Pathologic Calcification

Question 1

Pathologic calcification

Abnormal deposition of _______ in tissues.
Smaller amounts of __,___ other minerals may also be present.

Answer 1

calcium salt

Mg, Fe,

Question 2

Pathologic calcification

● 2 types:
○_______ calcification
○________ calcification

Answer 2

Metastatic

Dystrophic

Question 3

Dystrophic
●______ tissues
●____ Ca levels
●________ in Ca metabolism

Answer 3

Dying

Normal

No derangement

Question 4

Metastatic

•_____ tissue
●____ Ca levels
●_______ in Ca
metabolism

Answer 4

Normal

High

Derangement

Question 5

Dystrophic calcification - Pathogenesis

● Found in ______ tissue regardless of ___

● The ________ in degenerate or necrotic tissue bind ______ ions and then react with _____ ions to form precipitates of _____

Answer 5

necrotic; type

denatured proteins

phosphate; calcium

calcium phosphate

Question 6

Dystrophic calcification

The final common pathway is the formation of _______ as an ____ which is similar to the ______ of _____

Answer 6

calcium phosphate mineral

Apatite; hydroxyapatite of bone.

Question 7

Dystrophic calcification

● _________ causes the accumulation of calcium in membrane bound vesicles.
● The calcium deposit attracts the deposition of _____

Answer 7

Membrane damage

phosphate

Question 8

Dystrophic calcification

The cycle of calcium and phosphate deposition continues until a _______ that then propagates and leads to _______

On occasion, a sigle necrotic cell can bind with ____ and then attract layers of mineral deposition and form a _______

Answer 8

microcrystal is formed.

more calcium deposition.

calcium

psammoma body.

Question 9

Dystrophic calcification

Morphology
● Macroscopically (naked eye), they appear as ___, ____ granules or clumps which are ___ to touch.

Answer 9

fine

white

gritty

Question 10

Dystrophic calcification

Microscopically, Ca salts look _____ (____), _______ and may have a lamellated appearance.

Answer 10

basophilic; purplish blue

amorphous

Question 11

Dystrophic calcification is only intracellular
T/F

Answer 11

F

They may be intracellular or extracellular

Question 12

Metastatic calcification
● Occurs in tissues when there is _____

● Principally affects ______ of gastric mucosa, lungs, kidneys, pulmonary veins and systemic arteries. These sites tend to have an _______ compartment that predisposes them to metastatic calcification

Answer 12

hypercalcemia

interstitial tissues

internal alkaline

Question 13

hypercalcemia may also accentuate dystrophic calcification.

T/F

Answer 13

T

Question 14

Aetiology of metastatic calcification

● Hyperparathyroidism:
○________ tumors
○ Secretion of _____

Answer 14

Parathyroid; PTH-rP

Question 15

Aetiology of metastatic calcification

● Destruction of bone tissue
○ Primary tumours of bone e.g. _____
○ Metastatic cancer to the bone e.g. ____
○ Accelerated bone turnover e.g. ________
○ Prolonged _____

Answer 15

multiple myeloma

breast cancer; Paget’s disease

immobilization

Question 16

Aetiology of metastatic calcification

Vitamin D related disorders
○ Vit. D _______
○_____ (_______ activate Vit. D precursor)
○_______ syndrome (idiopathic hypercalcemia of infancy) causes abnormal sensitivity to Vit. D.

Answer 16

intoxication

Sarcoidosis; macrophages

Williams

Question 17

Aetiology of metastatic calcification

● Hyperphosphatemia
○______ failure leads to phosphate retention which causes secondary hyperparathyroidism
○_________ phosphate

Answer 17

Renal

Exogenous

Question 18

Aetiology of metastatic calcification

Milk-alkali syndrome: ___ supplements taken for e.g.______ together with an _____.

Answer 18

Ca

osteoporosis

antacid

Question 19

Morphology of metastatic calcification

● Usually there is no loss of function in the organ, however massive deposits in
the _____ and ______ ( ______ ) may result in _______ difficulties and ____ damage.

Answer 19

lungs and kidney

nephrocalcinosis

respiratory; kidney

Question 20

metastatic calcification is Similar to dystrophic calcification morphologically

T/F

Answer 20

T

Question 21

Examples of dystrophic calcification
1. In _______ heart valves
2. Uterine ______
3._______ blood vessels
4. Tumours e.g. papillary thyroid carcinoma, papillary serous carcinoma
5. ________
6.________ lymphnodes
7. _______ in the lungs
8._______

Answer 21

aging or damaged

leiomyomas

Damaged; Atherosclerosis

Tuberculous; Asbestosis

Lithopaedion

Question 22

The following except one are causes of metastatic calcification

Parathyroid adenoma
Rickets
Multiple myeloma
Paget’s disease
Renal failure

Answer 22

Rickets

Question 23

Heterotopic calcification is the ______________

Answer 23

presence of bone in soft tissue where bone normally does not exist.

Question 24

Dystrophic Calcification
is almost always present in the _____ of advanced atherosclerosis. It also commonly develops in aging or
damaged ______, further hampering their function

Answer 24

atheromas

heart valves

Question 25

Calcification can be intracellular, extracellular, or in both locations.

T/F

Answer 25

T

Question 26

Examples of dystrophic calcification

Calcifications in thickened myometrial vessels (___________).

__________ in some tumors like papillary carcinoma thyroid/ Meningioma/ Papillary renal cell carcinoma/ Papillary serous cystadenoma.

Gamma gandy bodies in congestive _______

__________ in Asbestosis of lung

Answer 26

Monckebergs sclerosis

Psammoma bodies

spleenomegaly

Asbestos bodies

Question 27

Monckeberg’s arteriosclerosis is a ________ and _______ disease involving the ____ of small and medium-sized muscular arteries.

These vessels become calcified independently of ___.

Answer 27

degenerative and noninflammatory

media

atherosclerosis

Question 28

Psammoma bodies are formed by ____ deposition of calcium around ____ cell which forms ____ for calcium deposit. The term “psammoma” is derived from greek word “psammos” means _____

Answer 28

concentric

necrotic

seed

sand grain