Cell Adaptations & Accumulations

Question 1

What are the 4 adaptive responses?

Answer 1

1. hypertrophy
2. hyperplasia
3. atrophy
4. metaplasia

Question 2

What is hypertrophy?

Answer 2

increased size of cells result in increased organ size

Question 3

What is hyperplasia?

Answer 3

increased number of cells result in increased organ size

Question 4

What is atrophy?

Answer 4

shrinkage in cell size result in decreased decreased organ size

Question 5

What is metaplasia?

Answer 5

an adult cell type is replaced with another adult cell type of the same tissue

Question 6

What type of cells does hypertrophy work with?

Answer 6

differentiated (permanent) cells; muscle cells

Question 7

What type of cells does hyperplasia work with?

Answer 7

labile cells; epithelial cells

Question 8

What is compensatory hypertrophy?

Answer 8

following the removal of one kidney, with increased workload, the remaining kidney increases in size to compensate

Question 9

What does hypertrophy usually respond to?

Answer 9

increased workload

Question 10

What does hyperplasia usually respond to?

Answer 10

• hormones
• growth factors

Question 11

Prolonged hyperplasia is a risk for what?

Answer 11

malignant transformation

Question 12

What is the term for a decrease in cell number?

Answer 12

involution (apoptosis); losing tissues

Question 13

Breast epithelial hyperplasia responds to what hormone?

Answer 13

estrogen

Question 14

Prostatic epithelial hyperplasia responds to what hormone?

Answer 14

testosterone

Question 15

Can benign prostatic hyperplasia become cancerous?

Answer 15

NEVER

Question 16

A 1/3 partial hepatectomy can be regenerated by which adaptive response?

Answer 16

hypertrophy

Question 17

A 2/3 partial hepatectomy be regenerated by which adaptive response?

Answer 17

hyperplasia

Question 18

What is atrophy driven by?

Answer 18

loss of trophic factors

Question 19

What is a unique characteristic of atropic cells?

Answer 19

reduce to lowest capacity to maintain survival mode; NOT DEAD

Question 20

Where is physiologic atrophy seen?

Answer 20

in development/aging

Question 21

Where is pathologic atrophy seen?

Answer 21

immobilization, ischemia, skinny leg syndrome

Question 22

What is the earliest change in epithelial transitions?

Answer 22

from esophagus to stomach

Question 23

Is there a change in size for metaplasia?

Answer 23

NO

Question 24

What is the risk with metaplasia when the tissue is NOT suited?

Answer 24

malignant transformation

Question 25

Where does metaplasia usually occur?

Answer 25

in areas of chronic inflammation

Question 26

What type of cells does metaplasia work with?

Answer 26

epithelial

Question 27

What is Barrett's esophagus?

Answer 27

gastric simple columnar epithelium goes past junction into esophagus

Question 28

In Barret's esophagus, what happens in response to chronic acid reflux?

Answer 28

esophageal stratified squamous epithelium changes to mucus-secreting columnar epithelium

Question 29

What is bronchial metaplasia?

Answer 29

columnar epithelium to stratified squamous epithelium

Question 30

Bronchial metaplasia has an increased risk of what?

Answer 30

malignant transformation

Question 31

What is cervical metaplasia?

Answer 31

simple columnar epithelium changes to stratified squamous epithelium

Question 32

What is the endocervix?

Answer 32

lower portion of uterus

Question 33

Where in the cervix does cervical metaplasia occur?

Answer 33

endocervix

Question 34

What are examples of intracellular accumulations?

Answer 34

* proteins * lipids * fats * metals * pigments

Question 35

Intracellular/extracellular accumulations may signal what?

Answer 35

damage or adaptation to stress by cells

Question 36

How does liver disease form in intracellular accumulations?

Answer 36

rate of metabolism is inadequate

Question 37

What are the mechanisms of intracellular accumulations?

Answer 37

1. normal substance produced but rate of metabolism is inadequate 2. normal accumulation d/t defect in metabolism, packaging, transport, or secretion 3. gene mutation resulting in inactive metabolic enzyme 4. gene mutation results in abnormal protein

Question 38

What is the inherited disorder associated with the accumulation of proteins?

Answer 38

alpha-1-antitrypsin disease (A1AT)

Question 39

What does alpha-1-antitrypsin disease (A1AT) arise from?

Answer 39

misfolded AAT proteins

Question 40

What occurs when the misfolded AAT proteins cannot be packaged/secreted?

Answer 40

causes damage/accumulation

Question 41

What is the disease associated with intracellular accumulations that code for alpha subunit lysosomal enzyme beta-hexosaminidase A?

Answer 41

Tay-Sachs disease

Question 42

What does Tay-Sachs disease inhibit?

Answer 42

complete digestion of gangliosides

Question 43

What are the 2 disorders associated with fat accumulation?

Answer 43

* Reyes syndrome * acute fatty liver of pregnancy

Question 44

Reyes syndrome affects what organs in whom?

Answer 44

liver and brain in children/teenagers recovering from viral infection

Question 45

What is acute fatty liver of pregnancy?

Answer 45

mitochondrial dysfunction of fatty acids d/t deficiency of 3-hydroxyacyl-CoA dehydrogenase

Question 46

What does the accumulation of cholesterol contritbute to?

Answer 46

atherosclerosis

Question 47

What is iron from damaged RBCs stored by macrophages as?

Answer 47

ferritin

Question 48

How can ferritin be transported?

Answer 48

by transferrin via circulation to liver

Question 49

What is known as the undigestable hemosiderin?

Answer 49

end product of ferritin metabolic degradation

Question 50

What is hemochromatosis?

Answer 50

autosomal recessive disorder of iron absorption

Question 51

What disorder involves an increased uptake of iron in GI tract?

Answer 51

hemochromatosis

Question 52

What stain is associated with the accumulation of copper?

Answer 52

rhodanine stain

Question 53

What is the mechanism of copper excretion?

Answer 53

biliary tract

Question 54

What can chronic biliary obstruction lead to?

Answer 54

copper accumulation in hepatocytes

Question 55

What is the disease associated with the accumulation of copper?

Answer 55

Wilson's disease

Question 56

What is Wilson's disease?

Answer 56

autosomal recessive disease of inability to excrete copper from hepatocyte to bile tract

Question 57

Where do the toxic levels appear with the accumulation of copper?

Answer 57

liver and brain

Question 58

What are the endogenous pigments?

Answer 58

* bilirubin * jaundice * lipofuscin

Question 59

What is bilirubin?

Answer 59

breakdown of heme moiety of hemoglobin and heme-containing enzymes

Question 60

What is lipofuscin?

Answer 60

wear and tear/aging pigment

Question 61

What are the exogenous pigments?

Answer 61

carbon particles and tattoos

Question 62

What are the 2 extracellular accumulations?

Answer 62

amyloidosis and pathologic calcification

Question 63

What is amyloidosis?

Answer 63

inherited and inflammatory disorder with extracellular deposition of misfolded fibrillar amyloid proteins

Question 64

What is the protein plaque found in Alzheimer and the most common form of amyloidosis?

Answer 64

alpha-beta

Question 65

Where is amyloid esophagus found?

Answer 65

in people who smoke or drink

Question 66

Where is amyloid kidney glomerulus found?

Answer 66

in people with diabetes

Question 67

What is pathologic calcification?

Answer 67

large intracellular calcific bodies in irreversibly injured mitochondria

Question 68

What are the 2 types of pathologic calcifications?

Answer 68

dystrophic and metastatic

Question 69

What is dystrophic calcification?

Answer 69

extracellular Ca in necrotic/chronically traumatized tissue

Question 70

Are the serum values for Ca normal in dystrophic calcification?

Answer 70

YES

Question 71

Is dystrophic calcification always localized?

Answer 71

YES

Question 72

When does metastatic calcification occur?

Answer 72

in conditions of high serum Ca levels with deposits of Ca salts in viable normal tissue

Question 73

What are the serum conditions like in metastatic calcification?

Answer 73

high

Question 74

What are some causes of hypercalcemia?

Answer 74

* hypersecretion of parathyroid hormone * destruction of bone tissue * vitamin D poisoning * milk-alkali syndrome * uremia