Patho1 - Cdsa-cell Adaptation And Injury

SITUATIONAL ANALYSIS CELL REACTIONS TO INJURY Part 1 Cell Adaptation and Injury

Prepared by Emmanuel R. de la Fuente, M.D.

Objectives 2.Recognize the essential morphologic features of important cell reactions to injury 3.Correlate the morphologic features with the situational events 4.Briefly discuss the etiopathogenesis including their biomolecular aspects

This morning’s activities should include the following: 2. Lecturette by group facilitator which may be a separate activity or integrated with discussion of the situations. 3. Discussion of situations 4. Morphologic recognition of lesions on actual specimens and slides

SITUATION NO. 1 A 60-year-old man had been hypertensive for the past 20 years with blood pressures ranging from 150/90 to 180/110. Compliance to anti-hypertensive medications was poor. Chest X-ray disclosed significant enlargement of the left ventricle of the heart.

Slide1. Indicate which of these two hearts probable represents the heart of this patient? Describe and explain why?

640 gm

220 gm

Slide 2. Which of the following transverse sections of the heart illustrates the patient’s heart? Explain why and describe.

3 cm

A

1 cm

B

Slide 3. Which of the following microscopic features is probably a representation of the left ventricle? Explain why and describe.

Slide 4. Discuss the biomolecular basis for this nuclear features.

1. Briefly discuss the etiopathogenesis of the lesion, including the biomolecular events. 2.Correlate the lesions with the situational events. 3. Which of the ff. glass slides have features consistent with the patient’s history? - Glass slide CV-001, CV-004A, and CV-017 4. Select a heart from the museum or from the available gross hearts that illustrates the heart of this case.

Situation No. 2 Slide 1. The testicle at the left side is normal. Describe the testicle at the right side. Give conditions that may give rise to such a testicle. Discuss the pathogenesis for such a lesion.

Slide 2. Which of the areas in this section of the testicle illustrates the lesion in the previous picture. Describe.

Situation No. 3 Slide 1. This is a section of the skeletal muscle of a lower extremity. Describe your observations. Discuss the possible etiopathogenesis of the lesion including the biomolecular events.

Situation No. 4 Slide 1. This brain is from an 95 yr old man who showed severe memory loss and impaired intellectual capacity. Describe the gross and discuss possible etiopathogenesis. What is the expected microscopic findings.

SITUATION NO. 5 A 57-year-old menopausic woman had intermittent vaginal bleeding for the past two years. The bleeding was subsequently determined to originate from the endometrium. Work-ups disclosed an ovarian tumor that is known to secrete large amount of estrogen.

Slide 1. Which of these two uteri most probably is the cause of bleeding? Explain. Describe the gross lesion.

Slide 2. Two microscopic sections of endometria. Which of the 2 illustrates the patient’s endometrium? Explain why and describe. (Same magnifications)

1.Briefly discuss the etiopathogenesis of the lesion, including the biomolecular events. 2.Correlate the lesions with the situational events. 3. Study the following glass slides. Which slide is similar to the lesion of the case? - E – 10 and FRS-001

SITUATION NO. 6 A 32 year old sexually promiscuous woman had repeated infections of the cervix.

Slide 1. Two microscopic sections of the cervix. Which of the 2 is the expected lesion taking into consideration the history of the patient? Indicate the lesion and describe.

1. Explain why this is an expected lesion. 2. Briefly discuss the etiopathogenesis of the lesion. 3. Study the following glass slides. Which of the following slides is similar to the lesion of this case? - FRS-002 and CE-03

Situation No. 7 Slide 1. This is a biopsy of the esophagus of a 54 yr. old woman with dyspepsia. Identify and describe the lesion. Discuss possible etiopathogenesis.

SITUATION NO. 8 A 64-year-old policeman while getting drunk and smoking heavily in a beer house was shot in the head by another customer who got irritated with the smoke. He died on the spot. Investigation revealed that his behavior indicated an addiction to alcohol beverages and cigarettes.

Without proceeding to the next set of slides, which of the following organs do you expect lesions to be present? State the lesion and explain. 2. Brain

6. Spleen

3. Lungs

7. Thyroid

4. Heart

8. Prostate

5. Liver

9. Testicle

6. Gastrointestinal tract

Slide 1. A section of the gross liver. Describe.

Slide 2. Two microscopic sections of the liver. Which of the 2 is more consistent with the gross lesion? Describe and discuss the pathogenesis of the lesion.

Slide 3. The external surface of the gross lung. Indicate the lesion and describe.

Slide 4. Two microscopic sections of the lung. Which of the 2 is more consistent with the history of the patient? Explain why and describe. (arrows indicate the respiratory bronchioles)

Slide 5. A section of a hilar lymph node. Describe

Slide 6. A section of the renal proximal tubules. Indicate the lesion and describe.

1. Briefly discuss the etiopathogenesis of these lesions, including the biomolecular events. 2. Correlate the lesions with the situational events. 3. Study the following glass slides. Which of the following lesions is/are similar to the lesions of the liver and lungs? - GI-018, GI-019, and GI-020 - LIV-001 - LU – 010 and LU - 017

Situation No. 9 Slide 1. A 52 year old man developed jaundice. The liver was enlarged. The conjugated bilirubin was markedly elevated. Indicate the lesion, describe, and discuss the possible etiopathogenesis.

Situation no. 10 Slide 1. A child had received repeated blood transfusion because of hemolytic anemia. This is the liver. Indicate, describe, and discuss the pathogenesis of the lesion. Discuss possible outcomes.

H & E stain

Prussian Blue stain

THE KEY TO SURVIVING ENVIRONMENTAL CHANGES IS THE ABILITY TO ADAPT.