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PATHOLOGY MED2 > CELL ADAPTATION, INJURY AND DEATH > Flashcards

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

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2
Q

This division of pathology is concerned with the common reactions of cells and tissues to injurious stimuli

A

General Pathology

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3
Q

This division of pathology examines the alterations and underlying mechanisms in organ-specific diseases

A

Systemic Pathology

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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

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5
Q

This division of pathology deals with the determination of cause, manner, and time of death

A

Forensic pathology

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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

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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

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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

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9
Q

This division of pathology concerned with various disease aspects that affect the blood including bleeding disorder, clotting problems, and anemia

A

Hematology

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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

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11
Q

This division of pathology is concerned with diseases caused by pathogenic agents such as bacteria, viruses, parasites, and fungi

A

Microbiology

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12
Q

What are the four aspects of disease process?

A

Etiology
Pathogenesis
Morphology
Functional derangements and clinical manifestations

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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

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14
Q

What are the two classes of etiology of diseases?

A

Genetic and Acquired

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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

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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

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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

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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
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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

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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

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21
Q

This is the most commonly used method in the study of pathology

A

Light microscopy

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22
Q

This is the method in studying pathology that utilizes antigens

A

Immunochemistry

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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

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24
Q

This method represents the application of the principles of basic molecular biology to the investigation of human disease process

A

Molecular pathology

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25
Q

Excess physiologic stress or potentially injurious conditions force the new cell to a new steady state. This is known as

A

adaptation

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26
Q

This occurs when the external stress is inherently harmful or exceeds the cell’s adaptive capacity

A

Cell injury

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27
Q

What is the expected cellular response of cells to chronic irritation (physical or chemical)?

A

Metaplasia

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28
Q

This is the reversible functional and structural responses undergone by the cell to respond to changes in physiologic states

A

Adaptations

  • change in cell morphology and function in response to a stimulus
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29
Q

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

A

Hypertrophy

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30
Q

Hypertrophy occurs due to:

A

synthesis and assembly of additional intracellular structural components

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31
Q

Type of hypertrophy that may be due to increased functional demand or hormone stimulation

A

Physiologic hypertrophy

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32
Q

What is the most common stimulus for muscle hypertrophy?

A

increased workload

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33
Q

This is the type of hypertrophy that results in response to injurious stimuli

A

Pathologic hypertrophy

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34
Q

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

A

E.

  • should be Switching of contractile proteins from adult to fetal or neonatal forms
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35
Q

Which isoform of myosin heavy chain is slower and has more energetically economic contraction; hence, activates during muscle hypertrophy?

A

β isoform

  • replaces α isoform
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36
Q

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?

A

ANF gene

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37
Q

True or False:

When cardiac hypertrophy exceeds its limit, lysis and loss of myofibrillar contractile elements may occur

A

True

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38
Q

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

A

Hyperplasia

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39
Q

What specific type of principal adaptive response occurs when the liver regenerates in individuals who donate one lobe of the liver for transplantation?

A

Compensatory hyperplasia

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40
Q

What is the stimulus for the liver’s hyperplasia after a lobe transplant?

A

Polypeptide growth factors (PGF) from uninjured hepatocytes and non-parenchymal cells in the liver

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41
Q

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

A

B.

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42
Q

This pertains to the reduction in the size of an organ or tissue due to a decrease in cell size and number

A

Atrophy

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43
Q

Which type of atrophy results from a combination of decrease protein synthesis and increased in protein degradation?

A

Pathologic atrophy

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44
Q

This pertains to the reversible change in which one adult cell type is replaced by another adult cell type

A

Metaplasia

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45
Q

This squamous-columnar metaplasia may lead to a future case of glandular adenocarcinoma

A

Barrett’s esophagus

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46
Q

Which cells principally encounters disordered cell growth and maturation?

A

Epithelial cells

  • principally encounters DYSPLASIA
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47
Q

This principal adaptive response of cells marks a tissue being at increased risk for developing an invasive cancer

A

Dysplasia

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48
Q

What type of metaplasia of the respiratory tract often coexists with lung cancers?

A

Squamous metaplasia

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49
Q

What type of metaplasia of the respiratory tract often coexists with lung cancers?

A
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50
Q

Which growth factor from uninjured hepatocytes and non-parenchymal cells in the liver are responsible for the organ’s compensatory hyperplasia?

A

Polypeptide Growth Factors

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51
Q

Which principal adaptive response occurs when the uterus decreases in size after parturition?

A

Physiologic atrophy

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52
Q

This condition of muscle wasting occurs when skeletal muscle proteins are used as source of energy due to inadequate nutrition (e.g., Marasmus)

A

Cachexia

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53
Q

This type of metaplasia occurs in excretory ducts of salivary glands, pancreas, and bile ducts due to the presence of stones

A

Secretory columnar to stratified squamous

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54
Q

Which vitamin deficiency can result to respiratory epithelial metaplasia?

A

Vitamin A

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55
Q

What changes occurs during metaplasia of the epithelium in chronic gastric reflux?

A

from stratified squamous to gastric or intestinal-type columnar epithelium

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56
Q

Which principal adaptive response occurs in Myositis ossificans?

A

Metaplasia

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57
Q

WhWhich principal adaptive response results to cells that exhibit considerable pleomorphism (variation in cell size and shape)?

A

Dysplasia

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58
Q

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

A

cell injury

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59
Q

In ischemia of the heart, unmistakable light microscopic changes of cell death, may not be seen until _____ hours after onset of ischemia

A

4-12 hours

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60
Q

This is the first manifestation of almost all forms of injury to cells

A

Cell swelling

61
Q

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:

A

Hydropic change or Vacuolar degeneration

62
Q

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

A

RNA

63
Q

These are collections of phospholipids resembling myelin sheaths that are derived from damaged cellular membranes

A

(Intracytoplasmic) Myelin figures

64
Q

A depletion of ___-___% of ATP can already have significant changes in the cell

A

5-10%

65
Q

If unfolded or misfolded proteins accumulate in the ER, they trigger a number of alterations that are collectively called the:

A

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
Q

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:

A

ER stress

67
Q

The mitochondria can be damaged by increase of ______ which increases membrane permeability, and _______ deprivation which increases sensitivity to all injurious stimuli

A

increase in cytosolic calcium and oxygen deprivation

68
Q

This is a high-conductance channel formed in the mitochondrial membrane when in is damaged

A

mitochondrial permeability transition pore

69
Q

This is a structural component of the mitochondrial membrane that is targeted by cyclosporine (used to prevent graft rejection)

A

Cyclophilin D

70
Q

What are the injurious causes of calcium influx?

A

ischemia and toxins

71
Q

This pertains to the imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage

A

Oxidative stress

72
Q

These are extremely unstable, partially reduced, highly reactive chemical species with a single unpaired electron

A

Free radicals

73
Q

Defects in leukocytic superoxide production lead to which disease?

A

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
Q

What are the highly reactive forms of Nitric oxide?

A

Peroxynitrite anion (ONOO-)
NO2
NO3-

75
Q

This reaction utilizes transition metals like iron and copper to convert H2O2 to a highly reactive hydroxyl radical

A

Fenton reaction

76
Q

Manganese-SOD and Copper-zinc-SOD are localized in which compartment of the cell?

A

Manganese-SOD = mitochondria
Copper-zinc-SOD = cytoplasm

77
Q

This is the most abundant of the glutathione peroxidase family

A

GSH peroxidase 1

78
Q

This enzyme is present in peroxisomes and catalyzes the decomposition of H2O2

A

Catalase

79
Q

Final products of the action of catalase

A

O2 + 2H2O

80
Q

This chemical species initiates catalytic reactions

A

free radicals

81
Q

This chemical species initiates catalytic reactions

A

Free radicals

82
Q

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

A

D.
Irreversible injury manifests as:
- denaturation of intracellular proteins
- enzymatic digestion of the lethally injured cell

83
Q

The necrotic cell may have a glassy homogeneous appearance relative to normal cells, mainly as a result of the loss of ___________ particles

A

glycogen

84
Q

In irreversible cell injury, nuclear changes appear due to breakdown of ______

A

DNA

85
Q

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

A

karyolysis

86
Q

A nuclear change in necrotic and apoptotic cells characterized by nuclear shrinkage and increased basophilia

A

pyknosis

87
Q

This pertains to the nuclear change in necrotic cells wherein the pyknotic nucleus
undergoes fragmentation

A

karyorrhexis

88
Q

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?

A

coagulative necrosis

89
Q

This is the type of necrosis where there is loss of nuclei but the cell membrane remains intact

A

coagulative

89
Q

This is the type of necrosis where there is loss of nuclei, but the cell membrane remains intact

A

coagulative necrosis

90
Q

This type of necrosis results into the digestion of dead cells resulting in transformation of tissue into liquid, viscous mass

A

liquefactive necrosis

91
Q

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

A. should be accumulation of leukocytes

92
Q

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:

A

wet gangrene

93
Q

This type of necrosis is encountered most often in foci of tuberculous infection, manifesting with a friable white appearance of the area of necrosis.

A

caseous necrosis

94
Q

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

A

granuloma

-body is unable to clear away the M. tuberculosis

95
Q

Histologically, this type of necrosis presents with shadowy outlines of necrotic fat cells with basophilic calcium deposits, surrounded by inflammation

A

caseous necrosis

96
Q

Necrosis that happens due to direct trauma to the breast or enzymatic degradation from leakage in the pancreas

A

Fat necrosis

97
Q

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)

A

white chalky deposits

98
Q

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.

A

Fibrinoid necrosis

99
Q

This type of necrosis is a characteristic of the following except:
A. Malignant hypertension
B. Vasculitis
C. Autoimmune disease
D. Infarction

A

D. Infraction is coagulative necrosis

100
Q

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:

A

dystrophic calcification

101
Q

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

A

apoptosis

102
Q

What are the 2 best known death receptors that trigger the extrinsic pathway of apoptosis?

A

Type 1 TNF receptor (TNFR1)
Fas (CD95)

103
Q

Which of the following is not an arbiter of apoptosis?
A. BAD
B. BIM
C. MCL-1
D. PUMA
E. NOXA

A

C. MCL-1, BCL2, BCL-XL are all anti-apoptotic

104
Q

This is the most characteristic feature of apoptosis

A

chromatin condensation

105
Q

Caspases are cysteine proteases that cleave proteins after ______ residues

A

Aspartic residues

106
Q

These are markers of cells undergoing apoptosis

A

caspases

107
Q

This is the major mechanism of apoptosis in all mammalian cells

A

Intrinsic or Mitochondrial apoptosis

108
Q

The pro-apoptotic proteins from the BCL2 family

A

BAX and BAK

109
Q

During apoptosis, Cyt C in the cytosol binds with ___ to form the apoptosome

A

APAF-1

110
Q

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

A

E. AOTA

111
Q

This protein inhibits the activation of caspase 8

A

FLICE Inhibitory Protein (FLIP)

112
Q

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

A

FasL

  • CD95 is Fas (a death receptor)
113
Q

The initiator caspases of the Death receptor pathway

A

Caspase-8 and Caspase-10

114
Q

Initiator caspase of the mitochondrial apoptotic pathway

A

Caspase-9

115
Q

The executioner caspases of apoptosis

A

Caspase-3 and Caspase-6

116
Q

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.

A

Phosphatidylserine

117
Q

Apoptotic bodies may also become coated with natural antibodies and proteins of the complement system, notably ______, which are recognized by phagocytes.

A

C1q

118
Q

Apoptosis due to genotoxic stress causing DNA damage involves which specific gene?

A

tumor suppressor gene TP53

119
Q

These are Cytotoxic T lymphocyte granule serine proteases that cleaves proteins at aspartic residues

A

granzymes

120
Q

This serine protease kills target cells by directly inducing effector phase of apoptosis

A

granzymes

121
Q

This refers to the lysosomal digestion of cell’s own components that is prominent in atrophic cells exposed to sever nutrient deprivation

A

Autophagy

122
Q

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.

A

All of the above
Examples:
A. Liver steatosis
B. α1-antitrypsin mutation
C. lysosomal storage disease
D. Accumulation of carbon or silica particles

123
Q

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.

A

steatosis and fatty change

124
Q

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:

A

xanthomas

125
Q

This refers to the focal accumulations of cholesterol-laden macrophages in the lamina propria of the gallbladder

A

cholesterolosis

126
Q

This lysosomal storage disease is caused by mutations affecting an enzyme involved in cholesterol trafficking, resulting in cholesterol accumulation in multiple organs

A

Niemann Pick disease, type C

127
Q

Intracellular accumulations of _________ usually appear as rounded, eosinophilic droplets, vacuoles, or aggregates in the cytoplasm

A

proteins

128
Q

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.

A

hyaline change

129
Q

In cases of accumulation of normal proteins in the ER, the ER becomes hugely distended, producing large, homogeneous eosinophilic inclusions called

A

Russell bodies

130
Q

______ 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.

A

glycogen

131
Q

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.

A

glycogen storage diseases, or glycogenosis

132
Q

The most common exogenous pigment is ______, a ubiquitous air pollutant in urban areas.

A

carbon (coal dust)

133
Q

This pertains to blackened tissues of the lung due to the accumulation of carbon pigments

A

anthracosis

134
Q

_________ 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.

A

Tattooing

135
Q

_________ 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.

A

lipofuscin or lipochrome or wear-and-tear pigment

136
Q

_________ is a telltale sign pigment of free radical injury and lipid peroxidation.

A

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
Q

This is an endogenous, brown-black, pigment formed when the enzyme tyrosinase catalyzes the oxidation of tyrosine to dihydroxyphenylalanine.

A

Melanin

138
Q

This is the only endogenous brown-black pigment.

A

melanin

139
Q

This is a black pigment that occurs in patients with alkaptonuria, a rare metabolic disease.

A

homogentisic acid

140
Q

In alkaptanuria, the pigment is deposited in the skin, connective tissue, and cartilage, and the pigmentation is known as __________.

A

ochronosis

141
Q

________, a hemoglobin-derived, golden yellow to brown, granular, or crystalline pigment is one of the major storage forms of iron.

A

Hemosiderin

142
Q

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.

A

metastatic calcification

143
Q

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.

A

dystrophic calcification

144
Q

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.

A

psammoma bodies

145
Q

_______ 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

A

Cellular aging

146
Q

Type of calcification expected with aluminum intoxication

A

metastatic calcification

  • other cause (most common) is hypercalcemia
147
Q

________ is a specialized RNA-protein complex that uses its own RNA as a template for adding nucleotides to the ends of chromosomes.

A

Telomerase

PATHOLOGY MED2 (5 decks)

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