Clinical Presentation

Question 0

Cyanosis

Chocolate-colored blood

Answer 0

Methemoglobinemia

Treat with IV methylene blue

Question 1

Cherry red skin

Headache

Answer 1

CO poisoning

Question 2

Hallmark of reversible cellular injury

Answer 2

Cellular swelling

Loss of microvilli and membrane blebbing

RER swelling leads to dissociation of ribosomes and decreased protein synthesis

Question 3

Hallmark of irreversible cellular injury

Answer 3

Membrane damage

Plasma: cytosolic enzymes, Ca
Mitochondrial: ETC, cytochrome c
Lysosome: hydrolytic enzymes

Question 4

Which organ is most commonly involved in systemic amyloidosis?

What are other findings?

Answer 4

Kidney: nephrotic syndrome

Restrictive cardiomyopathy or arrhythmia

Tongue enlargement
Malabsorption
Hepatosplenomegaly

Question 5

Protein deposited in SENILE CARDIAC AMYLOIDOSIS

Answer 5

NON-MUTATED serum transthyretin

Deposit in heart
Usually asymptomatic

Question 6

Protein deposited in FAMILIAL AMYLOID CARDIOMYOPATHY

Answer 6

MUTATED serum transthyretin

Deposit in heart
Leads to restrictive cardiomyopathy

Question 7

Protein deposited in TYPE 2 DM

Answer 7

Amylin

Deposits in islets of pancreas

Question 8

Protein deposited in ALZHEIMER DISEASE

Answer 8

AB amyloid

Deposits in brain - amyloid plaques

Gene for B-amyloid precursor protein is on chromosome 21 = most individuals with Down syndrome develop Alzheimer’s by age 40

Question 9

Protein deposited in DIALYSIS-ASSOCIATED AMYLOIDOSIS

Answer 9

B2-microglobulin

Deposits in joints

Question 10

Protein deposited in MEDULLARY CARCINOMA OF THE THYROID

Answer 10

Calcitonin (produced by tumor cells)

Deposits within the tumor
“tumors cells in an amyloid background”