25: Amyloidosis

Question 1

Amyloid

Answer 1

Misfolded protein made of non-parallel Beta pleated sheets

Question 2

Two reasons AA/AL amyloids accumulate

Answer 2

1. Too much amyloid accumulating too quickly

2. Genetic inability to get rid of the tough proteins fast enough

Question 3

Two signs of renal amyloids

Answer 3

Proteinuria, edema

Question 4

Three stains in order to ID amyloids

Answer 4

1. H&E
2. Congo red
3. Additional stain to find type of amyloid (ex: brown stain for AA amyloid)

Question 5

What color do amyloids appear with Congo red stain and a polarized filter?

Answer 5

Apple green (birefringence)

Question 6

What gives a definite diagnosis of amyloidosis

Answer 6

Congo red staining

Question 7

ATTR protein

Answer 7

Non-degradable mutant amyloid

Question 8

AL protein cause

Answer 8

Plasma cell cancer creating Ig light chains

Question 9

Cause of AA proteins

Answer 9

Chronic inflammation -> macrophage activation -> IL-1 and IL-6 -> liver cells make SAA (serum amyloid A protein)

Question 10

What causes AA amyloidosis

Answer 10

Chronic inflammatory conditions

Question 11

Steps in inflammatory is AA amyloidosis systemic?

Answer 11

Because the SAA is found in the serum -> can affect multiple sites

Question 12

Sx of amyloids in kidneys, blood vessels, heart, and liver

Answer 12

Kidneys -> edema
Blood vessels -> bruising
Heart -> rhythmic disturbances
Liver -> jaundice

Question 13

How to treat amyloids

Answer 13

Based on the initiating inflammatory condition that is causing the amyloids