Exam 1 Flashcards
What is anasarca?
Generalized edema with profuse accumulation of fluid w/in the subcutaneous tissue
What is general pathology
Major pathological processes in incited by various injurious stimuli. Applies is all cells/tissues/organs.
What distribution is the image displaying
Locally Extensive
Define clinical manifestations
clinical signs resulting from functional abnormalities of affected tissues
What is the clinical significance of edema
- Depends on: extent, location, duration
- Tissue may become firm and distorted due to an increase in fibrous CT after prolonged edema
What is this image showing?
Venous infarction, small intestinal volvulus. Note the intensely congested loops of small intestine undergoing early venous infarction. The twisting of the mesentery associated with the volvulus has resulted compression of the arteries and veins of the intestine.
What is livor mortis (aka hypostatic congestion)
Gravity pulling blood post death. -variation in color of tissues, skin, lungs and kidneys. -in some areas the tissues will be more red, in other areas pale
What is hydrothorax
Fluid in the thoracic cavity
Define Diffuse
Throughout a large portion of the effected tissue
What is antithrombin III
a major inhibitor of thrombin
Pulmonary edema- non-inflammatory is associated with what?
Associated to left-sided congestive heart failure (CHF)
What is the outcome of thrombi
- Lysis
- Propagation
- Embolization
- Organization/recanalization
What is most associated with chronic pulmonary edema, what happens?
- Most commonly associated with cardiac failure
- Alveolar walls become thickened -> may lead to fibrosis
- Congestion, micro-hemorrhages -> accumulation of heart failure cells.
What is the difference between hyperemia and congestion
Hyperemia indicates increase of arteriole-mediated engorgement of the vascular bed. Blood is oxygenated (red)
Congestion indicates passive, venous engorgement. Blood is not oxygenated (blue)
What are some associated changes when an animal has bloat
Rectal/vaginal prolapse, froth in trachea, ruptured viscera
What does the rate of decomposition depend on
-Cause of death -Environmental and body temp -Microbial flora (GI tract, Bacterial fermentation -> heat/gas)
Define focal
one isolated lesion
What is vascular enodthelium’s role in hemostasis
- Anti-thrombotic and pro-fibrinolytic in the normal state
- Pro-thrombotic and anti-fibrinolytic during injury
Define Edema
- Abnormal accumulation of excess extracellular water in interstitial spaces or in body cavities.
- Fluid is outside both the vascular fluid compartment and cellular fluid compartment. (i.e.: w/in the interstitium)
What causes tissue edema?
If there is an increase in hydrostatic pressure or diminished plasma osmotic pressure will cause extravascular fluid to accumulate. Tissue lymphatics will remove the excess volume, eventually returning it to the circulation via the thoracic duct. However, if the capacity for lymphatic drainage is exceeded then tissue edema results.
What is an embolism
Embolism is the passage through the venous or arterial circulation of any material capable of lodging in a blood vessel lumen.
Describe a post mortem clot
-unattached, shiny/wet, elastic, perfect cast of vessel lumen.
What organs are very susceptible to tissue hypoxia
Brain and tissue
In agonal hemorrhages what is petechiae and ecchymoses associated with?
Terminal hypoxia
Pulmonary edema inflammatory edema is associated with what
Damage to pulmonary capillary endothelium -> e.g. pulmonary
ARDS (acute respiratory distress syndrome) : Sudden, diffuse, and direct- increase in vascular permeability: high fatality rate -> followed by pneumonia is animal survives
What is cardiac hypertrophy
Limit beyond which enlargement of muscle mass is no longer able to cope with the increased burden-> several regressive changes occur in the myocardial fibers (eg. lysis and loss of myofibrillar contractile elements)
What is the medium that all metabolic prodcuts must pass between the microcirculation and the cells
Interstitium
What is this image displaying?
“Chicken fat clot” from a horse; due to separation of RBCs and clotted serum. - PM Blood Clotting
What is Virchow triad
Virchow triad = pathogenesis of thrombosis
- endothelial injury
- Alterations in blood flow (turbulence or stasis)
- Hypercoagulability: Increase in coagulation factors (or increase sensitivity), decrease in coagulation inhibitors
Define etiology
The cause
What can well vs poorly demarcated margins tell you?
Well demarcated = the lesion represents a different tissue (tumors), Infarcts, chronic lesion with fibrous capsule.
Poorly demarcated = the lesion and adjacent tissue may be similar. The process is gradually infiltrating into the normal tissue; is poorly contained
What is disease name? (define)
Aims to encapsulate the host, morphology, and cause of disease; ex: Bovine Viral Disease
What is the image showing and what is happening
Chronic hepatic congestion: nutmeg liver
Chronically there is low-grade hypoxia and increase pressure of centrolobular hepatocytes leading to atrophy and necrosis
Explain the following image
Diffuse brown discoloration of the lungs of a dog with chronic pulmonary edema and congestion secondary to left-sided CHF.
Define hemorrhage
the escape of blood from the blood vessels (extravasation)
-can be internal or external (w/in tissues or body cavities
What is post mortem blood clotting
Occurs several hrs. Post death in the heart and vessels. Coagulopathies can delay or cause failure of blood to clot. Chicken fat clot appearance: due to separation of RBCs and clotted serum.
Regardless of the underlying pathology, shock gives rise to what? and what causes it
Systemic Hypoperfusion - it can be caused either by reduced cardiac output or by reduced effective circulating blood volume.
What are features of a description
(near shore lobsters dig starfish clams coral and molluks)
Number, Size, Location, Distribution, Shape, Color, Consistency, Margins/suface
Is the image a PM clot or AM clot?
PM Clot
Unattached, shiny/wet, elastic, perfect cast of vessel lumen
What distribution is the image displaying
Multifocal-coalescing
What are the 3 types of shock
- Cardiogenic shock- failure of the heart to maintain normal cardiac output
- Hypovolemic shock- fluid loss due to hemorrhage, vomiting and diarrhea
- Blood Maldistribution: Anaphylactic (type I hypersensitivty), Neurogenic, Septic
What can distribution tell you?
multifocal?
Locally extensive?
Symmetrical?
Multifocal = embolic/hematogenous route
Locally extensive = local introduction via penetrating wound or anatomic pathway
Symmetrical = indicates systemic/metabolic cause of the lesion
What distribution is the image displaying
Diffuse
Define Multifocal
Numerous similar lesions that can be of variable size
True or False - determining the pathological process facilitates determining the etiology
True
What distribution is the image displaying ?
Multifocal
What is this histological slide showing?
Edema
- Clear or pale eosinophilic staining depending on whether is non-inflammed or inflammatory edema
- Spaces are distended
- Blood vessels may be filled with RBCs
- Lymphatics are dilated
- Collagen bundles are separated
What is pericardial effusion?
Means fluid around the heart. Image shows “mulberry heart disease” (inflammatory edema). Note the fibrin strands and cloudy appearance of the pericardial fluid
Define pathogenesis
sequence of events from initial stimulus to ultimate expression of disease
What is infarction?
Venous Infarcts?
Localized area of ischemic necrosis in a tissue or organ caused by occlusion of either the arterial supply or the venous drainage.
-Venous infarcts are usually intensely hemorrhagic as blood backs up into the affected tissue behind the obstruction
What is suffusive hemorrhage
Larger than ecchymosis and contiguous.
Explain the pathogenesis of septic shock
caused by endotoxin-producing gram-negative bacilli (endotoxic shock). LPS and other microbial substances induce injury and activation of the vascular endothelium plus stimulate (“active”) WBCs to release cytokines -> vasodilation and pro-thromotic diathesis (DIC)
List some etiologies
-Genetic/Inherited -Infectious - bacterial, viral, parasitic etc -Metabolic -Toxicologic -Autoimmune -Idiopathic -Iatrogenic
Total body water is how much % of total body weight?
65%
What is autolysis
Self digestion or degradation of cells and tissues by the hydrologic enzymes normally present in tissues -Occurs after somatic death due to total diffuse hypoxia -Cells degenerate as for hypoxic injury
What is the red top tube used for?
Sterile tube for culture
Define lesion
any morphological change in tissues during disease
Define Hypotrophy
Hypotrophy = Abiotrophy - progressive loss of vitality of certain tissues or organs, leading to disorders or loss of function; applied especially to degenerative hereditary diseases of late onset
How can you differentiate between an antemortem clot and PM clot
Am Clot (thrombus) is attached to vessel walls, dry and dull, lamellated, friable
PM clot is unattached, shiny/wet, elastic, perfect cast of vessel lumen
Define molecular and morphologic changes
biochemical and structural alterations induced in cells and organs of the body
Define Aplasia
lack of development of an organ or tissue
What is pathology
The study of disease
What is Petechia?
Hemorrhage that is up to 1-2mm in size. Especially found on skin, mucosal and serosal surfaces
Physiologic hyperplasia examples
Hormonal: e.g mammary gland during pregnancy
Compensatory: e.g. hepatectomy
When does cell adaptation occur
Occurs when the cell homeostasis is distorted by stresses or pathologic stimuli
Describe an antemortem clot (thrombus)
-attached to vessel walls, dry/dull, lamellated, friable
What are the types of hyperemia
Physiological Hyperemia and pathological hyperemia
Physiological:
Digestion: increases blood flow to the GI tract during digestion
Exercise: Increase blood flow to muscles
Dissipate heat: increase BF to the skin to cool down
Neurovascular: Invol. increase in BF to the face
Pathological:
- Caused by an underlying pathological process- usually inflammation
- Arteriolar dilation occurs secondary to inflammatory stimuli
- Reddening is one of the cardinal signs of inflammation
- Often associated with edema
Edema can also be classified as what?
“Inflammatory” or “non-inflammatory”
Inflammatory: Increased vascular permeability- exudate
Non-inflammatory: Edema of CHF; edema of liver- Transudate
What is disease
any deviation from the normal structure or function
What is the % of intracellular fluid in the body
40%
Define Hemothorax, Hemoperitoneum, Hemarthrosis, Hemoptysis, Epistaxis
Hemothorax- blood in the thoracic cavity
Hemoperitoneum- blood in the peritoneal cavity
Hemarthrosis- blood w/in a joint space
Hemoptysis- coughing up or blood-stained sputum from the lungs or airways
Epistaxis- bleeding from the nose
Describe the morphological change of blood clotting during PM decomposition
- Occurs several hrs post death in the heart and vessels
- Coagulopathies can delay or cause failure of blood to clot
- Chicken fat clot appearace: due to separation of RBCs and clotted serum
Define Hemorrhage by diapedesis
Hemorrhage due to a small defect in the vessel wall or RBC’s passing through the vessel wall in cases of inflammation or congestion (like in the lungs of animals with left-sided CHF)
What are some words used when you are interpreting during a PM
- Abscess
- Fibrin
- Scar or fibrous CT
- multifocal hemorrhage
- edema
- Necrotic
What is the image displaying
Acute pulmonary congestion - usually the result of heart failure and associated with edema.
What is submandibular edema commonly associated with in sheep?
GI parasitism and hypoproteinemia
You find this kidney in a dead sheep
- What is a potential disease to consider?
Disease = Pulpy Kidney disease, accelerated renal autolysis associated with Clostridium perfringens type D septicemia
Define Hypertrophy
Increased size of cells and their functions
- Synthesis of more organelles and structural proteins: bigger cells
- More common in cells with little replication- stable or permanent cells: cardiomyocytes, neurons
What is the ratio of formalin:tissue
10:1
What occurs during atrophy and what causes it
-Decrease protein synthesis and increase protein degradation in cells.
Causes: Decrease workload
- Denervation
- Decrease blood supply or oxygen
- Inadequate nutrition
- Loss of endocrine stimulation
- aging (senescence)
What are 4 pathomechanisms of edema
- Increased blood hydrostatic pressure: (Generalized: e.g. right sided congestive heart failure; Localized: e.g. tightly bandaged limb resulting in venous obstruction
- Decreased plasma colloidal osmotic (aka oncotic) pressure
- Lymphatic obstruction
- Increased vascular permeability (inflammation)
What are some causes of hemorrhage
- Trauma
- Sepsis, viremia, bacteremia or toxic conditions
- Abdominal neoplasia may lead to hemoperitoneum
- Coagulation abnormalities (platelet and coagulation factor defects or deficiencies)
What is putrefaction?
Process by which post mortem bacT break down in tissues. Gives color, texture changes, gas production and odors.
Define diagnosis
Concise statement or conclusion concerning the nature, cause or name of a disease
When does rigor mortis begin?
1-6 hours post death, persist 1-2 days.
Define Hypoplasia
Incomplete development or underdevelopment of an organ or tissue; it is less severe in degree than aplasia
What is the image showing?
Renal infarct
-Microscopically an infarct is a focal area of coagulation necrosis
T/F Atrophy of an organ can be caused by a decrease in size (hypotrophy) or a decrease in the amount of cells (hypoplasia).
TRUE
What is ecchymosis
Hemorrhage that is larger than petechia (up to ~1-2cm). As seen in bruise (contusion) or small hematoma.
What does the image show?
How can you differentiate between hemorrhage and hyperemia/congestion
Image depicts congestion and heart failure cells.
Hemorrhage- blood is outside the vessel wall
Hyperemia/Congestion- blood is w/in the blood vessels
Define hemorrhage diathesis
Increased tendency to hemorrhage from usually insignificant injuries (seen in a wide variety of clotting disorders)
What is the result of right sided CHF
(image shows)
Subacute to chronic hepatic congestion
Livers are large and exhibit rounded edges
What is this image showing?
Ascites or hydroperitoneum: fluid (transudate) within the peritoneal cavity (dog w/ CHF)
What is pseudomelanosis
Refers to greenish-black discoloration of tissues post mortem.
- decomposition of blood by bacterial action forming hydrogen sulfide with iron
- occurs soon after death
- commonly seen in tissues in contact with the gut: kidney, liver, spleen, even gut wall.
Define Thrombosis
Define Thrombus
Thrombosis: Formation or presence of a solid mass (thrombus) w/in the CV system
Thrombus: aggregate of platelets, fibrin and entrapped blood cells. Can result in occlusion of the vascular lumen and embolism. It is adhered to the vascular wall as opposite to a blood clot.
Pathologic hypertrophy example
Cardiac hypertrophy from hypertension or aortic valve dz
What tissues autolyze the quickest?
GI tract, pancreas, gallbladder, other soft tissues
What does the following picture depict?
Paint-brush hemorrhage- most common on mucosal and serosal surfaces.
What is purple top tube used for?
EDTA- for fluid analysis and cytology
What is an embolism and embolus?
If pices of a thrombus break off from the original mass and sail downstream to lodge at a distant site, that process is called embolism. The mass that breaks off is called an embolus.
What is hemoglobin imbibition
Red staining of tissue, esp. the intima of heart, arteries and veins. Hb is released by lysed RBCs, penetrates the vessel wall and extends into the adjacent tissues
Coagulation factors are plasma proteins produced mainly by the ____ (what organ)
LIVER
Define Hemostasis
Arrest bleeding by the physiological properties of vasoconstriction and coagulation or by surgical means.
What is the image showing? Explain
Bacterial valvular endocarditis in cattle often involve the right AV valve and can give rise to septic emboli that will lodge in the pulmonary arteries. Inflammation/abscess formation.
Define HOMEOSTASIS
*Not to be confused with HEMOSTASIS
Tendency to stability in the normal body states of the organism; it is the ability to maintain internal equilibrium by adjusting its physiological processes
What is the following image displaying
and what is it?
Gastric volvulus (torsion) in a dog
Twisting of vessels obstructs gastric veins -> severe venous congestion (acute,local,congestion) -> ischemia (necrosis) -> loss of endothelial integrity -> hemorrhage -> shock -> death
What is pitting edema
When pressure is applied to an area of edema a depression or dent results as excessive interstitial fluid is proced to adjacent areas
Define Hyperplasia
Increase in number of cell of an organ
-cells capable of replication
What is the pathological form of hemostasis?
Thrombosis- in which a clot (thrombus) forms w/in a vessel which is not injured or only mildly injured.
What are the general components necessary for normal hemostasis or thrombosis to occur
- Vascular wall
- Platelets
- Coagulation cascade
Define Atrophy
Decrease in size and/or number of the cells and their metabolic activity after normal growth has been reached *cells are NOT dead*
Atrophy Examples
- Muscle disuse in a limb that is in a cast
- Sedentary atrophy
- Atophy of adrenal cortex by reduction of ACTH
- Atrophy in tissues adjacent to a tumor due to pressure and compromised blood supply
- physiologic atrophy (e.g non-lactating mammary gland
What can shape tell you?
Geometric?
Straight lines?
Raised?
Depressed?
Geometric (triangle, diamond, wedge, circle) = the lesion involves vasculature
Straight lines = the lesion is following an anatomic structure (blood vessels, bronchiole, nerve etc..)
Raised = something has been added (edema, blood, inflammatory cells, neoplastic/hyperplastic cells)
Depressed = something has been lost (necrosis) or the tissue has been contracted (CT)
Systemic hypoperfusion- what are the end results
the end results are hypotension, impaired tissue perfusion and cellular hypoxia. This may lead to DIC and “multi-organ system failure”
What is arrow trying to show us
An esophageal “bloat line” in a cow with remenal tympany
Define hemorrhage by rhexis
Due to a substantial rent or tear in the vascular wall (or heart)
Formalin penetrates how thick of tissue
Formalin will not penetrate more than 1/2 cm tissue so a total of 1 cm. 1/2 on each side.
What is morphologic diagnosis (MDx)
Includes pathological process, location, distribution, duration and severity
-Interprets the description and makes subjective conclusions
What is the image showing?
Image shows fat embolism
-Could be a complication of long bone fractures
What is the image and signs?
Disseminated Intravascular Coagulation (DIC)
-signs of tissue hypoxia, infarction and/or hemorrhage are seen.
What is the clinical significance of hemorrhage
- Determined by the location and the severity
e. g. Profuse blood loss is the most common cause of hypovolemic shock; hemorrhage in the brain or heart can be fatal - The image shows hemopericardium which is the presence of blood within the pericardial sac
List the 5 main pathological processes
- Degeneration/Necrosis 2. Inflammation and repair 3. Circulatory disorders 4. Disorders of growth 5. Deposits and pigmentations
What is Disseminated Intravascular Coagulation (DIC)
DIC is a potentially catastrophic systemic reaction (thrombo-hemorrhagic disorder) in which there is generalized activation of the blood coagulation system.
-Many etiologies including extensive tissue injury, neoplasia, systemic immunologic reactions (eg. anaphylaxis) and sepsis -> can lead to “consumptive coagulopathy” and hemorrhagic diathesis.
What are the common post mortem eye changes
Corneal opacity due to dehydration of cornea
What is the image showing?
Thrombotic Meningenocephalitis (TME)
Etiology: caused by bacterial Histophilus somni-produces endothelial damage, results in thrombosis and animal present with acute neurological signs.
What is etiologic diagnosis (Edx)
Includes pathological process, location and cause
what is endothelium’s role in inflammation
- Regulates the traffic of inflammatory cells
- Produces pro-inflammatory cytokines
- Control angiogenesis and tissue repair
What are the following images depicting
Pulmonary Hemosiderosis -> presence of heart failure cells
What is bile imbibition
Bile in the gallbladder starts to penetrate the wall and stains the adjacent tissues- yellowish-greenish brown. Tissues stained are those in contact with the gallbladder: liver, intestines, diaphragm.
What are the routes of exposure to pathogens during a PM
-Oral, Splash into eye, Aerosolization, Percutaneous
What is systemic pathology
System-specific disease. Builds on main pathologic processes, but takes into account -unique responses to injury of each tissue -specific diseases for each system
