6. Infectious Disease 1 - Tissue Responses

Front 1

What are the 6 types of tissue responses to inflammation?

Back 1

1. Suppurative
2. Mononuclear
3. Granulomatous
4. Cytopathic-Cytoproliferative
5. Necrotizing
6. Chronic/scarring

Front 2

What is the hallmark of Suppurative inflammation?

Back 2

PMNs + Increased Vascular Permeability

Front 3

What types of pathogens stimulate Suppurative Inflammation?

Back 3

Pyogenic bacteria (GPC/GNB)

Front 4

How do the pyogenic bacteria induce suppurative inflammation?

Back 4

By releasing chemoattractants (kines)

Front 5

What pathogens typically cause Mononuclear inflammation?

Back 5

-Viruses
-Intracellular bacteria
-Parasites (intracellular)

Front 6

What is the hallmark of Granulomatous inflammation?

Back 6

Aggregates of macrophages that fuse to form giant cells.

Front 7

What is another name for the giant cells in granulomatous inflammation?

Back 7

Epithelioid cells

Front 8

What 4 pathogens stimulate granulomatous inflammation?

Back 8

-Mycobacteria
-Fungi
-Spirochetes
-Helminths

Front 9

What 2 responses compose the mechanism by which tissue injury occurs in granulomatous inflammation?

Back 9

-Strong Tcell response elicited by TNF-a and IFN-y
-AFB resist eradication

Front 10

What pathogens typically induce cytopathic-cytoproliferative inflammation?

Back 10

Viruses in the ABSENCE of inflammatory cells

Front 11

What can be induced by cytopathic-cytoproliferative inflammation causing viruses?

Back 11

dysplasia and/or neoplasia

Front 12

What is the hallmark of coagulative necrosis?

Back 12

Cytoarchitecture is retained, but you can tell its dead because of karyorhexis/lysis

Front 13

What 5 pathogens cause necrotizing inflammation?

Back 13

-Clostridium perfringens
-Entamoeba histolytica
-Pseudomonas aeruginosa
-Herpes virus
-Hep b virus

Front 14

When do Herpes and Hep B cause necrotizing inflammation?

Back 14

When they are disseminated widely in an immunosuppresed host

Front 15

And how do we identify necrotizing inflammation?

Back 15

It resembles coagulative necrosis - normal cytoarchitecture, lysed or broken up nuclei.

Front 16

What types of pathogens cause chronic inflammation and scarring?

Back 16

MANY - its the FCP of many infections if healing doesn't occur.

Front 17

What are 2 classic pathogens that cause chronic inflammation?

Back 17

-Schistosoma
-Hep B

Front 18

What's the typical cell that causes mononuclear inflammation?

Back 18

lymphocyte

Front 19

What are 3 organisms that typically cause lymphocytic inflammation?

Back 19

-Viruses
-mycoplasma
-secondary syphilis can show it

Front 20

What type of inflammation do you normally see in interstitial pneumonia?

Back 20

Mononuclear

Front 21

What does interstitial inflammation mean?

Back 21

Inflammation in the connective tissue of the alveolar walls deep in the lungs

Front 22

What is the CLASSIC cell type in granulomatous inflammation?

Back 22

Giant cells

Front 23

What are Giant cells?

Back 23

Epithelioid cells made by macrophages that aggregated

Front 24

What triggers the aggregation of macrophages into Giant cells?

Back 24

Agents that resist eradication and are capable of inducing strong T-cell mediated immune responses.

Front 25

Are giant cells the only cells you seen in granulomatous inflammation?

Back 25

No the giant cells are commonly surrounded by the Tcells that are responding to the bugs.

Front 26

What is a Granuloma?

Back 26

A focal area of granulomatous inflammation

Front 27

Is granulomatous inflammation only stimulated by infectious agents?

Back 27

No it can also be stimulated by FOREIGN BODIES

Front 28

What foreign bodies stimulate granulomatous inflammation?

Back 28

-Talc
-Sutures

Front 29

What is the hallmark of an immune Tuberculosis granuloma?

Back 29

Central Caseous necrosis

Front 30

What are the four major examples of granulomatous inflammation?

Back 30

1. Tuberculosis
2. Leprosy
3. Syphilis
4. Cat scratch disease

Front 31

Agent that causes Tuberculosis

Back 31

M. tb

Front 32

Agent that causes leprosy

Back 32

M leprae

Front 33

Agent that causes Syphilis

Back 33

Treponema pallidum

Front 34

Agetnt that causes cat scratch fever

Back 34

Bartonella henselae

Front 35

Can you have granulomatous inflammation without forming a granuloma?

Back 35

yes

Front 36

Can you have a granuloma without granulomatous inflammation?

Back 36

umm no, because its a focus of granulomatous inflammation..

Front 37

What patients would not form a granuloma in the face of granulomatous inflammation? Why?

Back 37

immunosuppressed because they lack the cytokines necessary for attracting the Tcells that mediate formation of the granuloma

Front 38

Is all cytopathic cytoproliferative inflammation equal?

Back 38

No; viruses cause distinctive patterns of cytopathic effects

Front 39

What is the presumptive diagnosis in the case of seeing Multinucleated giant cells where the nuclei are all clumped together in the middle?

Back 39

HERPES VIRUS

Front 40

How are nuclei arranged in granulomatous giant cells?

Back 40

Peripherally

Front 41

What is the virus that makes big cells?

Back 41

Cytomegalovirus

Front 42

Why does CMV make cells get big?

Back 42

Because it replicates in the cytoplasm and nucleus

Front 43

What type of inflammation is seen when tissue injury is initially quite severe or the host immune response is dysfunctional?

Back 43

Necrotizing

Front 44

What is a common final pathway to many infections?

Back 44

Chronic inflammation and scarring

Front 45

What are noninfectious causes of neutrophilia?

Back 45

-stress
-severe exercise
-steroids

Front 46

What is the most common cause of neutrophilia?

Back 46

Bacterial infection

Front 47

What will you see lots of in bacterial infections?

Back 47

Bands

Front 48

What are 3 inflammatory conditions that you'll see a PMN response in?

Back 48

-IBD
-RA
-Vasculitis

Front 49

What type of cell will you see in Myeloid leukemias? What about lymphocytic?

Back 49

Myeloid = pmn
Lymphocytic = lymphs

Front 50

3 conditions where you'll see a lymphocytosis:

Back 50

-viral infection
-pertussis
-CLL

Front 51

What is the most common case where you'll see Eosinophilia? What are 2 less common causes?

Back 51

Parasitic infections
Allergy
Drug Hypersensitivity

Front 52

What is the most common cause of eosinophilia in the US?

Back 52

Visceral larva migrans caused by Toxocara canis (dog roundworm)

Front 53

What cell increase is not associated with infectious diseases? What is?

Back 53

Basophilia = not
Monocytosis = is

Front 54

If you see basophilia think...

Back 54

Myeloproliferative disorder or acute leukemia