A/16

Question 1

What are exogenous pigments?

Answer 1

coming from outside of the body : coal

Question 2

What are endogenous pigments?

Answer 2

synthesized in the body : lipofuscin, hemosiderin

Question 3

Cause of antracosis

Answer 3

coal (carbon) phagocytosed by alveolar macrophages drained to the lymph nodes, causing aggregates on the nodes and lungs

Question 4

What is a diseases specific to coal workers?

Answer 4

coal workers pneumoconiosis

Question 5

What causes fibrosis of the lungs in pneumoconiosis?

Answer 5

the silica crystals, metals contained in the coal dust kill the macrophages, causing inflammation and thus fibrosis of the lungs

Question 6

What does lung fibrosis in pneumoconiosis evolve into?

Answer 6

cor pulmonale chronicum : right side cardiac hypertrophy and then failure

Question 7

What produces lipofuscin pigments?

Answer 7

the lipid peroxydation of the subcellular membranes catalized by ROS

Question 8

Characteristic of brown atrophy of the heart (4)

Answer 8

• reduction of the size of the heart
• reduction of base apex distance : curvy arteries
• sharp apex pointing downwards
• pigment in the perinuclear area

Question 9

When does brown atrophy of the heart happen?

Answer 9

• aging
• cancer cachexia
• devastating diseases

Question 10

What is hemosiderin?

Answer 10

large aggregates of ferritin micells, golden yellow pigment

Question 11

What is hemosiderin derived from?

Answer 11

From hemoglobin

Question 12

Histological detection of hemosiderin

Answer 12

Prussian blue

Question 13

What is hemosiderosis

Answer 13

Accumulation of hemosiderin in phagocytic cells of bone marrow, liver, spleen, lymph node

Question 14

Example of hemosiderosis

Answer 14

induratio brunea pulmonis

Question 15

What is brown induration of the lungs?

Answer 15

brown discoloration of the lung with hardening

Question 16

What causes brown induration of the lungs?

Answer 16

Heart pumping problem / mitral stenosis causes RBC to move to the alveoli, where they get digested by macrophages. The iron stays in the macrophages and causes local hemosiderosis

Question 17

Example of systemic hemosiderosis

Answer 17

Hemolytic anaemias (autoimmune)

Question 18

What is the heredity of hemochromatosis?

Answer 18

autosomal recessive disorder

Question 19

What is hereditary hemochromatosis?

Answer 19

excessive accumulation of body iron, with deposition in parenchymal cells that causes fibrosis

Question 20

Pathogenesis of hereditary chromatosis

Answer 20

HFE gene mutation : regulation of hepcidin (iron hormone)

Question 21

What does low hepcidin cause?

Answer 21

uncontrolled absorption of iron (50mg pool instead of 2-6mg)

Question 22

Morphology of hereditary hemochromatosis

Answer 22

• hepatic cirrhosis
• pancreas fibrosis (bronze diabetes)
• deposits in myocardium, skin, adrenals

Question 23

Therapy of hereditary hemochromatosis

Answer 23

iron chelators, phlebotomy