Lab 2: Patterns of Necrosis

Question 1

What are the six types of necrosis?

Answer 1

1. Coagulative
2. Liquefactive
3. Fat
4. Caseous
5. Fibrinoid
6. Gangrenous

Question 2

What is coagulative necrosis seen in?

Answer 2

Ischemia/infarcts in most tissue (except brain)

Question 3

What is liquefactive necrosis seen in?

Answer 3

Bacterial abscesses, brain infarcts

Question 4

What is caseous necrosis seen in?

Answer 4

TB, systemic fungi

Question 5

What is fat necrosis seen in?

Answer 5

Enzymatic: acute pancreatitis
Nonenzymatic: traumatic

Question 6

What is fibrinoid necrosis seen in?

Answer 6

Immune reactions in vessels, preeclampsia, malignant hypertension

Question 7

Gangrenous

Answer 7

Distal extremity and GI tract, after chonic ischemia

Question 8

What happens in coagulative necrosis?

Answer 8

Ischemia or infarction; proteins denature, then enzymatic degradation

Question 9

What happens in liquefactive necrosis?

Answer 9

Neutrophils release lysosomal enzymes that digest the tissue; enzymatic degradation first, then proteins denature

Question 10

What happens in caseous necrosis?

Answer 10

Macrophages wall off the infecting microorganism –> granular debris

Question 11

What happens in fat necrosis?

Answer 11

Damaged cells release lipase to break down triglycerides, liberating fatty acids to bind calcium –> saponification

Question 12

What happens in fibrinoid necrosis?

Answer 12

Immune reactions in vessels, preeclampsia, malignant hypertension

Question 13

What is gangrenous necrosis?

Answer 13

Dry: ischemia
Wet: superinfection

Question 14

Infarct of heart?

Answer 14

Coagulative

Question 15

Infarct of kidney?

Answer 15

Coagulative

Question 16

Infarct of brain?

Answer 16

Liquefactive

Question 17

Trauma to breast?

Answer 17

Fat

Question 18

TB or fungal infection?

Answer 18

Caseous

Question 19

Vasculitis

Answer 19

Fibrinoid

Question 20

Gangrene on a diabetic?

Answer 20

Gangrenous

Question 21

Abscess?

Answer 21

Liquefactive

Question 22

Pancreatitis?

Answer 22

Liquefactive and fat

Question 23

Dystrophic calcification: Etiology?

Answer 23

Secondary to injury or necrosis

Question 24

Dystrophic calcification: Tissues involved?

Answer 24

Abnormal

Question 25

Dystrophic calcification: serum calcium level?

Answer 25

Normal

Question 26

Dystrophic calcification: extent of involvement?

Answer 26

Localized

Question 27

Metastatic calcification: etiology?

Answer 27

Secondary to hypercalcemia

Question 28

Metastatic clarification: tissues involved?

Answer 28

Normal

Question 29

Metastatic clarification: serum calcium level?

Answer 29

High

Question 30

Metastatic calcification: extent of involvement?

Answer 30

Widespread

Question 31

Three signs of left heart failure?

Answer 31

1 - Orthopnea 2 - Paroxysmal nocturnal dyspnea 3 - Pulmonary edema

Question 32

Three signs of right heart failure?

Answer 32

1 - Hepatomegaly 2 - Jugular venous distention 3 - Peripheral edema

Question 33

What are the three types of ischemic stroke?

Answer 33

1 - Thrombotic 2 - Embolic 3 - Hypoxic

Question 34

Which tissues contain CK - MM?

Answer 34

Skeletal and Cardiac

Question 35

Which tissues contain CK - MB?

Answer 35

Cardiac

Question 36

Hypereosinophilia

Answer 36

Acidosis, loss of the hemotoxylin-blue-staining DNA

Question 37

Pyknosis

Answer 37

Nucleus shrinks into a condensed knot

Question 38

Karyorhexis

Answer 38

Chromatin gets fragmented

Question 39

Karyolysis

Answer 39

Nucleus fades/disintegrates

Question 40

Hemorrharge

Answer 40

12-18hrs into MI

Question 41

What are reversible cell injury changes?

Answer 41

- Cellular swelling - Nuclear chromatin clumping - Decreased ATP synthesis - Decreased glycogen - Decreased fatty change - Ribosomal detachment

Question 42

What are irreversible cell injury changes?

Answer 42

- Nuclear pyknosis, karyolysis, karyorrhexis - Ca2+ influx --> caspase activation - Plasma membrane damage - Lysosomal rupture - Mitochondrial permeability OCCURS WITHIN 30 MINTUTES

Question 43

What is the most severely injured site of necrosis in the heart?

Answer 43

Subendocardium

Question 44

What three elevated lab tests would indicate dying myocytes?

Answer 44

CK-MB Troponins LDH

Question 45

Day 1-3 in dead tissue

Answer 45

Neutrophils dissolve and phagocytize dead tissue

Question 46

Day 2-7 in dead tissue

Answer 46

Macrophages phagocytize dead tissue

Question 47

Week 1-2 to 2 mo. in dead tissue

Answer 47

Fibroblasts deposit collagen, resulting in scar tissue

Question 48

Post-MI Complications: Intermediate

Answer 48

Arrhythmias