Regressive lesions - 1

Question 1

Atrophy def:

Answer 1

Atrophy of any organ is defined as shrinkage in the size of the cell by the loss of cell substance.

Frequently, this condition is manifested by shrinkage (reduced size) of affected organ.

However, shrinking parenchymal cells are in some cases replaced by connective or fat tissue the dimension of atrophic organ remaining unchanged

Question 2

Atrophy depends on the underlying cause and can be ……

Answer 2

local or generalized

Question 3

The common causes of atrophy are the following:

Answer 3

• diminished blood supply
• decreased workload (atrophy of disuse)
• inadequate nutrition
• loss of endocrine stimulation
• pressure
• loss of innervation (denervation atrophy)

Question 4

Atrophy- morphologic classification:

Answer 4

• Reference to cells
• Reference to stroma
• Reference to an entire organ

Question 5

Reference to cells:

Atrophy- morphologic classification

Answer 5

e.g. simple atrophy

Question 6

Reference to stroma:

Atrophy- morphologic classification

Answer 6

• normal stroma ( e.g. simple atrophy)

- increased stroma (e.g. due to excess of collagen „fibrous a.”, due to accumulation lymphocytes)

Question 7

Reference to an entire organ:

Atrophy- morphologic classification

Answer 7

• concentric atrophy:
  diminution of an organ
• eccentric atrophy:
  diminished mass of an organ while its size is normal or even increased (pulmonary emphysema, hydronephrosis, osteoporosis, lipomatous atrophy of the pancreas)

Question 8

Increased stroma

Answer 8

e.g. due to excess of collagen „fibrous a.”, due to accumulation lymphocytes

Question 9

Concentric atrophy

Answer 9

diminution of an organ

Question 10

Eccentric atrophy:

Answer 10

diminished mass of an organ while its size is normal or even increased (pulmonary emphysema, hydronephrosis, osteoporosis, lipomatous atrophy of the pancreas)

Question 11

Pulmonary emphysema:

Answer 11

Emphysema pulmonum essentiale

Question 12

The term pulmonary emphysema….

Answer 12

is applied to a condition characterized by abnormal distention of air spaces distal to the terminal bronchioles with destruction of interalveolar septa.

Question 13

The term „overinflation”……..

Answer 13

refers to dilatation of air spaces which is not accompanied by destruction of their walls.

Question 14

Emphysema (besides chronic bronchitis and small airways disease) is included in a group of pulmonary disorders, referred to as…….

Answer 14

Chronic Obstructive Pulmonary Disease (COPD)

Question 15

The most important factors contributing to development of pulmonary emphysema:

Answer 15

• smoking
• inherited susceptibility
• frequent respiratory tract infections (especially in childhood)

Question 16

What is the clinically presenting symptom of pulmonary emphysema?

Answer 16

dyspnea is the presenting symptom.

It results from loss of elastic recoil properties and reduction of gas exchanging surface.

Question 17

MORHOLOGICALLY, emphysema is classified according to the distribution of changes within pulmonary acini.

Answer 17

• Centrilobular (centriacinar)
• Paraseptal
• Panacinar

Question 18

Centrilobular (centriacinar):

Answer 18

• proximal acinar
• involving respiratory bronchioles
  
  • result of cigarette smoking!

Question 19

Paraseptal

Answer 19

• distal acinar

- involving alveoli and alveolar ducts

Question 20

Panacinar

Answer 20

• panlobular

- involving pulmonary acini uniformly

Question 21

Centriacinar (centrilobular)

Answer 21

• result of cigarette smoking
• Distal alveoli are spared and respiratory bronchioles are involved (both distended and normal airspaces are present)
• upper lobes
• spaces that exceed 1 cm in size – „bullae”

Question 22

Panacinar:

Answer 22

• inherited alpha-1 antitrypsin deficiency
• Develops usually early in life (third decade)
• respiratory bronchioles and terminal alveoli are involved
• lower lobes

Question 23

The protease-antiprotease imbalance

Answer 23

The destructive effect of high protease activity (cellular proteases from neutrophils) in subjects with low antiprotease activity (low levels of serum α1-antitrypsin)

• elastic tissue destruction is unchecked and emphysema
  results.