CELLULAR INJURY CELL ADAPTATION AND CELL DEATH

Question 1

As cells encounter some stresses they may make functional or structural adaptations to maintain viability/homeostasis

Answer 1

Cellular Adaptation

Question 2

Adaptive processes

Answer 2

Atrophy
Hypertrophy
Hyperplasia
Metaplasia

Question 3

Limits of adaptive response are exceeded, or in certain instances when adaptation Is not possible

Answer 3

Cell Injury

Question 4

Removal of stress/injurious stimulus results in complete restoration of structural and functional integrity

Answer 4

Reversible cell injury

Question 5

If stimulus persists the cell will suffer

Answer 5

Irreversible cell injury/ cell death

Question 6

One of the most crucial events in Pathology and can affect any type of cell

Answer 6

Cell death

Question 7

Two principle morphologic patterns that are indicative of cell death

Answer 7

Necrosis
Apoptosis

Question 8

Type of cell death characterized by severe membrane injury and enzymatic degradation; always a pathologic process.

Answer 8

Necrosis

Question 9

Regulated form of cell death; can be a physiologic or pathologic process

Answer 9

Apoptosis

Question 10

Causes of cell injury

Answer 10

Hypoxia( oxygen deficiency)
Physical Agents
Chemical, drugs & toxins
Infectious agents
Immunologic radiations
Genetic abnormalities
Nutritional Imbalances
Cell Aging

Question 11

Hypoxia Occurs with

Answer 11

Deficient blood supply
Reduced-oxygen carrying capacity of the blood
Interference with respiratory chain/oxidative phosphorylation

Question 12

Most important and common causes of cell injury and cell death

Answer 12

Hypoxia

Question 13

Causes impairment of oxidative respiration

Answer 13

Hypoxia

Question 14

Deficiency of blood supply from impedded arterial flow or reduced venous drainage

Answer 14

Ischemia

Question 15

Localized area of ischemic necrosis

Answer 15

Infarction

Question 16

Severity of a physical injury may be increased by tissue hypoxia die to associated local vascular injury

Answer 16

Physical Agents

Question 17

Physical Agents

Answer 17

Direct mechanical trauma
Temperature extremes
Radiation
Electrocaution
Sudden changes in atmospheric pressure

Question 18

Chemical drugs& toxins

Answer 18

In organic poisons
Organic poisons
Manufactured chemicals
Physiologic compounds
Plant toxins
Animal toxins
Bacterial toxins/ mycotoxins

Question 19

Infectious agents

Answer 19

Viruses
bacteria/rickettsiae/Chlamydia
Fungi
Protozoa
Metazoan prasite

Question 20

Immunologic response

Answer 20

Immune response
Hypersensitivity (allergic) reactions
Autoimmune diseases

Question 21

eg. Cells damaged as “innocent bystanders” in immune/inflammatory response.

Answer 21

Immune response

Question 22

eg anaphylactic reaction to a foreign protein or drug

Answer 22

Hypersensitivity(allergic) reactions

Question 23

Reactions to self-antigens

Answer 23

Autoimmune diseases

Question 24

Genetic abnormalities

Answer 24

Cytogenetic disorders/chromosomal aberrations
Mendelian disorders(mutant genes)
Multifactorial inheritance

Question 25

Nutritional imbalances

Answer 25

Deficiencies Overnutrition

Question 26

One cause of congenital anomalies

Answer 26

Cytogenetic disorders/chromosomal aberrations

Question 27

Enzymes defects, eg. Lysosomal storage disease

Answer 27

Mendelian Disorders(mutant genes)

Question 28

Combined effects of environmental factors and 2 or more mutated genes

Answer 28

Multifactorial Inheritance

Question 29

A workload Imbalances which cell injury occurs if stimulus prolonged and/or exceeds ability to adapt.

Answer 29

Overworked cells

Question 30

Prolonged lack of stimulation can lead to atrophy and eventually the loss of cells.

Answer 30

Underworked cells

Question 31

The cumulative effects of a life time of cell damage leads to a diminished capacity of aged cells/tissues to maintain homeostasis and adapt to harmful stimuli

Answer 31

Cell Aging

Question 32

Mechanisms of cell injury

Answer 32

General Consideration Biochemical Mechanisms Chemical (toxic) Injury

Question 33

4 intracellular systems are particularly vulnerable to injury.

Answer 33

Cell membranes Mitochondria Protein synthesis Genetic apparatus

Question 34

Are chemicals species with a single unpaired electrons in outer orbit

Answer 34

Free radicals

Question 35

It occurs when free radical generation overwhelms antioxidant defense mechanisms.

Answer 35

Cell injury

Question 36

Generation of free radicals

Answer 36

Cellular metabolism Enzymatic metabolism of exogenous chemicals Ionizing radiation Divalent metals

Question 37

Small amounts produced from cell redox reactions

Answer 37

Cellular metabolism

Question 38

Some intermediary metabolites of chemical/drugs are highly reactive free radicals.

Answer 38

Enzymatic metabolism of exogenous chemicals

Question 39

Hydrolyzes water into hydroxyl (•OH) and hydrogen (H°) free radicals

Answer 39

Ionizing radiation

Question 40

Accept or donate free electrons during certain intracellular reactions

Answer 40

Divalent metals

Question 41

Main sites of damage

Answer 41

Damage of membranes (lipid peroxidation) Damage of Proteins Damage of DNA

Question 42

Protective mechanisms of the cell

Answer 42

Storage and transport proteins Antioxidants Enzymes which are involved in neutralizing free radicals Intracellular calcium and loss of calcium homeostasis Mitochondrial damage Defects in membrane permeability

Question 43

Enzymes which are involved in neutralizing free radicals:

Answer 43

Glutathione peroxidase Superoxide dismutase (SOD) Catalase

Question 44

A selenium-containing enzyme which catalyzes GSH to GSSG

Answer 44

Glutathione peroxidase

Question 45

All cells are depending on oxidative metabolism for long term survival, regardless of glycolytic ability.

Answer 45

Mitochondrial damage

Question 46

Some chemicals act directly by damaging particular organelles or critical cell molecules

Answer 46

Direct interaction

Question 47

Damages mitochondrial cytochrome oxidase-blocks oxidative phosphorylation

Answer 47

Cyanide

Question 48

Prevents citrate from being used in the citric acid cyclem

Answer 48

Fluoroacetate

Question 49

Major adaptive responses:

Answer 49

Atrophy Hypertrophy Hyperplasia Aplasia Hypoplasia Metaplasia Dysplasia

Question 50

Decrease in the amount of a tissue or organ after normal growth has been attained.

Answer 50

Atrophy

Question 51

Not dead or necessarily badly injured but they have a reduced functional capacity

Answer 51

Atrophic cells

Question 52

Organelles removed by autophagocytosis and decreased proteins by?

Answer 52

Ubiquitin-proteosome pathway

Question 53

Organs are increased in size

Answer 53

Hypertrophy

Question 54

Increase in organ size or tissue mass caused by an increase in the number of constituent cells

Answer 54

Hyperplasia

Question 55

Two features consistently characterize irreversibility

Answer 55

Inability to reverse mitochondrial dysfunction Profound disturbances of membrane function

Question 56

Reasons for irreversible injury

Answer 56

Inability to reverse mitochondrial dysfunction Profound disturbances of membrane function

Question 57

Two main types of reversible cell injury are recognized

Answer 57

Cellular swelling Fatty change

Question 58

The most common and most important response to cellular injuries of all types

Answer 58

Cellular swelling

Question 59

The process continues many vacuoles of variable size appear in the cytoplasm called?

Answer 59

Hydropic or vacuolar degeneration

Question 60

The severe process of continues vacuoles of variable size appear in the cytoplasm

Answer 60

Ballooning degeneration

Question 61

A sick cell, a reversible form of injury, and an adaptive change that may progress to cell death

Answer 61

Degeneration

Question 62

Refers to the rapid death of a limited portion of an organism and is considered to be final stage in irreversible degeneration.

Answer 62

Necrosis

Question 63

Term used for the entire process of degeneration and death of cells

Answer 63

Necrobiosis

Question 64

The morphologic appearance is due to 2 concurrent processes.

Answer 64

Denaturation of proteins Enzymatic digestion of the cell

Question 65

Term often used to describe the changes that occur in all of the cells after an animal has died.

Answer 65

Autolysis

Question 66

Types of necrosis

Answer 66

Coagulation necrosis Liquefactive necrosis Caseous necrosis Gangrenous necrosis Fat necrosis Infarction(Ischemic Necrosis) Zenker's Necrosis

Question 67

Most common manifestation of cell death

Answer 67

Coagulation Necrosis

Question 68

3 patterns of nuclear changes

Answer 68

Karyolysis Pyknosis Karyorrhexis

Question 69

Dissolution/fading of the nucleus

Answer 69

Karyolysis

Question 70

Shrunken and densely basophilic nuclei

Answer 70

Pyknosis

Question 71

Nuclear Fragmentation

Answer 71

Karyorrhexis

Question 72

Occurs when enzymatic digestion of necrotic cells predomjnates over protein denaturation

Answer 72

Liquefactive necrosis

Question 73

Typical lession seen with specific bacterial diseases

Answer 73

Caseous Necrosis

Question 74

Occurs when saprophytic bacteria grow in necrotic tissue.

Answer 74

Gangrenous Necrosis

Question 75

Two types of gangrene

Answer 75

Wet gangrene Dry gangrene

Question 76

Occurs in necrotized portion of the skin with moisture loss due to evaporation and drainage presence of saprophytic bacteria

Answer 76

Dry gangrene

Question 77

When the coagulative necrosis of dry gangrene is modified by the liquefactive action of invading saprophytic/putrefactive bacteria.

Answer 77

Wet gangrene

Question 78

Form of coagulative necrosis resulting from a sudden deprivation of blood supply

Answer 78

Infarct

Question 79

Characterized by loss of striations following necrosis

Answer 79

Zenker's necrosis

Question 80

A shallow area of necrosis confined to epidermis that heals without scarring

Answer 80

Erosion

Question 81

An excavation of a surface produced by necrosis

Answer 81

Ulcer

Question 82

A piece of necrotic tissue in the process of separation from viable tissue

Answer 82

Slough

Question 83

An area of liquefactive necrosis of the nervous tissue. Literally means "softening"

Answer 83

Malacia

Question 84

Isolated necrotic mass

Answer 84

Sequestrum

Question 85

Favorable outcome or Sequela of necrosis

Answer 85

Organization Petrifaction Ossification Aseptic autolysis

Question 86

Falling off

Answer 86

Apoptosis

Question 87

Death of a single cells as a result of activation of a genetically programmed "suicide" pathway.

Answer 87

Apoptosis

Question 88

Pigments and other tissue deposits

Answer 88

Lipid accumulation Glycogen accumulation Protein Accumulation Amyloid and amyloidosis Endogenous pigments Pathologic calcification(mineralization) Crystals Exogenous pigments Parasite pigments

Question 89

Endogenous pigments compised of:

Answer 89

Lipofuscin Ceroid Melanin Copper Hemosiderin Biliburin Hematoidin Acid-Hemalin

Question 90

Other enzymes used to evaluate tissue damage are:

Answer 90

Lactic dehydrogenase(LHD) Creatine phosphokinase(CPK) Alkaline Phosphatase (AP)

Question 91

Post mortem Artifacts

Answer 91

Postmortem scavenging vs. predation Rigor mortis Algor mortis Livor mortis Postmortem clotting Hemoglobin imbibition Bile imbibition Pseudomelanosis Postmortem autolysis/decomposition Putrefaction and postmortem emphysema(bloating) Postmortem ruptures and organ displacements Other abnormalities

Question 92

Types of calcification

Answer 92

Dystrophic calcification Metastatic Calcification

Question 93

Exogenous pigments

Answer 93

Antracosis Silicosis Asbestosis