Visceral Pathology Lab Midterm I

Front 1

What is this? Characteristics

Back 1

Concentric hypertrophy
- Enlargement of cardiomyocytes
- Thicker myocardium
- Increase in heart weight
- Increase in ratio of wall thickness
- No dilation of chamber

Front 2

Is this due to pressure or volume overload?

Back 2

Concentric hypertrophy

PRESSURE overload

Front 3

What are the complications?

Back 3

Concentric hypertrophy

- Ischemia
- Myocardial infarction
- CHF
- Angina

Front 4

What is this? Characteristics

Back 4

Eccentric hypertrophy

- Hypertrophy on the OUTSIDE
- Enlargement of cardiomyocytes
- Thicker myocardium
- DILATION of chamber
- Increase in wall thickness and chamber size are proportional

Front 5

Histologically what kinds of cells are here? What do they resemble?

Back 5

- Sarcomatoid cells
- Smooth muscle cells

Front 6

What is this?

Back 6

Mesothelioma

Cancer of the pleura

Front 7

What is this due to?

Back 7

Mesothelioma

-Asbestos exposure

Front 8

15 - 20 years may elapse between what?

Back 8

Mesothelioma

- 15 - 20 years may elapse between EXPOSURE and DEVELOPMENT of the tumor

Front 9

This will grow to encase what?

Back 9

Mesothelioma

- The lung

Front 10

Pulmonary effects?

Back 10

Alevolar cell carcinoma of the lung

- Cough
- Dyspnea
- Hemoptysis
- Chest pain
- Obstructive pneumonia
- Pleural effusion

Front 11

What is this? From what cells does it arise?

Back 11

Small (oat) cell carcinoma

- Arises from NEUROENDOCRINE cells

Front 12

What does this secrete?

Back 12

Small (oat) cell carcinoma

- Secrete ectopic hormones like ADH, ACTH (look for these in a blood analysis)

Front 13

What is this? Where is it located?

Back 13

Squamous cell carcinoma of the lung

* THIS IS THE MOST COMMON! *

- Located near the center of the lung

Front 14

This is silent until what?

Back 14

Squamous cell carcinoma of the lung

- Silent until narrowing of the bronchi

Front 15

What is characteristic about this?

Back 15

Squamous cell carcinoma of the lung

- Squamous epithelial pearl with keratinisation

Front 16

What is this?

Back 16

Laryngeal squamous cell carcinoma

Front 17

Risk factors?

Back 17

Laryngeal squamous cell carcinoma

- Smoking and alcohol

Front 18

Clinical feature?

Back 18

Laryngeal squamous cell carcinoma

Hoarseness of voice

Front 19

Who does this occur in?

Back 19

Hyaline membrane disease (NRDS)

- Preterm infants <34 weeks of gestational age

Front 20

Histologically, what is happening here?

Back 20

Hyaline membrane disease (NRDS)

Immaturity of Type II Pneumocytes resulting in inadequate surfactant production

Front 21

How is this evaluated?

Back 21

Hyaline membrane disease (NRDS)

Amniocentesis

Front 22

Clinical features?

Back 22

Hyaline membrane disease (NRDS)

- Flaring nostrils
- Grunting
- Strained, or abnormal breathing

Front 23

What is this? Define.

Back 23

Bronchial asthma

Chronic inflammatory, reversible disorder of the airways

Front 24

Histological features?

Back 24

Bronchial asthma

- Glands become bigger (hyperplastic hypertrophy) which are secreting a lot of mucus (lots of sputum production)
- Increase in goblet cells (hyperplastic goblet cells) which are also secreting mucus
- Inflammatory cells such as: lymphocytes and plasma cells
- Eosinophils

Front 25

What is this? Define.

Back 25

Emphysema

Enlargement of the alveoli DISTAL to the terminal bronchioles with destruction of interalveolar septum

Front 26

Etiology?

Back 26

Emphysema

Alpha-1-antitrypsin deficiency

Front 27

Clinical features?

Back 27

Emphysema

- Patients present with a prolonged history of exertional dyspnea and a minimal non-productive cough

Front 28

What are the (2) kinds of this?

- This was NOT a Seva Question -

Back 28

Emphysema

1. Centriacinar
2. Panacinar

Front 29

What are the (2) kinds of this?

- This was NOT a Seva Question -

Back 29

Emphysema

1. Centriacinar
2. Panacinar

Front 30

Histological features?

Back 30

Emphysema

- In those big pink spaces we should really have lots of alveoli
- The IV septum is broken so the alveoli have become "bigger"
- There is a lack of gas exchange

Front 31

What is this? What is increased?

Back 31

Pulmonary hypertension

- Increase in thickness of tunica media
- Increase in pulmonary vasculature pressure

Front 32

Etiology if this is secondary?

Back 32

Pulmonary hypertension

Secondary = R - L shunt, Mitral Stenosis, COPD

Front 33

Etiology if this is primary?

Back 33

Pulmonary hypertension

Primary = IDIOPATHIC

Front 34

Clinical features?

Back 34

Pulmonary hypertension

- DYSPNEA
- Weakness
- Recurrent syncope

Front 35

What is this? What is another name for it?

Back 35

Viral pneumonia (Interstitial pneumonia)

Front 36

What is this? What is another name for it?

Back 36

Viral pneumonia (interstitial pneumonia)

Front 37

Etiology?

Back 37

Viral pneumonia

Cytomegalovirus

Front 38

Etiology?

Back 38

Viral pneumonia

Cytomegalovirus

Front 39

Clinical features?

Back 39

Viral pneumonia

- Low grade fever
- Dry cough
- Headache, malaise

Front 40

Clinical features?

Back 40

Viral pneumonia

- Low grade fever
- Dry cough
- Headache, malaise

Front 41

Radiological criteria of lobar pneumonia?

Back 41

Viral pneumonia

LOBAR: consolidation of an entire lobe or segment of a lung

Front 42

Radiological criteria of lobar pneumonia?

Back 42

Viral pneumonia

LOBAR: consolidation of an entire lobe or segment of a lung

Front 43

Radiological criteria of bronchopneumonia

Back 43

Viral pneumonia

BRONCHO: dispersed bilateral, focal, patchy area of consolidation

Front 44

Radiological criteria of viral pneumonia?

Back 44

Bat wing apperance

Front 45

Radiological criteria of viral pneumonia?

Back 45

Bat wing appearance

Front 46

What is this?

Back 46

Bronchopneumonia

Front 47

Clinical features?

Back 47

Bronchopneumonia

- Abrupt onset of high fever (with rigor and chills)
- Malaise
- Productive cough

(same as lobar)

Front 48

What does this typically involve?

Back 48

Bronchopneumonia

Typically involves a small airway and surrounding alveolar spaces; relatively small area of involvement

Front 49

What is this?

Back 49

Lobar pneumonia

Front 50

What is this?

Back 50

Lobar pneumonia

Front 51

What are pre-disposing factors?

Back 51

Lobar pneumonia

- Decrease cough reflex
- Injury to cilia (smokers)
- Decrease function of the alveolar macrophages
- Edema or congestion
- Retention of secretions

Front 52

Routes of infection?

Back 52

Lobar pneumonia

- Aspiration
- Inhalation
- Bacteremia
- Direct extension

Front 53

Clinical features

Back 53

Lobar pneumonia

- Abrupt onset of high fever (with rigor and chills)
- Malaise
- Productive cough

(same as bronchopneumonia)

Front 54

Identify the central vein.

Back 54

Liver passive congestion

Identify the central vein

Front 55

Look for the congested central zone with atrophic hepatocytes

Back 55

Liver passive congestion

Look for the congested central zone with atrophic hepatocytes

Front 56

Etiology?

Back 56

Liver passive congestion

??

Front 57

Etiology?

Back 57

Liver passive congestion

??

Front 58

Histologically, what are we looking for?

Back 58

Pulmonary edema

- Alveoli
- Fibrin crystals
- RBCs
- Macrophages
- Heart failure cells

Front 59

Etiology?

Back 59

Pulmonary edema

- Left ventricular failure
- Mitral stenosis
- ARDS
- Sepsis

Front 60

What is in the alveoli?

Back 60

Pulmonary edema- FLUID

Front 61

What kinds of cells should we see here?

Back 61

MI Granulation tissue

- Capillaries
- Fibroblasts
- Residual inflammatory cells

Front 62

What is this?

Back 62

Myocardial infarction

Front 63

What is this? Define.

Back 63

Cardiomegaly

- Increase in weight or size of the heart

Front 64

Etiologies? (LOTS)

Back 64

Cardiomegaly

- Hypertension (LV)
- Valvular disease (MS, MR, AS, AR)
- Hypertrophic cardiomyopathy
- Congenital heart disorders
- Alcohol
- Sarcoidosis
- Amyloidosis
- Acromegaly

Front 65

What is this

Back 65

Biological heart valve

Front 66

What is this made of

Back 66

Bio prostheses

Mechanical frame with the porcine aortic valve cusp or bovine pericardial pieces

Front 67

Characteristics

Back 67

Bio prostheses

Good hemodynamic function, with little obstruction and resists thromboembolic complications

Front 68

Complications

Back 68

Bio prostheses

- Tissue degeneration with calcification and fragmentation. Indicated in females of reproductive age group

Front 69

What is this?

Back 69

Mechanical valve

Front 70

This kind of valve requires what

Back 70

Mechanical valve

- Life long anti-coagulants

Front 71

Complications

Back 71

Mechanical valve

Front 72

What is this?

Back 72

Cardiac

Front 73

How is this described radiologically?

Back 73

Cardiac tamponade

Water bottle appearance

Front 74

Is this a medical emergency or a chronic condition?

Back 74

Cardiac tamponade

Medical EMERGENCY!

Front 75

Name the features of Becks Triad

Back 75

Cardiac tamponade

- Hypotension
- Increased jugular venous pressure
- Muffled heart sounds

Front 76

Etiology?

Back 76

Acute pericarditis

- Common coxsachie virus (young adult male will suddenly have a fever)
- Myocardial infarction (Dressler's syndrome)
- Rheumatic fever

Front 77

Clinical features?

Back 77

Acute pericarditis

Pericardial friction rub on auscultation (scratching sound) is the cardinal sign, and a fever

Front 78

How is this chest pain different from MI angina?

Back 78

Acute pericarditis

- Relieved by sitting forward
- Increased by lying down and respiration
- Pericardial friction rub sound

Front 79

Define the terminology

Back 79

Acute pericarditis

SUDDEN, sharp, substernal chest pain that can refer to the neck or shoulder

Front 80

What is this?

Back 80

Rhabdomyoma

Front 81

Benign or malignant

Back 81

Benign