Images Flashcards
What gross features do you see in this heart post-MI?
How long after MI do you think this could be?
this shows mottling = reddish/blue discoloration caused by stagnated blood
definitely < 24 hrs; likely 12-24 because mottling is more developed
What gross features do you see in this heart post MI?
How long after MI could this be?
zone of yellow-tan infarctnecrosis with red/hyperemic border due to granulation tissue
likely 3-14 days –> before 3 days no granulation tissue; after 14 scar formation complete
What gross features do you see in the heart post MI?
When could this be post MI?
healed myocardial infarct with white scarring
likely > 2 months after MI
What stages and time point post-MI do these images represent?
from left to right starting with top row = in order of progression
A. wavy fibers on left + early coagulative necrosis = 4-12 hrs
B. More coagulatie necrosis = very eosinophlic; presence of neutrophils = 12 hrs - 3 days
C. Presence of phagocytes and macrophages = 3-14 days
D. Loose granulation tissue starting from edge of infarct and creeping in = 3-14 days
E. well healed infarct with blue collagenous scar on trichrome stain = > 2 months
What is happening histologically in this tissue?
What time frame?
What is happening histologically in this tissue?
What time frame?
Wavy fibers
the slide says < 4 hrs but I think this could also be early in the 4-12 hrs period
What kind of stain is this? What is it detecting?
stain for complement C5b-9
provides evidence of ischemia [red fibers] even if myocardium looks apparently normal under H&E
What is happening histologically in this tissue?
What time frame?
What do the arrows and arrowheads point to?
This is coagulative necrosis and neutrophil infiltration
could be 12-24 hrs or 1-3 days; more likely 1-3 days since that is when neutrophils are most prominent
arrow = neurtophil
arrow heads = myocytes undergoing coagulative necrosis = loss of nuceli and striations
What is happening histologically in this tissue?
What time frame?
What are the arrows? arrow heads?
This is coagulative necrosis and neutrophil inflammation
12 hrs - 3 days; likely 1-3 days since tahts when neutrophils are most prominent
arrow head = coagulative necrosis of myocytes
arrow = neutrophils
What is happening histologically in this tissue?
What time frame?
This is coagulative necrosis of myoctyes and neutrophil inflammation
occurs 12-24 and 1-3 days after MI; likely 1-3 days b/c tahts when neutrophils are most prominent
arrow = neutrophils
What is happening histologically in this tissue?
What time frame?
This is granulation tissue
granulation tissue starts toward end of 1st week and continues for 2 wks
What is happening histologically in this tissue?
What time frame?
This is an old MI infarct scar w/ dense collagen tissue and no inflammation
> 2 months old; could be way older than that no way to tell
What complication of MI does this represent?
post MI septal rupture –> leads to VSD and L to R shunt
=
What complication postMI does this represent?
post MI pericarditis = only happens in transmural MI
What complication of MI does this represent?
post MI papillary muscle rupture –> leads to mitral regurgitation
What is this complication of MI?
thinned true aneurysm wall [arrow] with mural thrombus due to stasis of blood
What is this post MI complication?
What is this post MI complication?
What do the two arrows point to [2 different things]?
This is hemorrhage = reperfusion injury
leakage from injured ischemic vessels causes hemorrhage
left arrow = area of necrosis
right arrow = area of hemorrhage
How does arterial pulse volume waveform change in normal vs obstruction from peripheral artery disease
normal = rapid upstoke then dichrotic notch
obstruction = delayed rise and rounded peak, lose dicrotic notch, widened blunted waveform
What is order from normal –> severe obstruction in these aertial pulse volume recordings?
top left = normal: sharp upstroke + dichrotic notch
top right = less normal –> still have sharp peak but lose dichrotic notch
bottom left = even less normal –> flattened peak
bottom right = severely abnormal
Is this high or low resistance artery?
Examples of some vessels this could be?
This is a low resistnace vessel since you see flow in both systole and diastole
could be:
internal carotid
vertebral
renal
mesenteric [after eating]
Is this high or low resistance artery
What are examples of some vessels this could be?
High resistance = very low flow in diastole
could be:
muscular arteries of arm/leg
external carotid
mesenteric [before eating]
What is this? What disease does it suggest?
These are corkscrew collaterals
classic sign of beurgers disease = thromboangiitis obliterans
What is this picture of?
coronary atherosclerosis
What does the arrow in this picture of a blood vessel point to?
fatty streak formation
What is happening in the aorta on the left? What disease?
this is cystic medial degeneration and fragmentation of elastic fibers
pathognemonic for marfans aortic media
What does this silver stain show in this vasculitis?
shows that it is infectious vasculitis
due to aspergillis directly invading vessel wall
What type of vasculitis is characterized by this type of tissue?
What do the left, right, and bottom arrows eah point to?
this is granulomatous inflammation with giant cells
left arrows = epithelioid macrophages
right arrow = giant cell
bottom arrows = collar of mononuclear [lymphocytes] cells
What do each of these things point to in this biopsy of temporal artery?
left section = intima
bottom arrow = internal elastic lamina
left section = media
top arrow = giant cell
What type of vasculitits is characterized by this?
granulomatosis with polyangitis [wegener]
the triad is:
- Focal necrotizing vasculitis [seen left]
- Necrotizing granulomas in the lung and upper airway [seen right]
- Necrotizing glomerulonephritis.
arrows point to epithelioid macrophages characteristic of granulomatous inflammation
What type of vasculitis is this?
This is eosinophilic granulomatosis with polyangitis
also called churg-strauss
characterized by:
- necrotizing vasculitis
- granulomas with eosinophils
- peripheral eosnophilia, asthma, allergic rhinitis
- associated wtih MPO-ANCA
