Outcomes of Acute Inflammation
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Questions and Answers

What leads to the transition from acute to chronic inflammation?

The transition occurs due to the persistence of the injurious agent or interference with the normal healing process.

Describe the nature of chronic inflammation.

Chronic inflammation is a prolonged process involving simultaneous active inflammation, tissue destruction, and healing.

Identify two contexts in which chronic inflammation occurs.

Chronic inflammation occurs after acute inflammation and due to persistent inciting stimuli.

Name two causes of chronic inflammation.

<p>Causes include persistent infections by intracellular microbes and hypersensitivity diseases.</p> Signup and view all the answers

What are the morphological features of chronic inflammation?

<p>Key features include infiltration by mononuclear cells, tissue destruction, and attempts at healing through fibrosis.</p> Signup and view all the answers

Explain what granulomatous inflammation entails.

<p>Granulomatous inflammation is characterized by focal accumulations of activated macrophages called granulomas.</p> Signup and view all the answers

What role do macrophages play in chronic inflammation?

<p>Macrophages are central to chronic inflammation; they mediate tissue destruction and healing.</p> Signup and view all the answers

How does chronic inflammation differ from acute inflammation?

<p>Chronic inflammation is longer-lasting and involves ongoing tissue destruction and healing, unlike acute inflammation.</p> Signup and view all the answers

What are the primary factors that influence the outcome of acute inflammation?

<p>The primary factors are the nature of injury, intensity of injury, tissue involved, and host responsiveness.</p> Signup and view all the answers

Define complete resolution in the context of acute inflammation.

<p>Complete resolution is the restoration of the site of acute inflammation to normal, involving removal of debris and edema resorption.</p> Signup and view all the answers

Under what circumstances does healing by connective tissue replacement occur?

<p>Healing by connective tissue replacement occurs when there is substantial tissue destruction or when tissues are incapable of regeneration.</p> Signup and view all the answers

Explain the term 'organization' in relation to acute inflammation.

<p>Organization refers to the process where connective tissue grows into the area of damage or exudate, converting it into fibrous tissue.</p> Signup and view all the answers

What is the typical outcome of acute inflammation in cases like a common cold?

<p>The typical outcome is complete resolution due to the limited and short-lived nature of the injury.</p> Signup and view all the answers

What type of immune response is primarily responsible for the formation of immune granulomas?

<p>T cell-mediated immune response.</p> Signup and view all the answers

Describe the outcomes of acute inflammation when there has been extensive tissue destruction.

<p>The outcomes involve healing by fibrosis due to the inability of damaged tissues to regenerate.</p> Signup and view all the answers

How does host responsiveness affect outcomes of acute inflammation?

<p>Host responsiveness can significantly affect whether inflammation resolves completely, heals by fibrosis, or progresses to chronic inflammation.</p> Signup and view all the answers

What is a common characteristic of foreign body granulomas?

<p>They are incited by particles that cannot be phagocytosed and do not elicit a specific immune response.</p> Signup and view all the answers

What role do macrophages play in the resolution of acute inflammation?

<p>Macrophages are crucial in removing cellular debris and microbes during the resolution phase of acute inflammation.</p> Signup and view all the answers

What role do cytokines play in the acute phase response of inflammation?

<p>They mediate systemic changes such as fever and the production of acute-phase proteins.</p> Signup and view all the answers

Which infectious agent is specifically associated with the formation of tubercles in granulomatous inflammation?

<p>Mycobacterium tuberculosis.</p> Signup and view all the answers

What systemic effect is primarily induced by pyrogens during the acute phase response?

<p>Fever.</p> Signup and view all the answers

How do activated macrophages contribute to the formation of multinucleated giant cells?

<p>They may fuse together as part of the immune response to persistent antigens.</p> Signup and view all the answers

What is the consequence of macrophage activation in the context of granulomatous inflammation?

<p>It leads to the transformation of macrophages into epithelioid cells.</p> Signup and view all the answers

Identify one inflammatory disease that can cause granulomatous inflammation.

<p>Crohn disease.</p> Signup and view all the answers

What role do C-reactive protein (CRP) and serum amyloid A (SAA) play in the acute-phase response?

<p>CRP and SAA act as opsonins by binding to microbial cell walls and also aid in clearing necrotic cell nuclei.</p> Signup and view all the answers

How does elevated fibrinogen affect erythrocyte sedimentation rate (ESR)?

<p>Elevated fibrinogen leads to increased erythrocyte aggregation, resulting in a higher erythrocyte sedimentation rate.</p> Signup and view all the answers

What is the effect of prolonged infection on leukocyte production in the bone marrow?

<p>Prolonged infection induces proliferation of bone marrow precursors due to increased colony-stimulating factor production.</p> Signup and view all the answers

Which type of leukocytosis is typically associated with bacterial infections?

<p>Neutrophilia is associated with bacterial infections.</p> Signup and view all the answers

What central nervous system effects are caused by cytokines during the acute phase response?

<p>Cytokines can lead to increased pulse and blood pressure, along with decreased sweating and chills.</p> Signup and view all the answers

What are the components of the clinical triad observed in septic shock?

<p>The clinical triad of septic shock includes disseminated intravascular coagulation (DIC), metabolic disturbances, and cardiovascular failure.</p> Signup and view all the answers

Describe the shift to the left in the context of leukocytosis.

<p>The shift to the left refers to the presence of immature neutrophils in the blood during leukocytosis.</p> Signup and view all the answers

What is the role of hepcidin during chronic inflammation, particularly in relation to iron-deficiency anemia?

<p>Hepcidin regulates the release of intracellular iron stores, and chronic elevation leads to iron-deficiency anemia associated with chronic inflammation.</p> Signup and view all the answers

Flashcards

Complete Resolution of Acute Inflammation

Complete restoration of the tissue to its normal state following acute inflammation. This involves removal of debris and microbes by macrophages, and resorption of fluid by lymphatics.

Healing by Fibrosis

The process of healing by replacement of damaged tissue with fibrous connective tissue. This occurs when there is extensive tissue destruction, involvement of non-regenerative tissues, or abundant fibrin exudate.

Suppurative Inflammation

A type of inflammation characterized by the accumulation of neutrophils and pus formation.

Constrictive Pericarditis

A specific outcome of suppurative inflammation where the pericardium (heart lining) becomes thickened due to fibrous tissue growth.

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Adhesive Pericarditis

An outcome of suppurative inflammation where adhesions form between the layers of the pericardium, restricting heart movement.

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Organization

The process by which fibrinous exudate is replaced by fibrous tissue.

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Chronic Inflammation

An inflammatory response that persists for prolonged periods, often with tissue destruction and repair occurring simultaneously.

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Granulomatous Inflammation

A type of chronic inflammation characterized by the presence of granulomas, which are collections of immune cells that encapsulate foreign material.

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Chronic Inflammation by Persistent Infection

Chronic inflammation caused by persistent infection from microbes like viruses or bacteria, leading to a sustained immune response.

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Chronic Inflammation by Hypersensitivity

Chronic inflammation triggered by an overactive immune response against self-antigens, normal flora, or harmless environmental substances.

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Chronic Inflammation by Toxic Exposure

Chronic inflammation caused by prolonged exposure to toxic substances, either from outside the body (e.g., silica) or produced within (e.g., lipids).

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Low-Grade Chronic Inflammation

Chronic inflammation that may not involve prior acute inflammation, often occurring gradually and subtly.

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Epithelioid Macrophages

Macrophages in granulomas, enlarged and flattened, indicating their intense activation.

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Tissue Destruction and Healing

A feature of chronic inflammation where the persistent injury triggers tissue breakdown and replacement with scar tissue.

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Granulomas: What are they?

Clusters of immune cells, primarily macrophages, that form in response to persistent antigens or foreign bodies. They are characterized by central necrosis (death of cells) and a surrounding layer of lymphocytes.

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Foreign body granulomas

These granulomas are caused by foreign substances the body cannot easily digest, such as sutures or talc. The immune system doesn't mount a specific response to these materials.

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Immune granulomas

These granulomas arise from immune responses to persistent antigens that the body struggles to eliminate. T cells play a major role, triggering macrophage activation.

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Tuberculosis granulomas (Tubercles)

A classic example of an immune granuloma is caused by the tuberculosis bacillus. It's characterized by central caseous necrosis and a specific name, 'tubercle'.

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Acute Phase Response

The body's collective response to infection or injury, involving various physiological changes, including fever and production of acute-phase proteins.

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Pyrogens

Substances that trigger prostaglandin synthesis in the hypothalamus, leading to fever. These can include bacterial products like endotoxin.

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Acute-phase proteins

Plasma proteins produced mainly by the liver whose synthesis increases dramatically in response to inflammation. These proteins contribute to fighting infection and repairing damaged tissue.

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Systemic Inflammatory Response Syndrome (SIRS)

Severe systemic inflammatory response syndrome (SIRS) is a life-threatening condition marked by widespread inflammation and organ dysfunction. It's an exaggerated form of the acute phase response.

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Acute-phase reactants

Proteins that increase in response to inflammation, like C-reactive protein (CRP), fibrinogen, and serum amyloid A (SAA). They help fight infection and clear debris.

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Leukocytosis

Increased white blood cell count, often due to rapid release of bone marrow cells, especially immature neutrophils.

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Neutrophilia

Increase in neutrophils, a type of white blood cell, often seen in bacterial infections.

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Lymphocytosis

Increase in lymphocytes, another type of white blood cell, often seen in viral infections.

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Eosinophilia

Increase in eosinophils, a type of white blood cell, often seen in parasitic infections and allergic reactions.

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Leukopenia

Decreased white blood cell count due to increased consumption during certain infections, like typhoid fever or some viral infections.

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Sepsis

A severe, life-threatening condition characterized by widespread inflammation and organ dysfunction, often caused by infections.

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Septic shock

A syndrome associated with sepsis, characterized by disseminated intravascular coagulation (DIC), metabolic disturbances, and cardiovascular failure.

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Study Notes

Outcomes of Acute Inflammation

  • Acute inflammation outcomes depend on injury nature, intensity, tissue type, and host response.
  • Resolution: Restoration of the inflamed area to normal. Macrophages remove debris and microbes, while lymphatics absorb fluid.
  • Common causes for resolution include: Limited or short-lived injury, minimal tissue damage, and regenerable cells (e.g., skin, bone).
  • Healing by connective tissue replacement (fibrosis): Occurs with substantial tissue destruction & non-regenerable tissues. Example: severe burns, suppurative inflammation, and specific medical conditions.

Acute to Chronic Inflammation Transition

  • Acute inflammation can progress to chronic inflammation if the triggering agent persists or if healing is disrupted.
  • Factors include: Persistent injurious agent (e.g., Hepatitis C virus), or interference with the normal healing process (e.g., diabetic ulcers).

Chronic Inflammation

  • Chronic inflammation is a prolonged process involving simultaneous inflammation, tissue damage, and healing.
  • Possible contexts include: Following acute inflammation, due to persistent stimulation, or as a low-grade response without prior acute inflammation.

Causes of Chronic Inflammation

  • Persistent infection by intracellular microbes (e.g., tuberculosis, viruses).
  • Hypersensitivity diseases (e.g., autoimmune diseases).
  • Prolonged exposure to toxins (e.g., silica, lipids).
  • Diseases not traditionally categorized as inflammatory. Example: Neurodegenerative disorders, metabolic syndrome, and some cancers.

Granulomatous Inflammation

  • A distinct form of chronic inflammation featuring focal collections of activated macrophages (granulomas).
  • Macrophage activation leads to cell enlargement (epithelioid macrophages).
  • Nodules of inflammatory cells are often found, surrounded by lymphocytes.
  • Can involve central necrosis and/or fibrosis.

Causes of Granulomatous Inflammation

  • Infectious agents: Tuberculosis, leprosy, syphilis, fungal infections.
  • Inflammatory causes: Temporal arteritis, Crohn's disease, sarcoidosis.
  • Inorganic particulates: Silica, beryllium.

Types of Granulomas

  • Foreign body granulomas: Result from substances that macrophages cannot readily consume.
  • Immune granulomas: Immune response to persistent or poorly degradable antigens. Typical example is tuberculosis.

Systemic Effects of Inflammation

  • Systemic effects collectively called the acute-phase response. Can involve cytokines from either bacterial products or inflammatory stimuli.
  • Fever: Response to pyrogens (e.g., bacteria). Cytokines stimulate prostaglandin synthesis in the hypothalamus.
  • Acute-phase proteins: Plasma proteins (e.g., CRP, fibrinogen) produced by the liver, increasing in concentration during inflammation.
  • Elevated leukocytes (white blood cells).
  • Increased ESR/Sedimentation rate.
  • Other indicators like increased pulse and blood pressure, decreased sweating, anorexia, and malaise. 

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Outcomes of Acute and Chronic Inflammation PDF

Description

This quiz explores the various outcomes of acute inflammation, including resolution and the transition to chronic inflammation. It covers how factors like injury nature, tissue type, and host response influence healing processes. Moreover, it highlights the differences between resolution and fibrosis in inflammation.

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