5. accumulation

Question 1

Accumulation of abnormal amounts of various substances

Question 2

Reversible/ irreversible if the derangement controlled

Answer 2

reverse

Question 3

Substances accumulated fall into 3 categories

Answer 3

Normal cellular constituent such as H2O, lipids, proteins, & carbohydrates

Abnormal exogenous or endogenous substance

Pigment

Question 4

Mechanisms of intracellular accumulation 3

Answer 4

rate of metabolism is inadequate to remove the substance eg. fatty liver disease

Genetic or acquired defects in metabolism, packaging, transport, or secretion e.g., lysosomal storage disease

The cell lacks enzyme to degrade or transport it e.g., carbon or silica

Question 5

water accumulation

Answer 5

hydropic change
early signs of cellular injury

Question 6

lipid accumulation can be

Answer 6

TAG
cholestrol
xanthomas

Question 7

TAG accumulation

Answer 7

Accumulations of triglycerides within parenchymal cells
Liver but also in the heart, muscle & kidney

Question 8

TAG 1st accumulates in the ………….=> fat globules without membrane

Answer 8

rough ER (liposomes)

Question 9

under microscope seen as clear vacuole so stains are

Answer 9

Special stains like Sudan IV or oil red are used to confirm

Question 10

Fatty change (steatosis) of the liver:mechanisms

Answer 10

Excessive entry of free fatty acids
Increased fatty acid synthesis
Decreased fatty acid oxidation
Excess esterification of fatty acid to triglycerides: alcohol poisoning
Decreased apoprotein synthesis : malnutrition, CCL4, phosphorus
Impaired lipoprotein secretion from the liver

Question 11

Causes of fatty change of the liver

Answer 11

Alcohol
Non-alcoholic fatty liver disease in metabolic syndrome (obesity, type II DM, dyslipidemia & hypertension)
Nutritional: Kwashiorkor
Drugs & toxins: steroids, ART, mushroom
Metabolic: abetalipoprteinemia
Others: acute fatty liver of pregnancy, Hepatitis C virus

Question 12

why Alcohol most common hepatotoxin

Answer 12

Alters mitochondrial function
Increases free fatty acid (FFA) synthesis
Diminishes triglycerides utilization
Decreases fatty acid oxidation
Blocks lipoprotein excretion
Enhances lipolysis
Increases delivery and uptake of FFA

Question 13

causes of Fatty change of the heart

Answer 13

poor oxygenation
diptheria exotoxin

Question 14

Differential diagnosis of clear space in an H&E-stained tissue in a cell

Answer 14

Special stains:
Periodic acid-Schiff (PAS) for glycogen
Mucicarmine & Alcian blue for mucin

Question 15

cholestrol accumulation in

Answer 15

tunica intima
athermatious plaque

Question 16

Cholesterol crystals appear to be………..

Answer 16

Cholesterol crystals appear to be needle-shaped clefts

Question 17

xanthomas

Answer 17

Intracellular cholesterol accumulation
Deposited in skin & tendons as foam cells
Acquired / hereditary hyperlipedemic states
Tumor like masses ”Xanthomas”

Question 18

foam cells

Question 19

protein accumulation causes 3

Question 20

causes of glycogen accumulation

Answer 20

DM
glycogen storing disease

Question 21

Insoluble pigments inside cells are typically stored in ………………

Answer 21

phagolysosomes

Question 22

types of pigments endogenous and exogenous examples

Answer 22

exo
coal/ carbon
tattoo

endo
lipofuscins

Question 23

The carbon blacken the lungs & nearby lymph nodes and is called “…………..” which is harmless

Answer 23

Anthracosis

Question 24

coal worker’s pneumoconiosis

Answer 24

a condition in which large areas of lung tissue are replaced by scar tissue.
Heavy exposure in coal miners induce fibroblastic reactions

Question 25

tatoo

Answer 25

Inoculation of metal salts into the skin
Ink is taken by dermal macrophages, keratinocytes, fibroblasts within a month

Question 26

endogenous
lipofuscin

Answer 26

Lipofuscin is a yellow-brown pigment that accumulates in the lysosomes of cells as a result of oxidative damage and incomplete degradation of cellular components. It is often referred to as the “wear and tear” pigment because it accumulates with age and is associated with cellular aging and degeneration.

Question 27

melanin

Answer 27

albinism lack of tyrosine kinase
seen in melanocyte and their tumors (mole/naevus or melanoma)
increased pigmentation in pregnancy and addisons disease

Question 28

melanosis coli pigment

Answer 28

Melanosis coli is a condition characterized by the abnormal accumulation of a brown-black pigment in the lining of the colon. The pigment is often referred to as “pseudomelanin” or “melanin-like pigment” because it resembles melanin

following cascara laxative intake or inflammatory bowel disease (IBD)

results from apoptosis of the colonic epithelial cells

Question 29

hemosiderin

Answer 29

Hemoglobin derived golden yellow to brown, granular pigment
Pigments represent aggregates of ferritin micelles
Normally small amounts in mononuclear phagocytes of RES

Question 30

stain to know hemosiderosis

Answer 30

Prussian blue stains blue

Question 31

types of hemosiderosis

Answer 31

localized and systemic

Question 32

local hemosiderin causes

Answer 32

Longstanding congestion (lungs, leg veins) or repeated minor injury (sports, bruise, etc.)

Question 33

Generalized (systemic) hemosiderosis causes

Answer 33

Causes
Multiple blood transfusions
Increased absorption of dietary iron
Longstanding hemolysis
Impaired use of iron
Hemochromatosis

Question 34

In Hemochromatosis excess hemosiderin causes ………….by generating free oxygen radicals in liver, heart & pancreas
by reaction called

Answer 34

organ failure

Question 35

bilirubin

Answer 35

Non-iron containing, yellow-orange pigment that results from breakdown of porphyrin rings (mostly hemoglobin)