Session 1 - Pictures and Drug Overdose Flashcards

1
Q

What can be seen on this image?

A

Coagulative necrosis

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2
Q

Name three features of coagulative necrosis

A

Dead tissue has solid consitency

Ghost outline of cells

Appearance lasts a few days before phagocytes invade and ingest dead material

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3
Q

What can be seen?

A

Liquefactive necrosis

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4
Q

Why does this type of necrosis occur?

A

Release of active enzymes such as proteases by neutrophils in response to bacterial infection.

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5
Q

What is the type of necrosis demonstrated in the picture?

A

Caseuous necrosis

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6
Q

How can caseuous necrosis occur?

A

* Tissue appears amorphous

* Associated with infections such as tuberculosis

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7
Q

What is the type of necrosis shown here?

A

Fat necrosis

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8
Q

How can fat necrosis occur?

A

* Occurs in pancreatitis > release of lipases > damage adipocytes

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9
Q

What is the cause of this necrosis?

A

Infarction causing white necrosis

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10
Q

What causes this type of necrosis?

A
  • Occurs with the occlusion of an “end” artery (sole source of arterial blood to a segment of an organ). If occluded, the tissue will die and appear white due to lack of blood
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11
Q

What is this type of necrosis caused by?

A

Red infarction

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12
Q

Why does this type of infarction occur?

A

Tissue filled with blood due to extensive haemorrhage. Limited blood supply, not enough for tissue to survive so lots of blood. Can be caused by occlusion of one of a pair of arteries.

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13
Q

What is the pathway for alchol metabolism?

A

Ethanol –> (alcohol dehydrogenase, CYPZE1, catalase) –> Acetaldehyde –> (aldehyde dehydrogenase) –> Acetate

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14
Q

How can excess alcohol abuse be detected in blood?

A
  • Elevated mean cell volume (large red blood cells) due to direct toxic effects of alcohol on bone marrow, or folate defiency.
  • Raised AST and ALT, due to damage to hepatocytes
  • Gamma-GT (aminotransferase) - Raised in regular moder and heavy drinkers
  • Alcoholic hepatitis, eleveated serum bilirubin, aminotransferases, alkaline phosphatases
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15
Q

What affect does alcohol have on liver presentation?

How are these changes caused?

A

Fatty change

Acute hepatitis

Alcoholic cirrosis

  • Caused by toxicity
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16
Q

What change to liver cells can been seen here, and what is the clinical name for it?

A

Fatty change

Steatosis

17
Q

What affect can alcohol have on nervous system?

A
  • Wernicke syndrome, due to thiamine defiency
  • Results in ataxia (loss of voluntary muscle control), disturbed cognition, nystagmus (involuntary eye movement)
  • Korkasoff syndrome
  • Thiamine defiency + toxicity
  • Sever memory loss
  • Peripheral neuropathy
  • Epilepsy
18
Q

What affect can alcohol have on cardiovascular system?

A

Cardiomyopathy

Hypertension

Beri Beri heart disease

19
Q

What affect does alcohol have on GI tract?

A

Pancreatitis, leads to vitamin defiency (unable to breakdown fat, fat soluble vitamins cannot be absorbed)

20
Q

What is foetal alcohol syndrome?

A

Acetaldehyde crosses over placental barrier and damages foetal brain. Causes mental retardation.

21
Q

What happens after an OD of paracetamol?

A

Glutathione depleted and NAPQI binds with suplhdryl groups on liver membrane, causing necrosis and liver failure

22
Q

Give three examples of patients will suffer from paracetamol OD at lower doses and why

A

Lower glutathione in first place

  • Alcohol with the OD
  • Malnourished
  • HIV positive
23
Q

What are the physiological effects of paracetamol overdose?

What is the antidote?

A

Liver failure at 36-96 hours and death

N-acetylcysteine, which increases availability of hepatic glutathione

24
Q

What is a method of determining severity of liver damage?

A

Prothrombin time (PT), clotting in blood

Measure Creatinine and blood pH

25
Q

What are the consequences of an aspirin overdose?

A

Acidosis (acetysalicylic acid)

Increase in lactose, ketones and pyruvate also contributes to acidosis

26
Q
A