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Principles of Disease > Chronic Inflammation 2 > Flashcards

Chronic Inflammation 2 Flashcards

1
Q

What is granulomatous inflammation always characterised by?

A

Granulomas (granulomata) in tissues and organs

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2
Q

How is Granulomatous inflammation stimulated?

A

Stimulated by indigestible antigen, body cannot get rid of it

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3
Q

What are idiopathic diseases?

A

Diseases which we don’t know why they happened.

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4
Q

How are granulomas formed?

A

aggregates of epithelioid macrophages in tissue

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5
Q

What is epitheliod?

A

Looks like epithelial

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6
Q

What might granulomas surround?

A

Giant cells, dead material

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7
Q

What might granulomas be surrounded by?

A

lymphocytes

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8
Q

What do granulomas contain?

A

neutrophils, eosinophils

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9
Q

Granulomas are formed as a result of?

A

response to indigestible antigen

Many are type 4 hypersensitivity reactions

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10
Q

What do giant cells consist of?

A

A giant cell is a mass formed by the union of several distinct cells (usually macrophages)

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11
Q

Describe the structure of a giant cell?

A

large cytoplasm; multiple nuclei

- several types

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12
Q

Are there always granuloma for giant cells to be present?

A

no

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13
Q

Name a type of giant cell

A

Langhans type

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14
Q

What is a Langhans type giant cell classically found in?

A

TB

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15
Q

Describe the structure of Langhans type

A

peripheral rim of nuclei

large eosinophilic cytoplasm

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16
Q

What is the giant cell often associated with pyogenic granulation tissue

A

Foreign body type

acutely inflamed
neutrophils, pus
organisation
giant cells

17
Q

What type of giant cell might you see with a ruptured silicone implant? e.g breast implant

A

Silicone associated giant cells

Vacuoles contain leaked silicone

18
Q

Name some Infectious granulomatous diseases

A

Tuberculosis (Mycobacterium tuberculosis),

Leprosy Mycobacterium leprae

syphilis

19
Q

Describe Caseous necrosis

A

Cell death in which the tissue maintains a cheese-like appearance. Dead tissue appears as a soft and white proteinaceous dead cell mass.

Dead tissue surrounded by macrophages, giant cells, lymphocytes

No neutrophils?

Feature of TB?

20
Q

Give examples of Non-infective granulomas

A

rheumatoid disease - tissue specific auto-immune disease

sarcoidosis

Crohn’s disease – chronic inflammatory bowel disease

21
Q

What is Sarcoidosis?

A

Development of granulomas within organs of the body

22
Q

What are the common processes in chronic inflammation?

A

Acute inflammation
Granulation tissue formation
Local angiogenesis - new vessels grow
Fibrosis and scar formation

23
Q

What is surgical wound healing?

A

Healing by primary intention

24
Q

What are the goals of surgical wound healing?

A

Minimal gap, small amount of granulation tissue, small linear scar

25
Q

What is healing of larger defects?

A

Healing by secondary intention

26
Q

Describe the granulation tissue ingrowth in larger defects

A

Lots of it

Contraction and scarring

27
Q

What is the sequence of events in wound healing?

A
  • injury, blood clot, acute inflammation, fibrin
  • many growth factors and cytokines involved
  • granulation tissue growth - angiogenesis
  • phagocytosis of fibrin
  • myofibroblasts move in and lay down collagen
  • contraction of scar
  • re-epithelialisation
28
Q

What conditions favour wound healing?

A

Cleanliness

Apposition of edges (no haematoma)

Sound nutrition

Metabolic stability and normality

Normal inflammatory and coagulation mechanisms

Note local mediators

29
Q

What conditions result in impaired wound healing?

A

Dirty, gaping wound, large haematoma

Poorly nourished, lack of vitamins C, A

Abnormal CHO metabolism, diabetes, corticosteroid therapy

Inhibition of angiogenesis

30
Q

What is the sequence of events in fracture healing?

A

Trauma, fracture, haematoma

Bits of dead bone and soft tissue

Acute inflammation, organisation, granulation tissue, macrophages remove debris

Granulation tissue contains osteoblasts as well as fibroblasts

31
Q

What are the stages of callus formation?

A

Osteoblasts lay down woven bone

Nodules of cartilage present

Followed by bone remodelling:
osteoclasts remove dead bone
progressive replacement of woven bone by lamellar bone
reformation of cortical and trabecular bone

32
Q

What stimulates proliferation of vessels?

A

Vascular endothelial growth factor, released by hypoxic cells, stimulates proliferation

33
Q

What aids the process of angiogenesis?

A

Enzyme secretion

34
Q

What is the benefit of angiogenesis?

A

Allows blood supply to enter damaged tissue

35
Q

What is the effect of angiogenesis on thrombus

A

Grows vessels through the thrombus, limits its propagation

36
Q

What is the effect of angiogenesis in malignant tumours

A

angiogenesis occurs as tumour grows,

potential for therapeutic control

Principles of Disease (48 decks)

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