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Pathophysiology > Chapter 4 - Cell Injury and Death > Flashcards

Chapter 4 - Cell Injury and Death Flashcards

1
Q

True or false: metaplasia is irreversible when injurious stimulation is removed

A

false - it’s reversible

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2
Q

What is apoptosis?

A
  • programmed cell death
  • not always pathologic
  • used to
    • control cell size numbers
    • limit tissue size
    • remove dangerous cells
  • occurs in response to injury that does not directly kill cell
    • triggers intracellular cascades
    • activates cellular suicide response via caspases
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3
Q

What are the three main reactive oxygen molecules generated during an ischemic episode?

A
  1. OH-
  2. O2-
  3. H2O2
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4
Q

What is programmed senescene theory?

A

aging is the result of an intrinsic genetic program

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5
Q

What is nutrition excess?

A
  • primarily result from excessive intake
    • BMI greater than 27 kg health risk
    • BMI greater than 30 kg obesity
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6
Q

What causes hytrophy?

A
  • increased cellular protein content
  • increased workload
  • hormonal stimulation
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7
Q

What does this image show?

A

fat necrosis

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8
Q

What does irreversible injury consist of?

A

Two basic processes that underlie the morphologic changes of necrosis

  • denaturation of protein
  • enzymatic digestion of cell components
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9
Q

How do chaperone proteins limit protein damage?

A

Stress/mutation –> accumulation of misfolded proteins –> synthesis of chaperones –> repair

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10
Q

What are common causes of malnutrition?

A
  • poverty
  • chronic alcoholism
  • acute and/or chronic illness
  • self-imposed dietary restrictions
  • malabsorption syndromes
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11
Q

Which type of cells are capable of hyperplasia?

A) Skeletal muscle cells

B) Cardiac muscle cells

C) Epithelial cells

D) All of the above

A

C

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12
Q

Which of the following are reversible cell injury types:

A) intracellular accumulations

B) Hydropic Swelling

C) limiting protein damage

D) none of the above

A
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13
Q

____ is the most common type of necrosis

A

coagulative

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14
Q

What does this picture show?

A
  • gas gangre
  • results from infection of necrotic tissue by anerobic clostridium sp
    • release hydrolytic enzymes that destroy cell membranes and connective tissue
  • formation of gas bubbles in damaged muscle
  • can be fatal due to lysis of RBCs
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15
Q

Clicker: Which type of irreversible injury initiates an inflammatory response?

A) Apoptosis

B) Necrosis

C) Hydropic swelling

D) Intracelliular accumulations

A

B

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16
Q

What happens if the cell is unable to maintain homeostasis in the face of injurious stimuli?

A

cell injury

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17
Q

Physiologic stresses or pathologic stimuli results in _________.

A

adaptation

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18
Q

Dysplasia is also known as ________

A

atypical hyperplasia

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19
Q

Bestowing to ischemia-induced cell injury, damage often occurs through the formation of _______.

A

reactive oxygen radicals

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20
Q

What is hyperplasia?

A
  • increase in functional capacity related to an increase in cell number due to mitotic division
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21
Q

What is ischemia-reperfusion injury?

A
  • damage occuring after blood supply to tissues has been restored
  • components
    • calcium overload
    • formation of free radicals
    • subsequent inflammation
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22
Q

What is gangrene (gangrenous necrosis)?

A
  • death in a large area of a tissue from interupttion of blood supply to a particular part of the body
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23
Q

What is the free radical theory?

A

aging is a result of accumulated metabolic cell damage over time

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24
Q

What are intracellular accumulations?

A
  • excess accumulations in cells
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25
Q

_____ is a type of necrosis that occurs in the pancreas

A

fat

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26
Q

Generalized swelling of cells in organs can lead to incease in size and weight called _______.

A

megaly

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27
Q

What does this picture show?

A) atrophy

B) hypertrophy

C) hyperplasia

D) metaplasia

E) dysplasia

A

E

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28
Q

What are the three types of gangrene?

A
  1. dry gangrene
  2. wet gangrene
  3. gas gangrene
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29
Q

What is this a picture of?

A

caseous necrosis

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30
Q

What does this picture show?

A) atrophy

B) hypertrophy

C) hyperpasia

D) metaplasia

E) dysplasia

A

A

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31
Q

Reduced endoplasmic reticulum, mitochondria and myofilaments are all cell changes due to:

A) atrophy

B) hypertrophy

C) hyperpasia

D) metaplasia

E) dysplasia

A

A

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32
Q

What is coagulative necrosis?

A
  • arises from ischemic injury and metabolic acidosis due to hypoxic conditions
  • dead cells form a gel-like consitency
    • lower pH causes protein albumins to coagulate to form a jelly-like firm substance
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33
Q

What is dysplasia?

A

disorganized appearance of cells because of abnormal variation in size, shape and arrangement

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34
Q

What is ischemia?

A
  • restriction in blood supply causing a shortage of O2 and glucose needed for cellular metabolism
  • leads to lactic acidosis
  • cell death occurs when plasma, mitochondrial, and lysosomal membranes become damaged
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35
Q

What are the mechanisms responsible for aging?

A
  • DNA damage
  • Reduced proliferative capacity of stem cells
  • accumulation of metabolic change
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36
Q

What are the 5 mechanisms of cell injury?

A
  1. depletion of ATP
  2. mitochondrial damage
  3. influx of intracellular calcium and loss of calcium homeostasis
  4. accumulation of oxygen-derived free radical (oxidative stress)
  5. defects in membrane permeability
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37
Q

What is caseous necrosis?

A
  • characteristic of lung damage secondary to tuberculosis
  • resembles clumpy cheese
  • cellular detail gone
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38
Q

During what phase of the uterine cycle does hyperplasia occur to the endometrial lining?

A

proliferative

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39
Q

What is infectious and immunologic injury?

A
  • bacteria and viruses can injure cells depending on virulence
  • added injury may occur indirectly by triggering body’s immune response
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40
Q

What is atrophy?

A

Cells shrink and reduce their differentiated functions in response to normal and injurious factors

41
Q

Activation of capases leads to ______.

A

apoptosis

42
Q

What are the two phases of necrosis?

A
  1. pyknosis: shrinkage of nucleus and clumping of chromatin
  2. karyolysis: loss of nuclear membrane followed by rupturing
43
Q

True or false: any injury that results in loss of energy (ATP) will also result in swelling

A

true

44
Q

What is hypertrophy?

A

increased cell mass accompanied by augmented functional capacity in response to physiologic and pathophysiologic demands

45
Q

______ is a type of necrosis that occurs in the brain

A

liquefactive

46
Q

What is hydropic swelling?

A
  • cellular swelling due to accumulation of water
  • results from malfunction of sodium-potassium pump with accumulation of Na+ within the cell
47
Q

________ is a cumulative result from two factors that cause cellular and molecular damage:

  • progressive decline in proliferation and reparative capacity of cells
  • exposure to environmental factors
A
48
Q

What is chemical injury?

A

toxic chemicals or poisons can cause cellular injury both directly and by becoming metabolized into reactive chemicals by the body

49
Q

What causes metaplasia?

A

adaptation to persistent injury with replacement of a cell type that is better suited to tolerate injurious stimulation

50
Q

A common site of intracellular accumulations is the

A) stomach

B) liver

C) intestines

D) gallblader

A

B

51
Q

Which of the following results from persistent injury?

A) atrophy

B) hypertrophy

C) hyperpasia

D) metaplasia

E) dysplasia

A

D, E

52
Q

What is necrosis?

A

pathologic cell death that occurs as a consequence of ischemia or toxic injury when the injury is too severe or prolonged to allow adaptation

53
Q

_____ is a type of necrosis occuring in the heart.

A

coagulative

54
Q

What do nutritional deficiencies result from?

A
  • poor intake
  • altered absorption
  • impared distribution by circulatory system
  • inefficient cellular uptake
55
Q

What is metaplasia?

A

replacement of one differentiated cell type with another

56
Q

What is liquefactive necrosis?

A
  • occurs when dead tissue dissolves into liquid
  • arises from ischemic injury to neurons & glial cells of brain or bacterial infection which release hydrolytic enzymes
  • cells liquefy, tissues become soft and encysted
  • formation of abscess or cyst from dissolved dead tissue
57
Q

What is fat necrosis?

A
  • death of adipose tissue in breast, pancrease and abdominal structures
  • result of trauma or inflammation
  • chalky white area of tissue - “soap like”
  • triglycerides digested & free fatty acids precipitate as salts (saponification)
58
Q

True or false: hyperplasia often accompanies hypertrophy

A

True

59
Q

What does this image show?

A

liquefactive necrosis

60
Q

What causes hyperplasia?

A
  • increased physiologic demands
  • hormonal stimulation
  • persistent cell injury
  • chronic irritation of epithelial cells (i.e. calluses & corns)
61
Q

A patient who is 85 years old reports to a health care provider every year for a flu shot. This is important because:

A) telomeres increase with age

B) immune and respiratory reserves decline with age

C) rigor mortis can lead to somatic death and aging

D) radiation sickness can make flu and aging worse

A

B

62
Q

What are the two types of irreversible cell injury?

A
  • apoptosis
  • necrosis
63
Q

Clicker: Reperfusion injury following an ischemic episode results in further tissue damage to:

A) production of excessive lactate

B) excessive intracellular calcium

C) excess body fat and adipose tissue

D) production of exotoxins

A
64
Q

What does this picture show?

A) atrophy

B) hypertrophy

C) hyperpasia

D) metaplasia

E) dysplasia

A

C

65
Q

True or false: chemical injury is dose related

A

true

66
Q

How does intracellular accumulations lead to cellular injury?

A
  • toxicity
  • immune response
  • taking up cellular space
67
Q

What is this an example of?

A

Atrophy

68
Q

_______ is the first menifestation of most forms of reversible cell injury

A

hydropic swelling

69
Q

What organs are most vulnerable to coagulative necrosis?

A
  • heart
  • kidneys
  • adrenal glands
70
Q

What does this diagram explain?

A

As cellular change increases, radical oxygen species inceases. This is because molecules that react with free radicals are in turn converted to free radicals, continuing the destructive cascade.

71
Q

What three proceses occur after cell death?

A
  1. autolysis (self-digestion)
  2. degeneration of chromatin in nucleus
  3. disruption of plasma & orgnalle membrane
72
Q

What do free radicals do?

A

steal hydrogen bonds and form abnormal molecular bonds

73
Q

______ is a type of necrosis that is located in the lung

A

caseous

74
Q

What limits protein damage?

A
  • chaperone proteins
  • ubiquitin-proteosome complex
75
Q

Clicker: The cellular response indicative of injury due to faulty metabolism is:

A) hydropic swelling

B) lactate production

C) metaplasia

D) intracellular accumulation

E) all of the above

A

D

76
Q

What does this picture show?

A) atrophy

B) hypertrophy

C) hyperpasia

D) metaplasia

E) dysplasia

A

B

77
Q

What is radiation-induced injury?

A
  • ionizes H2O into H+ and OH-
    • OH attaches to DNA & prevents cell reproduction
  • causes DNA mutations
78
Q

How does the ubiquitin-proteosome complex limit protein damage?

A

stress/mutations –> accumulation of misfolded proteins –> activation of uniquitin-proteosome complex –> degrades unfolded proteins

79
Q

Lack of growth hormone and testosterone can lead to which of the following:

A) atrophy

B) hypertrophy

C) hyperpasia

D) metaplasia

E) dysplasia

A

A

80
Q

What do these pictures show?

A
  • wet gangrene
  • form of liquefactive necrosis
  • due to anerobic bacteria invading lymphocytes (neutrophils)
  • combined effect is liquid, cold, swollen & black appearance
  • fould odour
  • can be fatal
81
Q

What does this picture show?

A
  • dry gangrene
  • form of coagulative necrosis characterized by blackened, dry, wrinkled tissue separated by a line of demarcation from healthy tissue
  • few bacteria
82
Q

What does reversible cell injury consist of?

A
  • cell swelling develops when cells are incapable of fluid and ion homeostasis
    • decreased function of ATP dependent pumps
  • accumulation of lipid vaculoes in cytoplasm
83
Q

True or false: dysplasia that is severe and involves the entire thickness of the epithelium is called carcinoma in situ.

A

true

84
Q

What is somatic death?

A
  • death of entire organism
  • no inflammation or immunologic response
  • due to cessation of respiration and heart beat
  • presence of stiffened muscles (rigor mortis) after death then flaccid
  • release of lytic enzymes in body tissues: postmortem autolysis
85
Q

What does this picture show?

A

coagulative necrosis

86
Q

A large, pale cytoplasm, dilated endoplasmic reticulum and swollen mitochondria are all characteristics of what?

A

hydropic swelling

87
Q

True or false: apoptosis causes inflammation

A

false - does not

88
Q

Which of the following results from decreased functional demand or ischemia?

A) atrophy

B) hypertrophy

C) hyperpasia

D) metaplasia

E) dysplasia

A

A

89
Q

_______ is used to excape and protect itself from injury

A

cellular adaptation

90
Q

______ is inadequate oxygenation usually due to ischemia, causes chemical and acid-base imbalances, and is reversible if 02 restored.

A

hypoxia

91
Q

What are cells?

A

active participants in the environment constantly adjusting structure and function to accomodate changing demands & extracellular stress to maintain homeostasis

92
Q

What are the causes of atropy?

A
  • disuse
  • denervation
  • ischemia
  • nutrient starvation
  • interruption of endocrine signals
  • persistent cell injury
  • aging
93
Q

What are the characteristics of intracellular accumulations?

A
  • accumulation of excessive amounts of intracellular substance
  • accumulation of abnormal substances from faulty metabolism or synthesis
  • accumulation of pigments or particles the cell is unable to degrade
94
Q

Which of the following increases from functional demand?

A) atrophy

B) hypertrophy

C) hyperpasia

D) metaplasia

E) dysplasia

A

B,C

95
Q

What does this diagram show?

A

hydropic swelling

96
Q

Hyperplasia typically occurs in

A) endometrium

B) liver

C) wound healing

D) warts

E) all of the above

A

E

97
Q

Cigarette smoke causes the mucus-secreting ciliated pseudostratified columnar respiratory epithelial cells that line the airways to be replaced by stratified squamous epithelium. What is this an example of?

A) atrophy

B) hypertrophy

C) hyperplasia

D) metaplasia

E) dysplasia

A

D

98
Q

What is an example of hypertrophy?

A

building muscle

Pathophysiology (6 decks)

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