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Cellular Week 3 > Cellular Adaptations > Flashcards

Cellular Adaptations Flashcards

1
Q

Adaptive responses/Accumulations are typically…

A

reversible responses

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2
Q

Four different adaptations?

A

Hyperplasia
Hypertrophy
Atrophy
Metaplasia

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3
Q

Hyperplasia

A

An increase in cell number

Normal response:
Stimulus - may be normal or pathological
Mechanism - growth factors or hormones

Contrast to neoplasia where proliferation is abnormal

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4
Q

Where does hyperplasia occur?

A

Skin, fibroblasts, liver, bone marrow

Cells that are capable of normal division

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5
Q

Where does hyperplasia not occur?

A

neurons, cardiac muscle, skeletal muscle

cells that are post-mitotic

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6
Q

physiologic exs of hyperplasia?

A

endometrium (menustral cycle)

breast (puberty/lactation)

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7
Q

pathologic examples of hyperplasia?

A

endometrial hyperplasia (too much estrogen stimulation) - increased risk for carcinoma

prostatic hyperplasia

lymphoid hyperplasia due to viral infection

erthyroid hyperplasia of the bone marrow after hemolytic anemia

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8
Q

view slide of non-lacting vs lactating breast…

A

glands is lactating are hyperplasic and large and full of milk that will be secreted

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9
Q

As menstrual cycle progresses, there is hyperplasia of endometrial lining

A

…

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10
Q

Benign prostatic hyperplasia (BPH)

What is characteristic of it?
What process is it? (dependent on what?)

A

Hyperplastic nodules (hyperplasia of both epithelium and stroma - fibroblasts/muscle - proportion varies)

androgen-dependent process (blocked by prepubertal castration)

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11
Q

What does BPH commonly involve?

A

involves the inner periurethral zone

nodules may compress the urethra

prevalence increases with age!! (age 40 -20%; age 60 - 70%, age 70 - 90%)

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12
Q

what is the tx for BPH?

A

5-alpha-reductase inhibitors

Avodart - BPH
Propecia - male pattern baldness
block conversion of testoerone to more potent dihydrotestosterone

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13
Q

Hyperplastic Prostate slide….

A

looks like a scrunched up rug - “papillary infoldings”

more epi - folded and abundant

stroma also increases in size

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14
Q

What is the significance of hyperplasia?

A

persistent hyperplasia is a fertile ground for the development of cancer

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15
Q

What is hypertrophy?

What can it be accompanied by?

A

An increase in cell size (corresponding increase in organ size)

may be accompanied by hyperplasia

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16
Q

physiologic example of hypertrophy?

A

skeletal muscle

smooth muscle (pregnant uterus)

cardiac muscle (athletes)—usually reversible

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17
Q

pathologic exs of hypertrophy?

A

cardiac muscle (hypertension) — usually nonreversible

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18
Q

skeletal muscle hypertrophy is a normal healthy response to exercise and it is reversible

A

….

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19
Q

cardiac muscle hypertrophy can be in response to what two things?

A

1) response to exercise
- “athletes” heart - cross country skiers, cyclists, rowers

2) response to disease
- chronic hypertension
- myocardial infarct
- valve disease
(hypertrophy in disease is disorganized and has fibrosis)

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20
Q

See slide of hypertrophic myocytes

A

…

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21
Q

cardiac hypertrophy with exercise… tissue organization?

heart function?

A

normal

normal or enchanted

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22
Q

cardiac hypertrophy with disease… tissue organization?

heart function?

A

abnormal with fibrosis

abnormal gene expression; overtime, functional degeneration

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23
Q

Hypertrophy mechanism?

A

balance between protein synthesis and degradation shifts to synthesis

  • mechanical triggers (Stretch/load receptors)
  • hormonal triggers
24
Q

Atrophy definition?

A

a decrease in the size and/or number of cells in a tissue

25
Q

physiologic response to atrophy ex?

A

menopause

endometrium, vaginal epithelium, breast epithelium

26
Q

pathologic response with atrophy ex.?

A
  • skeletal muscle immobilization (cast)
  • reduced blood supply (aging brain, vessel constriction by tumors, atheroschlerosis)
  • poor nutrion
  • cachexia
  • hormonal dysfunction (pituitary damage from tumors/infection/trauma/surgery: thyroid/adrenal atrophy)
  • aging
27
Q

see slide of renal atrophy due to ischemia (reduced blood flow example)

A

….

28
Q

what is the mechanism of atrophy?

A

there is a balance between synthesis and degradation that shifts to degradation….

1)autophagy
major pathway for bulk degradation
cytoplasm is sequestered in vacoules and delivered to the lysosome
leads to lipofuscion

2)ubiquitin-proteasome system
proteins are conjugated to ubiquitin, and degraded by the proteasome (A cytoplasmic proteolytic organelle)

29
Q

Hypertrophy or hyperplasia are sometimes not enough to adapt to stress…
persisten stress sometimes leads to what?

A

metaplasia

30
Q

what is metaplasia?

A

really happens in progenitor cells

  • replacement of one mature cell type by one that is more stress-resistant
  • mechanism: changes in gene expression that reprogram STEM CELLS
  • often reversible if the irritant is removed
31
Q

airways will change from columnar (glandular) to squamous with cigarettes

A

…

32
Q

bladder will chane from transitional to squamos with stones/schistoma

A

…

33
Q

esophagus will go from squamous to COLUMNAR! if reflux

A

…

34
Q

What is intestinal metaplasia called?

A

Barrett’s esophagus

replaces stratified epi with goblet cells - may occur in stomach response to H. pylori

due to heart burn = acid reflux

changes to look more like the lining of the intestine

35
Q

Metaplasia may be accompanied by a loss of function (cilia) or may progress to cancer!!

metaplasia is not considered to be a preneoplastic change BUT the types of stress that trigger metaplasia are also associated with dysplasia and then neoplasia if unresolved

A

…

36
Q

Dysplasia def?
characterized by?
ex?

A

preneoplastic change

characterized by cellular atypia (aberrant maturation, enlarged nuclei, nuclear HYPERCHROMASIA)

ex. often associated in the cervix with HPV infection

37
Q

see slide of dysplastic cells in pap smear!!

cells become smaller and the nuclei enlarge

A

…

38
Q

If cellular adaptations persist/are unresolved….

A

irreversible damage or cancer may occur

39
Q

Hypertrophy occurs in…

A

pregnancy (uterus)
hypertension (heart)
sport (heart, skeletal muscles)

40
Q

Atrophy occurs in….

A

plaster cast (skeletal muscles)

41
Q

hyperplasia occurs in…

A

pregnancy (uterus)

42
Q

metaplasia occurs in…

A 
chronic gastritis (gastric epi)
reflux esophagitis (esophageal epi)
smoking (respiratory epithelium)
43
Q

Metaplsia is similar to embryonic development because it is changing the progenitor/stem cells themselves (probably only changing a few key transcription factors)

A

…

44
Q

Lesions/Diseases can have an intrinsic etiology (genetic/autoimmune) or extrinsic etiology (infection/infestation/predation from prion, virus, fungus, etc) or (non-infectious like hypoxia, trauma, radiation, drugs, nutritional deficiencies, etc)

A

…

45
Q

Patient can have right ventricular hypertrophy due to mitral valve damage (causes regurgitation and pulmonary hypertension)

Weight loss drug called Fen-Phem

A

…

46
Q

Very severe asthma can result in…

A

hyperplasia of the smooth muscle cells in the airways

47
Q

Chronic denervation (thus leading to muscle atrophy) can occur because of post polio syndrome…

can arise decades laser (orthotic devices may help)

polio virus is spread by fecal-oral route, initially kills cells of anterior horn of spinal cord needed for lower motor neuron function

A

…

48
Q

Osteoporosis is what?

A

atrophy of bone tissue

cortex is narrowed, the number and thickness of the trabecular are reduced, and the proportion of bone substance is reduced in proportion to marrow cavity tissue

49
Q

epidermal atrophy is due to overuse of topical corticosterioids

epidermal atrophy at ankles due to reduced blood supply from venostasis/peripheral vascular disease

A

…

50
Q

callus on feet is result of what?

what is it called?

A

hyperplasia of epidermis…called “acanthosis”

results from chronic injury (e.g. friction)

see also on hands of rowers, guitar players, etc.

51
Q

what is a corn (clavus)?

A

similar to callus (hyperplasia) atop toe having a central plug of keratin, sometimes overlies bone spur

52
Q

Mono CBC finding?

A

lymphocytosis and atypical lymphocytes (large)

53
Q

How do you test for mono?

A

serology tests such as anti-EBV antibodies

“monospot test” or “heterophile test” where serum of diseased causes clumping of RBC of other species, e.g. horse

54
Q

changes in lymph node with mono?

A

interfollicular hyperplasia!!

follicle size stays the same though

55
Q

mononucleosis virus… usually self-limited disease and virus has a low transmissibility so pt isolation is not required…

which viruses cause it?
possible complications?

A

EBV mostly
CMV occasionally

splenic rupture is a complication

56
Q

when does intestinal metaplasia sometimes occur in the stomach?

what does it have increased risk for? (2)

A

Helicobacter pylori infection, alcohol consumption, chronic bile reflux, and smoking

carries increased risk of developing dysplasia and gastric cancer

Cellular Week 3 (21 decks)

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