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10 Cards in this Set
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- Back
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hallmarks of amyloidosis? what makes up the deposits?
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deposits in organs or histologically similar homogenous material. different forms have different proteins, but each individual case will have the same protein depsosited all over the body.
deposits are made of 95% fibriliary protein (made from a plasma protein), amyloid P component, and a glycosaminoglycan. note that the main types are AL (made from Ig light chain) and AA, not made from Ig's. |
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how can you stain for it?
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congo red stain - under polarized light, have green birefrigency.
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what are the main classifications of amyloidosis?
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primary = AL
secondary = AA familial = AA isolated = different types. primary = no other diseases, with the exception of lymphoma. secondary = other immune diseases, like SLE or RA or tuburculosis are going on too. familial is in eastern europeans, and is AA. isolated = not systemic, and include alzheimer's disease, diabetes, down's (after age 35), and senile cardiac amylodosis. All the systemic ones (top 3) are fatal |
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what do you see on cross sections of amylodosis organs?
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lots of white spots, lots of protein in between cells.
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okay, gout time: what crystals are involved? where do they come from? how do they get out of the body?
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uric acid crystals. this is the end product of PURINE biosynthesis.
they can come from de novo synthesis, the diet, or breakdown of purine DNA's. cleared via the intestines and mainly the kidneys. in the kidneys, it's weird - filtered and reabsorbed proximally, then secreted distally. if GFR goes up, excretion goes up. in kidney disease, it goes down. |
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what's the general pathway?
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ionsine to xanthine to uric acid. get ionisine from breakdown of purines.
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groups at risk?
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men, obese, rich. older = more uric acid in the plasma.
note that the uric acid crystlas come out of solution in the cold, so peripheral joints are the most likely to get affected. |
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what conditions go along with gout?
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increasing dietary intake, or having a disease that involves the rapid turnover of purines. these would include cancers, psoriasis, polycythemia, drugs.
also, if the kidney isn't working ,taking drugs, poisons, other acids, DRINKING ALCOHOL. |
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why is this in our inflamation block?
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crystals deposited in tissues attract PMN's, which try to eat them. macrophages too. Macs release IL1/TNF, and you get leakage of the lysosomal products from both cells = get inflammation.
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what's a gross feature of repeated gout attacks?
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tophi! they're lots of crystals surrounded by macrophages.
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