Defective Wound Healing and Amyloidosis

Question 1

What are the major local factors that impair wound healing. Which one is most important?

Answer 1

a. Infection – most important
b. Mechanical factors
c. Foreign bodies
d. Size/location/type of wound

Question 2

What are the general categories of pathologic wound healing and give an example of each one.

Answer 2

1. Deficient scar formation
   i. Ulceration
   ii. Wound dehiscence
2. Excessive formation of the repair components
   i. Proud flesh
   ii. Hypertrophic scar
   iii. Keloid
3. Formation of contractures
   i. Common after serious burns
   ii. Contraction of a joint

Question 3

What is AMYLOIDOSIS?

Answer 3

Deposition of misfolded proteins into the extracellular space, leading to cell dysfunction and tissue death

Question 4

What are the 3 common chemical forms of amyloid?

Answer 4

AL – Amyloid light chain

AA – Amyloid associated
i. From serum amyloid A protein made in liver during acute phase reactions

AB – found in Alzheimer’s patients

Question 5

What is the pathogenesis of amyloidosis.

Answer 5

a. Abnormal folding of proteins
b. Insoluble fibrils deposited in extracellular tissue
c. Protein deposits interfere with normal cellular function
d. Everything dies.

Question 6

What is the difference between primary and secondary amyloidosis? and be able to explain the underlying cause of each.

Answer 6

a. Primary – caused by AL

b. Secondary – caused by AA

Question 7

What is/are the underlying cause(s) of PRIMARY Amyloidosis?

Answer 7

Plasma cell tumors/multiple myeloma (plasma cell tumor) create too much amyloid.

Proteolysis can’t occur fast enough to remove the protein.

Question 8

What is/are the underlying cause(s) of SECONDARY Amyloidosis.

Answer 8

Inflammation causes amyloid A release from the LIVER.

Persistent inflammation leads to too much of this protein being made.

Proteolysis can’t occur fast enough to remove the protein.