Test 1: lecture 5 calcification, pigments and amyloid

Question 1

two categories of mineralization or calcification

Answer 1

dystrophic → calcification of necrotic tissue with a normal serum calcium

metastatic→ calcification in a living tissue with high serum calcium

Question 2

___ is the calcification of necrotic tissue in an animal with normal serum calcium

Answer 2

dystrophic mineralization

dead cells that have too much calcium

Question 3

dystrophic mineralization occurs in ___ cells with ___ levels of calcium

Answer 3

dead (necrotic)

normal

Question 4

metastatic mineralization occurs in ___ cells with ___ levels of calcium

Answer 4

living

elevated (hypercalcemia)

Question 5

what are some causes of hypercalcemia

Answer 5

Hypercalcemia of malignancy associated with some lymphomas, anal sac gland carcinomas and others (parathyroid-like hormone - PTH-rP- produced by these tumors)

Primary hyperparathyroidism (due to parathyroid adenomas)

Vitamin D toxicity (plant-derived (e.g., Cestrum diurnum), therapeutic overdoses, cholecalciferol rodenticides)

Question 6

how does anal sac gland carcinomas effect calcium

Answer 6

they produce PTH-rP that causes the increase of serum calcium

example of metastatic calcification

Question 7

how does an adenoma effect serum calcium

Answer 7

Question 8

how does Vit D effect serum calcium

Answer 8

Question 9

how does bone destruction effect serum calcium

Answer 9

Question 10

___ is caused by abnormal Ca: PO4 ratio

Answer 10

uremic mineralization→ caused by the accumulation of uremic toxins resulting from renal failure

type of metastatic calcification

Question 11

Answer 11

uremic mineralization

metastatic calcification caused by abnormal Ca: PO4 ratio due to renal failure

Question 12

where are common places to see uremic mineralization

Answer 12

lung, tongue, kidney, plural cavity

Question 13

what two pigments come from heme

Answer 13

hemosiderin( golden-yellow)→ contains iron

bilirubin→ green brown

Question 14

___ contains iron and is golden yellow

Answer 14

hemosiderin

found within macrophages where RBC are being broken down

Question 15

hemosiderin

Answer 15

golden-yellow or blue based on stain

contains iron

found inside macrophages when RBC are being broken down

Heme → iron(hemosiderin) and bilirubin

Question 16

another name for jaundice

Answer 16

icterus

Question 17

bulirubin

Answer 17

green-brown

does not contain iron

too much = jaundice/icterus

from breakdown of red blood cells

major component of bile

3 types: prehepatic, hepatic, posthepatic

Question 18

3 types of icterus

Answer 18

prehepatic → hemolysis occurs in RBC when they are being broken down → unconjugated bilirubin

Hepatic→ liver disease→ increased conjugated and unconjugated bilirubin

Posthepatic→ bile duct obstruction → increased conjugated bilirubin

Question 19

___ is the major component of bile

Answer 19

bilirubin

Question 20

prehepatic icterus

Answer 20

Hemolysis- at the RBC level

Many different causes (immune-mediated, infectious, metabolic, trauma, toxin)

Increased unconjugated bilirubin (at first)

Question 21

hepatic icterus

Answer 21

liver disease

compromised ability to take up or excrete bilirubin

increased conjugated and unconjugated bilirubin

Question 22

posthepatic icterus

Answer 22

Bile duct obstruction

increased conjugated bilirubin

Question 23

path of colors for a bruise

Answer 23

(red-blue) hemoglobin broken down by lysosomes in macrophages

green-blue (biliverdin and bilirubin)

golden yellow (hemosiderin)

Question 24

melanin is produced by ___

Answer 24

melanosomes inside melanocytes

Question 25

what are some benefits of melanin

Answer 25

Absorbs ultraviolet light quench free radicals to prevent solar- induced cell damage cosmetic pigmentation camouflage.

Question 26

what organelles produce pigment

Answer 26

melanosomes

Question 27

\_\_\_ is patchy pigment

Answer 27

vitiligo

Question 28

\_\_\_ is a mutation in the tyrosinase gene

Answer 28

albinism

Question 29

albinism is a mutation in what gene?

Answer 29

tyrosinase

Question 30

hyperpigmentation can be caused by \_\_\_

Answer 30

chronic irritation- secondary to cutaneous insult

Question 31

Lipofuscin

Answer 31

wear and tear this cell had a rough life→ shows past trauma formed in lysosomes and consists of lipids complexed with proteins brownish yellow granular intracellular pigment

Question 32

Answer 32

lipofuscin wear and tear pigment→ shows previous damage, formed by lysosomes

Question 33

three types of amyloid

Answer 33

**light chain-** plasma cells **reactive**- inflammation (SAA) **islet**

Question 34

\_\_\_ causes atrophy and impaired function and is deposited in the interstitium of various organs

Answer 34

amyloid

Question 35

Answer 35

light pink→ amyloid dark pink → hepatocyte the amyloid is squishing the hepatocyte causing atrophy and impaired function

Question 36

amyloid is deposited where?

Answer 36

in the space outside a cell and then it squishes the cell into atrophy and impaired function

Question 37

what color is amyloid with iodine?

Answer 37

blue-black Lugol's iodine

Question 38

what stain is used to make amyloid show up

Answer 38

lugols iodine → blue black congo red → orange-red and then apple-green birefringence with polarized light H and E: light pink (eosinophilic)

Question 39

Light chain amyloid

Answer 39

primary plasma cells composed of immunoglobulin light chains secreted by neoplastic plasma cells **broken plasma cells produce too many antibodies→ not related to inflammation**

Question 40

\_\_\_ type of amyloid is from overactive plasma cells

Answer 40

light chain (primary)

Question 41

Answer 41

``` Light chain (AL) • “Primary” amyloidosis ``` Composed of immunoglobulin light chains secreted by neoplastic plasma cells NOT related to inflammation!

Question 42

Reactive AA

Answer 42

secondary derived from **serum amyloid associated (SAA)** caused by **inflammation**

Question 43

chronic inflammation causes the formation of ___ protein by the liver

Answer 43

reactive amyloid from SAA(serum amyloid associated) protein produced by the liver during inflammation

Question 44

islet amyloid polypeptide

Answer 44

**endocrine (insulin by beta cells)** seen in aged cats +/- diabetes forms in the pancreas

Question 45

(a partial decrease in oxygen supply)

Answer 45

Hypoxia

Question 46

(complete absence of oxygen

Answer 46

anoxia

Question 47

(reduction in blood flow

Answer 47

ischemia

Question 48

complete absence of blood flow

Answer 48

infarction

Question 49

carcinoma vs sarcoma

Answer 49

**Carcinomas.** A carcinoma begins in the skin or the tissue that covers the surface of internal organs and glands. Carcinomas usually form solid tumors. They are the most common type of cancer. Examples of carcinomas include [**_prostate cancer**_](https://www.cancer.net/node/19562), [_**breast cancer**_](https://www.cancer.net/node/18618), [_**lung cancer**_](https://www.cancer.net/node/19148), and [_**colorectal cancer_**](https://www.cancer.net/node/18701). **Sarcomas.** A [**_sarcoma_**](https://www.cancer.net/node/19604) begins in the tissues that support and connect the body. A sarcoma can develop in fat, muscles, nerves, tendons, joints, blood vessels, lymph vessels, cartilage, or bone.

Question 50

**Leukemias vs lymphoma**

Answer 50

**Leukemias.** Leukemia is a cancer of the blood. Leukemia begins when healthy blood cells change and grow uncontrollably. The 4 main types of leukemia are [**_acute lymphocytic leukemia**_](https://www.cancer.net/node/19037), [_**chronic lymphocytic leukemia**_](https://www.cancer.net/node/19092), [_**acute myeloid leukemia**_](https://www.cancer.net/node/19065), and [_**chronic myeloid leukemia_**](https://www.cancer.net/node/19106). **Lymphomas.** Lymphoma is a cancer that begins in the lymphatic system. The lymphatic system is a network of vessels and glands that help fight infection. There are 2 main types of lymphomas: [**_Hodgkin lymphoma**_](https://www.cancer.net/node/19178) and [_**non-Hodgkin lymphoma_**](https://www.cancer.net/node/19207).

Question 51

pathogenesis of secondary amyloidosis

Answer 51

inflammation → SAA protein made in the liver → SAA eaten by macrophages and turned into amyloid . amyloid deposits into the space of disse in the liver and the glomerulus or intersititum of the kidney cells atrophy

Question 52

where in amyloid deposited in the liver

Answer 52

space of Disse

Question 53

where is amyloid deposited in the kidney

Answer 53

glomerulus

Question 54

what stain and what is the pink stuff?

Answer 54

amyloid in the glomerulus of the kidney Red congo stain

Question 55

what is the pink stuff in the tubules and why

Answer 55

The eosinophilic material in the tubules is **proteinaceous fluid** that has leaked through the glomeruli **damaged by the amyloid.**

Question 56

what is the most common form of amyloid found in the kidney?

Answer 56

AA- reactive/ inflammatory → secondary

Question 57

familiar forms of AA(secondary amyloid) are found in what species

Answer 57

Sharpei dogs and Abyssinian cats)

Question 58

where are common places to see uremic mineralization

Answer 58

left atrium, kidney, parietal pleura, tongue and lungs

Question 59

Answer 59

pancreatic nodular hyperplasia

Question 60

what type of mineralization?

Answer 60

Dystrophic; This horse had a bacterial infection of the umbilicus when it was a foal which resulted in necrosis and then dystrophic mineralization.

Question 61

bright golden yellow spicular-cocklebur shaped pigment

Answer 61

hematoidin.

Question 62

golden brown granular pigment in macrophages

Answer 62

hemosiderin

Question 63

hemosiderin vs hematoidin

Answer 63

**Hemosiderin** is hemoglobin-derived granular golden yellow to yellow brown pigment. It is most often found in **macrophages** at sites of erythrocyte lysis or breakdown. It **contains iron** and will stain positively for iron pigment (Prussian blue). **Hematoidin** is derived from hemoglobin deposited locally in tissues at the site of prior hemorrhage. It is a refractive, yellow-brown and orange-red cocklebur-shaped granular pigment. Hematoidin and bilirubin are very similar if not the same in chemical composition. It does not stain positively with Prussian blue. **No iron**

Question 64

what type of pigment

Answer 64

melanin

Question 65

The main pigment in this liver is \_\_\_in canaliculi and in larger accumulations (bile lakes). Some students found a small amount of brown intracytoplasmic pigment in hepatocytes and Kupffer cells that is most likely ___ and some slides contain \_\_\_in Kupffer cells.

Answer 65

**bilirubin** **lipofuscin** **hemosiderin**

Question 66

Bilirubin stains with

Answer 66

Hall's stain for bile

Question 67

what stain for hemosiderin

Answer 67

Prussian Blue- iron

Question 68

where is hemosiderin found

Answer 68

in macrophages (kupffer cells)