Introduction to inflammation Flashcards

1
Q

List the signs and symptoms of inflammation

A
  • Heat
  • Swelling
  • Pain
  • Erythema
  • Loss of function
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2
Q

What is the definition of inflammation?

What is its purpose?

What part of the immune system is it part of?

A

The body’s immediate defensive response to an insult or injury.

Designed to:

  • Rid the body of the initial cause of injury
  • Break down cells damaged by injury

Part of innate immunity

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3
Q

What are the beneficial effects of inflammation?

A
  • Allows delivery of immune cells and proteins to site of insult/injury
  • Dilution of toxins
  • Eliminate substance and repair of tissue OR stimulate further immune response
  • Entry of drugs (increased blood supply to area)
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4
Q

What are the causes of inflammation?

A
  • Infection
  • Physical trauma
  • Chemicals
  • Dead cells
  • Foreign bodies
  • Allergens
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5
Q

Define acute inflammation

A

The body’s immediate defensive reaction of a tissue to injury, in which vascular and exudative processes predominate.

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6
Q

What are the macroscopic features of acute inflammation?

A

Heat

Swelling

Loss of function

Pain

Erythema

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7
Q

What are the microscopic features of acute inflammation?

A
  • Vascular changes:
    • Vasodilation
    • Increased permeability of blood vessels
      • Leads to erythema, warmth and oedema which leads to pain and loss of function.
  • Exudative changes:
    • Fluid and protein leakage
    • Emigration of leukocytes
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8
Q

Which leukocyte predominates usually in acute infection?

A

Neutrophils

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9
Q

What is the role of leukocytes?

A

Phagocytosis (of any substance identified as non-self)

  • Identifies substance
  • Engulfs it into a phagosome
  • Phagosome joints with a lysosome which contains lytic enzymes that break down the substance
  • Remaining debris releasd from the cell through exocytosis
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10
Q

What are the possible outcomes of acute inflammation?

A
  • Resolution
  • Chronic inflammation:
    • → resolution OR
    • → scarring
  • Injury of nearby healthy tissues
    • Lytic enzymes are not specific to insulting substances
    • Accumulation of pus
    • Autoimmunity (can be triggered from a response to a pathogen)
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11
Q

Define chronic inflammation

A

Prolonged and persistent inflammation which may be a continuation of acute inflammation or the result of an insidious insult, characterised by scar tissue formation

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12
Q

What are the causes of chronic inflammation?

Give examples for each

A

Persisting (unresolved) acute infection:

  • Immunodeficiency/suppression, e.g. AIDS
  • Persistant infection, e.g. TB

Autoimmunity, e.g. crohn’s disease

Persisting trauma, e.g. pressure sores

Persisting foreign bodies, e.g. asbestos

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13
Q

Describe the macroscopic features of chronic inflammation

A

Combination of injury, repair and inflammation that co-exist

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14
Q

Describe the microscopic features of chronic inflammation

A

New leukocytes:

  • Lymphocytes: T-lymphocytes (TH and TC) and B cells
  • Macrophages
  • Eosinophils and basophils
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15
Q

What are the roles of TH and TC lymphocytes?

Where do they originate from?

A

Develop in the thymus

TH: secrete cytokines which direct other immune cells to the affected area.

TC: destroy the infecting organism by stimulating cell death.

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16
Q

What are the roles of B-cells?

Where do they originate from?

A

Originate from bone

Secrete antibodies that bind to micro-organism, identifying it for destruction by other immune cells

17
Q

Define leukocytosis

What can be seen on the blood results of someone with:

Acute infection

Chronic/viral infection

Parasitic infection

Allergic reaction

A

Leukocytosis = high WCC

  • Acute infection = high neutrophil count
  • Chronic/viral infection = high lymphocyte count
  • Parasitic infection = high eosinophil count
  • Allergic reaction = high basophil count
18
Q

What other mediators are involved in inflammation aside from neutrophils, lymphocytes, eosinophils and basophils?

A

Interleukins

Monocytes/macrophages

Acute phase proteins (CRP, ESR)

Complement

19
Q

Describe a granulomatous pattern of inflammation?

When can this be seen?

A

Granuloma = collection of macrophages

Can be seen in:

  • TB
  • Foreign material
  • Fungi
  • Sarcoidosis
20
Q

What is an ulcer? Describe what can be seen in a chronic ulcer

What is an example of an acute ulcer?

A

Ulcers= break in epithelial lined surface

Acute ulcers: e.g. apthous

Chronic ulcers:

  • Acute inflammatory exudate
  • Vascular granulation tissue
  • Fibrovascular granulation tissue
  • Fibrous scar
21
Q

Describe a serous and fibrinous pattern of inflammation

Give examples of each

A

Accummulation of fluid caused by vasodilation and increased vascular permeability allowing fluid to leak into spaces created by injury or body cavities.

Acute: serous, e.g. blister

Chronic: fibrinous, e.g. pericardial effusion

22
Q

What is suppuration?

A

Pus

From persistent organism or foreign body, e.g. abscess, empyema

23
Q

What are the possible outcomes of chronic inflammation?

A
  • Resolution if damaging stimulus removed
  • Change in function of the affected organ/tissue:
    • Atrophy
    • Metaplasia
  • Scarring and dysfunction, e.g. cirrhosis (viral hepatitis)
24
Q

What is Crohn’s disease?

A

Inflammatory bowel disease that can affect anywhere in the GI tract from the mouth to the anus. Characterised by inflammation.

25
Q

What are the macroscopic features of Crohn’s disease?

A

Thickenings and narrowings of bowel- cobblestone appearance

Fistulae

Abscesses

26
Q

What are the microscopic features of Crohn’s disease?

A

Transmural inflammaiton

Patchy, skip lesions

Granulomas

Chronic inflammatory cells predominate

27
Q

What is ulcerative colitis?

A

Inflammatory bowel disease affecting the colon only.

28
Q

What are the macroscopic features of ulcerative colitis?

A

Red, inflamed mucosa that bleeds easily

Ulceration

Polyps

29
Q

What are the microscopic features of ulcerative colitis?

A

Abscesses

Infiltration of chronic inflammatory cells