Cell Death and Perfusion Disorders III

Question 1

autolysis

Answer 1

cell destruction that occurs after death (by a cells own enzymes)

Question 2

putrefaction

Answer 2

decomposition of dead tissues by microorganisms

Question 3

ischemia

Answer 3

decrease in blood supply to a tissue with resultant hypoxia, decreased glucose and other nutrients and decreased removal of metabolic waste

Question 4

infarct

Answer 4

local area of peracute ischemia that causes coagulative necrosis

Question 5

what is the time progression of necrosis types

Answer 5

coagulative -> caseous -> liquifactive

Question 6

common causes of coagulative necrosis

Answer 6

hypoxia, ischemia, toxins

Question 7

common cause of caseous necrosis

Answer 7

infectious agents

Question 8

common area of liquefactive necrosis

Answer 8

nervous tissue

Question 9

gangrenous necrosis occurs at

Answer 9

extremities or dependent portions of organs

Question 10

dry gangrenous necrosis resembles

Answer 10

coagulative necrosis

Question 11

wet gangrenous necrosis resembles

Answer 11

liquefactive necrosis

Question 12

gross appearance of coagulative necrosis

Answer 12

pale tan to gray, sharply demarcated, solid

Question 13

histologic appearance of coagulative necrosis

Answer 13

retained architecture, cytoplasmic eosinophilia

Question 14

gross appearance of caseous necrosis

Answer 14

dry or moist, crumbly, granular or laminated, may have central exudate

Question 15

histologic appearance of caseous necrosis

Answer 15

architecture lost, lysed cells, granular to amorphous debris, nuclear debris

Question 16

gross appearance of liquefactive necrosis

Answer 16

pale to translucent, soft to liquid, cavitated

Question 17

histologic appearance of liquefactive necrosis

Answer 17

architecture lost, parenchymal cells lost, space filled with inflammatory cells

Question 18

gross appearance of dry gangrene

Answer 18

dry, leathery

Question 19

histologic appearance of dry gangrene

Answer 19

(coagulative necrosis): cytoplasmic eosinophilia, architecture retained

Question 20

gross appearance of wet gangrene

Answer 20

red-black, wet

Question 21

histologic appearance of wet gangrene

Answer 21

(liquefactive necrosis): architecture lost, parenchyma lost, inflammatory cells

Question 22

describe what hematogenous agents would cause a zonal pattern and what would cause a random multifocal pattern

Answer 22

toxins would cause zonal patterns; bacteria would cause a random multifocal pattern

Question 23

what pattern would inhaled pathogens cause on the lung

Answer 23

cranioventral distribution

Question 24

what would the presence of fibrin in a lesion tell you

Answer 24

the lesion was an ulcer (reached the blood vessels) as opposed to an erosion

Question 25

what layers does erosion go through vs an ulcer

Answer 25

erosion: just mucosa; ulcer: mucosa, submucosa, muscularis

Question 26

what part of the kidney is most susceptible to NSAID overdose

Answer 26

medulla; specifically the medullary capillary plexus

Question 27

what is a clinical sign of growth plate necrosis

Answer 27

affected limb is shorter than non-affected limb

Question 28

anemic hypoxia would impact what part of the liver first

Answer 28

zone III (last to receive oxygen)

Question 29

causes of oxygen deprivation (4)

Answer 29

1. inadequate blood oxygenation 2. inadequate oxygen-carrying capacity of blood 3. inadequate delivery of oxygenated blood to tissue 4. inhibition of cellular respiration enzymes

Question 30

what is reperfusion syndrome

Answer 30

reperfusion of tissues -> ROS/free-radical generation -> further damage to tissue

Question 31

how does ischemia of watershed zones appear

Answer 31

segmental

Question 32

example of end-artery ischemia

Answer 32

coagulative necrosis of a renal pyramid

Question 33

difference between arterial and venous occlusion

Answer 33

arterial causes an immediate infarction, whereas venous first causes congestion and edema, which promotes the infarction

Question 34

what would cause a pale and non-swollen infarct

Answer 34

ACUTE arterial infarct

Question 35

what would cause a dark red/swollen infarct

Answer 35

venous infarct; slightly later arterial infarct with damage of blood vessels in the infarcted tissue and backflow of blood from other tissues

Question 36

what would cause a pale, swollen, red-rimmed infarct

Answer 36

cell swelling and necrosis that pushes blood out of the infarct, macrophage cleaning red rim = hyperemia/hemorrhage/acute inflammation

Question 37

what would cause a multicoloured infarct

Answer 37

RBC breakdown, inflammation, neovascularization

Question 38

what would cause a white and contracted infarct

Answer 38

chronic infarction with subsequent scarring

Question 39

what is the endpoint of infarction

Answer 39

scarring with contraction

Question 40

what is DIC

Answer 40

loss of localization of the coagulation process and generation of excess thrombin, with widespread microvascular thrombi

Question 41

name 3 causes of DIC

Answer 41

sepsis, shock, extensive trauma

Question 42

DIC sequela

Answer 42

bleeding due to consumption of all coagulation factors; ischemic tissue damage