Shared Flashcard Set

Details

Intracellular Accumulations
8.5 at 8:30 by Dr. Vander Heade
70
Pathology
Professional
08/05/2011

Additional Pathology Flashcards

 


 

Cards

Term
Mallory's Hyalin
Definition
pink staining amorphous mass made up of cytokeratin with ubiquitin in the cytoplasm of hepatocytes. Highly associated with EtOH injury to hepatocytes.
Term
What can happen to fatty acids once they are delivered to the liver?
Definition
they can be made into 1) ketone bodies via oxidation 2) phospholipids 3) cholesterol esters 4) triglycerides via esterification
Term
Increased accumulation of triglycerides within hepatocytes might be due to three broad categories. Name them.
Definition
Increased delivery of FA (DM, EtoH), decreased oxidation of FA (hypoxia, EtOH, toxins), reduced apoprotein availability (CCl4, malnutrition)
Term
How does EtOH cause a fatty liver?
Definition
increases supply of FFA, increases esterification of FFA to triglycerides and decreases oxidation of FFA
Term
How do toxins cause a fatty liver?
Definition
reduced apoprotein availability and decreased oxidation of FFA
Term
Name two diseases that are characterized by microvesicular fat in the liver.
Definition
Reye's syndrome and fatty liver of pregnancy
Term
How do phagocytic cells end up with large amounts of cholesterol in their cytoplasm?
Definition
They phagocytose cells that have cholesterol in their cell membranes. They are unable to break down the cholesterol so it builds up
Term
Which cells can metabolize cholesterol?
Definition
ONLY hepatocytes
Term
What to cells of the kidney when proteins leak across the glomerular basement membrane? What does it look like histologically?
Definition
tubular epithelial cells absorb it faster that they can metabolize/export it. Looks like pink droplets called protein resorption droplets.
Term
What is alpha 1 antitrypsin (A1AT) disease?
Definition
when you make an an abnormally folded form of A1AT that can't be exported out of the hepatocyte ER and so your lung is eaten up by bacterial elastase
Term
What happens to the iron in RBCs when they die?
Definition
RBCs are metabolized by the reticulo-endothelial system. Then iron is first bound to ferritin within the phagocytic cells and then transported via transferrin in the blood to the liver where it is stored inside the hepatocytes bound to ferritin
Term
What is hemosiderin?
Definition
brown intracellular iron-containing pigment that builds up when small amounts of ferritin undergo autophagy (or partial digestion)
Term
How does the body get rid of excess iron?
Definition
It doesn't. There is no physiologic echanism to rid the body of excess iron. Control of total body iron stores lies in the area of absorption from the gut
Term
How is buildup of iron in cells harmful?
Definition
causes lipid peroxidation through iron catalyzed free radical formation. Iron directly interacts with and damages DNA (resulting in death or mutation), and stimulates collagen synthesis
Term
How do you differentiate hemosiderin from other brown pigments?
Definition
you can stain the tissue with Prussian blue stain that will turn hemosiderin bright blue.
Term
What are two types of diseases that can lead to increase iron in cells?
Definition
blood diseases involving ineffective hematopoesis or requiring numerous transfusions, and genetic hemochromatosis
Term
What is the inheritance pattern of hemochromatosis?
Definition
autosomal recessive
Term
What happens to the excess iron taken up from the GI in a disease like hemochromatosis?
Definition
deposited in parenchymal organs such as the liver, pancreas, and skin
Term
How does the body get rid of copper?
Definition
through the biliary system, so chronic biliary obstruction can lead to excess accumulation of copper within hepatocytes
Term
What is the inheritance pattern of Wilson's Disease?
Definition
autosomal recessive
Term
What is Wilson's disease?
Definition
a genetic inability to excrete copper from hepatocyte into canaliculi resulting in accumulation of copper in liver and brain (and also cornea, kidneys, bones, and joints)
Term
What is the mechanism by which Wilson's disease causes anemia?
Definition
excess copper builds up in hepatocytes and is reguritated back into the circulatory system where it can cause hemolysis of RBCs
Term
What is the most common exogenous pigment?
Definition
carbon
Term
What is anthrocotic pigment made up of?
Definition
carbon
Term
What are dust cells?
Definition
alveolar macrophages that have phagocytosed carbon particles
Term
How does the carbon you breathe in end up in you lymph nodes?
Definition
carbon particles move into connective tissue then lymphatics then to lymph nodes and stay there forever
Term
How do tattoos work?
Definition
colored pigments is injected into teh skin, are engulfed by macrophages in the connective tissue and remain in place
Term
What is bilirubin?
Definition
a yellow-green breakdown product of the heme moiety of hemoglobin and heme-containing enzymes. Causes jaundice
Term
What is lipofuscin?
Definition
the wear and tear pigment that is yellow-brown and is the final product of free radical damage and cross linking of membrane lipids
Term
In what cells is lipofuscin prominent?
Definition
aging myocardial cells and hepatocytes and in the cells of patients with severe malnutrition or cachexia
Term
What is dystrophic calcification?
Definition
condition in which calcium is deposited on necrotic or chronically traumatized tissue. Always local in distribution and in the presence of normal serum calcium levels
Term
Name some common examples of dystrophic calcification.
Definition
happens in areas of fat necrosis, foci of coagulation or caseous necrosis, artherosclerotic vessel, and heart valves (especially aortic)
Term
Why does calcium deposit on damaged tissue?
Definition
terminally damaged mitochondria form calcific densities. Also, the exposed phospholipids of damaged cells may act as a template allowing the orderly binding of calcium and phosphate
Term
What is metastatic calcification?
Definition
condition in which, due to high serum calcium, deposition of calcium salts ocurs in viable or living tissue
Term
Name some principle causes of hypercalcemia.
Definition
hypersecretion of PTH, destruction of bone tissue, poisoning with vitamin D, milk-alkali syndrome, uremia and dialysis
Term
What might cause hypersecretion of PTH with increase bone resorption?
Definition
primary hyperparathyroidism (parathyroid hyperplasia or tumor), secondary to renal failure, and ectopic secretion of PTH by malignant tumor
Term
What might cause destruction of bone tissue(besides PTH)?
Definition
primary tumor of bone marrow, diffuse skeletal metastases, immobilization
Term
Although metastatic calcification may affect any tissue or organ, it tends to affect tissues that...
Definition
may lose acid and therefore generate an internal alkaline milieu. Ex: gastric mucosa, kidneys, lungs, systemic arteries, and pulmonary vein
Term
What is an amyloid?
Definition
an abnormal proteinaceous deposit in the extracellular space with unique light microscopic features and a characteristic ultrastructure
Term
What is the characteristic ultrastructure of amyloids? What is the characteristic light microscope appearance?
Definition
anti parallel beta pleated sheet with N and C terminals oriented in oposite directions; glassy pink/hyaline with H&E and red with Congo Red
Term
What are the mechanisms that cause amyloids?
Definition
mutation of a gene, protein's nature is to form amyloid after a long time or when in high concentration, abnormal metabolism (proteolysis), or a combo of all of those
Term
Under polarized light, amyloids stained with congo red are what color?
Definition
green
Term
How many different proteins have been associated with amyloid deposits?
Definition
21
Term
AL amyloidosis is also called ________.
Definition
primary amyloidosis
Term
Amyloid deposits of AL amyloidosis are formed by _____________.
Definition
abnormal immunoglobulin light chains, usually of the lambda type (associated with multiple myeloma)
Term
What is Bence-Jones protein?
Definition
protein in the urine that is due to excess immunoglobulin in the blood due to multiple myeloma
Term
Amyloid deposition in the heart results in...
Definition
a stiffened less contractile myocardium called a restrictive cardiomyopathy
Term
Amyloid deposits in the kidney results in...
Definition
disruption of the normal filtration membrane allowing serum proteins to leak into urine
Term
AA amyloidosis is sometiems called ___________.
Definition
secondary amyloidosis
Term
What causes AA amyloidosis?
Definition
excess serum AA (sAA) protein which is an acute phase reactant secreted by the liver in high concentrations due to chronic inflammatory disorders. THey can be abnormally processed by macrophages and eposited into tissues as amyloid.
Term
Name a few chronic infections that cause AA amyloidosis.
Definition
chronic tuberculosis infection, chronic osteomyelitis, chronic skin infections as in drug users, chronic autoimmune disorders (rheumatoid arthritis, crohn's disease), and certain malignant tumors (medullary carcinoma of the thyroid and renal cell carcinoma)
Term
What do you call the inherited form of AA amyloidosis?
Definition
Familial Mediterranean Fever
Term
In what ethnicities is Familial Mediterranean Fever common?
Definition
Armenian, Turkish, Sephardic Jewish and Arabic
Term
What is the mechanism of Familial Mediterranean Fever?
Definition
recurrent bouts of fever and inflammation of serosal surfaces of unknown origin (but associated with mutations in teh MEFV gene) that result in continual high levels of sAA protein
Term
What is the function of the MEFV gene?
Definition
down regulator of inflammation within the polymorphonuclear lymphocytes
Term
What is A"beta2"microglobulin amyloidosis also called?
Definition
dialysis associated amyloidosis
Term
What is the mechanism of dialysis associated amyloidosis?
Definition
Pts on chronic dialysis maintain high levels of beta2-microglobulin because dialysis can't remove it. These are abnormally processed or have an intrinsic propensity to form amyloids that deposit in the joints, resulting in a destructive arthropathy
Term
What is the name of the amyloid protein associated with Alzheimer's disease? Where does it deposit?
Definition
beta-amyloid; cerebral plaques and blood vessels
Term
Hyaline
Definition
adj that refers to a homogeneous glassy pink appearance
Term
What causes hyaline arteriosclerosis?
Definition
when HTN causes slow leakage of plasma proteins through damaged endothelium into the vessel wall where they become lodged
Term
Hyalin
Definition
noun. the substance itselfthat has a hyaline appearance
Term
[image]
Definition
Mallory's hyalin
Term
[image]
Definition
Congo red staining of amyloid
Term
[image]
Definition
Amyloid depositions in kidney
Term
[image]
Definition
Hemosiderin in liver cells
Term
[image]
Definition
Bilirubin in liver cells
Term
[image]
Definition
Copper in hepatocytes
Term
[image]
Definition
lipofuscin in cardiac myocytes
Term
[image]
Definition
Metastatic calcification
Term
[image]
Definition
Dust cells in lung
Supporting users have an ad free experience!