Cellular Responses to Stress, Inflammation and Repair, Hemodynamic Disorders Flashcards
The two (2) consistent features of
reversible cell injury
Cellular swelling,
Fatty change
Increase in cell NUMBER due to
increased workload or
compensatory response
Hyperplasia
Increase in cell SIZE due to
hormonal stimulation or
compensatory response
Hypertrophy
Decrease in cell size and/or
number due to loss of
innervation, loss of blood
supply, etc.
Atrophy
Differentiated cell type
replaced by another
metaplasia
Most common type of metaplasia
Squamous metaplasia
Type of metaplasia in Barrett’s
esophagus
Intestinal metaplasia
Degradation of this molecule
causes increased cytoplasmic
eosinophilia in necrotic cells
Nucleic acids
Decreased basophilia of
chromatin
Karyolysis
Nuclear shrinkage with
increased basophilia
Pyknosis
Fragmentation of pyknotic
nucleus
Karyorrhexis
Pattern of necrosis in the setting of ischemia in most organs; (+) “ghost cells” - preserved cell architecture, loss of nucleus. Acidophilic tombstones
Coagulative necrosis
All organs undergo coagulative
necrosis following ischemia,
except:
Brain
Pattern of necrosis occurring in
bacterial infections and
ischemic necrosis of the brain;
due to neutrophilic enzymes;
(+) pus
Liquefactive necrosis
Pattern of necrosis due to loss
of blood supply in a limb; can
be dry or wet (superimposed
with bacterial infection)
Gangrenous necrosis
Pattern of necrosis
characterized by cheese-like
friable foci of necrosis and
structureless collection of lysed
cells and amorphous debris;
seen in tuberculous infections
Caseous necrosis
Pattern of necrosis seen in
acute pancreatitis; (+) chalkywhite
areas of saponification,
(+) basophilic calcium deposits
Fat necrosis
Pattern of necrosis
characterized by pink,
amorphous material in the
walls of arteries; due to
immune complex deposition
Fibrinoid necrosis
Most characteristics feature of
apoptosis
Chromatin condensation
Pathologic calcification that
occurs in necrotic tissue in the
setting of normal serum
calcium levels
Dystrophic calcification
Sand-like lamellated dystrophic
calcifications seen in papillary
cancers
Psammoma bodies
Pathologic calcification that
occurs in viable tissue in the
setting of hypercalcemia
Metastatic calcification
Transmigration of leukocytes
across the endothelium i.e.
postcapillary venules
Diapedesis
Movement of leukocytes
towards a chemotactic signal
Chemotaxis
Most common exogenous
chemotactic product
N-formylmethionine
Endogenous chemotactic
signals
IL-8, C5a, leukotriene B4
Vasoactive amine that causes
vasodilation and increased
vascular permeability;
produced by mast cells,
platelets, and basophils
Histamine
Vasoactive amine that causes
vasoconstriction; produced
by platelets and
neuroendocrine cells
Serotonin
Parent molecule of
eicosanoids
Arachidonic Acid
Vasodilating eicosanoids
PGI2 (Prostacyclin, PGE1,
PGE2, PGD2
Vasoconstricting eicosanoids
TXA2, LTC4, D4, E4
Cytokine that has a significant role in fever
IL-1, TNF
Complement system pathway
activated by antibodies
Classical pathway
Complement system pathway
activated by microbial
products
Alternative pathway
Deficient complement
proteins associated with
increased risk to Neisseria
infections
Late components or
Membrane attack complex
(C5b, C6-C9)
Complement proteins acting
as anaphylatoxins
C3a, C5a
Most common complement
deficiency
C2
An autosomal dominant
disease caused by deficiency
in C1 inhibitor
Hereditary angioedema
Hallmark of acute
inflammation
Dilation of small blood
vessels and accumulation
of leukocytes and fluid in
the extravascular tissue
Cells involved in chronic
inflammation
Macrophage, lymphocytes
Pattern of inflammation in TB
or foreign body deposition
Chronic granulomatous
Hallmark of granuloma
Epithelioid cells
Acute phase protein that
causes red blood cells to form
stacks (rouleaux)
Fibrinogen
Reduces availability of iron to
erythroid precursors in
marrow; Causes anemia of
chronic inflammation
Hepcidin
Most important source of
growth factors during
repair
Macrophage
Examples of stable tissues -
quiescent but with limited
capacity to proliferate in
response to tissue injury and
loss
Liver, Kidney, Pancreas,
Endothelium, Fibroblasts,
Smooth muscle
Examples of permanent
tissue - terminally
differentiated and nonproliferative
Neurons, Cardiac and
skeletal myocytes
Hallmark of repair
Granulation tissue
Scar tissue that does not
grow beyond the boundaries
of the original wound
Hypertrophic scar
Scar tissue grows beyond the
boundaries of the original
wound; more common in
African American
Keloid
Mechanism of edema or
effusion in heart failure
↑ Hydrostatic pressure
Mechanism of edema or
effusion in nephrotic
syndrome or liver cirrhosis
↓ Oncotic pressure
Mechanism of edema or
effusion in burns or
infections
↑ Vascular permeability
Mechanism of edema or
effusion in tumors, filariasis,
post-radiation fibrosis, postlymphadenectomy in breast
cancer
Lymphatic obstruction
Type of effusion
characterized by increased
protein content, specific
gravity, fibrin, and
inflammatory cells
Exudate
Increased in blood volume in
tissues due to arteriolar
dilation; an active process
Hyperemia
Increased in blood volume in
tissues due to reduced
outflow; a passive process
Congestion
Engorged alveolar capillaries,
septal edema, and focal intraalveolar
hemorrhage
Acute pulmonary
congestion
(+) Hemosiderin-laden
macrophages (heart failure
cells); fibrotic septa
Chronic pulmonary
congestion
Distended central vein and
sinusoids, centrilobular
ischemic necrosis, periportal
fatty change
Acute hepatic congestion
Nutmeg liver, (+)
hemosiderin-laden
macrophages, hepatocyte
dropout and necrosis
Chronic hepatic congestion
Initial step in hemostasis that
occurs due to reflex
neurogenic mechanisms and
endothelin
Arteriolar vasoconstriction
Vitamin K-dependent
proteins that act together as
anticoagulants
Protein C, Protein S
Main factor of fibrin
degradation
Plasmin
Virchow triad of thrombosis
Endothelial injury,
Abnormal blood flow,
Hypercoagulability
Most common inherited
thrombophilia; FV becomes
resistant to Protein C
inactivation
Factor V Leiden
Type of thrombosis that
occurs due to
turbulence/endothelial
injury; retrograde
propagation
Arterial thrombosis
Common sites involved in
arterial thrombosis
Coronary > Cerebral >
Femoral
Type of thrombosis that
occurs due to stasis;
anterograde propagation
Venous thrombosis
Most common site involved
in venous thrombosis
Lower extremity veins
(90%)
Detached intravascular mass
that is carried by the blood
from its point of origin to a
distant site
Embolus
Most common form of
thromboembolic disease
Pulmonary embolism
Most common source of
pulmonary embolism
Deep venous thrombosis
Type of pulmonary embolism
that causes sudden death;
located at the pulmonary
artery bifurcation
Saddle embolus
Most common source of
systemic thromboembolism
that results in end-organ
ischemia
Mural thrombi
Type of embolism associated
with long bone fractures and
soft tissue trauma
Fat embolism
5th most common cause of
maternal mortality
worldwide, occurs in
immediate postpartum
Amniotic fluid embolism
Specific form of air embolism
seen in divers who did rapid
ascent; (+) bends and chokes
Decompression sickness
Area of ischemic necrosis
caused by vascular occlusion
Infarct
Type of infarct in solid organs
with end-arterial circulation
White infarct
Type of infarct occurring due
to venous occlusion in
spongy tissues or organs with
dual blood supply
Red infarct
State in which diminished
cardiac output or reduced
effective circulating blood
volume impairs tissue
perfusion and leads to
cellular hypoxia
Shock
Type of shock seen in MI,
arrhythmia, cardiac
tamponade, tension
pneumothorax
Cardiogenic shock
Type of shock seen in
hemorrhage, diarrhea
Hypovolemic shock
Stage of shock where
worsening circulatory and
metabolic derangement
(lactic acidosis) is observed
Progressive
Stage of shock refractory to
corrective measures
Irreversible
