Hemodynamic Disorders
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| 🇬🇧 | 🇬🇧 |
| •engorged alveolar capillaries •alveolar septal edema • focal intra-alveolar hemorrhage | Acute pulmonary congestion |
| What condition? black arrow? | Acute Pulmonary Congestion: Engorged alveolar capillaries, accumulation of RBCs due to stasis |
| What condition? blue arrow? | Acute Pulmonary Congestion: Alveolar septal edema: usually “empty” air spaces are filled with a pale pink, homogenous to slightly granular material which is edema fluid |
| What condition? red arrow? | Acute Pulmonary Congestion: Focal intra-alveolar hemorrhage: capillary may rupture → fluid and RBCs may leak into the alveolar space |
| What condition? black arrow? | Chronic Pulmonary Congestion: Hemosiderin-laden macrophages aka heart failure cells |
| What condition? Red arrow? | Chronic Pulmonary Congestion: Thickened septa: hypoxia due to stasis of blood flow → cell injury → scarring and fibrosis |
| What is the hallmark of the following condition? | Hemosiderin-laden macrophages contain in cytoplasm hemosiderin pigment (brown, granular), resulted from destruction of red blood cells in alveolar lumen. |
| Disruption of normal vascular integrity → leakage of RBCs → petechial hemorrhage (<2 mm) | Petechial hemorrhage |
| Lining of TRACHEOBRONCHIAL TREE | Tall ciliated columnar |
| What condition? | Pulmonary edema with a few extravasated RBCs |
| What condition? | Heart failure cells (Blue arrows) |
| Which condition? | CVC - Lung (Perl’s stain): anthracotic (carbon) pigment: perivascular. |
| Green-blue | Trivalent iron from hemosiderin |
| Remains dark-brown and is mainly located perivascular. | Anthracotic pigment |
| What condition? BLUE ARROW? | Pulmonary hemorrhage Veins are filled with RBCs |
| What condition? GREEN ARROW | Pulmonary hemorrhage: dark/black stained figures- Anthracosis (the accumulation of carbon in the lungs) |
| What condition? BLUE ARROW? | Represents Intra alveolar hemorrhage. Hyaline Arteriolosclerosis (a sign of pulmonary hypertension) → Note the onion skin appearance |
| What condition? GREEN ARROW? | → terminal respiratory bronchiole* → not a blood vessel kasi di naman squamous ang lining → the lining epithelium of this structure is tall columnar |
| What condition? YELLOW ARROW? | Fluid-filled alveoli. Macrophages pointed at by the yellow arrows. |
| Microscopic Hallmark of Pulmonary Edema: | Pinkish homogenous finely granular material inside alveoli |
| What condition? YELLOW ARROW? | Fluid-filled alveoli. Erythrophagocytic cells or siderophages (yellow arrows) and |
| What condition? BLACK ARROW? | Fluid-filled alveoli. RBCs (black arrows) in the alveoli. |
| What condition? | Accumulation of hemosiderin inside the alveolar macrophages inside the lung of the patient with congestive heart failure (hence heart failure cells), resulting from release of iron from breakdown of hemoglobin of dead RBCs |
| Black arrows? | Macrophage contains RBCs. |
| Yellow arrows? | Hemosiderin inside RBC |
| GREEN ARROWS? | Type 1 Pneumocyte |
| RED ARROWS? | Type 2 Pneumocyte |
| What condition? Black arrow? | ARDS in the early proliferative stage: Type 2 pneumocyte proliferation |
| What condition? red arrow? | ARDS in the early proliferative stage. Interstitial fibroblast proliferation |
| What condition? Black arrow? | ARDS in the late proliferative stage. Extensive fibroblast proliferation, with incorporation of the hyaline membranes. |
| What condition? | ACUTE RESPIRATORY DISTRESS SYNDROME |
| What condition? | Acute Respiratory Distress Syndrome |
| What condition? Black arrow | Hyaline membrane proliferation |
| What condition? Black arrow | ARDS; Hyaline membrane proliferation in dilated alveoli, magnified |
| Type of Hemorrhoid? | INTERNAL HEMORRHOIDS |
| What condition? Notable characteristics? | EXTERNAL HEMORRHOIDS: thrombosed vein • Enlarged or dilated • Vein is filled with RBCs → RBCs are organized → RBCs are attached on the inner lining of the endothelium |
| What condition? Black arrow? | EXTERNAL HEMORRHOIDS: thrombosed vein; squamous lining |
| The primary abnormalities that lead to thrombosis: | 1. Endothelial injury 2. Stasis or turbulent blood flow 3. Stasis or turbulent blood flow |