CELL ADAPTATION, INJURY AND DEATH Flashcards
1
Q
This is the scientific study of molecular, cellular, tissue or organ system response to injurious agents
A
Pathology
2
Q
This division of pathology is concerned with the common reactions of cells and tissues to injurious stimuli
A
General Pathology
3
Q
This division of pathology examines the alterations and underlying mechanisms in organ-specific diseases
A
Systemic Pathology
4
Q
This division of pathology is concerned with the diagnosis of disease based on laboratory analysis, bodily fluids such as urine, blood, etc.
A
Clinical Pathology
aka laboratory medicine
5
Q
This division of pathology deals with the determination of cause, manner, and time of death
A
Forensic pathology
6
Q
This division of pathology is concerned with the study and diagnosis of illness through microscopic analysis from samples of bodily fluids, tissues, organs and sometimes the entire body
A
Anatomical Pathology
7
Q
This division of pathology involves the analysis of all asspects of disease, identifying various substances found in the blood and bodily fluids such as proteins, hormones, and electrolytes
A
Chemical Pathology
8
Q
This division of pathology involves performing tests on chromosomes, bochemical markers, or DNA taken from bodily fluids and tissues to detect genetic illness
A
Genetic pathology
9
Q
This division of pathology concerned with various disease aspects that affect the blood including bleeding disorder, clotting problems, and anemia
A
Hematology
10
Q
This division of pathology includes immunologists performing immune function tests to establish whether a patient is suffering from an allergy and if so, what they are allergic to
A
Immunology
11
Q
This division of pathology is concerned with diseases caused by pathogenic agents such as bacteria, viruses, parasites, and fungi
A
Microbiology
12
Q
What are the four aspects of disease process?
A
Etiology
Pathogenesis
Morphology
Functional derangements and clinical manifestations
13
Q
This is the aspect of disease process that pertains to the origin of the disease (i.e., uderlying causes and modifying factor)
A
Etiology
14
Q
What are the two classes of etiology of diseases?
A
Genetic and Acquired
15
Q
Which of the following is not under the acquired etiology of disease?
A. nutritional etiology
B. chemical etiology
C. polymorphisms
D. infectious disease
A
C. polymorphisms, gene variants and inherited mutations are GENETIC
16
Q
This aspect of the disease process describes how etiologic factors trigger cellular and molecular changes, giving rise to specific functional and structural abnormalities that characterize the disease
A
Pathogenesis
17
Q
This pertains to the sequence of cellular, biochemical, and molecular events that follow exposure of the cells or tissues to injurious stimuli
A
Pathogenesis
18
Q
This aspect of disease process pertains to the structural alterations in cells or tissues that are either charateristic of a disease or diagnostic of an etiologic disease.
A
Morphological changes
- includes both gross and microscopic morphology
19
Q
This aspect of disease process pertains to the end-results of genetic, niochemical, and structural changes in cells and tissues
A
Functional derangements and Clinical Manifestations
20
Q
This is the process by which the pathology specimen is inspected with bare eyes to obtain diagmostic information while being processed for further microscopic examination
A
Gross examination
21
Q
This is the most commonly used method in the study of pathology
A
Light microscopy
22
Q
This is the method in studying pathology that utilizes antigens
A
Immunochemistry
23
Q
This method of studying pathology is often used in cases where it’s necessary to look at the detailed parts of the cells
A
Electron microscopy
24
Q
This method represents the application of the principles of basic molecular biology to the investigation of human disease process
A
Molecular pathology
25
Excess physiologic stress or potentially injurious conditions force the new cell to a new steady state. This is known as
adaptation
26
This occurs when the external stress is inherently harmful or exceeds the cell's adaptive capacity
Cell injury
27
What is the expected cellular response of cells to chronic irritation (physical or chemical)?
Metaplasia
28
This is the reversible functional and structural responses undergone by the cell to respond to changes in physiologic states
Adaptations
- change in cell morphology and function in response to a stimulus
29
This refers to an increase in the size of cells that results in an in increase in the size of the affected organ as an adaptive response
Hypertrophy
30
Hypertrophy occurs due to:
synthesis and assembly of additional intracellular structural components
31
Type of hypertrophy that may be due to increased functional demand or hormone stimulation
Physiologic hypertrophy
32
What is the most common stimulus for muscle hypertrophy?
increased workload
33
This is the type of hypertrophy that results in response to injurious stimuli
Pathologic hypertrophy
34
Which of the following is not a mechanism of hypertrophy?
A. Integrated actions of mechanical sensors, Agonists, Growth Factors
B. Signals originating from the cell membrane activate a web of signal transduction pathways
C. Activation of transcription factors
D. Transcription factors working to increase muscle protein synthesis leading to muscle hypertrophy
E. Switching contractile proteins from fetal to adult forms
E.
- should be Switching of contractile proteins from adult to fetal or neonatal forms
35
Which isoform of myosin heavy chain is slower and has more energetically economic contraction; hence, activates during muscle hypertrophy?
β isoform
- replaces α isoform
36
Which gene expressed in the atrium and ventricle of the embryonic heart is downregulated after birth, but is again increased during cardiac hypertrophy to provide a net effect of a decrease in blood volume and pressure thereby reducing hemodynamic load during stress?
ANF gene
37
True or False:
When cardiac hypertrophy exceeds its limit, lysis and loss of myofibrillar contractile elements may occur
True
38
This pertains to the increase in the number of cells in an organ or tissue, usually resulting in increased volume of the organ or tissue
Hyperplasia
39
What specific type of principal adaptive response occurs when the liver regenerates in individuals who donate one lobe of the liver for transplantation?
Compensatory hyperplasia
40
What is the stimulus for the liver's hyperplasia after a lobe transplant?
Polypeptide growth factors (PGF) from uninjured hepatocytes and non-parenchymal cells in the liver
41
Which of the following exhibits compensatory hyperplasia?
A. Glandular epithelial proliferation of the breast in pregnant women
B. Hyperplasia of erythroid precursor in when in high altitude regions and areas of low oxygen tension
C. Benign prostatic hyperplasia due to abnormal levels of androgen
D. Endometrial hyperplasia due to increased estrogen over progesterone
B.
42
This pertains to the reduction in the size of an organ or tissue due to a decrease in cell size and number
Atrophy
43
Which type of atrophy results from a combination of decrease protein synthesis and increased in protein degradation?
Pathologic atrophy
44
This pertains to the reversible change in which one adult cell type is replaced by another adult cell type
Metaplasia
45
This squamous-columnar metaplasia may lead to a future case of glandular adenocarcinoma
Barrett's esophagus
46
Which cells principally encounters disordered cell growth and maturation?
Epithelial cells
- principally encounters DYSPLASIA
47
This principal adaptive response of cells marks a tissue being at increased risk for developing an invasive cancer
Dysplasia
48
What type of metaplasia of the respiratory tract often coexists with lung cancers?
Squamous metaplasia
49
What type of metaplasia of the respiratory tract often coexists with lung cancers?
50
Which growth factor from uninjured hepatocytes and non-parenchymal cells in the liver are responsible for the organ's compensatory hyperplasia?
Polypeptide Growth Factors
51
Which principal adaptive response occurs when the uterus decreases in size after parturition?
Physiologic atrophy
52
This condition of muscle wasting occurs when skeletal muscle proteins are used as source of energy due to inadequate nutrition (e.g., Marasmus)
Cachexia
53
This type of metaplasia occurs in excretory ducts of salivary glands, pancreas, and bile ducts due to the presence of stones
Secretory columnar to stratified squamous
54
Which vitamin deficiency can result to respiratory epithelial metaplasia?
Vitamin A
55
What changes occurs during metaplasia of the epithelium in chronic gastric reflux?
from stratified squamous to gastric or intestinal-type columnar epithelium
56
Which principal adaptive response occurs in Myositis ossificans?
Metaplasia
57
WhWhich principal adaptive response results to cells that exhibit considerable pleomorphism (variation in cell size and shape)?
Dysplasia
58
This results when cells are stressed so severely that they are no longer able to adapt or when cells are exposed to inherently damaging agents or suffer from intrinsic abnormalities
cell injury
59
In ischemia of the heart, unmistakable light microscopic changes of cell death, may not be seen until _____ hours after onset of ischemia
4-12 hours
60
This is the first manifestation of almost all forms of injury to cells
Cell swelling
61
On microscopic examination, small clear vacuoles may be seen within the cytoplasm; these represent distended and pinched-off segments of the ER. This pattern of nonlethal injury is sometimes called:
Hydropic change or Vacuolar degeneration
62
The cytoplasm of necrotic cells appears red (eosinophilic) when stained with hematoxylin and eosin (H&E) due to loss of _____, which binds the blue hematoxylin
RNA
63
These are collections of phospholipids resembling myelin sheaths that are derived from damaged cellular membranes
(Intracytoplasmic) Myelin figures
64
A depletion of ___-___% of ATP can already have significant changes in the cell
5-10%
65
If unfolded or misfolded proteins accumulate in the ER, they trigger a number of alterations that are collectively called the:
unfolded protein response
- activates signaling pathways that increase the production of chaperones, enhance proteasomal degradation of abnormal proteins, and slow protein translation, thus reducing the load of misfolded proteins in the cell
66
If the unfolded protein response is unable to cope with the accumulation of misfolded proteins, the cell activates caspases and induces apoptosis. This process is called:
ER stress
67
The mitochondria can be damaged by increase of ______ which increases membrane permeability, and _______ deprivation which increases sensitivity to all injurious stimuli
increase in cytosolic calcium and oxygen deprivation
68
This is a high-conductance channel formed in the mitochondrial membrane when in is damaged
mitochondrial permeability transition pore
69
This is a structural component of the mitochondrial membrane that is targeted by cyclosporine (used to prevent graft rejection)
Cyclophilin D
70
What are the injurious causes of calcium influx?
ischemia and toxins
71
This pertains to the imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage
Oxidative stress
72
These are extremely unstable, partially reduced, highly reactive chemical species with a single unpaired electron
Free radicals
73
Defects in leukocytic superoxide production lead to which disease?
Chronic granulomatous disease (CGD) is a genetic disorder in which white blood cells called phagocytes are unable to kill certain types of bacteria and fungi. People with CGD are highly susceptible to frequent and sometimes life-threatening bacterial and fungal infections.
74
What are the highly reactive forms of Nitric oxide?
Peroxynitrite anion (ONOO-)
NO2
NO3-
75
This reaction utilizes transition metals like iron and copper to convert H2O2 to a highly reactive hydroxyl radical
Fenton reaction
76
Manganese-SOD and Copper-zinc-SOD are localized in which compartment of the cell?
Manganese-SOD = mitochondria
Copper-zinc-SOD = cytoplasm
77
This is the most abundant of the glutathione peroxidase family
GSH peroxidase 1
78
This enzyme is present in peroxisomes and catalyzes the decomposition of H2O2
Catalase
79
Final products of the action of catalase
O2 + 2H2O
80
This chemical species initiates catalytic reactions
free radicals
81
This chemical species initiates catalytic reactions
Free radicals
82
Which of the following is not a manifestation of reversible injury?
A. Dilation of ER and detachment of polysomes
B. Intracytoplasmic myelin figures
C. Loss of microvilli
D. Denaturation of intracellular proteins
D.
Irreversible injury manifests as:
- denaturation of intracellular proteins
- enzymatic digestion of the lethally injured cell
83
The necrotic cell may have a glassy homogeneous appearance relative to normal cells, mainly as a result of the loss of ___________ particles
glycogen
84
In irreversible cell injury, nuclear changes appear due to breakdown of ______
DNA
85
A nuclear change in necrotic cells wherein the basophilia of the chromatin may fade, a change that presumably reflects loss of DNA because of enzymatic degradation by endonucleases
karyolysis
86
A nuclear change in necrotic and apoptotic cells characterized by nuclear shrinkage and increased basophilia
pyknosis
87
This pertains to the nuclear change in necrotic cells wherein the pyknotic nucleus
undergoes fragmentation
karyorrhexis
88
This is a type of necrosis in which the architecture of dead tissue is preserved for a span of at least some days and the affected tissue exhibit a firm texture?
coagulative necrosis
89
This is the type of necrosis where there is loss of nuclei but the cell membrane remains intact
coagulative
89
This is the type of necrosis where there is loss of nuclei, but the cell membrane remains intact
coagulative necrosis
90
This type of necrosis results into the digestion of dead cells resulting in transformation of tissue into liquid, viscous mass
liquefactive necrosis
91
Which of the following is not accurate to liquefactive necrosis?
A. Caused by accumulation of macrophages in Focal bacterial or fungal infections
B. Characteristic of brain infarction due to microglial proteolytic enzymes
C. Caused by neutrophilic proteolytic enzymes forming abscess
D. Seen in pancreatitis as pancreatic enzymes liquefy the parenchyma
A. should be accumulation of leukocytes
92
When bacterial infection is superimposed onto a necrotic limb, there is more liquefactive necrosis because of the actions of degradative enzymes in the bacteria and the attracted leukocytes giving rise to so-called:
wet gangrene
93
This type of necrosis is encountered most often in foci of tuberculous infection, manifesting with a friable white appearance of the area of necrosis.
caseous necrosis
94
This pertains to the focus of inflammation that appears as a structureless collection of fragmented or lysed cells and amorphous granular debris enclosed within a distinctive inflammatory border
granuloma
-body is unable to clear away the M. tuberculosis
95
Histologically, this type of necrosis presents with shadowy outlines of necrotic fat cells with basophilic calcium deposits, surrounded by inflammation
caseous necrosis
96
Necrosis that happens due to direct trauma to the breast or enzymatic degradation from leakage in the pancreas
Fat necrosis
97
Enzymatic fat necrosis results to areas of __________ deposits representing foci of fat necrosis with calcium soap formation (saponification) at sites of lipid breakdown. (key appearance)
white chalky deposits
98
This necrosis is a special form of vascular damage usually seen in immune reactions involving blood vessels. It typically occurs when complexes of antigens and antibodies are deposited in the walls of arteries.
Fibrinoid necrosis
99
This type of necrosis is a characteristic of the following except:
A. Malignant hypertension
B. Vasculitis
C. Autoimmune disease
D. Infarction
D. Infraction is coagulative necrosis
100
Ultimately, in the living patient most necrotic cells and their contents disappear due to enzymatic digestion and phagocytosis of the debris by leukocytes. If necrotic cells and cellular debris are not promptly destroyed and reabsorbed, they provide a nidus for the deposition of calcium salts and other minerals and thus tend to become calcified. This phenomenon, called:
dystrophic calcification
101
This is a tightly regulated program in which cells destined to die activate intrinsic enzymes that degrade the cells’ genomic DNA and nuclear and cytoplasmic proteins
apoptosis
102
What are the 2 best known death receptors that trigger the extrinsic pathway of apoptosis?
Type 1 TNF receptor (TNFR1)
Fas (CD95)
103
Which of the following is not an arbiter of apoptosis?
A. BAD
B. BIM
C. MCL-1
D. PUMA
E. NOXA
C. MCL-1, BCL2, BCL-XL are all anti-apoptotic
104
This is the most characteristic feature of apoptosis
chromatin condensation
105
Caspases are cysteine proteases that cleave proteins after ______ residues
Aspartic residues
106
These are markers of cells undergoing apoptosis
caspases
107
This is the major mechanism of apoptosis in all mammalian cells
Intrinsic or Mitochondrial apoptosis
108
The pro-apoptotic proteins from the BCL2 family
BAX and BAK
109
During apoptosis, Cyt C in the cytosol binds with ___ to form the apoptosome
APAF-1
110
Which of the following, when inhibited, permits initiation of the caspase cascade?
A. IAPs
B. Smac
C. Diablo
D. Physiologic inhibitors of Apoptosis
E. AOTA
E. AOTA
111
This protein inhibits the activation of caspase 8
FLICE Inhibitory Protein (FLIP)
112
This is the ligand of CD95 that is expressed on T cells that recognize self antigens (and functions to eliminate self-reactive lymphocytes that also express the receptor Fas upon recognition of self antigens) and on some CTLs that kill virus-infected and tumor cells
FasL
- CD95 is Fas (a death receptor)
113
The initiator caspases of the Death receptor pathway
Caspase-8 and Caspase-10
114
Initiator caspase of the mitochondrial apoptotic pathway
Caspase-9
115
The executioner caspases of apoptosis
Caspase-3 and Caspase-6
116
In healthy cells, phosphatidylserine is present on the inner leaflet of the plasma membrane, but in apoptotic cells this phospholipid “flips” out and is expressed on the outer layer of the membrane, where it is recognized by several macrophage receptors.
Phosphatidylserine
117
Apoptotic bodies may also become coated with natural antibodies and proteins of the complement system, notably ______, which are recognized by phagocytes.
C1q
118
Apoptosis due to genotoxic stress causing DNA damage involves which specific gene?
tumor suppressor gene TP53
119
These are Cytotoxic T lymphocyte granule serine proteases that cleaves proteins at aspartic residues
granzymes
120
This serine protease kills target cells by directly inducing effector phase of apoptosis
granzymes
121
This refers to the lysosomal digestion of cell's own components that is prominent in atrophic cells exposed to sever nutrient deprivation
Autophagy
122
Which of the following is a main mechanism leading to abnormal intracellular accumulations?
A. Inadequate removal of a normal substance secondary to defects in packaging and transport
B. Accumulation of an endogenous substance as a result of genetic or acquired defects in its folding, packaging, transport, or secretion
C. Failure to degrade a metabolite due to inherited enzyme deficiencies, typically lysosomal enzymes
D. Deposition and accumulation of an abnormal exogenous substance when the cell has neither the enzymatic
machinery to degrade the substance nor the ability to transport it to other sites.
All of the above
Examples:
A. Liver steatosis
B. α1-antitrypsin mutation
C. lysosomal storage disease
D. Accumulation of carbon or silica particles
123
The terms _____and ______ describe abnormal accumulations of triglycerides within parenchymal cells. Fatty change is often seen in the liver because it is the major organ involved in fat metabolism, but it also occurs in the heart, muscle, and kidney.
steatosis and fatty change
124
Intracellular accumulation of cholesterol within macrophages is also characteristic of acquired and hereditary hyperlipidemic states. Clusters of foamy cells are found in the subepithelial connective tissue of the skin and in tendons, producing tumorous masses known as:
xanthomas
125
This refers to the focal accumulations of cholesterol-laden macrophages in the lamina propria of the gallbladder
cholesterolosis
126
This lysosomal storage disease is caused by mutations affecting an enzyme involved in cholesterol trafficking, resulting in cholesterol accumulation in multiple organs
Niemann Pick disease, type C
127
Intracellular accumulations of _________ usually appear as rounded, eosinophilic droplets, vacuoles, or aggregates in the cytoplasm
proteins
128
The term _____ usually refers to an alteration within cells or in the extracellular space that gives a homogeneous, glassy, pink appearance in routine histologic sections stained with H&E.
hyaline change
129
In cases of accumulation of normal proteins in the ER, the ER becomes hugely distended, producing large, homogeneous eosinophilic inclusions called
Russell bodies
130
______ masses appear as clear vacuoles within the cytoplasm because it dissolves in aqueous fixatives; thus, it is most readily identified when tissues are fixed in absolute alcohol.
glycogen
131
Glycogen accumulates within select cells in a group of related genetic disorders that are collectively referred to as the ________. In these diseases, enzymatic defects in the synthesis or breakdown of glycogen result in massive accumulation, causing cell injury and cell death.
glycogen storage diseases, or glycogenosis
132
The most common exogenous pigment is ______, a ubiquitous air pollutant in urban areas.
carbon (coal dust)
133
This pertains to blackened tissues of the lung due to the accumulation of carbon pigments
anthracosis
134
_________ is a form of localized, exogenous pigmentation of the skin. The pigments inoculated are phagocytosed by dermal macrophages, in which they reside for the remainder of the life of the embellished.
Tattooing
135
_________ is an insoluble pigment that is composed of polymers of lipids and phospholipids in complex with protein, suggesting that it is derived through lipid peroxidation of polyunsaturated lipids of intracellular membranes.
lipofuscin or lipochrome or wear-and-tear pigment
136
_________ is a telltale sign pigment of free radical injury and lipid peroxidation.
lipofuscin
It is seen in cells undergoing slow, regressive changes and is particularly prominent in the liver and heart of aging patients or patients with severe malnutrition and cancer cachexia
137
This is an endogenous, brown-black, pigment formed when the enzyme tyrosinase catalyzes the oxidation of tyrosine to dihydroxyphenylalanine.
Melanin
138
This is the only endogenous brown-black pigment.
melanin
139
This is a black pigment that occurs in patients with alkaptonuria, a rare metabolic disease.
homogentisic acid
140
In alkaptanuria, the pigment is deposited in the skin, connective tissue, and cartilage, and the pigmentation is known as __________.
ochronosis
141
________, a hemoglobin-derived, golden yellow to brown, granular, or crystalline pigment is one of the major storage forms of iron.
Hemosiderin
142
The deposition of calcium salts in otherwise normal tissues is known as __________, and it almost always results from hypercalcemia secondary to some disturbance in calcium metabolism.
metastatic calcification
143
This is the form of pathologic calcium deposition that occurs locally in dying tissues occurring despite normal serum levels of calcium and in the absence of derangements in calcium metabolism.
dystrophic calcification
144
On occasion, single necrotic cells may constitute seed crystals that become encrusted by the mineral deposits. The progressive acquisition of outer layers may create lamellated configurations, called _________ because of their resemblance to grains of sand.
psammoma bodies
145
_______ is the result of a progressive decline in cellular function and viability caused by genetic abnormalities and the accumulation of cellular and molecular damage due to the effects of exposure to exogenous influences
Cellular aging
146
Type of calcification expected with aluminum intoxication
metastatic calcification
- other cause (most common) is hypercalcemia
147
________ is a specialized RNA-protein complex that uses its own RNA as a template for adding nucleotides to the ends of chromosomes.
Telomerase
