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Semester 2 - Mechanisms of Disease > Session 3 - Chronic inflammation > Flashcards

Session 3 - Chronic inflammation Flashcards

1
Q

What is the definition of chronic inflammation?

A

Definition: chronic response to injury with associated fibrosis; may overlap with host immunity

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2
Q

What are macrophages derived from?

A

monocytes

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3
Q

What is the role of lymphocytes?

A

Chronic inflammatory cells

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4
Q

What are the three functions of lymphocytes?

A

o Adaptive immune response

o B lymphocytes > antibodies

o T lymphocytes > control & cytotoxic functions

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5
Q

What are plasma cells derived from?

A

Terminally differentiated B lymphocytes

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6
Q

What do plasma cells imply?

A

Chronic inflammation

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7
Q

What do plasma cells do?

A

Synthesis and secrete antibodies

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8
Q

What do plasma cells look like?

A

o Clock face chromatin

o Pale around nucleus – lots of golgi

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9
Q

What reactions are Eosinophills involved in?

A
  • Allergic reactions, parasitic infections, some tumours
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10
Q

What do eosinophils look like?

A
  • Appearance: “sunburtn face with sunglasses”`
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11
Q

What are fibroblasts recruited by?

A

Macrophages

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12
Q

What pathology underlies scarring?

A

Fibrosis

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13
Q

How do giant cells appear?

A

Multinucleated and via the fusion of macrophages

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14
Q

What is are the roles of macrophages?

A
  • Phagocytosis of non-pyogenic debris and bacteria
  • Anti-gen presentation
  • Synthesis of cytokines, complement factors, blood clotting factors and proteases
  • Control of other cells via cytokine release
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15
Q

What do macrophages fuse together to form?

A

o Langhans – TB – horse shoe shaped
o Foreign body type – disorganized
o Touton – fat necrosis

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16
Q

When might chronic inflammation arise?

A
  • May take over from acute inflammation if damage too severe

- May occur De Novo

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17
Q

How does chronic inflammation occur de novo? (4)

A
  • Autoimmune disease e.g. rheumatoid arthritis
  • Chronic infections e.g. viral hepatitis
  • Chronic low level irritation e.g. suture (considered a foreign body)
  • May develop alongside acute inflammation e.g. if severe/repeated inflammation
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18
Q

Give five complications of chronic inflammation

A
  • Fibrosis (scarring) e.g. cirrhosis of the liver
  • Impaired function e.g. chronic inflammatory bowel disease > diarrhoea
  • Increased function (rare) e.g. thyrotoxicosis
  • Atropy e.g. autoimmune destruction of adrenal glands/ gastric mucosa
  • Stimulated immune responsep
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19
Q

What is chronic cholecystitis and how is it caused?

Give a treatment

A
  • Repeated obstruction, of cystic duct of gall bladder by gallstones > ischaemia
  • Repeated acute inflammation > chronic inflammation
  • Fibrosis of bladder wall
  • Treated with surgicalremoval
20
Q

What is gastric ulceration and how is it caused?

A
  • Acute gastritis (alcohol, drugs)
  • Helicobacter pylori > chronic gastric ulceration
  • Occurs due to imbalance between acid production and mucosal defence
  • Fibrosis of stomach mucosa
21
Q

Give two types of inflammatory bowel disease

A

Ulcerative colitis

Chron’s disease

22
Q

What is ulcerative colitis?

Give two treatments

A

o Superficial
o Diarrhoea > dehydration > malnutrition
o Bleeding
- Treat with immunosupression, surgical removal of the large bowel

23
Q

What is crohn’s disease?

Give three treatments

A

o Transmural
o Strictures
o Fistulae: connections between two eipthelia

  • Treat with lifestyle modifications, diet/hydration, immunosupression
24
Q

What is inflammatory bowel disease?

Give two symptoms

A
  • Infllammatory disease affecting the large and small bowel.
    Present with diarrhea, rectal bleeding and other symptoms
25
Q

What are common causes of cirrhosis?

A

Alcohol, infection (Hep B, HIV), immunological, fatty liver disease

26
Q

What is cirrhosis?

A

Chronic inflammation with fibrosis and impaired function

27
Q

What is fibrosis?

A
  • Fibrosis > disorganization of architecture and attempted regeneration
28
Q

What is thyrotoxicosis?

A
  • Grave’s disease

* Increased function

29
Q

What is a granuloma?

A

Granuloma: aggregate of macrophages which arise from persistent, low-grade antigenic stimulation and hypersensitivity.

30
Q

What are tuberculosis and leprosy?

A

Caused by mycobacterium

31
Q

What is not produced by myobacterium?

A

Toxins or lytic enzymes

32
Q

How do tuberculosis and leprosy cause disease?

A

o Cause disease by persistence and induction of cell-mediated immunity

33
Q

When are tuberculous granulomas present?

A

Caseous necrosis

34
Q

What is sarcoidosis?

A

o Abnormal collections of granulomas in organs

o Non-caseous granulomas in lungs, lymph nodes…

35
Q

Give four causes of granulomas

A
  • Sarcoidosis
  • Myobacterium (Tuberculosis and leprosy)
  • Syphilis
  • Foreign body reactions
36
Q

What is polymyositis?

A

Chronic inflammation of the muscles
Patient has dificulty swallowing and muscle pain. Muscle weakness also present.

Main treatment is corticosteroids

37
Q

What is a treatment for helicobacter pylori?

A

PPI inhibitor

Antibiotics

38
Q

What is a treatment for liver cirrhosis?

A

Lifestyle changes to prevent further damage and a transplantation of a new liver if necessary

39
Q

What is rheumatoid arthritis?

A

Autoimmune disease
Localised and systemic immune response
Localised chronic inflammation leads to joint destruction
Systemic immune response

40
Q

When do chronic inflammation and immune responses overlap?

A
  • Immune diseases cause pathology by chronic inflammation

- Chronic inflammatory processes can stimulate immune response

41
Q

What are the outcomes of tuberculosis?

A 
Arrest, fibrosis, scarring
Erosion into bronchus
Tuberculous empyema (collection of pus)
Erosion into bloodstream
42
Q

What is polymyositis?
What are its symptoms? (3)
What is the main treatment?

A

Chronic inflammation of the muscles
Patient has dificulty swallowing and muscle pain. Muscle weakness also present.

Main treatment is corticosteroids

43
Q

What is a treatment for helicobacter pylori? (2)

A

PPI inhibitor

Antibiotics

44
Q

What is a treatment for liver cirrhosis?

A

Lifestyle changes to prevent further damage and a transplantation of a new liver if necessary

45
Q

What is rheumatoid arthritis?

A

Autoimmune disease
Localised and systemic immune response
Localised chronic inflammation leads to joint destruction

46
Q

When do chronic inflammation and immune responses overlap?

A
  • Immune diseases cause pathology by chronic inflammation

- Chronic inflammatory processes can stimulate immune response

47
Q

What are the outcomes of tuberculosis?

A 
Arrest, fibrosis, scarring
Erosion into bronchus
Tuberculous empyema (collection of pus)
Erosion into bloodstream

Semester 2 - Mechanisms of Disease (16 decks)

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