*UNFINISHED* MOD Session 3 Flashcards
What is meant by ‘chronic’ inflammation?
Chronic response to injury with associated fibrosis
How can chronic inflammation arise?
1) May ‘take over’ from acute inflammation (if damage is too severe to be resolved in a few days)
2) De novo e.g. RA, chronic infec HCV, ‘‘chronic low level irritation
3) Develop alongside acute inflammation e.g. in severe persistent or repeated irritation (chronic cholecystitis)
What cell types is associated with chronic inflammation?
Macrophages, Lymphocytes, Plasma cells, Eosinophils, Fibroblasts/Myofibroblasts
Give 4 functions of macrophages in C.I?
Phagocytosis
Processing and presentation of antigen (APC)
Synthesis of cytokines, complement, blood clotting factors and proteases
Control of other cells by cytokine release
If plasma cells are present with C.I, what would this indicate?
Implies considerable chronicity
What are eosinophils described as histologically and where are they seen?
1) Sun burnt with shades
2) Allergic reactions, parasitic infections, some tumours
What are giant cells?
Multinucleate cells made by fusion of macrophages (during frustrated phagocytosis)
What types of giant cells are there?
1) Langhans (TB)
2) Foreign body type
3) Touton (fat necrosis)
What are the effects of C.I? Give examples of each
1) Fibrosis e.g. chronic cholecystitis, chronic peptic ulcers, cirrhosis
2) Impaired function e.g. chronic inflammatory bowel disease (rare to be increased e.g. thyrotoxicosis)
3) Atrophy e.g. gastric mucosa, adrenal glands
4) Stimulation of the I.S e.g. macrophage-lymphocyte interactions
Give three features of chronic cholecystitis that lead to C.I?
1) Repeated obstruction by gall stones
2) Repeated A.I. leads to C.I.
3) Fibrosis of gall bladder wall
Why does ulceration occur? Give examples of acute and chronic gastritis.
1) Imbalance of acid production and mucosal defence
2) Acute - alchohol, drugs e.g. NSAIDs
Chronic - H.Pylori
What symptoms do patients with IBD present with?
Diarrhoea, rectal bleeding, possible abdominal pain, malabsorption.
Describe the inflammation seen in RA?
1) Localised and systemic immune response
2) Local chronic inflammation leading to joint destruction
3) Systemic immune response - affect other organs and cause amyloidosis
What is granulomatous inflammation?
Chronic inflammation with granulomas
What is a granuloma?
Aggregate of activated macrophages. Modified, immobile macrophages
What are the two types of granulomas and what do they contain? When do they arise?
1) Foreign body granulomas : contain macrophages, FBGCs that develop around material that is not antigenic e.g. surgical thread
2) Hypersensitivity granulomas: contain macrophages, Langhans GCs, undergo central necrosis developing around insoluble antigenic particles e.g. organisms causing syphillis, TB, leprosy. Seen in sarcoidosis
What are the main causes of granulomatous inflammation?
1) Mildly irritant foreign material
2) Infections (Mycobacterium TB, Leporosy)
3) Unknown e.g. sarcoid, Wegener’s granulomatosis (granulomatous vasculitis), Crohn’s disease
What are the possible outcomes from a TB infection?
1) Arrest, fibrosis, scarring
2) Erosion into bronchus»_space;> bronchopneumonia, TB in GIT
3) Tuberculous empyema
4) Erosion into the bloodstream
What type of giant cell and necrosis is seen in TB? How does it differ from sarcoidosis?
1) Langhans with caseous necrosis
2) Sarcoidosis has non-caseating granumoas
Which of the four cardinal signs of acute inflammation persists in chronic inflammation?
Swelling and pain
