cell injury, cell death, and toxin insult

Question 1

what are the main adaptive cellular responses

Answer 1

hypertrophy (increase in cell size), hyperplasia (increase in # of cells), atrophy (decrease in size and metabolic activity), and metaplasia (change in phenotype)

Question 2

physiological adaptation occurs under

Answer 2

responses to normal stimuli

Question 3

pathological adaptation occurs under

Answer 3

responses to stress that allows cells to change structure and function

Question 4

what occurs in hypertrophy

Answer 4

-increase in size of cells leading to increase size of organ
- adaptive response in cells with limited capacity to divide

Question 5

what are the causes for hypertrophy

Answer 5

physiological increase hormone or pathological increase workload

Question 6

what occurs in hyperplasia

Answer 6

• adaptive response in cell capable of replication
• increase in number of cells

Question 7

what occurs in atrophy

Answer 7

shrinkage in size of cells

Question 8

what are the etiological factors associated with atrophy

Answer 8

decreased workload, loss of innervation, diminished blood supply

Question 9

what are the mechanisms of atrophy

Answer 9

decreased protein synthesis and increased protein degradation

Question 10

what occurs in metaplasia

Answer 10

reversible changes in cell type in response to stress

Question 11

what are the two types of cell death

Answer 11

necrosis- pathologic process
apoptosis- not necessarily associated with pathology

Question 12

characteristics of necrosis

Answer 12

cell swelling, membrane disrupted, no ATP required

Question 13

characteristics of apoptosis

Answer 13

cell shrinkage, requires ATP

Question 14

what are the causes of cell injury

Answer 14

hypoxia, chemical agents, infectious agent, immunological reaction, genetic factors, nutritional imbalance, physical agents, aging

Question 15

what two phenomena characterize irreversibility

Answer 15

inability to correct mitochondria dysfunction
profound disturbance in membrane function

Question 16

two main morphological correlate of reversible cell injury are

Answer 16

cell swelling and fatty change

Question 17

why is cell swelling first manufactured

Answer 17

failure of energy depended ion pumps in plasma membrane

Question 18

what is seen in fatty change

Answer 18

appearance of lipid vacuoles in cytoplasm
occurs in hypoxic injury

Question 19

necrosis is characterized by

Answer 19

changes in cytoplasm and nuclei of injured cells

Question 20

cytoplasmic changes in necrosis is characterized by

Answer 20

increased eosinophilia due to increased binding of eosin to denatured protein

Question 21

what are the 3 patterns that occur in nuclear changes in necrosis

Answer 21

karyolysis, pyknosis, karyorrhexis

Question 22

karyolysis is seen by

Answer 22

basophils of chromatin may fade

Question 23

pyknosis is seen by

Answer 23

nuclear shrinkage and increased basophilia

Question 24

karyorrhexis is seen by

Answer 24

pyknotic nucleus undergoes fragmentation

Question 25

dead cells may be replaced by

Answer 25

myelin figures that can be degraded to fatty acids

Question 26

fatty acids can bind to

Answer 26

calcium salts that may result in dead cells calcified

Question 27

what are the patterns of tissue necrosis

Answer 27

coagulative necrosis, liquefaction necrosis, fat necrosis, caseous necrosis, fibrinoid necrosis, gangrenous necrosis

Question 28

what are the causes of coagulative necrosis

Answer 28

sudden cut of the blood supply (ischemic necrosis)

Question 29

hypoxia is what

Answer 29

deficiency of oxygen

Question 30

ischemia is

Answer 30

reduced blood flow

Question 31

ultrastructure changes of reversible injury

Answer 31

-blabbing and loss of microvilli in plasma membrane - modest mitochondria swelling -dilation with detachment of polysomes of ER

Question 32

ultrastructure changes of irreversible injury

Answer 32

- disruption of plasma membrane - massive mitochondria swelling - extensive disruption and fragmentation of ER

Question 33

denaturation of cellular proteins in coagulative necrosis causes tissue to appear

Answer 33

hard, opaque white and preserve its architecture

Question 34

in coagulative necrosis, it presents area of

Answer 34

infarcts

Question 35

liquefactive necrosis is characterized by

Answer 35

digestion of dead cells resulting in transformation of tissue into liquid viscous mass

Question 36

what organs is liquefactive necrosis typically seen

Answer 36

brain and spinal cord

Question 37

pyogenic abscess is

Answer 37

the necrotic core is liquefied by proteolytic enzymes releasing pus

Question 38

what mechanism is seen in liquefactive necrosis

Answer 38

lysosomal enzymes released by necrotic cells/neutrophils

Question 39

the most clinical cause of gangrenous necrosis is

Answer 39

ischemia to lower extremities

Question 40

caseous necrosis typical for ____ lesions

Answer 40

tuberculous

Question 41

the tissue in caseous necrosis appears

Answer 41

yellowish white and cheesy

Question 42

necrosis is followed by _____ in caseous necrosis

Answer 42

slow partial liquefaction

Question 43

fat necrosis occurs due to

Answer 43

enzyme lipase digesting fat cells to fatty acids

Question 44

combination of fatty acids with calcium leads to

Answer 44

calcium soaps/ opaque white patches

Question 45

what is the fundamental cause of necrotic death

Answer 45

depletion of ATP

Question 46

major causes of ATP depletion are

Answer 46

- decreased O2 and nutrient supply - mitochondrial damage - toxins

Question 47

what are consequences of ATP depletion

Answer 47

- plasma membrane pumps decreases - increase anaerobic glycolysis - failure of ATP Ca2+ pumps - disruption of protein synthesis

Question 48

what are stimuli for mitochondria injury

Answer 48

ischemia, chemical toxins, and radiation

Question 49

mitochondrial damage may result in

Answer 49

-failure to oxidative phosphorylation -abnormal oxidative phosphorylation - formation of abnormal mitochondria permeability transition pore

Question 50

influx of calcium is caused by

Answer 50

ischemia and some toxins

Question 51

what are the effects of increased cytosolic calcium

Answer 51

activates enzymes that can deteriorate cells ex. phospholipase, protease, endonuclease

Question 52

oxidative stress is the ....

Answer 52

abnormal accumulation of oxygen derived free radicals

Question 53

the damage caused by free radicals is determined by

Answer 53

rate of production and removal of ROS

Question 54

excess free radicals leads to

Answer 54

oxidative stress

Question 55

plasma membrane can be damaged by

Answer 55

ischemia, microbial toxins, lytic complement components, physical agents, chemical agents

Question 56

major cellular abnormality in oxygen deprived cells are

Answer 56

-decrease ATP generation - mitochondria damage - accumulation of ROS

Question 57

loss of ATP leads to

Answer 57

- failure of ion pumps - depletion of glycogen stores - decreased protein synthesis

Question 58

ischemia-reperfusion injury is caused when

Answer 58

restoration of blood flow to ischemic tissues leading to cell death

Question 59

apoptosis is normal phenomena that serves to

Answer 59

eliminate cells that are no longer needed

Question 60

apoptosis results from activation of

Answer 60

caspases enzymes

Question 61

what are the two distinct pathways for apoptosis

Answer 61

mitochondria (intrinsic) pathway death receptor (extrinsic) pathway

Question 62

intrinsic pathway is triggered by...

Answer 62

loss of survival signals, DNA damage, and accumulation of misfolded proteins

Question 63

extrinsic pathway is responsible for

Answer 63

elimination of self reactive lymphocytes and damage by cytotoxic T cells

Question 64

autophagy refers to

Answer 64

lysosomal digestion of cells own components

Question 65

autophagy is survival mechanism in

Answer 65

times of nutrient deprevation

Question 66

intracellular organelles and some cytosol sequester into

Answer 66

a autophagic vacuole

Question 67

vacuole fuses with lysosomes to form

Answer 67

autophagolysosome

Question 68

what substances can accumulate inside cells

Answer 68

water, fat, mucin, glycogen, proteins, pigments

Question 69

what are the 2 main pathways of abnormal intracellular accumulations

Answer 69

- inadequate removal of normal substances (fatty liver) - failure to degrade a metabolite (storage disorders)

Question 70

dystrophic calcification occurs when...

Answer 70

deposition occurs in dead or dying tissues

Question 71

metastatic calcification occurs when...

Answer 71

- deposition of calcium salts in normal tissue - reflects hypercalcemia

Question 72

mechanism responsible for cellular aging

Answer 72

- DNA damage - decreased cellular replication - defective protein homeostasis