Cell Injury & Death Flashcards
1
Q
Define etiology
A
Cause of disease
2
Q
Define pathogenesis
A
Mechanism of development
3
Q
Define molecular or morphogenic changes
A
Biochemical and structural alterations
4
Q
Define clinical manifestations
A
Functional consequences of disease or dysfunction
5
Q
What are the (2) circumstances that lead to cell injury?
A
- exceeding limits of adaptation
- adaptive resources unavailable when needed
6
Q
What is the difference between symptoms and signs?
A
Symptoms = what a pt feels
Signs = what is observed during exam
7
Q
Define edema
A
Accumulation of fluid in body tissues and cavities
8
Q
What are protooncogenes?
A
Genes of differentiation
9
Q
Define atrophy
A
Shrinkage of cells or organs
10
Q
What is the most common cause of pathologic atrophy?
A
Hypoxia
11
Q
What are less common causes of pathologic atrophy?
A
- disuse
- pressure
- denervation
- endocrine deficiency (target organ experiences atrophy)
12
Q
Define hypertrophy
A
Enlargement of existing cells - especially permanent, non-dividing cells - due to increased work load or hormonal action
13
Q
Define hyperplasia
A
Enlargement of tissue due to proliferation of cells - only in mitotic cell populations
14
Q
Define metaplasia
A
Substitution of one type of mature cell with another cell type
15
Q
What is Barrett’s Esophagus?
A
Columnar cell metaplasia of lower esophagus
16
Q
Define dysplasia
A
Atypical metaplasia - bad growth
17
Q
What is a prominent example of dysplasia and what does it lead to?
A
Uterine cervix dysplasia as seen with HPV, usually leads to cancer
18
Q
What usually regulates hyperplasia?
A
Growth factors & inhibitors
Cytokines
19
Q
What is are examples of nonpathological hyperplasia?
A
- compensatory response to partial loss of tissue
- pregnancy & nursing (uterine & breast tissue hyperplasia)
- wound repair
20
Q
What is ischemia?
A
Injury due to decreased blood flow - can be local or systemic
21
Q
What is hypoxemia?
A
Decreased blood oxygen due to decreased available oxygen or hemoglobin issues
22
Q
What is the first cellular problem during hypoxic injury?
A
Depletion of ATP stopping cellular activity, especially of NA/K pumps
23
Q
What are the enzymes activated by increased intracellular calcium, that can lead to cell injury and death?
A
- phospholipases
- proteases
- ATPases
- endonucleases
24
Q
How are free radicals removed or degraded?
A
- spontaneous decay
- action of enzymes
- antioxidant action (like vit A and C)
25
What is the consequence of mitochondrial injury?
Cell death
26
What are the (4) characteristics of fatty change seen in reversibly injured cells?
- Cell swelling & cloudiness
- mitochondria & ER swelling
- dispersed ribosomes
- formation of blebs
27
What change to cell membranes usually leads to cell death?
Degradation of membrane phospholipids reducing membrane integrity
28
What serum marker is considered to be a sign of cell injury and death?
Increased serum enzymes
29
Define pkynosis
Condensation - nuclear shrinkage
30
Define karyorrhexis
Fragmentation and breakdown of nucleus
31
Define karyolysis
Dissolution of nucleus
32
Coagulation necrosis is common in what types of tissue?
Solid organs - heart, kidney, muscle, adrenals
33
What is coagulation necrosis?
Denaturation of cytoplasmic proteins
34
What is liquefaction necrosis?
Tissues are lysed by enzymes from injured cells - a fluid filled cavity (cyst) forms
35
What is a common cause of liquefaction necrosis?
Infarcts of soft tissue (stroke!)
36
What is caseous necrosis?
Necrotic tissue has cheesy appearance - thought to be a combination of coagulation and liquefaction
37
What are common causes of caseous necrosis?
TB and leprosy
38
What is fat necrosis?
Hydrolysis of lipid deposits present in adipose -
| Resulting fatty acids interact with calcium to form chalky soap deposits
39
What are examples of fat necrosis?
Acute pancreatitis
| Liver saponification
40
What is gummatous necrosis?
Chronic, nodular fibrotic deposits
41
What disease causes gummatous necrosis?
Syphilis
42
What is gangrene?
Coagulation necrosis often with putrefaction from bacterial activity
43
What is dry gangrene and what body parts are most often affected?
Mummification - coagulation happens and the affected tissue dries out before bacteria activity
Happens in the digits and superficial structures
44
What are 2 common causes of dry gangrene?
- frostbite
| - infarctions
45
What is wet gangrene and what are common body parts affected?
Necrosis with bacterial infection leading to liquefaction
Intestinal infarcts
Acute appendicitis
46
What is gas, or infectious, gangrene?
Occurs in deep, blood deprived wounds with anaerobic bacteria that destroy tissues and release gas bubbles
47
Does apoptosis cause inflammation?
Nope. Cells shrink, nucleus undergoes karyorrhexis and karyolysis - then consumed by phagocytes
48
What are (4) non pathological causes of apoptosis?
- programmed tissue remodeling
- scheduled involution of tissues (thymus, post-lactating breast)
- regulated cell turn over of proliferating cells (dermis)
- programmed destruction of activation inflammatory cells (neutrophils) at the end of inflammation
49
What are pathological causes of apoptosis?
- radiation
- toxins / viruses
- autoimmunity
- neuron loss (Alzheimer’s)
50
Where does lipofuscin come from and what does it make?
From the accumulation of lipid products
Can make residual bodies
51
What is lipid accumulation or fatty metamorphosis?
Accumulation of lipids in parenchymal cells, especially common in the liver
52
What happens in the liver as a result of fatty metamorphosis?
Enlargement
Softening
Yellowing
Blunted margins
53
What leads to fatty liver?
- overloading the system with fatty acids
| - failure to secrete lipoproteins
54
When can the heart experience fatty metamorphosis?
- chronic hypoxia, as in anemia
| - profound hypoxia
55
What is the tigered effect?
Alternating yellow fat and red muscle bands in heart muscle.
AKA thrust breast
56
What is a xanthoma, and what causes it?
Cluster of lipids, often in macrophages, often in the dermis and tendons
Caused by hyperlipidemia
57
What are foam cells and what disorders are they associated with?
Cells that have accumulated metabolites due to deficiency of specific lysosomal enzymes
Associated with lysosomal storage disorders
58
What kind of disorder is Tay-Sachs disease, and what is it’s most common symptom?
A lysosomal storage disorder - hexosaminidase is deficient
Main symptom = macular cherry red spot (retina)
59
What kind of disorder is Neimann-Pick disease, and what is it’s distinguishing symptom?
Lysosomal storage disorder - sphingomyelinase is deficient
Fovea cherry red spot
60
What is deficient in Gaucher’s disease?
Glucocerebrosidase
61
What are Russell bodies?
Accumulated immunoglobulins - part of a hyaline storage disorder because they stain pink
62
What are Mallory bodies?
Alcoholic hyaline - accumulation of fibrils and ubiquitin in hepatocytes
63
What are Lewy bodies?
Hyaline deposits in Parkinson’s
64
Which diseases have neurofibrillary tangles of hyaline deposits?
Alzheimer’s
| Huntington’s
65
What are chaperonins?
Proteins that participate in protein folding in normal cells - minimizes injury
66
What are ubiquitins?
Proteins that appear after injury to refold denatured proteins
67
What is an amyloid?
Starch-like deposit of fibrils in organs or tissues
68
What conditions are associated with AAP (amyloid associated proteins)?
Chronic inflammation: Chron’s or RA
Infections conditions: TB or leprosy
69
Excess abnormal amyloids are associated with which degenerative condition?
Alzheimer’s
70
What is deficient in von Gierke’s disease?
Glucose-6-phosphatase (type 1 glycogen storage disorder)
71
What is Pompe’s disorder?
A type II glycogen storage disorder, affecting the heart, resulting from a defect in alpha glucosidase
72
What is albinism?
Congenital lack of melanin
73
What is vitiligo?
Patchy areas of skin depigmentation - acquired
74
What is alkaptonuria?
Accumulation of homogenistic acid, giving urine a black color
75
What is ochronosis?
Tissue discoloration resulting from accumulated homogenistic acid
76
What is hemochromatosis?
Accumulation of iron, usually through excess absorption, that can cause organ damage
May cause crystal formation in joints
77
What is the classic triad of manifestations of hemochromatosis?
Cirrhosis
Pancreatic fibrosis
Bronzed skin
78
What is lipofuscin and where is it found?
Undigestible lipid derivatives - usually brown
Found in ear wax
79
Plumbism is the absorption of what material? Where does it manifest in the body?
Lead.
Lead-sulfide line at gingival margin (gums)
Effects on CNS development in children
80
What disease is related to the accumulation of copper? Where does it deposit in the body?
Wilson’s disease
Deposits in liver, basal ganglia, and eyes
81
What are examples of extracellular calcifications?
Hematomas
Phleboliths
Tunica media of arteries
Uterine fibroids
82
What is a lithopedion?
A stone child - a calcified unaborted fetus
83
What is the Hayflick phenomenon?
Limitations in doubling:
| The finite potential of a cell to duplicate - implication that all organisms are programmed to wear out and die.
84
What is the standard expectation for fibroblast doubling in normal adults?
50
