Term
What is the arrow pointing at?
[image] |
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Definition
| Fatty streak, pre atherosclerotic plaque. |
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Term
[image]
What is the picture showing in general?
What do the F, C and L stand for?
What disease would we see this in? |
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Definition
A blood vessel with an atherosclerotic plaque as would be seen in atherosclerosis.
L is the Vessel lumen.
F is the Fibrous Cap
C is the Necrotic Core. |
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Term
[image]
What are these cells and what indicates there is some form of pathology present? |
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Definition
| These are red blood cells with a lack of central pallor. This observed in hereditary spherocytosis. |
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Term
[image]
What are these arrows pointing too and what pathology is it characteristic of? |
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Definition
Top arrow: Increased Central Pallor.
Middle Arrow: Pencil Cell
Bottom Arrow: Target Cell
This is characteristic of Iron deficient anaemia. |
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Term
| [image] What is shown in this image and what can cause this? |
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Definition
Shown is obliterated alveolar spaces.
Seen in cardio-respiratory failure which is caused by inadequate oxygenation (such as in pneumonia). |
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Term
| [image] This image shows an accumulation of what? Where is it often seen? |
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Definition
| Triglycerides (fats). Accumulation of small lipid droplets in the cytoplasm of liver cells as it has a major involvement in fat metabolism. Alcohol abuse is a major cause. |
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Term
| [image] What has happened to these cells and the organ they belong to? |
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Definition
| Atrophy where organ size decreases. The cells can still be alive but with diminished function (or may have undergone apoptosis). |
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Term
| [image] Shown is the reduced oxygen carrying capacity of blood, what are the causes of it? |
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Definition
Severe anaemia (reduced haemoglobin)
Carbon monoxide poisoning |
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Term
| [image] Shown is hypertrophy of the uterus, what is it? |
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Definition
Hypertrophy is increase in cell size and as a result the organ size. The cells are unable to divide, so they increase the cellular components. Can be physiologic or pathologic.
If there is a continued demand, necrosis will follow. |
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Term
| [image] This image is an example of what? |
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Definition
| Hyperplasia. Which is an increase in the number of cells and as a result the organ size. The cells respond to physiological or pathological demand by dividing. Can occur in conjunction with hypertrophy. |
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Term
| [image] What is this image showing? |
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Definition
On left - metaplasia which is a reversible change in the adult cell type.
On right - stimulus has persisted, causing epithelium to become dysplastic (disordered cellular morphology, organisation and function). |
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Term
| [image] What is happening to the cell nuclei? |
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Definition
Necrosis is occurring.
Nucleus undergoes pyknosis (shrinkage), karyorrhexis (fragmentation) and karyolysis(fading). |
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Term
What is happening here?
[image] |
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Definition
| Cell Swelling (Reversible Injury) |
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Term
[image]
Describe this cell |
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Definition
Neutrophil
Multi-lobed, granular, phagocytic
Recruited by IL-8
Have complement receptors on their surface |
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Term
[image]
Describe this cell |
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Definition
Basophil
Large cell with large dark purple granules.
Secretes histamine, leukotrienes, bind IgE.
Often increased in allergic response |
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Term
[image]
Describe this cell |
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Definition
Eosinophil
Multi-lobed nucleus, large orange granules which contain major basic protein, eosinophil cationic protein and peroxidase.
Role in immune defense against parasites and allergic reactions |
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Term
[image]
Describe this cell |
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Definition
Monocyte which differentiates to macrophage in tissues (where they are long lived).
Phagocytic, produce pro-inflammatory cytokines and present antigen to T cells.
Kidney shaped nucleus. |
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Term
[image]
Describe this cell |
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Definition
Lymphocyte (T and B cell)
Small cell, large nucleus and little cytoplasm.
B cells produce antibody
T cells secrete cytokines (CD4) and induce apoptosis (CD8) |
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Term
[image]
Describe this cell |
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Definition
Natural Killer cell, large granular lymphocyte.
Activated by low MHC-I or activating receptors on target cells, and then induce apoptosis. |
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Term
[image]
Describe this cell |
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Definition
Natural Killer cell, large granular lymphocyte.
Activated by low MHC-I or activating receptors on target cells, and then induce apoptosis. |
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Term
[image]
This shows bone marrow, what is the condition associated. |
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Definition
Acute leukaemia
Rapid growth of blast cells (progenitor cells).
Require intensive chemotherapy and stem cell transplant. Children have better prognosis than adults. |
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Term
What has occured here?
[image] |
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Definition
Fatty Change in injured liver cells.
Commonly seen in alcohol abuse. |
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Term
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Definition
| This is normal muscle compared to hypertrophic muscle |
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Term
What is happening here?
[image] |
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Definition
| This is a recent infarct. The nervous tissue seems to have the same consistency as the normal side as it is early. The affected area shows many petechiae caused by reperfusion. |
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Term
[image]
What do these images show? |
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Definition
Hepatic abscess
Localised area of hepatic necrosis (liquefactive) with an area of inflammatory exudate (shown top right of image) replacing the necrotic hepatocytes. Bottom left viable hepatocytes remain.
If stained, would see reticulin framework is disrupted in the abscess area and the hepatocytes will not be able to regenerate in a normal fashion. |
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Term
[image]
What is this image showing? |
|
Definition
Granulation tissue.
Gross - pink, soft, granular
3-5 days after damage
New thin walled, delicate vessels and proliferating fibroblasts in loose ECM
ECM gradually accumulates, as well as collagen and results in dense fibrosis or a scar which is remodeled over time |
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Term
| What is happening here?[image] |
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Definition
| Acute inflammation of the lung. In the second picture you can see dilation of the blood vessels and in the third you can see the cellular phase of acute inflammation occurring, filling the spaces that are meant to be clear for gas exchange. |
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Term
What is this a picture of, describe it:
[image] |
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Definition
| This is pneumonia of the lungs. The tissue would be grey and consolidated because pus is occupying the spaces that are normally filled with air. Alveoli are filled with fluid exudate, neutrophils and some macrophages. |
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Term
What is the arrow pointing to?
[image] |
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Definition
| Lung abscesses in bronchopneumonia |
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Term
[image]
What cell is pictured here, What morphological changes indicate a pathology and where would we see this in the body? |
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Definition
| This Cell is a Macrophage. It is full of oxidised LDL molecules (White fat droplets). This occurs in atherosclerotic plaque formation, these cells would be accumulating in blood vessel intima layers. |
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Term
[image]
What is this image showing? |
|
Definition
Cartilage fibrillation.
Cartilage breaks down in osteoarthritis, the exposed surface becomes frayed. |
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Term
[image]
What is this image of? |
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Definition
| Eburnation in osteoarthritis. It is when the bone has no cartilage to protect it and the bone is polished by the grinding action |
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Term
[image]
What is this image and what are numbers 1,2 and 3? |
|
Definition
Subchondral cyst.
1. eburnated articular surfcae exposing subchondral bone
2. subchondral cyst
3. residual articular cartilage |
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Term
[image]
What pathological change is seen at the white arrow? |
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Definition
| Osteophytes which are mushroom shaped bony outgrowths that develop at the margins of articulating bone. Pathological change in osteoarthritis. |
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Term
[image]
What is wrong with this joint? What is the pahtogenesis? |
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Definition
| Osteoarthritis a wear and tear disease due to mechanical stress. Pathogenesis is altered chrondrocyte homeostasis with a decrease in proteoglycan concentration and cleavage of collagen type II fibres, resulting in degradation of cartilage. |
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Term
| What are these labels pointing to?[image] |
|
Definition
1. Eburnated articular surface exposing subchondral bone
2. Subchondral cyst
Residual articular cartilage |
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Term
| What is this deformity called?[image] |
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Definition
| Boutonniere deformity (RA) |
|
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Term
| What is this deformity called?[image] |
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Definition
|
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Term
[image]
What complication has occurred here? |
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Definition
| Cardiac tamponade. This is when there is a transmural rupture, and blood under high pressure escapes into the pericardium. As the sac is inelastic, the pressure increases and more blood accumulates it pushes the heart shut. |
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Term
[image]
What type of epithelium is this? What is the function and where would you find it? |
|
Definition
Stratified squamous
Protection
Oesophagus |
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Term
[image]
This shows histology of synovium in what condition? |
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Definition
Rheumatoid arthritis
Left is normal
Middle shows thickening of the synovium
Right top arrow shows synovial hyperplasia.
Middle and right image show infiltration of chronic inflammatory cells (mainly plasma cells and lymphocytes) |
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Term
[image]
What bone histology disorder is shown here? |
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Definition
Osteomyelitis
On left is dead bone with no cells visable
Middle is pus = neutrophils and necrotic debris |
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Term
[image]
How do part A and B heal? |
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Definition
A - wound edges relatively close and clean, can suture this area to heal by first intention.
B - this area is extensive and cannot be sutured due to its size. It will heal by secondary intention and will form a large scar |
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Term
[image]
Describe the abnormal features of this lung |
|
Definition
3 different stages of lobar pneumonia.
Upper lobe - grey hepatisation (infected first, then spread downwards)
Middle lobe - grey and red hepatisation
Base lobe - shows congestion and the earliest changes. |
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|
Term
|
Definition
-Infarct in anterior wall of the LV
- Roughly 10-14days
Pale regions due to degradaton, no blood supply
- thinner area due to necrotic cells
mural thombus due to turbulence from impaired contraction & necrosis of endothelial lining
- hypertrophy of surviving LV |
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Term
|
Definition
24 hours
Viable cells are at the top (larger)
Eosinophilic region due to eosin binding abnormal cell
No nuclei in cells
Neutrophils present |
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Term
[image]
What is the complication that has occurred here? |
|
Definition
Cardiac tamponade
- blood in myocardium (due to ruptured vessel)
- due to ruptured vessel, there is increased pressure in the pericardium as the blood leaks out
- blood accumulates so as left ventricle fills it will eventually squeeze the heart shut
- color changes indicates early necrosis |
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Term
[image]
What is abnormal about this skeletal muscle? |
|
Definition
Atrophied skeletal muscle
- due to lack of stimulation leading to decreased protein synthesis and increased protein breakdown
- muscle fibers are still visible but smaller/shrunken
- neutrophils presents w |
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Term
[image]
What type of tissue is this and what is it used for? |
|
Definition
Stratified squamous tissue
Used for protection
As the the cell mature, they start to change their appearance (matured cells at the top) |
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Term
[image]
What is your diagnosis? |
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Definition
| Acute pyogenic bacterial meningitis |
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Term
[image]
What is happening in the brain and meninges in this picture? |
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Definition
Space should be relatively clear but:
- there are many neutrophils present
- arterioles are congested and vasodilated
- pia is swollen (due to fluid moving through post-capillary valve) |
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Term
[image]
Describe what you can see in the curettings taken from the medullary cavity of the bone post-surgery? |
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Definition
LHS red/pink zone is the trabecular bone (has less fat, no periosteum and no osetoecytes presents which indicates necrosis
Also many neutrophils present as well as pus (white tracks through bone) |
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Term
[image]
What is abnormal about this heart? How many days post MI roughly? |
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Definition
Mural thrombus in LV
Start of discoloration
Few days after |
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Term
[image]
What is abnormal about this heart and roughly how long post MI? |
|
Definition
Old infarct in the posterior third of the inter-ventricular septum
Recent infarct (1-2wks old) in the left anterior descending coronary artery (yellow area (necrosis) surrounded by a thick rim of granulation tissue which is 3-7 days old)
Mural thrombus
Hypertrophic region due to long-term hypertension (built over a long time) |
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Term
[image]
What is abnormal about this heart and roughly how long post MI? |
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Definition
Months to years post MI
White pearly scarring that has retracted
Infarct occurred in the right coronary artery |
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Term
[image]
What is abnormal about this brain and roughly how long post cerebral infarction? |
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Definition
Days post infarct
Blood still present from reperfusion
Asymmetry between hemispheres
Infarct occurred in the right middle cerebral artery |
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Term
[image]
What is abnormal about this brain and roughly how long post cerebral infarction? |
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Definition
Different consistency between hemispheres
Liquefactive necrosis present
Reactive gliousis -> signs of healing (equivalent to granulation tissue)
Weeks post infarction |
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Term
[image]
What is abnormal about this brain and roughly how long post cerebral infarction? |
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Definition
Months to years post infarct
All of the liquefactive necrotic tissue has been removed by macrophages leaving a cavity behind |
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Term
[image]
Is this a liver abscess or centriolobular necrosis? |
|
Definition
Hepatic abscess
Many neutrophils present
Left lower corner contains normal hepatocytes |
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Term
[image]
Is this a liver abscess or centriolobular necrosis? |
|
Definition
Centriolobular necrosis
Left corner around central vein are just ghost cells of necrotic hepatocytes
Nuclear debris present but no inflammation |
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Term
[image]
Is this hepatic centriolobular necrosis or a hepatic abscess? Would this tissue heal through regeneration or repair? |
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Definition
Hepatic centriolobular necrosis
Supporting reticulum framework remains intact so despite extensive hepatocyte necrosis the hepatocytes are able to regenerate and return to normal |
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Term
[image]
Is this hepatic centriolobular necrosis or a hepatic abscess? Would this tissue heal through regeneration or repair? |
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Definition
Hepatic abscess
Reticulum framework is disrupted (top LHS)
so therefore cannot regenerate so must heal via repair |
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Term
[image]
Identify the types of tissue present in this tibial fracture sample? |
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Definition
Dot apperance = marrow cavity (granulation tissue-> darker than usual)
Bone (well-organised)
Center region = collagen (wavy hamogenous appearance) |
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Term
[image]
Describe what is seen in the upper, middle and lower lobes? |
|
Definition
Upper-> most advanced changes (grey hepatisation)
Middle-> Mixture of grey and red hepatisation
Lower-> earliest changes (congestion) |
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Term
[image]
What are the abnormal features of this lung? What will these abnormalities do to normal lung function? |
|
Definition
Visceral surface shows yellow exudate covering the right upper lobe (particularly at the apex)
The exudate is sticky and rich in fibrin
On inspiration, the lungs expand and the sticky visceral pleuera rubs against the parietal pleura causing pain
This is pleuritis |
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Term
[image]
What is happening in this section of lung? |
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Definition
Congestion, oedema alveolar walls w an acute inflammation exudate, neutrophil and some macrophages present within the alveolar spaces
Pus fills the space normally filled w air |
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Term
[image]
Diagnosis from these results? |
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Definition
Hepatitis B
Total bilirubin (liver not working correctly)
High ALP & ALT (indicates hepatocyte death) |
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Term
[image]
Diagnosis?
What causes these abnormalities? |
|
Definition
Miliary Tuberculosis
Small round pale lesions are granulomas
(distributed throughout all 3 of the lobes because dissemination occurred through circulation) |
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Term
[image]
What is abnormal about this chest x-ray? |
|
Definition
Lungs have miliary TB lesions (ground glass appearance)
(but normal heart shadow and diaphragm) |
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Term
[image]
What is this? What does it contain? |
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Definition
| Granuloma -> epitheliod cells, giant cells, macrophages, lymphocytes, fibroblasts |
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Term
[image]
What is abnormal about this spleen? |
|
Definition
The large lesions are granulomata with central, soft areas of caseation (caused by spread of TB)
Dissemination to the liver, kidneys and peritoneal surfaces had occurred via haematogenous spread of TB |
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Term
[image]
Describe the abnormalities and what is the diagnosis? |
|
Definition
Rheumatoid arthritis
top arrow - inflamed synovium
middle & bottom arrow - erosion of the cartilage with larger areas of damage |
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|
Term
[image]
Describe the abnormalities and what is the diagnosis? |
|
Definition
Osteoarthritis
top arrow - synovium is not inflammed
middle arrow - rough surface of the articular cartilage of the pate due to degeneration of the cartilage
bottom 2 arrows - erosion of the articular cartilage |
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Term
[image]
What is this and why does it look like this? When would this occur? |
|
Definition
Rheumatoid arthritis
Pannus removed from a joint
Fronds of fleshy tissue grow out from periphery of the joint over the articular cartilage
Enzymes and cytokines result in destruction of the underlying cartilage |
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Term
[image]
What is this and what could have caused it? |
|
Definition
Intercerebal mass
Due to warfarin overdose |
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Term
[image]
Describe abnormalities? |
|
Definition
Pulmonary infarct in lower lobe (embolus in pulmonary artery)
Triangle apex points towards occluded artery
Hemorrhagic due to double blood supply to lungs (so downstream blood from occlusion becomes necrotic) |
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Term
[image]
what does this CT Angiogram show? Diagnosis? |
|
Definition
Pulmonary embolism
Shows arterial blood flow is blocked (goes black-> whit arteries do not continue so shows blood flow has stopped) |
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Term
[image]
What does this Leg Ultrasound show? Diagnosis? |
|
Definition
Pulmonary embolism
Shows that vein is blocked
When compressed vein should disappear (because it doesn't it shows that something is holding it open)
Artery should stay open (even under compression) |
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Term
[image]
Describe appearance? Possible diagnosis? |
|
Definition
Left leg is swollen, red, and likely warm to touch (indicative of inflammation)
Possibly due to DVT |
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Term
[image]
Diagnosis? Possible cause? |
|
Definition
Saddle embolus
due to occluded pulmonary trunk and/or left & right pulmonary arteries being blocked |
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Term
[image]
Why do these thrombi look different? Why are there lines of zahn? |
|
Definition
Darker = stasis thrombi
Pinker/ lighter = primary thrombi
Lines of zahn present because thrombi grows outwards layers -> lines represent trapped RBC between layers of platelets and fibrin |
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Term
|
Definition
| Deep vein thrombosis (DVT) -> thrombus forms a cast of the vein and propagates in the direction of blood flow |
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Term
[image]
What condition does this patient have?
What are the arrows pointing to on the articular cartilage? |
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Definition
Osteoarthritis
Left arrow - Hyperplasia of the chrondrocytes with disorganisation of the architecture
Right arrow - Fibrillation (splitting and fragmentation) |
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Term
[image]
Diagnosis? Describe picture? |
|
Definition
Rheumatoid Arthritis
Outer layer - Hyperplastic synoviocytes
Dark cluster in the center - dense chronic inflammation |
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Term
[image]
Diagnosis? Whats occurring at points 1, 2 & 3? |
|
Definition
Osteoarthritis
1. Subchondral bone
2. subchondral cyst
3. residual articular cartilage |
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Term
[image]
Diagnosis? What are the arrows pointing at? |
|
Definition
Osteoarthritis
Top arrow - ligament to the head of the femur
Middle arrow - eburnation of the exposed bone
bottom arrow - osteophytes |
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Term
[image]
Diagnosis? What is happening in regions 1,2 & 3? |
|
Definition
Secondary pulmonary TB
1. Cavitated lesion surrounded by a thick rim of fibrosis at the apex
2. Consolidation (due to TB)
3. Multiple granulomas surrounding bronchi |
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Term
[image]
What is this? What is happening at each number? |
|
Definition
Granuloma
1. Necrosis
2. Thick mass of proliferated macrophage-derived epithelioid
3. Giant cells (proliferated macrophages derived cells fuse together)
4. CD4 lymphocytes |
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Term
[image]
What causes this condition? |
|
Definition
| Jaundice. Inflammation of the hepatocytes cause them to cell and push on the canaliculi. Therefore conjugated bilirubin cannot travel to the bile duct and it is force into the blood. As bilirubin is water soluble it can be excreted in the urine (turns urine very dark) |
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Term
[image][image]
Here is a low power and higher power view of which liver condition? What does B, C and D point to in the second image? |
|
Definition
Acute hepatitis.
First image shows the portal tract infiltrated by lymphocytes spilling over the adjacent parenchyma.
B = balloon cell
C = apoptotic body (councilman body)
D = lymphocyte |
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Term
[image]
What liver condition is this? |
|
Definition
Fulminant hepatitis
General architecture from the portal tract to the central vein is intact
Necrosis of a substantial number hepatocytes especially in the central vein region (here reticulin framework is disrupted).
Imaged stained with trichrome stain (collagen is blue) |
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Term
[image]
What liver condition is shown here? |
|
Definition
Interface hepatitis
Inflammation has spread from the portal tract to to adjacent tissue. It is at the interface of the portal tract and liver lobule |
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Term
[image]
What liver disease is shown in this image? |
|
Definition
Lobular hepatitis
This is when there is inflammation within the liver lobule. |
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Term
[image]
These cells (hint - 'bodies') are seen in what liver condition? |
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Definition
| Mallory bodies are seen in alcoholic hepatitis. They are found in the cytoplasm, they are damaged cytokeratin intermediate filaments |
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Term
[image]
This is the end result of a lot of liver diseases, what is it? |
|
Definition
Cirrhosis of the liver. Can result from alcohol, and chronic hepatitis B and C infections. Once it is established then the cause of the cirrhosis may not be obvious.
Micronodular cirrhosis is associated with alcohol. |
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