Cellular Adaption To Stress

Question 1

Involves the cause of disease as well as the mechanisms leading to the presentation of signs and symptoms in the patient

Answer 1

Pathology

Question 2

Name the 3 types of physiologic cells in the body:

Answer 2

1. Labile cells
2. Stable cells
3. Permanent cells

Question 3

These physiologic cells do not normally regenerate but may do so in certain situations (liver cells after hepatitis or partial liver donation)

Answer 3

Stable cells

Question 4

Which type of physiologic cells are normally replaced at different intervals? (Ex: Enterocytes, gastric and squamous epithelium)

Answer 4

Labile cells

Question 5

Cardiac muscle cells do not regenerate during a lifetime. These are called ___ cells

Answer 5

Permanent

Question 6

The 3 patterns of injury to cells?

Answer 6

1. Reversible injury
2. Persistent stress
3. Irreversible (lethal) injury

Question 7

Two types of reversible injury?

Answer 7

1. Hydropic swelling

2. Fatty metamorphosis

Question 8

This type of reversible cell injury is due to accumulation of triacylglycerol in the cell. It is most commonly caused by alcohol intake

Answer 8

Fatty metamorphosis

Question 9

Metabolism of alcohol involves what three substrates which contribute to triacylglycerol synthesis?

Answer 9

1. NADH + H+
2. Acetate
3. Acetyl CoA

Question 10

The result of failure of energy dependent ATP pump in plasma membrane leading to inability to maintain ionic and fluid homeostasis

Answer 10

Hydropic swelling

Question 11

An increase in cell size. (Ex: enlarged heart in a well-trained athlete)

Answer 11

Hypertrophy

Question 12

The reversible replacement of one cell type by another. (Ex: replacement of urinary transitional epithelium with squamous epithelium due to repeated UTI’s)

Answer 12

Metaplasia

Question 13

A decrease in cell size. (Ex: a bodybuilder stops working out, muscles become smaller)

Answer 13

Atrophy

Question 14

A disorderly proliferation of cells with varying size and shape of nuclei. May become cancer if the irritating stimulus is not removed. (Ex: mucosa of bronchus of a smoker)

Answer 14

Dysplasia

Question 15

An increase in cell number. (Ex: endometrial glands during proliferative phase of menstrual cycle)

Answer 15

Hyperplasia

Question 16

A decrease in cell number. (Ex: smaller thymus with advancing age)

Answer 16

Involution

Question 17

A marker of past injury in cardiomyocytes?

Answer 17

Lipofuscin pigment

Question 18

Marker of past injury in hepatocytes?

Answer 18

Mallory bodies

Question 19

Neurofibrillary tangles are markers of past injury to what type of cells?

Answer 19

Brain cells (neurons)

Question 20

Macrophages that have engulfed lipid debris

Answer 20

Foam cells

Question 21

Irreversible cell injury is also known as:

Answer 21

Necrosis

Question 22

List the 3 lipid bilayer membranes involved in necrosis

Answer 22

1. Cell plasma membrane
2. Inner mitochondrial membrane
3. Lysosomal membrane

Question 23

A group of molecules that injure the lipid bilayer membrane through the process of lipid peroxidation

Answer 23

Reactive Oxygen Species (ROS)

Question 24

Oxidative degradation of lipids

Answer 24

Peroxidation

Question 25

List the three most common Reactive Oxygen Species (ROS):

Answer 25

1. Superoxide 2. Hydrogen peroxide 3. Hydroxyl radical

Question 26

List the three changes to the cell nucleus during necrosis:

Answer 26

1. Pyknosis (shrinkage) 2. Karyorrhexis (fragmentation) 3. Karyolysis (dissolution - nucleus no longer visible)

Question 27

The final event in lethal cell injury is massive leakage of ____ into the cytosol, which destroys all of the critical parts of the cell

Answer 27

Calcium (Ca2+)

Question 28

Individual cell death without an inflammatory reaction

Answer 28

Apoptosis

Question 29

More widespread cell death with an inflammatory process

Answer 29

Necrosis

Question 30

Cell death resulting from a hepatitis infection of liver cells would fall under what category?

Answer 30

Apoptosis

Question 31

The major pathway of cell death in many injuries (trauma, infections, toxins, ischemia)

Answer 31

Necrosis

Question 32

An inadequate blood supply to an organ or part of the body, especially the heart muscles

Answer 32

Ischemia

Question 33

Name the two steps in apoptosis:

Answer 33

1. Intrinsic pathway (mitochondrial) | 2. Extrinsic pathway (death receptor)

Question 34

Which step of apoptosis is triggered by the loss of survival signals and DNA damage. Mediated by proteins called caspases

Answer 34

Intrinsic

Question 35

Which apoptosis pathway is Tumor Necrosis Factor (TNF) receptor mediated?

Answer 35

Extrinsic

Question 36

Most common type of necrosis:

Answer 36

Coagulative necrosis (Ex: myocardial infarction...heart attack)

Question 37

This type of necrosis is most commonly caused by ischemia (loss of blood supply) secondary to atherosclerosis (build up of plaque in arterial walls). Component cells die, but basic architecture is preserved

Answer 37

Coagulative necrosis

Question 38

In ___ necrosis, dead cells are completely digested resulting in transformation of the tissue into a liquid, thickened, viscous mass. (Ex: brain abscess)

Answer 38

Liquefactive

Question 39

___ necrosis results from enzymatic release of activated pancreatic lipases into the pancreas. Fatty acids combine with calcium to form a white area called saponification, OR traumatic injury to fatty tissue

Answer 39

Fat

Question 40

A combination of coagulation and liquefactive necrosis forming a granuloma (mass of granulation tissue) Associated w/tuberculosis

Answer 40

Casseous necrosis

Question 41

____ necrosis is seen in immune reactions involving small blood vessels. Occurs when antigens and antibodies are deposited in arterial walls together with fibrin that has leaked out of vessels

Answer 41

Fibrinoid

Question 42

This type of necrosis is due to disrupted blood supply secondary to bone fracture.

Answer 42

Avascular necrosis

Question 43

____ necrosis is a variant of casseous necrosis typically seen in tertiary syphilis.

Answer 43

Gummatous

Question 44

Coagulative necrosis involving multiple tissue layers, often refers to the skin and subcutaneous tissue

Answer 44

Gangrene

Question 45

Fluid accumulation in tissue outside the vascular system is known as:

Answer 45

Edema

Question 46

Fluid accumulation in a confined anatomic space (joint, pleural or peritoneal cavity, pericardial sac)

Answer 46

Effusion

Question 47

Fluid with a low protein content is known as ___, high protein content known as ___

Answer 47

Transudate, exudate

Question 48

The 5 clinical signs of inflammation?

Answer 48

1. Redness 2. Heat 3. Swelling 4. Pain 5. Loss of function

Question 49

Most common cause of acute inflammation?

Answer 49

Staphylococcal or streptococcal infection

Question 50

Superficial skin infections are known as:

Answer 50

Impetigo, folliculitis

Question 51

A deeper infection that has invaded the lymph nodes is known as:

Answer 51

Erysipelas

Question 52

A deep infection of the subcutaneous tissue is called:

Answer 52

Cellulitis

Question 53

Where is the site of cellular and most fluid transfer into the surrounding tissue?

Answer 53

Post capillary venules

Question 54

Leukocyte accumulation at the margin of vessels is called ____ (inflammatory response)

Answer 54

Margination

Question 55

When WBC's fall and tumble on the endothelial surface of the blood vessel it is called ___

Answer 55

Rolling

Question 56

The most common leukocytes to migrate to the area of injury? These begin arriving in the first 24 hours.

Answer 56

Neutrophils

Question 57

After neutrophils have arrived at the site of injury during the first 24 hours, ___ and ___ (of leukocytes) begin arriving in the next 24 hours

Answer 57

Monocytes, macrophages

Question 58

Name the 5 stages of the cellular response to injury

Answer 58

1. Margination 2. Adhesion 3. Transmigration (emigration) 4. Chemotaxis 5. Phagocytosis

Question 59

During cell adhesion, ___ on the leukocyte cell surface interact with ___ on endothelial cells

Answer 59

Integrins, ligands

Question 60

___ are secreted by many cells at the site of inflammation causing the firm adhesion of leukocytes to their appropriate ligands

Answer 60

Chemokines

Question 61

After adhesion, the activated leukocytes squeeze through the endothelial cells (called diapedesis) to enter the area of injury. This step is called ____

Answer 61

Transmigration (emigration)

Question 62

Once transmigration occurs, directed movement of the cells along an increasing concentration gradient to the area of injury occurs. This step is called ___

Answer 62

Chemotaxis

Question 63

C5a complement, leukotriene B4 (LTB4), and fragments of collagen and fibrin are examples of ___ agents

Answer 63

Chemotactic

Question 64

List the three steps in phagocytosis:

Answer 64

1. Recognition and attachment 2. Engulfment 3. Killing and degradation

Question 65

When NADPH oxidase (enzyme) is not present for phagocytosis, it is known as:

Answer 65

Chronic granulomatous disease of childhood

Question 66

A genetic defect in gene coding for the fusion of the phagocyte with the lysosome is known as ____ syndrome

Answer 66

Chediak-Higashi

Question 67

The mediators of inflammation can be broken into three groups, they are:

Answer 67

1. Cell derived 2. Arachidonic acid derived 3. Plasma derived

Question 68

___ cells release histamine, which causes vasodilation

Answer 68

Mast

Question 69

____ release serotonin, which causes vasoconstriction

Answer 69

Platelets

Question 70

The arachidonic acid derived mediators of inflammation have two pathways. Name them

Answer 70

1. Cyclooxygenase pathway (blocked by NSAIDS) | 2. Lipooxygenase pathway (blocked by Steroids-both pathways are blocked by steroids)

Question 71

Complement proteins are part of which mediators of inflammation category?

Answer 71

Plasma-derived

Question 72

In reference to the arachidonic acid derived mediators, ___ causes vasodilation and therefore edema

Answer 72

Prostaglandins

Question 73

In reference to the arachidonic acid derived mediators of inflammation, ____ causes vasoconstriction

Answer 73

Thromboxane

Question 74

In reference to the arachidonic acid derived mediators of inflammation, ____ causes small muscle contractions

Answer 74

Leukotriene

Question 75

The three pathways that makeup the classical blood coagulation pathway are:

Answer 75

1. Intrinsic 2. Extrinsic 3. Common

Question 76

The two major pathways of the complement system are:

Answer 76

1. Classical | 2. Alternative

Question 77

The ___ pathway is activated by antigen-antibody complexes. Operates in acquired immunity

Answer 77

Classical

Question 78

The ___ pathway is directly activated by the presence of bacteria or other microorganisms. Operates in innate or natural immunity

Answer 78

Alternative