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SP16- Gen Path Exam 1 > Cell Injury, Death, and Adaptations > Flashcards

Cell Injury, Death, and Adaptations Flashcards

1
Q

_____ is the origin of disease.

A

etiology

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2
Q

_______ is the development of disease

A

pathogenesis

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3
Q

What are the two studies of pathology?

A

etiology and pathogenesis

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4
Q

Which branch of pathology seeks to identify WHY a disease occurs?

A

etiology

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5
Q

Which branch of pathology seeks to describe HOW a disease occurs?

A

pathogenesis

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6
Q

True or False: Cell injury is not common to all forms of pathology.

A

False

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7
Q

True or False: Clinical signs or symptoms are usually several steps removed from the biochemical changes associated with cell injury.

A

True

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8
Q

Cell injury results from disruption of one or more components that maintain ______.

A

viability

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9
Q

Cell injury induces a _____ of effects.

A

cascade

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10
Q

True or False: Cell injury may be reversible.

A

True

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11
Q

What are the three options that follow cell injury?

A
  1. Reverse injury
  2. cell adaptation to injury)
  3. cell death
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12
Q

Stress + Adaptation = ______.

A

strengthening (i.e: exercise)

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13
Q

What are the 4 events that follow “etiologic agent” in the cascade?

A
  1. cell injury
  2. cell response
  3. disease state
  4. disease treatment
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14
Q

What are four rapid causes of cell injury?

A

hypoxia
infectious agents
physical injury
chemicals/drugs

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15
Q

What are three causes of cell injury that are more slowly progressing?

A

immune response
genetic abnormalities
nutritional imbalance

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16
Q

Which cells are most susceptible to hypoxia?

A

brain cells

heart cells

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17
Q

An “aspirin burn” is an example of a _______ reaction.

A

chemical

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18
Q

What are three examples of genetic abnormalities that have oral signs?

A

Down’s Syndrome
Ehrlos-Danlos
Cancer

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19
Q

Diabetes and Scurvy are examples of cell injury from _____ _____.

A

nutritional imbalance

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20
Q

What are the four important targets in cell injury?

A

cell membrane
mitochondria
cell proteins
DNA

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21
Q

Cell injury can result from _____ depletion.

A

ATP

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22
Q

Cell injury can result from generation of ______ ______ species.

A

reactive oxygen

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23
Q

Cell injury can result from loss of ______ homeostasis.

A

calcium

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24
Q

Cell injury can result from altered _____ permeability.

A

membrane

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25
Q

Cell injury can result from _______ , ____, or _____ damage.

A

mitochondrial, DNA, protein

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26
Q

According to the Hypoxia-Ischemia Model, a thrombus in a blood vessel (ischemia) results in a decrease in ____ ______ within the mitochondria.

A

oxidative phosphorylation

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27
Q

A decrease in oxidative phosphorylation results in a _____ in ATP.

A

decrease

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28
Q

According to the Hypoxia-Ischemia Model, a reduction in ATP will increase ____ and ____ influx, while it will also increase _____ efflux.

A

Sodium and Calcium (influx)

Potassium (efflux)

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29
Q

What is the result of increased sodium/calcium influx and potassium efflux?

A

Increased water influx–> cellular swelling, membrane blebs, loss of villi, and ER swelling

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30
Q

How does an increase in glycolysis influence pH?

A

decreases pH (increases acid)

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31
Q

How does an increase in glycolysis influence glycogen stores?

A

decreases glycogen stores

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32
Q

Free radicals have a(n) _________ electron.

A

unpaired

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33
Q

Name five processes that will generate ROS.

A
  1. inflammation
  2. oxygen toxicity
  3. chemicals/drugs (metabolism of)
  4. Radiation
  5. Aging
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34
Q

How do ROS cause cellular injury?

A
  1. lipid peroxidation
  2. protein fragmentation
  3. single strand breaks in DNA
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35
Q

What is lipid peroxidation?

A

The oxidative degradation of lipids. It is the process in which free radicals “steal” electrons from the lipids in cell membranes, resulting in cell damage. This process proceeds by a free radical chain reaction mechanism (initiation, propagation, termination).

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36
Q

ROS cause single strand breaks in DNA by causing _____ _______ in both purines and pyrimidines.

A

base modifications

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37
Q

What are the major sites that ROS cause base modification/breaks in DNA?

A

thymidine and guanine

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38
Q

What are three basic mechanisms for controlling/preventing ROS damage?

A
  1. Enzymes
  2. Antioxidants
  3. Serum proteins that reduce/bind iron
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39
Q

What is a major enzyme involved in controlling ROS?

A

Super Oxide Dismutase (SOD)

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40
Q

Is there a significant difference between extracellular and cytoplasmic calcium concentration?

A

YES, 1000-fold difference (higher extracellular) allows for maintenance of diffusion gradient. If there is a problem with diffusion, the membrane and DNA is destroyed. The cell viability depends on calcium

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41
Q

Other than ROS, what are five other causes of cell membrane injury?

A
  1. complements (C5-C9 Membrane Attack Complex)
  2. Cytotoxic T Cells and NK Cells
  3. Viruses
  4. Bacterial Endotoxins and Exotoxins
  5. Drugs
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42
Q

________ ________ occur prior to morphologic changes.

A

biochemical alterations

43
Q

The degree of cell injury is determined by physiological state of the cell, number of exposures to insult, _____ of insult, and ______ of insult.

A

intensity

duration

44
Q

Micronutrient composition and amount of oxygen are two aspects that describe the ______ state of the cell.

A

physiologic

45
Q

What are the three possible outcomes of cell injury?

A
  1. reversible
  2. cell adaptation
  3. cell death
46
Q

What are two forms of cell death?

A

necrosis

apoptosis

47
Q

What are four possible cell adaptations?

A
  1. cell size
  2. cell number
  3. functional modifications
  4. intracellular accumulations
48
Q

Reversible cell injury is often an _____ process that is usually _____ duration and ____ intensity.

A

acute
short duration
low intensity

49
Q

Ischemia, exposure to toxins, infectious agents, and thermal injury are possible causes of what type of cell injury?

A

reversible

50
Q

The increase in intracellular _____ leads to an isosmotic gain in water and cell swelling.

A

sodium

51
Q

______ occurs when an insult overcomes compensation mechanisms.

A

cell death

52
Q

True or False: There is a signature biochemical event that equates with cell death.

A

False

53
Q

As the duration of injury increases, what are the three changes that follow cell death (in order)?

A

cell death –> ultrastructural changes–> light microscopic changes–> gross morphologic changes

54
Q

What are the four morphologic types of necrosis?

A
  1. coagulative
  2. liquefactive
  3. caseous
  4. enzymatic
55
Q

Which type of necrosis is most common?

A

coagulative

56
Q

Coagulation is associated with _____ acidity.

A

high

57
Q

Which type of necrosis is most often associated with tuberculosis?

A

caseous

58
Q

Which type of necrosis is uncommon and often associated with pancreatic disease?

A

enzymatic

59
Q

Which type of necrosis involves bacterial infections and pus?

A

liquefactive

60
Q

The necrosis pattern is determined by the _______ of cells/ECM, the type of necrotic ______, and by bacterial ______ when present.

A

degradation
debris
products

61
Q

The _____-____ appearance is indicative of coagulative necrosis.

A

cooked-egg

62
Q

What are three histological features of coagulative necrosis?

A
  1. cell outline
  2. pink cytoplasm
  3. anucleated cells
63
Q

Myocardium that has gone through coagulative necrosis will lose what important feature?

A

the “z bands”

64
Q

A “hyper-cellular sea of neutrophils” is histologically evident in _____ necrosis.

A

liquefactive

65
Q

True or False: In caseous necrosis associated with TB, macrophages act as a barrier to close off the lesion and kill the organisms.

A

False: the organisms are closed off but not killed

66
Q

____ necrosis is associated with acute pancreatitis.

A

fat (enzymatic)

67
Q

What is the “maintainer of homeostasis?”

A

apoptosis

68
Q

What are three processes that are maintained by apoptosis?

A
  1. normal cell turnover
  2. embryogenesis
  3. immune function
69
Q

True or False: Disease is associated with excessive apoptosis or inhibition of apoptosis.

A

True

70
Q

AIDS, ischemia, neurodegenerative diseases, myelodysplasia, and toxin induced liver injury are all associated with _____ apoptosis.

A

excessive

71
Q

Inhibition of apotosis is associated with _____, _______, and _______.

A

cancer
autoimmune diseases
viral diseases

72
Q

List the five morphological stages of apoptosis.

A
  1. chromatin condensation
  2. progressive cell shrinkage
  3. plasma membrane blebbing
  4. formation of apoptotic bodies
  5. phagocytosis- no inflammation
73
Q

What are the two pathway in the mechanism of apoptosis?

A
  1. Mitochondrial (intrinsic)

2. Death Receptor (extrinsic)

74
Q

Bcl-2 is a ____ of apoptosis.

A

inhibitor/regulator

75
Q

Bax/Bak are ______ of apoptosis.

A

initiators

76
Q

True or False: Necrosis and Apoptosis are caused by both pathologic and physiologic stimuli.

A

False: Apoptosis is BOTH….Necrosis is only PATHOlogic

77
Q

Which has a morphology that is “multiple cells,” necrosis or apoptosis?

A

necrosis

78
Q

Which has a morphology in which the cells SHRINK, necrosis or apoptosis?

A

apoptosis

79
Q

True or False: Necrosis and Apoptosis have an inflammatory host response.

A

False: no inflammation is associated with apoptosis

80
Q

Cells undergo ________ changes due to persistent (chronic) stress or injury.

A

adaptive

81
Q

True or False: Similar responses at the cell level can produce different morphological changes in different organs.

A

True

82
Q

In chronic cell injury, what aspect is prolonged in comparison to acute cell injury?

A

duration of stress

83
Q

Cellular adaptations include: alterations in cell size, number, or differentiation and abnormal intracellular _______.

A

accumulations

84
Q

_____ is a decrease in cell SIZE and function with concurrent decrease in organ size and/or function.

A

atrophy

85
Q

True or False: it is normal for the brain to atrophy with age.

A

True. the sulci tend to deepen and the width of gyri shrink

86
Q

What are some possible etiologies of atrophy?

A
  • decreased workload (ex. arm in a cast)
  • loss of innervation
  • decreased blood supply
  • inadequate nutrition
  • decreased hormonal stimulation
  • aging
  • local pressure
87
Q

What is hypertrophy?

A

increase in cell SIZE and function with concurrent increase in organ size and/or function

88
Q

What are the possible etiologies of hypertrophy?

A
  • increased functional demand (hypertensive heart)
  • increased or imbalanced nutrition
  • increased hormonal stimulation (pregnancy, steroid use)
89
Q

What is hyperplasia?

A

increase in cell NUMBER with concurrent increase in organ size and/or function

90
Q

Traumatic Keratosis involves callus formation due to an increase in the number of cells. This is an example of ______

A

hyperplasia

91
Q

What is metaplasia?

A

an alteration in cell DIFFERNTIATION with concurrent alteration of tissue/organ function

92
Q

Give a common example of metaplasia.

A
  1. Smokers = squamous metaplasia of the bronchus…
    the functional epithelium changes to a sturdy but non-functional epithelium
  2. Gastric Reflux = intestinal metaplasia…
    burning of stratified squamous epithelium and subsequent over production of mucus glands
93
Q

Normal cellular accumulations include _____, lipids, ____, and carbohydrates.

A

water

proteins

94
Q

True or False: Abnormal cellular constituents are always exogenous.

A

False: they can be exogenous or endogenous

95
Q

True or False: Pigments and calcium are cellular accumulations.

A

True

96
Q

What are the four mechanisms of intracellular accumulations?

A
  1. Abnormal metabolism
  2. Defective folding of proteins
  3. Lack of enzymes
  4. Ingestion of indigestible materials
97
Q

In “fatty liver” there is an accumulation of _____.

A

triglycerides

98
Q

What are xanthomas?

A

yellowish skin papules due to lipid (cholesterol) accumulation, often within macrophages

99
Q

Alzheimer’s Disease and Mallory bodies are due to accumulation of _____.

A

protein

100
Q

Von Gierke’s Disease is a glycogen storage disease that results from a decrease in what cellular activity?

A

decreased glucose 6-phosphatase

101
Q

What is the common dental-related exogenous accumulation?

A

exogenous pigment= Amalgam Tattoo

102
Q

To distinguish between melanoma and amalgam tattooing, the location of the pigment differs histologically: which pigment occurs at the border of the epithelium?

A

melanoma

103
Q

Macules and Jaundice are two examples of _____ pigments.

A

endogenous

SP16- Gen Path Exam 1 (10 decks)

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