Chronic Inflammation: Causes and Features

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Questions and Answers

What cellular process is a hallmark of chronic inflammation, indicative of the body's attempt to repair damaged tissue?

  • Stromal proliferation (correct)
  • Neutrophil extravasation culminating in pus formation
  • Eosinophil degranulation, leading to amplified allergic response
  • Massive coagulation necrosis, preventing tissue repair

A patient's biopsy reveals tissue damage occurring at the same time as tissue repair. Which type of inflammation is the MOST likely diagnosis?

  • Serous Inflammation
  • Acute inflammation
  • Fibrosis
  • Chronic inflammation (correct)

Which of the following infectious agents is MOST likely to cause chronic inflammation due to its difficulty to eradicate?

  • Streptococcus pyogenes
  • Mycobacteria (correct)
  • Staphylococcus aureus
  • Escherichia coli

A patient presents with silicosis after prolonged exposure to particulate silica. What type of chronic inflammation is MOST likely occurring in the patient's lungs?

<p>Inflammation due to prolonged exposure to toxic agents (B)</p> Signup and view all the answers

What cellular process is induced by a persistent offending agent in chronic inflammation, leading to tissue damage?

<p>Tissue destruction (A)</p> Signup and view all the answers

In the context of chronic inflammation, the attempt at healing damaged tissue involves connective tissue replacement. Which of the following processes is MOST directly associated with this?

<p>Angiogenesis (D)</p> Signup and view all the answers

What is the role of cytokines, such as IFN-γ, in the activation of macrophages during chronic inflammation?

<p>To promote macrophage differentiation and activation, enhancing their ability to phagocytose and present antigens (D)</p> Signup and view all the answers

What is the MAIN role of growth factors (PDGF, FGF, TGF-β) released by macrophages in chronic inflammation?

<p>Stimulating fibroblast proliferation, collagen synthesis, and angiogenesis, promoting fibrosis (C)</p> Signup and view all the answers

Which process is MOST closely associated with the "remodeling" of collagen during fibrosis in chronic inflammation?

<p>Balanced collagen synthesis and degradation to restore tissue architecture (A)</p> Signup and view all the answers

A biopsy from a chronically inflamed tissue site shows a collection of macrophages. What is the NEXT step to determine if this is a non-specific chronic inflammation or a granulomatous inflammation?

<p>Evaluate for specific ordering or organization of the cells (A)</p> Signup and view all the answers

What type of inflammatory response is characterized by granuloma formation in the affected tissue?

<p>Chronic granulomatous inflammation (B)</p> Signup and view all the answers

What is the primary cellular component of a granuloma, which distinguishes it from other forms of chronic inflammation?

<p>A microscopic aggregation of macrophages transformed into epithelium-like cells (C)</p> Signup and view all the answers

Which infectious disease is MOST strongly associated with granuloma formation due to infection by Mycobacterium tuberculosis?

<p>Tuberculosis (C)</p> Signup and view all the answers

A patient is diagnosed with leprosy. What is the causative agent MOST likely responsible for the granulomatous inflammation?

<p><em>Mycobacterium leprae</em> (D)</p> Signup and view all the answers

Which staining technique is MOST appropriate for identifying Mycobacterium in a granulomatous lesion?

<p>Ziehl-Neelsen stain (C)</p> Signup and view all the answers

A granuloma contains a central area of necrosis, what is this MOST likely?

<p>Caseating granuloma (C)</p> Signup and view all the answers

What is the etiology of sarcoidosis, a disease known to cause granulomatous inflammation?

<p>Unknown etiology (B)</p> Signup and view all the answers

In Crohn's disease, what type of inflammatory process is typically observed in the bowel?

<p>Chronic granulomatous inflammation (D)</p> Signup and view all the answers

What triggers the formation of a foreign body granuloma?

<p>Presence of inert, indigestible material (A)</p> Signup and view all the answers

Which of the following is a characteristic of non-specific chronic inflammation?

<p>No specific ordering of inflammatory cells (C)</p> Signup and view all the answers

What type of cells are commonly found in both non-specific and granulomatous inflammation?

<p>Mononuclear cells (D)</p> Signup and view all the answers

Which of the following is a typical feature of non-specific chronic inflammation?

<p>The absence of a specific aetiology (A)</p> Signup and view all the answers

What is a major difference between acute and chronic inflammation in terms of cellular infiltrate?

<p>Acute inflammation primarily involves neutrophils, while chronic inflammation is dominated by mononuclear cells. (D)</p> Signup and view all the answers

In the context of chronic inflammation following tissue injury, uncontrolled fibrosis can lead to which of the following outcomes?

<p>Loss of organ or tissue function (A)</p> Signup and view all the answers

Considering a patient with prolonged exposure to asbestos, which pathological process is MOST likely to occur in the lungs as a result?

<p>Chronic inflammation and fibrosis (B)</p> Signup and view all the answers

What role do chemokines play in the progression of chronic inflammation?

<p>They recruit more inflammatory cells to the site of inflammation. (D)</p> Signup and view all the answers

Which of the following distinguishes chronic inflammation from acute inflammation regarding the cells involved in the process?

<p>Chronic inflammation involves a predominance of mononuclear cells, such as macrophages and lymphocytes, while acute inflammation is dominated by neutrophils (C)</p> Signup and view all the answers

Which of the following processes is MOST directly associated with the development of granulomas?

<p>Accumulation of activated macrophages and T lymphocytes (D)</p> Signup and view all the answers

A patient is diagnosed with silicosis following long-term occupational exposure. What cellular changes MOST likely contribute to the pathophysiology of this condition?

<p>Macrophage activation and subsequent fibrosis in the lungs (C)</p> Signup and view all the answers

Flashcards

Chronic Inflammation Onset

May occur from the start or follow unresolved acute inflammation.

Chronic Inflammation Characteristics

Tissue injury or persistence of the injurious agent occurring along with tissue repair.

Hallmarks of Chronic Inflammation

Infiltration by macrophages and stromal proliferation.

Causes of Chronic Inflammation

Persistent infections, immune-mediated diseases and prolonged exposure to toxic agents.

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Morphologic Features of Chronic Inflammation

Infiltration with mononuclear cells, tissue destruction, attempts at healing.

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Mononuclear Cells in Chronic Inflammation

Macrophages, lymphocytes, and plasma cells.

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Causes of Tissue Destruction in Chronic Inflammation

Persistent offending agent and inflammatory cells.

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Healing Mechanisms in Chronic Inflammation

Angiogenesis and fibrosis.

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Classifications of chronic inflammation

Non-specific and granulomatous.

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Chronic Granulomatous Inflammation

Characterized by granuloma formation in affected tissues.

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Examples of Granulomatous Inflammation

Tuberculosis, leprosy, syphilis, sarcoidosis, Crohn's disease.

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Granuloma Definition

Focus of chronic inflammation with aggregated macrophages transformed into epithelium-like cells.

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Non-Specific Chronic Inflammation

Inflammatory cells present without specific ordering and lacks specific cause.

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Study Notes

  • Chronic inflammation can start "ab initio" (from the beginning) or result from unresolved acute inflammation.
  • Tissue injury, or the persistence of an injurious agent, happens simultaneously with tissue repair in chronic inflammation.
  • Hallmarks of chronic inflammation include infiltration by macrophages and stromal proliferation.

Causes of Chronic Inflammation

  • Persistent infections by microorganisms that are difficult to eradicate are a cause of chronic inflammation.
  • Examples of microorganisms that cause persistent infections include mycobacteria, viruses, fungi, and parasites.
  • Chronic inflammation can be caused by immune-mediated inflammatory diseases.
  • Another cause of chronic inflammation is prolonged exposure to potentially toxic agents, which can be exogenous or endogenous.
  • An example of an exogenous agent is particulate silica, which leads to silicosis.

Morphologic Features

  • Infiltration with mononuclear cells is a key morphologic feature, including macrophages, lymphocytes, and plasma cells.
  • Tissue destruction, induced by a persistent offending agent and inflammatory cells also occurs.
  • In chronic inflammation the body attempts to heal by connective tissue replacement of damaged tissue.
  • This is accomplished by angiogenesis and fibrosis.

Chronic Granulomatous Inflammation

  • Granuloma formation in affected tissue characterizes this
  • A granuloma is a microscopic aggregation of macrophages transformed into epithelium-like cells.

Conditions

  • Tuberculosis, where the causative agent is Mycobacterium tuberculosis
  • Leprosy, where the causative agent is Mycobacterium leprae
  • Syphilis, where the causative agent is Treponema pallidum
  • Cat-scratch disease, caused by a Gram-negative bacillus
  • Sarcoidosis, which has an unknown etiology
  • Crohn disease, which is an inflammatory bowel disease

Non-Specific Chronic Inflammation

  • Inflammatory cells are similar to those in granulomatous inflammation
  • No specific ordering of cells occurs.
  • Usually does not show a specific etiology.

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