Path 2 Flashcards
Coagulative necrosis
ischemic infarct
Usually wedge-shaped, pale or red
Liquifactive necrosis
Enzymes lyse cells & proteins
- Brain - microglia
- Abscess - neutrophils
- Pancreatitis - enzymes - parenchyma
Dry gangrene
Ischemia of lower limb - Diabetics
Wet gangrene
Superimposed infection, then liqufactive necrosis
Caseous necrosis
Soft, friable tissue w/ cottage cheese appearance
FUNGAL/TB - granulomatous inflammation
Coagulative + liquifactive
Fat necrosis
Chalk-white d/t Ca
- Breast trauma
- PERI-pancreatic fat
Saponification
Fat + calcium
Dystrophic calcification
Necrotic tissue becomes nidus for calcification (saponification)
Psamomma bodies
NORMAL serum Ca, Phos
Metastatic calcification
HIGH serum Ca, Phos –> calcium deposition in normal tissues
- hyperparathyroidism
Fibrinoid necrosis
Blood vessel wall
Fibrin leaks into wall –> BRIGHT PINK wall
- Malignant HTN
- Vasculitis
- Pre-eclampsia - 30 y/o woman
Apoptosis
Caspases –> proteases & endonucleases –> apoptotic bodies –> cleaned by MO
- Lack of BCL-2 –> cytochrome C leaks out
- FAS-L –> CD95 on T-cells or TNF-alpha
- CD8+
Underlying mechanism of damage in Wilson disease and Hemochromatosis
Hydroxyl free radical generation
CCl4
Dry cleaning
P450 –> CCl3 –> swelling –> dec Apos –> FATTY CHANGE
Continued inc in cardiac enzymes after opening of vessel
Reperfusion injury
Amyloidosis
Misfolded protein deposition –> tissue damage
- often around BVs
- B-pleated sheet
- Congo-red stain + apple-green birefringence
Primary Systemic amyloidosis
AL Amyloid - light chain
Blood dyscraisias - MM
Secondary Systemic amyloidosis
AA amyloid - from SAA (acute phase reactant)
Chronic inflammation
- auto-immune, crohn’s, UC, RA
- Malignancy
- Familial mediterranean fever
Familial Mediterranean fever
AR
Dysfxn of NEUTROPHILS
Mimics appendicitis, MI, arthritis
Findings of systemic amyloidosis
Kidney is most commonly involved organ
- Nephrotic syndrome
- Restrictive cardiomyopathy
- Tongue enlargement, malabs, HSM
Dx = Bx Tx = transplant
Senile amyloid
Serum transthyretin
Elderly, No sx, heart
Familial amyloid cardiomyopathy
MUTATED serum transthyretin
Restrictive cardiomyopathy
5% A.A.s
Type II DM Amyloid
Amylin (from insulin) –> islets
Alzheimer amyloid
A-Beta amyloid from beta amyloid precursor protein
Chr21 - Down syndrome develop early alzheimers
Dialysis amyloid
Beta-2 micoglobulin
Joints
Medullary carcinoma of the thyroid amyloid
Calcitonin deposits in tumor - ‘tumor cells in an amyloid backgrouns’
Mechanism of metaplasia
Reprogramming of stem cells
It is reversible
Only dysplasia w/o inc risk of cancer
Apocrine metaplasia of breast
Keratomalacia
Vit A deficiency –> metaplasia/thickening of conjunctiva
Myostitis ossificans
Mesenchymal metaplasia - muscle –> bone after trauma
Cause of Budd-Chiari
Polycythemia vera
Causes of hypoxemia
- High altitude
- Hypovent
- diffusion defect/fibrosis
- V/Q mmismatch
Methemoglobinemia
Fe2 oxidized to Fe3
SaO2 DEC
Sulfas, nitrates, newborns
Cyanosis w/ CHOCOLATE colored blood
Tx = methylene blue
Reversible cell injury
Cellular swelling
- blebs, dec protein syn, no microvilli
Irreversible cell injury
Membrane damage
- cytosolic contents, Ca into cell, cyto c, lysosomal enzymes
