2 Lecture

Question 1

Define Pathology

Answer 1

The study of suffering (Disease)

Question 2

What is the difference between general pathology and systemic pathology?

Answer 2

general= basic reactions common to most tissues

systemic=specific responses in specific organs/tissues

Question 3

what is the difference between the anatomic pathologist and the clinical pathologist?

Answer 3

anatomical= morphology based to figure out what etiology/pathogenesis mainly done under microscope.

Clinical= interpretation of laboratory data and very little morphology. This generally involves the study of body fluids even down to mutated genes.

Question 4

What are the 4 aspects of a disease in order?

Answer 4

1) Etiology
2) Pathogenesis
3) Morphological changes
4) Clinical significance

(Note: of these 4, clinical pathologist generally focus on all except for #3. Anatomical pathologists focus on 3)

Question 5

T/F All diseases start with abnormalities in cells?

Answer 5

True (for us)

Question 6

What can we learn from the morphology of a cell?

Answer 6

The morphology of a cell can tell you a lot about the etiology/pathogenesis as well as the clinical behavior of the disease.

Question 7

What are the two different categories of etiologies of a disease?

Answer 7

1) intrinsic= genetic problem from birth

2) acquired= hypoxia/ischemia, physical/chemical damage, nutritional defects, newly acquired mutations, etc.

Question 8

What generally happens to cells when there is an added stress put on them? What will happen if this is long term?

Answer 8

The cells try to adapt to the situation by methods such as hypertrophy/atrophy, hyperplasia/dysplasia, etc.

If this goes on long term you generally get cell injury when the cells are no longer able to adapt to the situation.

Question 9

If you have a severely injured cell, what 2 options does it have to die?

Answer 9

1) apoptosis

2) necrosis (the majority of the cells will undergo the necrosis method)

Question 10

When can you see the morphological changes in cells under a light microscope?

Answer 10

Only after prolonged or severe injury.

Question 11

What is the general trend (time frame) for noticing irreversible cell damage ?

Answer 11

1st in Labs
2nd in EM
3rd with Light microscope
4th with Autopsy/surgery/radiology

Question 12

what is hyperplasia?

Answer 12

hyperplasia=more cells are produced

Question 13

what is metaplasia?

Answer 13

metaplasia= cells change differentiation

Question 14

what is dystrophic calcification?

Answer 14

calcification occurring in degenerated or necrotic tissue.

This is NI serum Ca+

Question 15

what is metastatic calcification

Answer 15

Metastatic calcification=deposition of calcium salts in otherwise normal tissue because of elevated serum levels of calcium. (hypercalcemia)

Question 16

What is a hyaline change? (intracellular and extracellular)

Answer 16

hyaline change =a pale, eosinophilic, homogeneous glassy appearance by H&E; it is a purely descriptive term and has a variety of causes.

Question 17

Mechanisms of cell injury occur everywhere in the cell. However, there are 4 sites/processes that are more vulnerable than others which include?

Answer 17

1) cell membrane
2) aerobic respiration
3) protein synthesis
4) DNA integrity

Question 18

T/F hypoxia for 2 minutes in the liver will have the same effects as in the brain tissue?

Answer 18

False. The effect of cell injury depends on:

1) state of the cell
2) type of cell
3) duration/severity of injury

Question 19

There are 6 major mechanisms of biochemical injury to cells which include?

Answer 19

1) decreased ATP in cell
2) mitochondrial damage with Cytochrome C leakage
3) High intracellular calcium
4) High ROS
5) Membrane damage
6) Protein/DNA damage or misfolding

Question 20

CK-MB and troponin are increased in MI patients. Why do we see increases in these serum values?

Answer 20

It occurs because the cell membrane has been damaged due to the hypoxia/ischemia.

Question 21

A decrease in ATP leads to decreased function of the Na/K+ pump within the cell. What are the results of this?

Answer 21

1) increased Ca+,Na+, H2O influx, increased K+ efflux.

This leads to ER/cellular swelling, loss of microvilli, and blebbing of the cell.

Question 22

what affect does decreasing the pH of a cell have on chromatin?

Answer 22

it causes it to clump together

Question 23

If you have a decrease in ATP many ribosomes detach. This results in decreased proteins synthesis and ______?

Answer 23

lipid deposition

Question 24

Increased cytosolic Ca+, ROS, and lipid peroxidation have what affect on the cell?

Answer 24

Mainly mitochondrial injury. Mitochondrial dysfunction is frequently at the core of both necrosis and apoptosis.

Question 25

what is the normal cytoplasmic concentration of Ca+?

Answer 25

0.1 microMolar

Question 26

How does high/prolonged calcium inside the cell cause cell damage?

Answer 26

Calcium in high concentrations activates the enzymes that break down the cell. These include lipase, protease, ATPase, nucleases. (mainly target mitochondria)

Question 27

What are the 4 major ROS and their chemical breakdown?

Answer 27

1) super-oxide radical (02-)
2) Hydrogen peroxide (H2O2)
3) Hydroxide radical (OH-)
4) peroxynitrate anion (ONOO-)

Question 28

What is the function of NADPH Oxidase?

Answer 28

It generates ROS for use in killing bacteria such as in PMN’s.

Question 29

O2 is known to turn into superoxide (O2-) radical and cause damage. How does the body fix this problem?

Answer 29

It turns superoxide radical into H2O2 through the enzyme superoxide dismutase (SUD).

Question 30

H2O2 is also known to cause damage to the cell. How does the cell get rid of this ROS?

Answer 30

H2O2 is turned into H2O and O2 through the enzyme called catalase. Catalase is found in peroxisomes.

Question 31

How does your body get rid of the hydroxyl radical (OH-)?

Answer 31

The Hydroxyl radical can be converted into H2O2 by glutathione peroxidase. The H2O2 can then be converted into H2O and O2 through Catalase.

Question 32

T/F ROS contribute to atherosclerosis, cancer, and aging?

Answer 32

True. If you mess up the DNA it can lead to cancer and aging, and if you mess up lipid metabolism it can lead to atherosclerosis.

Question 33

T/F vitamin C and Vitamin E greatly reduce free radicals in the body?

Answer 33

False, to date few in any data has shown any benefit.

Question 34

What is NAC? What does it treat?

Answer 34

N-acetly cystine. It is used in tylenol overdoses to help enhance Glutathione pools in the liver.

Question 35

What is NAPQI?

Answer 35

NAPQI is a toxic byproduct produced during the xenobiotic metabolism of paracetamol (acetaminophen). It is normally produced only in small amounts, and then almost immediately detoxified in the liver.
However, under some conditions in which NAPQI is not effectively detoxified it causes severe damage to the liver.

Question 36

what is anoxia?

Answer 36

no oxygen delivery

Question 37

what is asphyxia?

Answer 37

No oxygen delivery due to an interruption of breathing.

Question 38

what is ischemia?

Answer 38

decreased blood flow. (note that this does not just limit oxygen)

Question 39

What are some of the characteristics of reversible cell injury? (6x)

Answer 39

1) loss of ATP
2) glycogen depletion
3) decreased pH (causes chromatin to clump)
4) failure of cell transport (causes edema)
5) detachment of ribosomes (decreases proteins syn.)
6) loss of microvilli
7) blebbing

Question 40

What are some of the characteristics of irreversible cell damage? (4X)

Answer 40

1) Membrane damage
2) intracellular loss of lysosomal enzymes
3) Large influx of calcium
4) Everything included under reversible cell injury.
a) loss of ATP
b) glycogen depletion
c) decreased pH (causes chromatin to clump)
d) failure of cell transport (causes edema)
e) detachment of ribosomes (decreases proteins syn.)
f) loss of microvilli
g) blebbing