Ch 2 - 5/4 Dobson Flashcards
What kind of cellular adaptation is a result of increased demand and stimulation?
Hyperplasia or hypertrophy
What kind of cellular adaptation is a result of chronic irritation (physical or chemical)?
Metaplasia
What cellular adaptation is most common in the uterus during pregnancy?
Endometrium from estrogen?
Hypertrophy
Hyperplasia
What cellular adaptation is most common in muscle disuse?
Barrett esophagus?
Atrophy
Goblet cell Metaplasia
Metabolic alterations to a cell that are due to chronic injury result in what?
Intracellular accumulations, calcification
Cumulative sub lethal injury over long life span induce what cellular response?
Cellular aging
What type of necrosis is associated with tuberculous infection?
What type specifically?
Caseous
Myobacterium tuberculosis
Caseous necrosis is described as what?
How does it look on microscopic examination?
Yellow-white and “cheese-like”
Appears as a structure less collection of fragmented or lysed cells and amorphous granular debris enclosed within a distinctive inflammatory border (Granuloma)
If there is ischemia to a cell, what happens in the mitochondria?
DEC ox-phosph and DEC ATP production
What are the 3 consequences of DEC ATP production in the mitochondria?
DEC Na pump
INC anaerobic glycolysis
Detachment of ribosomes (dec protein synthesis)
What are the major sequellae of increased anaerobic synthesis in the cell?
What happens structurally in the cell?
DEC glycogen
INC lactic acid and Dec pH
Clumping of nuclear chromatin
What are the consequences of DEC activity in the Na+ pump?
What structural changes seen in the cell?
INC influx of Ca, H2O, and Na
INC effluent of K+
ER swelling, cellular swelling, loss of Microvilli and Blebbing
What are the major causes of ATP depletion?
Reduced supply of oxygen and nutrients, mitochondrial damage, and actions of toxins (Cyanide)
What are the consequences of membrane damage?
Loss of cellular components
Enzymatic digestion of cellular components
What are the microscopic features of coagulative necrosis in the heart?
Wavy fibers
Widened spaces bw dead fibers containing edema fluid and scattered neutrophils
What pathological conditions lead to apoptosis?
DNA damage
Accumulation of misfolded proteins
Cell death in infection
Pathological atrophy in parenchymal organs after duct obstruction
Li-Fraumeni syndrome is a result of DNA damage to what gene?
TP53
What kind of cellular adaptation is a result of decreased nutrients and and decreased stimulation?
Atrophy
What are the 3 basic steps in the molecular pathogenesis of cardiac hypertrophy?
Actions of mechanical sensors
Signals that activate a signal transduction pathways
Signaling pathways activating TFs
What are the the GFs of mechanical sensors in hypertrophy?
Vasoactive agents?
TGF-B, IGF-1, FGF
A-adrenergic agonists, Endothelin-1, Angiontensin II
What are the TFs which increases the synthesis of muscle proteins responsible for muscle hypertrophy?
GATA4
NFAT
MEF2
Cardiac hypertrophy is associated with INC/DEC gene expression of ANF?
What does this do?
Increased
Decreases blood volume and pressure
What is an example of hormonal hyperplasia?
Compensatory hyperplasia?
Pathologic hyperplasia?
Enlargement of breast tissue during puberty
Liver regeneration
Endometrial, BPH
What are the 6 different causes of atrophy?
Dec workload Loss of innervation Diminished blood supply Inadequate nutrition / malnutrition Loss of endocrine stimulation Pressure (tissue compression)
How does the degradation of cellular protein mainly occur?
Ubiquitin-proteasome pathway
Some of the cell debris within autophagic vacuoles may resist digestion and persist in the cytoplasm as what?
Example of one?
Residual bodies
Lipofuscin granule (brown color)
What is the order of change in a cell during irreversible cell injury? (Fig. 2-7)
Biomechanical alterations leading to cell death
Ultrastructural
Light microscopic
Gross morphologic
BULGe
How does the cell size change in necrosis?
Apoptosis?
Swell
Shrinks
Describe the plasma membrane in necrosis?
Apoptosis?
Disrupted
Intact with altered structure
What happens to the cellular contents in necrosis?
Apoptosis?
Enzymatic digestion, may leak out of cell
Intact, released into apoptotic bodies
What is it called on microscopic examination, small clear vacuoles may be seen within the cytoplasm, representing distended and pinched-off segments of the ER?
The may show what kind of staining?
Hydropic change or vacuolar degeneration
Increased eosinophilic staining
What are the Ultrastructural changes of reversible cell injury?
Blebbing, blunting, loss of Microvilli
Mitochondrial swelling and amorphous densities
Dilation of the ER with detachment of polysomes
Nuclear alterations -> disaggregate on of granular and fibrillar elements
What do necrotic cells show in a H&E stain?
Due to what?
Increased eosinophilia
Loss of cytoplasmic RNA and denatured cytoplasmic proteins
Dead cells may be replaced by whirled phospholipid masses called what?
Derived from where?
Myelin figures
Damaged cell membranes
In living patients, if necrotic cells and cellular debris are not promptly destroyed and reabsorbed, what happens to them?
Dystrophic calcification
What kind of necrosis is characteristic of malignant hypertension and vasculitis?
Fibroid necrosis