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ESA 2 - Pathological Processes > Session 3: Chronic Inflammation > Flashcards

Session 3: Chronic Inflammation Flashcards

1
Q

What is chronic inflammation?

A

Chronic response to injury with associated fibrosis

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2
Q

What does chronic inflammation result in?

A
  • Repair and scarring

- Some long-term consequences

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3
Q

When does chronic inflammation arise? (4)

A
  1. After or alongside acute inflammation
  2. Chronic persistent infections
  3. Autoimmune conditions
  4. Prolonged exposure to toxic agents
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4
Q

Which cells are mainly involved in chronic inflammation? (4)

A
  1. Macrophages
  2. Lymphocytes - B, T, plasma
  3. Eosinophils
  4. Fibroblasts/myofibroblasts
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5
Q

What do macrophages synthesise? (4)

A
  1. Cytokines
  2. Complement components
  3. Blood clotting factors
  4. Proteases
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6
Q

What is characteristic of lymphocytes histologically?

A

Large cytoplasm

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7
Q

What is characteristic of plasma cells histologically?

A
  • Pale area
  • Golgi visible
  • Open nucleus - lumps of chromatin around it
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8
Q

What is characteristic of eosinophils histologically?

A
  • stains bright pink

- bilobed nucleus

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9
Q

What are giant cells?

A

Fusion of frustrated macrophages because of frustrated phagocytosis - they fuse and become multi-nucleated

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10
Q

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

A
  1. Langhans
  2. Foreign body
  3. Touton
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11
Q

Which disease are Langhans giant cells most commonly associated with?

A

Tuberculosis

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12
Q

What is characteristic of foreign body type giant cells histologically?

A
  • Multiple irregular aggregates of nuclei in middle

- foreign material can be seen

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13
Q

When are Touton giant cells seen?

A

Fat necrosis

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14
Q

What is characteristic of Touton giant cells histologically?

A

Organised multiple nuclei in middle

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15
Q

What are the possible complications of chronic inflammation? (4)

A
  1. Tissue destruction
  2. Excessive fibrosis - scarring
  3. Impaired function
  4. Atrophy
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16
Q

What is chronic cholecystitis?

A

Inflammation of gall bladder

  • gall stones
  • thickened fibrotic walls
  • white scar tissue
17
Q

How does chronic cholecystitis arise?

A

Repeated attacks of acute inflammation

18
Q

What is Inflammatory Bowel Disease (IBD)?

A

Family of idiopathic diseases affecting small and large bowel

19
Q

How does IBD arise?

A

Repeated attacks of acute and chronic inflammation together

- underlying cause is chronic inflammation of bowel

20
Q

How do IBD patients present?

A

Diarrhoea, rectal bleeding, loss of weight etc

21
Q

What are the features of Ulcerative Colitis? (5)

A
  1. Often most severe in distal colon
  2. Superficial - inflammation only in mucosa and submucosae
  3. Crypt abscesses are common
  4. Significant risk of colon cancer
  5. Often colectomy indicated
22
Q

What are the features of Crohn’s Disease? (9)

A
  1. Transmural inflammation
  2. Affects any part of the GI tract
  3. Discontinuous distribution
  4. Bowel fistulae common
  5. Anal lesions common
  6. Bowel granulomas present
  7. ‘Cobblestone’ appearance to bowel mucosa
  8. Distorted crypt architecture common
  9. Diarrhoea
23
Q

What are the common causes of cirrhosis? (6)

A
  1. Alcohol
  2. Infection - Hepatitis (B or C)
  3. Immunological
  4. Fatty liver disease
  5. Drugs, toxins
  6. Obesity
24
Q

How does cirrhosis arise?

A
  • Chronic inflammation with fibrosis (attempted regeneration due to disorganisation of architecture)
25
Q

Name an inflammatory disease that leads to increased function of an organ/tissue.

A

Graves’ Disease - thyrotoxicosis

26
Q

What is Graves’ Disease?

A

Rare, autoimmune disease that attacks the thyroid and causes it to become overactive

27
Q

What is a granuloma?

A

Group of macrophages and lymphocytes sticking together

28
Q

When do granulomas arise? (2)

A
  1. Persistent, low grade antigenic stimulation

2. Hypersensitivity - immune reactions

29
Q

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

A
  1. Mildly irritant ‘foreign’ material

2. Infections (TB, leprosy, fungi)

30
Q

What causes Tuberculosis?

A

Mycobacterium tuberculosis

31
Q

How does M. tuberculosis cause disease?

A

Persistence and induction of cell-mediated immunity

33
Q

What is characteristic of tuberculous granuloma histologically? (2)

A
  1. Caseous necrosis (central) - looks like soft cheese

2. Langhans’ type giant cell

34
Q

Name 3 granulomatous diseases of unknown cause.

A
  1. Sarcoidosis
  2. Crohn’s Disease
  3. Wegener’s granulomatosis
35
Q

What is sarcoidosis?

A
  • Enlargement of lymph nodes in many parts of body

- more common in young adult women

36
Q

What is characteristic of sarcoidosis histologically?

A

Non-caseous granulomas, giant cells

37
Q

Why is it difficult to kill M. tuberculosis?

A

It doesn’t produce toxins or lytic enzymes and just survives

38
Q

What is characteristic of tuberculosis histologically? (3)

A

GRANULOMA

  1. Central caseous necrosis
  2. Langhans type giant cell
  3. Macrophages

ESA 2 - Pathological Processes (4 decks)

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