Cell Injury Flashcards

1
Q

What can cause cell injury?

A

Hypoxia

Toxins

Physical agents

  • trauma
  • temperature
  • pressure

Radiation

Micro-organisms

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2
Q

What is hypoxia?

A

Lack of oxygen

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3
Q

Difference between hypoxia and ischaemia

A
Hypoxia = lack of oxygen
Ischaemia = lack of blood supply
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4
Q

What are the different types of hypoxia?

A

Hypoxaemic
- arterial content of oxygen is low

Anaemic
- decreased ability of haemoglobin to carry oxygen

Ischaemic
- interruption to blood supply

Histoxic

  • Inability to utilise oxygen in cells
  • disabled oxidative phosphorylation enzymes
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5
Q

What happens in reversible injury?

A
No oxidative phosphorylation 
Reduced ATP
Na+ pump stops
Influx of Na+ and water
Cell swells
Anaerobic respiration 
pH lowered
Chromatin clumps
Detachment of ribosomes
Protein synthesis decreases
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6
Q

What happens in irreversible injury?

A

Ca2+ enters cell
Activates ATPase
Breaks down ATP
Activates phospholipase - reduces phospholipids
Activates protease - disrupts membranes
Activates endonucleases - nuclear chromatin damage

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7
Q

What are free radicals?

A

Reactive oxygen species

OH (hydroxyl)
O2- (superoxide)
H2O2 (hydrogen peroxide)

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8
Q

When are free radicals produced?

A

Normal metabolic reactions
Inflammation
Radiation

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9
Q

How does the body control free radicals?

A
Vitamins A, C, E 
Metal carrier/storage proteins
Enzymes 
- superoxide dismutase
- catalase
- glutathione peroxidase
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10
Q

How do free radicals injure cells?

A

Oxidative imbalance - number of free radicals overwhelms anti-oxidant system

Cause lipid peroxidation
Oxidise proteins, carbs, DNA

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11
Q

What are heat shock proteins?

A

In cell injury aim to ‘mend’ misfolded proteins

Unfoldases or chaperonins

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12
Q

What are cellular changes in reversible injury?

A
Dispersion of ribosomes
Blebs
Swelling - pale cytoplasm 
Chromatin clumping 
Autophagy by lysosomes 
Mitochondrial swelling
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13
Q

What are cellular changes in irreversible injury?

A
Rupture of lysosomes 
Myelin figures
ER lysis 
Disruption of membrane 
Nucleus changes
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14
Q

What is pyknosis?

A

Nucleus shrinks due to condensation of chromatin

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15
Q

What is karyorrhexis?

A

Nucleus breaks up

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16
Q

What is karyolysis?

A

Nucleus dissolves

17
Q

What is oncosis?

A

Cell death with swelling

18
Q

What is necrosis?

A

Appearance after cell death

19
Q

What are the types of necrosis?

A

Coagualtive
Liquefactive
Caseous
Fat necrosis

20
Q

What is coagulative necrosis?

A

Protein denaturation
Occurs in solid organs

Appearance = ghost outline of cells

21
Q

What is liquefactive necrosis?

A

Enzyme degradation
Enzymatic digestion of tissues

Appearance = dissolved cells

22
Q

What is caseous necrosis?

A

Associated with infections
- TB

Appearance = structureless debris

23
Q

What is fat necrosis?

A

Looks like coagulative necrosis but occurs in fat
Lipase releases fatty acids - Ca2+

Occurs in pancreatitis

24
Q

What is gangrene?

A

Visible appearance of necrosis

25
Q

What is an infarct?

A

Necrotic tissue as a result of loss of blood flow

26
Q

What is dry gangrene?

A

Necrosis modified by air exposure

coagulative necrosis

27
Q

What is wet gangrene?

A

Necrosis modified by infection

liquefactive necrosis

28
Q

What is gas gangrene?

A

Wet gangrene where the infection is with an anaerobic bacteria that produces gas

29
Q

What are the common causes of infarction?

A

Thrombosis

Embolism

30
Q

What are white infarcts?

A

Anaemic infarcts

Occur in solid organs - occlusion of an end artery
Often wedge shaped
Coagulative necrosis

31
Q

What are red infarcts?

A

Haemorrhagic infarct

Loose tissues or with dual blood supply
Bleeding into tissue

32
Q

What is ischaemia-reperfusion injury?

A

Return of blood supply to damaged tissue

Increased production of free radicals
Increased number of neutrophils - inflammation
Activation of complement pathway