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**Host and Defense > Basic pathology and response to stress > Flashcards

Basic pathology and response to stress Flashcards

1
Q

What is the order of events in which to think about diseases?

A
  1. Cause/Etiology
  2. Pathogenesis
  3. Morphologic Changes
  4. Clinical consequences and prognosis
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2
Q

What are the 7 causes of cell injury and death?

A
  1. Physical
  2. Ischemia and Hypoxia
  3. Toxins and Drugs
  4. Infections
  5. Inflammation
  6. Genetic diseases
  7. Nutritional problems
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3
Q

Give some example of physical causes of cell injury and death

A
  1. Physical stress/trauma
  2. Heat
  3. Cold
  4. Radiation
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4
Q

What is the difference between Ischemia and Hypoxia?

A
  1. Ischemia: Circulation is impaired and blood not getting to tissue
  2. Hypoxia: Lungs aren’t working well or you’re holding your breath or something

*Both involve inadequate oxygen supply to a tissue

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5
Q

Which would be worse, Ischemia or hypoxia?

A

Ischemia

*Because in hypoxia you are just affecting oxygen content and there are other ways for the cell to make energy but in ischemia you get a bigger problem because lactate accumulates and blood doesn’t get to the site

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6
Q

What are the kinds of cell adaptations to injury?

A
  1. Hypertrophy/atrophy
  2. Hyperplasia
  3. Metaplasia
  4. Dysplasia
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7
Q

What is cell hypertrophy?

A

Increased cell size, not number

*Common locations include heart and skeletal muscle

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8
Q

What is atrophy?

A

Cell shrinkage or loss

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9
Q

What causes atrophy?

A
  1. Lack of hormonal signals
  2. Loss of innervation
  3. Lack of use
  4. Loss of blood supply
  5. Starvation
  6. Individual cell death
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10
Q

What is Cachexia?

A
  • Fatty atrophy

- Fat cells don’t have much fat anymore and they get smaller

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11
Q

At what point is cachexia fatal?

A

At 68% of normal body weight, +/- 2%

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12
Q

What is hyperplasia?

A

Increased NUMBER of cells

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13
Q

What causes hyperplasia?

A

Causes are similar to hypertrophy:

  • Stress
  • Hormones
  • etc.
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14
Q

T/F Hyperplasia and hypertrophy never occur at the same time

A

FALSE, Hyperplasia can occur with hypertrophy

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15
Q

Give some examples of where hyperplasia can be seen?

A
  1. BPH (Prostate)
  2. Liver
  3. Kidney
  4. Breast
  5. Endometrium
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16
Q

What is Metaplasia?

A

Replacement of one cell type by another

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17
Q

Give some examples of where you would see metaplasia?

A
  1. Smoker’s airways
  2. Cervix
  3. Barrett’s esophagus
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18
Q

What would metaplasia look like in a smoker’s airways?

A

Normal respiratory epithelium may become squamous

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19
Q

What is barret’s esophagus?

A

Refers to an abnormal change (metaplasia) in the cells of the lower portion of the esophagus. It is characterized by the replacement of the normal stratified squamous epithelium lining of the esophagus by simple columnar epithelium with goblet cells (which are usually found lower in the gastrointestinal tract)

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20
Q

What is dysplasia?

A

Disordered hyperplasia without maturation

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21
Q

T/F Dysplasia is preneoplastic

A

True

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22
Q

Define Preneoplastic

A

Preceding the formation of a benign or malignant neoplasm.

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23
Q

Give some examples of where Dysplasia can occur

A
  1. Uterine Cervix
  2. Bowel in inflammatory bowel disease
  3. Esophagus with Barret’s
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24
Q

What types of cells are most prone to injury?

A
  1. Cells with High metabolic activity

2. Rapidly proliferating cells

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25
Q

Give 3 examples of cells with high metabolic activity

A
  1. Cardiac myocytes
  2. Renal Tubular cells
  3. Hepatocytes
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26
Q

Give 3 examples of Rapidly proliferating cells

A
  1. Testicular germ cells
  2. Intestinal epithelium
  3. Hematopoietic cells
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27
Q

What are the two degrees of cell injury?

A
  1. Reversible

2. Irreversible-cell death

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28
Q

Describe reversible cell injury

A

Damage not enough to kill cell

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29
Q

Give 3 examples of reversible cell injury

A
  1. Mild ATN (renal acute tubular “necrosis”)
  2. Toxic liver inury
  3. Severe exercise
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30
Q

Describe irreversible cell injury

A
  • More severe damage
    • Holes in cell membrane
    • Long Ca2+ influx
    • Mitochondrial loss
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31
Q

What are the two types of cell death?

A
  1. Apoptosis (programmed cell death)
  2. Necrosis (uncontrolled)

*Mixed apoptosis and necrosis is common

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32
Q

What are the effects of hypoxia in reversible cell injury?

A

Loss of ATP

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33
Q

How do cells compensate for hypoxia in reversible cell injury?

A

Anaerobic glycolysis with lactate and acidosis

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34
Q

In reversible cell injury, what two things are associated with the loss of sodium pump?

A

Cell swelling and ER vacuoles

35
Q

T/F There is a fatty change in reversible cell injury

A

True

36
Q

What type of cell death is energy-requiring programmed cell death?

A

Apoptosis

37
Q

What type of cell death is often a normal phenomenon?

A

Apoptosis

38
Q

T/F Apoptosis results in moderate inflammation and the destruction of multiple cells at a time

A

False,

*No inflammation, usually one cell at a time

39
Q

Name several things in which apoptosis happens.

A
  1. Normal embryology
  2. Normal cell turnover (Intestine, skin, menses)
  3. Viral infection
  4. Cell damage (DNA, unfolded proteins)
  5. Immunologically mediated
  6. Hormone withdrawal
40
Q

What are the things involved in Immunoligically mediated apoptosis?

A
  • Fas or TNF signals

- Cytotoxic T lymphocytes granzymes

41
Q

The caspase pathway is involved in which type of cell death?

A

Apoptosis

42
Q

What is Pyknosis?

A
  • Also called Karyopyknosis
  • The irreversible condensation of chromatin in the nucleus of a cell undergoing necrosis or apoptosis. It is followed by karyorrhexis, or fragmentation of the nucleus
43
Q

Which type of cell death is uncoordinated cell death?

A

Necrosis

44
Q

What are the early events in necrosis?

A
  1. Cell membrane disruption
  2. Ca2+ signal (Leaking into cytoplasm)
  3. Energy loss (ATP depletion)
45
Q

T/F Necrosis is associated with inflammation

A

True,

*cells often swollen due to loss of ion pumps early in process

46
Q

In necrosis, cell contents _____, causing _____

A
  1. Leak

2. Acute inflammation

47
Q

Necrosis often occurs in _____ rather than individual cells

A

Cell clusters

48
Q

What would you call necrosis of a whole anatomic area like a toe?

A

Gangrene

49
Q

Describe some cellular changes in necrosis

A
  • Cytoplasm is a deeper red (Loss of mRNA)
  • Cells swell
  • Nuclei not basophilic
  • Hemorrhage, acute inflammation, then chronic inflammation and fibrosis
50
Q

What are 3 nuclear changes in cell death and how do they appear histologically?

A
  1. Nuclear Pyknosis (shriveled, dark)
  2. Karyolysis (digested, pale nucleus)
  3. Karyorrhexis (nuclear fragmentation)
51
Q

What are the 6 patterns of necrosis?

A
  1. Coagulative
  2. Liquefactive
  3. Fat necrosis
  4. Caseous necrosis
  5. Gangrenous necrosis
  6. Fibrinoid necrosis
52
Q

Coagulative necrosis happens with ____ and makes ___

A
  1. Ischemia

2. Infarct

53
Q

Liquefactive necrosis is _______, examples include brain or lung _____

A
  1. Loss of substance

2. Abscess

54
Q

What is Caseous necrosis?

A
  • Necrotizing granulomas
  • Combination of liquefactive and coagulative
  • Can be caused by fungal or TB infection
55
Q

Fat necrosis looks like _______ when it happens in the breast

A

Cancer

56
Q

T/F Fat necrosis can also happen in pancreatitis

A

True

57
Q

What is Fibrinoid necrosis?

A

Really it is fibrin deposition +/- actual necrosis

58
Q

T/F Like cells, organelles can have hypertrophy of atrophy

A

True

59
Q

Give an example of an organelle changing similar to a cell

A

In the liver, increased smooth ER with barbiturate use. Increased cytocrhome p450 2C metabolizes other drugs or toxins more quickly

60
Q

Give an example of an injured organelle

A
  • Mallory body in liver due to alcohol or other injury-clump of intermediate filaments
  • Fat and pale vacuoles (dilated ER) also seen
61
Q

What are some examples of abnormal storage?

A
  1. Fatty change in liver
  2. Glycogen accumulation
  3. Lipid storage
62
Q

Describe fatty change in the liver as it pertains to abnormal storage

A
  • Common and nonspecific

- Seen with alcoholism, obesity, starvation, toxins

63
Q

Describe glycogen accumulation as it pertains to abnormal storage

A
  • In liver in diabetes
  • In glycogen storage disease
  • In certain tumors
64
Q

Describe lipid storage as it pertains to abnormal storage products

A
  • lipid storage disease-Fabry’s, gaucher’s

- In vessels in atherosclerosis

65
Q

Describe Gaucher disease

A

Lysosomal accumulation of lipid

66
Q

What are 3 examples of brown storage products?

A
  1. Lipofuscin
  2. Bilirubin
  3. Hemosiderin
67
Q

Describe Lipofuscin

A
  • Degraded in lysosomes

- Increases with age, free radical damage

68
Q

Describe bilirubin

A
  • Hemoglobin breakdown product
  • Normally present in bile
  • Increased with biliary obstruction and hepatocyte disorders
  • Too much causes jaundice/icterus
69
Q

Describe Hemosiderin

A
  • Iron containing pigment

- Increased with excessive iron absorption, bleeding into tissues

70
Q

In jaundice, a yellow-brown color is see with _____

A

Hyperbilirubinemia

71
Q

What is hemochromatosis?

A

Hereditary iron storage disease

72
Q

What are two types of protein storage?

A
  1. Intracellular

2. Extracellular

73
Q

Describe intracellular protein storage

A
  • Alpha-1-antitrypsin deficiency

- Russel bodies in plasma cells

74
Q

Describe Extracellular protein storage

A
  • Amyloid
    • Beta pleated sheet protein accumulations
    • Can be many different protein types
    • Occurs in a variety of diseases
    • Seen in vessels, brain, heart, glomeruli, tumors, other sites
  • Fibrosis
75
Q

What are Russel bodies?

A

Large deposits of immunoglobulin in plasma cell cytoplasm

76
Q

What are two types of Miscellaneous storage products?

A
  1. Anthracosis–carbon pigment

2. Calcification–Hydroxyapatite

77
Q

Describe Anthracosis–carbon pigment

A
  1. Harmless, but other harmful materials can be depositied with it (silica, asbestos)
  2. Mostly in and near lungs
78
Q

What are the two types of calcification?

A
  1. Dystrophic calcification

2. Metastatic calcification

79
Q

Describe Dystrophic calcification

A
  • Into damaged tissue

- Seen with necrosis without enough dead tissue removal

80
Q

Describe Metastatic Calcification

A
  • Into normal tissue

- Disordered calcium metabolism (renal failure, hyperparathyroidism, malignancy) with hypercalcemia

81
Q

Muscles in a body builder is an example of ______

A

Hypertrophy

82
Q

Brain in dementia patient is an example of ________

A

Atrophy

83
Q

Prostatic enlargement is an example of ______

A

Hyperplasia

84
Q

Uterine cervical premalignant change is an example of ____

A

Dysplasia

**Host and Defense (31 decks)

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