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U8 Pathology > Cell Injury > Flashcards

Cell Injury Flashcards

1
Q

What are some clinical findings in hypoxia?

A

Cyanosis
Confusion
Cognitive impairment
lethargy

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2
Q

What are the consequences of ischemia?

A

Atrophy
Infarction of tissue
Organ dysfunction

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3
Q

What is the hallmark of reversible injury to cells?

A

Cell swelling

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4
Q

What is the hallmark of irreversible cell injury?

A

membrane damage

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5
Q

What is cytochrome C and when/where is it released?

A

activates apoptosis–released when there is damage to the mitochondrial membrane–leaking into cytosol

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6
Q

What is a fenton reaction and what does this cause?

A

Generation of OH free radical from H2O2—causing cell injury

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7
Q

What does glutathione peroxidase do?

A

neutralizes H2O2, OH and NAPQ1–toxic intermediate of Acetaminophen

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8
Q

What antioxidant neutralizes oxidized LDL?

A

Vit E

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9
Q

What antioxidant neutralizes FRs from pollutants and cigarette smoke?

A

Vit C

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10
Q

What enzyme converts superoxide to H2O2?

A

superoxide dismutase

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11
Q

How is liver necrosis caused from acetaminophen poisoning?

A

CYP2E1 (MEOS)–converts high doses of acetaminophen into toxic intermediate NAPQ1–FR

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12
Q

What is Chediak-Higashi syndrome (CHS)?

A

Defect in lysosomal transport protein affecting the synthesis and/or maintenance of storage of secretory granules

Result– giant lysosomal granules–defect in formation of phagolysoscomes–increased susceptibility to developing Staphylococcus aureus infection

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13
Q

What is ferritin? What does serum levels of ferritin correlate with?

A

soluble iron-binding protein that stores iron in macrophages

Serum levels directly correlate with bone marrow into stores–decreased serum ferritin=iron deficiency

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14
Q

What is hemosiderin?

A

insoluble product of ferritin degradation in lysosomes—does NOT circulate in serum

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15
Q

What is Dystrophic calcification?

A

Deposition of Calcium phosphate in necrotic tissue–Ca enters tissue and binds to phosphate that has been released from damaged membranes—Ca and PO4 levels are normal

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16
Q

What is metastatic calcification?

A

Deposition of calcium phosphate in the interstitial of NORMAL tissue due to increased serum Ca and PO4

Ca–hyperparathyroid/malignancy induced hypercalcemia
PO4- Renal failure/hypoparathyroid

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17
Q

What type of growth alteration does the uterus undergo during pregnancy and how is this induced?

A

Estrogen induced hypertrophy and hyperplasia

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18
Q

What growth alteration occurs in cardiac and skeletal muscle?

A

both can ONLY undergo hypertrophy

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19
Q

What are some examples of pathogenic hypertrophy?

A

LV hypertrophy

cytomegalovirus infection–cytomegaly

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20
Q

What are examples of increased hormone stimulation hyperplasia?

A

Endometrial gland hyperplasia–caused by increase in estrogen (decrease in progesterone inhibition)–increased risk of cancer

Benign prostatic hyperplasia (BPH)–caused by increased sensitivity to dihydrotestosterone(DHT)–NO increased risk of cancer

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21
Q

What are some examples of chronic irritation hyperplasia?

A

Scratching of itchy skin—thickening of epidermis

Branchial mucous gland hyperplasia

Regenerative nodules in cirrhosis of liver–excess ETOH

22
Q

What are examples of Chemical imbalance hyperplasia?

A

Hypocalcemia–stimulates parathyroid gland hyperplasia

Iodine deficiency– thyroid enlargement–both hypertrophy and hyperplasia cause goiter formation

23
Q

What is an example of stimulating antibodies causing hyperplasia?

A

Hyperthyroidism in Graves Dz–due to thyroid stimulating antibodies directed against thyroid hormone receptors

Thyroid gland increases to increase synthesize of thyroid hormones

24
Q

What is an example of viral infection causing hyperplasia?

A

HPV causing epidermal hyperplasia/common wart

25
Q

Example of metaplasia from squamous to glandular epithelium?

A

Barrett esophagus—Occurs when there is acid reflux from the stomach into the distal esophagus—increase in goblet and mucus secreting cells for protection

Increased risk of developing adenocarcinoma

26
Q

Example of metaplasia from glandular to other type of glandular?

A

Occurs in the pylorus and antrum epithelium in the stomach–infection cause by helicobacter pylori—cytokines produce chronic gastritis—increased goblet and paneth cells normally present in intestinal epithelium

Increased risk of developing a gastric cancer

27
Q

Examples of metaplasia from glandular to squamous epithelium?

A

occurs in the main stem bronchus epithelium–pseudostratified columnar–develops squamous metaplasia in response to cigarette smoke–increased risk of cancer

Mucus-secreting endocervical cells encountering acid pH of vagina–squamous cell metaplasia

28
Q

Example of metaplasia from transitional to squamous epithelium?

A

Schistosoma haematobium infection—urinary bladder

increased risk for developing squamous cancer of the urinary bladder

29
Q

Example of mesenchymal metaplasia involving connective tissue?

A

osseous metaplasia– bone tissue develops in an area of muscle trauma

30
Q

What are some risk factors for dysplasia?

A 
Hyperplasia--endometrial gland 
Metaplasia-Barrett esophagus
HPV infection
Chemicals--cigarette smoke--squamous metaplasia in main stem bronchus
UV light--squamous dysplasia
31
Q

What are the microscopic features of dysplasia?

A

Increased mitotic activity
increased nuclear size and chromatin
disorderly proliferation of cells with loss of cell maturation as cells progress to the surface

32
Q

Define coagulative necrosis?

A

Cell shape and organ structure preserved

Loss of nucleus

33
Q

What are the characteristics of coagulative necrosis?

A

Most likely involves an ischemic infarct to any organ—except brain

Wedge shaped and pale area

34
Q

What is a pale ischemic type of infarct?

A

Coagulative necrosis

Increased density of tissue–heart/kidney/spleen–prevents RBCs from diffusing through necrotic tissue

35
Q

What is a hemorrhagic (red) type of infarct?

A

Coagulative necrosis

loose-textured tissue–lungs/small bowel/testicle—allows RBCs to differs through the necrotic tissue

36
Q

Where is infarction more likely?

A

Kidney and spleen due to presence of end arteries

37
Q

Where is infarction least likely?

A

Lungs–due to the dual blood supply from pulmonary and bronchial arteries

38
Q

Define liquefactive necrosis?

A

Necrotic degradation of tissue that softens and becomes liquified

39
Q

What are some examples of liquefactive necrosis

A

Brain infarction–microglial cells
abscess–neutrophils
Pancreatitis–pancreas itself

40
Q

What are examples of caseous necrosis?

A

Formation of Granulomas from

  • -mycobacterium tuberculosis
  • -fungi (histoplasma)
41
Q

What is caseous necrosis?

A

variant of coagulation necrosis–combination of coagulative and liquefactive

Acellular, cheese-like material present on gross examination

Characteristic of granulomatous inflammation due to TB or fungal infection

42
Q

What is a Noncaseating granuloma and what are some examples of where it is seen?

A

Lack excessive amour of lipid–so they don’t exhibit caseation

Ex: crohn dz/sarcoidosis/foreign body giant cell granulomas

43
Q

What is dry gangrene?

A

Coagulative necrosis that resembles mummified tissue–lower limbs and GI

44
Q

What is wet gangrene?

A

Gangrenous necrosis with infection–liquefactive necrosis

45
Q

What is enzymatic necrosis?

A

Necrosis to adipose tissue located around an acutely inflamed pancreas

–Ca and fatty acids coming together—saponification

46
Q

What is traumatic fat necrosis?

A

Necrosis in fatty tissue–breast/abdomen as a result of blunt trauma or surgery

–Ca and fatty acids coming together—saponification

47
Q

What is fibrinoid necrosis?

A

Necrotic damage to blood vessel wall—immune mediated dz

Immune vasculitis/malignant HTN/rheumatic fever

48
Q

What proteins maintain mito membrane integrity and prevent leakage of mito proteins that can trigger apoptosis?

A

BCl-2 and BCl-XL

49
Q

What BCl-2 effectors activate the intrinsic pathway of apoptosis?

A

BAX and BAK

50
Q

What receptors and ligands are involved in the extrinsic pathway of apoptosis?

A

TNF receptors

FAS ligands—binds FAS death receptor (CD95) activating caspases

51
Q

What is pyropotosis?

A

pro inflammatory cell death using caspase-1

monocyte/macrophage/dendritic cell destruction—-salmonella/shigella/legionella

U8 Pathology (3 decks)

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