10.13 Injury/ Inflammation/ Healing / Cancer Flashcards
_ is an increased size of cells
Hypertrophy is an increased size of cells
* Ex: weight lifting
_ is a non-neoplastic increase in the number of cells in an organ/tissue
Hyperplasia is a non-neoplastic increase in the number of cells in an organ/tissue
* Physiologic not pathologic
* Ex: mammary tissue increasing during pregnancy
_ is a reduced size of cells or organs
Atrophy is a reduced size of cells or organs
* Ex: old people don’t use muscles so they lose them
_ is a conversion of one differentiated cell type to another
Metaplasia is a conversion of one differentiated cell type to another
Once changes occur to the _ of the cell, the damage is irreversible and cell death will proceed via _ or _
Once changes occur to the nucleus of the cell, the damage is irreversible and cell death will proceed via necrosis or apoptosis
A normal nucleus will appear round with chromatin still _ and nuclear membrane _
A normal nucleus will appear round with chromatin still dispersed and nuclear membrane still intact
_ is when the nucleus shrinks into a blue-black dot due to the chromatin clumping
Pyknosis is when the nucleus shrinks into a blue-black dot due to the chromatin clumping
_ is the fading or disappearance of the nucleus (less blue and distinct)
Karyolysis is the fading or disappearance of the nucleus (less blue and distinct)
_ is the fragmentation of the nucleus
Karyorrhexis is the fragmentation of the nucleus
One big difference between necrosis and apoptosis is that _ is always pathologic
One big difference between necrosis and apoptosis is that necrosis is always pathologic
(Necrosis/ apoptosis) usually involves mutliple cells within the tissue
Necrosis usually involves mutliple cells within the tissue
Another difference in necrosis and apoptosis is that _ can be initiated intrinsically
Another difference in necrosis and apoptosis is that apoptosis can be initiated intrinsically
* Apoptosis- intrinsic or extrinsic signal
* Necrosis- extrinsic signal (burn, hypoxia, toxin)
A series of steps involved in apoptosis ultimately release _ from the mitochondria which causes a _ cascade and disrupts the cytoskeleton
A series of steps involved in apoptosis ultimately release cytochrome c from the mitochondria which causes a caspase cascade and disrupts the cytoskeleton
The intrinsic apoptotic pathway begins with DNA damage activating _ and increasing _
The intrinsic apoptotic pathway begins with DNA damage activating P53 and increasing BAX/BAK
* Leads to cyt c release –> caspase cascade –> cytoskeleton disruption
Alternatively, apoptosis can be triggered extrinsically by _ ligand or by _ adaptive immune cells
Alternatively, apoptosis can be triggered extrinsically by Fas Ligand or by CD8+ adaptive immune cells
_ necrosis is the most common type of necrosis and is caused by loss of blood flow (ischemia)
Coagulative necrosis is the most common type of necrosis and is caused by loss of blood flow (ischemia)
_ necrosis is a type of necrosis associated with abscess formation with intense infiltration of neutrophils (pus-forming)
Liquifactive necrosis is a type of necrosis associated with abscess formation with intense infiltration of neutrophils (pus-forming); it is caused by enzymatic lysis of cells
* Ex: lung abscess with liquifactive necrosis and cavitation
* Neural tissue liquefaction
How would necrotic myocytes look different from normal?
Necrotic myocytes (following MI) are hyper-eosinophilic (pink) and have ghost cells (lack nuclei)
_ necrosis occurs when granuloma formation leads to the death of surrounding tissue
Caseous necrosis occurs when granuloma formation leads to the death of surrounding tissue
What are the common causes of caseous necrosis?
TB infection, histoplasmosis
* These are granuloma-forming
_ necrosis occurs from a breakdown of triglycerides and resulting fat saponification (due to pancreatitis)
Fat necrosis occurs from a breakdown of triglycerides and resulting fat saponification (due to pancreatitis)
_ necrosis is the deposition of fibrin and immune complexes in blood vessel walls
Fibrinoid necrosis is the deposition of fibrin and immune complexes in blood vessel walls
* Associated with vasculitis, autoimmune disease, hypertensive emergencies
4 cardinal signs of acute inflammation:
- Swelling (tumor)
- Redness (rubor)
- Heat (calor)
- Pain (dolor)
What is the goal of acute inflammation?
- We want to deliver effective molecules to the site of injury/inflammation –> vasodilation
- We want to cause blood clotting at the site –> clotting
- We want to promote repair of the tissue –> recruit inflammatory cells
How do we recruit and activate inflammatory cells to come to the site of infection?
Increase expression of leukocyte adhesion molecules on endothelial cells
During acute inflammation, the first innate immune cells to arrive are _
During acute inflammation, the first innate immune cells to arrive are neutrophils
* They will kill microorganisms via phagocytosis
Neutrophil response will peak about _ hours after injury/infection
Neutrophil response will peak after 24 hours after injury/infection
_ are the predominant cell type 48-72 hours after injury/infection
Macrophages are the predominant cell type 48-72 hours after injury/infection
What are the steps of neutrophil migration?
- Margination: increased vascular permeability leads to increased hemoconcentration which increases the probability of neutrophils contacting the endothelium; “marginate” meaning they move toward the periphery of blood flow
- Rolling: slows the neutrophil down; Sialyl-lewis glycoproteins interact with the “selectin speed bumps”
- Binding: tight adhesion with ICAM-1 on the endothelium stops the neutrophil in place
- Diapedesis: neutrophil crawls between endothelial cells (PECAM-1)
- Chemotaxis: IL-8
Neutrophil rolling involves _ glycoproteins on the neutrophil interacting with _ on the endothelium
Neutrophil rolling involves sialyl-lewis glycoproteins on the neutrophil interacting with E-selectin, P-selectin on the endothelium; selectin speed bumps slow down neutrophil
Neutrophil binding involves an integrin on the neutrophil interacting with _ on the endothelium
Neutrophil binding involves an integrin on the neutrophil interacting with ICAM-1 on the endothelium
Diapedesis/ migration of neutrophils through the endothelium involves _
Diapedesis/ migration of neutrophils through the endothelium involves PECAM-1
Chronic inflammation can onset _ hours after injury/infection and can last weeks, months, years
Chronic inflammation can onset 48 hours after injury/infection and can last weeks, months, years
_ inflammation is exudative
_ inflammation is proliferative
acute inflammation is exudative
chronic inflammation is proliferative
_ are the main cells of acute inflammation
_ are the main cells of chronic
Neutrophils are the main cells of acute inflammation
Macrophages, lymphocytes, plasma cells are the main cells of chronic inflammation
What are the manifestations/ results of acute inflammation?
Vascular changes, edema, pus, abscess
What are the manifestations/ results of chronic inflammation?
Tissue destruction, angiogenesis, fibrosis, granulomas
Define these consequences of chronic inflammation:
Fibrosis:
Angiogenesis:
Tissue remodeling:
Define these consequences of chronic inflammation:
Fibrosis: scar formation
Angiogenesis: new vessel formation
Tissue remodeling: alter structure to suit new environment
coagulative necrosis
Liquifactive necrosis
Caseous necrosis
fat necrosis
Fibrinoid necrosis
Caseous necrosis (infectious granuloma)
Non-infectious/ non-caseating granuloma (ex: sarcoidosis)
Fat necrosis in the pancreas
Liquifactive necrosis
Coagulative necrosis (myocyte)
_ is chronic inflammation of arteries
Atherosclerosis is chronic inflammation of arteries
_ is cirrhosis or scarring of the liver parenchyma
Hepatic fibrosis is cirrhosis or scarring of the liver parenchyma
_ are tracts that form between hollow organs
Fistulas are tracts that form between hollow organs
_ are tumor-like nodules formed by activated macrophages which can fuse into giant cells and be surrounded by T lymphocytes
Granulomas are tumor-like nodules formed by activated macrophages which can fuse into giant cells and be surrounded by T lymphocytes
* Infectious: TB
* Autoimmune: Sarcoidosis
Tissue repair following MI:
1. Acute inflammation and _ necrosis
Tissue repair following MI:
1. Acute inflammation and coagulative necrosis
Tissue repair following MI:
1. Acute inflammation and coagulative necrosis
2. Proliferation of fibroblasts and vasculature in attempt to repair –> _ tissue
Tissue repair following MI:
1. Acute inflammation and coagulative necrosis
2. Proliferation of fibroblasts and vasculature in attempt to repair –> granulation tissue
Tissue repair following MI:
1. Acute inflammation and coagulative necrosis
2. Proliferation of fibroblasts and vasculature in attempt to repair –> granulation tissue
3. Heart cannot repair itself; we have collagen maturation and _ tissue formation
Tissue repair following MI:
1. Acute inflammation and coagulative necrosis
2. Proliferation of fibroblasts and vasculature in attempt to repair –> granulation tissue
3. Heart cannot repair itself; we have collagen maturation and fibrous (scar) tissue formation
Whether a tissue is able to regenerate or will instead be replaced by fibrosis (scar) is determined by two factors _ and _
Whether a tissue is able to regenerate or will instead be replaced by fibrosis (scar) is determined by two factors tissue type and extent of damage to the ECM
Neurons, cardiac muscle, and skeletal muscle are examples of _ tissue which undergo fibrosis
Neurons, cardiac muscle, and skeletal muscle are examples of non-dividing tissues which undergo fibrosis
Labile tissues (are/ are not) able to regenerate
Labile tissues can regenerate –> these are continuously dividng tissues like the skin
_ is a new or abnormal growth of tissue in the body
Neoplasma is a new or abnormal growth of tissue in the body
* Unregulated, irreversible, monoclonal
_ is the feature of a neoplasm (tumor) that classifies it as malignant
Metastasis is the feature of a neoplasm (tumor) that classifies it as malignant
_ is a term that describes the degree to which neoplastic cells resemble the tissue of origin
Differentiation is a term that describes the degree to which neoplastic cells resemble the tissue of origin
* Well differentiated means that the neoplastic cells still look similar to the original tissue
_ describes a neoplasm that does not resemble the tissue of origin at all (high grade)
Anaplastic describes a neoplasm that does not resemble the tissue of origin at all (high grade)
(Stage/ Grade) is the histologic features of the neoplasm (degrees of differentiation)
Grade is the histologic features of the neoplasm (degrees of differentiation)
* better predictor of prognosis
What does cancer stage refer to?
Stage: tumor size and the extent of the spread
Barret’s esophagus is a condition where the esophagus is chronically exposed to HCl from the gut, which triggers the replacement of _ cells with _ cells; this is an example of _
Barret’s esophagus is a condition where the esophagus is chronically exposed to HCl from the gut, which triggers the replacement of stratified squamous cells with columnar cells; this is an example of metaplasia
Tobacco smoke causes another type of metaplasia where _ cells are replaced with _ in the bronchi
Tobacco smoke causes another type of metaplasia where columnar cells are replaced with squamous epithelium in the bronchi
What is dysplasia?
Dysplasia is disordered growth/formation; involves various shapes, sizes, staining of cells
* These cells are rapidly dividing
* There is an increase in ratio of nucleus: cytoplasm
Cancers that end in -oma are normally (benign/ malignant)
Cancers that end in -oma are normally benign
Cancers that end in _ or _ are normally malignant
Cancers that end in -carcinoma or -sarcoma are normally malignant
What are some neoplastic cancers that are the exception to the naming rules?
Neoplastic cancers:
* Lymphoma (Lymphocytes)
* Leukemia (WBCs)
* Mesothelioma
* Melanoma
* Seminoma (male germ cells)
_ is disorganized tissue indigenous to the site
Hamartoma is disorganized tissue indigenous to the site (harmless)
_ are microscopically normal cells in an abnormal location
Choristomas are microscopically normal cells in an abnormal location (benign)
4 steps of metastasis
- Invasion decrease cell adhesions (disrupt cadherins and catenins)
- Intravasation: entry into bloodstream/ lymphatics
- Extravasation: exit the bloodstream and into the tissue
- Growth at secondary site: need favorable growing conditions
3 routes of metastasis
- Hematogenous: blood
- Lymphatic: lymphatic system
- Seeding: spreading through body cavities
What are paraneoplastic syndromes?
Paraneoplastic syndromes: groups of signs and sx that occur in cancer patients but aren’t directly related to the tumor growth itself
* Ex: squamous cell carcinomas can cause hypercalcemia
(True/ False) stress on skeletal muscle can cause hyperplasia
False; skeletal muscle is a permanent tissue –> permanent tissues cannot make new cells –> undergo hypertrophy only
Metaplasia is technically reversible if stress conditions are removed; however, if not, it can progress to _
Metaplasia is technically reversible if stress conditions are removed; however, if not, it can progress to dysplasia
_ necrosis is a coagulative necrosis that resembles mummified tissue; it is characterized by ischemia of the lower limb or GI tract
Gangrenous necrosis is a coagulative necrosis that resembles mummified tissue; it is characterized by ischemia of the lower limb or GI tract
* If superimposed infection of dead tissue happens –> liquifactive necrosis –> wet gangrene
Noncaseating granulomas are different from caseating granulomomas because they lack _
Noncaseating granulomas are different from caseating granulomomas because they lack central necrosis
The most common cancers by incidence are:
1. 2. 3
Incidence:
1. Breat, prostate
2. Lung
3. Colorectal
The most common cancers by mortality are:
1. 2. 3
Mortality:
1. Lung
2. Breat/prostate
3. Colorectal
