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Old 05-24-2015
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Default hyaline arteriolosclerosis

Hey guys. In Pathoma, Dr. Sattar said that the hyperglycemia in diabetic patients causes non-enzymatic glycosylation of the vascular basement membranes, and this leads to hyaline arteriolosclerosis. However, in QBank, an explanation to q. id 455 says that the hyaline is because of leakage of plasma components across the endothelium, and also because of excessive extracellular matrix laid down by overly-stimulated smooth muscle cells... Am I missing something? Do both of these processes lead to hyaline arteriolosclerosis?
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Old 05-24-2015
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Actually in diabetes smooth muscles hyperplasia not occur. Whenever smooth muscle changes occur that is called hyperplastic artreriolar sclerosis. In hypertension both changes occur hyaline and hyperplastic. In diabetes only hyaline changes occur By non enzymatic glycation.whenever proteins get deposited in vessels membrane it is called hyaline arteriolar sclerosis
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Old 05-25-2015
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Quote:
Originally Posted by ayeshak View Post
Hey guys. In Pathoma, Dr. Sattar said that the hyperglycemia in diabetic patients causes non-enzymatic glycosylation of the vascular basement membranes, and this leads to hyaline arteriolosclerosis. However, in QBank, an explanation to q. id 455 says that the hyaline is because of leakage of plasma components across the endothelium, and also because of excessive extracellular matrix laid down by overly-stimulated smooth muscle cells... Am I missing something? Do both of these processes lead to hyaline arteriolosclerosis?
Concept >>If its "PINK" PROTEINACEOUS STUFF / COLLAGEN on the H and E stain, its Hyaline.

*First scenario : Hyaline due to non enzymatic glycosylation = more glycoproteins! Pink!

*Second : Plasma Component leak = PINK PROTEIN DEPOSITS MATRIX = COLLAGEN. (Expect somethin real pink!)

**Bonus example : HYALINE membrane dusease of newborn = Less sulfactant. So more inflammatory exudates that leak and cause a HYLANE MEMBRANE around the lungs = PINK!

Pathology stains, describe how the tissue reacts to the stain and what the tissue looks like.
Hope this helps
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Old 05-25-2015
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Originally Posted by gokulramani View Post
Concept >>If its "PINK" PROTEINACEOUS STUFF / COLLAGEN on the H and E stain, its Hyaline.

*First scenario : Hyaline due to non enzymatic glycosylation = more glycoproteins! Pink!

*Second : Plasma Component leak = PINK PROTEIN DEPOSITS MATRIX = COLLAGEN. (Expect somethin real pink!)

**Bonus example : HYALINE membrane dusease of newborn = Less sulfactant. So more inflammatory exudates that leak and cause a HYLANE MEMBRANE around the lungs = PINK!

Pathology stains, describe how the tissue reacts to the stain and what the tissue looks like.
Hope this helps
Both are pink! any images to differentiate would be great, even reference would help.
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Old 05-25-2015
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Originally Posted by Ahmed1992 View Post
Both are pink! any images to differentiate would be great, even reference would help.
Its pretty much the same in all tissues. Dense pink goo...if its PINK its PROTEIN!

Diagnosis would depend on the tissue sample, and clinical history!

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Old 05-29-2015
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Originally Posted by Ahmed1992 View Post
Both are pink! any images to differentiate would be great, even reference would help.
Ahmed and gokul, thanks for your input. This is what I have found in response to my initial question (from pathoma):

1. non-enzymatic glycosylation leads to hyaline arteriolosclerosis
2. the arteriolosclerosis impacts the efferent arteriole more than the afferent arteriole, therefore high GFR --> hyperfiltration --> eventually leads to microalbuminuria
3. eventually, you see nodular glomerulosclerosis with formation of kimmelstiel wilson nodules (not sure if I spelled that correctly lol) which can progress to renal failure.

Hence, the three primary lesions of the kidney in diabetics are 1. vascular 2. glomerular 3. renal papillary necrosis
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