langhans giant cells appear under a microscope?

A

As a horse shoe of nuclei around the periphery of foreign body

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27
Q

How do foreign body type giant cells appear under a microscope?

A

More disorganised/irregular compared to Langhans giant cells with foreign body seen in the centre

28
Q

How do Touton giant cells appear under a microscope?

A

As cells with a foamy cytoplasm that accumulates fat

29
Q

Cells found in most chronic inflammatory reactions are _____________ about the condition

A

Non-specific

30
Q

How can the cells seen in chronic inflammation indicate the condition that the patient has?

A

Proportions of each chronic inflammation cell type often vary in certain conditions

31
Q

Name a condition where mainly plasma cells are seen as a chronic inflammatory response?

Mainly lymphocytes?

Mainly macrophages?

A

Rheumatoid arthritis

Chronic gastritis

Leishmaniasis

32
Q

Leishmaniasis is caused by which type of microorganism?

A

Protozoa

33
Q

Name 4 effects of chronic inflammation

A

Fibrosis

Impaired function

Atrophy

Stimulation of immune response

34
Q

How does fibrosis vary in chronic inflammation?

A

Has different effects depending on where it occurs

35
Q

Give an example of a condition where there is impaired function as a result of chronic inflammation?

Increased function?

A

Chronic inflammatory bowel disease

Very rare - thyroid

36
Q

What is atrophy?

Give an example of tissues that can undergo atrophy as a result of chronic inflammation?

A

Reduction in tissue size

Gastric mucosa
Adrenal glands

37
Q

What causes chronic cholecystitis?

A

Repeated obstruction of gall bladder by gall stones. Repeated acute inflammation (damaged mucosa) leads to chronic inflammation.

38
Q

What is the effect of chronic cholecystitis on the gall bladder?

A

Results in a thickened fibrotic gall bladder wall

39
Q

What is the normal appearance of a healthy gall bladder?

A

Should be nearly translucent

40
Q

Inflammatory bowel disease is an inflammatory disease affecting…

A

Both the large and small bowel

41
Q

What sort of inflammation takes place in inflammatory bowel disease?

A

Repeated attacks of chronic and cute inflammation together

42
Q

Name two symptoms of inflammatory bowel disease

A

Diarrhoea

Rectal bleeding

43
Q

Inflammatory bowel disease is an umbrella term including which two conditions?

A

Ulcerative Colitis

Crohn’s disease

44
Q

Name the basic difference between ulcerative colitis and Crohn’s disease

A

Ulcerative colitis is superficial - inflammation affects the mucosa

Crohn’s is transmural - inflammation affects deeper layers such as submucosa

45
Q

Name two symptoms of UC and Crohn’s

Name two consequences of inflammatory bowel disease that are more associated with specifically Crohn’s

A

Diarrhoea
Rectal bleeding

Strictures
Fistulae

46
Q

What is a stricture?

What is a fistulae?

A

A narrowing of a structure

Abnormal connection between two epithelium lined organs

47
Q

Name 4 common causes of liver cirrhosis?

A

Alcohol
Fatty liver disease
HBV
HCV

48
Q

Cirrhosis happens at the end stage of…

A

Chronic liver disease

49
Q

What are the consequences of cirrhosis?

A

Lots of fibrosis and impaired liver function

50
Q

Graves’ disease results in _________ thyroid function as a result of ___________ inflammation.

What type of disease is Graves’?

What effect does the change in thyroid function have on the thyroid?

A

Increased

Chronic

Autoimmune

Too much thyroxin is produced

51
Q

How does chronic inflammation lead to atrophy?

A

Damages cells resulting in scarring, the inability to regenerate results in atrophy

52
Q

What is granulomatous inflammation?

A

Chronic inflammation with granulomas

53
Q

What are granulomas?

A

Groups of macrophages and lymphocytes that stick together

54
Q

Granulomas arise with… (2)

A

Persistent, low-grade antigenic stimulation

Hypersensitivity

55
Q

Name three causes of granulomatous inflammation

A

Mildly irritant foreign material
Infections
Unknown cause (idiopathic)

56
Q

Give two examples of infections where granulomatous inflammation is commonly seen

A

TB

Leprosy

57
Q

Give examples of two diseases where granulomatous inflammation may arise idiopathically with unknown cause

A

Sarcoidosis

Crohn’s disease

58
Q

Which microorganism causes tuberculosis?

A

Mycobacteria - commonly Mycobacterium tuberculosis

59
Q

Which type of necrosis is commonly seen in tuberculosis?

A

Caseous necrosis

60
Q

Are mycobacteria easily cultured?

A

No, difficult and slow to culture and see

61
Q

Why is it difficult for mycobacteria to be killed by phagocytosis?

A

Mycosides (wall lipids) protect against phagocytosis

62
Q

What are mycosides?

A

Wall lipids found in mycobacteria

63
Q

How does mycobacteria cause disease?

What toxins are produced by mycobacteria?

A

By persistence and induction of cell-mediated immunity

Doesn’t produce any toxins or lytic enzymes

64
Q

What is the most common site for tuberculosis?

A

In the lungs, pathogens inhaled

65
Q

Name 3 things you are likely to see under a microscope in tuberculosis

A

Langhans giant cells
Caseous necrosis
Granulomas