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2 - CR/MET > Met histology > Flashcards

Met histology Flashcards

1
Q

Portal tract contents

A

Islands of connective tissue
Contain branches of the hepatic portal vein and hepatic artery
Also contain a bile duct

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2
Q

Bile duct epithelium type

A

Simple cuboidal

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3
Q

Hepatic lobule

A

Hexagonal shaped
Central vein (hepatic venue) in the muddle
Portal tracts at corners
Blood flows from corner –> centre

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4
Q

Types of hepatic necrosis

A 
Zonal = in one zone of the acinar unit 
--> haemodynamic changes
Bridging = forms bridge between portal tract and central vein 
--> severe hepatitis
Interface = around a portal tract 
--> autoimmune 
Apoptotic = single cells 
--> acute viral hepatitis
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5
Q

Primary biliary cirrhosis

A 
Autoimmune disease (anti-mitochondrial antibodies)
Infiltration of portal tracts 
Interface necrosis 
Granulomas around portal tracts
--> cirrhosis
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6
Q

Collagen produced in cirrhosis

A

Types I and III

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7
Q

Classification of nodules

A 
Micro = <3mm --> alcoholic liver disease
Macro = >3mm --> greater risk of HCC
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8
Q

HCC features

A

Cells resemble hepatocytes resting in nests
Central lumen
Bile may be secreted

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9
Q

Pituitary cell types

A 
Somatotrophs (50%) --> GH 
Mammotrophs (20%) --> PRL 
Corticotrophs (20%) --> ACTH
Thyrotrophs (5%) --> TSH 
Gonadotrophs (5%) --> FSH and LH
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10
Q

Pituitary stalk contents

A

Pituicytes
Portal vessels
Hypothalamic neurone axons

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11
Q

Thyroid follicle structure

A

Lined by simple cuboidal follicular cells –> release T3 and T4
Thyroid colloid in the middle containing thyroglobulin

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12
Q

C cells

A

= parafollicular cells

Secrete calcitonin in response to high calcium levels

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13
Q

Parathyroid cells

A 
Chief cells --> PTH production 
Oxyphil cells (small central nuclei) --> function unknown
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14
Q

ZG cells

A

Rounded clumps

  • -> mineralocorticoids
  • -> aldosterone
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15
Q

ZF cells

A

Parallel cords of cells

  • -> glucocorticoids
  • -> cortisol
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16
Q

ZR cells

A

Irregular cords of cells

  • -> androgens
  • -> testosterone
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17
Q

Adrenal gland blood supply

A 
Adrenal artery in capsule
Subscapular plexus in ZG 
Venous sinusoids through ZF 
Medullary plexus in ZR and medulla 
Adrenal vein drains from medulla
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18
Q

Medulla blood supply

A

Blood from the cortex

Direct supply from vessels in the outer cortex

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19
Q

Islet cell proportions

A 
Alpha = 20% 
Beta = 70% 
Delta = 5-10% 
F = 1-2%
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20
Q

Somatostatin release and function

A

From islet delta cells

Inhibits insulin and glucagon secretion

21
Q

Pancreatic polypeptide release and function

A 
From F (pp) islet cells 
Inhibits pancreatic enzyme secretion
22
Q

Pituitary adenoma cell features

A

Uniform cells with large amounts of cytoplasm
Reduction in supporting network
Large areas stain positive for the same hormone

23
Q

Features of Grave’s disease

A

Thyrotoxic hyperplasia
Colloid scallopping
Follicular cells are taller with larger nuclei
Follicles themselves are smaller

24
Q

Renal cortex contents

A 
Renal corpuscles
PCT
DCT 
Capillary network 
Medullary rays (some collecting ducts)
25
Q

Renal medulla contents

A

Loops of Henle
Collecting ducts and tubules
Vasa recta

26
Q

Bowman’s capsule walls

A 
Visceral = podocytes 
Parietal = simple squamous
27
Q

Glomerular filtration barrier

A

Podocytes
Basement membrane
Glomerulus endothelium

28
Q

PCT wall structure

A

Simple cuboidal
Brush border
Endocytotic vesicles + lysosomes
Basolateral interdigitations

29
Q

Loop of Henle sections

A

Pars recta = same structure as PCT
Thin descending limb = simple squamous
Thin ascending limb = simple squamous
Thick ascending = simple cuboidal with basal interdigitations

30
Q

Loop of Henle permeability

A

Thin descending = permeable to urea and water but not NaCl
Thin ascending = permeable to NaCl but not water
Thick ascending = active transport of NaCl

31
Q

DCT wall structure

A

Simple cuboidal
Few microvilli and vesicles
No brush border
Basolateral interdigitations

32
Q

Collecting duct wall structure

A

Simple cuboidal

No interdigitations

33
Q

Juxtaglomerular cells

A

Specialised smooth muscle cells
Around afferent (few in efferent) arterioles
Secrete renin
Beta1 receptors for SNS stimulation

34
Q

Macula densa cells

A

Taller and more densely packed than the rest of the DCT
Sense the sodium concentration
Communicate with JG cells via mesangial cells

35
Q

Lacis cells

A

Extraglomerular mesangial cells

36
Q

Urinary passageway mucosa

A

Transitional epithelium

Impermeable to urine

37
Q

Ureter muscle layers

A 
Inner = longitudinal 
Middle = circular 
Outer = longitudinal
38
Q

Urinary passageway layers

A

Transitional epithelium
Lamina propria/submucosa (no musculares mucosae)
Muscularis (3 layers)
Adventitia

39
Q

Glomerular response in GN

A

Swelling of endothelial cells
Podocyte proliferation
BM thickening
Mesangial cell proliferation

40
Q

Histological patterns of GN

A 
Diffuse = affects all glomeruli 
Focal = affect some glomeruli 
Global = entire glomerulus abnormal 
Segmental = only part of the glomerulus abnormal
41
Q

Minimal change GN

A

–> nephrotic syndrome
Cell mediated immune response
LM is normal
EM shows flattened podocyte foot processes
Children under 6 after respiratory infection
Corticosteroid treatment

42
Q

Membranous GN

A

–> nephrotic syndrome
Chronic immune mediated disease
LM shows diffuse BM thickening
EM shows deposition of electron dense immune complexes
Occurs in adults
Associated with infection, drugs, tumours and autoimmune disease

43
Q

Diabetic GN

A

–> nephrotic syndrome
Caused by hyperglycaemia
Capillary wall thickening, mesangial matrix expansion, BM thickening
Kimmelstein-Wilson nodules (mesangial expansion)

44
Q

Acute proliferative GN

A

–> nephritic syndrome
Diffuse glomerular hypercellularity
–> proliferation of endothelial and mesangial cells
–> neutrophil infiltration
Occurs most commonly in children 1-4 weeks after Strep infection of pharynx or skin
EM shows sub endothelial lumps (immune complex deposition)

45
Q

Nephrotic vs nephritis syndrome

A

Nephrotic = without inflammation
Nephrotic –> proteinuria, hypoalbuminaemia, oedema, hyperlipidaemia, lipiduria
Nephritic –> haematuria, proteinuria, periorbital oedema, hypertension

46
Q

Renal cell carcinoma

A

Adenocarcinomas derived from tubular epithelial cells

90% of primary kidney tumours

47
Q

Clear cell carcinoma

A

Derived from PCT cells

Tend to invade renal vein

48
Q

Transitional cell carinoma

A

Most common malignant bladder tumour
Often have a papillary growth pattern
May see large blood vessels

49
Q

Nephroblastoma

A

= small round blue cell tumour
= Wilm’s tumour
Very rate
Seen in very young children

2 - CR/MET (8 decks)

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