Cellular Responses to Stress and Injury Flashcards by Marize Gregorio

Reversible functional and structural responses to more severe physiologic stresses and some pathologic stimuli allowing the cell to survive and continue to function

Cellular adaptation

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Results when cells are stressed so severely, they are no longer able to adapt

Cell injury

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End result of progressive cell injury

Cell death

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Type of cell death that occurs after such abnormal stresses as ischemia and chemical injury

Necrosis

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T/F: Necrosis is always pathologic

True

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Type of cell death that occurs due to activation of an internally controlled suicide program

Apoptosis

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Adaptive cellular response triggered by nutrient deprivation

Autophagy

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Results from calcium deposition at sites of cell death

Pathologic calcification

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T/F: Hyperplasia cannot occur simultaneously with hypertrophy

False

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Increased functional capacity of a tissue when needed

Hormonal hyperplasia

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Increased tissue mass after damage or partial resection

Compensatory hyperplasia

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Differentiate hyperplasia from hypertrophy

Hyperplasia - happens in cells capable of dividing; results in an inc. in the mass of organ

Hypertrophy - happens in cells which are not capable of dividing; results in an inc. in size of the organ

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Most important biochemical pathway involved in physiologic hypertrophy

Phosphoinositide 3-kinase/Akt pathway

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Induced by many growth factors and vasoactive agents and thought to be more important in pathologic hypertrophy

G-protein coupled receptors

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Associated with reinduction of ANF gene expression

Myocardial hypertrophy

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Most common setting for atrophy to occur

Aging

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Generalized atrophy

Malnutrition

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A reversible change in which one differentiated cell type is replaced by another cell type

Metaplasia

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T/F: Metaplasia results from a change in the phenotype of an already differentiated cell type

False

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Result of a reprogramming of stem cells that are known to exist in normal tissues, or of undifferentiated mesenchymal cells present in connective tissue

Metaplasia

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Most common metaplasia

Columnar to squamous

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Disordered cellular growth and maturation

Dysplasia

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Dysplasia occurs most often in?

Hyperplastic squamous epithelium and in areas of squamous metaplasia

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T/F: Dysplastic cells are not autonomous and with intervention, the tissue may still revert to normal

True

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Hallmarks of cell injury

Dec. oxidative phosphorylation Cellular swelling due to changes in ion concentration and water influx Alterations in organelles (mitochondria and cytoskeleton)

Cellular response to injurious stimuli depends on?

Nature, duration, and severity of the injury

Consequences of cll injury depends on?

Type, state and adaptability

Fundamental cause of necrotic cell death

ATP depletion

Increased intracellular calcium levels result in the induction of apoptosis by?

Direct activation of caspases and by increasing mitochondrial permeability

Appears whenever cells are incapable of maintaining ionic and fluid homeostasis

Cellular swelling

T/F: Hydropic swelling results in an increased number of organelles

False

Occurs in hypoxic injury and various forms of toxic or metabolic injury

Fatty change

Manifestation of fatty change

Lipid vacuoles in cytoplasm

Features of cell injury under light microscope

Cytoplasmic eosinophilia | Nuclear degeneration

Nuclear shrinkage and creased basophilia

Pyknosis

Pyknotic nucleus breaks up into smaller fragments scattered around the cytoplasm

Karyorrhexis

Fading of basophilia of the chromatin due to loss of DNA because of enzymatic degradation by endonucleases

Karyolysis

T/F: Coagulative necrosis is denaturation of both structural proteins and enzymes with proteolysis

False

Type of necrosis in TB

Caseous necrosis

Cell death characterized by dominant enzyme digestion

Liquefactive necrosis

Associated with secondary bacterial infection of already ischemic tissues

Gangrenous necrosis

Diabetic foot is which type of gangrenous necrosis?

Dry gangrene

Bacterial infection superimposed on coagulative necrosis

Dry gangrene

Bacterial infection superimposed on liquefactive necrosis

Wet gangrene

Process of combination of free fatty acids with calcium resulting to chalky white areas

Fat saponification

Which type of necrosis occurs in acute pancreatitis?

Fat necrosis

Occurs when there is deposition of Ag-Ab complexes in the walls if arteries

Fibrinoid necrosis

Which type of necrosis occurs in vasculitis?

Fibrinoid necrosis

Fragments of apoptotic cells containing portion of its nucleus and cytoplasm

Apoptotic bodies

Most characterized feature of apoptosis

Chromatin condensation

Fragmentation into apoptotic bodies containing cytoplasmic organelles with or without nuclear fragments

Blebbing

Best known death receptors

TNFR1 and Fas ( CD95)

Anti-apoptotic proteins

BCL2, BCL-XL, MCL1

Pro-apoptotic proteins

BAX, BAK

Act as sensors of cellular stress and damage and regulate the balance between anti- and pro-apoptotic proteins

Arbiters of apoptosis

BAD, BIM, Puma, Noxa

T/F: Both anti- and pro-apoptotic proteins have 4 BH domains

True

Abnormal accumulations of triglycerides within parenchymal cells

Steatosis

Steatosis is often seen in which organ?

Liver

Smooth muscle cells and macrophages within the intimal layer of the aorta and large arteries which are filled with lipid vacuoles

Foam cells

Intracellular accumulation of cholesterol within macrophages

Xanthomas

Lysosomal storage disease caused by mutations affecting an enzyme involved in cholesterol trafficking, resulting in cholesterol accumulation

Niemann-pick disease, type C

Focal accumulation of cholesterol-laden macrophages in the lamina propria of the gallbladder

Cholesterolosis

Marked accumulation of newly synthesized immunoglobulins that may occur in the RER

Russell bodies

Abnormal proteins deposit primarily in extracellular spaces

Amyloidosis

An alteration within cells or in extracellular space that gives a homogeneous, glassy, pink appearance in sections stained with H&E

Hyaline change

Most common exogenous pigment

Carbon

Wear and tear pigment

Lipofuscin

Appearance when large amounts of lipofuscin is present

Brown atrophy

Pigment that accumulates in tissues when local or systemic excess of iron is present

Hemosiderin

Condition where unconjugated bilirubin is found in the brain and may lead to death

Kernicterus

Type of calcification which occurs in the absence of derangements in calcium metabolism

Dystrophic calcification

Type of calcification which occurs in normal tissue during hypercalcemia

Metastatic hypercalcemia

Disease of premature aging

Werner's syndrome