Primeira prova prática Flashcards
Órgão?
Tipo de degeneração predominante?
Seta laranja?
Seta preta?
Estrutura circulada?
Fígado
Degeneração gordurosa
Foco de degeneração gordurosa
Foco de degeneração hidrópica
Veia centrolobular
Órgão?
Estrutura delimitada?
Tipo de degeneração predominante?
Seta rosa?
Seta azul?
Seta verde?
Fígado
Tríade portal
Degeneração gordurosa
Ramo da artéria hepática
Ducto biliar
Veia porta
Órgão?
Degeneração predominante?
Círculo verde?
Rim
Degeneração hialina (amiloidose renal)
Glómerulo renal com depósito de material hialino -> a medida que progride se torna acelular, como uma “bola hialina”
Órgão?
Degeneração predominante?
Círculo amarela?
Rim
Degeneração hialina (amiloidose renal)
Túbulos com hipertrofia compensatória aos glomérulos funcionantes com cilíndros proteicos na luz tubular
Órgão?
Degeneração predominante?
Flecha vermelha?
Colchete?
Pele
Degeneração hialina extracelular propriamente dita
Epitélio pluriestratificado pavimentoso queratinizado (Epiderme)
Derme mais eosinofílica com depósito de tecido conjunttivo
Órgão?
Degeneração predominante?
Círculo preto?
Flecha azul?
Rim
Amiloidose renal
Acúmulo de material homogêneo, amorfo e eosinofílico na porção extracelular
Glomérulo renal (Algumas regiões podem sofrer hipertrofia
na tentativa de compensar a área prejudicada. Na amiloidose o volume se mantém inalterado, enquanto que na hialinização glomerular devido a isquemia por hipertensão, ocorre certa redução de volume.)
Órgão?
Degeneração predominante?
Círculo preto?
Rim
Amiloidose renal
Acúmulo de material homogêneo, amorfo e eosinofílico na porção extracelular
Órgão?
Adaptação predominante?
Colchete?
Seta laranja?
Seta verde?
Secção transversal de músculo cardíaco
Hipertrofia cardíaca compensatória
Região do tecido de granulação após infarto
Cardiomiócitos hipertrofiadas perto da área para compensar
Cardiomiócitos próximos a normalidade
Órgão?
Adaptação predominante?
Seta azul?
Seta rosa?
Seta preta?
Seta laranja?
Próstata
Hiperplasia prostática
Glândulas proliferadas e dilatadas
Dobras epiteliais mais pronunciadas
Corpos amiláceos
Tecido conjuntivo fibroelástico com fibras musculares lisas
Órgão?
Adaptação predominante?
Seta verde
Seta amarela?
Próstata
Hiperplasia prostática benigna
Células colunares
Células basais
NB: carcinomas há perda da dupla população celular, na HPB não
Órgão/porção do órgão?
Adaptação predominanate?
Seta azul?
Seta amarela?
Seta rosa?
Colo uterino
Metaplasia escamosa
Glândula endocervical
epitélio escamoso metaplásico
Cisto de Naboth
Tecido?
Tipo de necrose?
Círculo verde?
Seta vermelha?
Adiposo
Necrose gordurosa traumática
Adipócitos com arquitetura distorcida, sem núcleos na periferia
Células inflamatórias
NB: sem focos evidentes de saponificação= provavelmente necrose gordurosa traumática
IMAGEM: nessa imagem dá pra ver os macrófagos espumosos, que fagocitaram essa gordura necrosada
Tecido?
Tipo de necrose?
Círculo verde?
Seta vermelha?
Seta amarela?
Adiposo
Necrose gordurosa enzimática
Adipócitos com arquitetura distorcida/sem núcleo na periferia
Ácinos pancreáticos
Mucosa do intestino delgado (criptas de lieberkuhn + caliceformes)
NB: enzimática pois há vários focos da saponificação (reação em que há acumulo de cálcio associado à gordura) e dá pra ver que esse tipo de necrose ocorre mais na gordura do pâncreas
Órgão?
Necrose?
Cículo vermelho?
Seta verde?
Seta amarela?
Rim
Necrose coagulativa renal (infarto branco)
Glomérulo renal
células inflamatórias
Células renais sem núcleo
Órgão?
Necrose?
Seta preta?
Círculo preto?
Seta laranja?
Pulmão
Necrose hemorrágica secundária a necrose coagulativa do pulmão (infarto pulmonar hemorrágico)
Plasma dentro do alvéolo
Alvéolo
Hemácias dentro do alvéolo
NB: infarto hemorrágico ocrre em órgãos com circulação dupla, principalmente: no pulmÃO, houve obstrução dos vasos brônquicos = necrose coagulativa, mas os vasos pulmonares continuam depositando sangue ali = necrose hemorrágica.
Órgão?
Necrose?
Seta vermelha?
Pulmão
Necrose hemorrágica
Focos de depósito de hemossiderina
Órgão?
Alteração circulatória?
Seta laranja?
Círculo verde?
Seta preta?
Fígado
Congestão (passiva) do fígado
Focos de esteatose microgoticular
Veia centrolobular congesta
Sinusóides congestos
NB: nessa imagem
Círculo vermelho = núcleo picnótico por necrose local
Círculo verde= células inflamatórias
Órgão?
Alteração circulatória?
Patologia característica dessa alteração?
Seta amarela?
Reto/ânus
Congestão
Hemorróida
Vaso congesto dilatado
NB: nessa outra imagem, é possível ver, na seta vermelha, um trombo aderido ao vaso, secundário à estase sanguínea pela congestão desses vasos.
Alteração?
Some of these skeletal muscle fibers here show atrophy, compared to normal fibers.
The number of cells is the same as before the atrophy occurred, but the size of some fibers is reduced
Alteração?
The testis at the right has undergone atrophy and is much smaller than the normal testis at the left.
Principalmente por criptorquidia
Alteração?
This is cerebral atrophy in a patient with Alzheimer disease. The entire size of the brain is reduced, but some parts are more affected than others. The gyri are narrowed and the intervening sulci are widened,
Alteração?
Here is the centrilobular portion of liver next to a central vein. The cells have reduced in size (atrophy) or been lost from hypoxia. The pale brown-yellow pigment is lipochrome that has accumulated as the atrophic and dying cells undergo autophagocytosis.
Alteração?
This is cardiac hypertrophy involving the left ventricle. The number of myocardial fibers does not increase, but their size can increase in response to an increased workload, leading to the marked thickening of the left ventricle in this patient with systemic hypertension
Alteração?
The prominent folds of endometrium in this uterus opened to reveal the endometrial cavity are an example of hyperplasia. Cells forming both the endometrial glands and the stroma have increased in number. As a result, the size of the endometrium has increased. This increase is physiologic with a normal menstrual cycle
Alteração?
This is prostatic hyperplasia.
The number of prostatic glands, as well as the stroma, has increased in this enlarged prostate seen in transverse section, and as a result, the entire prostate has increased in size.
The pattern of increase here is not uniform, but nodular. This increase is in response to hormonal action on the cells, but in this case is not a normal physiologic process, but a pathologic process that could interfere with emptying of the urinary bladder.
Alteração?
Here is one of the nodules of hyperplastic prostate, with many glands along with some intervening stroma. The cells making up the glands are normal in appearance, but there are just too many of them
Alteração?
Metaplasia of laryngeal respiratory epithelium has occurred here in a smoker. The chronic irritation has led to an exchanging of one type of epithelium (the normal respiratory epithelium at the right) for another (the more resilient squamous epithelium at the left). Metaplasia is not a normal physiologic process and may be the first step toward neoplasia.
Alteração?
Metaplasia of the normal esophageal squamous mucosa has occurred here, with the appearance of gastric type columnar mucosa.
Direita: tá normal
Esquerda: metaplásia estomacal
Alteração?
This is cellular dysplasia in the uterine cervix. The normal cervical squamous epithelium has become transformed to a more disorderly growth pattern, or dysplastic epithelium. This is farther down the road toward neoplasia, but dysplasia is still a potentially reversible process.
Alteração
Apoptosis
Apoptosis is a more orderly process of cell death. Apoptosis is individual cell necrosis, not simultaneous localized necrosis of large numbers of cells. In this example, hepatocytes are dying individually (arrows) from injury through infection by viral hepatitis. The apoptotic cells are enlarged, pink from loss of cytoplasmic detail, and without nuclei. The cell nucleus and cytoplasm become fragmented as enzymes such as caspases destroy cellular components
Alteração?
In this fetal thymus there is involution of thymic lymphocytes by the mechanism of apoptosis. In this case, it is an orderly process and part of normal immune system maturation. Individual cells fragment and are consumed by phagocytes to give the appearance of clear spaces filled with cellular debris. Apoptosis is controlled by many mechanisms. Genes such as BCL-2 are turned off and Bax genes turned on. Intracellular proteolytic enzymes called caspases produce much cellular breakdown.
Alteração?
When there is marked cellular injury, there is cell death and necrosis. This microscopic appearance of myocardium shown here is a mess because so many cells have died that the tissue is not recognizable. Many nuclei have become pyknotic (shrunken and dark) and have then undergone karorrhexis (fragmentation) and karyolysis (dissolution). The cytoplasm and cell borders are no longer recognizable. In this case, loss of the blood supply from a major coronary artery led to ischemia and cell death
Alteração?
Here is myocardium in which the cells are dying as a result of ischemic injury from coronary artery occlusion. This is early in the process of necrosis. The nuclei of the myocardial fibers are being lost. The cytoplasm is losing its structure, because no well-defined cross-striations are seen.
Alteração?
When many cells undergo necrosis at once, then definable patterns of necrosis are produced, depending upon the nature of the injury, the type of tissue, and the length of time. This is an example of coagulative necrosis. This is the typical pattern with ischemia and infarction (loss of blood supply and resultant tissue anoxia). Here, there is a wedge-shaped pale area of coagulative necrosis (infarction) in the cortex of the kidney.
Alteração?
Microscopically, the renal cortex has undergone anoxic injury at the left so that the cells appear pale and ghost-like. There is a hemorrhagic zone in the middle where the cells are dying or have not quite died along with damaged blood vessels that are leaking, and then normal renal parenchyma at the far right. This is an example of coagulative necrosis.
Alteração?
The contrast between normal adrenal cortex and the small pale infarct is good. The area just under the capsule is spared because of blood supply from capsular arterial branches. This is an odd place for an infarct, but it illustrates the shape and appearance of an ischemic (pale) infarct well.
Alteração?
Two large infarctions (areas of coagulative necrosis) are seen in this sectioned spleen. Since the etiology of coagulative necrosis is usually vascular with loss of blood supply, the infarct occurs in a vascular distribution. Thus, infarcts are often wedge-shaped with a base on the organ capsule.
Alteração?
A large portion of the small intestine is infarcted. The dark red to grey infarcted bowel contrasts with the pale pink normal bowel at the bottom. Some organs such as bowel with anastomosing blood supplies, or liver with a dual blood supply, are harder to infarct. This bowel was caught in a hernia and the mesenteric blood supply was constricted by the small opening to the hernia sac.
Alteração?
The two lung abscesses seen here are examples of liquefactive necrosis in which there is a liquid center in an area of tissue injury. One abscess appears in the upper lobe and one in the lower lobe. Liquefactive necrosis is typical of organs in which the tissues have a lot of lipid (such as brain) or when there is an abscess with lots of acute inflammatory cells whose release of proteolytic enzymes destroys the surrounding tissues.
Alteração?
The liver shows a small abscess here filled with many neutrophils. This abscess is an example of localized liquefactive necrosis. Grossly, such an abscess appears yellow to tan because it is filled with pus (purulent exudate).
Alteração?
The liver shows a small abscess here filled with many neutrophils. This abscess is an example of localized liquefactive necrosis. Grossly, such an abscess appears yellow to tan because it is filled with pus (purulent exudate).
Alteração?
This is liquefactive necrosis in the brain of a patient who suffered a “stroke” with focal loss of blood supply to a portion of cerebrum. This type of infarction leads to necrosis which is marked by loss of neurons and neuroglial cells and the formation of a clear space at the center left. As it resolves, the liquefied area becomes a cystic space.
Alteração?
At high magnification, liquefactive necrosis of the brain demonstrates many macrophages at the right which are cleaning up the necrotic cellular debris. The job description of a macrophage includes janitorial services such as this, particularly when there is lipid debris.
Alteração?
Grossly, the cerebral infarction at the upper left in this image, in the distribution of the middle cerebral artery, demonstrates liquefactive necrosis. Eventually, the removal of the dead tissue leaves behind a cavity.
Alteração?
This infarct in the brain is organizing and being resolved. The liquefactive necrosis leads to resolution with cystic spaces as the necrotic tissue is removed.
Alteração?
This is fat necrosis of the pancreas. Cellular injury to the pancreatic acini leads to release of powerful enzymes which damage fat by the production of soaps, and these appear grossly as the soft, chalky white areas seen here on the cut surfaces.
Alteração?
Microscopically, fat necrosis adjacent to pancreas is seen here. There are some remaining steatocytes at the left which are not necrotic. The necrotic fat cells at the right have vague cellular outlines, have lost their peripheral nuclei, and their cytoplasm has become a pink amorphous mass of necrotic material.
This is the gross appearance of caseous necrosis in a hilar lymph node infected with tuberculosis. The node has a cheesy tan to white appearance. Caseous necrosis is really just a combination of coagulative and liquefactive necrosis that is most characteristic of granulomatous inflammation.
Alteração?
This is more extensive caseous necrosis, with confluent cheesy tan granulomas in the upper portion of this lung in a patient with tuberculosis. The tissue destruction is so extensive that there are areas of cavitation (cystic spaces) being formed as the necrotic (mainly liquefied) debris drains out via the bronchi.
Alteração?
Microscopically, caseous necrosis is characterized by acellular pink areas of necrosis, as seen here at the upper right, surrounded by a granulomatous inflammatory process.
Esse pé tá normal?
Se não está, qual a alteração?
This is gangrene, or necrosis of many tissues in a body part. In this case, the toes were involved in a frostbite injury. This is an example of “dry” gangrene in which there is mainly coagulative necrosis from the anoxic injury.
Qual o tipo de necrose ?
This is gangrene of the lower extremity. In this case the term “wet” gangrene is more applicable because of the liquefactive component from superimposed infection in addition to the coagulative necrosis from loss of blood supply. This patient had diabetes mellitus with severe peripheral vascular disease.
Tipo de degeneração
Hialina de Mallory
Here are Mallory bodies (the red globular material) composed of cytoskeletal filaments in liver cells chronically damaged from alcoholism. These are a type of “intermediate” filament between the size of actin (thin) and myosin (thick).
O que é esse pigmento marrom no pulmão?
The brown coarsely granular material in macrophages in this alveolus is hemosiderin that has accumulated as a result of the breakdown of red blood cells and release of the iron in heme. The macrophages clear up this debris, which is eventually recycled.
Tipo de calcificação?
Distrófica.
This is dystrophic calcification in the wall of the stomach. At the far left is an artery with calcification in its wall. There are also irregular bluish-purple deposits of calcium in the submucosa. Calcium is more likely to be deposited in tissues that are damaged.
Tipo de calcificação?
Metastática
Here is so-called “metastatic calcification” in the lung of a patient with a very high serum calcium level (hypercalcemia).
Alteração?
Amiloidose primária em nervo
Alteração?
Amiloidose primária em linfonodo
Alteração
This Congo red stain reveals amorphous orange-red deposits of amyloid, which is an abnormal accumulation of breakdown products of proteinaceous material that can collect within cells and tissues.
