Chapter 1 Flashcards
what is the study of suffering or disease?
pathology
what three things do the study of the changes of pathology occur to?
cellular level, tissue changes, organs
what is the basis for rational care?
prognosis (what is to come next)
define etiology.
origin of disease; the “why”
true or false. etiology deals with the nature and nurture theory.
true
define the nature/nurture theory as it pertains to etiology.
genetic risks/environmental factors (cig smoke)
ionized radiation, increased risk for cancer
what is the origin of disease?
etiology
define pathogenesis.
steps of development of disease; the “how”
what are etiological factor affects pathogenesis usually for the worst?
cellular change
what term is defined as the steps of development of disease; the “how”?
pathogenesis
what are three types of altered appearance (morphology)?
gross, microscopic, biochemical
what is an example of a biochemical altered appearance?
number of cells in blood substance in urine
how does health originate from cellular homeostasis?
preserve viability of cells; must also adapt to stress
what are the four types of adaptation that affect cellular homeostasis?
- hypertrophy 2. hyperplasia 3. atrophy 4. metaplasia
if a cell’s ability to adapt is exceeded, what will it lead to?
injury
what are two types of cellular homeostatic injury?
reversible and irreversible
define a reversible injury.
short lived or mold injury
what is an example of an irreversible injury?
high blood pressure; cells become hypertrophied to work harder –> heart attack
true or false. you will develop a pathology when cellular injury leads to reversible cellular injury.
false. (irreversible cellular injury)
what are the two types of cellular injury?
necrosis and apoptosis
what will happen to the body before cell death?
loss of function
define phenotype.
observable characteristics or traits
if you change a cell’s phenotype, it will affect what two things?
appearance and function
what is the term for observable characteristic or traits?
phenotype
define hypertrophy.
an increase in cell size, but no new cell
hypertrophy occurs in what type of cells?
cells that cannot replicate
hypertrophy is a result of what two factors?
- overloading 2. increase in growth factors (e.g. hormones)
what is an example of physiologic hypertrophy?
lifting weights, pregnant uterus
what is an example of pathologic hypertrophy?
congestive heart failure
what is the term for an increase in cell size?
hypertrophy
Rhinophyma is a form of what pathology?
Rosacea
Rhinophyma is the hypertrophy of what glands?
sebaceous
true or false. Rhinophyma is not idiopathic.
false. it is idiopathic
what are some types of stressors of hypertrophy?
hypertension and valvular stenosis
what are some types of injury of hypertrophy?
swelling and steatosis
true or false. 2/3 of heart attacks are lethal.
false. 1/3
what is an example when a normal monocyte undergoes adaptation in response to increased load?
ventricular hypertrophy
what is an example when a reversibly injured monocyte undergoes cell death?
myocardial infarction
define hyperplasia.
an increase in number of cells
in what type of cells does hyperplasia occur?
cells that must be able to divide
hyperplasia is a result of what three factors?
compensatory factors. gene activation, HPV infection (wart)
what is an example of physiologic hyperplasia?
female breast tissue during breast feeding
what is an example of pathological hyperplasia?
HPV–> wart or can induce cancer
what is the difference between hyperplasia and cancer?
hyperplasia is controlled while cancer is uncontrolled
true or false. hyperplasia will accompany hypertrophy.
true. (may accompany)
what is the term to describe and increase in the number of cells?
hyperplasia
define atrophy.
reduced size in cells
what are two factors that define atrophy?
- reduced protein synthesis 2. increased rate of protein breakdown
true or false. since the cells are reduced in atrophy, this means that are dead as well.
false
atrophy is the result of what 5 factors?
- denervation (compression) 2. disease 3. ischemia (decreased blood supply) 4. endocrine disruption 5. aging
what is the term to describe a reduced size of cells?
atrophy
define senile atrophy.
subcutaneous fat and skin tissue atrophy
what accelerates senile atrophy?
UV light
what are some possible causes of cerebral atrophy?
atherosclerosis, malnutrition, alzheimer disease, huntington disease
cerebral atrophy is a risk for pathology?
intracranial hemorrhage
denervation atrophy of the thenar musculature is a symptom of what pathology?
carpal tunnel
define metaplasia.
reversible replacement of 1 mature cell type by another
metaplasia is the response to what type of prolonged stressor?
chronic stress (inflammation) (e.g. smoking, GERD)
what are the consequences of metaplasia?
cancerous transformation; altered structure (decrease in function)
what type of cellular adaptation can transform into cancer?
metaplasia
true or false. cellular injury can lead to cell death.
true
cellular injury occurs once stressors do what three things?
- exceed a cell’s ability to adapt 2. directly induce abnormalities 3. intrinsic abnormalities (DNA damage)
what are some various causes of cell injury/death?
mutations, trauma- physical, thermal, ionizing radiation, ischemia, poisons/toxins, autoimmune infection
true or false. cellular injury can only be reversible.
false. irreversible and reversible
in reversible injury, the cell function will increase or decrease with duration of the injury?
decrease
what type of cellular injury is from short lived or mild stress?
reversible
what are some features of reversible cellular injury?
steatosis (fatty change), cellular swelling
in reversible injuries, is there damage to the membrane?
no
in reversible injuries, is there damage to the nucleus?
no
what type of cellular injury is from long term or severe stress?
irreversible
in irreversible injury, is there damage to the membranes?
yes
what three membranes will be affected in irreversible injury?
lipid bilayer, mitochondria, lysosomal
what are the two types of irreversible injury?
necrosis and apoptosis
true or false. necrosis is always pathological.
true
what are some causes of necrosis?
toxins, ischemia, trauma
is necrosis inflammatory?
yes
true or false. apoptosis will always be physiological.
false. pathological or physiological
what are some causes of apoptosis?
decreased in growth factors, DNA damage, viral infection
is apoptosis inflammatory?
no
is the cell membrane intact during necrosis? apoptosis?
no; yes
what is karyolysis necrosis?
nuclear fading
what is pyknosis necrosis?
nuclear shrinkage
what is karyorrhexis necrosis?
nuclear fragmentation
karyolysis, karyorrhexis, pyknosis will lead to nuclear dissolution which will eventually lead to _______?
anuclear necrotic cell
what are the 5 morphologic patters of necrosis?
- coagulative 2. liquefactive 3. caseous 4. fat necrosis 5. fibrinoid
what is another name for coagulative necrosis?
ischemic necrosis
in coagulative necrosis, what process will eventually lead to tissue death?
vascular occlusion (ischemia)
name the location of coagulative/ischemic necrosis. (give example)
solid organ (infarction); kidneys and heart
what are two features of coagulative necrosis?
- feel solid to the touch for weeks/days 2. denatures proteolytic enzymes
what is an example of coagulative necrosis?
peripheral vascular disease (PVD) from diabetes
what is a type of coagulative necrosis?
gangrenous necrosis
what is the location gangrenous necrosis?
extremities
what are some causes of gangrenous necrosis?
PVD (diabetes), atherosclerosis (plaques), frost bite
what are the 3 types of gangrenous necrosis?
dry, wet, gas
what type of gangrenous necrosis is due to deep infection?
gas gangrene
what is the definition of wet gangrene?
infection superimposed on a site of gangrene
define liquefactive necrosis.
dead cells are completely digested by WBCs into a liquid viscous mass
what are 2 causes of liquefactive necrosis?
- stroke (CNS dies) 2. infection (bacterial and fungal)
between bacterial and fungal infections, what is the most common cause of liquefactive necrosis?
bacterial
define caseous necrosis.
dead tissue with a “cheese-like” appearance
caseous necrosis is typical of pathology?
tuberculosis
what is a granuloma?
walled off collection of macrophages
what is another name for fat necrosis?
ezymatic necrosis
what is fat necrosis due to?
lipase ezymes
what are the location for fat necrosis?
pancreas and breast tissue (peritoneum)
what is a cause of fat necrosis?
pancreatitis
what is pancreatitis due to?
alcoholism and abdominal trauma
what type of appearance will fat necrosis show?
chalky white
what type of necrosis requires a microscope/histological evaluation?
fibrinoid necrosis
what type of reactions will result in fibrinoid necrosis?
autoimmune diseases
what pathology will result in fibrinoid necrosis?
vasculitis
what is vasculitis caused by?
autoimmune conditions that are destroying blood vessel walls e.g. Lupus
what term describes programmed cell death?
apoptosis
what are examples of physiologic apoptosis?
embryogenesis, endometrium, immune cells
what are examples of pathologic apoptosis?
genetic damage, virally infected cells (HIV)
apoptosis is autophagy as ______ is to _____.
apoptotic bodies; autophagic vacules
what needs to be activated for apoptosis mechanisms?
caspases
what are the 2 types of apoptosis mechanisms?
mitochondrial (intrinsic) pathway and death receptor (extrinsic) pathway
what apoptotic mechanism is the most common?
mitochondrial (intrinsic) pathway
what caspase will be found in mitochondrial pathway? death receptor pathway?
9;8
what apoptotic mechanism deals with autoimmunity?
death receptor pathway
define autophagy.
self-eating; sequesters internal organelles
what is a survival mechanism during nutrient deprivation?
autophagy
prolonged autophagy will lead to _____?
apoptosis
is apoptosis or autophagy associated with Alzheimer’s?
autophagy
during mitochondrial dysfunction, mitochondrial damage will lead to an increase in_____ and decrease in_____.
oxidation stress, ATP
during calcium homeostasis, activatin of multiple cellular enzymes will induce _____?
apoptosis
membrane abnormalities will lead to what cell injury?
necrosis
DNA damages or misfolded proteins will activate what cell injury?
apoptosis
what are the three types of cellular injury?
ischemia and hypoxia; ischemia reperfusion, chemical
ischemia is the decrease in ______ and hypoxia is the decrease in ______.
blood flow; oxygen
what will cause ischemia/hypoxia?
acute cell injury
true or false. ischemia and hypoxia will not alter metabolism.
false. it will alter
what is the outcome of aerobic cellular injury? anaerobic cellular injury?
decrease in oxygen and ATP; shut down glycolysis because of reduced substrates
define ischemia-reperfusion injury.
increase in WBC will released ROS and will cause injury to cells
what are two types of ischemia-reperfusion injury?
myocardial infarction and cerebral infart
what are the two types of chemical injury?
direct and indirect injury
define a direct chemical injury.
toxic exposure binds directly to cell and is harmful; usually cells that absorb or store; DO NOT require conversion
define indirect chemical injury.
require conversion; usually in liver
what are the four types of intracellular accumulations?
abnormal metabolism, defective protein folding or transport, defective or absent enzymes, ingestion of indigestible material
what is the prime example of abnormal metabolism of intracellular accumulation?
fatty liver disease
what type of intracellular accumulation is a result of genetic mutation?
defective protein folding or transport
what type of intracellular accumulation is an inherited mutation?
defective or absent enzyme
what are some examples of indigestible material?
coal, silica, asbestos (mesothelioma)
what hepatomegaly a result of?
steatosis (fatty liver)
what are 4 location of steatosis?
cardiac muscles, skeletal muscles, liver, kidneys
nonalcoholic fatty liver disease could be due to what three things?
diabetes, obesity, increase in cholesterol
what are the microscopic findings of steatosis?
fat blebs
what percentage of heavy drinkers will develop steatosis?
90-100%
what percentage of heavy drinkers will develop hepatitis?
10-35%
what percentage of heavy drinkers will develop cirrhosis?
8-20%
true or false. 1/5 of heavy drinkers will develop cirrhosis.
true
what are the two possible symptoms of alcoholic liver disease?
ascites and caput medusae
what pathology is associated with fluid filled/excess accumulation in peritoneal lining in the abdominal region?
ascites (alcoholic liver disease)
define caput medusae.
long term damage to liver; engorged superficial epigastric veins; late stage of liver damage
freckles are the intracellular accumulation of _____.
melanin; UVB exposure
what is the term associated with the bleeding condition of intracellular accumulation?
hemosidenin
define lipofuscin intracellular accumulation.
wear and tear of pigments in older cells
what are the two types of pathologic calcification?
dystrophic and metastatic
where does dystrophic calcification occur?
damaged tissue
what are three types of dystrophic calcification?
atherosclerosis, aortic stenosis, myositis ossificans
where does metastatic calcification occur?
in normal tissues
what is metastatic calcification due to?
hypercalcemia in blood
where are common sites for metastatic calcification?
vessel walls, kidneys, lungs, GI tract
what are some causes of metastatic hypercalcemia?
bone cancer, leukemia, hypervitaminosis, renal failure
what are three factors that affect cellular aging?
DNA damage, replicative senescence, defective protein homeostasis
true or false. DNA damage is due to oxidative stress during cellular aging.
true
define replicative senescence as it pertains to cellular aging.
decreased cells ability to divide; shortened telomeres
during cellular aging, what factor is a signal for apoptosis?
defective protein homeostasis
during cellular aging, what is the enzyme that builds the ends of chromosomes?
telomerase
what is Progeroid Syndromes?
increased rate of cellular aging
true or false. telomere shortening will prevent the re-enter into cell cycle.
true
