Section 1
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what are hyaline changes?
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Section 1
(50 cards)
what are hyaline changes?
alteration within cells/ECM and produce homogeneous, glassy, pink appearance with H&E staining -protein droplets, Russell bodies, alcohol hyaline can all produce hyalinization
causes of protein accumulation in the cell
1. reabsorption droplets (reabsorbed proteins in renal tubular cells, in proteinuria) 2. Russell bodies (excessive protein production) 3. partially folded intermediates (increased accumulation-apoptosis of cells) 4. accumulation of cytoskeletal proteins (neurofibrillary tangle in Alzheimer's) 5. aggregation of abnormal proteins (ex. amyloidosis)
Is hypertrophy reversible or irreversible?
reversible
early responses to cell injury (reversible)
1. cloudy swelling (earliest evidence, loss of normal staining) 2. hydropic degeneration (continued swelling, appearance of vacuoles) 3. fatty change (accumulation of triglycerides in cytoplasm)
what is dysplasia a risk for?
increased risk of neoplasia
common tissues affected by hyperplasia
endometrium (hormonal stimulation) prostate gland (hormonal stimulation) red blood cells (high altitude) glandular epithelium of breast (hormonal stimulation) uterine enlargement (pregnancy)
what is dysplasia?
rapid proliferation and failure of differentiation and maturation of cells
common causes of fatty change (steatosis)
toxins (ex. alcohol) and chronic hypoxia
tissues commonly affected by atrophy
testis in elderly skeletal muscle (disuse, loss of innervation) brain (neurodegenerative, aging)
what is an example of an exogenous pigment that accumulates in cells?
carbon particles within lung tissue from smoking
common tissues affected by metaplasia
respiratory epithelium cervical epithelium esophageal epithelium
features of apoptosis
-physiological -genetic programmed cell death -cell shrinking -nucleus fragmentation -DNA aggregation -maintains plasma membrane integrity (blebbing) -no surrounding tissue damage or inflammation
2 major mechanisms of cell death
1. apoptosis (physiological most of the time) 2. necrosis (pathological)
What is autophagy?
The cell recycles its own organic material. Lysosome will surround it and eat it, allowing its building blocks to be something else.
What is lipofuscin?
Wear and tear pigment that accumulates in the liver due to peroxidized lipids; it is commonly present in hepatocytes and cardiac myocytes
common causes of metaplasia
adaptive response to environmental stimuli ex. cigarette smoke and acid reflux
3 Cellular adaptations to nonlethal injury
1. Alteration in size - Atrophy . a. Decrease in size of existing cells - Hypertrophy . a. Increase in size of exhisting cells 2. Increase in number . a. Hyperplasia 3. Change in differentiation . a. Metaplasia
What is fibrinoid necrosis?
necrotic damage to blood vessel wall causes leaking of proteins into vessel wall (including fibrin) Ag-Ab complexes deposited into arterial walls bright pink, amorphous appearance on H&E stain seen commonly in immunologically mediated vasculitis syndromes
2 mechanisms of apoptosis
1. intrinsic 2. extrinsic *both result in activation of initiator and executioner caspases
characteristics of coagulative necrosis
denaturation of proteins and enzymes cells are eosinophilic and anucleate *ischemia due to obstruction of blood vessel leads to coagulative necrosis in all organs except the brain
Causes of intracellular accumulations
1. inadequate removal of normal substances secondary to defects in mechanisms of packaging and transport 2. accumulation of abnormal endogenous substance secondary to genetic/acquired defects in folding, packaging, transport, or secretion 3. failure to degrade a metabolite secondary to inherited enzyme deficiency 4. deposition and accumulation of abnormal exogenous substance
Are fatty changes reversible? what about fibrotic changes?
Fatty change: reversible if stimulus removed Fibrotic change: irreversible
common causes of hypertrophy
increased functional demand specific hormonal stimulation
What is atherosclerosis?
a disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls. smooth muscle cells and macrophages within tunic intima are filled with lipid vacuoles (foam cells)
Is metaplasia reversible or irreversible?
reversible as long as you remove the driving stressor
what is neoplasia?
Cellular proliferation and growth in absence of external stimulus Neoplasm = Abnormal mass of cells Variable states of differentiation - Commonly fail to reach highly differentiated state
What is pleomorphism?
variations in size and shape among cells of a single species
common causes of cell injury
-metabolic -physical -chemical -immune -genetic -biologic -aging
Is hyperplasia reversible or irreversible?
reversible
Is neoplasia reversible or irreversible?
irreversible
common tissues affected by hypertrophy
cardiac muscle (increased demand, hypertension) skeletal muscle (increased workload, exercise) uterus (hormonal, pregnancy)
4 major intracellular systems affected by injury
1. membrane integrity (plasma membrane and organelles) 2. ATP production 3. protein synthesis 4. genomic or chromosomal integrity
What is a xanthoma?
Plaques or nodules comprised of lipid-laden macrophages in the skin, esp eyelids.
what is metaplasia a risk for?
increases risk for dysplasia and neoplasia
what is carcinoma in situ?
epithelial tissue shows features of carcinoma without breaching the basement membrane (so it is confined) -structural abnormalities -cell crowding -pleomorphisms -increased and abnormal mitotic activity
What is hemosiderin?
extravasated RBCs are engulfed by macrophages which reserve their iron in ferritin stores which develop into hemosiderin stores if there is too much ferritin
what are the types of necrosis?
1. coagulative 2. liquefactive 3. caseous 4. fat necrosis
what is gangrenous necrosis?
A form of coagulative (ischemic, lack of blood supply) necrosis involving multiple tissue layers.
common causes of atrophy
decreased functional demand, loss of innervation, decreased blood supply, poor nutrition, loss of endocrine stimulation, aging
characteristics of fat necrosis
-focal areas of fat destruction -typically due to release of active pancreatic lipases into pancreatic parenchyma and peritoneum -fatty acid + calcium==> fat saponification (chalky white areas)
characteristics of liquefactive necrosis
- liquid area in center of necrotic tissue ("pus") -digestion of dead cells - seen in abscesses associated with bacterial or fungal infection - occurs in the brain, likely because of high lipid content and lack of supporting stroma - over time, necrotic tissue replaced by an empty cavity/pseudocyst
what are pathological calcifications?
abnormal tissue deposition of calcium salts with small amounts of iron, magnesium, and other mineral salts
common tissues affected by dysplasia
uterine cervix skin
is atrophy reversible or irreversible?
reversible
what is cholesterolosis?
A condition in which cholesterol-filled macrophages are deposited in the GB wall
features of necrosis
-enlarged cell size (swelling) -pyknosis-->karyorrhexia-->karyolysis -plasma membrane disrupted -cell unable to maintain homeostasis -enzymatic digestion of cellular contents; may leak out of cell -frequent adjacent inflammation and tissue damage -invariably pathologic (culmination of irreversible cell injury)
Is dysplasia reversible or irreversible?
reversible up to a point and as long as the stimulus is removed
characteristics of caseous necrosis
friable, white appearance of tissue collection of fragmented/lysed cells and debris in a granuloma no specific structure common in tuberculosis infection
2 Main groups of neoplasms
1. Benign - Grows slowly - Remains localized to site of origin 2. Malignant - Grows rapidly - May spread wildly
common causes of hyperplasia
increased functional demand hormonal stimulation
Section 2
(50 cards)
What is metastatic calcification?
Calcification of normal tissue due to increased serum calcium (Hypercalcemia)
examples of environmental factors that can cause anomalies
-maternal/placental infection -maternal disease states (ex. PKU, diabetes) -drugs and chemicals (ex. alcohol, thalidomide) -irriadiations
what is primary malnutrition?
defective diet
What is a hemangioma?
benign tumor of blood vessels port wine stains spontaneous, regress with age
What is exudate?
fluid containing serum, fibrin, and leukocytes specific gravity > 1.020 protein content > 25 g/L
What is Kwashiorkor?
protein malnutrition hypoalbuminemia edema present (may mask weight loss) fatty liver skin and hair desquamation and variable pigment apathy, listlessness, loss of appetite
causes of hydrops fetalis
1. Immune hydrops: hemolytic disease caused by blood group antigen incompatibility between mother and fetus 2. Non-immune -cardiovascular defects, chromosomal anomalies, fetal anemia
What can oligohydramnios lead to?
amnion nodosum pulmonary hypoplasia fetal compression which can lead to breech presentation, positioning defects of hands and feet, altered facies, pulmonary hypoplasia
what is acute fibrinous inflammation?
inflammation with extensive fluid leakage and allows passage of large plasma proteins, especially fibrinogen into the tissues
characteristics of vitamin B3 (niacin) deficiency
Pellagra 1. Dermatitis 2. Diarrhea 3. Dementia 4. Death
What is cachexia?
weakness and wasting of the body due to severe chronic illness; mobilization of nutrients to feed the tumor
what is prematurity?
birth before 37 completed weeks of gestation *2nd most common cause of neonatal fatality
What are pyogenic bacteria?
bacteria that promote purulent inflammation ex. streptococcus pyogenes, staphylococcus aureus
what is pneumonia?
inflammation of the lungs; consolidated alveoli filled with lots of neutrophils and few macrophages, fibrin, and fluid, congested alveolar capillaries
What is a lymphangioma?
congenital malformation of dilated lymphatics
3 major components of acute inflammation
1. vascular size changes (dilation) to facilitate increased blood flow 2. Structural changes in the microvasculature (increased permeability) facilitate the arrival of plasma proteins and leukocytes from the circulation 3. Immigration of neutrophils (PMNs) from circulation to the site of injury
What is pneumatosis intestinalis?
gas within intestinal wall that can be seen in patients with congenital variant or chronic steroids
What is oligohydramnios?
too little amniotic fluid may be caused by renal agenesis, amniotic leak, other causes
What is hyaline membrane disease?
Premature parturition before the lungs mature with insufficient surfactant produced (NRDS)
2 types of giant cells
1. Langhans giant cell (immunological cause) -ex. infectious organisms 2. Foreign body giant cell (non-immunological cause) -ex. splinters, glass, silica, asbestos
Outcomes of acute inflammation
1. complete resolution 2. healing by connective tissue 3. abscess formation 4. chronic, persistent inflammation that does not recede
characteristics of vitamin A deficiency
1. night blindness 2. keratomalacia in cornea 3. epithelial metaplasia, renal keratin stones; transitional metaplasia to squamous
what are some common malignant neoplasms in infants and children?
leukemia, retinoblastoma, neuroblastoma, Wilms tumor, hepatoblastoma, hepatocellular carcinoma, teratomas, Ewing's sarcoma, osteogenic sarcoma, lymphoma, Hodgkin disease, CNS tumors, thyroid carcinoma, soft-tissue sarcoma
what is secondary malnutrition?
supply of nutrients is adequate but there may be defective absorption, impaired utilization or storage, excess loss, increased need for nutrients
characteristics of vitamin D deficiency
Rickets (children) and osteomalacia (adults) abnormal mineralization of bone matrix==> softening of bone bowing of legs, frontal bossing, pigeon chest, rachitic rosary
What is dystrophic calcification?
occurs in dying tissue due to injury or necrosis serum calcium levels are normal
characteristics of vitamin B9 (folic acid) deficiency
macrocytic anemia
what is acute pericarditis?
inflammation of the pericardium with a mat of fibrin coating the visceral layer of serous pericardium
what is acute serous inflammation?
inflammation accompanied by accumulation of fluid with low protein and cell content (transudate) ex. skin in response to a burn, pleural effusion
what are some risk factors for preterm premature rupture of placental membranes?
preterm labor, vaginal bleed, smoking, low nutrition
what are some risk factors for intrauterine infection?
ureaplasma urealyticum, mycoplasma hominis, trichomonas, gonorrhea, chlamydia, malaria, HIV
characteristics of vitamin K deficiency
bleeding
what are some common congenital malformation presentations?
-congenital heart disease -Down syndrome -cleft lip and cleft palate -spina bifida -club foot -PKU -Edward's syndrome (trisomy 18)
examples of maternal/placental infections that can cause anomalies
rubella, cytomegalovirus, toxoplasmosis, HIV, syphilis, herpes
Types of perinatal infections
1. transcervical (ascending): inhalation of infected amniotic fluid just before birth/passing through birth canal; ex. HSV II 2. transplacental: gain access to fetal blood stream through chorionic villi; ex. treponema, malaria, Hep B, HIV 3. sepsis: acute onset (within 4-5 days), ex. pneumonia, streptococcus, meningitis; late onset, ex. listeria, candida
characteristics of vitamin B2 (riboflavin) deficiency
1. cheilosis (cracks in lips) 2. glossitis (tongue inflammation) 3. seborrheic dermatitis 4. pharyngeal hyperemia
what is acute suppurative inflammation?
inflammation accompanied by discharge of purulent exudate (pus) ex. lobar pneumonia, bronchpneumonia, acute suppurative tonsillitis
What is neonatal respiratory distress syndrome?
Respiratory distress caused by inadequate surfactant levels by type II pneumocytes
What is Sudden Infant Death Syndrome (SIDS)?
Sudden unanticipated death of an infant in whom, after examination, there is no recognized cause of death There may be findings of underlying chronic hypoxemia, congenital anomaly, genetic disorder
What is transudate?
watery fluid accumulation specific gravity < 1.020 protein content < 25 g/L
What is hydrops fetalis?
Severe edema Fluid accumulation in at least two fetal compartments Can be associated with polyhydramnios and placental edema
major causes of congenital malformations
single gene defects chromosomal disorders multifactorial inheritance environmental teratogens micronutrient deficiencies
characteristics of vitamin B1 (thiamine) deficiency
Beriberi -dilated heart (edema) -Wernicke's encephalopathy: confusion, ataxia, ophthalmoplegia -Korsakoff's psychosis: psychosis, amnesia, confabulation
What is a granuloma?
nodular collections of epitheliod macrophages and giant cells; attempt to wall off infection that it can't eliminate
What is marasmus?
1. "to waste away" (chronic condition) [body's adaptation to starvation] 2. Inadequate food intake (protein and calories deficiency) over a long period of time 3. Common in children 6-18 months; impairs brain development and learning 4. Muscles, including heart, waste and weaken (no edema) skin and bones 5. Poor growth if any 6. anemia and vitamin deficiencies 7. T cell-mediated immune deficiency
What is necrotizing enterocolitis?
A condition in premature infants where the bowel undergoes necrosis and bacteria invade the intestinal wall -may be due to underdeveloped intestine or poor perfusion to the segment
Symptoms of necrotizing enterocolitis
Vomiting Poor feeding Abdominal distention Stool retention Blood in stools Lethargy Decreased urine production
Causes of fetal growth restriction
-Fetal abnormalities (chromosomal disorders, congenital anomalies, congenital infections) -Placental abnormalities (placental abruptions, placenta previa, placental thrombosis, infarction, infection) -Maternal abnormalities (preeclampsia, narcotics abuse, alcohol, drugs, malnutrition)
cardinal signs of inflammation
redness, swelling, heat, pain, loss of function
what are some associated causes/conditions of neonatal respiratory distress?
increased sedation of mothers head injury to fetus placental insufficiency asphyxia secondary to cord around neck underdevelopment of type II pneumocytes
Section 3
(11 cards)