DD4

Question 1

3 phases of tissue repair:

Answer 1

1. Inflammatory Phase
2. Proliferative Phase
3. Re-epithelial/scar remodeling phase

Question 2

Is high methamalonic acid found in B12 or folate deficiency or both?

Answer 2

B12 - methylmalonyl-CoA mutase to break down MA

Question 3

What is the primary collagen produced by fibroblasts? Remodeling collagen (later)?

Answer 3

Primary: Collagen type III

Remodeling: Type I

Question 4

Granulation tissue
what is it?
What does it do?

Answer 4

• New CT and blood vessels that form on surface of wound during healing
  
  • Forms extracellular matrix
  • A response to injury
  • Part of scar formation

Question 5

Which cell is involved in neovascularization? What does that do?

Answer 5

Endothelial cells

- provide oxygen and nutrient to tissue -> macrophages come in -> remove waste products

Question 6

Describe re-epithelialization

Answer 6

Adjacent cells, Bulge stem cells (deep) and Epidermal stem cells

○ Stem cells line along follicle → start to regenerate deep

○ Epidermal stem cells in skin → regenerate epithelium

Question 7

What two mechanisms does the liver use to regenerate?

Answer 7

1. Proliferation of remaining hepatocytes

2. Repopulation from progenitor cells

Question 8

Describe the proliferation phase of liver regeneration

Answer 8

Priming: cytokines (IL-6) produced by Kupffer cells → make parenchymal cells able to receive/respond to growth factor signals

Growth factor phase: growth factors (HGF and TGF-α) → stimulate cell metabolism →stim cell cycle (S phase of DNA replication) → almost all hepatocytes replicate → followed by nonparenchymal cells

Question 9

Define scar formation

Answer 9

lay down CT (fibrous) tissue in severely damaged tissue

Question 10

Describe steps in scar formation

Answer 10

1. angiogenesis
2. formation of granulation tissue
3. Remodeling of CT

Question 11

Abnormal (pathologic) scar types due to excess granulation tissue:

Answer 11

1. cirrhosis
2. Hypertrophic scar
3. Keloid
4. Desmoid tumor
5. Contracture

Question 12

Hypertrophic scar

Answer 12

raised beyond boundary of wound
*but not as much as keloid
can regress
limited to area of injury

Question 13

Keloid scar

Answer 13

raised beyond boundary of wound

regressed

Question 14

Desmoid tumor (scar)

Answer 14

aggressive fibromatosis

benign neoplasm - safe

Question 15

contracture scar

Answer 15

deformity crosses joint

-ie: effed up wrists

Question 16

List some systemic (not local) factors that might affect tissue repair

Answer 16

nutritional
metabolic
vascular

Question 17

Untreated appendicitis can lead to what?

Answer 17

Peritonitis (bacterial inflammation of peritoneum)

Adhesions w/ repair -> complications

Question 18

Cholelithiasis vs Cholecystitis

Answer 18

Cholelithiasis:: Gallstones
○ “lith” = stone

Cholecystitis: Gallbladder inflammation

Question 19

What does the liver portal triad consist of?

Answer 19

bile duct
portal vein
hepatic artery

*picture the histo slides

Question 20

Fatty change of hepatocytes are called?

Answer 20

Steatosis

Question 21

Esophageal varices

Answer 21

enlarged veins in lower part of esophagus

Question 22

Hemorrhoids

Answer 22

vascular structures in anal canal