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Pathology A - General Pathology > [B] 1.11 Autointoxication > Flashcards

[B] 1.11 Autointoxication Flashcards

1
Q

Autotoxication AKA =

A

Autotoxaemia

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2
Q

Define autointoxication

A
  • Poisoning of the body with endogen toxins
  • Toxins are produced during the process in different diseases
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3
Q

Causes of autointoxication

A
  1. Normal metabolism gets stuck - accumulation of metabolites
  2. Normal metabolites not excreted
  3. Abnormal metabolism
  4. Decreased function of an organ
  5. Histolysis/heterolysis by gangrene
  6. Enterogenic autointoxication
  7. Absorbed metabolites from special cases
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4
Q

Diabetic autointoxication

A
  • “Diabetic toxins”: Ketone bodies
  • Ketone bodies produced during:
    • Fasting
    • Carb. restrictive diets
    • Starvation
    • Prolonged exercise
    • Type-1 diabetes mellitus
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5
Q

List the ketone bodies

A
  • Acetoacetate
  • B-hydroxybutyrate
  • Acetone
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6
Q

Ketosis

A

Metabolic state where most of the body’s energy comes from ketone bodies in the blood

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7
Q

Diabetic ketoacidosis (DKA) symptoms

A
  • Nausea + vomiting
  • Thirst + excessive urine production
  • Abdominal pain
  • Dehydration
  • Tachycardia
  • Low BP
  • Cerebral oedema
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8
Q

What is shown?

A

Pancreas fibrosis

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9
Q

List the pathological findings from diabetic autointoxication

A
  • Pancreas fibrosis
  • Lipidosis in the liver
  • Brain oedema
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10
Q

What is shown?

A

Lipidosis of the liver

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11
Q

What is shown?

A

Brain oedema

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12
Q

Retention autointoxication

A
  • Develops with excretory organs
  • Accompanied by a delay in metabolic product removal
    • Kidney failure = Uraemia
    • Uricosis
    • Icterus (hepatopathy)
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13
Q

Uraemic autointoxication is characterised by…

A

Retention of various solutes that would normally be excreted by the kidneys

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14
Q

List some uremic toxins/retention solutes

A
  • Creatine
  • Creatinine
  • Urea
  • Uric acid
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15
Q

List the classifications of uremic toxins

A
  • Low-molecular-weight water-soluble uremic toxins
  • Protein-bound solutes
  • Middle-molecular-weight molecules
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16
Q

Complications of uremic toxins

A
  • Seizure, coma, cardiac arrest, death
  • Spontaneous bleeding
  • Subdural hematoma
  • Electrolyte abnormalities (hyperkalaemia, metabolic acidosis)
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17
Q

What is shown?

A

Uremia (Kidney fibrosis, Dog)

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18
Q

Hepatic autointoxication examples

A
  • Hepatitis
  • Hepatosis
  • Tumour
  • Fibrosis
  • Cirrhosis
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19
Q

Hepatosis

A

Degeneration of the liver

20
Q

Hepatic fibrosis

A

Necrosis, scar formation

21
Q

Cirrhosis

A
  • Generalised formation of scar tissue associated with liver cell nercrosis
  • Ineffective regenerative liver cell nodules
22
Q

Give the effect of cirrhosis

A
  • Retention of the bilirubin
  • Decreased detoxification of the GI toxins (enterogen autointoxication)
23
Q

Impaired hepatic detoxification refers to…

A
  • Decreased phase I and/or phase II enzyme activity
  • Levels of hepatic detoxification enzymes decreased
24
Q

Phase one of detoxification consists of…

A
  • Oxidation
  • Reduction
  • Hydrolysis
25
Q

Phase I detoxification is catalysed by enzymes referred to as…

A

Cytochrome P450 enzyme group/Mixed Function Oxidase enzymes (MFO)

  • Located in the membrane of the liver
26
Q

Phase II of detoxification

A

Conjugation pathway

  • Liver cells at substances to a toxic chemical/drug
  • Renders the chemical less harmful
  • Excreted from the body via bile/urine
27
Q

Toxic effect of bilirubin

A

Inhibition of :

  • Enzyme systems
  • Cell regulatory reactions
28
Q

Toxic effect of bilirubin in the brain

A
  1. If serum bilirubin > albumin binding capacity
  2. Bilirubin → CNS
  3. Permanent neurological damage/death

Bilirubin encephalopathy with kernicterus

29
Q

Kernicterus: Etymology

A

“Yellow Kern”

Refers to an anatomic diagnosis made at autopsy

30
Q

BIND

A

Bilirubin-induced neurologic dysfunction

  • Clinical signs associated with bilirubin toxicity
31
Q

Give some clinical signs associated with BIND

A
  • Hypotonia → Hypertonia
  • Opisthotonus
  • Retrocollis
32
Q

Impaired hepatic detoxification can result from…

A
  • Exposure to food additives/solvents/pesticides/heavy metals
  • Viral infections
  • Restricted bile flow
  • Old age
    • Affects phase I enzymes
    • Decreased blood flow to liver
33
Q

Hepatic autointoxication - Complications

A
  • Presence of chronic fatigue
  • Depression
  • Headaches, digestive disturbances
  • Mental confusion
  • Mental ilness
34
Q

Histolysis by gangrene =

A

Putrid intoxication

35
Q

Gangrene

A

A variety of necrosis

(Ichorous inflammation)

36
Q

Give the varieties of gangrene

A
  • Dry
  • Wet
  • Gas
  • Internal
37
Q

Dry gangrene

A
  • Develops in ischemic tissue - Low blood supply
  • ↓ Oxygen = limited putrefaction/bacterial growth
  • The affected part is dry and shrunken
  • Leads to autoamputation of affected area
38
Q

Wet/infected gangrene

A
  • Thriving bacteria
  • Poor prognosis
  • Free communication between: Infected fluid ⇔ circulation
  • Can lead to sepsis
39
Q

In wet gangrene, the tissue is affected by…

A

Saprogenic microorganisms

Causes tissues to swell and emit a smell

40
Q

Give the fate of the toxins produced by the wet gangrene bacteria

A
  1. Necrotoxins are absorbed
  2. The systemic manifestation of sepsis
  3. Death
41
Q

Describe clinical signs of wet gangrene

A

Affected part:

  • Edematous
  • Soft
  • Putrid
  • Rotten
  • Dark
42
Q

What is Porphyria/porphyrias?

A

A group of rare diseases in which porphyrins accumulate with high metabolism

43
Q

Enterogenic autointoxication, enterotoxaemia

A

Absorbed decomposition products from GI system

E.g Grass fever; Grass sickness: C. botulinum

44
Q

Intestinal autointoxication/Toxic colon

A
  • Colon’s main role is toxin elimination via faeces
  • Faecal toxins: Indol, skatol, phenol, urobilin
  • Constipation → Intestinal autointoxication
45
Q

Absorbed metabolites from special cases: Examples

A
  • Arrodated stomach
  • Ruptures
  • Perforations
46
Q

Autotoxaemia example

A

DIC (Disseminated intravascular coagulopathy)

Pathology A - General Pathology (85 decks)

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