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Flashcards in Chronic Inflammation Deck (61)
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1

What is chronic inflammation

Inflammation in which the cell population is especially: lymphocytes, plasma cells and macrophages
Tends to be long term

2

What does chronic inflammation tend to feature

Tissue or organ damage
Necrosis
Loss of function
Healing and repair (with granulation tissue, scarring and fibrosis)

3

What could chronic inflammation be due to

Following from ongoing acute inflammation
Arising as primary pathology

4

What are the clinical presentation of chronic inflammation

Often no specific area which is sore
Malaise (e.g. TB which can affect lung, lymph node, bone, kidney, skin causing a systemic effect)
Weight loss
Loss of function (e.g. autoimmune thyroiditis, a functional gland destruction, Crohn’s disease, a GI tract ulceration and fibrosis causing pain, diarrhoea and gut obstruction and Leprosy which is cutaneous nerve destruction causing loss of sensation)

5

How does acute inflammation lead to chronic inflammation

It follows on from where there is a large volume of damage and an inability to remove debris. When this fails to resolve the ongoing acute is insult

6

When chronic inflammation arises as a primary lesion what is seen

No preceding acute phase
Only chronic changes will be seen

7

What is organisation

An outcome of acute inflammation where granulation tissue is a characteristic which results in healing and repair and can lead to fibrosis and formation of a scar

8

What is the function of granulation tissue

Patches tissue defects
Replaces dead or necrotic tissue
Contracts and pulls together

9

What is the mechanism of action of granulation tissue

Capillaries grow into inflammatory mass
Plasma proteins access
Macrophages from blood and tissue
Fibroblasts lay down collagen to repair damaged tissue
Collagen replaces inflammatory exudate

10

What are the products of granulation tissue

Fibrous tissue - scar (small firm blemish on skin)
Fibrosis as a problem - adhesions between loops of bowel following peritonitis
Can progress to chronic inflammation

11

What cells are involved in primary chronic inflammation

Lymphocytes
Plasma cells
Macrophages
Fibrosis

12

What is primary chronic inflammation

An autoimmune disease where autoantibodies are directed against own cell and tissue components through autoantigens
It causes damage or destroy organs, tissues, cells and cell components and can result in thyroiditis, rheumatoid disease, pernicious anaemia (chief/parietal cells) and systemic lupus erythematosis (nuclear antigen)

13

What type of inflammation is common

Granulomatous

14

What could primary chronic inflammation be due to

Material resistant to digestion (e.g. mycobacteria, Brucella, viruses)
Cell wall resistant to enzymes
Exogenous substances (e.g. sutures, metal and plastic like joint replacements, mineral crystals, glass) which do not provoke an immune response
Endogenous substances (e.g. necrotic tissue, keratin, hair) which cannot be easily phagocytosed

15

What tissue components are involved in primary chronic inflammation

Granulation tissue
Collagen

16

What are lymphocytes

Cells which are part of the immune system
Small and round with lots of subtypes and functions

17

What are the main types of lymphocytes

T cells
B cells

18

What is the main function of lymphocytes

Immune response
Immune memory

19

What are plasma cells

Differentiated B cells that assist in antibody production and are intermediate in size

20

What mechanisms can B cells undertake

Differentiate into plasma cells to produce antibodies
Facilitate an immune response
Act with macrophages for the antigen presenting capacity
Have immune memory

21

What do T cells do

Produce cytokines
Produce interferons
Damage and kill (lyse) other cells
Destroy antigens

22

What do cytokines do

Attract and hold macrophages
Activate macrophages
Other cells (e.g. lymphocytes)
Affect permeability

23

What do interferons do

Antiviral effects
Attract and stimulate other cells

24

What do NK-cells do

Destroy antigens and cells using chemical mechanisms involving granule proteins

25

State the features of macrophages

Remove debris
Have a role in the immune system (APC)
Found in the bone marrow and blood tissues
Contain enzymes (e.g. lysozymes)

26

What can macrophages be

Monocyte
Histiocyte
Activated macrophage
Epithelioid cell
Giant cells

27

What mechanisms are macrophages involved in

The motile phagocyte move from blood and live long
Can take over from neutrophils
Produce interferons and other chemicals to destroy or influence processes

28

What are fibroblasts

Motile cells which are metabolically active and can make and assemble structural proteins (e.g. collagens various types)

29

What is granulomatous inflammation characterised by

The presence of granulomas (granulomata) in tissues and organs

30

What stimulates granulomatous inflammation

Indigestible antigen (body cannot get rid of it) which causes many serious infectious and idiopathic (= no known cause) diseases