PP: Chronic Inflammation

Question 1

What is the role of macrophages in chronic inflammation?

Answer 1

• Phagocytosis
• Presentation of antigens to immune system
• Synthesis of proteins (such as cytokines, complement proteins, blood clotting factors)
• Control of other cells (by cytokine release)

Question 2

What is the role of lymphocytes in chronic inflammation?

Answer 2

• B: produce antibodies

- T: cytokine functions

Question 3

What is the role of eosinophils in chronic inflammation?

Answer 3

Present in response to parasitic infections and some tumours

Question 4

What is the role of fibroblasts/myocytes in chronic inflammation?

Answer 4

To synthesis collagen

Question 5

What is a giant cell?

Answer 5

Multinucleate cells made by fusion of macrophages.

Question 6

Why are giant cells formed?

Answer 6

When macrophages undergo frustrated phagocytosis.

Question 7

What giant cell is typically seen in TB?

Answer 7

Langhans

Question 8

Why might foreign body giant cells be seen?

Answer 8

There is foreign material present in the tissue.

Question 9

When might touton giant cells be present?

Answer 9

In lesions with high lipid content.

Question 10

Name 4 possible complications of chronic inflammation.

Answer 10

• Tissue destruction
• Excessive fibrosis (and scarring)
• Impaired function
• Atrophy

Question 11

Describe chronic cholecystitis.

Answer 11

Repeated obstruction by gall stones results in repeated acute inflammation which eventually leads to chronic inflammation. This eventually leads to scaring and fibrosis of the gall bladder wall.

Question 12

What is the biological difference between ulcerative colitis and Crohn’s disease?

Answer 12

Ulcerative colitis is superficial (affecting only the mucosa not the deeper tissues), whereas crohns is transmural.

Question 13

What is the difference in symptoms between ulcerative colitis and Crohn’s disease?

Answer 13

UC: diarrhoea, bleeding
CD: Strictures (fibrous narrowing), fistulae (abnormal connection between 2 epithelium-lined organs)

Question 14

Name some common causes of cirrhosis of the liver.

Answer 14

1. Alcohol
2. HBV, HCV
3. Fatty liver disease
4. Drugs and toxins

Question 15

Name a disease that results in an increase in function due to chronic inflammation.

Answer 15

Thyrotoxicosis: Graves’ disease

Question 16

What is a granuloma?

Answer 16

A group of macrophages and lymphocytes stick together.

Question 17

When does granulomatous infection occur?

Answer 17

• Irritant foreign material
• Infections (e.g.mycobacteria like TB and leprosy)
• unknown causes

Question 18

Name 3 unknown causes of granulomatous inflammation.

Answer 18

• Sarcoid
• Wegener’s granulomatosis
• Crohn’s disease

Question 19

Define chronic inflammation.

Answer 19

Chronic Rep once to injury with associated fibrosis.

Question 20

How might chronic inflammation arise?

Answer 20

1. Take over from acute
2. Arise de novo (from the beginning)
3. Alongside acute inflammation

Question 21

What is seen under a microscope within a granuloma of TB?

Answer 21

A caseous centre surrounded by giant cells (langhans type), epithiloid histiocytes and lymphocytes.

Question 22

What does sarcoidosis granulomas in a lymph node look like under a microscope?

Answer 22

Many closely packed granulomas.