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27 Cards in this Set
- Front
- Back
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An infarct must be a geographic well demarcated zone of what?
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Necrosis, visible to the naked eye
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5 types of necrosis
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Coagulative: most common, often hypoxic
Liquefactive: Brain and abscesses Caseous: Cheese like, think TB Fibrinoid: smooth muscle and blood vessel walls, necrotizing vasculitis Enzymatic: enzymes leak out and digest, pancreatitis |
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In a myocardial infarct what type of necrosis would you expect to see and how would it present in the first 1-2 days? 2-3 days?
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Coagulative necrosis
1-2 days: hypereosinophilia, loss of striation, loss of nuclei, limited inflammation! 2-3 days: Coagulation of cytoplasm, highly neutrophilic, maximum inflammation! |
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With coagulative necrosis how would you expect a renal infarct to look on gross examination?
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Wedge shaped, with point toward the hillum of the kidney.
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What is the name of the area of transition between an infarct and intact tissue under microscopic inspection?
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Hemorrhagic rim
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What occurs if coagulative necrosis goes untreated?
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Gangrene
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What are the pathologic markers of coagulative necrosis?
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Nuclear karyolysis
Loss of nuclei Coagulation of cytoplasm Pale staining cytoplasm No cavitation |
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Why does a brain infarct undergo liquefactive necrosis and form cysts versus coagulative?
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The brain is lipid rich instead of protein rich. The infarcted brain liquefies and leaves a hole where it was after it is reabsorbed. This process of creating cavities or cavitation does not occur with coagulative necrosis.
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Describe an abscess
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An infected walled off lesion with abundant neutrophils that digest and liquefy the tissue.
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Caseous necrosis is a hallmark sign of what disease?
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Tuberculosis, but it's absence does not rule TB out.
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What process do liquefactive and caseous necrosis have in common?
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Cavitation
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Caseous necrosis is seen often in the liver, lungs, lymph nodes, and spleen. Why is it rarely seen in the intestine and kidneys?
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Tuberculosis is almost nonexistant in milk products due to pasteurization.
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What structure might one see associated with caseous necrosis?
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Granulomas containing Giant and epithelioid cells.
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What cell type is associated with fibrinoid necrosis?
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Eosinophils
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What complications might arise in vessels involved with necrotizing vasculitis?
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Thrombosis and Aneurysm
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Polyarteritis Nodosa
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The hallmark disease involving fibrinoid necrosis
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What types of cells are associated with enzymatic necrosis?
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Giant cells and Histiocytes
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What processes are common in enzymatic necrosis?
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Saponification, Calcification. Also accompanied by acute inflammation and hemorrhage
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What tissue presents with ruptured septae and severe hemorrhage during enzymatic necrosis?
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Adipose tissue.
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If you observed fatty infiltration into the myocardium of an elderly man would you be concerned?
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No, fatty infiltration is a normal process of aging
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If you observed a middle aged man's liver and saw large amounts of lipid would you be concerned?
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Yes, a fatty liver is not fatty infiltration, a normal process. It is the result of fatty metamorphose where hepatocytes begin storing fat, this condition occurs with alcoholism.
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What differentiates dystrophic from metastatic tissue calcification?
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Dystrophic calcification occurs in diseased tissue with a normal Ca level
Metastatic calcification occurs in normal tissue with elevated Ca levels. |
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What tissues are most common for metastatic calcification? Why?
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Lungs, Kidneys, Stomach wall. These sites have extreme pH levels. The lumens have a low pH but the cells themselves are alkaline where the Ca can precipitate out and harden the walls of the organ.
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What part of the heart most commonly develops calcification?
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The valves, namely the aortic valve. Calcification can be a cause of stenosis and cardiomegaly.
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You look into a patient's eyes and see a yellow tinge. The patient is jaundiced. What type of pigmentation causes this?
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Endogenous bilirubin
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In hemachromatosis the liver picks up extra hemosiderin due to an inability to block iron absorption in the intestines. The liver picks up a pigmentation that would be considered?
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Endogenous
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Upon autopsy a patient's lungs look black. The doctor mentions athracosis. What is the pigment?
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Exogenous carbon
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