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PATHOMA > Ch. 1 - Cell Growth, Injury, and Death > Flashcards

Ch. 1 - Cell Growth, Injury, and Death Flashcards

1
Q

differentiate hypertrophy from hyperplasia

A

hypertrophy: inc in size
hyperplasia: inc in number of cells

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2
Q

(hypertrophy/hyperplasia) involves gene activation, protein synth, and production of organelles

A

hypertrophy

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3
Q

t/f: hypertrophy and hyperplasia tend to happen together

A

true

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4
Q

What are the permanent tissues that cannot undergo hyperplasia and can only hypertrophy?

A

cardiac muscle
skeletal muscle
nerve

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5
Q

pathologic hyperplasia leads to…

A

dysplasia and cancer

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6
Q

atrophy is the opposite of…

A

BOTH hyperplasia and hypertrophy

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7
Q

dec in cell number in atrophy occurs as a result of increased….

A

apoptosis

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8
Q

dec in cell size occurs via (blank) mediated proteosome degradation of the cytoskeleton and autophagy of cellular components

A

ubiquitin

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9
Q

what part of the cytoskeleton is tagged with ubiquitin?

A

intermediate filaments

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10
Q

autophagic vacuoles fuse with what other organelle to break down cellular stuff?

A

lysosomes

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11
Q

what is the most common type of metaplasia?

A

change in one type of surface epi to another (eg squamous to columnar)

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12
Q

t/f: metaplastic cells are better able to handle the stress that creates them

A

true

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13
Q

t/f; metaplasia is reversible

A

true

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14
Q

what vitamin deficiency can lead directly to metaplasia?

A

vitamin A

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15
Q

with a vit. A def, goblet and columnar cells of the conjunctiva metplast into what cell type?

A

keratinizing squamous epi

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16
Q

t/f: connective tissue can undergo metaplasia

A

true

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17
Q

dysplasia results from….

A

long standing pathologic hyperplasia

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18
Q

t/f: dysplasia is reversible

A

true

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19
Q

neurons are particularly susceptible to what type of injury?

A

ischemia

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20
Q

slowly developing ischemia results in (blank), whereas acute ischemia results in (blank)

A

chronic ischemia: atrophy

acute ischemia: injury

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21
Q

How does hypoxia lead to cell injury?

A

lack of ATP production

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22
Q

What are the three general causes of decreased flow through an organ?

A
  1. dec arterial perfusion
  2. dec venous drainage
  3. shock state
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23
Q

What are the measured cutoffs for ischemia?

A

PaO2 <90%

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24
Q

High altitude lowers what O2 sat?

A

PAO2

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25
Q

Hypoventilations lowers which O2 sat?

A

inc. PACO2 leads to dec PAO2

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26
Q

A diffusion defect has a normal PAO2 but results in hypoxemia because…

A

the PAO2 is not able to push as much O2 into the blood due to a thicker diffusion barrier

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27
Q

Describe how a V/Q mismatch leads to hypoxemia

A

blood bypasses oxygenated lung (shunting) or oxygenated air cannot reach the blood (atelectasis)

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28
Q

t/f: in anemia, both the PaO2 and SaO2 are normal

A

true

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29
Q

Which O2 sat decreases in CO exposure?

A

SaO2

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30
Q

what is the classic finding in CO poisoning?

A

cherry red skin

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31
Q

Methemoglobinemia, in which Fe is oxidized to Fe3+, is commonly seen after what?

A

oxidant stresses like sulfa and nitrate drugs OR in newborns

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32
Q

what is the treatment for methemoglobinemia?

A

methylene blue

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33
Q

what is the weird ass classic presentation of methemglobinemia?

A

cyanosis with chocolate colored blood!

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34
Q

As a result of decreased ATP from hypoxia, what are the three major processes that are impaired?

A
  1. water buildup from impaired Na/K ATPase
  2. Ca buildup in the cytosol
  3. Lactic acid buildup and pH lowering from anerobic glycolysis b/c no more aerobic glycolysis
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35
Q

What is the histological hallmark of reversible cellular injury?

A

cellular swelling

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36
Q

Cytosol swelling results in the loss of (blank) and membrane (blanking)

A

loss of microvilli

membrane blebbing

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37
Q

Swelling of the rER leads to dissociation of the ribosomes and what result?

A

dec protein synth

38
Q

What is the histological hallmark of irreversible cell injury?

A

membrane damage

39
Q

Plasma membrane damage leads to what two things?

A
  1. cytosol enzymes leaking into the serum

2. buildup of Ca in the cell

40
Q

Mitochondrial membrane damage leads to what two things?

A
  1. loss of electron transport if the inner membrane is damaged
  2. Apoptotic activation via cytochrome C leaking into the cytosol
41
Q

Lysosome membrane damage releases lysozymes into the cytosol which are activated by….

A

the already elevated intracell Ca

42
Q

what is the histologic hallmark of cell death?

A

loss of the nucleus

43
Q

What are:
pyknosis
karyorrhexis
karyolysis

A

nuclear condensation
fragmentation
dissolution

44
Q

t/f: the tissue remains firm in coagulative necrosis

A

true

45
Q

t/f: cell shape and organ structure are preserved in coagulative necrosis

A

true

46
Q

coagulative necrosis is indicative of an ischemic infarction in any organ except the…

A

brain

47
Q

in coag. necrosis, the infarct is (blank) shaped and pale

A

wedge

48
Q

When do you get a red coag. infarction?

A

when blood reenters a loosely organized tissue (lung or testicle)

49
Q

Liquefactive necrosis is seen primarily in which three processes?

A

brain infarction
abscess
Pancreatitis

50
Q

Gangrenous necrosis resembles mummified tissue and is a subtype of what type of necrosis?

A

coagulative

51
Q

If gangrenous necrosis of dead tissue occurs, then liquefactive necrosis takes over and this is known as…

A

wet grangrene

52
Q

Caseous necrosis is the combo of which two types of necrosis?

A

coagulative and liquefactive

53
Q

Caseous necrosis is characteristic of what type of infection?

A

Tb or fungal

54
Q

what does fat necrosis look like?

A

chalky white due to Ca deposition

55
Q

Fat necrosis happens after what?

A

trauma to fat or pancreatic mediated

56
Q

What is dystrophic calcification?

A

Necrotic tissue acts as a nidus for calcification in NORMAL serum Ca

57
Q

What is metastatic calcification?

A

HIGH serum Ca or PO4 leads to calcium deposition in normal tissues

58
Q

what is fibrinoid necrosis?

A

necrosis of a Blood vessel

59
Q

How does a BV look that has fibrinoid necrosis?

A

bright pink wall

60
Q

fibrinoid necrosis is characterstic of what dzs?

A

malignant HTN

vasculitis

61
Q

Describe the histologic changes of the cell that is undergoing apoptosis (3)

A
  1. Cell shrinks; cytoplasm more eosinophilic
  2. Nucleus condenses and fragments
  3. Apoptotic bodies form
62
Q

What are the the things that activate the intrinsic mitochondrial pathway of apoptosis?

A
  1. cell injury
  2. DNA damage
  3. dec. hormonal stim which leads to inactivation of Bcl2
63
Q

Lack of Bcl2 lets (blank) leak out of the IMM into the cytosol to activate caspases

A

ctyochrome C

64
Q

Which ligand pair activates the extrinsic apoptotic pathway?

A
  1. FAS ligand binds the death receptor CD95 on the target cell
  2. TNf binds the TNF receptor on the cell
65
Q

Explain how CTLs kill virally infected cells

A
  1. perforins make holes in the membrane

2. granzymes get into the cell and activate caspase

66
Q

what are the causes of pathological generation of free radicals?

A
  1. ionizing radiation - Water hydrolyzed to free radical OH
  2. inflammation - NADPH oxidase makes superoxide ion
  3. copper and Iron - Fe2+ via Fenton rxn
  4. Drugs and chemicals- P450 system during detox
67
Q

how doe free radicals cause cellular injury?

A

peroxidation of lipids

oxidation of DNA and proteins

68
Q

what are the four common intracellular antioxidants? (hint: three are vitamins!)

A
  1. glutathione
  2. Vit. A
  3. Vit. C
  4. Vit. E
69
Q

What are the three antioxidant enzymes and where are they found in the cell?

A
  1. Superoxide dismutase: mito
  2. Glutathione peroxidase: mito
  3. Catalase: peroxisomes
70
Q

What are the two metal carrier proteins that prevents iron oxidation in our blood?

A

transferrin

ceruloplasmin

71
Q

Describe the free radical damage caused by CCl4 in dry cleaning?

A

converted to CCl3 by P450
cell injury; swelling of rER
Dec apolipoproteins leads to fatty liver changes

72
Q

Describe the free radical injury in reperfusion injury

A

return of blood to ischemic tissue produces O2 free radicals

73
Q

Where does amyloid deposit wrt the cell?

A

in the extracellular space

74
Q

What are the shared features of deposisted amyloid proteins?

A

b-sheet config

CONGO RED STAINING WITH APPLE GREEN BIREFRINGENCE

75
Q

From what protein is the AL amyloid derived from in primary amyloidosis?

A

immunoglobulin light chain

76
Q

What dz is primary amyloidosis associated with?

A

plasma cell dyscrasias d/t multiple myeloma

77
Q

From what protein is the AA amyloid derived from in secondary amyloidosis?

A

serum amyloid associated protein

78
Q

SAA is a (blank) type protein

A

acute phase reactant

79
Q

SAA is elevated in chronic inflammatory states, malignancy, and in Familial (blank)

A

familial Mediterranean fever

80
Q

How does FMF present?

A

episodes of acute fever and acute serosal inflamm that can mimmic appendicits, arthritis, or MI

81
Q

High levels of SAA in FMF attacks leads to..

A

deposition of AA amyloid in normal tissue

82
Q

What are the three classic findings in systemic amyloidosis?

A

Nephrotic syndrome: KIDNEY IS MOST COMMONLY INVOLVED
Restrictive cardiomyopathy/arrhythmia
Tongue enlargement, malabsorption and HSM

83
Q

What test must be done to Dx systemic amyloidosis?

A

biopsy of abd fat pad or rectum

84
Q

t/f: amyloid cannot be removed

A

true; damaged organs must be transplanted

85
Q

In senile cardiac amyloidosis, what protein deposits in the heart? what familial disorder is this associated with?

A

non-mutated serum transthyretin; assc’d with familial amyloid cardiomyopathy

86
Q

deposition of mutated serum transerythrin in the heart leads to….

A

restrictive cardiomyopathy

87
Q

5% of what particular minority carries the gene for familial amyloid cardiomyopathy

A

blacks

88
Q

What type of amyloid deposits in the pancreas in type II DM

A

amylin

89
Q

Which amyloid deposits in the brain in Alzheimer’s?

A

amylin in the islets of the pancreas

90
Q

the Gene for b-APP in alzheimers is present on which chromosome?

A

21

91
Q

In dialysis-associated amyloidosis, which protein deposits in the joints?

A

b2-microglobulin

92
Q

“tumor cells in an amyloid background” are characteristic of calcitonin deposits in what type of tumor?

A

Medullary carcinoma of the thyroid

PATHOMA (11 decks)

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