Necrosis Apoptosis

Question 1

T/F
Caseous necrosis is a type of necrosis where architecture of cells is not maintained and there is coagulation of proteins.

Answer 1

True

Question 2

What is a Langhans giant cell?

Answer 2

Cell formed by fusion of epithelioid cells and contains nuclei arranged in a horseshoe patter.

Question 3

Typical location of caseous necrosis:

a. Brain
b. Lung
c. Spleen
d. Hilar Lymph nodes
e. Kidneys

Answer 3

Lung. Hilar Lymph node. Kidneys

Question 4

Which is true concerning Fat Necrosis?

a. Can occur in Breast
b. Can occur in Salivary gland
c. Generally appear in Pancreas
d. Can lead to Calcification
e. Characterized by digestive enzymes acting on fat

Answer 4

All

Question 5

Fat Necrosis generally associated with:

a. Acute Pancreatitis
b. Pulmonary Embolism
c. Acute Myocardial Infarct
d. Breast trauma
e. Bile obstruction

Answer 5

Trauma to Fat (breast, salivary glands)
Acute pancreatitis
Bile obstruction leading to activation of pancreatic enzymes

Question 6

True or false

Alcohol consumption promotes fat necrosis

Answer 6

True, alcohol increases the production of pancreatic enzymes and obstruct acini leading to rupture and leakage of enzymes

Question 7

Which is false about fibrinogen necrosis?

a. Is not a necrosis
b. Involved antibody antigen complexes deposition in arterial wall
c. can be detected by naked eye in autopsy
d. Can be due to preeclampsia
e. Can lead to calcification

Answer 7

C) is false.
Fibrinoid necrosis which is not a true necrosis but an injury of autoimmune origin can only be detected by histological examination.
Complexes of Ab/ag are deposited in arterial wall. Fibrin leaks out of blood vessel and bind to the complexes. Formation of a pink amorphous fibrinoid mass. Normally can be phagocytosed but in some cases debris can attract calcium salts resulting in calcification.

Question 8

Fibrinoid necrosis is present in/ can be due to:

a. Vasculitis
b. Poly Arteritis Nodosa
c. Ischemic Stroke
d. Gastric Ulcer
e. Malignant hypertension

Answer 8

Vasculitis, Poly Arteritis Nodosa, Malignant hypertension in particular renal vessels, preeclampsia

Question 9

True or False

Swelling is present in apoptosis while shrinkage is present in necrosis

Answer 9

False swelling is present in NECROSIS while shrinkage is present in APOPTOSIS

Question 10

True for APOPTOSIS

a. Nucleus undergoes fragmentation
b. It is a physiological process which doesn’t require energy
c. There is shrinkage of the cell
d. Often lead to inflammation
e. There is unspecific enzymatic digestion of the cellular content

Answer 10

Nucleus undergo fragmentation, this process requires energy, no inflammation present, cellular content intact enzyme activation via cas passé.

Question 11

Which is true for coagulative necrosis?

a. Proteolysis is blocked
b. Necrosis is so extensive that autolytic enzymes digest the tissue
c. Nucleus disappears and outiline of the cell is preserved
d. Forms a pale triangle shaped area of infarctus tissue
e. Common in the brain

Answer 11

a. c. d.

In coagulative necrosis underlying tissue architecture is preserved.
In coagulative necrosis there is no digestion due to enzymatic coagulation. Autolytic enzymes are denatured. Eosinophilia can occurs due to block proteolysis.
It is characteristic of infarction in solid organs. Primarily occurs in heart kidney and adrenal gland.

Question 12

T/F

Liquefactive necrosis is typical of bacterial and fungal infection.

Answer 12

True

Question 13

T/F

Dry gangrene is mainly due to venous blockage.

Answer 13

False

Dry gangrene is mainly due to arterial occlusion and is not found in coronary, aortic arch vasculature or brain

Question 14

What causes the black color present in gangrene?

Answer 14

Due to release of hemoglobin from hemolyzed red blood cells

Question 15

What is claudication intermittens?

Answer 15

Early symptom of gangrene development. Pain develops during use of limb. Causing patient to stop (e.g stop walking). Due to increase demand when limited supply.

Question 16

T/F

Dry gangrene can result in auto-amputation

Answer 16

True

Dry gangrene (gangrene Wicca) is characterized by presence of a separation line

Question 17

What is the pathogenesis of gangrena humida?

Answer 17

Heterolytic enzymes from bacteria digest the tissue.

Toxic products from bacteria are absorbed and there is free communication between infected fluid and circulatory fluid leading to sepsis.

Question 18

False about dry gangrene:

a. Occurs in moist tissues : mouth bowel lungs cervix vulva
b. Develops mainly due to venous blockage
c. Limited putrefaction
d. A type of coagulative necrosis
e. lots of fluid in early stages because acute inflammation and hyperemic reaction

Answer 18

c. d

These are characteristics of dry gangrene

Question 19

Gangrene affecting deeper layers of the skin:

Answer 19

Necrotizing Fasciitis

Question 20

Male genitals/groin gangrene

Answer 20

Fournier gangrene

Question 21

True about caseous necrosis

a. Common in pancreas
b. Tissue is firm and architecture is maintained
c. Digestion by activated autolytic enzymes
d. Giant Langhans cells often present formed by fusion of epitheloid cells (macrophages)
e. Necrosis surrounded by granulomatous tissue

Answer 21

d and e

Tissue is SOFT and architecture is not maintained
There is coagulative of proteins.
Can be caused by mycobacterium (tuberculosis)

Question 22

Which are the variables affect onset time of necrosis?

Answer 22

1. Type of tissue

2. Glycogen content

Question 23

How does fat necrosis looks like in histology?

Answer 23

Foci of necrosis with shadowy outlines. Dead adipolyses with blurred borders. Basophils calcium deposits surrounded by inflammatory reaction.

Question 24

Which caspase is recruited and activated to Fasligand Fasreceptor complex?

Answer 24

Caspase 8

Question 25

Witch are the three pathways example of extrinsic apoptosis?

Answer 25

1. Fas Ligand pathway 2. TNF pathway 3. Tc Pathway

Question 26

What are the differences between extrinsic and intrinsic pathway of apoptosis?

Answer 26

Intrinsic pathway is mainly due to mitochondria, activation of Bcl-2 family leading to release of cytochrome c. Activation of pro caspase 9 leading to activation of caspase 3. No death receptors is needed.

Question 27

Give three possible ways to activate p53

Answer 27

1. DNA damage 2. Hypoxia 3. Aberrant oncogene expression

Question 28

True about p53 a. Promotes DNA damage b. Usually Activated in human cancer it has the ability to deactivate apoptosis c. Can be activated by hypoxia d. Too much activation can lead to arthritis and multiple sclerosis e. P53 promotes cell cycle check points

Answer 28

c d and e P53 tumor suppressor gene can ACTIVATE apoptosis. Activated by DNA damage, hypoxis and aberrant oncogene expression. P53 promotes cell-cycle checkpoints, DNA repair, cellular senescence and apoptosis. Most commonly inactivated tumor suppressor gene in human cancer. Over activation can lead to arthritis, multiple sclerosis and neuropathies.

Question 29

Give 4 morphological characteristics of apoptosis.

Answer 29

1. Apoptotic bodies inside the cells 2. Eosinophilia cytoplasm 3. Nuclear condensation and fragment (pyknosis, karyorrhexis) 4. No inflammation or enzymatic leakage 5. Dystrophy Degeneration

Question 30

Give 5 organs where coagulative necrosis mainly occurs

Answer 30

1. Kidney 2. Heart 3. Adrenal Gland 4. Liver 5. Spleen

Question 31

Give 5 general characteristics of morphology of coagulative necrosis

Answer 31

1. Firm architecture 2. Acidophilia 3. Lack of nucleus 4. Outline of cell preserved 5. Enzymatic coagulation. No digestion