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Pathophysiology > Cellular Adapatation > Flashcards

Cellular Adapatation Flashcards

1
Q

What Characterizes reversible cell injury?

A

mild or short-lived. cell swelling from influx of water into cytoplasm and mitochondria from altered permeability.

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2
Q

What is hydropic degeneration?

A

cellular swelling from influx of water into cytoplasm

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3
Q

Give an example of reversible cell injury and how it works.

A

Hypoxia –> dysfunction of ATP-driven Na, K pump–>alters permeability. When ATP function restored, Na and water are pumped out of cell and swelling disappears.

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4
Q

In reversible cell injury what changes occur in the mitochondria?

A

They swell–>generate less energy–>cell reverts to anaerobic glycolysis–>excessive production of lactic acid–>cell pH becomes acidic–>further slows cell metabolism

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5
Q

What determines reversible from irreversible cell injury?

A

NUCLEUS. if the nucleus remains untouched and if energy sources is restored, the cell will revert to its normal state.

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6
Q

What constitutes irreversible cell injury?

A

If the stress is too great for the cell to adapt and changes in the nucleus or rupture of the cell occurs.

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7
Q

How can irreversible cell injury be diagnosed?

A

by use of light microscopy or ultra-structurally (electron microscope)

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8
Q

What 3 ways can damage to the nucleus manifest?

A

Pyknosis (condensationof the chromatin), Karyorrexis (fragmentation of the nucleus into small particles (nuclear dust) and Karyolysis (dissolution of the nucleus and lysis of chromatin by enzymes)

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9
Q

Define Pyknosis, Kayrorrexis, and Karyolysis

A

Pyk-condensationof the chromatin
Karyorrexis-fragmentation of the nucleus into small particles (nuclear dust)
Karyolysis-dissolution of the nucleus and lysis of chromatin by enzymes

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10
Q

What other changes occur in irreversible cell damage other than to the nucleus?

A

the cytoplasm is fragmented and lost, releasing their cellular enzymes into the ECF

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11
Q

How can irreversible cell changes be diagnosed?

A

By measuring cytoplasmic enzymes (such as AST or LDH) in the blood.

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12
Q

What kind of patients generally have high levels of cytoplasmic enzymes in their blood?

A

MI or viral hepatitis patients

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13
Q

Define necrosis

A

death of cells or groups of cells with in a LIVING organism

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14
Q

What is the difference between necrosis and autolysis?

A

necrosis is in LIVING (along with inflammation) and autolysis is only in tissues after death (basically decomposition)

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15
Q

what are the 4 types of necrosis? what is the most common one*?

A

coagulative, liquefactive, caseous, and fat

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16
Q

Define coagulative necrosis

A

MOST COMMON. when cell proteins are altered or denatured (think eggs), cell outlines are preserved and cytoplasm appears granular.

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17
Q

What tissue is coagulative necrosis usually found in? what is it usually caused by? and what is the best example?

A
  • solid internal organs (heart, kidney, spleen, liver, etc)
  • caused by anoxia
  • heart tissue undergoing MI
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18
Q

what is liquefactive necrosis?

A

dead cells liquefy by certain cell enzymes. Tissue becomes soft and gel-like

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19
Q

Where does liquefactive necrosis most often occur and why? What happens to this tissue? another example?

A
  • most often in brain, usually because of brain infarcts
  • brain cells lose their contours and liquify, it is soft and transformed into fluid-filled cavity.
  • also seen in bacterial infections (abscesses in the lungs)
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20
Q

What is caseous necrosis?

A

a form of coagulative necrosis where a thick, yellowish, cheesy substance forms.

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21
Q

Best example of caseous necrosis? Characterized by what? What are these called? Could this be something else?

A

TB characterized by granlomas inside caseous necrosis called a Ghon complex. These could also be a fungal infection (histoplasmosis)

22
Q

What is fat necrosis?

A

form of liquefaction necrosis cause by lipolytic enzymes

23
Q

What is the most common example of fat necrosis? How and why does it happen here?

A
  • limited to fat tissue usually around the pancreas
  • enzymes are released into adjaccent fat tissue, usually after rupture of pancreas, causing degredation of fat into glycerol and free FAs which rapidly bind with calcium, forming soaps, causing white, calcified specks.
24
Q

What is the difference between wet and dry gangrene?

A

Bacterial infection of coagulated tissue that leads to inflammation and a secondary liquefaction=wet gangrene.
If the necrotic tissue dries out, it becomes black and mummified=dry gangrene

25
Q

What is the most common underlying conditions that contributes to gangrene?

A

Usually after and infarction of the intestines, or a limb caused by ATHEROSCLEROSIS OR DIABETES.

26
Q

What are dystrophic calcifications?

A

When necrotic tissue attracts calcium salts which leads to calcification.
It is the macroscopic deposition of calcium in injured or dead tissues, visible to the naked eye, ranging from gritty, sand-like grains to firm, rock-hard material.

27
Q

What are 4 examples of dystrophic calcifications?

A
  1. Calcifications in ATHEROSCLEROTIC coronary arteries and narrows the vessels
  2. calcifications of the mitral or aortic valves leading to impeded blood flow (STENOSIS).
  3. Calcification seen around BREAST CANCERS that can be visualized by mammography
  4. Infant periventricular calcification seen in congenital TOXOPLASMOSIS.
28
Q

What are metastatic calcifications? What usually causes it?

A

From deranged calcium metabolism (not cell injury), usually associated with increased serum calcim levels. leading to calcium deposition in other locations

29
Q

What 3 disorders is metastatic calcification usually seen in? What happens?

A
  • Hyperparathyroidism, Vitamin D toxicity, and Chronic renal failure.
  • Calcium stones form in sites such as gallbladder, kidney and bladder.
30
Q

What is cellular adaptation? How does it revert back? what if it can’t?

A
  • Changes of individual cells, tissues or organs from prolonged exposure to adverse or exaggerated normal stimuli.
  • when the cause is removed, cells revert to normalcy
  • if not, detrimental results happen
31
Q

what are the 6 ways cells adapt to change?

A
  1. atrophy
  2. hypertrophy
  3. hyperplasia
  4. metaplasia
  5. dysplasia
  6. anaplasia
32
Q

what is atrophy? how is it further classified?

A
  • decrease in size of a tissue organ or entire body.

- physiologic vs pathologic

33
Q

What examples of physiologic atrophy?

A

thymus undergoing involution, ovaries, uterus and breasts after menopause, atrophic bones and muscles in elderly (thing and prone to fracture)

34
Q

What are examples of pathologic atrophy? Which ones is the BEST example?

A

Ischemic organs–>small (kidneys with atherosclerosis)
testicular atrophy
ALZHEIMER DEMENTIA

35
Q

What is hypertrophy?

A

increase in SIZE of tissues or organs due to enlargement of individual cells

36
Q

can hypertrophy be further classified? how?

A

yes, physiologic or pathologic

37
Q

what are examples of physiologic hypertrophy?

A

-enlargement of skeletal muscles in body after weightlifting

38
Q

what are examples of pathologic hypertrophy?

A
  • Hypertropy of the heart that occurs from adapting to increased workload
  • concentric hypertrophy of the left ventricular muscle from HTN
39
Q

What is hyperplasia?

A

adaptive increase in number of cells that cause enlargement of tissues or organs

40
Q

What are some examples of hyperplastic processes and states?

A
  • endometrial hyperplasia due to estrogens

- hyperplastic polyps of the colon or stomach

41
Q

Can hyperplasia and hypertrophy be seen together? what are some examples?

A

yes
physiologic hypertrophy of uterin smooth muscles cells during pregnancy accompanied by hyperplasia
-BPH increases both size and number of glands and stroma

42
Q

what is metaplasia?

A

adaptive change of one cell type for another to suit environment.

43
Q

give examples of metaplasia.

A
  • PANCE*- squamouns metaplasia of bronchial epithelium due to smoking
  • gastric/glandular metaplasia of GE junction in barrett esophagus
44
Q

is metaplasia reversible? can it progress to a more detrimental growth (what is this called?)?

A
  • yes

- yes, can progress to dysplasia

45
Q

What is dysplasia? is it associated with cancer?

A

disordered growth of tissues resulting from chronic irritation or infection
-yes, it is considered precancerous

46
Q

Give the best example of dysplastic change as it relates to disease

A

detection of cervical dysplaisia (cervical intraepithelial neoplasia-CIN) based on PAP smears. (remember cervical cancers have association with HPV)

47
Q

what is anaplasia?

A

undifferentiated and uncontrolled growth of cells-hallmark of malignant transformation

48
Q

what are 4 other names for anaplasia?

A

malignancy, carcinoma, cancer, neoplasm

49
Q

give a few examples of anaplasia

A

squamous cell carcinoma of the cervix, lung cancer, malignant melanoma, renal cell carcinoma

50
Q

what are 5 microscopic hallmarks of anaplasia?

A
  1. pleomorphism of cells and nuclei
  2. irregular and hyperchromatic nuclei
  3. HIGH nuclear/cytoplasmic ration (N/C ratio)
  4. large nucleoli within nucleus
  5. lots of abnormal mitotic figures

Pathophysiology (3 decks)

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