Podcast
Questions and Answers
In a patient with suspected gout, which of the following is a key characteristic of sodium urate deposition?
In a patient with suspected gout, which of the following is a key characteristic of sodium urate deposition?
- Deposition exclusively within cardiac muscle, causing restrictive cardiomyopathy.
- Deposition in the skin, kidneys, and joints, particularly affecting the metatarsophalangeal joint of the big toe. (correct)
- Deposition primarily in the brain tissue, leading to cognitive impairment.
- Deposition within the lung parenchyma, leading to pulmonary fibrosis.
Which of the following is the primary reason for the development of light brown paranuclear pigments in cardiac cells in an 84-year-old male?
Which of the following is the primary reason for the development of light brown paranuclear pigments in cardiac cells in an 84-year-old male?
- Deposition of lipochrome (lipofuscin) resulting from tissue breakdown. (correct)
- Intracellular buildup of glycogen as a result of a storage disease.
- The effect of metastatic calcification following hypercalcemia.
- Accumulation of hemosiderin due to increased iron absorption.
What microscopic finding is characteristic of cells affected by glycogen storage diseases?
What microscopic finding is characteristic of cells affected by glycogen storage diseases?
- Cells displaying a 'signet-ring' morphology, indicating mucin accumulation.
- Cells with needle-shaped crystal inclusions.
- Extracellular amorphous deposits of amyloid.
- Cells that appear swollen with clear cytoplasmic vacuoles and stain positive with PAS (correct)
Which of the following best describes the microscopic appearance of cells distended with mucin, characteristic of conditions such as catarrhal inflammation or mucoid carcinoma?
Which of the following best describes the microscopic appearance of cells distended with mucin, characteristic of conditions such as catarrhal inflammation or mucoid carcinoma?
Which of the following is a defining feature of hyalinosis?
Which of the following is a defining feature of hyalinosis?
Systemic amyloidosis can be associated with which of the following conditions?
Systemic amyloidosis can be associated with which of the following conditions?
What microscopic characteristics confirm amyloid deposits in tissue samples?
What microscopic characteristics confirm amyloid deposits in tissue samples?
What is dystrophic calcification characterized by?
What is dystrophic calcification characterized by?
Which of the following conditions is an example of metastatic calcification?
Which of the following conditions is an example of metastatic calcification?
What is the primary difference between dystrophic and metastatic calcification?
What is the primary difference between dystrophic and metastatic calcification?
In cases of chronic lead poisoning (plumbism), what is the route of entry for the exogenous pigment leading to tissue accumulation?
In cases of chronic lead poisoning (plumbism), what is the route of entry for the exogenous pigment leading to tissue accumulation?
What is the underlying mechanism by which lipofuscin accumulates within cells?
What is the underlying mechanism by which lipofuscin accumulates within cells?
Patients requiring repeated blood transfusions are at risk for developing which type of tissue accumulation?
Patients requiring repeated blood transfusions are at risk for developing which type of tissue accumulation?
Which of the following statements correctly links a tissue accumulation with its associated condition?
Which of the following statements correctly links a tissue accumulation with its associated condition?
Select the scenario that best describes the pathogenesis of metastatic calcification.
Select the scenario that best describes the pathogenesis of metastatic calcification.
A pathologist is examining a lung biopsy from a coal miner. Which type of pigment accumulation is most likely to be observed?
A pathologist is examining a lung biopsy from a coal miner. Which type of pigment accumulation is most likely to be observed?
Which of the following is the most likely outcome of progressive amyloidosis?
Which of the following is the most likely outcome of progressive amyloidosis?
How does the primary form of gout differ from the secondary form in terms of etiology?
How does the primary form of gout differ from the secondary form in terms of etiology?
In a patient with suspected amyloidosis, which of the following sequences accurately describes the diagnostic process involving tissue staining?
In a patient with suspected amyloidosis, which of the following sequences accurately describes the diagnostic process involving tissue staining?
A 22-year-old woman has congenital anemia that requires repeated blood transfusions for many years. What cellular change would likely be observed?
A 22-year-old woman has congenital anemia that requires repeated blood transfusions for many years. What cellular change would likely be observed?
Which of the following best explains the pathophysiology behind crystal-induced arthritis in gout?
Which of the following best explains the pathophysiology behind crystal-induced arthritis in gout?
Which of the following is the most likely sequence of events that leads to lipofuscin accumulation in cells?
Which of the following is the most likely sequence of events that leads to lipofuscin accumulation in cells?
A patient with a history of chronic alcoholism and cirrhosis is at risk for developing which type of tissue accumulation?
A patient with a history of chronic alcoholism and cirrhosis is at risk for developing which type of tissue accumulation?
What is the underlying mechanism by which hypercalcemia leads to metastatic calcification?
What is the underlying mechanism by which hypercalcemia leads to metastatic calcification?
A patient with a history of intravenous drug use presents with tattoos and local skin infections. Which type of pigment accumulation is likely present in the skin?
A patient with a history of intravenous drug use presents with tattoos and local skin infections. Which type of pigment accumulation is likely present in the skin?
Which of the following descriptions best explains the effects of amyloid deposition on organ function?
Which of the following descriptions best explains the effects of amyloid deposition on organ function?
Which of the following are familial or genetic mutations associated with primary gout?
Which of the following are familial or genetic mutations associated with primary gout?
A pathologist is examining a renal biopsy from a patient with a history of multiple myeloma. What sequence of staining would they expect to see to confirm amyloid?
A pathologist is examining a renal biopsy from a patient with a history of multiple myeloma. What sequence of staining would they expect to see to confirm amyloid?
In a microscopic examination of an atheroma, which form of calcification is most likely to be observed?
In a microscopic examination of an atheroma, which form of calcification is most likely to be observed?
Which of the following conditions can cause hypercalcemia?
Which of the following conditions can cause hypercalcemia?
A pathologist examines tissue from a patient with suspected occupational lung disease. Which of the following patterns of pigment accumulation is most indicative of pneumoconiosis?
A pathologist examines tissue from a patient with suspected occupational lung disease. Which of the following patterns of pigment accumulation is most indicative of pneumoconiosis?
In a patient who has been diagnosed with cardiac amyloidosis, which outcome is the most likely development?
In a patient who has been diagnosed with cardiac amyloidosis, which outcome is the most likely development?
A 55-year-old man with a history of alcoholism presents with swollen and painful joints, particularly in the metatarsophalangeal joint of the big toe. Uric acid crystal deposition results in which type of cell injury?
A 55-year-old man with a history of alcoholism presents with swollen and painful joints, particularly in the metatarsophalangeal joint of the big toe. Uric acid crystal deposition results in which type of cell injury?
When examining heart tissue from an elderly patient, the presence of lipofuscin pigment is noted. What reflects the significance of this finding?
When examining heart tissue from an elderly patient, the presence of lipofuscin pigment is noted. What reflects the significance of this finding?
A patient with a history of hepatitis C develops liver cirrhosis. Which accumulation may be observed in biopsy of the liver?
A patient with a history of hepatitis C develops liver cirrhosis. Which accumulation may be observed in biopsy of the liver?
What is the impact of calcification in atherosclerosis on blood vasculature?
What is the impact of calcification in atherosclerosis on blood vasculature?
During initial environmental exposure assessments, what is the pathogenesis of lung diseases caused by dust inhalation?
During initial environmental exposure assessments, what is the pathogenesis of lung diseases caused by dust inhalation?
A pathologist examines a patient diagnosed with systemic amyloidosis. Which long-term effect on organ systems is more likely?
A pathologist examines a patient diagnosed with systemic amyloidosis. Which long-term effect on organ systems is more likely?
A patient with suspected gout exhibits elevated levels of uric acid. What is the most critical factor determining the formation of sodium urate crystals in the joint tissues?
A patient with suspected gout exhibits elevated levels of uric acid. What is the most critical factor determining the formation of sodium urate crystals in the joint tissues?
What is the underlying mechanism by which abnormal glycogen metabolism leads to cellular swelling and clear cytoplasmic vacuoles in glycogen storage diseases?
What is the underlying mechanism by which abnormal glycogen metabolism leads to cellular swelling and clear cytoplasmic vacuoles in glycogen storage diseases?
Hyalinosis is characterized by the accumulation of glassy, refractile, homogenous material. Which of the following cellular mechanisms contributes most significantly to this accumulation?
Hyalinosis is characterized by the accumulation of glassy, refractile, homogenous material. Which of the following cellular mechanisms contributes most significantly to this accumulation?
In systemic amyloidosis, which pathogenic mechanism most directly leads to organ dysfunction?
In systemic amyloidosis, which pathogenic mechanism most directly leads to organ dysfunction?
What is the primary pathophysiological mechanism that differentiates metastatic calcification from dystrophic calcification?
What is the primary pathophysiological mechanism that differentiates metastatic calcification from dystrophic calcification?
Flashcards
Gout Definition
Gout Definition
Disturbance in purine metabolism, leading to sodium urate deposition, elevating blood and urine levels.
Primary Gout Cause
Primary Gout Cause
Familial; males are more prone. Caused by increased purine breakdown or decreased clearance.
Secondary Gout Cause
Secondary Gout Cause
Increased cellular destruction, such as in Polycythemia rubra vera.
Gout Deposition Sites
Gout Deposition Sites
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Carbohydrate/Glycoprotein Accumulation
Carbohydrate/Glycoprotein Accumulation
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Glycogen Accumulation
Glycogen Accumulation
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Microscopic Appearance of Glycogen Accumulation
Microscopic Appearance of Glycogen Accumulation
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Mucin Accumulation
Mucin Accumulation
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Microscopic Appearance of Mucin Accumulation
Microscopic Appearance of Mucin Accumulation
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Hyalinosis Definition
Hyalinosis Definition
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Examples of Hyalinosis
Examples of Hyalinosis
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Amyloidosis Definition
Amyloidosis Definition
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Localized Nodular deposits
Localized Nodular deposits
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Senile Amyloidosis
Senile Amyloidosis
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Endocrine Amyloidosis
Endocrine Amyloidosis
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Primary Systemic Amyloidosis
Primary Systemic Amyloidosis
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Secondary Systemic Amyloidosis
Secondary Systemic Amyloidosis
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Amyloidosis Diagnosis
Amyloidosis Diagnosis
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Amyloidosis H&E Stain
Amyloidosis H&E Stain
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Amyloidosis Congo Red Stain
Amyloidosis Congo Red Stain
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Amyloidosis Polarized Light
Amyloidosis Polarized Light
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Effects of Amyloidosis
Effects of Amyloidosis
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Pathological Calcification
Pathological Calcification
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Appearance of Pathological Calcification
Appearance of Pathological Calcification
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Dystrophic Calcification
Dystrophic Calcification
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Examples of Dystrophic Calcification
Examples of Dystrophic Calcification
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Metastatic Calcification
Metastatic Calcification
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Causes of Metastatic Calcification
Causes of Metastatic Calcification
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Sites of Metastatic Calcification
Sites of Metastatic Calcification
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Stone Formation
Stone Formation
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Pathological Pigments Definition
Pathological Pigments Definition
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Exogenous Pigment Entry
Exogenous Pigment Entry
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Endogenous Pigments
Endogenous Pigments
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Melanin Pigment Variations
Melanin Pigment Variations
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Lipochrome (Lipofuscin) Pigment
Lipochrome (Lipofuscin) Pigment
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Increased Lipochrome
Increased Lipochrome
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Hemosiderosis Definition
Hemosiderosis Definition
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Localized Hemosiderosis
Localized Hemosiderosis
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Generalized Hemosiderosis
Generalized Hemosiderosis
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Gout is disturbed metabolism of
Gout is disturbed metabolism of
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Repeated blood transfusions
Repeated blood transfusions
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Brown atrophy of heart is due to?
Brown atrophy of heart is due to?
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Study Notes
- Study notes on pathology of cellular and tissue response to injury (part 3).
Gout
- Gout is a disturbance in purine metabolism
- It results in the deposition of sodium urate in tissues and increased levels in blood and urine.
- Primary causes are familial with a higher occurrence in males; it is due to increased purine breakdown or decreased clearance.
- Secondary causes include increased cellular destruction seen in Polycythaemia rubra vera.
- Sodium urates are deposited in the skin, kidney, and joints, often affecting the metatarsophalangeal joint of the big toe.
Carbohydrates & Glycoproteins
- Glycogen storage diseases result from abnormal glycogen metabolism.
- Cells swell with clear cytoplasmic vacuoles; Periodic Acid Schiff (PAS) stain is used and will test positive.
Mucin
- Examples, catarrhal inflammation and mucoid carcinoma.
- Cells are distended with mucin (forming signet-ring cells)
- The cells may ultimately rupture and release mucin (mucin lacks).
Hyalinosis (Hyaline Deposition)
- Hyalinosis is identified by:
- Glassy appearance
- Refractile
- Homogenous
- Structureless protein material
- Stains red with eosin.
- Examples include Russell’s bodies in Rhinoscleroma and Corpora amylacia in prostatic hyperplasia.
Amyloidosis
- Amyloidosis is the extracellular deposition of abnormal fibrillary protein
- Has a homogenous eosinophilic appearance.
Types of Amyloidosis
- Localized: -Nodular deposits affect tongue, larynx, and lung -Senile cases affect cardiac or cerebral functions such as Alzheimer's -Endocrine amyloidosis found in endocrine tumors
- Systemic (Generalized): -1ry amyloidosis occurs in plasma cell tumors like multiple myeloma -2ry amyloidosis (reactive amyloidosis) occurs in inflammatory diseases like tuberculosis (TB) -Heredofamilial amyloidosis
Diagnosis of Amyloidosis
- Requires tissue biopsy.
- Hx & E stain shows esinophilic properties
- Congo red stain shows orange red
- Under polarized light with Congo red, it appears apple green.
Effects of Amyloidosis
- Results in progressive organ dysfunction due to vascular compression and pressure atrophy.
Pathological Calcification
- Pathological calcification involves abnormal deposition of calcium (Ca) salts in tissues outside of bone and teeth.
- N/E chalky white and hard.
- M/E appears dark blue.
- Three types: -Dystrophic calcification occurs in nonviable tissue with normal blood calcium levels -Found in fat necrosis, walls of chronic abscesses, old scars, dead bilharzial ova, fibrosed valves, and atheroma of large vessels -Metastatic calcification occurs in viable tissue with hypercalcemia -Hypercalcemia is caused by excess absorption of calcium from the intestine (e.g., Hypervitaminosis D or Milk-alkali syndrome) or excess mobilization of calcium from bone (e.g., Endocrinal disorders, prolonged immobilization, or bone destruction by malignant tumors) -Common sites are the Kidney (in tubules) (Nephrocalinosis), the wall of arteries, the mucosa of the stomach and the lung alveoli -Stone formation is caused by precipitation of Ca salts in the ducts, biliary tract, urinary tract, and salivary gland.
Pathological Pigmentation
- Colored substances stain tissue.
- There are exogenous and endogenous types.
- Exogenous sources enter the body through inhalation (anthracosis/carbon particles), ingestion (chronic lead poisoning/plumbism), or inoculation (tattooing).
- Two types of Endogenous Pigments: -Melanin pigment -Lipochrome (lipofuscin) pigment -Hemosiderin pigment.
Melanin Pigment:
- Hyperpigmentation is localized in Nevus and Melanoma, and generalized with prolonged exposure to sunlight.
- Hypopigmentation is localized in Vetiligo and generalized in Albinism.
Lipochrome (lipofuscin) Pigment
- It is a yellowish-brown, fat-soluble pigment.
- Normally present in cells of the heart, testis, seminal vesicles, corpus luteum, and adrenal cortex.
- Increases due to tissue breakdown, releasing phospholipids which are phagocytosed by neighboring cells, leading to intracellular accumulation.
- Causes include old age (brown atrophy of heart), wasting diseases, and cancer cachexia.
Hemosiderin Pigment
- Deposition of hemosiderin (iron-containing brown pigment); a special stain Prussian Blue is used
- Two Types: -Localized hemosiderosis is due to localized hemorrhage -Generalized hemosiderosis includes primary (due to inborn error of metabolism) and secondary (repeated blood transfusions or hemolytic anemias) forms.
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