Path 2

Question 1

Coagulative necrosis

Answer 1

ischemic infarct

Usually wedge-shaped, pale or red

Question 2

Liquifactive necrosis

Answer 2

Enzymes lyse cells & proteins

1. Brain - microglia
2. Abscess - neutrophils
3. Pancreatitis - enzymes - parenchyma

Question 3

Dry gangrene

Answer 3

Ischemia of lower limb - Diabetics

Question 4

Wet gangrene

Answer 4

Superimposed infection, then liqufactive necrosis

Question 5

Caseous necrosis

Answer 5

Soft, friable tissue w/ cottage cheese appearance

FUNGAL/TB - granulomatous inflammation

Coagulative + liquifactive

Question 6

Fat necrosis

Answer 6

Chalk-white d/t Ca

1. Breast trauma
2. PERI-pancreatic fat

Question 7

Saponification

Answer 7

Fat + calcium

Question 8

Dystrophic calcification

Answer 8

Necrotic tissue becomes nidus for calcification (saponification)

Psamomma bodies

NORMAL serum Ca, Phos

Question 9

Metastatic calcification

Answer 9

HIGH serum Ca, Phos –> calcium deposition in normal tissues

- hyperparathyroidism

Question 10

Fibrinoid necrosis

Answer 10

Blood vessel wall
Fibrin leaks into wall –> BRIGHT PINK wall

1. Malignant HTN
2. Vasculitis
3. Pre-eclampsia - 30 y/o woman

Question 11

Apoptosis

Answer 11

Caspases –> proteases & endonucleases –> apoptotic bodies –> cleaned by MO

1. Lack of BCL-2 –> cytochrome C leaks out
2. FAS-L –> CD95 on T-cells or TNF-alpha
3. CD8+

Question 12

Underlying mechanism of damage in Wilson disease and Hemochromatosis

Answer 12

Hydroxyl free radical generation

Question 13

CCl4

Answer 13

Dry cleaning

P450 –> CCl3 –> swelling –> dec Apos –> FATTY CHANGE

Question 14

Continued inc in cardiac enzymes after opening of vessel

Answer 14

Reperfusion injury

Question 15

Amyloidosis

Answer 15

Misfolded protein deposition –> tissue damage
- often around BVs

1. B-pleated sheet
2. Congo-red stain + apple-green birefringence

Question 16

Primary Systemic amyloidosis

Answer 16

AL Amyloid - light chain

Blood dyscraisias - MM

Question 17

Secondary Systemic amyloidosis

Answer 17

AA amyloid - from SAA (acute phase reactant)

Chronic inflammation

• auto-immune, crohn’s, UC, RA
• Malignancy
• Familial mediterranean fever

Question 18

Familial Mediterranean fever

Answer 18

AR
Dysfxn of NEUTROPHILS

Mimics appendicitis, MI, arthritis

Question 19

Findings of systemic amyloidosis

Answer 19

Kidney is most commonly involved organ

1. Nephrotic syndrome
2. Restrictive cardiomyopathy
3. Tongue enlargement, malabs, HSM

Dx = Bx
Tx = transplant

Question 20

Senile amyloid

Answer 20

Serum transthyretin

Elderly, No sx, heart

Question 21

Familial amyloid cardiomyopathy

Answer 21

MUTATED serum transthyretin

Restrictive cardiomyopathy
5% A.A.s

Question 22

Type II DM Amyloid

Answer 22

Amylin (from insulin) –> islets

Question 23

Alzheimer amyloid

Answer 23

A-Beta amyloid from beta amyloid precursor protein

Chr21 - Down syndrome develop early alzheimers

Question 24

Dialysis amyloid

Answer 24

Beta-2 micoglobulin

Joints

Question 25

Medullary carcinoma of the thyroid amyloid

Answer 25

Calcitonin deposits in tumor - 'tumor cells in an amyloid backgrouns'

Question 26

Mechanism of metaplasia

Answer 26

Reprogramming of stem cells | It is reversible

Question 27

Only dysplasia w/o inc risk of cancer

Answer 27

Apocrine metaplasia of breast

Question 28

Keratomalacia

Answer 28

Vit A deficiency --> metaplasia/thickening of conjunctiva

Question 29

Myostitis ossificans

Answer 29

Mesenchymal metaplasia - muscle --> bone after trauma

Question 30

Cause of Budd-Chiari

Answer 30

Polycythemia vera

Question 31

Causes of hypoxemia

Answer 31

1. High altitude 2. Hypovent 3. diffusion defect/fibrosis 4. V/Q mmismatch

Question 32

Methemoglobinemia

Answer 32

Fe2 oxidized to Fe3 SaO2 DEC Sulfas, nitrates, newborns Cyanosis w/ CHOCOLATE colored blood Tx = methylene blue

Question 33

Reversible cell injury

Answer 33

Cellular swelling | - blebs, dec protein syn, no microvilli

Question 34

Irreversible cell injury

Answer 34

Membrane damage | - cytosolic contents, Ca into cell, cyto c, lysosomal enzymes