Exam 1: Fundamentals 1 + 2 Flashcards
What is Pathology?
The study of diseases and their processes and understanding the structural changes that occur in cells, tissues and organs as a result of disease
- based on basic sciences and clinical sciences
What is Homeostasis?
- The steady state in which cells exist normally
- Equilibrium between cells and their environment for optimal function
What is Disease?
An alteration or deviation from normal physiological function or homeostasis
what are some causes of disease?
- genetic abnormalities
- infections
- environmental exposures
- lifestyle choices
what are the classifications of disease?
(VINDICATED)
Vascular
Infective
Neoplastic
Degenerative
Iatrogenic
Congenital
Autoimmune
Traumatic
Endocrine
Drugs
What is the definition of Diagnosis?
The art and science of distinguishing one disease from another
What is the goal in a diagnosis?
To determine underlying cause of patient’s health issue so appropriate treatment can be initiated
What are some steps done to determine a diagnosis?
- history taking
- evaluate S/Sx (recognising patterns, common manifestations of disease)
- physical examination
- laboratory investigations (cellular)
- biopsy of tissue samples
- differential diagnosis
What are the goals for treatment?
restore homeostasis by curing disease, prevent complications, improve patients quality of life,
What are the different categories for treatment?
- Curative treatment (meds, surgery)
- Palliative treatment (incurable, comfort)
- Preventative treatment (vaccination, lifestyle changes)
- Support treatment * for normal body function (oxygen therapy, kidney dialysis)
What is a prognosis?
- a predicted outcome of course of the disease
- dependent on:
1. Nature of disease
2. Stage and severity
3. Response to treatment
4. Patient related health factors (obesity)
5. Complications (infection)
6. Pathogenic mechanisms (genetics)
what is an example of a disease without symptoms?
Hypertension:
- only sign is elevated B.P.
what is an example of symptoms without disease?
P.T.S.D, anxiety, fibromyalgia, depression
- severe symptoms with no sign of disease
What is Etiology?
The study of causation
In Greek : giving a reason for
What is Pathogenesis?
The mechanisms for the development of a disease
What is the purpose for understanding pathology?
The basis for understanding pathology includes:
- classification of diseases
- diagnosis
- treatment
- prognosis
- understanding complications
What are the divisions of pathology?
- Immunology
- Hematology
- Histopathology
- Cytopathology
- Genetics
Define Immunology
The study of specific defense mechanisms of the body
Define Hematology
The study of blood related diseases
Define Histopathology
The study of diseases by looking at changes in tissues
Define Cytopathology
The study of disease by looking at individual cell changes
Define Genetics
The study of abnormal chromosomes and genes
List 4 categories of Etiology
- Damage
ex: physical/ chemical radiation - Degeneration
ex: wear n tear - Diet
- Don’t know ( idiopathic)
What is an example of a morphological change in the cells of an organ?
A FATTY LIVER vs a normal liver
What are causes of cell injury?
What are some examples of cell injury?
- Physical agents
ex: uv rays, extreme temperature, cuts, fractures etc. - Chemical agents
ex: pollutants, heavy metals, alcohol, drugs.. - Infectious
ex: bacteria, fungus, virus, parasite - Immunological reactions
ex: allergic, autoimmune disorder - Genetic defects
ex: inherited genetic mutations causing cystic fibrosis
or sickle cell disease - Nutritional imbalances or deficiency
ex: obesity, diabetes - Hypoxia
ex: oxygen deprivation - Cellular aging
ex: damage accumulation from internal or external sources/ damage DNA
What are the reactions of the body to stress?
what can the cell do as a response to stress?
In response to a potentially injurious stimulus, a cell will undergo a series of changes which may include:
- cellular adaptations
- reversible cell injury
- irreversible cell injury
- cell death
What are several factors that affect the way the body responds to injury?
- type of cell
- severity of injury
- cellular adaptation mechanisms
- genetic and metabolic status of the cell
- availability of nutrients
- inflammatory response
- regenerative capacity
- cells intrinsic repair mechanisms
- type of injury
- environmental factors
what are the three types of cells based on their ability to generate?
what is the regeneration potential for each of these cells?
some cells like skin and liver recover better
what are the ways a cell adapts to stress/ stimuli?
Adaptation:
- hypofunctioning
- hyperfunctioning
- size of cells
- number of cells
what is Hypertrophy?
increase in size of size of cell
ex:
hypertension
what is Atrophy?
decrease in size or number of cells
ex:
poliomyelitis
what is Hyperplasia?
increase in number of cells
ex:
benign prostatic hyperplasia
what is Metaplasia?
change in the type of the cell
ex:
what is Dysplasia?
disorderly growth of the cells
ex:
cervical dysplasia with HPV infection
Name each substance that can accumulate in the cell?
- Iron
- Lipofuscin
- Bilirubin
- Amyloid
- Cholesterol
Give an example of Iron accumulation in the cell
color: brown
ex: Bruise or Hemochromatosis
Give an example of Lipofuscin accumulation in the cell
color: brown
ex: Heart, Smooth muscle
Give an example of Bilirubin accumulation in the cell
color: yellow
ex: Hepatitis or Sickle cell Disease
Give an example of Amyloid accumulation in the cell
color: colorless
ex: Alzheimer’s and Amyloidosis
Give an example of Cholesterol accumulation in the cell
color: creamy
ex: Xanthelasma, Artherosclerosis
#1 CAUSE OF DEATH/ WORLD
What is the difference between Xanthelasma and Xanthoma?
- Xanthelasma:
yellow, lipid-rich plaque on eyelids - Xanthoma:
fat deposits under skin(mostly joints), yellow rich plaque
What is the difference between Dystrophic and Metastatic tissue damage?
- Dystrophic:
tissue = damaged
serum calcium = normal - Metastatic:
tissue = normal
serum calcium = elevated
What are is the Mnemonic for hypercalcemia?
Stones (kidney stones)
Bones (bone fractures)
Groans (peptic ulcers)
Moans (depression)
What components of the cell can be injured?
- nucleus
- cell membrane
- enzymes
- energy production
What ways can the nucleus of a cell be injured?
Genetically:
- defective gene hemoglobin synthesis
- sickle cell disease
Nutritionally:
- DNA synthesis in RBC’s
- Pernicous anemia (vitamin B12 deficiency)
Toxic injury:
- radiation free radicals
- division of nucleus
- skin and thyroid cancer
What ways can the lysosome (waste disposal)
be injured?
Storage disorders:
- Gaucher’s disease
- Tay-Sachs disease
What ways can the ribosome (protein factory)
be injured?
- Ribosomopathies
What ways can the endoplasmic reticulum (roadway network)
be injured?
- Neurodegenerative disorders
(ALS, Alzheimer’s, MS, Parkinson’s)
What ways can the cell membrane (city wall)
be injured?
Receptor defects:
- familial hypercholesterolemia
- retrolental fibroplasia from free radical injury
Micro-organism damage:
- clostridium perfringens
- alpha toxin disrupts membrane function
What ways can the cell’s energy production be injured?
Mitochondria
(source of energy/ ATP) :
- hypoxia ( O2 deprivation)
- ischemia (low blood supply)
- anoxia (lack of O2/ ATP synthesis)
- increase intracellular calcium (activating calcium dependent enzymes)
- depletion of ATP (loss/intracellularly function)
- defective membrane permeability (free radicals/ toxins)
Effecting:
- muscle contraction
- transmembrane ionic exchange
What is the process that occurs during a Hypoxic injury within the cell?
Cause: Compromised aerobic respiration
1. Increases rate of anaerobic glycolysis leading to increased production of lactic acid, decreasing cellular pH
2. Acute swelling then results and ribosomes detach from rough ER
3. This leads to water entering the cell (hydropic change) leading to vacuolization
4. Lysosomal membrane eventually ruptures
(if hypoxia is severe, it may lead to anoxia and necrosis)
What is a free radical injury?
= a chemical with an unpaired electron
- injury may be highly reactive, autocatalytic, unstable
-injury may involve lipid peroxidation, oxidative modification, damage to cellular DNA
What are free radicals?
Physiologically: produced/ECF during inflammation
Pathologically: BRAIDS
Built up iron/ copper
Radiation
Air pollution
Inflammation
Drug metabolism
Smoking
What are the 2 classes of free radicals?
- ROS (reactive oxygen species) :
- derived from oxygen
- superoxide, hydrogen peroxide, hydroxyl radical - RNS (reactive nitrogen species) :
- derived from L-arginine
- nitric oxide
What are the substances that neutralize / mitigate each free radical?
Anti-oxidants:
- vitamin C
- vitamin E
- Selenium
What is oxidative stress?
an imbalance of free radicals and anti-oxidants that occurs naturally;
plays a role in aging process
What is the difference between reversible and irreversible cell injuries?
Reversible:
- cell is swollen
- fat accumulation
- clumping nuclear chromatic
- cell recovers if stress is removed
Irreversible:
- cell dies from stress/ injury
- leads to necrosis
- lysosomes rupture
- autolysis (self digestion)
In reversible cell injury, what is membrane damage?
cellular swelling:
- loss of ATP production leads to no Na/K and ATPase pumps activity
- Na and water influxes
= Hydropic changes / swell
What is intracellular edema?
- increase in water accumulation / parenchymal cells (cytoplasm and cytoplasmic organelles)
- ballooning of cells/ vacuolation
What is Steatosis?
- accumulation of triglycerides
- most commonly involved organ is liver = fatty liver disease
- cell can recover/ autophagy
Causes: - malnutrition
- toxins
- obesity
- alcohol abuse
In irreversible cell damage, what are specific changes the cells nucleus undergoes?
- Autophagy:
= to eat itself
- release of intracellular enxymes (LDH, CK) - Lysosomes rupture
- Changes in nucleus:
- Pyknosis (
- Karyorrhexis
- Karyolysis
In irreversible cell damage, what is Pyknosis?
reversible nuclear chromatin condensation/ clumping
(small dense nuclei)
In irreversible cell damage, what is Karyorrhexis?
irriversible chromatin/ nuclei fragmentation
(Ca++ influx)
In irreversible cell damage, what is Karyolysis?
enzymatic breakdown of DNA after cell death
(complete disappearance of nuclear material)
What is cell necrosis?
- a 2 step process:
denaturation of proteins followed by enzymatic digestion of organelles - occurs when damage is too much/cell, nucleus dies and cell functions decline
- final step = increased intracytoplasmic levels of calcium
= Cell Death
What are the types of Necrosis?
- coagulative
- liquefactive
- caseous
- gangrenous
- enzymatic
- fat
- fibrinoid
What is an example of coagulative necrosis?
process: proteins denature
ex: myocardial infarction
(coronary artery occlusion)
What is an example of liquefactive necrosis?
process: tissue liquifies
ex: stroke and abscess
What is an example of Caseous necrosis?
process: coagulative and liquefactive necrosis
ex: tuberculosis / fungal infections
(cheese appearance)
What is an example of gangrenous necrosis?
process: coagulative and liquifactive
ex:
1. dry - gangrene : frostbite
2. wet gangrene : diabetes
“stopping blood”
What is an example of gas gangrene necrosis?
clostridium perfringens
(deep penetrating wound accompanied by gas)
ex: dog bite
What is an example of enzymatic necrosis?
pancreatitis
(pancreatic enzymes destroy protein, fat and elastic tissue)
What is an example of fat necrosis?
process: cell disruption and enzymatic digestion
ex:
1. trauma to breast
2. acute pancreatitis
What is an example of fibrinoid necrosis?
process: fibrin-like material in BV’s
ex: polyarteris nodosa
What is apoptosis?
programmed cell death
(cell falls apart)
What is apoptosis regulated by?
nitric oxide
What is required for apoptosis to occur?
ATP
What are the 3 causes of apoptosis?
- Embryogenesis
(development of embryo finger/toe webbing) - Hormone dependence induction/involution
(death of endometrial tissue/ mensuration) - Cell deletion
(cells w/ normal turnover die periodically)
What are the stages of apoptosis?
- Cytosol and nucleus shrink
- Pyknosis
- Organelles and plasma membrane still intact
- No surrounding inflammatory response
- Rapid phagocytosis
- Surrounding tissue not affected
- Regulated by caspases
- Caspase - extrinsic factors act on the cytoplasm
- Caspase - intrinsic factors involve the mitochondria
How does apoptosis differ from necrosis?
Cells affected:
apoptosis- single
necrosis- multiple
Inflammation:
apoptosis- absent
necrosis- present
Organelles:
apoptosis- intact
necrosis- damaged
Plasma membrane:
apoptosis- intact
necrosis- damaged
Surrounding tissue:
apoptosis- not affected
necrosis- affected
