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COM MOD > Robbins Chapter 6 Morphology > Flashcards

Robbins Chapter 6 Morphology Flashcards

1
Q

Principal morphologic manifestation of immune complex injury

A

acute vasculitis with necrosis of vessel wall and neutrophilic infiltration

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2
Q

Fibrinoid necrosis

A

necrotic tissue and deposits of immune complexes, complement, and plasma proteins

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3
Q

Fibrinoid necrosis morphology

A

smudgy eosinophilic area of tissue destruction

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4
Q

Immune complex morphology in the kidney

A

granular lumpy deposits of immunoglobulin and complement in immunofluorescence
electron-dense deposits along glomerular basement membrane in electron microscopy

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5
Q

Where are the most characteristic lesions from immune complexes deposited in SLE? (4)

A

blood vessels, kidney, skin, connective tissue

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6
Q

Blood vessel response in SLE

A

acute necrotizing vasculitis of capillaries, small arteries, and arterioles

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7
Q

What is arteritis characterized by in SLE

A

fibrinoid deposits in vessel walls

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8
Q

Blood vessels in chronic stages of SLE

A

fibrous thickening with luminal narrowing

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9
Q

Kidney response in SLE

A

glomerular lesions due to deposition of immune complex in basement membrane and glomerulus
6 patterns of glomerular disease in SLE

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10
Q

Class I glomerular disease in SLE

A

least common
minimal mesangial lupus nephritis
immune complex deposition in mesangium

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11
Q

Class II glomerular disease in SLE

A

Mesangial prolliferative lupus nephritis
characterized by mesangial proliferation
no involvement of glomerular capillaries

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12
Q

Class III glomerular disease in SLE

A

Focal lupus nephritis
involvement of fewer than 50% of all glomeruli
affected glomeruli exhibit swelling and proliferation with leukocyte accumulation
focal necrosis and crescent formation
red cell casts in urine

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13
Q

Class IV glomerular disease in SLE

A

Diffuse lupus nephritis - most common*
half or more of the glomeruli are affected
affected glomeruli show crescents that fill Bowman’s Space
thickening of capillary wall forming “wire loop”
proteinuria and hematuria

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14
Q

Class V glomerular disease in SLE

A

Membranous Lupus Nephritis
characterized by diffuse thickening of the capillary walls form deposition of subepithelial immune complexes
severe proteinuria or nephrotic syndrome

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15
Q

Class VI glomerular disease in SLE

A

Advanced sclerosing lupus nephritis

more than 90% of glomeruli are involved

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16
Q

Skin response in SLE

A

“butterfly” rash- erythema affects the face along the bridge of nose and cheeks
involved areas show vacuolar degeneration of basal layer or epidermis
deposition of Igs and complement along dermoepidermal junction

17
Q

Joints response in SLE

A

nonerosive synovitis with little deformity

*makes it different from rheumatoid arthritis

18
Q

Pericarditis and Serosal Cavity in SLE

A

inflammation of serosal lining
can be acute with fibrinous exudate
can be subacute with thickened and opaque
can be chronic fibrous tissue

19
Q

Cardiovascular system response in SLE

A

valvular abnormalities of mitral or aortic valves

Libman-Sacks endocarditis and vegetations are large

20
Q

Spleen response in SLE

A

splenomegaly, capsular thickening, follicular hyperplasia

“onion skin” lesions

21
Q

Lungs response in SLE

A

pleuritis and pleural effusion

22
Q

What can be tested in the bone marrow when diagnosing SLE?

A

LE bodies (hemotoxylin)

23
Q

Morphology of Sjogren Syndrome

A

periductal and perivascular lymphocytic infiltration in salivary glands
ductal linings of epithelial cells show hyperplasia
can cause lymphoma

24
Q

Results of lack of tears in Sjogren Syndrome

A

drying of corneal epithelium which becomes inflamed, eroded, and ulcerated

25
Q

Results of lack of salvation in Sjogren Syndrome

A

oral mucosa may atrophy

inflammatory fissuring and ulceration

26
Q

What is the main changing area in systemic sclerosis?

A

skin, alimentary tract, musculoskeletal system

27
Q

Skin response in systemic sclerosis

A

diffuse, sclerotic atrophy
begins in fingers and then extends proximally to upper trunk and head/neck
atrophic changes in terminal phalanges

28
Q

Histological skin in systemic sclerosis

A

edema and perivascular infiltrates containing CD4+
increased fibrosis
increased collagen

29
Q

Alimentary tract response to systemic sclerosis

A

progressive atrophy and collagenous fibrosis replacement of the muscularis of esophagus and guy
Esophagus becomes like a “rubber-hose” inflexibility

30
Q

Musculoskeletal response to systemic sclerosis

A

early stages- inflammation of synovium from hypertrophy and hyperplasia
later stages- fibrosis

31
Q

Kidney response to systemic sclerosis

A

vascular lesions - interlobular arteries show thickening and deposits of collagen
proliferation of intimal cells

32
Q

Lung response to systemic sclerosis

A

pulmonary vasospasm

pulmonary fibrosis

33
Q

Heart response to systemic sclerosis

A

pericarditis with effusion, myocardial fibrosis and thickening of intramyocardial arterioles

34
Q

3 classifications of rejection reactions

A

hyperacute, acute, and chronic rejection

35
Q

Characteristics of hyperacute rejection

A

occurs within minutes or hours
cyanotic, mottles, flaccid
neutrophils accumulate

36
Q

Characteristics of acute rejection

A

occurs within days of transplant
can be cellular mediated acute rejection
can be humoral mediated acute rejection

37
Q

2 patterns of acute cellular (T cell mediated) rejection

A 
tubulointerstitial patterns (type I)- tubulitis associated with tubular injury
vascular patterns- endotheliitis- inflammation of vessels
38
Q

Characteristics of acute antibody-mediated rejection

A

damage to glomeruli and small blood vessels

deposition of C4d

39
Q

Characteristics of chronic rejection

A

4-6 months

dominated by vascular changes of intimal thickening, glomerulopathy, and peritubular capillaritis

COM MOD (21 decks)

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