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Pathology > Cell injury & Postmortem changes > Flashcards

Cell injury & Postmortem changes Flashcards

1
Q

Cell Injury

Rank the following cells by their sensitivity to injury
- Fibroblasts / Skeletal muscles
- Neurons
- Cardiomyocytes / Hepatocytes / Renal epithelium

A

Neurons > Cardiomyocytes / Hepatocytes / Renal Epithelium > Fibroblasts / Skeletal muscles

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2
Q

Mechanisms of cell injury

What happens to cellular mitochondria when Hypoxia (Inadequate of O2) happens?

A

(D) means decrease. (I) means increase

Oxidative phosphorylation (D)
ATP (D)

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3
Q

What are the 3 things that happens when cellular ATP decreases?

A

Na+/K+ pump fails
Anaerobic glycolysis (I)
Detachment of ribosomes

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4
Q

What happens to the cell if Na+/K+ pump fails due to the lack of ATP? (1)

A

Intracellular Na+ (I) which also brings in H2O
-> ER swelling, Cellular swelling
-> Extensive vacuolation

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5
Q

What happens to the cell if Na+/K+ pump fails due to the lack of ATP? (2)

A

Influx of Na+
-> Influx of Ca2+
Cytosolic Ca2+ activates cellular enzymes
Phospholipase -> Phospholipids (D) [Membrane damage]
Protease -> Cytoskeletal proteins (D) [Membrane damage]
Endonuclease -> Cleave between nucleosomes [Nuclear damage]
ATPase -> ATP (D)

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6
Q

What happens when a cell undergoes anaerobic glycolysis due to the lack of ATP?

A

Lactic acid is produced
-> pH (D)
-> Clumping of nuclear chromatin

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7
Q

What happens when detachment of ribosomes happens due to the lack ATP?

A

RNA translation (D)
-> Protein synthesis (D)

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8
Q

Other than Hypoxia which causes ATP depletion, what are the other mechanism of cell injury?

A

Free radicals
Increased membrane permeability
Mitochondrial damage
Apoptosis

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9
Q

What are the 3 main sites of free radical damage?

A

Membrane
Proteins
DNA

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10
Q

What causes the increase of membrane permeability?

A

Free radicals
Hypoxia
-> Decrease in phospholipid & protein synthesis
-> Cytosolic Ca2+ (I)
-> Phospholipase activation
-> Protease activation

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11
Q

Is acute cell swelling a reversible or irreversible cell injury?

A

Reversible cell injury

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12
Q

Morphology of acute cell swelling

What is the 3 microscopic appearances of acute cell swelling?

A

Cloudy swelling
Hydropic degeneration
Ballooning degeneration

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13
Q

What are the 4 histologic changes of nucleus in necrosis?

A

Pyknosis : Shrunken & darken nucleus

Karyorrhexis : Ruptured nucleus

Karyolysis : Pale nucleus due to the dissolution of chromatin by DNAases & RNAases

Absence of nucleus

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14
Q

What are the 5 types of necrosis?

A

Coagulative necrosis
Liquefactive necrosis
Caseous necrosis
Gangrenous necrosis
Fat necrosis

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15
Q

What is coagulative necrosis?

A

Denatures both structural proteins and hydrolytic enzyme
-> Outline of cell persists

Essentially coagulative necrosis primarily involves denaturation of structural proteins rather than the activation of hydrolytic enzymes

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16
Q

What are the names for skeletal /muscular acute cell swollen & coagulative necrosis?
And what are the properties of it?

A

Zenker’s degeneration & Zenker’s necrosis

Zenker’s degeneration : Swollen & vacuolation of muscle fibers. Hyalinization

Zenker’s necrosis : Fragmentation of myofibers. Loss of cross striations

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17
Q

What is liquefactive necrosis?

A

Activation of hydrolytic enzyme
-> Enzymatic digestion of necrotic cells

Usually bacterial infection
-> Abcess
-> Attraction of neutrophils which contains hydrolases

Hypoxic damage of brain / spinal cord
-> Enzymatic dissolution of neurons
-> Lack of fibrous connective tissues
-> Liquefactive necrosis

18
Q

What is caseous necrosis?

A

Formation of granuloma consisting lymphocytes and multi- nucleated macrophage.

Classic cause is by tuberculosis and Corynebacterium

Often associated with slow and persistence infection

19
Q

What is gangrenous necrosis?

A

Necrosis of extremities

Usually caused by hypoxia

20
Q

What are the 3 types of gangrenous necrosis?

A

Dry gangrene
Moist gangrene
Gas gangrene

21
Q

What are the difference between dry and moist gangrene?
(Location, cause)

A

Dry gangrene usually occurs in extremities caused by toxins or cold

Moist gangrene usually occurs in organs and is infected by putrefactive bacteria

22
Q

What is gas gangrene?

A

It is the production of gas bubbles caused by infection of bacteria, especially Clostridia

23
Q

What is fat necrosis?

A

Necrosis of fatty tissue, especially subcutaneous fat and adipose tissue

24
Q

What are the names of the 2 pathway in apoptosis?

A

Extrinsic ( Receptor - initiated ) pathway
Intrinsic ( Mitochondrial ) pathway

25
Q

What is the main caspase for apoptosis?
And what are the caspases for extrinsic and intrinsic pathway?

A

Main : Caspase 3
Extrinsic : Caspase 8
Intrinsic : Caspase 9

26
Q

Is inflammation present or absent during apoptosis?

A

absent

27
Q

Which are the 2 receptor-ligand interactions for extrinsic pathway?

A

Fas
TNF receptor

28
Q

What are the 2 receptor - ligand interaction in extrinsic apoptosis pathway?

A

Fas
TNF

29
Q

In hypoxia, what does cyanide poisoning do to interfere with oxidative phosphorylation?

A

Cyanide poisoning inactivates cytochrome oxidase in mitochondria

30
Q

Morphologic appearance of postmortem changes

What is Autolysis?

A

Self - digestion of cells by hydrolytic enzymes

31
Q

Morphologic appearance of postmortem changes

What is putrefaction?

A

Postmortem bacterial metabolism
-> Production of color
-> Texture change
-> Production of gas ( Ruminant forestomach & equine cecum )
-> Odors

32
Q

Morphologic appearance of postmortem changes

What is Rigor mortis?

A

Contraction of muscles after death

33
Q

Morphologic appearance of postmortem changes

What is Livor mortis?

A

Gravitational pooling of blood

In large vessels, clotting happens then the separation of blood cells & plasma (Chicken fat)

34
Q

Morphologic appearance of postmortem changes

What is Postmortem clotting?

A

Botton RBC, Top plasma
( Chicken fat )

35
Q

Morphologic appearance of postmortem changes

What is hemoglobin inbibition?

A

Red staining of tissue
Especially heart and vessels ( apparent in Aorta )

36
Q

Morphologic appearance of postmortem changes

What is bile imbibition?

A

Staining of tissue around gallbladder after bile penetrates its wall

37
Q

Morphologic appearance of postmortem changes

What is pseudomelanosis?

A

Bluegreen discoloration of tissue by FeS

H2S by putrefactive bacteria + Fe2+ from RBC

38
Q

Morphologic appearance of postmortem changes

What is bloating?

A

Postmortem bacterial metabolism that causes gas formation in lumen ( Ruminants forestomach and equine cecum )

39
Q

Morphologic appearance of postmortem changes

What is Pale foci subserosally?

A

Paler organ caused by
- Increased intraabdominal pressure -> Squeeze blood away
- Bacterial infection -> Looks like coagulative necrosis

40
Q

Morphologic appearance of postmortem changes

What is mucosal sloughing?

A

Rapid shedding of mucosa in rumen by enzymes

41
Q

Morphologic appearance of postmortem changes

What is lens opacity?

A

Turbidity of lens caused by the extreme coldness

Back to transparent when warm

Often confused with cataracts

42
Q

What causes Rigor mortis?

A

Calcium influx into muscle cell causes contraction

Pathology (5 decks)

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