04b: Pathology 2 Flashcards
List the elements of tissue repair.
- Regeneration
2. Fibrosis
(Stable/Labile/Permanent) cells are continuously dividing cells. Give examples.
Labile; surface epithelia
(Stable/Labile/Permanent) cells are infrequently dividing cells.
Stable; liver, smooth muscle
(Stable/Labile/Permanent) cells are rarely or non- dividing cells.
Permanent; neurons, skeletal muscle
Ideal outcome of repair is (X), aka healing by (primary/secondary) intention.
X = regeneration
Primary
(X) is also referred to as healing by secondary intention. It occurs if regeneration is not possible.
X = fibrosis/fibroplasia
(Adult/embryonic) stem cells are derived from (X) and are pluripotent.
Embryonic;
X = developing blastocyst
T/F: Adult stem cells reside permanently in most organs.
True
Healing of tissue defects is usually (regeneration/fibrosis).
Combination of both
List examples of diseases that are complicated by fibrosis.
- MI (myocardial fibrosis)
- Chronic viral hep (liver cirrhosis)
- Diffuse alveolar damage (pulm interstitial fibrosis)
List some local factors that affect wound healing.
- Blood/nerve supply
- Infection, foreign bodies
- Necrotic tissue
- Mechanical stress
- Type/location of tissue
- Surgical technique used
List some systemic factors that affect wound healing.
- Diabetes, malnutrition, Vit C deficiency
- Steroids
- Hypoxia
- Malignancy (cancer)
List the first step in tissue repair and the corresponding tissue layer.
Inflammation;
Acute inflamm and necrotic cell mass
List the second step in tissue repair and the corresponding tissue layer.
Cell proliferation and Migration;
Granulation tissue
List the third step in tissue repair and the corresponding tissue layer.
Synthesis of ECM;
Granulation tissue and ECM
List the fourth step in tissue repair and the corresponding tissue layer.
Remodeling of ECM;
Fibrous scar
Tissue repair: In the inflammation step, which tissue elements are present in that layer?
- Fibrin
- Neutrophils, macrophages
- Platelets
Tissue repair: The purpose of acute inflammation is to…
Contain injury and initiate reparative process
Tissue repair: In the inflammation step, which molecular elements play key roles?
- Cytokines (interleukins, interferons, TNF)
2. Growth Factors (FGF, PDGF)
Tissue repair: In layer 2, there’s an ingrowth of (X) cells to form (Y).
X = fibroblasts, endothelial cells Y = granulation tissue (specialized reparative stroma)
Tissue repair: (X) layer/tissue is the “organ of repair” that ultimately produces (Y) tissue.
X = Layer 2 (granulation tissue) Y = mature scar (layer 4)
Tissue repair: which tissue layer undergoes (X) process, which involves formation of new vessels?
X = angiogensis
Layer 2 (granulation tissue)
Angiogenesis is driven by multiple (cytokines/growth factors), particularly (X).
Growth factors;
X = VEGF
List the steps of angiogenesis from pre-existing vessels.
- Basement membrane degradation
- Endothelial cell migration
- Endothelial cell prolif
- Maturation and tube formation
Growth factors are typically (CHO/peptides/steroids) that signal via (autocrine/paracrine/endocrine) mechanism.
Peptides;
All
(X) and (Y) are related growth factors that induce wide variety of cells (including epithelial and fibroblasts) to divide.
X = EGF Y = TGF-alpha
(X) growth factor is stored in alpha granules of platelets, as well as in some other cells. Among its effects are induction of (growth/migration/prolif) of (Y) cells.
X = PDGF
Migration and proliferation
Y = endothelial and fibroblasts
(X) growth factor is produced by variety of cells. Among its effects are induction of (growth/migration/prolif) of (Y) cells as well as angiogenesis.
X = FGF;
Migration
Y = macrophage, fibroblast, endothelial
(X) growth factor induces increased vascular permeability and is essential to (Y).
X = VEGF Y = angiogenesis
(X) growth factor can function as growth inhibitory and stimulatory agent, depending on tissue environment. It stimulates production of (Y).
X = TGF-beta Y = collagen and fibronectin
(X) is an important growth factor in development of fibrosis in many chronic inflammatory conditions.
X = TGF-beta
ECM: functions to give tissues physical properties such as (X).
X = turgor, elasticity, rigidity
Tissue repair: which tissue layer acts as reservoir for growth factors?
ECM (layer 3, granulation tissue and ECM)
Tissue repair: which tissue layer provides substratum/matrix for cells to use for (X)?
ECM (layer 3, granulation tissue and ECM);
X = adherence/migration
ECM is found in which two distinct domains?
- Basal membrane
2. Interstitial matrix
Fibrillary collagens would be found in (X) domain of ECM. Non-fibrillary collagens in (Y) domain. And elastin in (Z) domain.
X = Z = interstitial matrix Y = both (interstitial matrix and basement membrane)
ECM consists mainly of which groups of macromolecules?
- Fibrous structural proteins
- CAMs (cell adhesion proteins)
- Proteoglycans and Hyaluronan
Most collagen types are (fibrillary/non-fibrillary). Type (X) is the exception, which forms in which structural shape?
Fibrillary;
X = 4
Sheets
(Elastins/collagens) have numerous (X), a property that confers tensile strength to these macromolecules.
Collages;
X = cross linkages (between adjacent molecules)
(Elastins/collagens) are abundant in structures like the aorta, uterus, ligaments due to the tissue’s ability to (X).
Elastins;
X = stretch and recoil
CAMs are cell adhesion (X) that function to (Y). List some important examples.
X = glycoproteins Y = link cells and ECM
- Cadherins
- Integrins
- Fibronectin
- Laminin
(X) are the major family of transmembrane cell surface receptors that mediate cell attachment to ECM.
X = integrins
Which part of ECM involved in organizing the actin cytoskeleton of cells to induce shape alterations and cell movement?
Integrins
ECM: (X) is large adhesive glycoprotein with specific binding domains. List the cells that produce it.
X = fibronectin
Monocytes, fibroblasts, endothelial cells
ECM: (X) is the most abundant glycoprotein in basement membranes, spanning the entire membrane. IT binds specific surface receptors to (Y).
X = laminin Y = collagen type 4 and heparan sulfate
ECM: (X) consist of core proteins linked to one or more disaccharide polymers called (Y). What’s the role/function?
X = proteoglycans Y = GAGs (glycosaminoglycans)
Regulate ECM structure/permeability
ECM: (X) is a large molecule consisting of numerous simple (mono/di/tri)-saccharide repeats. It associates with various core proteins and surface receptors.
X = hyaluronan
Disaccharide
ECM: (X) molecule binds (Y) to give tissues turgor pressure. It’s abundant in matrix of cells that are actively (growing/dividing/migrating/differentiating).
X = hyaluronan Y = water
Migrating
Tissue repair: ECM of layer 4 consists predominantly of (X).
X = collagen fibers
ECM remodeling achieved by process of degradation of (X) by (Y) enzymes.
X = collagen (and other ECM proteins) Y = metalloproteinases
ECM remodeling involves synthesis of new (X) by (Y) cells.
X = collagen bundles Y = fibroblasts
ECM remodeling: (X) cells contract and draw the edges of tissue defect together. What’s the fate of blood vessels?
X = myofibroblasts
Apoptosis
