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MOD I Exam I > Chapter 2 > Flashcards

Chapter 2 Flashcards

1
Q

Most common stimulus for hypertrophy in skeletal vs. cardiac muscle

A

Skeletal muscle: Increased workload

Cardiac muscle: increased hemodynamic load

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2
Q

Which cellular adaptive responses may result in malignancy?

A

Hyperplasia

Metaplasia

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3
Q

Morphologic features of reversible cell injury

A

Cell swelling (hydropic change) and fatty change
PM blebbing, loss of microvilli
Mitochondrial swelling + formation of amorphous densities
Dilation of ER with detachment of ribosomes
Nuclear alterations

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4
Q

Morphologic features of necrosis

A 
Increased eosinophilia
Myelin figures (may become calcified)
Nuclear changes (pyknosis, karyorrhexis, karyolysis)
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5
Q

Architecture of dead tissues is preserved for span of a few days

Tissues exhibit firm texture, denaturation of structural proteins and enzymes, so dead cells remain and are ultimately removed by phagocytosis and lysosomal digestion

Localized area of this type of necrosis = infarction

A

Coagulative necrosis

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6
Q

Characterized by digestion of dead cells into liquid viscous mass; seen in focal bacterial or fungal infections which result in pus production

Hypoxic death of cell within CNS results in this type of necrosis

A

Liquefactive

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7
Q

Type of necrosis d/t loss of blood supply typically to a lilmb, affecting multiple planes

A

Gangrenous necrosis

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8
Q

Cheese-like necrosis often characteristic of Tb infection

A

Caseous necrosis

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9
Q

Necrotic area that appears as structureless collection of fragmented or lysed cells and amorphous granular debris enclosed in distinct inflammatory border

A

Granuloma — often seen with caseous necrosis

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10
Q

Necrosis typically resulting from activated pancreatic lipases into substance of pancreas and peritoneal cavity which digest and liquefy membranes of fat cells

Appears as chalk-like areas surrounded by inflammatory reaction

A

Fat necrosis

[chalk-like areas = fat saponification]

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11
Q

Type of necrosis usually seen in immune reactions involving blood vessels

Typically occurs when complexes of Ag-Ab are deposited in walls of arteries

A

Fibrinoid necrosis

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12
Q

Mechanism of mitochondrial damage in necrosis

A

Formation of mitochondrial permeability pore (contains CYCLOPHILLIN D which is target of cyclosporin abx) —> loss of mito.membrane potential —> decreased ATP —> eventual release of cyt C

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13
Q

In conditions of cell damage: Entry of calcium occurs via mitochondrial permeability transition pore leading to failure of ATP generation

This leads to activation of multiple cellular enzymes leading to cell damage — what are some examples?

A

Phospholipases —> membrane damage

Proteases —> breakdown of membrane and cytoskeletal proteins

Endonucleases —> DNA and chromatin fragmentation

ATPases —> ATP depletion

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14
Q

Most reactive oxygen-derived free radical and the principal ROS responsible for damaging lipids, proteins, and DNA

A

OH*-

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15
Q

Most common type of cell injury in clinical medicine

A

Ischemia

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16
Q

Difference between ischemia and hypoxia

A

In contrast to hypoxia, ischemia blocks the delivery of substrates for glycolysis, so both aerobic and anaerobic metabolism are affected

Thus ischemia leads to more rapid and severe cell damage

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17
Q

Activation of complement is proposed as a mechanism for ischemia-reperfusion injury, due to the fact that ______ deposit in ischemic tissues

A

IgM Abs

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18
Q

2 general mechanisms for chemical (toxic) injury

A

Direct toxicity (mercury, cyanide, chemotherapy drugs)

Conversion to toxic metabolites (usually by Cyt P450, examples include CCl4 in dry cleaning agents, or acetaminophen in liver)

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19
Q

Most characteristic feature of apoptosis

A

Chromatin condensation

[others include cell shrinkage, formation of cytoplasmic blebs and apoptotic bodies, phagocytosis of apoptotic cells or bodies by macrophages]

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20
Q

Wheel-like hexamer complex that binds caspase-9 (critical initiator caspase of mitochondrial pathway) setting up autoamplification process); formation is triggered by Cyt C

A

Apoptosome

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21
Q

Mitochondrial pathway of apoptosis

A

Cell injury activates Bcl2 family sensors (BH3-only) —> antagonism of Bcl2 —> BAX and BAK activation —> Cyt C release —> initiator caspase activation —> executioner caspase activation —> apoptosis

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22
Q

Extrinsic path for apoptosis

A

FasL binds Fas (CD95) receptor —> formation of FADD domain —> recruitment of caspases —> autocatalytic caspase activation —> executioner caspase activation —> apoptosis

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23
Q

Necroptosis mechanistically resembles apoptosis in that it is a genetically programmed signal transduction event that culminates in cell death. What is the primary difference?

A

Necroptosis does not result in caspase activation; instead RIPS

Associated with formation of growth plate, steatohepatitis, acute pancreatitis, reperfusion injury, and neurodegenerative disorders

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24
Q

Programmed cell death that is accompanied by release of IL-1

A

Pyroptosis

25
Q

3 types of autophagy

A

Chaperone mediated = direct translocation across lysosomal membrane by chaperone proteins

Microautophagy = inward invagination of lysosomal membrane for delivery

Macroautophagy = major form involving sequestration and transportation of portions of cytosol in a double membrane bound autophagic vacuole (autophagosome)

26
Q

Steps of autophagy

A

Formation of isolation membrane (Derived from ER)

Elongation of vesicle

Maturation of autophagosome and fusion with lysosomes

27
Q

Microtubule-associated protein that serves as cellular marker that autophagy is occurring

What is this protein’s function?

A

LC3

Targets protein aggregates and effete organelles; helps select the contents from the cytosol that should be eaten in times of low nutrients

28
Q

Human diseases associated with dysregulated autophagy

A 
Cancer
Alzheimers
Huntington’s
Shigella
HIV
IBD (Crohns and UC)
29
Q

Examples of intracellular accumulations of lipids

A 
Steatosis
Atherosclerosis
Xanthomas
Cholesterolosis
Niemann pick disease, type C
30
Q

Intracellular accumulations of proteins may be seen as reabsorption droplets in proximal renal tubules in renal disease when _____ occurs

A

Proteinuria

31
Q

Large, homogenous inclusions produced when ER becomes distended in plasma cells engaged in active synthesis of immunoglobulins

A

Russell bodies

[found in cells that are producing lots of proteins very quickly, like in synthesis of Igs in plasma cells]

32
Q

In what disease might you find intracellular inclusions of glycogen in renal epithelial cells, liver cells, beta islets, and myocardium?

A

DM

33
Q

Most common exogenous pigment

A

Carbon (coal dust)

34
Q

Endogenous pigments

A

Lipofuscin (telltale of lipid peroxidation)
Melanin
Alkaptonuria (in ochronosis)
Hemosiderin (in hemosiderosis)

35
Q

Alteration within cells or EC space giving homogenous, glassy, pink appearance in routine histologic staining

A

Hyaline

[note that this is a descriptive histologic term rather than a specific marker for cell injury; produced by a variety of alterations and does not represent a specific pattern of accumulation]

36
Q

2 types of pathologic calcification

A

Dystrophic — deposition occurs locally in dying tissues; serum calcium is normal

Metastatic — occurs in normal tissues under conditions of hypercalcemia

37
Q

2 mechanisms of senescence

A

Telomere attrition

Activation of tumor suppressor genes

38
Q

Key characteristic of hypertrophy

A

Increased protein synthesis

39
Q

Most important biochemical pathway in physiologic cardiac muscle hypertrophy

A

PI3/AKT

40
Q

A 68 y/o obese, post-menopausal woman experiences abdominal pain. A biopsy of her uterus is obtained and shows increased proliferation of endometrial tissue and presence of glands. What is the underlying mechanism of this hyperplasia?

A

Increased levels of estrogen; the estrogen is coming from peripheral conversion in adipocytes

41
Q

2 characteristic signs of atrophy

A

Autophagy

Decreased protein synthesis

42
Q

What factor suppresses appetite in cancer leading to cachexia?

A

TNF

43
Q

Most common type of metaplasia

A

Squamous—> columnar [named “columnar metaplasia” for what it turns into]

Ex: Barrett’s esophagus

44
Q

T/F: detachment of polysomes from ER as well as presence of myelin figures are associated with reversible cell injury

A

False

Myelin figures are characteristic of irreversible cell injury

45
Q

Describe production of free radicals by transition metals — particularly iron

A

Fenton reaction — reduces Fe2+ to Fe3+ and reaction is enhanced by O2*-

46
Q

T/F: Major actions of superoxide anion (O2-*) stem from its ability to stimulate production of degradative enzymes rather than direct damage of macromolecules

A

True

47
Q

Anti-apoptotic proteins

A

BCL2
BCL-XL
MCL1

48
Q

Pro-apoptotic proteins

A

BAX

BAK

49
Q

Apoptotic sensors

A 
BAD
BIM
BID
Puma
Noxa

[serve to activate pro-apoptotic proteins BAX and BAK while blocking anti-apoptotic proteins]

50
Q

Where is FasL vs. Fas expressed?

A

FasL on T cells

Fas is on all cells

[Fas expression is induced by cells undergoing apoptosis]

51
Q

Function of TP53 gene

A

Makes p53 that binds to DNA

Causes cell cycle arrest (at G1 phase) to allow time for DNA repair — or apoptosis in response to DNA damage

52
Q

Intracellular accumulations are manifestations of what type of cell damage?

A

Metabolic derangement

53
Q

What is steatosis

A

Abnormal accumulation of TAGs within parenchymal cells (usually in liver but also seen in heart)

54
Q

When might you seen lipofuscin as an endogenous pigment?

A

Lipofuscin is derived from lipid peroxidation and is a sign of wear-and-tear (physiologically seen with aging)

[lipofusin = lipochrome = wear-and-tear pigment]

55
Q

Hemosiderin granules represents aggregates of _____ micelles when there is a local or systemic excess of _____

A

Ferritin; iron

56
Q

What type of calcification is seen in foci of enzymatic necrosis of fat (aka fat saponification)? What is the serum calcium in these situations?

A

Dystrophic calcification

SERUM CALCIUM IS NORMAL

[hypercalcemia may accentuate dystrophic calcification but does not cause it]

57
Q

Insulin and IGF-1 signaling pathway activation can shorten life-span. This pathway can be inhibited by ______ or caloric restriction.

A

Rapamycin

[rapamycin inhibits mTOR pathway and increases lifespan of middle aged mice]

58
Q

______ = promote expression of genes that promote longevity by inhibiting metabolic activity, reducing apoptosis, stimulating protein folding, and inhibiting effects of ROS

A

Sirtuins

MOD I Exam I (5 decks)

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