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Path SJSM > Cell injury & adaptive response > Flashcards

Cell injury & adaptive response Flashcards

1
Q

Necrosis:
Gangrenous (Wet & Dry)

A

Wet: Seen in ischemia & is coagulative in nature

Dry: Seen in super infections (i.e clostridium perfringens) & is liquefactive in nature

Both present in distal limbs, testis & Gi tract

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2
Q

Necrosis:

Fat (Enzymatic vs Non-enzymatic)

A

Leaves dead fat cell outlines without peripheral nuclei

Seen in fat saponification (fat turns chalky white, looks dark blue on H&E)

Enzymatic: due to acute pancreatitis
Non-enzymatic: due to trauma

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3
Q

Necrosis:

Fibrinoid (Immune vs non-immune mediated)

A

Vessel walls are outlined by an eosinophilic layer of protein

Seen in type 3 hypersensitivity reactions or from plasma leaking out of blood vessels

Immune vascular reactions (PAN)
Non-immune (Preeclampsia or a hypertensive emergency)

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4
Q

Necrosis:

Coagulative

A

Outlines of cells with no nuclei and cytoplasmic eosinophilia are seen

Happens in ischemia or infarcts (not in brain)

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5
Q

Necrosis:

Liquefactive

A

Early stages show neutrophil/macrophage infiltration & cell debris
Late stages show cystic spaces

Common in bacterial abscesses & brain infarcts

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6
Q

Necrosis:

Caseous

A

Fragmented cells and lymph/macrophages (granuloma) that looks like cheese.

Seen in TB, systemic fungal infections, & nocardiosis

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7
Q

Rheumatic arthritis
Peptic ulcers
Immune vasculitis
Preeclampsia
Hypertensive emergency

Are all examples of:

A

Fibrinoid necrosis

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8
Q

Tuberculosis
Systemic fungal infection (Histoplasmosis)
Nocardiosis

Are all examples of:

A

Caseous necrosis

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9
Q

Peripheral arterial disease
Acute limb ischemia
Intestinal ischemia
Clostridium prefringes
Sepsis

All examples of:

A

Gas gangrenous necrosis

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10
Q

Ischemia & causes

A

Lack of/insufficient blood supply to tissues

Causes:
Low arterial perfusion (atherosclerosis)
Low venous drainage (Testicular torsion or Budd-Chiari syndrome)
Shock

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11
Q

Risky areas for ischemia

A

Brain (ACA, MCA, PCA)

Heart (Sub endocardium of the LV)

Kidney (Proximal tubule & thick ascending limb of renal medulla)

Liver (Zone 3 around the central vein)

Colon (Splenic flexure aka Griffith’s point & Rectosigmoid junction)

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12
Q

Red vs Pale infarcts

A

Red: Seen in venous occlusion & tissues with multiple blood supply (liver, lungs, intestines, & testes) with a reperfusion injury (usually from free radicals)

Pale: Happens in solid organs with a single blood supply (heart & kidneys)

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13
Q

What type of necrosis is shown here:

A

Fibrinoid necrosis

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14
Q

Necrosis:

Fibrinoid

A

Is associated with immune complex vasculitis and hypertension

ex. Hypersensitivity reactions 2 & 3 and Vascular hypertensive damage

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15
Q

What is the type of necrosis shown:

A

Fat necrosis

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16
Q

Outlines of necrotic fat cells with basophilic calcium deposits, surrounded with inflammation

A

Fat necrosis

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17
Q

Infection with mycobacterium tuberculosis, systemic fungi (histoplasma capsulatum) and nocardia can cause what type of necrosis

A

Caseous necrosis

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18
Q

Necrosis:

Caseous

A

Caseous (cheese like) with a granuloma (lysed cells and amorphous granular debris walled off by macrophages

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19
Q

Patient is an alcoholic and presents with a lung infection what should you automatically presume they have and what type of necrosis does it progress to?

A

Patient probably has aspiration which can develop into liquefactive necrosis

20
Q

Nuclear shrinkage and more basophilia

A

Pyknosis

21
Q

Nucleus undergoes fragmentation

A

Karyorrhexis

22
Q

Fading/disappearing chromatin (loss of DNA vie endonucleases)

A

Karyolysis

23
Q

60 Yr old patient presents with left lower quadrant pain and chronic constipation what is the next step of action for the test and the possible results?

A

Preform a Guaiac stool test (blood in stool)

+ test could mean Diverticulosis or colon cancer

Preform a colonoscopy:
Herniations(Diverticulosis)
Masses (Colon cancer)

24
Q

Patient presents with cardiac hypertrophy, if no other info is given it’s the _____ side & if lung disease is involved it’s the ____ side

A

Left ventricular hypertrophy

or

Right ventricular hypertrophy

25
Q

Breasts during puberty
(Hyperplasia or Hypertrophy)

A

Hypeplasia (estrogen)

26
Q

Breast feeding mother
(Hyperplasia or Hypertrophy)

A

Hyperplasia (prolactin)

27
Q

Chronic hypertension in a older man
(Hyperplasia or Hypertrophy)

A

Hypertrophy

28
Q

Blood losses effect on bone marrow
(Hyperplasia or Hypertrophy)

A

Hyperplasia (erythropoietin)

29
Q

Patient receives a partial liver transplant, & the organ regrows to it’s original size
(Hyperplasia or Hypertrophy)

A

Hyperplasia (Hepatocyte growth factor)

30
Q

Iron deficient & anemic patient starts taking iron supplements. What happens to the bone marrow?
(Hyperplasia or Hypertrophy)

A

Hyperplasia (Iron increases heme levels which fuel more new RBC production)

31
Q

Iron deficiency in hypothyroidism triggers what
(Hyperplasia or Hypertrophy)

A

Thyroid hyperplasia (TSH)

32
Q

HPV types 6 & 8 warts (Hyperplasia or Hypertrophy)

A

Hyperplasia

33
Q

Graves disease (autoimmune IgG against thyroid tissue) triggers (Hyperplasia or Hypertrophy)

A

Thyroid hyperplasia

34
Q

Female patient, 40 yrs old presents with irregular menstruation. Testing shows a normal cervix what is the likely condition and ass risk

A

Hyperplastic endometrium and high risk of cancer

35
Q

Patient presents with neck fat (buffalo hump), moon face, purple streaks in skin, and osteoporosis. What’s the diagnosis and pathology

A

Cushing’s disease due to a pituitary adenoma which increases ACTH secretions from the zona fasciculata in the adrenals

36
Q

Continuous stress reprograms stem cells to differentiate into another cell type

A

Metaplasia

37
Q

Patient has a positive guaiac test and colonoscopy shows polyps

A

colon polyps (Hyperplasia of colonic villi) super high risk of cancer (100%)

38
Q

Menstrual period stops & the endometrium sheds
(what type of cellular adaptation?)

A

Apoptosis

39
Q

A breastfeeding mother weans her baby, and her breast size shrinks
(What type of cellular adaptation?)

A

Apoptosis

40
Q

Graft vs. host disease
(What type of cellular adaptation)

A

Apoptosis

41
Q

What characteristic about mycobacterium TB causes caseous necrosis?

A

the waxy coat (usually presents in the apical lobe)

42
Q

Patient presents with pain in the left lumbar region which radiates to the back, they said a few days prior they attended a Redskins tail gate party and drank their weight in alcohol

What’s the likely diagnosis?

A

Pancreatitis

43
Q

Most common cause of pancreatitis?

A

Alcoholism

44
Q

Patient presents with chronic hepatitis B, fever, and nodules in their hands, upon examination you notice multiple needle stick injuries. What is the type of necrosis they are experiencing?

A

Fibrinoid

45
Q

Patient presents with stroke and chronic hypertension, what type of necrosis will they have?

A

Fibrinoid

46
Q

A diabetic patient presents with discolored feet with no distal pedal pulse. What type of necrosis is this?

Additionally the same patient later in hospital develops exudate/pus within the discolored tissue what is the necrosis?

A

Dry gangrene
&
Wet gangrene

Path SJSM (26 decks)

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