Outcomes of acute inflammation (tbc)

What are some systemic manifestations of acute inflammation?

Fever
Malaise
Loss of appetite
Nausea
Haematological changes- increased sedimentation rate, leukocytosis

What are the outcomes of inflammation?

The four outcomes of acute inflammation are:-

Resolution
Suppuration
Scarring or fibrosis
Chronic inflammation

What would constitute resolution following a period of acute inflammation?

Considering there is a good regenerative capacity, there would be minimal tissue damage or cell death. There would be quick elimination of the causative agent and good vascular drainage to remove the fluid and debris.

What is suppuration?

Suppuration is an outcome of acute inflammation where there is formation of pus. Pus is a substance which is a mix of neutrophils, debris, bacteria. It can also cause empyema where a space is filled by pus and walled off. Signup and view all the answers

What is organisation as an outcome of acute inflammation?

Organisation as an outcome of inflammation results in the formation of granulation tissue. It can occur with <ol> <li>Lots of necrosis</li> <li>Lots of fibrin</li> <li>Poor blood supply</li> <li>Damage goes beyond basement membrane</li> </ol> New capillaries, leading to more macrophages, leading proliferation of fibroblasts, leading to fibrosis and scarring. Signup and view all the answers

What are the two ways of skin healing?

<ol> <li>Primary intention</li> <li>Secondary intention</li> </ol> Signup and view all the answers

What is the primary intention in skin healing?

When two edges of the wound can be brought together, fibrin joins the edges together weakly and over time, epidermal regrowth and collagen synthesis makes a stronger join. Signup and view all the answers

What is the process of skin healing by secondary intention?

Skin healing by secondary intention allows the tissue defect to be filled in by granulation tissue. There is epithelial regrowth over the surface. A fibrous scar forms and contracts over time. Signup and view all the answers

What is the process of bone healing?

Following a break in the bone, there is a haematoma and an inflammatory response. There is a callus formation which is eventually replaced by the stronger lamellar bone. Signup and view all the answers

What are the ways in which a liver heals?

If there is loss of hepatocytes without damage to the architecture, it can get complete healing. However, if there is a loss of hepatocytes plus damage to architecture, then there is fibrous scarring/ nodule formation. Signup and view all the answers

What are the ways the cells kidney heal?

Loss of tubular epithelium can regenerate/ repopulate cells. However, damage to the architecture like glomerulus or interstitium usually results in scarring or impaired function. Signup and view all the answers

What is the way in which smooth muscle cells can heal?

Vascular smooth muscle cells can regenerate but other smooth muscle cells cannot. Damaged muscle is replaced by the scar tissue. Signup and view all the answers

What ways does a neural tissue heal?

Central nervous system does not repair well. However, peripheral nerves may regrow, although recovery is variable and dependent on alignment and continuity. Signup and view all the answers

Why does an acute inflammation progress to being chronic?

Although most cases of acute inflammation resolve, some cases progress to being chronic in certain situations:- 1) Suppuration- collection of pus, abscess formation and walling off with granulation and fibrous tissue 2) Presence of foreign material- it cannot be digested or broken down. This provokes a granulomatous inflammation/ foreign body giant cells. 3) Infectious agent 4) Persistence of injury- recurring cycles of acute inflammation then healing. Signup and view all the answers

What are the characteristics of chronic inflammation in terms of the immune system?

Neutrophils are replaced with lymphocytes, plasma cells and macrophages. Signup and view all the answers

What are the macroscopic characteristics or signs of chronic inflammation?

Chronic ulcer, chronic abscess cavity, fibrosis/thickening of tissue Signup and view all the answers

What are the functions of the lymphocytes in chronic inflammation?

Lymphocytes- B lymphocytes meet antigens and turn into plasma cells. Plasma cells produce immunoglobulins/antibodies. 2) T lymphocytes- Killer T cells (CD8+) cytotoxic function and recruiting other immune cells. Helper T cells (CD4+)- Activate Killer T and plasma cells. Signup and view all the answers

What is the function of macrophages in chronic inflammation?

Macrophages are good at phagocytosis. Neutrophils are also capable of phagocytosis but they are replaced by macrophages in chronic inflammation. Macrophages also clear microorganisms, debris , foreign material, cyst contents etc and also produce cytokines. Signup and view all the answers

What is the function of cytokines in chronic inflammation?

Cytokines are small proteins which enhance cell mediated immunity and antibody response. Their functions include cell signalling (interleukins, TNF), promoting chemotaxis (chemokines), anti viral defences (interferons), promote apoptosis (TNF) Signup and view all the answers

What is a granulomatous inflammation?

<ul> <li>Aggregate of epithelioid histiocytes (macrophages)</li> <li>Associated with foreign bodies - endogenous and exogenous</li> <li>Also associated with specific infections e.g. parasites, TB</li> </ul> Signup and view all the answers

What are giant cells?

Giant cells are formed when macrophages collide while more than one tries to phagocytose the same particle. This makes it end up with huge multinucleate cells. Signup and view all the answers

What are the three types of giant cells?

<ol> <li>Foreign body type- randomly scattered nuclei</li> <li>Langhans- Seen in TB, horseshoe nuclei</li> <li>Touton type- Lipid breakdown, xanthomas, neat circles of nuclei</li> </ol> Signup and view all the answers