04a: Pathology 1

Question 1

List the cell/tissue adaptations to stress.

Answer 1

1. Hyperplasia
2. Metaplasia
3. Hypertrophy
4. Atrophy

Question 2

Cell adaptation: Increase in number of cells, resulting in increased volume of tissue/organ.

Answer 2

Hyperplasia

Question 3

T/F: Hyperplasia is indicative of pathology.

Answer 3

False - can be physiologic (ex: lactating breast) or pathologic (ex: BPH)

Question 4

T/F: In both physiologic and pathologic hyperplasia, when the stimulus that induces it is removed, proliferation ceases.

Answer 4

True

Question 5

Responses of uterus and breasts in pregnancy/lactation are examples of (hyperplasia/metaplasia/hypertrophy).

Answer 5

Both hyperplasia and hypertrophy (often occur in association)

Question 6

T/F: Hypertrophy does not require a cell population

capable of cell division, but can occur in fully mature non-dividing cells.

Answer 6

True

Question 7

Cell adaptation: Increase in size of cells, resulting in increased volume of tissue/organ.

Answer 7

Hypertrophy

Question 8

Example(s) of physiologic hypertrophy.

Answer 8

1. Hepatocyte hypertrophy (demand for drug metabolism)

2. Muscle hypertrophy

Question 9

(X) appear to be the major triggers for physiologic hypertrophy. In pathologic states, (Y) signals may be more important.

Answer 9

X = mechanical stretch/sensors
Y = alpha-adrenergic hormones, angiotensin, and growth factors

Question 10

Cell adaptation: Shrinkage of a tissue due to loss of cell (substance/number).

Answer 10

Atrophy;

Either

Question 11

(X) is a pathway responsible for

accelerated proteolysis in atrophy.

Answer 11

X = ubiquitin-proteasome

Question 12

Sequestration of cell organelles into (X) that fuse with (Y) and digest enclosed material.

Answer 12

X = autophagic 
Y = lysosomes

Autophagy

Question 13

Atrophic cells ultimately accumulate numerous shrunken

X) that contain only lipofuschin, the residue of (Y). These structures are called (Z

Answer 13

X = lysosomes
Y = hydrolytic enzyme digestion
Z = residual bodies

Question 14

Metaplasia is (reversible/irreversible) change in which (epithelial/mesenchymal) cell is replaced by (X).

Answer 14

Reversible;
Either;
X = another adult cell type

Question 15

Metaplasia is induced by (X) and results from the reprogramming of (Y) cells.

Answer 15

X = cytokines and growth factors
Y = tissue stem

Question 16

List the general causes of cell injury.

Answer 16

1. Hypoxia
2. Physical, chemical, infectious agents
3. Immunologic reactions
4. Genetics and nutrition

Question 17

Reversible cell injury has which two characteristic features/changes in cell?

Answer 17

1. Cell swelling

2. Fatty change/accumulation

Question 18

Necrosis: Disruption/fragmentation of cell membranes, forming spiral aggregates called (X).

Answer 18

X = myelin bodies

Question 19

A reliable morphologic characteristic of necrosis is (X) of which organelle?

Answer 19

X = absence or fragmentation

Nucleus

Question 20

(Cell death/ultrastructural changes) occurs first on timeframe of changes in necrosis.

Answer 20

Cell death

Question 21

(X) necrosis is typical of ischemic injury.

Answer 21

X = coagulative

Question 22

Gangrenous necrosis is example of (fibrinoid/caseous/coagulative) necrosis.

Answer 22

coagulative

Question 23

(X) necrosis shows no ghost outlines because dead cells undergo (Y). What is the gross appearance of this necrosis?

Answer 23

X = liquefactive
Y = hydrolysis by enzymes from ruptured lysosomes

Viscous liquid then cavity

Question 24

(X) necrosis is seen following bacterial infection.

Answer 24

X = liquefactive

Question 25

(X) necrosis seen as result of lung abscess or CNS infarct.

Answer 25

X = liquefactive

Question 26

(X) necrosis describes gross appearance of that seen in (Y) tissue in TB.

Answer 26

``` X = caseous (cheesy) Y = lung ```

Question 27

(X) necrosis produced by action of free pancreatic enzyme on adjacent, mainly (Y), tissues.

Answer 27

X = Y = fat

Question 28

In (X) necrosis, the release of FA from the tissue promotes early formation of (Y) deposits.

Answer 28

``` X = fat Y = Ca ```

Question 29

(X) necrosis seen in immune reactions, involving (Y) structures.

Answer 29

``` X = fibrinoid Y = blood vessels ```

Question 30

(X) necrosis: appearance of bright pink amorphous material called (Y). What forms this?

Answer 30

X = Y = fibrinoid Ag and Ab and fibrin complexes

Question 31

ATP depletion to (X)% levels is a potential deathblow to cell. This depletion is most frequently caused by (Y).

Answer 31

``` X = 5-10 Y = anoxia ```

Question 32

Influx of (X) to cytosol has damaging effects to cell due to which 2 effects/mechanisms?

Answer 32

X = Ca 1. Increase mito permeability 2. Activates multiple cell enzymes (ATPases, proteases, endonucleases)

Question 33

Re-perfusion of tissue following period of ischemia can be damaging to cells for what reason?

Answer 33

Major buildup of ROS

Question 34

T/F: Apoptosis is more often a pathologic process than a physiologic one.

Answer 34

False - vise versa

Question 35

T/F: Apoptotic process preserves targeted cell membrane intact.

Answer 35

True

Question 36

Execution of (apoptosis/necrosis) is accomplished by activation of (X) enzymes cascade.

Answer 36

Apoptosis; | X = caspase

Question 37

T/F: Both necrosis and apoptosis involve inflammatory response.

Answer 37

False - only necrosis

Question 38

List some adaptive/physiologic causes of apoptosis.

Answer 38

1. Organogenesis 2. Hormone-dependent involution (ex: menstrual cycle) 3. Cell deletion/replacement in proliferating cell populations 4. Immune stuff (neutrophils, self-reactive lymphocytes)

Question 39

(Apoptosis/necrosis) in response to (X) is the mechanism important in neurodegenerative diseases, such as AD and Parkinson's.

Answer 39

Apoptosis; | X = misfolded protein accumulation in ER

Question 40

Necroptosis resembles (apoptosis/necrosis) morphologically and (apoptosis/necrosis) mechanistically.

Answer 40

Necrosis; apoptosis

Question 41

(Necrosis/apoptosis/necroptosis) is driven by signaling by RIP1 and RIP3 protein complexes.

Answer 41

Necroptosis

Question 42

T/F: Cell swelling and membrane damage is seen in necroptosis.

Answer 42

True

Question 43

T/F: Inflammatory reaction is seen in necroptosis.

Answer 43

True

Question 44

T/F: Necroptosis is unique to pathological conditions.

Answer 44

False - also seen in some normal processes

Question 45

The (extrinsic/intrinsic) (X) apoptotic pathway involves cell injury such as (Y).

Answer 45

Intrinsic; X = mitochondrial Y = DNA damage, protein misfolding

Question 46

The (extrinsic/intrinsic) (X) apoptotic pathway occurs when ligands, often present on (Y) engage (Z) membrane receptors.

Answer 46

Extrinsic; X = death receptor Y = T lymphocytes Z = TNF

Question 47

The (extrinsic/intrinsic) (X) apoptotic pathway: bcl2 and bclx replaced by bak and bax on (Y) membrane. What does this do?

Answer 47

Intrinsic; X = Y = mitochondrial Increase membrane permeability and cytochrome c released into cytoplasm (activates caspase cascade)