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MTC 3- Immunology > 10.13 Injury/ Inflammation/ Healing / Cancer > Flashcards

10.13 Injury/ Inflammation/ Healing / Cancer Flashcards

1
Q

_ is an increased size of cells

A

Hypertrophy is an increased size of cells
* Ex: weight lifting

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2
Q

_ is a non-neoplastic increase in the number of cells in an organ/tissue

A

Hyperplasia is a non-neoplastic increase in the number of cells in an organ/tissue
* Physiologic not pathologic
* Ex: mammary tissue increasing during pregnancy

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3
Q

_ is a reduced size of cells or organs

A

Atrophy is a reduced size of cells or organs
* Ex: old people don’t use muscles so they lose them

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4
Q

_ is a conversion of one differentiated cell type to another

A

Metaplasia is a conversion of one differentiated cell type to another

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5
Q

Once changes occur to the _ of the cell, the damage is irreversible and cell death will proceed via _ or _

A

Once changes occur to the nucleus of the cell, the damage is irreversible and cell death will proceed via necrosis or apoptosis

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6
Q

A normal nucleus will appear round with chromatin still _ and nuclear membrane _

A

A normal nucleus will appear round with chromatin still dispersed and nuclear membrane still intact

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7
Q

_ is when the nucleus shrinks into a blue-black dot due to the chromatin clumping

A

Pyknosis is when the nucleus shrinks into a blue-black dot due to the chromatin clumping

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8
Q

_ is the fading or disappearance of the nucleus (less blue and distinct)

A

Karyolysis is the fading or disappearance of the nucleus (less blue and distinct)

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9
Q

_ is the fragmentation of the nucleus

A

Karyorrhexis is the fragmentation of the nucleus

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10
Q

One big difference between necrosis and apoptosis is that _ is always pathologic

A

One big difference between necrosis and apoptosis is that necrosis is always pathologic

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11
Q

(Necrosis/ apoptosis) usually involves mutliple cells within the tissue

A

Necrosis usually involves mutliple cells within the tissue

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12
Q

Another difference in necrosis and apoptosis is that _ can be initiated intrinsically

A

Another difference in necrosis and apoptosis is that apoptosis can be initiated intrinsically
* Apoptosis- intrinsic or extrinsic signal
* Necrosis- extrinsic signal (burn, hypoxia, toxin)

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13
Q

A series of steps involved in apoptosis ultimately release _ from the mitochondria which causes a _ cascade and disrupts the cytoskeleton

A

A series of steps involved in apoptosis ultimately release cytochrome c from the mitochondria which causes a caspase cascade and disrupts the cytoskeleton

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14
Q

The intrinsic apoptotic pathway begins with DNA damage activating _ and increasing _

A

The intrinsic apoptotic pathway begins with DNA damage activating P53 and increasing BAX/BAK
* Leads to cyt c release –> caspase cascade –> cytoskeleton disruption

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15
Q

Alternatively, apoptosis can be triggered extrinsically by _ ligand or by _ adaptive immune cells

A

Alternatively, apoptosis can be triggered extrinsically by Fas Ligand or by CD8+ adaptive immune cells

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16
Q

_ necrosis is the most common type of necrosis and is caused by loss of blood flow (ischemia)

A

Coagulative necrosis is the most common type of necrosis and is caused by loss of blood flow (ischemia)

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17
Q

_ necrosis is a type of necrosis associated with abscess formation with intense infiltration of neutrophils (pus-forming)

A

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

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18
Q

How would necrotic myocytes look different from normal?

A

Necrotic myocytes (following MI) are hyper-eosinophilic (pink) and have ghost cells (lack nuclei)

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19
Q

_ necrosis occurs when granuloma formation leads to the death of surrounding tissue

A

Caseous necrosis occurs when granuloma formation leads to the death of surrounding tissue

Cheese appearance
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20
Q

What are the common causes of caseous necrosis?

A

TB infection, histoplasmosis
* These are granuloma-forming

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21
Q

_ necrosis occurs from a breakdown of triglycerides and resulting fat saponification (due to pancreatitis)

A

Fat necrosis occurs from a breakdown of triglycerides and resulting fat saponification (due to pancreatitis)

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22
Q

_ necrosis is the deposition of fibrin and immune complexes in blood vessel walls

A

Fibrinoid necrosis is the deposition of fibrin and immune complexes in blood vessel walls
* Associated with vasculitis, autoimmune disease, hypertensive emergencies

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23
Q

4 cardinal signs of acute inflammation:

A
  1. Swelling (tumor)
  2. Redness (rubor)
  3. Heat (calor)
  4. Pain (dolor)
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24
Q

What is the goal of acute inflammation?

A
  • 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
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25
Q

How do we recruit and activate inflammatory cells to come to the site of infection?

A

Increase expression of leukocyte adhesion molecules on endothelial cells

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26
Q

During acute inflammation, the first innate immune cells to arrive are _

A

During acute inflammation, the first innate immune cells to arrive are neutrophils
* They will kill microorganisms via phagocytosis

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27
Q

Neutrophil response will peak about _ hours after injury/infection

A

Neutrophil response will peak after 24 hours after injury/infection

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28
Q

_ are the predominant cell type 48-72 hours after injury/infection

A

Macrophages are the predominant cell type 48-72 hours after injury/infection

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29
Q

What are the steps of neutrophil migration?

A
  1. 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
  2. Rolling: slows the neutrophil down; Sialyl-lewis glycoproteins interact with the “selectin speed bumps”
  3. Binding: tight adhesion with ICAM-1 on the endothelium stops the neutrophil in place
  4. Diapedesis: neutrophil crawls between endothelial cells (PECAM-1)
  5. Chemotaxis: IL-8
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30
Q

Neutrophil rolling involves _ glycoproteins on the neutrophil interacting with _ on the endothelium

A

Neutrophil rolling involves sialyl-lewis glycoproteins on the neutrophil interacting with E-selectin, P-selectin on the endothelium; selectin speed bumps slow down neutrophil

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31
Q

Neutrophil binding involves an integrin on the neutrophil interacting with _ on the endothelium

A

Neutrophil binding involves an integrin on the neutrophil interacting with ICAM-1 on the endothelium

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32
Q

Diapedesis/ migration of neutrophils through the endothelium involves _

A

Diapedesis/ migration of neutrophils through the endothelium involves PECAM-1

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33
Q

Chronic inflammation can onset _ hours after injury/infection and can last weeks, months, years

A

Chronic inflammation can onset 48 hours after injury/infection and can last weeks, months, years

34
Q

_ inflammation is exudative
_ inflammation is proliferative

A

acute inflammation is exudative
chronic inflammation is proliferative

35
Q

_ are the main cells of acute inflammation
_ are the main cells of chronic

A

Neutrophils are the main cells of acute inflammation
Macrophages, lymphocytes, plasma cells are the main cells of chronic inflammation

36
Q

What are the manifestations/ results of acute inflammation?

A

Vascular changes, edema, pus, abscess

37
Q

What are the manifestations/ results of chronic inflammation?

A

Tissue destruction, angiogenesis, fibrosis, granulomas

38
Q

Define these consequences of chronic inflammation:
Fibrosis:
Angiogenesis:
Tissue remodeling:

A

Define these consequences of chronic inflammation:
Fibrosis: scar formation
Angiogenesis: new vessel formation
Tissue remodeling: alter structure to suit new environment

39
Q
A

coagulative necrosis

40
Q
A

Liquifactive necrosis

41
Q
A

Caseous necrosis

42
Q
A

fat necrosis

43
Q
A

Fibrinoid necrosis

44
Q
A

Caseous necrosis (infectious granuloma)

45
Q
A

Non-infectious/ non-caseating granuloma (ex: sarcoidosis)

46
Q
A

Fat necrosis in the pancreas

47
Q
A

Liquifactive necrosis

48
Q
A

Coagulative necrosis (myocyte)

49
Q

_ is chronic inflammation of arteries

A

Atherosclerosis is chronic inflammation of arteries

50
Q

_ is cirrhosis or scarring of the liver parenchyma

A

Hepatic fibrosis is cirrhosis or scarring of the liver parenchyma

51
Q

_ are tracts that form between hollow organs

A

Fistulas are tracts that form between hollow organs

52
Q

_ are tumor-like nodules formed by activated macrophages which can fuse into giant cells and be surrounded by T lymphocytes

A

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

53
Q

Tissue repair following MI:
1. Acute inflammation and _ necrosis

A

Tissue repair following MI:
1. Acute inflammation and coagulative necrosis

54
Q

Tissue repair following MI:
1. Acute inflammation and coagulative necrosis
2. Proliferation of fibroblasts and vasculature in attempt to repair –> _ tissue

A

Tissue repair following MI:
1. Acute inflammation and coagulative necrosis
2. Proliferation of fibroblasts and vasculature in attempt to repair –> granulation tissue

55
Q

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

A

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

56
Q

Whether a tissue is able to regenerate or will instead be replaced by fibrosis (scar) is determined by two factors _ and _

A

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

57
Q

Neurons, cardiac muscle, and skeletal muscle are examples of _ tissue which undergo fibrosis

A

Neurons, cardiac muscle, and skeletal muscle are examples of non-dividing tissues which undergo fibrosis

58
Q

Labile tissues (are/ are not) able to regenerate

A

Labile tissues can regenerate –> these are continuously dividng tissues like the skin

59
Q

_ is a new or abnormal growth of tissue in the body

A

Neoplasma is a new or abnormal growth of tissue in the body
* Unregulated, irreversible, monoclonal

60
Q

_ is the feature of a neoplasm (tumor) that classifies it as malignant

A

Metastasis is the feature of a neoplasm (tumor) that classifies it as malignant

61
Q

_ is a term that describes the degree to which neoplastic cells resemble the tissue of origin

A

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

62
Q

_ describes a neoplasm that does not resemble the tissue of origin at all (high grade)

A

Anaplastic describes a neoplasm that does not resemble the tissue of origin at all (high grade)

63
Q

(Stage/ Grade) is the histologic features of the neoplasm (degrees of differentiation)

A

Grade is the histologic features of the neoplasm (degrees of differentiation)
* better predictor of prognosis

64
Q

What does cancer stage refer to?

A

Stage: tumor size and the extent of the spread

65
Q

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 _

A

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

66
Q

Tobacco smoke causes another type of metaplasia where _ cells are replaced with _ in the bronchi

A

Tobacco smoke causes another type of metaplasia where columnar cells are replaced with squamous epithelium in the bronchi

67
Q

What is dysplasia?

A

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

68
Q

Cancers that end in -oma are normally (benign/ malignant)

A

Cancers that end in -oma are normally benign

69
Q

Cancers that end in _ or _ are normally malignant

A

Cancers that end in -carcinoma or -sarcoma are normally malignant

70
Q

What are some neoplastic cancers that are the exception to the naming rules?

A

Neoplastic cancers:
* Lymphoma (Lymphocytes)
* Leukemia (WBCs)
* Mesothelioma
* Melanoma
* Seminoma (male germ cells)

71
Q

_ is disorganized tissue indigenous to the site

A

Hamartoma is disorganized tissue indigenous to the site (harmless)

72
Q

_ are microscopically normal cells in an abnormal location

A

Choristomas are microscopically normal cells in an abnormal location (benign)

73
Q

4 steps of metastasis

A
  1. Invasion decrease cell adhesions (disrupt cadherins and catenins)
  2. Intravasation: entry into bloodstream/ lymphatics
  3. Extravasation: exit the bloodstream and into the tissue
  4. Growth at secondary site: need favorable growing conditions
74
Q

3 routes of metastasis

A
  1. Hematogenous: blood
  2. Lymphatic: lymphatic system
  3. Seeding: spreading through body cavities
75
Q

What are paraneoplastic syndromes?

A

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

76
Q

(True/ False) stress on skeletal muscle can cause hyperplasia

A

False; skeletal muscle is a permanent tissue –> permanent tissues cannot make new cells –> undergo hypertrophy only

77
Q

Metaplasia is technically reversible if stress conditions are removed; however, if not, it can progress to _

A

Metaplasia is technically reversible if stress conditions are removed; however, if not, it can progress to dysplasia

78
Q

_ necrosis is a coagulative necrosis that resembles mummified tissue; it is characterized by ischemia of the lower limb or GI tract

A

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

79
Q

Noncaseating granulomas are different from caseating granulomomas because they lack _

A

Noncaseating granulomas are different from caseating granulomomas because they lack central necrosis

80
Q

The most common cancers by incidence are:
1. 2. 3

A

Incidence:
1. Breat, prostate
2. Lung
3. Colorectal

81
Q

The most common cancers by mortality are:
1. 2. 3

A

Mortality:
1. Lung
2. Breat/prostate
3. Colorectal

MTC 3- Immunology (8 decks)

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