Pathology Chapter: Inflammation and Abscesses

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary causative agent of an abscess?

Clostridium perfringens

Streptococcus pneumoniae

Staphylococcus aureus (correct)

Escherichia coli

Which complication of an abscess involves the formation of a tract between the abscess cavity and a hollow organ?

Fistula (correct)

Keloid

Sinus

Chronic ulcer

Which characteristic differentiates an abscess from cellulitis?

Types of tissue affected

Presence of pus

Presence of Staphylococcus bacteria

Localized versus diffuse inflammation (correct)

What type of inflammation is characterized by the presence of mucus secretion?

Catarrhal inflammation Signup and view all the answers

In which anatomical area is a carbuncle most commonly found?

Back of neck Signup and view all the answers

What type of inflammation is characterized by an accumulation of fluid that is poor in protein?

Serous inflammation Signup and view all the answers

Which type of inflammation is specifically characterized by a localized aggregate of macrophages and giant cells?

Granulomatous inflammation Signup and view all the answers

Which of the following is NOT a characteristic of tuberculous inflammation?

Excess eosinophils Signup and view all the answers

What describes the fluid accumulation in fibrinous inflammation?

Rich in fibrin Signup and view all the answers

Which of these is an example of a condition associated with chronic granulomatous inflammation?

Tuberculosis Signup and view all the answers

What is the primary cause of hemosiderin deposition in tissues?

Gene defect on chromosome 6 Signup and view all the answers

What is bronze diabetes associated with?

Iron-induced damage of pancreatic islets Signup and view all the answers

Which stain reveals iron pigment in tissues?

Prussian blue Signup and view all the answers

Dystrophic calcification occurs in which of the following conditions?

Injured and necrotic tissue Signup and view all the answers

What is the stain of choice for amyloid when using polarized light?

Congo red Signup and view all the answers

Which type of amyloidosis is linked with plasma cell tumors?

Primary amyloidosis Signup and view all the answers

What process does inflammation primarily aim to achieve?

Localize and destroy causative agents Signup and view all the answers

What is a consequence of chronic lead ingestion?

Deposition in gum mucosa Signup and view all the answers

What is a characteristic of healing by primary union?

Small, pale linear scar Signup and view all the answers

Which complication of wound healing can lead to loss of movement?

Excessive scar contraction Signup and view all the answers

What defines cellular atrophy?

Acquired shrinkage of cell size Signup and view all the answers

Which of the following is NOT a type of pathological atrophy?

Physiological atrophy Signup and view all the answers

Which type of wound healing typically results in a larger scar?

Healing by secondary union Signup and view all the answers

What is Marjolin’s ulcer associated with?

Scars from burns Signup and view all the answers

Which condition is characterized by a cyst lined by squamous epithelium filled with keratin?

Implantation epidermoid cyst Signup and view all the answers

What differentiates primary union from secondary union in wound healing?

Primary union is always quicker than secondary union Signup and view all the answers

What causes hypertrophy in cells?

Increased protein synthesis Signup and view all the answers

Which type of hypertrophy occurs due to hormonal stimulation during pregnancy?

Physiological hypertrophy Signup and view all the answers

Which condition is an example of pathological hyperplasia?

Endometrial hyperplasia from excessive estrogen Signup and view all the answers

What defines metaplasia?

Transformation of one mature cell type into another Signup and view all the answers

Which type of metaplasia is commonly seen in smokers?

Squamous metaplasia Signup and view all the answers

What is a key feature of dysplastic cells?

Enlarged hyperchromatic nuclei Signup and view all the answers

What is leukoplakia primarily characterized by?

Hyperkeratotic stratified squamous epithelium Signup and view all the answers

Compensatory hypertrophy is most likely to occur in which scenario?

After surgical removal of a kidney Signup and view all the answers

How do benign tumors typically grow compared to malignant tumors?

They grow expansively. Signup and view all the answers

What histologic differentiation is associated with malignant tumors?

Cellular pleomorphism Signup and view all the answers

What is a common gross characteristic of malignant tumors?

Non capsulated structures Signup and view all the answers

Which of the following is a feature of benign tumors?

Slow rate of growth Signup and view all the answers

What is the primary difference in the cellular differentiation of malignant tumors?

Cells show anaplasia and atypia. Signup and view all the answers

How do malignant tumors typically appear microscopically?

Increased mitotic figures. Signup and view all the answers

Which of the following best describes the gross appearance of malignant tumors?

Irregular and ulcerated with raised edges. Signup and view all the answers

Which term describes the degree of differentiation in malignant tumors?

Poorly differentiated. Signup and view all the answers

Study Notes

Cell Injury

Causes of cell injury include: hypoxia (lack of oxygen), infectious agents, physical agents (trauma, radiation), chemical agents, immunologic reactions, and nutritional imbalances.
Types of cell injury include reversible cell injury (degeneration) and irreversible cell injury (necrosis and apoptosis).
Reversible cell injury includes hydropic degeneration (cloudy swelling) - a type of cell swelling due to water accumulation.
Other forms of reversible cell injury include fatty change (steatosis) - excess fat in parenchymal cells (liver, frequently).
Irreversible cell injury includes necrosis, characterized by cell death in a group of cells in a living body.
Different types of necrosis include coagulative necrosis (occurs in various organs except the brain), liquefactive necrosis (in brain and abscess), and caseous necrosis (in tuberculosis).

Fat Necrosis

Types include enzymatic and traumatic fat necrosis.
- Enzymatic fat necrosis forms calcium soaps in acute pancreatitis.
- Traumatic fat necrosis occurs in the female breast due to trauma.

Fibrinoid Necrosis

Fibrinoid necrosis occurs in autoimmune diseases like rheumatic myocarditis.

Apoptosis

Is a programmed cell death, often involving few or single cells.
It is regulated by the Bcl-2 gene.
It does not involve release of chemical mediators or inflammation.
Can be physiological (normal) such as during embryogenesis or menstruation, or pathological.
Examples: Liver cells in hepatitis, and some malignant tumour cells.

Morphological features of Apoptosis

Shrinkage of cell size
Nuclear chromatin condensation, followed by DNA fragmentation
Formation of apoptotic bodies
The apoptotic bodies consist of a dark nuclear fragmented cytoplasm. They become engulfed by phagocytic cells.

Intracellular Accumulation & Extracellular Deposition

Cells may accumulate water, fat, glycogen, protein (in hyalinosis), and pigments (endogenous and exogenous).
Melanin is a naturally occurring pigment in skin and hair, increased melanin exposure can occur due to sun exposure or pregnancy, decreased melanin is present in albinism.
Hemosiderin is a form of iron deposition sometimes resulting in hemosiderosis (localized) and haemochromatosis(generalized).
Lipochromes are yellow-brown pigments that increase in older tissues.
Examples of Haemoglobin derived pigment include hemosiderin and haemoglobin.

Exogenous Pigments

Inhalation of carbon particles can result in black lung pigment (anthracosis).
Chronic lead ingestion results in lead deposition in gum mucosa.

Calcium

Dystrophic calcification is the deposition of calcium salts in injured/necrotic tissue.
Metastatic calcification is the deposition of calcium salts in normal tissues due to high blood calcium.

Amyloidosis

Extracellular deposition of abnormal protein (amyloid), mainly in walls of blood vessels and basement membranes.
Examples include systemic amyloidosis (amyloid deposited in many organs) & localized amyloidosis (amyloid deposited in one organ).

Tuberculosis (TB)

A chronic granulomatous inflammation caused by tubercle bacilli.
The basic lesion is a tubercle, which is a granuloma containing caseous necrosis.
Grossly, tubercles fuse to form small (1-2mm) follicles.
Microscopically, the tubercles contain epithelioid cells, giant cells, lymphocytes, and caseous necrosis.
Pathologically, a primary TB complex develops containing Ghon's focus (initial TB lung lesion), tuberculous lymphangitis (lymph vessel involvement), and lymphadenitis (enlarged lymph nodes).

Acute and Chronic Inflammation

Inflammation: A protective response to tissue injury that aims to localize and destroy the injury and start repair.
Acute inflammation: Rapid onset, short duration (minutes or hours), mild injury, self-limiting.
Chronic inflammation: Gradual onset, prolonged duration (weeks to years), severe, prolonged.
Local vascular events (steps in acute inflammation):
- Temporary vasoconstriction (first to occur).
- Arteriolar vasodilation.
- Increased vascular permeability
- Vascular slowing.
- Inflammatory fluid exudate formation.

Types of Acute Inflammation

Suppurative (pus formation): abscess, boil, carbuncle, cellulitis, acute suppurative appendicitis, peritonitis.
Non-suppurative: Serous, fibrinous, serofibrinous, catarrhal, pseudomembranous, and allergic inflammation.

Healing by Fibrosis

The replacement of damaged tissue by granulation tissue, which matures into fibrous tissue (scar).

Types of Wound Healing

Healing by primary union (intension) - clean wound, minimal tissue damage, shorter healing time, less granulation tissue, small pale scar.
Healing by secondary union (second intention) - infected, gapping wound, longer healing time, more granulation tissue, larger scar.

Complications of Wound Healing

Cosmetic deformities (scarring).
Function loss (contractures).
Keloid formation.
Chronic ulcer, sinus, fistula.

Chapter 4 Cellular adaptation

Atrophy: Decrease in cell size due to decreased anabolism and/or increased catabolism.
- Physiological atrophy (e.g. thymus after puberty, mammary glands, or ovaries after menopause).
- Pathological atrophy (e.g., disuse atrophy or nerve injury related atrophy).
Hypertrophy: Increase in cell size due to increased protein synthesis
Physiological hypertrophy (e.g. pregnancy uterus, muscle builders).
Pathological hypertrophy (e.g. left ventricular hypertrophy due to hypertension).

Chapter 4. Cellular Adaptation and Growth Disturbances - Hyperplasia

Hyperplasia: Increase in the number of cells leading to an increase in tissue/organ size.
- Physiological hyperplasia (e.g., mammary glands at puberty, endometrial hyperplasia, or compensatory hyperplasia after partial hepatectomy).
- Pathologic hyperplasia (e.g., endometrial hyperplasia due to excessive estrogen stimulation).

Chapter 4. Cellular Adaptation and Growth Disturbances - Metaplasia

Metaplasia: Transformation of one mature cell type into another mature cell type of the same lineage.
- Epithelial metaplasia: Columnar or transitional cells transform into stratified squamous epithelium (e.g., bronchial or respiratory epithelium in smokers).
- Mesenchymal metaplasia: Transformation of fibroblasts into chondroblasts or osteoblasts resulting in bone or cartilage formation (e.g., local myositis ossificans).

Chapter 4 Cellular Adaptation and Growth Disturbances - Dysplasia

Dysplasia: Non-neoplastic proliferation of cells characterized by cell atypia/pleomorphism.
Cellular atypia - variations in cell morphology or shape.
Enlarged hyperchromatic nuclei and increased mitotic activity

Chapter 5 Neoplasia

Benign tumors: Slow growth rate, expansive growth pattern, well-defined margins, no metastasis, encapsulated/non-encapsulated.
Malignant tumors: Rapid growth rate, infiltrative growth pattern, irregular margins, potential for metastasis, and often lack encapsulation.
Carcinomas (epithelial origin), sarcomas (mesenchymal origin)

Chapter 6 Infections - Bacteremia and Septicemia

Bacteremia: low number of low-virulence bacteria in the blood
Septicemia: a fatal condition caused by substantial numbers of high-virulence bacteria in the blood
Pyaemia: development of multiple small abscesses in different organs due to a septic embolus.

Chapter 6 Infections - Parasitic Infections (Bilharziasis)

Bilharziasis: chronic granulomatous inflammation.
Etiology: Parasitic infection.
Pathogenesis: formation of granulomas containing macrophages, lymphocytes, plasma cells, eosinophils, and fibroblasts.

Chapter 6 Infections - Fungal Infections (Candidiasis)

Candidiasis (moniliasis): fungal infection with Candida albicans
- Superficial candidiasis (e.g., thrush, vaginal lesions).
- Invasive/disseminated candidiasis (usually in patients with low immunity).

Chapter 6 Infections - Viral Infection (HPV)

Human papillomavirus (HPV) is a family of over 100 types.
Some HPV types (low-risk) cause warts, others (high-risk) are associated with cancer development.
HPV is linked to cervical, anal, and other cancers.

Chapter 6 Hemodynamic Disturbances - Hyperemia and Congestion

Hyperemia: Active process (increase in blood flow to tissue).
Congestion: Passive process (venous outflow obstruction).
Types include local (single organ e.g. venous obstruction, or systemic) venous congestion (heart failure).

Chapter 6 Hemodynamic Disturbances - Thrombosis

Thrombosis: Abnormal blood clot (thrombus) inside the cardiovascular system.
Virchow's Triad: Three factors for thrombus formation: endothelial injury, alterations in blood flow (stasis/turbulence), and hypercoagulability.

Chapter 6 Hemodynamic Disturbances - Embolism

Embolism: Obstruction of a blood vessel by an embolus (solid, liquid, or gaseous).
Types of emboli include thromboemboli (most common), fat emboli, amniotic fluid emboli, gas emboli, tumor emboli, and septic emboli.

Chapter 6 Hemodynamic Disturbances - Ischemia and Infarction

Ischemia: Reduced blood supply to a tissue.
Infarction: Ischemic necrosis of tissue, often due to complete arterial occlusion (e.g. thrombosis or embolism).
Types of infarction, pale (e.g. heart, kidney), red (e.g. venous obstruction).

Chapter 6.6 Gangrene

Gangrene is massive tissue necrosis followed by putrefaction by saprophytic bacteria or organisms.
Types of gangrene: Dry, moist, and gas gangrene.
Differentiating characteristic features between dry and moist gangrene.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the characteristics and types of inflammation, particularly focusing on abscesses and their complications. This quiz covers essential concepts relevant to pathology and helps reinforce your understanding of inflammation processes in the human body.