Chapter 1/2/3 Flashcards
mechanism of hypertrophy
gene activation, protein synthesis and production of organelles
mechanism of hyperplasia
increase in cells from stem cells
permanent tissues can not undergo…..
hyperplasia
permanent tissue of body
cardiac/skeletal muscle and nerves
exception of hyperplasia to dysplasia
BPH
decrease in number of cells occurs by…
apoptosis
decrease in size of cells occurs by…
- ubiquitin proteasome degradation pathway
- autophagy (in vacuoles with lysosomes)
mechanism for metaplasia
reprogramming of stem cells
- reversible by removing stress
exception for metaplasia to cancer
apocrine metaplasia
______ deficiency can result in metaplasia
vitamin A (necessary for special epithelium) - results in thickening of conjunctiva
example of mesenchymal tissue metaplasia
myositis ossificans
- skeletal muscle converts to bone after trauma
- can be confused with osteosarcoma (not connected to bone)
is dysplasia reversible
YES
point where changes are irreversible
carcinoma
most common cause of Budd Chiari
polycythemia vera (also lupus)
what is decreased in CO poisoning
oxygen saturation (can’t bind to hemoglobin)
classic finding of CO poisoning
cherry red skin (also headache is early sign)
what is decreased in methemoglobinemia
oxygen saturation (iron is in Fe3+ state and cant bind to hemoglobin)
cause of methemoglobinemia
oxidant stress (sulfa and nitrate drugs) or in newborns (immature deoxidants)
classic finding in methemoglobinemia
cyanosis and chocolate colored blood
treatment of methemoglobinemia
methylene blue
findings of reversible injury
cellular swelling (water follows sodium)
- loss of microvilli, membrane blebbing(from cytoskeletal damage) and swelling of RER
hallmark of irreversible damage
membrane damage
apoptosis activator
cytochrome C
three membranes damages in cell injury
plasma, mitochondrial, lysosome
hallmark of cell death
loss of nucleus
pyknosis
shrinking of nucleus
karyorrhexis
breaking up of nucleus
karylosis
lysing of nucleus
what follows necrosis
acute inflammation
coagulative necrosis
- necrotic tissue remains firm, structure remains
- nucleus disappears
- a result of ischemic infarction (expect brain)
red infarction
if blood re enters tissue after infarction
liquefactive necrosis
- dead tissue becomes liquid by enzymatic destruction
liquefactive necrosis seen in….
- brain infarction (microglial cell mediated)
- abscess (neutrophils have hydrolytic enzymes)
- pancreatitis (of pancreas itself)
gangrenous necrosis
- ischemia of lower limb**
- can be GI tract
- usually in diabetics
- resembles mummified tissue
caseous necrosis
- soft friable necrotic tissue
- combination of coagulative and liquefactive necrosis
- TB and fungal infections
fat necrosis
- adipose tissue
- fatty acids bind with calcium (saponification)
- happens in pancreatitis (peripancreatic fat) and trauma to breast
saponification
fatty acids combining with calcium
- example of dystrophic calcification (nidus)
metastatic calcification
calcium or phosphate levels are high (does not mean there is cancer)
- calcium deposits in tissue
fibrinoid necrosis
- necrotic damage of blood vessel wall, leaking of proteins
- bright pink staining
- characteristic of malignant hypertension and vasculitis
preeclampsia leads to….
fibrinoid necrosis of placenta
apoptosis is mediated by….
caspases
- proteases to break down cytoskeleton
- endonucleases break down DNA
intrinsic mitochondrial pathway
- caused by cell injury, DNA damage or decreased hormone
- mediated by cytochrome C
Bcl2
stabilized mitochondria so cytochrome C stays in membrane
extrinsic apoptotic pathway
- FAS ligand binds FAS receptor on target cell
- TNF binds TNF receptor
- causes apoptosis
molecules CD8 cells use
perforin and granzymes
physiologic generation of free radicals
- cytochrome c oxidase transfers electrons to oxygen
- partial reduction leads to free radicals
most damaging free radical
OH
enzyme for producing free radical in neutrophil
NADPH oxidase
results of free radical damage
- peroxidation of lipids
- oxidation of DNA and proteins
enzymes of free radical removal
- super oxide dismutase (O2-)
- glutathione peroxidase (OH-)
- catalase (H2O2)
amyloid
misfolded protein that deposits in extracellular space
common characteristics of amyloid
- beta pleated sheets
- congo red stain with apple green birefringence on polarized light
primary amyloidosis
- AL amyloid derived from Ig light chain
- associated with plasma cell dyscrasias
secondary amyloidosis
- AA amyloid from SAA
- acute phase reactant from inflammation, malignancy, familial Mediterranean fever
familial Mediterranean fever
- dysfunction of neutrophils
- leads to fever and serosal inflammation
- High SAA during attacks and deposits of AA
findings of amyloidosis
- nephrotic syndrome (kidney most common)
- restrictive cardiomyopathy
- tongue enlargement, malabsorption
senile cardiac amyloidosis
- serum transthyretin in heart
- asymptomatic
familial amyloid cardiomyopathy
- mutated serum transthyretin
- restrictive cardiomyopathy
by product of insulin
amylin deposits in pancrease
alzheimer disease
Abeta deposits derived from beta-amyloid precursor protein (seen in down syndrome)
dialysis associated amyloidosis
beta-2 microglobulin in joints
- not filtered well from blood
medullary carcinoma of thyroid
- calcitonin deposits in tumor
- c cells
- classic for tumor cells and amyloid
hallmarks of acute inflammation
neutrophils and edema
CD14
on macrophages, recognizes LPS on gram negative bacteria
NF-KB
- TLR binding uses this to activate immune response
cyclooxygenase produces…
prostaglandins
PGI2, PGD2, PGE2
vasodilation and increased permability
PGE2
Feeever and pain
LTB4
attracts and activates neutrophils
LTC4, LTD4, LTE4
vasoconstriction, bronchospasm, and increase vascular permeability (pericyte contraction)
- smooth muscles contraction
mast cell activated by…
- tissue trauma
- C3a and C5a (anaphylatoxins)
- IgE crosslinking
histamine
- vasodilation of arterioles
- increased vascular permeability of post capillary venule
what is necessary for delayed response of mast cells
leukotrienes, second phase of mast cell response
classical pathway
C1 binds to IgG of IgM bound to antigen
alternative pathway
microbial products directly activate
C5a
chemotactic for neutrophils
C3b
opsonin for phagocytosis
4 things that attract neurotphils
- LTB4
- C5a
- IL8
- bacterial products