Cell injury CC

Question 1

Name the three acinar zones of the hepatic nodule

Answer 1

periportal, transitional, pericentral

Question 2

which acinar zone is most likely to be damaged by ischaemia and paracetemol overdose

Answer 2

pericentral zone

Question 3

What will be sign under the light microscope in hepatitis B/C

Answer 3

apoptotic cells called a councilman’s cell
eosinophilic
a dying hepatocyte surrounded by normal parenchymal cells

Question 4

Why are the councilman’s present in these viral infections

Answer 4

virally infected cells have been triggered to die by cytotoxic T cells

Question 5

Give 6 ways in which apoptosis differs to necrosis

Answer 5

Apoptosis:Cytoplasmic budding
Necrosis: Cytoplasmic blebbing

Apoptosis:Intact plasma membrane
Necrosis:Plasma membrane lyses

Apoptosis:happens to one or two cells on a slide
Necrosis:affects lots of cells

Apoptosis: Cell shrinkage
Necrosis: Cell swelling

Apoptosis:DNA fragmentation is ordered
Necrosis:DNA fragmentation is random

Apoptosis: No inflammatory reaction
Necrosis: Induces a inflammatory reaction

Question 6

Define hemiplegia

Answer 6

paralysis of one side

Question 7

what type of necrosis do you get in the brain and why

Answer 7

liquefactive

loose organ with little connective tissue

Question 8

A patient presents with pulmonary embolism. where do you need to check

Answer 8

legs for DVT

Question 9

How does excessive alcohol comsumption affect the liver?

Answer 9

fatty liver disease

Increased reacttive oxygen species–>DNA and protein damage

Immune destruction of hepatocytes–>Alcoholic hepatitis–>hepatomegaly and perivenular fibrosis

Question 10

What would you see in the lab with excessive alcohol consumption

Answer 10

Increased:
Alanine transaminase 
Aspartate transaminase
ALD
gamma-glutamyl transferase (GGT)

Thrombocytopenia
Hypoglycaemia
Mallory bodies present under the microscope- Damaged keratin filaments in the cytoplasm of hepatocytes

Question 11

how would someone present with hep B

Answer 11

Jaundice, abdo pain, anorexia, fever, malaise, nausea, hepatomegaly (inflammed so painful)

Question 12

What are the three markers for hepatitis used in laboratory diagnosis and seeing the progression of the disease

Answer 12

Surface antibody (HBsAb)
Core Antibody (HBcAg)      (IGM and IgG)
Surface antigen (HbsAg)

Question 13

Symptoms of acute pancreatitis

Answer 13

hypocalcaemia (Used by fat necrosis)
Cullen’s Sign (Bruised belly button)
Grey turners sign(Bruising along flanks)
Pain in epigastric region

Question 14

What would you see in the lab with acute pancreatitis?

Answer 14

Raised serum amylase and lipase

Question 15

What is Hereditary Haemochromatosis

Answer 15

Absorb an unusually high amoount of iron

Normally absorb about 10% of intake
Now absorb 25% ish

Question 16

What is the word for the deposition of iron in organs

Answer 16

Haemosiderosis

Question 17

Why is too high iron levels bad?

Answer 17

Can make free radicals (Fe2+ + H2O2–>Fe3+ + .OH + OH-

Causes cellular damage–>tissue fibrosis

Question 18

Name some complications of hereditary haemochromatosis (Organ then problem) (5 organs)

Answer 18

Liver- Cirrhosis and liver cancer
Pancreas- Type 1 diabetes(Destruction of β islet cells), Malabsorption
Skin- Bronze pigmentation
Heart- Arrythmias
Joints- degenerative joint disease

Question 19

Treatment for Hereditary Haemochromatosis

Answer 19

phlebotomy (blood letting)

Deferoxamine (Binds to free iron in the blood–>excretion in urine)

Question 20

What is alpha 1 antitrypsin deficiency?

Answer 20

liver produces incorrectly folded alpha 1 antityrpsin

Accumulates in the ER and not secreted

Question 21

Complications of alpha 1 antitrypsin deficiency

Answer 21

alpha 1 antitrypsin is a protease inhibitor
Normally macrophages secrete proteases to clear up debris in the lungs
to prevent excessive damage to lung tissue, the alpha 1 antitrypsin acts as an inhibitor

So decreased alpha 1 antitrypsin–> increased protease activity–>Emphhysema

Question 22

4 symptoms of alpha 1 antitrypsin deficiency

Answer 22

shortness of breath
wheezing
rhombi (crackling when breathing)
jaundice

Question 23

What is coal workers pneumoconiosis?

Answer 23

Build up of dust

Leads to inflammation, fibrosis and necrosis