Session 3-Chronic Inflammation

Question 1

Define chronic inflammation

Answer 1

Chronic response to injury with associated fibrosis

Question 2

How does chronic inflammation arise? (3)

Answer 2

1) may ‘take over’ from acute inflammation
2) may arise de novo
3) may develop alongside acute inflammation

Question 3

What does chronic inflammation look like?

Answer 3

Depends on which type of cells are present

Question 4

Which cells are associated with chronic inflammation? (5)

Answer 4

1) macrophages
2) lymphocytes
3) plasma cells
4) eosinophils
5) fibroblasts/myofibroblasts

Question 5

True or false: macrophages in bone marrow are called monocytes

Answer 5

TRUE

Question 6

What are the functions of macrophages? (4)

Answer 6

1) phagocytosis
2) presentation of antigen to immune system
3) synthesis of cytokines, complement proteins, blood clotting factors and proteases
4) control of other cells by cytokine release

Question 7

What are lymphocytes sometimes called?

Answer 7

Chronic inflammatory cells

Question 8

What are the functions of lymphocytes? (2)

Answer 8

1) B lymphocytes-differentiate to produce antibodies

2) T lymphocytes-control and cytotoxic functions

Question 9

What do plasma cells do in the chronic inflammatory response?

Answer 9

They are differentiated antibody-producing B lymphocytes

Question 10

What are eosinophils associated with?

Answer 10

Allergic reactions
Parasite infestations
Tumours

Question 11

Which cells recruit fibroblasts/myofibroblasts?

Answer 11

Macrophages

Question 12

What is the likely cause of infection if the following cells are present in abundance:

1) neutrophils
2) lymphocytes
3) eosinophils

Answer 12

1) bacterial
2) viral
3) parasitic

Question 13

What are ‘giant’ cells?

Answer 13

Multinucleate cells made by fusion of macrophages when phagocytosis cannot occur

Question 14

What are the different types of giant cells? (3)

Answer 14

1) Langhans
2) foreign body type
3) Touton

Question 15

Which giant cell is commonly present in tuberculosis?

Answer 15

Langhans

Question 16

What are the characteristics of foreign body type giant cells?

Answer 16

Multiple, irregular aggregates of nuclei with foreign material within the cell

Question 17

In which type of necrosis can Touton giant cells be seen?

Answer 17

Fat necrosis

Question 18

Which cell type is mainly present in rheumatoid arthritis?

Answer 18

Plasma cells

Question 19

Which type of cell is mainly seen in chronic gastritis?

Answer 19

Lymphocytes

Question 20

Which type of cell is mainly seen Leishmaniasis (protozoal infection)?

Answer 20

Macrophages

Question 21

What are the effects of chronic inflammation? (4)

Answer 21

1) fibrosis
2) impaired function
3) atrophy
4) stimulation of immune response

Question 22

What is chronic cholecystitis? (3)

Answer 22

1) Repeated obstruction by gall stones
2) Repeated acute inflammation leads to chronic inflammation
3) Fibrosis of gall bladder wall

Question 23

What are the symptoms of chronic cholecystitis?

Answer 23

Pain

Occasionally jaundice

Question 24

Which disease leads to impaired function as a consequence of chronic inflammation?

Answer 24

Inflammatory bowel disease

Question 25

True or false: inflammatory bowel disease occurs due to repeated attacks of acute and chronic inflammation

Answer 25

TRUE

Question 26

What is inflammatory bowel disease?

Answer 26

Idiopathic inflammatory disease affecting large and small bowel

Question 27

What are the symptoms of inflammatory bowel disease?

Answer 27

Diarrhoea Rectal bleeding (mucosal damage leads to ulcers -> bleeding) Weight loss

Question 28

What are two types of inflammatory bowel disease?

Answer 28

1) Ulcerative colitis | 2) Crohn's disease

Question 29

Complete the sentence: Ulcerative colitis is superficial, meaning it affects ________ and not deeper tissue.

Answer 29

Mucosa

Question 30

Complete the sentence: Crohn's disease affects mucosa, submucosa, muscularis _______ and adventitia and this is makes the disease ____________.

Answer 30

Propria | Transmural

Question 31

What are the symptoms of ulcerative colitis?

Answer 31

Diarrhoea | Bleeding

Question 32

What are the characteristics of Crohn's disease? (2)

Answer 32

1) Strictures (narrowing) | 2) fistulae

Question 33

What are fistulae?

Answer 33

Abnormal connections between two epithelium-lined organs

Question 34

Which condition leads to fibrosis and impaired function?

Answer 34

Cirrhosis

Question 35

What are the common causes of cirrhosis? (5)

Answer 35

1) alcohol 2) infection 3) immunological 4) fatty liver disease 5) drugs and toxins

Question 36

In which condition does chronic inflammation enhance function?

Answer 36

Thyrotoxicosis - Graves' disease

Question 37

In which condition does chronic inflammation lead to atrophy?

Answer 37

Atropic gastritis (pernicious anaemia)

Question 38

True or false: immune diseases cause pathology by chronic inflammation

Answer 38

TRUE

Question 39

What is granulomatous inflammation?

Answer 39

Chronic inflammation with granulomas

Question 40

What is a granuloma?

Answer 40

Group of macrophages and lymphocytes which stick together

Question 41

What are histiocytes?

Answer 41

Macrophages

Question 42

What do granulomas arise with?

Answer 42

Persistent, low-grade antigenic stimulation | Hypersensitivity

Question 43

What are the main causes of granulomatous inflammation? (2)

Answer 43

1) mildly irritant foreign material | 2) infections (TB, leprosy)

Question 44

How does mycobacteria cause disease?

Answer 44

By persistence and induction of cell-mediated immunity

Question 45

Which type of necrosis is seen in tuberculosis?

Answer 45

Caseous necrosis

Question 46

True or false: BCG is used as immunisation against tuberculosis

Answer 46

TRUE

Question 47

Which granulomatous diseases have unknown causes? (3)

Answer 47

1) sarcoidosis 2) Crohn's disease 3) Wegener's granulomatosis

Question 48

Where do sarcoid granulomas occur?

Answer 48

Lymph node