Cell Injury & Adaptation I, II

Question 1

Which three permanent tissues undergo hypertrophy only?

Answer 1

1. Skeletal muscle
2. Cardiac muscle
3. Nervous tissue

Question 2

Arnold’s skeletal muscle cells are an example of ________.

Answer 2

Hypertrophy - caused by high work demand, more trophic stimulation, and more nutrient supply.

Question 3

What are 3 general features of hypertrophic cells?

Answer 3

1. Open chromatin and larger nuclei
2. Greater cytoplasmic volume
3. Greater specialization

Question 4

Decrease in cell number occurs via:

A. Ubiquitin-proteosome degradation (of the cytoskeleton)

B. Apoptosis

C. Autophagy of cellular components

Answer 4

B (mechanisms A and C cause a decrease in cell size)

Question 5

The central role of mTOR protein kinase complexes is:

Answer 5

Regulation of atrophy

Question 6

What are three general features of Atrophic cells?

Answer 6

1. Condensed chromatin
2. Less cytoplasmic volume
3. Loss of specialization

Question 7

Is less trophic stimulation generally correlated with atrophy or hypertrophy?

Answer 7

Atrophy

Question 8

Metaplasia (a change in cell type) most commonly involves a change of what type of cell?

Answer 8

Surface epithelium (squamous, columnar, or urothelial)

Question 9

What is the mechanism behind Barrett espophagus?

Answer 9

Squamous epithelial cells of the esophagus change to columnar epithelial cells due to acid.

Question 10

The attached image is an example of which gastrointestinal condition?

Answer 10

Barrett esophagus

Question 11

What process is occurring here?

Answer 11

Squamous metaplasia of the endocervix; cells transitioning

Question 12

Cervical intraepithelial neoplasia, a precursor to cervical cancer, is an example of:

A. Metaplasia

B. Atrophy

C. Dysplasia

D. Aplasia

E. Hypoplasia

Answer 12

C

Question 13

Which of the following morphologic cell findings is an indicator of reversible injury?

A. Myelin figures

B. Chromatin clumping

C. Chromatin fragmentation

D. Disappearance of stable nuclei

E. Karyolysis

Answer 13

A - the other options - chromatin clumping (pyknosis), chromatin fragmentation (karyotrehexis), chromatin fading (karyolysis), and disappearance of nucleoi, are characteristic of irreversible injury and nuclear change!

Question 14

Ischemic cell injury is due primarily to what?

Answer 14

A failure to generate sufficient energy (ATP) for cell functions

Question 15

What determines the reversibility of ischemia damage?

Answer 15

the extent of excessive Calcium entry into the cytoplasm

Question 16

Which is an initial activating caspase?

A. Caspase-9

B. Caspase-3

C. Caspase-6

Answer 16

A

Question 17

Which is a terminal (execution) caspase?

A. Caspase-9

B. Caspase-8

C. Caspase-6

D. Caspase 10

Answer 17

C

Question 18

What is shown here?

Answer 18

An apoptotic body - membrane encased structure containing cytoplasm, densely-packed organelles and occasionally fragments of nuclei

Question 19

On histologic examination, caseous necrosis has what appearance?

Answer 19

Amorphous eosinophilic appearance

Question 20

Which describes necrosis?

A. Active form of cell death

B. Involves small clusters of cells, or single cells

C. Involves chromatin condensation and fragmentation

D. DNA fragmentation is haphazard rather than regular

E. No inflammatory reaction

Answer 20

D

Question 21

What process is shown here?

Answer 21

Necrosis (coagulative) in the liver - cells and their organelles swell and rupture

Question 22

Which type of necrosis is often associated with the lower extremities or bowel?

Answer 22

Gangrenous necrosis - note that this is also secondary to vascular occlusion

Question 23

What is shown here, and in what organ is this image located?

Answer 23

Lipfuscin - seen in hepatocytes (shown) and tissues with little to no cell turnover

Question 24

In acute hemorrhagic pancreatitis, fatty acids are liberated by what mechanism associated with enzymatic fat necrosis?

Answer 24

Saponification - fatty acid liberation by digestion of fat from calcium salts.

Question 25

Hypertensive heart disease causes symptoms in the left ventricle of the heart via increased workload from increased ventricular pressure. The increase in size of individual muscle cells is described as:

A. Aplasia

B. Hyperplasia

C. Hypertrophy

D. Metaplasia

Answer 25

C

Question 26

In hemochromatosis, is there increased or decreased melanin pigmentation in the skin?

Answer 26

Increased - this is part of the “bronze diabetes” triad - micronodular cirrohosis, diabetes mellitus, and skin pigmentation

Question 27

Which type of calcification is caused by hypercalcemia?

Answer 27

Metastatic calcification - in dystrophic calcification, the serum calcium concentration is normal becasue previously damaged tissues are the sties of deposition

Question 28

What is featured here?

Answer 28

Hepatic steatosis - a fatty change that is a feature of cell injury, especially in the liver.

Question 29

Which part of this image is abnormal, and what condition is featured?

Answer 29

bottom of image features coagulative necrosis of myocardial tissue; also referred to as infarction

Question 30

Angina pectoris is;

A. caused by increased blood flow to the heart muscle

B. Brought on by exertion

C. Typically referred to as ‘unstable angina’

D. Usually uncorrelated with atherosclerosis

Answer 30

B - aka “stable” angina

Question 31

What is being shown here?

Answer 31

a renal tubular hydropic change - meaning the the vesicular compartments of the kidney cell are swollen due to ionic imbalances due to loss of ATP

Question 32

What is being shown in these sections from the liver?

Answer 32

a hyaline change (a.k.a. Mallory’s Hyaline) - intermediate filament keratin-rich inclusions in hepatocytes - typically seen with chronic alcohol abuse