Cell adaption and necrosis

Question 1

What is cell adaption?

Answer 1

prolonged exposure of cell to pressure or toxin results in change in cell

if pressure: cells get big

If toxin: cells change shape

Question 2

What are the 6 ways that cells adapt to change?

Answer 2

atrophy, hypertrophy, hyperplasia, metaplasia, dysplasia and anaplasia

Question 3

Define atrophy

Answer 3

decrease in the size of a tissue, organ or the entire body

can be physiologic v. pathologic atrophy

Question 4

examples of physiologic atrophy?

Answer 4

thymus undergoing involution

ovaries, uterus and breasts after menopause

atrophic bones and muscles in the elderly become thin and prone to fracture

Question 5

examples of pathologic atrophy?

Answer 5

alzheimer dementia,

ischemic organs-typically small,

testicular atrophy

Question 6

Define hypertrophy

Answer 6

increase in the size of tissue due to enlargement of individual cells

can be physiologic or pathologic

Question 7

examples of physiologic hypertrophy?

Answer 7

enlargement of muscles in body builders

Question 8

examples of pathologic hypertrophy?

Answer 8

hypertrophy of the heart occurs as an adaption to increase workload

Question 9

When do we usually see concentric hypertrophy of the left ventricle? why?

Answer 9

in HTN

it is an adaptive response to left ventricular pressure overload

Question 10

What can be seen in hypertrophy cardiomyopathy?

Answer 10

banana septum

Question 11

Define hyperplasia

Answer 11

an increase in the number of cells which causes enlargement of tissues

Question 12

Can hyperplasia and hypertrophy be seen together?

Answer 12

yes, in pregnancy

hyperplastic prostate

Question 13

Examples of hyperplastic process?

Answer 13

endometrial hyperplasia due to estrogens

Question 14

Example of a disease where hyperplasia is seen?

Answer 14

hyperplastic polyps of the colon or stomach

Question 15

Define metaplasia

Answer 15

an adaptive change of one cell type for another cell type to suit the environment

reversible but can also progress to dysplasia

Question 16

Examples of metaplasia

Answer 16

squamous metaplasia of the bronchial epithelium due to smoking

gastric or glandular metaplasia of GE junction barrett esophagus

Question 17

Define dysplasia

Answer 17

disordered growth of tissues resulting from chronic irritation or infection

considered a precancerous condition

Question 18

Example of dysplastic change?

Answer 18

detection of cervical dysplasia on PAP smear

there is an association of dysplasias and cervical cancer with HPV

Question 19

With dysplasia …..gets large and …starts to shrink

Answer 19

nucleus

cytoplasm

Question 20

What does hyperchromatic mean?

Answer 20

stains darker

Question 21

define anaplasia

Answer 21

undifferentiated and uncontrolled growth of cells, hallmark of malignant transformation

Question 22

Anaplasia is also called??

Answer 22

malignancy, carcinoma, cancer, neoplasm

Question 23

neoplasm means?

Answer 23

new growth

Question 24

Examples of anaplasia?

Answer 24

squamous cell carcinoma of the cervix, cancer of the lung, malignant melanoma

Question 25

What color can malignant melanoma be?

Answer 25

red, white, blue, black or brown

Question 26

Which cancer are known as the silent killers?

Answer 26

renal cell carcinoma, ovarian, pancreatic, glioblastoma

Question 27

Hallmarks of anaplasia?

Answer 27

1. cells and nuclei display marked cellular pleomorphism 2. nuclei are irregular and hyperchromatic 3. high nuclear/cytoplasmic ratio (about 1:1) 4. large nucleoli present within nucleus 5. large numbers of abnormal mitotic figures

Question 28

Define pleomorphism

Answer 28

variation in size and shape

Question 29

Should you ever see mitotic figures in normal tissue?

Answer 29

NO

Question 30

What is cell necrosis?

Answer 30

death of cells or groups of cells within a living organism

Question 31

What is the difference between necrosis and autolysis?

Answer 31

necrosis: seen in living autolysis: seen in tissues after death

Question 32

Name the 4 types of necrosis

Answer 32

coagulative liquefactive caseous fat

Question 33

What is coagulative necrosis?

Answer 33

most common type of necrosis occurs when cell proteins are altered or denatured (like cooking eggs) cell outlines preserved and cytoplasm finely granular

Question 34

Examples of coagulative necrosis?

Answer 34

typically occurs in solid internal organs i.e. heart, kidney, spleen, liver most often caused by anoxia, ex. heart tissue undergoing MI

Question 35

What is anoxia?

Answer 35

lack of blood supply

Question 36

What is liquefactive necrosis?

Answer 36

dead cells liquify under the influence of certain cell enzymes, tissue becomes soft and gel like

Question 37

Examples of liquefactive necrosis?

Answer 37

most often occurs in the brain where the brain cells lose their contours and liquify, typical of brain infarcts can also be seen in bacterial infections (abscesses in the lungs)

Question 38

What is caseous necrosis?

Answer 38

a form of coagulative necrosis in which a thick, yellowish, cheesy substance forms

Question 39

Examples of caseous necrosis?

Answer 39

typically found in TB, characterized by the development of lung granulomas inside of which can be found caseous necrosis- Ghon complex can also be seen in some fungal infections

Question 40

What is fat necrosis?

Answer 40

a specialized form of liquefaction necrosis, caused by the action of lipolytic enzymes

Question 41

Examples of fat necrosis

Answer 41

limited to fat tissue, usually around the pancreas. Enzymes are released into the adjacent fat tissue, usually after rupture of the pancreas, causing degradation of fat

Question 42

Wet v. dry gangrene

Answer 42

gangrene is bacterial infection of necrotic tissue Wet: bacterial infection of coagulated tissue leads to inflammation and secondary liquefaction Dry: necrotic tissue dries out and becomes black and mummified

Question 43

What conditions can contribute to gangrene?

Answer 43

often occur after infarction of the intestines of in a limp, usually caused by atherosclerosis or DM

Question 44

What is dystrophic calcifications?

Answer 44

necrotic tissue attracts calcium salts and freq. undergoes calcification, refers to the macroscopic deposition of calcium in injured or dead tissues

Question 45

Examples of dystrophic calcification?

Answer 45

1. calcification in atherosclerotic CA contributes to narrowing of the vessels 2. calcifications of the mitral or aortic valves leading to impeded blood flow (stenosis) 3. Calcifications seen around breast cancer 4. infant periventricular calcifications seen in congenital toxoplasmosis

Question 46

what is metastatic calcifications?

Answer 46

reflects deranged calcium metabolism, usually associated with increased serum calcium levels, leading to deposition of calcium in other locations

Question 47

Examples of metastatic calcifications?

Answer 47

seen in various disorders including hyperparathyroidism, vit D toxicity and chronic renal failure formation of Ca stones in sites such as gallbladder, kidney and bladder are due to precipitation of salts from solutions into tissues