Cell injury/death/adaptation

Question 1

what is the difference between etiology and pathogenesis?

Answer 1

Etiology- ORIGIN of disease, WHY a disease occurs

Pathogenesis- DEVELOPMENT of disease, HOW a disease occurs

Question 2

cerebral infarction, myocardial infarction and Renal atrophy are all forms of _____ injury

Answer 2

hypoxic

Question 3

what are the (4) cellular targets for injury?

Answer 3

1) cell membranes
2) mitochondria
3) cell proteins
4) DNA

Question 4

T/F: clinical signs and symptoms are usually closely timed to the molecular/biochemical changes following injury

Answer 4

FALSE

clinical signs are usually several steps removed

Question 5

What are the effects of Hypoxia-ischemia on the cell membrane?

Answer 5

impairs Na+ pump: Na+ and Ca++ influx, K+ efflux

cell swells as water floods cell

Question 6

What are the end effects of Hypoxia-ischemia on cellular metabolism?

Answer 6

1) decreased glycogen stores

2) increased lipid deposition

Question 7

Generation of reactive oxygen species is associated with what?

Answer 7

1) inflammation
2) oxygen toxicity
3) chemical/drugs
4) radiation (UV, X-ray)
5) Aging

Question 8

how do ROS (reactive Ox) damage cellular components?

Answer 8

• lipid peroxidation
• protein fragmentation
• single strand DNA breaks

Question 9

ROS cause _____-_____ DNA breaks

Answer 9

single-strand

Question 10

How are reactive oxygen species controlled by cells?

Answer 10

1) enzymes
2) antioxidants (vitamins, glutathione)
3) serum proteins (bind/reduce iron and copper)

Question 11

_____ (an ion) activates many enzymes inside the cell, and its concentration within the cell is highly controlled

Answer 11

calcium (Ca2+)

Question 12

the degree of cell injury is determined by what factors?

Answer 12

A) physiologic state of the cell
B) intensity of insult
C) duration of insult
D) # of exposures to insult

Question 13

what are the signaling mechanisms for cellular apoptosis?

Answer 13

1) intrinsic program
2) “death signals”
3) removal of a trophic signals – e.g. hormones
4) ROS, radiation, and toxins
5) effect of cytotoxic T cells

Question 14

Fas-ligand binding to Fas receptor is a form of _____ signals

Answer 14

death signals

trigger apoptosis

Question 15

the ____ gene family serve as on and off switches that regulate the membrane permeability of the mitochondria

Answer 15

Bcl-2 gene family

Question 16

Bcl-2 and bcl-x gene products ______ apoptosis

Answer 16

inhibit

Question 17

when does cell death occur?

Answer 17

Cell death occurs when the insult overcomes compensation mechanisms

Question 18

apoptosis signaling pathways converge on an autocatalytic proteolytic cascade of ________

Answer 18

caspases

Question 19

high cytoplasmic levels of Ca2+ will activate which digressive enzymes?

Answer 19

a. phospholipases
b. proteases
c. endonucleases
d. ATPase

Question 20

Cell injury may result in what 4 effects?

Answer 20

a. Reversible cell injury
b. Cellular adaptations associated with changes in cell number, size or differentiation
c. Cellular adaptations associated with abnormal accumulations
d. Cell death – necrosis or apoptosis

Question 21

what are the common causes of reversible cell damage?

Answer 21

a. Toxins
b. Infectious agents
c. Hypoxia
d. Thermal injury

Question 22

what are the 2 morphological types of reversible cell injury?

Answer 22

hydropic change and fatty change

Question 23

what are the morphological types of necrosis?

Answer 23

Coagulative
Liquefactive
Caseous
Enzymatic (fat)

Question 24

what are the characteristics of coagulative necrosis?

Answer 24

1) cytoplasmic proteins are coagulated

2) The nucleus is lost, but the pink outline of the cell is still present

Question 25

what are the characteristics of liquefactive necrosis?

Answer 25

A) The tissue is totally digested by the release of lysosomal enzymes during the acute inflammatory response. B) associated with focal bacterial or fungal infections

Question 26

what is Caseous Necrosis?

Answer 26

a. Associated with M. tuberculosis infection. b. The tissue has a white and "cheesy" appearance on gross examination. c. the body "walls off" the area with granulocytes

Question 27

where is Fat Necrosis commonly found? what are its characteristics?

Answer 27

A) found in necrosis of breast or pancreatic tissue B) adipose has a chalky white-yelllow color C) dead cells look like "soap bubbles"

Question 28

Morphologic features of apoptosis include:

Answer 28

1) cell shrinkage 2) Chromatin condensation 3) Plasma membrane blebbing 4) Phagocytosis of the apoptotic bodies without a significant inflammatory response.

Question 29

how does the morphology of necrosis and apoptosis differ?

Answer 29

Necrosis- Multiple cells, Cell swelling, Cell lysis Apoptosis- Single cell, Cell shrinkage, Chromatin Condensation, Apoptotic bodies

Question 30

while inflammation is seen in forms of _______, it is not seen in ________

Answer 30

seen in necrosis, not seen in apoptosis

Question 31

Chronic cell injury leads to cell ________

Answer 31

adaptations

Question 32

how do cells change in response to chronic injury?

Answer 32

a. Alterations in cell size b. Alterations in cell number c. Alterations in cell differentiation d. Intracellular accumulations

Question 33

what is atrophy? hypertrophy?

Answer 33

Atrophy - a decrease in cell size and function Hypertrophy - an increase in cell size and is associated with an increase in functional capacity.

Question 34

what are the 2 etiologies of hypertrophy?

Answer 34

1) response to trophic signals (hormones) | 2) response to increased functional demand (AKA muscle growth)

Question 35

what is hyperplasia? what are its general characteristics?

Answer 35

Hyperplasia - an increase in the number of cells in a tissue or organ 1) may involve the proliferation of epithelial and/or stromal cells 2) proliferation is stimulated by trophic factors 3) increase the risk for subsequent neoplasia's

Question 36

what are some causes (etiologies) of cellular atrophy?

Answer 36

``` A) decreased workload B) loss of innervation C) chronic ischemia (reduced bloodflow) D) starvation E) lack of trophic factors ```

Question 37

what are the common etiological factors for hypertrophy?

Answer 37

A) increased functional demand B) increased or imbalanced nutrition C) increased hormonal stimulation

Question 38

Traumatic Keratosis is an example of what form of cell response?

Answer 38

Hyperplasia due to chronic irritation

Question 39

what is metaplasia?

Answer 39

Metaplasia - one adult cell type is replaced by another ADULT cell type in response to chronic stress.

Question 40

Acid reflux, and smoking, can both cause a _______ of epithelial tissues

Answer 40

metaplasia

Question 41

what is Steatosis?

Answer 41

Fatty liver - caused by triglyceride accumulation (intracellular accumulation)

Question 42

what is a Xanthoma?

Answer 42

cholesterol accumulation in the epithelium - common in elderly

Question 43

what are the histological characteristics of xanthomas?

Answer 43

foamy looking macrophages filled with cholesterol

Question 44

Cholesterol build-up in vessels can cause what 2 conditions?

Answer 44

Atherosclerosis cholesterol thrombus

Question 45

alpha-1 anti-trypsin deficiency, Mallory bodies, and Alzheimers disease are all associated with an accumulation of what?

Answer 45

protein

Question 46

what is an example of a disease caused by carbohydrate accumulation?

Answer 46

glycogen storage disease

Question 47

what are 2 examples of conditions caused by exogenous carbon pigmentation

Answer 47

1) Anthracosis (asymptomatic... anthricite coal dust) | 2) Pneumoconiosis (symptomatic- restriction. from coal)

Question 48

Melanotic-macules are caused by what?

Answer 48

accumulation of ENDOGENOUS pigments (melanin)

Question 49

what are the characteristics of a Hemosiderin? what causes them?

Answer 49

1) A yellow-brown pigment represents aggregates of ferritin micelles. 2) Its accumulation arises from excess iron locally due to hemorrhage and can lead to hemosiderosis.

Question 50

what causes Bilirubin to accumulate in the liver?

Answer 50

Accumulates in hepatocytes and bile ducts due to hemolysis, obstructed bile flow, and/or hepatocellular disease.