pathology (wk 3) Flashcards

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1
Q

what are the main components of the circulatory system?

A

the heart, blood, arterial side (blood distribution), capillaries (for exchange), venous side (blood collection)

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2
Q

which of the following is true for the arterial side of the circulatory system?
a. Removes waste and/or other products from the circulation and carries deoxygenated blood so is a dark purple colour.
b. Delivers oxygen and nutrients and carries oxygenated blood so this blood is a bright red colour
c. Is where the exchange of fluid, nutrients and waste products occur between the circulation and the interstitial space.

A

a. Removes waste and/or other products from the circulation and carries deoxygenated blood so is a dark purple colour.

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3
Q

which of the following is true for the venous side of the circulatory system?
a. Removes waste and/or other products from the circulation and carries deoxygenated blood so is a dark purple colour.
b. Delivers oxygen and nutrients and carries oxygenated blood so this blood is a bright red colour
c. Is where the exchange of fluid, nutrients and waste products occur between the circulation and the interstitial space.

A

a. Removes waste and/or other products from the circulation and carries deoxygenated blood so is a dark purple colour.

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4
Q

which of the following is true for the capillary bed or microcirculation?
a. Removes waste and/or other products from the circulation and carries deoxygenated blood so is a dark purple colour.
b. Delivers oxygen and nutrients and carries oxygenated blood so this blood is a bright red colour
c. Is where the exchange of fluid, nutrients and waste products occur between the circulation and the interstitial space.

A

c. Is where the exchange of fluid, nutrients and waste products occur between the circulation and the interstitial space.

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5
Q

what are the two conditions that arise from increased blood in the capillary bed?

A
  • hyperaemia
  • congestion
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6
Q

what is hyperaemia?

A

an increased inflow of blood to an area

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7
Q

is the hyperaemia that occurs in the stomach and intestine during digestion…
a. physiological
b. pathological

A

a. physiological

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8
Q

is the hyperaemia associated with inflammation…
a. pathological
b. physiological

A

b. physiological

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9
Q

what is congestion (accumulation of blood in capillaries/venules) caused by?

A

decreased blood flow out of the tissue - caused either by physical obstruction within (blood clot) or surrounding veins, or a failure of forward blood flow (failing heart).

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10
Q

is it hyperaemia or congestion - affected tissues will have a dark red appearance with a bluish tinge?

A

congestion - the haemoglobin will be less oxygenated compared to hyperaemia, hence the bluish colour

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11
Q

which type of congestion: seen where there is a restriction of venous blood flow from a particular part of the body, eg due to something within veins or external pressure collapsing veins eg tumour or tight bandage?
a. localised
b. systematic
c. hypostatic

A

a. localised

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12
Q

which type of congestion - involves a larger part of the body and is most commonly seen in heart failure (due to a deficient forward flow of blood through the heart, blood dams back in the great veins affecting quite wide areas of tissue as the pressure is transmitted back through the venous system?
a. localised
b. systematic
c. hypostatic

A

b. systematic (otherwise known as generalised congestion)

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13
Q

what type of congestion - occurs due to the force of gravity?
a. localised
b. systematic
c. hypostatic

A

c. hypostatic

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14
Q

what is the definition for the accumulation of fluid from blood vessels in surrounding tissues?

A

oedema

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15
Q

what is the definition for lack of blood supply to affected tissues?

A

ischaemia

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16
Q

what is the definition for the death of cells deprived of oxygen?

A

infarction

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17
Q

what is the definition for the loss of red blood cells through capillary walls?

A

diapedesis

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18
Q

what is the definition for loss of red blood cells due to ruptured capillaries?

A

haemorrhage

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19
Q

are the following the affects of hyperaemia or congestion?
- oedema, ischaemia, infarction, diapedesis or haemorrhage

A

congestion

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20
Q

hyperaemia or congestion?
- a response of inflammatory stimuli/mediators

A

hyperaemia

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21
Q

hyperaemia or congestion?
- redness in the skin to dissipate heat/redness in skeletal muscle after exercise

A

hyperaemia

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22
Q

hyperaemia or congestion?
- left sided and right sided heart failure

A

congestion (any kind of heart failure is)

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23
Q

hyperaemia or congestion?
- pressure from a large tumour mass

A

congestion

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24
Q

hyperaemia or congestion?
- intestinal torsion, pressure by a bandage on the finger

A

congestion

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25
Q

The image on the left shows the lungs of a young dog that died due to a pulmonary viral disease causing inflammation of the lungs - is it hyperaemia or congestion?

A

hyperaemia - the lungs are bright red, also an inflammation response

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26
Q

The image on the right shows the small and large intestines from a 3-week-old calf that died due to intestinal torsion. Do you think this is hyperemia or congestion?

A

congestion - affected tissue is dark red/bluish and swollen, and is due to decreased blood flow out of the intestines due to venous torsion

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27
Q

with left sided heart failure there is decreased blood flow out of the:
a. lungs
b. liver

A

a. lungs - left sided heart failure results in pulmonary congestion

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28
Q

with right sided heart failure there is decreased blood flow out of the
a. lungs
b. liver

A

b. liver - right sided heart failure causes portal vein and hepatic congestion

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29
Q

nutmeg liver (from chronic passive congestion) - is this from:
a. left sided heart failure
b. right sided heart failure

A

b. right sided heart failure

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30
Q

presence of heart failure cells (haemosiderin pigment in alveolar macrophages) in the lungs is a result of:
a. left sided heart failure
b. right sided heart failure

A

a. left sided heart failure

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31
Q

what is diapedesis?

A

the migration of cells through vessel walls, often capillaries - typically associated with inflammation.

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32
Q

which of these lungs belongs to a dog with chronic left sided heart failure?

A

b - due to the presence of haemosiderin in alveolar macrophages (“heart failure cells”)

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33
Q

what is ischaemia?

A

inadequate blood supply/flow to an area of tissue relative to it’s needs (directly translates to “without blood”)

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34
Q

term for inadequate blood supply/flow to an area of tissue relative to it’s needs (directly translates to “without blood”)?
a. ischaemia
b. infarction
c. hyperaemia

A

a. ischaemia

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35
Q

consequences of ischamia (inadequate blood supply - results from aterial obstruction/decreased cardiac output/local congestion or venous obstruction) are:
a. hypertrophy
b. hyperaemia
b. hyperplasia
c. necrosis

A

c. necrosis - with ischaemia there is oxygen deprivation (anoxia or hypoxia) that will lead to tissue necrosis

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36
Q

what is an infarct?

A

a localised area of necrotic tissue that occurs as a result of ischaemia (insufficient blood flow)

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37
Q

name for a localised area of necrotic tissue that occurs as a result of ischaemia (insufficient blood flow)?

A

infarct

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38
Q

what’s the name for the process by which an infarct develops?

A

infarction - original, I know

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39
Q

true or false - most infarcts are caused by obstruction of arterial supply?

A

true - the organs most commonly infarcted are those with terminal vascular bed type arterial supply (kidneys, spleen, limb extremities, brain, intestine etc)

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40
Q

a foreign object is present within the circulation and gets stuck in the renal vessel wall - in which will the presence of the foreign body be more likely to cause ischaemia?
a. image a
b. image b

A

a. image a - arterial blood supply

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41
Q

infarct development - affected tissue will have become red and swollen. is this:
a. several hours old (new)
b. middle aged
c. old

A

a. several hours old (new) - the redness is due to a backflow of blood from venous circulation, swelling from increased volume of red blood cells in the tissue etc

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42
Q

infarct development - becoming paler as the red cells haemolyse and affected tissue becomes necrotic, triggering an inflammatory reaction (margin of hyperaemia (dialated blood vessels) around the edges of necrosis) - is this
a. several hours old (new)
b. middle aged
c. old

A

b. middle aged - these are the characteristics of a subacute infarct

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43
Q

infarct development - macrophages will begin to infiltrate the affected tissue to remove necrotic debris, fibroblasts will move in and replace the necrotic tissue with a fibrous scar - is this
a. several hours old (new)
b. middle aged
c. old

A

c. old - we’re talking several days or older

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44
Q

what is haemorrhage?

A

bleeding from transected or ruptured blood vessels, or from the heart - often caused by trauma (not the therapist kind)

45
Q

which type of haemorrhage is this?
a. diapedesis
b. rexis

A

b. rexis - where the vessel is physically damaged

46
Q

which type of haemorrhage is this?
a. diapedesis
b. rexis

A

a. diapedesis - where there are tiny gaps between endothelial cells

47
Q

which haemorrhage classification: pinpoint 1-2mm diameter haemorrhage, usually dye to diapedesis or associated with platelet number and/or function disorders?
a. petechiae
b. ecchymoses
c. suffusive
d. hematoma

A

a. petechiae

48
Q

which haemorrhage classification: larger diameter of haemorrhage (2-3cm), secondary to more severe vascular damage and also issues in platelet number and/or function?
a. petechiae
b. ecchymoses
c. suffusive
d. hematoma

A

b. ecchymoses (similar to petechiae but bigger dots)

49
Q

which haemorrhage classification: much larger, irregular areas of haemorrhages affecting the tissue?
a. petechiae
b. ecchymoses
c. suffusive
d. hematoma

A

c. suffusive

50
Q

which haemorrhage classification: local, confined accumulation of blood, usually clotted?
a. petechiae
b. ecchymoses
c. suffusive
d. hematoma

A

d. hematoma

51
Q

order the following compensatory mechanisms for decreased blood volume: replacement of lost erythrocytes, redistribution of blood to vital centres, restoration of plasma volume

A
  1. redistribution of blood to vital centres (splenic contraction, arteriolar constriction)
  2. restoration of plasma volume (extravascular fluid moves into vessels, haemodilution)
  3. replacement of lost eythrocytes (more reticuloctyes (immature red blood cells) seen in circulation)
52
Q

what happens if the compensatory mechanisms for acute blood loss don’t cut it?

A

shock occurs (hypovolaemic edition)

53
Q

what kind of shock occurs when there is a dramatic decrease in the volume of blood present (due to loss of fluid, eg through dehydration/torsion of intestines with plasma leakage, or loss of blood eg haemorrhage)?
a. hypovolaemic
b. cardiogenic
c. vasculogenic

A

a. hypovolaemic

54
Q

what is shock?

A

failure of the circulatory system to adequately perfuse vital organs (eg due to a sudden decrease in blood volume)

55
Q

what kind of shock occurs when there is a decrease in cardiac output, eg acute changes in myocardial function (eg large infarcts, decreased contractility), decreased filling with blood or failure of heart to empty?
a. hypovolaemic
b. cardiogenic
c. vasculogenic

A

b. cardiogenic shock

56
Q

what kind of shock occurs when there is either widespread vasodilation, or widespread damage to a large number of capillary beds?
a. hypovolaemic
b. cardiogenic
c. vasculogenic

A

c. vasculogenic

57
Q

true or false - with shock, there is a failure of the circulatory system to deliver adequate blood (and therefore oxygen and nutrients) to cells and tissues?

A

true - leading to these outcomes

58
Q

what is thrombosis?

A

a pathological, excessive and inappropriate formation of a thrombus (blood clot formed during life), can have serious effects of cells and tissues

59
Q

what three things can start thrombosis?

A
  1. endothelial damage (damage to the blood vessel wall - most important cause)
  2. abnormal blood flow
  3. hypercoagulability
60
Q

what is the first phase of thrombus formation?
a. activation of clotting mechanism results in the formation of fibrin strands
b. deposition of platelets on the damaged endothelium

A

b. deposition of platelets on the damaged endothelium

61
Q

what is the second phase of thrombus formation?
a. activation of clotting mechanism results in the formation of fibrin strands
b. deposition of platelets on the damaged endothelium

A

a. activation of clotting mechanism results in the formation of fibrin strands - these are layered on the platelet plug

62
Q

which consequence of thrombosis is a?
1. lysis
2. organisation
3. recanalisation
4. blockage (occlusion)
5. bits detach

A
  1. lysis - this is where the thrombus stays attached to the vessel wall, but doesn’t occlude it and undergoes lysis and disappears leaving little or no damage to the surrounding tissue
63
Q

which consequence of thrombosis is b?
1. lysis
2. organisation
3. recanalisation
4. blockage (occlusion)
5. bits detach

A
  1. organisation - the thrombuses in slightly larger vessels can shrink and be organised over time, allowing blood to pass by to supply distal tissues
64
Q

which consequence of thrombosis is c?
1. lysis
2. organisation
3. recanalisation
4. blockage (occlusion)
5. bits detach

A
  1. recanalisation - this is where the new channel around the thrombus becomes lined with endothelial cells
65
Q

what is the consequence of thromosis in d?
1. lysis
2. organisation
3. recanalisation
4. blockage (occlusion)
5. bits detach

A
  1. blockage - this forms an occluding thrombus, which often leads to ischemia (inadequate blood flow) and infarction (area of necrotic tissue due to ischaemia)
66
Q

what is the consequence of thromosis in e?
1. lysis
2. organisation
3. recanalisation
4. blockage (occlusion)
5. bits detach

A
  1. bits detach (and move in the bloodstream) - this happens when a thrombus only partially fills a vessel and the blood constantly flows over the surface of the thrombus, dislodging parts of the clot
67
Q

what is an embolus?

A

an abnormal mass circulating in the bloodstream (plural, emboli)

68
Q

what is an abnormal mass circulating in the bloodstream?

A

an embolus (plural, emboli)

69
Q

what is an an embolism?

A

when an embolus (abnormal mass circulating in the bloodstream) gets stuck in the vessel and occludes it

70
Q

what is a thromboembolism?

A

when bits of a thrombus (blood clot formed during life) breaks away and circulates in the bloodstream - embolism just means abnormal mass circulating in the bloodstream

71
Q

if a chunk of a clot of blood formed during life breaks off and starts circulating in the bloodstream, what is the circulating mass called?

A

a thromboemboli

72
Q

A cow has an infected indwelling catheter in its jugular vein, which causes a septic thrombus to develop. A piece of the thrombus breaks off and begins to circulate in the blood stream.
What term best describe this process?
a. Thrombosis
b. Embolism
c. Septic thromboembolism
d. Thromboembolism

A

c. Septic thromboembolism

72
Q

true or false - there are other types of emboli aside from a thrombus

A

true - fat, gas, foreign bodies, cartilage, neoplastic etc

73
Q

what is hydrostatic pressure?
a. It is the force that will force water out of the capillary bed and into the interstitial fluid.
b. It is the force that will draw water from the interstitial fluid into the capillary bed.
c. It is the pressure of circulating blood against the walls of blood vessels.

A

a. It is the force that will force water out of the capillary bed and into the interstitial fluid.

74
Q

what is osmotic pressure?
a. It is the force that will force water out of the capillary bed and into the interstitial fluid.
b. It is the force that will draw water from the interstitial fluid into the capillary bed.
c. It is the pressure of circulating blood against the walls of blood vessels.

A

b. It is the force that will draw water from the interstitial fluid into the capillary bed.

75
Q

what substance is the main determinant of changes in the osmotic pressure?
a. plasma proteins (esp. albumin)
b. sodium
c. chloride

A

a. plasma proteins (esp. albumin) - they’re too big to pass through the capillary bed

76
Q

what is fluid formation within the thoracic cavity called?
a. hydrothorax
b. ascites or hydroperitoneum
c. hydropericardium
d. anasarca

A

a. hydrothorax

77
Q

what is fluid formation within the abdominal cavity called?
a. hydrothorax
b. ascites or hydroperitoneum
c. hydropericardium
d. anasarca

A

b. ascites or hydroperitoneum

78
Q

what is fluid formation within the pericardial sac called?
a. hydrothorax
b. ascites or hydroperitoneum
c. hydropericardium
d. anasarca

A

c. hydropericardium

79
Q

what is generalised accumulation of fluid in the subcutaneous tissue called?
a. hydrothorax
b. ascites or hydroperitoneum
c. hydropericardium
d. anasarca

A

d. anasarca

80
Q

what type of oedema is more likely after the removal of an axillary lymph node?
a. local
b. systematic

A

a. local

81
Q

what type of oedema is more likely with a tourniquet?
a. local
b. systematic

A

a. local

82
Q

what type of oedema is more likely with congestive heart failure?
a. local
b. systematic

A

b. systematic

83
Q

what type of oedema is more likely with severe liver disease?
a. local
b. systematic

A

b. systematic

84
Q

what type of oedema is more likely with high burden of blood sucking parasites in the gastrointestinal tract?
a. local
b. systematic

A

b. systematic

85
Q

what is oncotic or colloid-osmotic pressure?

A

a type of osmotic pressure induced by the plasma proteins in the blood, mainly albumin

86
Q

what do you think are main components of a capillary bed that are related to oedema?
a. hydrostatic pressure, oncotic/colloid-osmotic pressure, endothelial cells, lymphatic drainage
b. endothelial cells, osmotic pressure, hydrostatic pressure

A

a. hydrostatic pressure, oncotic/colloid-osmotic pressure, endothelial cells, lymphatic drainage - these guys all need to be functioning

87
Q

true or false - pressure in the capillary bed vessels in influenced mostly by pressure on the venous side and not by arterial pressure

A

true

88
Q

what is oedema?

A

an excessive accumulation of extracellular fluid - oedema occurs when either too much fluid forms, or not enough fluid is removed

89
Q

which mechanism of oedema occurs locally with some kind of obstruction or compression of the venous return, or systematically with heart failure?
a. increased hydrostatic pressure
b. decreased colloid osmotic pressure
c. decreased lymphatic drainage
d. increased vascular permeability

A

a. increased hydrostatic pressure

90
Q

which mechanism of oedema occurs when albumin levels in circulation (hypoalbuminaemia), which can lead to ascites, hydrothorax and peripheral subcutaneous oedema?
a. increased hydrostatic pressure
b. decreased colloid osmotic pressure
c. decreased lymphatic drainage
d. increased vascular permeability

A

b. decreased colloid osmotic pressure

91
Q

which mechanism of oedema occurs when excess fluid still present in the interstitial space cannot be removed due to something compressing a lymphatic vessel, extensive invasion of cancerous cells into a lymph node, surgically removed lymph nodes etc?
a. increased hydrostatic pressure
b. decreased colloid osmotic pressure
c. decreased lymphatic drainage (lymphoedema)
d. increased vascular permeability

A

c. decreased lymphatic drainage (lymphoedema)

92
Q

which mechanism of oedema occurs when products released during inflammation enlarge gaps between vascular endothelial cells leading to increased loss of fluid, proteins and inflammatory cells into the tissue space?
a. increased hydrostatic pressure
b. decreased colloid osmotic pressure
c. decreased lymphatic drainage (lymphoedema)
d. increased vascular permeability

A

d. increased vascular permeability

93
Q

the fluid that accumulates due to any mechanism except increased vascular permeability (increased hydrostatic pressure, decreased colloid-osmotic pressure, decreased lymphatic drainage/lymphoedema) is called
a. transudate
b. exudate

A

a. transudate - a clear to slightly yellow watery fluid

94
Q

fluid that accumulates due to increased vascular permeability is called:
a. transudate
b. exudate

A

b. exudate

95
Q

which has few cells present and a low specific gravity?
a. transudate
b. exudate

A

a. transudate

96
Q

which has a low quantity of protein?
a. transudate
b. exudate

A

a. transudate

97
Q

which is formed due to hypoalbuminaemia?
a. transudate
b. exudate

A

a. transudate - remember, transudate is formed by anything but vascular permeability (increased hydrostatic pressure, decreased colloid-osmotic pressure, decreased lymphatic drainage/lymphoedema) and hypoalbuminaemia is the cause of decreased colloid-osmotic pressure :)

98
Q

which looks clear to yellow?
a. transudate
b. exudate

A

a. transudate

99
Q

which looks turbid, hazy or cloudy?
a. transudate
b. exudate

A

b. exudate

100
Q

what has high quantity of protein, lots of cells present and high specific gravity?
a. transudate
b. exudate

A

b. exudate

101
Q

which tube contains a transudate - a, or b?

A

a - this is clear/yellow, whereas b is exudate - cloudy, hazy

102
Q

what is another name for severe generalised subcutaneous oedema?

A

anasarca

103
Q

choose two processes that will cause pale mucous membranes:
a. renal failure
b. poor peripheral perfusion (eg, cardiovascular collapse)
c. aplasia
d. inflammation
e. anaemia

A
  • b. poor peripheral perfusion (eg, cardiovascular collapse)
  • e. anaemia
104
Q

which of the following mechanisms often cause generalised oedema?
a. decreased colloid osmotic pressure
b. increased hydrostatic pressure
c. increased vascular permeability
e. lymphatic obstruction

A

a. decreased colloid osmotic pressure
b. increased hydrostatic pressure (but only if systematic)

105
Q

this image is a high-power view of the centrilobular hepatocytes. Changes in cell nuclei are typical of necrosis and are not present in cellular degeneration. is 1:
a. a karyolytic nucleus
b. a karyorrhectic nucleus
c. a pyknotic nucleus

A

a. a karyolytic nucleus

106
Q

this image is a high-power view of the centrilobular hepatocytes. Changes in cell nuclei are typical of necrosis and are not present in cellular degeneration. is 2:
a. a karyolytic nucleus
b. a karyorrhectic nucleus
c. a pyknotic nucleus

A

b. a karyorrhectic nucleus

107
Q

this image is a high-power view of the centrilobular hepatocytes. Changes in cell nuclei are typical of necrosis and are not present in cellular degeneration. is 3:
a. a karyolytic nucleus
b. a karyorrhectic nucleus
c. a pyknotic nucleus

A

c. a pyknotic nucleus