PATHOLOGY 1ST PRACTICAL EXAM PART 2

Please do read your manuals. Don’t solely rely on this reviewer. There are

other questions in the manual that I did not include in the slides.

THANK YOU FAISAL FOR MOST OF THE PICTURES.

FLUID AND HEMODYNAMICS

ACUTE APPENDICITISThe presence of segmenters densely occupying the appendical wall

Likewise there is necrosis of the mucosa

NEUTROPHILIC infiltrates on the wall

Blood vessels in the wall of the appendix have a dilated appearance with the lumen being more engorged with blood

*ACTIVE HYPEREMIA – bright-red discoloration*PASSIVE HYPEREMIA – blue-red discoloration

CPC, lungAlveolar septal wall is thickened; alveolar spaces contain numerous hemosiderin-laden macrophages

(+) fibrosis, vascular congestion, thickening of alveoli

Dark staining cells within the alveolar spaces: most likely due to the presence of macrophages that have taken up hemosiderin

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THROMBOSIS IN ATHEROSCLEROTIC ARTERY, coronary arteryNarrowed lumen occluded by thrombus (attached to the endothelial wall)-Damage to the endothelium exposes intimal collagen resulting in adherence and then aggregation of platelets atthe site of damage-Lines of Zahn

-2 kinds of thrombus:a.ARTERIAL – frequently occlusive, at sites of turbulence or injury, retrogradeb.VENOUS – invariably occlusive, occurs at site of stasis, in direction of blood flow

FATE OF THROMBUS:1.Propagation2.Embolization3.Dissolution4.Organization and recanalization

INFARCT, spleenMICRO:Ischemic coagulative necrosisOccluded vesselInfarct – dark red in color

HISTO:Loss of architectural structure and form

GROSS:Ischemic necrosis – occlusion of vascular supply; RED (hemorrhagic) and WHITE (pale)

White – solid organs: limits number of hemorrhage

Pale wedged shaped, sharply definedTriangular with the apex pointing to the vessel occluded and base, the periphery of the lesion

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GENETICS

GAUCHER’S DISEASE, spleen Crumpled tissue paper appearanceAccumulation of glucocerebrosides

Pathogenesis: affected gene is the gene that encodes glucocerebrosidase, an enzyme that normally cleaves the glucose residue from ceramide

DISEASES OF IMMUNITY

ACUTE PROLIFERATIVE GLOMERULONEPHRITISHypercellularity of the Glomerulus-Proliferation of endothelial cells -Thickening of capillary loops

-Type III (immune complex-mediated) hypersensitivity

- commonly caused by Streptococcal infection

TB with CASEATION, lung(+) central caseous necrosis

TYPE 4 delayed hypersensitivity

HISTO:- atelectatic alveoli (collapsed)-presence of epitheloid cells (arranged as Langerhan’s giant cell) which is rimmed by lymphocytes, fibroblasts, and plasma cells*Caseation necrosis is the pink-staining, granular, structureless material at the center of the lesion which contain foamy macrophages that are packed with Mycobacteria

lungs_tb42

LUPUS ERYTHEMATOUS, spleen-Periarteriolar fibrosis = “Onion skinning ” -thickening of capsule; prominence of red pulp

Onion skinning

LUPUS ERYTHEMATOUS, kidney

Thickened capillary loops“chicken-wire” loop appearance (indicative of active SLE

NEOPLASIA

I did not include adenocarcinoma, bronchogenic ca, squamous cell ca of the cervix. I don’t have pictures of these slides.

LEIOMYOMA, uterus- Smooth muscle- Benign tumor- Pink wavy cytoplasm- well differentiated mass- Presence of bundles- The usual location is in the myometrium- Typical long spindle muscle cells arranged in intercalating bundles

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RHABDOMYOSARCOMA, intercapsular massMalignant skeletal muscle tumor

Cytoplasm: eccentric eosinophilic(+) thin and thick filamentsLarge hyperchromatic nucleiPleomorphic

Striations is NOT always needed in the diagnosis of this tumor

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OSTEOGENIC SARCOMA, bone-Malignant mesenchymal tumor-Spread in the medullary canal and replace the marrow surrounding the pre-existing bone trabeculae-Pink osteoid formation

GROSS:-appears gritty and infiltrates cortex of bone-most common in long bones

TUBULAR ADENOMA, rectum- Benign tumor of the glands-Hyperchromatic nuclei in lining of the glands

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WILM’S TUMOR, kidney(demo slide)Malignant tumor in childhood

Combination of blastemal, stromal, and epithelial cell elements are represented by abortive tubules or primitive glomeruli

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DERMOID CYST, ovaryCyst wall lined by stratified squamous epithelium; underneath are hair follicles and sebaceous glands

GROSS: appears as unilocular cysts; contains hair, tooth structures, creamy-like material, and areas of calcification

Teratoma – more than one neoplastic cell type derived from more than one germ layer

END of PART 2

Sobrang haba ng reviewer na ito. Haaaysh.

Good luck again with the practical exam and thesis proposal.