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Year 2 EMS MoD > Cellular adaptation > Flashcards

Cellular adaptation Flashcards

1
Q

What is cellular adaptation?

A

Mechanisms which allow tissues and organs to cope with changes in demand. They may be part of an entirely normal (physiological) process or occur as part of a disease (pathological) process

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2
Q

Are cellular adaptations usually reversible?

A

yes

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3
Q

Give the 5 things that can alter in cellular adaptation, why do these alterations occur?

A

1) Size
2) Number
3) Phenotype
4) Metabolic activity
5) Function
Occur due to changes in environment or demand

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4
Q

What is the role of cellular adaptation? 3

A

1) Aquire a new and steady state of metabolism and structure
2) Better equips cells to survive in a new environment
3) Failure of adaptation may lead to lethal or sub-lethal injury

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5
Q

Give an example of cell which is very susceptible to damage?

A

Cerebral neurons

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6
Q

Give an example of cell which is very resistant to damage?

A

Fibroblast

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7
Q

Name a type of cell which does not need to adapt in the face of environmental change and why?

A

Fibroblasts - can survive severe metabolic stress without harm eg. absence of O2

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8
Q

Name a type of cell which adapts easily to environmental change and why?

A

Epithelial cells
Labile cell population, have an active stem cell compartment
Highly adaptive in number and function

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9
Q

Name a type of cell which cannot adapt and why?

A 
Cerebral neurons
Terminally differentiated
Permanent cell population
Highly specialised function
Easily damaged by environment change
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10
Q

What is meant by physiological cellular adaptation?

A

A cell responding to normal changes in physiology or demand

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11
Q

What is meant by pathological cellular adaptation?

A

A cell responding to disease related changes

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12
Q

What cellular adaptation occurs in response to increased cellular activity?

A

Increased size or number of cells

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13
Q

What cellular adaptation occurs in response to decreased cellular activity?

A

Decreased size or number of cells

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14
Q

What is the scientific term for increase in size of cells?

A

Hypertrophy

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15
Q

What is the scientific term for increase in number of cells?

A

Hyperplasia

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16
Q

Can hypertrophy and hyperplasia co-exist?

A

Yes

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17
Q

The net result of hypertrophy/hyperplasia is what?

A

Increased cell mass and thus increase in functional capacity

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18
Q

What kind of cell populations is hypertrophy commonly seen in, give an example?

A

Permanent cell populations

Especially cardiac and skeletal muscle

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19
Q

Give a physiological example of smooth muscle hypertrophy?

A

Hypertrophy of the smooth muscle cells of the uterus during pregnancy

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20
Q

Give a pathological example of muscle hypertrophy?

A

Hypertrophy of bladder muscle cells in benign prostatic hyperplasia - this leads to bladder outlet obstruction, bladder has to contract harder, so muscle becomes hypertrophied

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21
Q

Give an example of pathological hyperplasia?

A

Adenomyomatous hyperplasia of the prostate

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22
Q

Give a physiological example of skeletal muscle hypertrophy?

A

Skeletal muscle of a marathon runner

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23
Q

Give an example of pathological cardiac muscle hypertrophy?

A

Hypertrophy of cardiac muscle cells of left ventricle due to calcific aortic stenosis
This can also occur in systemic hypertension

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24
Q

Why can left ventricular hypertrophy lead to death?

A

Patients with LVH have increased ectopic beats, some of which can pre-dispose to sudden degeneration of rhythm to ventricular tachychardia or VF and sudden cardiac death

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25
Q

What is subcellular hypertrophy and hyperplasia, give an example?

A

Increase in size and number of subcellular organelles

For example, smooth ER hypertrophy in hepatocytes with barbiturates

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26
Q

What consequence can SER hypertrophy in hepatocytes with barbiturates lead to?

A

Increase in P450 mixed function oxidases which causes increased metabolism of other drugs - thus inactivating them

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27
Q

What 2 type of cell populations is hyperplasia possible in?

A

Labile and stable cell populations

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28
Q

For which 2 broad reasons may cell populations undergo physiological hyperplasia?

A

In response to hormones

As a compensatory mechanism

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29
Q

For which 2 broad reasons may cell populations undergo pathological hyperplasia?

A

Due to excess hormones or growth factors

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30
Q

Gynaecomastia is an example of what kind of cellular adaptation?

A

Pathological hyperplasia of the glandular and stromal tissue of the breast
Can be related to drugs and pathology elsewhere such as cirrhosis of the liver

31
Q

An enlarged kidney in the absence of the other kidney is an example of what kind of adaptation?

A

Hyperplasia of the kidney as a compensatory mechanism

32
Q

Graves disease is an example of what kind of pathological cellular adaptation?

A

Uncontrolled hyperplasia of the thyroid gland due to auto-Ab

33
Q

What is thyrotoxicosis?

A

Hyperthyroidism

34
Q

What is exophthalmos and why does it occur in graves disease?

A

Protruding eyeballs

Due to abnormal deposition of ground substance in the orbital tissues

35
Q

What kind of cellular adaptation occurs in liver cirrhosis leading to a ‘nobly’ liver?

A

The abnormal healing process in liver cirrhosis leads to the formation of hyperplastic nodules of hepatocytes

36
Q

What is atrophy?

A

Reduction in size of organ or tissue by decrease in cell size and number

37
Q

Give 2 examples of physiological atrophy?

A

1) Embryogenesis

2) Uterus after pregnancy or menopause

38
Q

What are the 2 types of pathological atrophy?

A

1) Localised

2) Generalised

39
Q

Decreased workload leads to what kind of pathological atrophy?

A

Disuse atrophy

40
Q

Loss of innervation leads to what kind of pathological atrophy?

A

Denervation atrophy

41
Q

Cachexia involves what kind of atrophy?

A

Atrophy of skeletal muscles due to inadequate nutrition

42
Q

Give 6 causes of pathological atrophy?

A

1) Decreased workload
2) Loss of innervation
3) Diminished blood supply
4) Inadequate nutrition
5) Loss of endocrine stimulation
6) Pressure

43
Q

Give 2 example of physiological global atrophy?

A

Shrinking of the brain with age

Physiological atrophy of the thymus with age

44
Q

Renal artery stenosis can lead to what kind of atrophy and why?

A

Atrophy of the kidneys due to diminished blood supply

45
Q

How does hydronephrosis lead to kidney atrophy?

A

Through back pressure from ureteric obstruction

46
Q

Steroid therapy can lead to what kind of atrophy?

A

Pathological atrophy of adrenal glands due to a dcrease in hormonal stimulation due to suppressed ACTH by exogenous steroids

47
Q

What is meant by involution?

A

Physiological atrophy by apoptosis

48
Q

What is the basic mechanism of atrophy?

A

1) Reduction in volume of individual cells

2) Death of individual cells - apoptosis/involution

49
Q

What embryonic failures lead to agenesis?

A

Have formation of an embryonic cell mass but that fails to differentiate into an organ specific tissue

50
Q

What embryonic failures lead to aplasia?

A

Have formation of an embryonic cell mass which differentiates into organ specific tissue but fails to structurally organize that tissue into an organ

51
Q

What embryonic failure leads to dysgenesis?

A

Have formation of an embryonic cell mass which differentiates into organ specific tissue and becomes structurally organized into an organ but don’t get growth of that organ to full size

52
Q

What embryonic failure leads to hypoplasia?

A

Have an organ which is smaller than normal

53
Q

What are the 4 developmental causes of reduced cell mass?

A

1) Agenesis
2) Aplasia
3) Dysgenesis
4) Hypoplasia

54
Q

What is metaplasia?

A

Transformation of one differentiated cell type into another through transdifferentiation of stem cells, can be physiological or pathological

55
Q

Why does metaplasia occur?

A

To make a cell mass better adapted to a new environment

56
Q

What 2 type of tissues can metaplasia affect?

A

1) Epithelium

2) Mesenchymal tissues

57
Q

Give an example of physiological metaplasia?

A

Movement of the squamocolumnar junction near the external os of the cervix during puberty and then again during menopause
ie. a change of epithelium beyond the external os of the cervix from squamous to columnar and back again

58
Q

Cigarette smoke can cause pathological metaplasia of pseudostratified ciliated bronchial epithelium to what kind of epithelium?

A

Squamous epithelium

59
Q

Pathological metaplasia of transitional epithelium of the bladder to become squamous epithelium can occur in response to which 3 stimuli?

A

1) Bladder calculus
2) Schistomosiasis
3) Long standing catheter

60
Q

Chronic trauma can cause pathological metaplasia of fibrocollagenous tissue to become what type of tissue?

A

Bone

61
Q

Acid reflux can cause pathological metaplasia of oesophageal squamous epithelium to become what kind of tissue?

A

Columnar (glandular) epithelium (like that of the stomach)

This is Barrett’s oesophagus

62
Q

How can metaplasia link to neoplasia?

A

Pathological metaplasia may form the basis on which neoplasia develops

63
Q

Squamous metaplasia in cervix may lead to what kind of neoplasia?

A

CIN and squamous cell carcinoma

64
Q

Endometrial hyperplasia due to increased oestrogens may lead to what kind of neoplasia?

A

Adenocarcinoma

65
Q

Parathyroid hyperplasia due to chronic renal failure may lead to what kind of neoplasia?

A

Adenoma

66
Q

Squamous metaplasia in bronchus may lead to what kind of neoplasia?

A

Dysplasia and squamous cell carcinoma

67
Q

Squamous metaplasia in the bladder may lead to what kind of neoplasia?

A

squamous cell carcinoma

68
Q

Glandular metaplasia in the oesophagus may lead to what kind of neoplasia?

A

Adenocarcinoma

69
Q

Why can endometrial hyperplasia be more common in obese populations?

A

Adipose tissue generates oestrogens which can lead to endometrial hyperplasia

70
Q

Disturbances in which 2 substances cause parathyroid hyperplasia in chronic renal failure?

A

Calcium and phosphate

71
Q

What is dysplasia?

A

The earliest morphological manifestation of the multistage process of neoplasia - it is irreversible
It is in-situ disease - ie. non invasive
It shows cytological features of malignancy but no invasion

72
Q

Why is recognition of dysplasia useful in treatment?

A

It gives us a chance to treat a potentially fatal tumour before it arises, the abnormal cells have not yet acquired the capacity of invasion so they cannot yet spread - eg. this is the whole basis of the cervical screening programme

73
Q

What is severe dysplasia sometimes also referred to as?

A

Carcinoma in situ

74
Q

What is the main difference between cellular adaptations and dysplasia/neoplasia?

A

Cellular adaptations reversible

Neoplasia and dysplasia are irreversible

Year 2 EMS MoD (16 decks)

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