Fatty Liver Pathology

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Questions and Answers

Which of the following causes fatty liver by increased esterification of fatty acids to triglycerides?

Obesity

Diabetes mellitus (correct)

Respiratory failure

Starvation

What is the common cause of fatty change (steatosis) in the liver, heart, skeletal muscle, and kidneys?

Viral infections

Excessive hydration

Hypoxia (correct)

Genetic mutations

What is the effect of hypoxic or toxic cell injury on the metabolism of fat in cells?

Decreased enzyme activity (correct)

Enhanced fat catabolism

Promoted secretion of fat

Increased fat oxidation

Which of the following conditions can lead to a signet ring appearance of cells due to fat accumulation?

Alcoholism Signup and view all the answers

In fatty liver, what results from decreased oxidation of fatty acids?

Increased esterification of fatty acids to triglycerides Signup and view all the answers

What microscopic feature is characteristic in cells with intracellular fat accumulation?

Signet ring appearance with fat globules pushing the nucleus against the cell membrane Signup and view all the answers

What is the result of a disturbance in purine metabolism with urates deposition in tissues?

Gout Signup and view all the answers

What is a common cause of gout?

Primary hereditary hyperuricemia Signup and view all the answers

How does pathologic calcification typically appear at the microscopic level?

Blue granules with H&E Signup and view all the answers

Which condition involves tan-white chalky, crumbly tophi deposits?

Gout Signup and view all the answers

What is the consequence of cells compressing intercellular capillaries?

Fatty liver Signup and view all the answers

What can be seen at the gross level in tissues affected by gout?

White plaques of urate deposits Signup and view all the answers

What is the definition of gangrene?

Massive tissue necrosis followed by putrefaction caused by bacterial activity Signup and view all the answers

How is dry gangrene different from moist gangrene?

Moist gangrene results from arterial occlusion with normal venous drainage Signup and view all the answers

Which risk factor can lead to gangrene?

Factors that result in reduced blood supply to the affected part Signup and view all the answers

What is the line of demarcation in dry gangrene?

Acute inflammatory zone between necrotic and healthy tissue Signup and view all the answers

How does moist gangrene differ from dry gangrene in terms of tissue characteristics?

Dry gangrene has severe tissue edema and swelling Signup and view all the answers

Which type of gangrene is caused by sudden complete occlusion of arterial and venous supply?

Moist gangrene Signup and view all the answers

Study Notes

Fatty Change (Steatosis)

Accumulation of neutral fat (triglycerides) in cytoplasm of parenchymal cells, commonly occurring in liver, but also in heart, skeletal muscle, and kidneys.
Causes include hypoxia, bacterial toxins, and chemical agents such as alcohol, phosphorus, and carbon trichloride.
Fatty liver is caused by increased fatty acid entry, increased fatty acid synthesis, decreased oxidation of fatty acids, and increased esterification of fatty acids.

Pathogenesis of Fatty Liver

Hypoxic or toxic cell injury leads to diminished enzyme activity, resulting in failure to metabolize fat and subsequent intracellular fat accumulation.

Microscopic Picture of Fatty Liver

Cells appear swollen with multiple tiny cytoplasmic vacuoles (fat globules) around the nucleus.
Fat globules fuse together, forming a large globule that pushes the nucleus against the cell membrane, giving a signet ring appearance.

Extracellular Depositions

Urate Deposition (Gout)

Definition: disturbance in purine metabolism with urate deposition in tissues.
Causes: primary hereditary hyperuricemia, failure of uric acid elimination in renal diseases, and disturbances of purine metabolism.
Pathogenesis: hyperuricemia leads to deposition of urate crystals (tophi) in tissues, mainly in joints.

Morphology of Urate Deposition

Gross: white plaques of urate deposits.
Microsc.: homogeneous mass (tophi) of urate crystals surrounded by inflammatory reaction with foreign body giant cells.

Amyloid Deposition (Amyloidosis)

Definition: deposition of amyloid proteins in tissues.
Composition: amyloid fibrils composed of protein aggregates.
Chemical classification: based on the type of protein aggregated.

Calcification

Definition: deposition of calcium salts in sites other than bones and teeth.
Gross: the calcified tissue appears chalky white and hard.
Microsc.: calcification appears as blue granules with H&E.

Types of Calcification

Dystrophic calcification: occurs in dead or dying tissues.
Metastatic calcification: occurs in normal tissues due to hypercalcemia.

Gangrene

Definition: massive tissue necrosis followed by putrefaction caused by bacterial activity.
Risk factors: any factor resulting in cut-off blood supply to the affected part.

Types of Gangrene

Dry gangrene: gangrene without tissue edema due to evaporation of fluids and drainage through veins and lymphatics of the exposed parts of the body.
Moist gangrene: gangrene with severe tissue edema and swelling.

Dry Gangrene

Caused by: gradual arterial occlusion with normal venous and lymphatic drainage.
Pathological features:
Area distal to occlusion appears pale and cold due to ischemia.
Then, it becomes red due to escape of blood from necrotic vessels.
Lastly, it becomes black.
Line of demarcation: acute inflammatory zone between
Grossly: the affected part is dry, shrunken, and dark black, resembling the foot of a mummy.

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Description

This quiz covers the topic of fatty change (steatosis) which involves the accumulation of neutral fat in the cytoplasm of parenchymal cells. It discusses the causes and factors contributing to fatty liver, including hypoxia, bacterial toxins, and chemical agents.