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Pathoma Chapter 1 > Cell Death > Flashcards

Cell Death Flashcards

1
Q

Hallmark of Cell Death

A

Loss of Nucleus

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2
Q

3 Steps to Loss of Nucleus in Cell Death

A

Pyknosis (Shrinkage)
Karyorrhexis (Breaking into Pieces)
Karyolysis (PIeces → Building Blocks)

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3
Q

2 Mechanisms of Cell Death

A

Necrosis (Murder)

Apoptosis (Suicide)

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4
Q

Necrosis

A

Death of a LARGE group of cells
Followed by Acute Inflammation
Always Pathologic
6 Types

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5
Q

6 Types of Necrosis

A 
Coagulative
Liquefactive
Gangrenous
Caseous
Fat
Fibrinoid
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6
Q

Coagulative Necrosis

A

Necrotic tissue that remains firm (due to coagulation of cellular proteins)
Tissue dies, but structure remains (except nuclei)

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7
Q

Classic Example of Coagulative Necrosis

A

Ischemic Infarction (any organ EXCEPT brain)

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8
Q

Path Findings of Coagulative Necrosis

A

Infarcted area wedge-shaped & pale
Wedge points to occlusion

If red infarction, that means blood re-entered a loosely-organized tissue

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9
Q

Classic Example of Red Ischemic Infarction

A

Testicle w/ Hemorrhagic Infarction (torsion around vein → congestive infarct)

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10
Q

Liquefactive Necrosis

A

Necrotic tissue becomes liquefied

Enzymatic lysis of cells & proteins

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11
Q

3 Circumstances Leading to Liquefactive Necrosis

A

Brain Infarction (Microglia have liquefactive enzymes)
Abscess (PMNs have hydrolytic enzymes)
Pancreatitis (Hyperactive pancreas digests itself, also leads to Fat Necrosis)

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12
Q

Gangrenous Necrosis

A

Coagulative Necrosis that resembles mummified tissue (Dry Gangrene)
Typically from ischemic insult to the lower limb, GI tract
Common in diabetics

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13
Q

Gangrenous Necrosis + Superimposed Infection

A

Liquefactive Necrosis (Wet Gangrene)

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14
Q

Caseous Necrosis

A

Soft, friable, cottage cheese appearance

Liquefactive + Coagulative

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15
Q

Caseous Necrosis Classically Associated With

A

Granulomatous Inflammation due to TB or Fungal Infection

Mycobacterial or Fungal walls = Flour in the gravy

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16
Q

Fat Necrosis

A

Fatty Acids released by trauma or lipase

Calcium deposits, forming Chalky-White appearance (saponification of Calcium)

17
Q

Fat Necrosis Classically Caused By

A

Trauma to fat (eg Breast) - Can present with a mass, due to giant cell reaction

OR

Peripancreatic fat in pancreatitis

18
Q

Saponification of Calcium Seen In

A 
Fat Necrosis
vs.
Dystrophic Calcification
vs.
Metastatic Calcification
19
Q

Dystrophic Calcification

A

Dead or dying tissue = Nidus for calcium deposition

Ex. Psammoma Bodies, Saponification

20
Q

Metastatic Calficiation

A

Not always associated with metastatic CANCER

Elevated Ca or Ph (for whatever reason) in serum → Ca precipitates in tissues

21
Q

Fibrinoid Necrosis

A

Necrosis to blood vessel wall

Proteins leak into vessel wall → Bright pink staining

22
Q

Fibrinoid Necrosis Classically Seen In

A 
Malignant Hypertension (Super high, headache, renal failure, papilledema) - Can be seen in pre-eclampsia
Vasculitis
23
Q

Significant Necrosis seen in Pre-Eclampsia

A

Fibrinoid Necrosis of Placental Vessels

24
Q

Apoptosis

A

Energy-Dependent, Genetically-Programmed Cell Death

Single cells or small groups of cells

25
Q

Examples of Apoptosis

A

Endometrial Shedding
Embryogenesis
CD8+ T-Cell mediated killing of virally-infected cells

26
Q

T Cell Lifespan

A

Born in Marrow
Educated in Thymus
Positive Selection (Can it bind self-Ag + MHC?)
Negative Selection (Does it bind self-Ag too strongly?)

27
Q

Mechanism of T-Cell death during negative selection

A

Binds self-Ag too strongly → Apoptosis via FAS

28
Q

Apoptosis Morphology

A 
Cell shrinks, becomes eosinophilic (from concentrated cytoplasm)
Nucleus condenses & fragments
Apoptotic bodies fall off cell
Apoptotic bodies removed by macrophages
No inflammation involved
29
Q

Apoptosis Mediators

A

Caspases activate:
Proteases (Break down cytoskeleton)
Endonucleases (Break down DNA)

30
Q

3 Caspase Pathways

A

Intrinsic Mitochondrial Pathway
Extrinsic Receptor-Ligand Pathway
Cytotoxic CD8+ T-Cell Pathway

31
Q

BCL2

A

Stabilizes mitochondrial membrane

Keeps Cytochrome C inside

32
Q

Intrinsic Mitochondrial Caspase Pathway

A 
Cellular Injury
OR
DNA Damage
OR
Decreased Hormonal Stimulation (eg Estrogen)
↓
BCL2 Inactivation
↓
Cytochrome C moves from mitochondrial matrix into cytoplasm
↓
Caspases Activated
33
Q

Extrinsic Receptor-Ligand Caspase Pathway

A 
FAS-L binds FAS Death Receptor (CD95) on target cell
OR
TNF binds TNF-R on target cell
↓
Caspases Activated
34
Q

Cytotoxic CD8+ T-Cell Caspase pathway

A 
CD8+ T Cell recognizes MHCI Ag
CD8+ T Cell binds and kills
Perforin drill a hole
Granzyme enters pores
↓
Caspases Activated

Pathoma Chapter 1 (5 decks)

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