Ward - Chronic Inflammation

Front 1

3 things that happen simultaneously with Chronic Inflammation:
______ inflammation
________ destruction
attempted _______

Back 1

active inflammation
tissue destruction
attempted repair

Front 2

Two different types of Chronic Inflammation

Back 2

Classic and Granulomatous (can be either OR both)

Front 3

3 Microorganisms that cause chronic inflammation

Back 3

tuberculosis
syphilis
certain fungi

Front 4

Exogenous or endogenous toxic agents that cause chronic inflammation

Back 4

silica (miners get it, chronic irritant)
atherosclerosis (toxic plasma lipid components) - toxic plasma lipids get into the plaque. Test CRP

Front 5

Autoimmune causes of Chronic inflammation

Back 5

rheumatoid arthritis
lupus erythematosis

Front 6

3 things found in histology of chronic inflammation:
1) ______ cells
2) _________ destruction
3) Attempted healing: ____genesis and _____genesis

Back 6

1) Mononuclear cells (lymphocyte, macrophage, plasma cell)
2) Tissue destruction
3) Attempted healing
+angiogenesis
+fibrogenesis

Front 7

Toxic oxygen metabolites
Proteases
Neutrophil chemotactic factors
Coagulation factors
AA metabolites
Nitric Oxide
What kind of cell is responsible for these tissue injuries?

Back 7

Macrophages

Front 8

Growth Factors
Fibrogenic cytokines
Angiogenesis factors
Remodeling collenagenesis

What kind of cell is involved in these types of fibrosis?

Back 8

Macrophages

Front 9

Macrophages are activated by 3 nonimmune factors and 1 immune factor

Back 9

Nonimmune-
endotoxin
fibronectin
chemical mediators
Immune -
Cytokine IFN-gamma

Front 10

Lymphocytes (B, T, memory) produce ___ (cytokine) to activate macrophages to produce ___

Back 10

Lymphocytes produce IFN-gamma to activate macrophages to produce monokines

Front 11

Plasma cells secrete antibodies against 2 things

Back 11

Persistant antigens/irritants
Altered tissue components

Front 12

2 mononuclear cell types that participate in certain immune inflammatory reactions... typically associated with allergens

Back 12

eosinophils, mast cells

Front 13

In images of CLASSIC, CHRONIC inflammation, _____ cells will be most evident.

Back 13

Mononuclear

Front 14

____ cells like to live around blood vessels

Back 14

Plasma cells like to live around bvs

Front 15

Salphingitis

Back 15

Inflammation of rugue folds of salphinx

Front 16

If something has both acute and chronic inflammation it is called:

Back 16

Chronic active inflammation

Front 17

Acute inflammation is indicated by what kind of cells?

Back 17

Neutrophils

Front 18

FOREIGN-BODY GIANT CELLS are seen in response to _____ ______ matter

Back 18

Particulate, foreign matter

Front 19

Macrophages fuse together to form a ____ in a FBGCR to ingest small, engulfable particles

Back 19

Syncitium

Front 20

FOREIGN-BODY GIANT CELLS is a granulomatous reaction
T/F

Back 20

False - NOT granulomatous! It is a classic

Front 21

Little white lumps – can be one of 3 things:

Back 21

Tuberculosis
Cancer
Pancreatitis

Front 22

Quandrants – multease crosses
2 things cause them:

Back 22

-Lump of cholesterol (seen in urine of people leaking lipids)

-Starch (surgeons gloves)

Front 23

4 types of Granulomata

Back 23

Foreign Body (ingestible material)
Non-caseating (Sarcoidoisis)
Caseating (Tubercle bacilli, Histoplasma, Coccidiodomycosis)
Necrotizing (Cat-scratch, Tularemia, LGV, Brucellosis)

Front 24

If the ______ can’t take care of the intruder (poorly soluble or particle material) then the next stage might be recruitment of more and more ___________.
Don’t form more giant cells, they come in and form a _____ around the arena.
This is called a _______

Back 24

FBGC
macrophages
collar
granuloma

Front 25

Foreign Body Granuloma. ___ presents particles to T-cells. T-lymphocytes activated, produce cytokines as follows:
___ activates other lymphocytes (perpetuation)
___ transforms Møs into:
- multinucleated giant cells (e.g., Langhans)
- epithelioid forms

Back 25

Macrophages
IL-2
IFN-gamma

Front 26

IFN-gamma transforms Møs into 2 different cell types

Back 26

1) multinucleated giant cells (e.g., Langhans)
2) epithelioid forms

Front 27

Granuloma is made up of a few components:
A cluster of _____ is generally discrete and round/oval
A few scattered ________
May or may not have ____-_____ macrophages (not necessary)

Back 27

macrophages
lymphocytes
multi-nucleated (giant cells)

Front 28

Visual evidence of macrophages is a large _______ distance compared to Lymphocytes. This is due to wide cytoplasm.

Back 28

Internuclear

Front 29

A sinus forms when there is chronic inflammation. Communication between two sinus epithelial surfaces is called a _____

Back 29

Fistula
same chronic inflammation in both
between 2 loops of bowel, between bowel and skin, etc

Front 30

Non-caseating granulomata (no white gunk) are typically:

Back 30

Sarcoidosis

Front 31

A round cytoplasmic inclusion composed of amorphous material. Present in the giant cells of sarcoidosis, in beryllium lesions, and sometimes in other giant cells.

Back 31

Schaumann's body

Front 32

Caseating granulomata have a collar of _____, few residual nuclei in the middle, eventually becomes _________ where the caseation is

Back 32

Macrophages
Homogenous

Front 33

Granuloma all over the body is called _____ granulomata

Back 33

Miliary

Front 34

Cat-scratch*
Tularemia
LGV
Brucellosis
all types of ________ granulomata

Back 34

Necrotizing

Front 35

"Triple zone" is a synonym for a _________ granuloma

Back 35

Necrotizing

Front 36

In a necrotizing granuloma what are the cell types in...
Zone 1 (center):
Zone 2:
Zone 3:

Back 36

PMNs
Macrophages (histeocytes)
Lymphocytes

Front 37

Necrotizing stuff like karyorrhexis fragments, picnotic nuclei, apoptotic cells can be found along with ______ (cell type) in ZONE _ of necrotizing granulomata?

Back 37

Neutrophils
Zone 1

Front 38

In what type of granuloma would you find the fusion of several granulomata

Back 38

Stellate granulomata (necrotizing)

Front 39

The first line of defense for bacterium to get through is:

Back 39

Neutrophils

Front 40

If PMNs fail (neutropenias, chemo, leukemia) the second line of defense is:

Back 40

Monocyte/Macrophage

Front 41

If bacteria gets away from the arena, it heads towards the third line of defense:

Back 41

Lymphatic system

Front 42

Red lines on a patient. Means infection is getting away from the arena. EMERGENCY – IV antibiotics

Back 42

Lymphangitis

Front 43

follicular hyperplasia
sinusoidal hyperplasia
paracortical (T-zone hyperplasia)

3 causes of _____________

Back 43

Lymphadenopathy

Front 44

Lymphadenitis

Back 44

inflammation of lymph node. You don't know if it's Lymphadenitis or Lymphadenopathy.Need to find out if it's infected. Look at hx – if they have giant pus filled lesion and big lymph node you can postulate lympadenitis

Front 45

Massively stimulated follicles in lymph node

Back 45

Follicular hyperplasia

Front 46

Little white things in Burkett's called “___ ___ effect”
Indicator of high cell turnover and aggressive malignancy.

If reactive (the opposite of malignancy) it's called lymphoma and this effect isn't seen

Back 46

starry sky

Front 47

Bacterial antigens usually cause big, infected lymph nodes - but _____ can do the same thing by shedding

Back 47

cancer

Front 48

Cause of lymphadenopathy - T-cell zone expansion by an infectious disease and a certain kind of cell

Back 48

Infectious mono
and
Migrating Dendritic Cells (clean cytoplasm compared to macrophages)

Front 49

Fourth barrier, after lymph node

Back 49

Reticuloendothelial system

Front 50

The reticuloendothelial system include phagocytic cells of what 3 organs?

Back 50

Liver, Spleen, Bone marrow

Front 51

When the RES sytem is working, there is a condition called "ketchup spleen" in which ________ cells make too much lytic enzymes

Back 51

Neutrophils

Front 52

When a bug gets past the RES defensive line, the next defense is

Back 52

Blood

Front 53

Last milestone when all else fails and the bug is rampant in the blood:

Back 53

Seeding in organs:
Heart, meninges, kidneys, joints

Front 54

If you see neutrophils in liver, suspect _______ of BACTERIAL process. Especially if it’s focal
You would NEVER see a whole liver full of PMN’s.

Back 54

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