3. Reversible Injury

Question 1

No ____ present once cell transfers over to the irreversible state

Reversible injury is a ____ injury; if stimulus is removed, the cell will revert to its normal self > however, there are ____ changes and changes in ____ within the cell

Answer 1

markers
sublethal
morphologic
mechanisms

Question 2

Overview of Cell Injury and Death

• Cell injury occurs when cells are stressed beyond ability to ____ (e.g. persistence) or when they are exposed to damaging agents
• Reversible injury: sublethal injury leading to morphological changes (e.g., cell swelling [____]) and functional changes (e.g., impairment of metabolism [____])—cells can return to normal if stimulus is removed
• Injury may progress through a reversible stage and culminate in irreversible injury (cell death)

Sublethal injury to one cell may be ____ injury to another cell

Cell swelling (not ____, typically associated with a decline in ____ (perhaps from hypoxia) and Na+ intake, breakdown of pumps) > ____

Functional change > fatty change > liver hepatocyte affected by ____

Answer 2

adapt
hydropic impairment
fatty change

lethal

hypertrophy
ATP
hydropic degeneration

ethanol

Question 3

Reversible cell injury: ____ patterns recognized at light microscopic level

• Hydropic change/swelling (cloudy swelling, vacuolar degeneration): large, pale ____, ____. Visible result
of:
—• Cell enlargement due to loss of ____
control (loss of ____ homeostasis):
—–• Decreased supply of ____
—–• Decreased ____ activity

• Fatty change/steatosis: accumulation of lipid vacuoles (____) in cytoplasm (hepatocytes and myocardium); may also observe increased ____ staining

Normal cell exposed to sublethal stimulus > swelling of cell (decline of ATP) as a result of Na entering (ER and mito also swell, and RER undergoes changes) > the cell is functionally/metabolically altered until stimulus is removed

Answer 3

2
cytoplasm
vacuoles
cell volume
ionic
ATP
sodium pump

triglycerides
eosinophilic

Question 4

Reversible cell injury

Left most: pancreas, in middle is islet and within are beta-cells (insulin producing) > diabetes is ____, where cytolytic T cells enter tissue and kill the cells and tissue; in early stages it may be sublethal which is presented on the farthest left, now as you go right > cells borders are expanded due to liquid entering with sodium (____)

In right: glomerulus (labeled), then a higher power, in normal tissue you see that cells are ciliated; early in injury cells becoming slightly enlarged and eosinophilic > when H swelling sets in > cells become massive, nucleus displaced to ____ side of cell, borders are ____ on lumen of tubule, and the brush border is being ____ (loss of specialized function, decline in absorption, and a ____ appearance)

Answer 4

autoimmune disease
hydropic changes

basal
encroaching
eliminated
“cloudy”

Question 5

Ultrastructural changes associated with reversible cell injury

• Ultrastructural changes:
• Plasma membrane ____ and
loss of ____ structures (e.g.
cilia)

As a result of swelling, the cell loses all specialized structures > loses the ____ and includes some blebbing of the nucleus > the nucleus is still functionally ____; it’s still permeable

Remove the stimulus and they will ____; also can occur to membranes ____

Answer 5

blebbling
specialized

microvilli
intact
return
internally

Question 6

Ultrastructural changes associated with reversible cell injury
• Ultrastructural changes:
• Swelling or dilatation of ER:
• detachment of ____ from RER (decreased ____)

Mitochondria in the image are also ____

Answer 6

ribosomes
protein synthesis
swollen

Question 7

Ultrastructural changes associated with reversible cell injury
• Ultrastructural changes:
• Mitochondrial swelling

These mitochondria cannot carry out ____ at great efficiency

These morphologic changes are involved with ____, but reversible

Answer 7

respiratory metabolism

functional changes

Question 8

Morphology of reversible cell injury (cont’d)

• Organ (if many cells are affected):
• • ____ (capillary compression)
• • Increased ____ (swollen/congested)

Kidney on right is undergoing hydropic change; it’s larger, swollen because it’s taken up water; and it will appear ____: pallor > because of water that compresses the ____ and interferes with blood flow into the tissue

Answer 8

pallor
weight
pale

Question 9

Fatty Change

Accumulation of fat within the cells (____), ____ is also observed with hydropic change (not a specific hallmark of ____)

Anything that increases TG can lead to fatty change; can see it in ____ patients, starvation, ____, hypoxia and toxins (leads to ____ of FFA which leads to production), protein malnutrition (reduced ____ availability, cannot export the TG and they accumulate in the cell)

Remove the stimulus > reversible

Answer 9

intracellularly
eosinophilia
steatosis

diabetic
ethanol
oxidation
apoprotein

Question 10

Morphology of reversible cell injury: fatty change

Right: tissue from ____ > leads to vacuole formation within a cell > eventually can lead to irreversible injury

Organ doesn’t necessarily get ____, but it looks ____ and it has a ____ appearance due to the lipid being accumulated

Answer 10

ethanol-mediated steatosis

larger
paler
greasy