Lecture title - Chronic inflammation
63 important questions on Lecture title - Chronic inflammation
What are the possible durations of chronic inflammation?
What are the cells involved in chronic inflammation?
(facilitates active inflammation)
What are the main characterising steps of chronic inflammation?
2) attempts at healing by connective tissue
3) tissue destruction
All occurs simultaneously.
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What is the main event that occurs during chronic inflammation to heal with connective tissue?
What induces tissue destruction (chronic inflammation)?
What are the possible causes of chronic inflammation?
List the causes of primary chronic inflammation with examples
2. Endogenous (from within the body) materials - necrotic adipose tissue, bone, uric acid crystals
3. Exogenous (from outside the body) materials - silica, asbestos fibres, suture materials, implanted prostheses
4. Some autoimmune (against something within the body) diseases - organ specific, nonorgan-specific like rheumatoid arthritis, contact hypersensitivity reactions
5. Specific diseases of unknown aetiology - chronic inflammatory bowel disease
6. Primary granulomatous diseases - crohn's disease, sarcoidosis
What is the main cell of chronic inflammation?
What are macrophages derived from?
What is exudate of chronic inflammation like?
Compare classical (M1) and alternative (M2) macrophages
1. Induced by microbial products and interferon (IFN)
2. Produces nitric oxide, reactive oxygen species, enzymes, and cytokines
3. + inflammation = phagocytosis, inflammation
Alternative M2
1. Induced by cytokines
2. Produces growth factors
3. - inflammation = ends inflammation, promotes tissue repair
List the secreted products for chronic inflammation
What is the overall purpose of the products secreted for chronic inflammation?
What is the purpose of oxygen metabolites for chronic inflammation(secreted products)?
What is the purpose of proteases for chronic inflammation (secreted products)?
What is the purpose of cytokines and chemotactic agents for chronic inflammation (secreted products)?
What is the purpose of growth factors for chronic inflammation (secreted products)?
Explain the interaction between macrophages and lymphocytes
What is granulomatous inflammation?
What are the major causes of granulomatous inflammation?
1. Specific infections - mycobacteria and parasites (including larvae, eggs, and worms)
2. Foreign bodies - either endogenous (cholesterol crystals) or exogenous (talc, sutures, and silica).
3. Unknown - Crohn’s disease and sarcoidosis.
What cells make up a typical granuloma?
2. Giant cells
3. Mantle of lymphocytes
What are epithelioid histiocytes?
What is a giant cell?
Explain the possible scenarios of giant cell formation
1. 2 or more macrophages attempt to engulf a particle
2. Cell membranes of those macrophages fuse = multinucleated giant cell
OR
Due to indigestible particulate matter like silica and tubercule bacilli
Identify which giant cell this is ![]()
- horseshoe shaped
- characteristically seen in tuberculosis
What are the histological features of a chronic peptic ulcer?
Sl: necrotic slough (dead tissue)
V: vascular granulation tissue (more vessels and RBCs)
F: fibrous granulation tissue (more collagen and less vessels)
Sc: fibrous scar
M: Muscular wall
What does systemic effects of inflammation mean?
What are the common systemic effects of inflammation?
Elevated acute-phase proteins
Leukocytosis (increased WBC production)
Constitutional symptoms (group of non-specific symptoms that point to an illness) like malaise, somnolence
How does inflammation cause fever (pyrexia)?
What can inhibit the production of prostaglandins?
Identify which giant cell this is ![]()
![]()
- nuclei scattered throughout cytoplasm
- formed due to foreign-body material
Identify which giant cell this is ![]()
Touton Giant cell
- Central ring of nuclei around lipid cytoplasm
- Seen at sites of adipose breakdown
What is the difference in the causes of foreign body granuloma and immune granuloma?
Immune granuloma - caused by insoluble particles
Explain the mechanistic differences in foreign body granuloma and immune granuloma
Immune granuloma - insoluble particles induce cell mediated immune response, involving engulfing of the particle by macrophages and introduction of antigens to T-cells for activation of T-cells to release cytokines
Why is tuberculosis considered the prototype of granulomatous disease?
2. Shows chronic inflammation with an immune-mediated response.
What histologic feature is characteristic of tuberculosis granulomas and uncommon in other granulomatous diseases?
Why does Mycobacterium tuberculosis provoke a chronic granulomatous response?
List the identifying characteristics of this image representing tuberculosis ![]()
1. Central caseous necrosis
2. Activated macrophages
3. Giant cell (horse-shoe shaped)
4. Lymphocytes (small blue stainings)
5. Fibroblasts (elongated, spindle-shaped cells)
What is serous inflammation?
How does serous inflammation produce skin blisters?
What histologic feature is seen in skin affected by serous inflammation?
What type of injury leads to fibrinous inflammation?
What is exuded in fibrinous inflammation?
What happens to fibrinogen in fibrinous inflammation?
Where in the body is fibrinous inflammation commonly seen?
What gross feature is seen in fibrinous inflammation of the pericardium (fibrinous pericarditis)?
2. Strands of stringy pale fibrin in pericardial cavity
3. Deposits of fibrin on pericardium
What histologic feature identifies fibrinous pericarditis?
What is suppurative/purulent inflammation?
What are the contents of the pus produced in suppurative/purulent inflammation?
What are the histological features of purulent inflammation?
2. Abscess filled with neutrophils and cellular debris (from liquefied tissue) - dense blue-purple mass
What is a gross feature of a lung with purulent inflammation (bronchopneumonia)?
Where are ulcers commonly encountered?
Skin and subcutaneous tissue of older people with circulatory disturbances
How does a peptic ulcer form?
What are the three possible outcomes of a peptic ulcer?
![]()
What happens during healing of a peptic ulcer?
2. Defect fills with fibrous scar
3. Surface is re-covered with gastric mucosa
= complete healing of ulcer
What leads to perforation of a peptic ulcer?
What causes a peptic ulcer to become chronic?
What are acute-phase proteins?
What do C-reactive protein (CRP) and serum amyloid A (SAA) do during inflammation?
What does fibrinogen do during inflammation?
What is systemic effects of inflammation?
What is leukocytosis and when is it seen?
What constitutional symptoms occur in systemic inflammation and what causes them?
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