FDN2_WK3_CellAdaptationAndDeath Flashcards
1
Q
What is hypertrophy?
A
Increase in cell size and metabolic activity
2
Q
What is atropy?
A
Decrease in cell size, metabolic activity, and number
3
Q
What is the term for “increase in cell size and metabolic activity”
A
Hypertrophy
4
Q
What is the term for “decrease in cell size, metabolic activity, and number”
A
Atrophy
5
Q
What is hyperplasia?
A
Increase in cell number
An orderly physiological response with a well-defined initiating factor and point of termination that leads to proliferation of normal cells
6
Q
What is the term for “increase in normal cell number”
A
Hyperplasia
7
Q
What is metaplasia?
A
The transformation of one differentiated cell type into another
8
Q
What is the term for “transformation of one differentiated cell type into another”
A
Metaplasia
9
Q
Which kinds of cells are most likely to undergy hypertophy instead of hyperplasia?
A
Cells that have a limited ability to divide
Cardiac muscle, skeletal muscle
10
Q
In which cell types are we least likely to see the
hyperplasia-> dysplasia -> neoplasia progression?
A
Cells with a limited ability to divide
Cardiac muscle, skeletal muscle, nerves
11
Q
Give examples of physiologic causes of hypertrophy
A
Increased load in skeletal muscle cells -> larger cells
Uterus in pregnancy -> larger cells
12
Q
Give an example of a pathologic cause of hypertrophy
A
Cardiac muscle due to hemodynamic overload -> Enlarged heart
13
Q
Give an example of a physiologic cause of atrophy
A
Embryonic structures in development
14
Q
Give some examples of pathologic causes of atrophy
A
Loss of innervation
Decreased blood supply
Inadequate nutrition
Decreased endocrine stimulation
Tissue compression
Lack of use (due to a fracture or break)
15
Q
Give some examples of physiologic causes of hyperplasia
A
New cells from mature or stem cells
Callous on hands from weight lifting
Breast tissue in pregnancy
Liver regeneration
16
Q
Give some examples of pathologic hyperplasia
A
There are none!
Hyperplasia refers to the normal proliferation of cells due to physiologic signals
17
Q
What is the name for pre-malignant cell growth?
A
Dysplasia
18
Q
What is dysplasia?
A
Disordered growth
19
Q
What are some characteristics of dysplasia?
A
Pleomorphism (loss of uniformity)
Accumulation of mutations
Dysregulated proliferation
20
Q
What might cause a dysplastic growth to become a malignant neoplasm?
A
Accumulation of more mutations
21
Q
Give some examples of physiologic causes of dysplasia
A
There are none! Dysplasia is always pathologic
22
Q
What is neoplasia?
A
Unchecked growth; the unregulated, clonal differentiation of abnormal cells
23
Q
How do neoplasms develop?
A
Unchecked growth of abnormal cells leads to a mass (neoplasm)
Benign: forms from hyperplastic cells
Malignant: Often preceeded by dysplasia
24
Q
Supposed there is a tissue experiencing metaplasia.
How would loss of regulation affect this tissue?
A
The tissue may become dysplastic
25
What characteristic would lead a dysplasia to be classified as "malignant"?
Invasion of the basement membrane
26
You look under the microscope at a sample of skeletal muscle and you see that the cells are large, with lots of cytoplasm and organelles.
What process is this tissue undergoing?
Hypertrophy
27
Give some examples of physiologic causes of metaplasia
Menarche
Glandular, columnar epithelium in the cervix transforms into squamous epithelium in the "transformation zone"
28
What are some pathologic causes of metaplasia?
Chronic stress/damage
Example: Barrett's esophagus
Alcoholism or chronic acid reflux -\> transformation of squamous epithelium to columnar epithelium in the esophagus
This is called "intestinal epithelialization of the esophagus" because the esophagus now looks like the intestine
29
In which tissues is metaplasia most common?
Epithelial
30
Under a microscope you see a high density of uniform cells with very little cytoplasm.
Should you be worried? Why or why not?
No worries! This sounds like hyperplasia
The cell uniformity indicates that the cells are clonal, and do not have new (and potentially dangerous) mutations
31
A sample of epithelial tissue under a microscope shows a high density of cells with large nuclei and very little cytoplasm. However, you're having trouble telling what kind of epithelium it is becasue many of the cells are different shapes.
What do you think the attending physician should tell the patient?
This sounds like dysplasia!
The attending should tell the patient to keep an eye on the area and check back for regular follow-ups; there is a chance that the dysplasia could regress, but it could also develop new mutations and become malignant
32
In the name of a neoplasm, what does the prefix indicate?
The type of tissue that has the neoplasm
33
In the name of a neoplasm, what does the suffix indicate?
Whether the neoplasm is benign or malignant
34
The prefix ________ indicates a glandular neoplasm
Adeno
35
The prefix ________ indicates a smooth muscle neoplasm
Leiomyo
36
The prefix ________ indicates a skeletal muscle neoplasm
Rhabdo
37
The prefix ________ indicates a neoplasm in adipose tissue
Lipo
38
The prefix ________ indicates a neoplasm in the bone
Osteo
39
The prefix ________ indicates a cartilage neoplasm
Chondro
40
The prefix ________ indicates a squamous neoplasm
Squamous (yay!)
41
The prefix **adeno** indicates a neoplasm in \_\_\_\_\_\_\_\_\_\_\_
Some type of gland
42
The prefix **eiomyo** indicates a neoplasm in \_\_\_\_\_\_\_\_\_\_\_
Smooth muscle
43
The prefix **rhabdo** indicates a neoplasm in \_\_\_\_\_\_\_\_\_\_\_
Skeletal muscle
44
The prefix **lipo** indicates a neoplasm in \_\_\_\_\_\_\_\_\_\_\_
Adipose tissue
45
The prefix **osteo** indicates a neoplasm in \_\_\_\_\_\_\_\_\_\_\_
Bone
46
The prefix **chondro** indicates a neoplasm in \_\_\_\_\_\_\_\_\_\_\_
Cartilage
47
The prefix **squamous** indicates a neoplasm in \_\_\_\_\_\_\_\_\_\_\_
Squamous epithelium
48
The suffix **-oma** indicates what type of neoplasm?
Benign
Except if it is an **adenoma** of the GI tract
49
The suffix **-sarcoma** indicates what type of neoplasm?
malignant mesenchymal neoplasm in **connective tissue or muscle**
50
The suffix -**carcinoma** indicates what type of neoplasm?
Malignant **epithelial** neoplasm
51
What is a **lymphoma**?
A malignant lymphoid tumor
52
What is a melanoma?
A malignant melanocytic tumor
53
What are the 4 most common types of malignant neoplasms?
Carcinoma, sarcoma, lymphoma, melanoma
54
You're reading the results of your patient's colonoscopy and you see "Adenoma"
What are the appropriate next steps?
Adenomas of the GI tract are **not** benign
They must be removed before they can evolve into carcinomas
55
What is the only adenoma that is concerning for malignancy?
An adenoma in the GI tract
56
What is the suffix that indicates a benign neoplasm?
-oma
| (except if in the GI tract)
57
What is the suffix that indicates a malignant mesenchymal neoplasm?
-sarcoma
58
What is the suffix that indicates a malignant epithelial neoplasm?
-carcinoma
59
What is the word that indicates a malignant lymphoid neoplasm?
Lymphoma
60
What is the suffix that indicates a malignant melanocytic neoplasm?
Melanoma
61
What change does female breast tissue undergo in pregnancy?
Lobular hyperplasia
62
A smoker develos a squamous cell carcinoma of the lung.
How is it possible for this patient to develop a squamous cell tumor in a location where squamous cells are not typically present?
Smoking (stressor) -\> **metaplasia**: a pre-neoplastic change
This causes the columnar epithelium of the lung to transform into squamous epithelium.
Continued exposure to the carciongen causes additional mutations, which leads to the development of the malignant neoplasm
63
What are two pre-neoplastic changes a tissue can undergo?
Metaplasia and dysplasia
64
What is the difference between a lipoma and a liposarcoma?
A lipoma is a benign neoplasm
A liposarcoma is a malignant neoplasm
65
What is the difference between grading and staging of a tumor?
**Grading** is histologic: How closely does a tumor reflect benign counterparts?
**Staging** is clinical: How far has the tumor spread?
66
What is TNM classification?
T = Tumor (T1-T4)
N = lymph Node (N0-N3)
M = Metastasis (M0-M1)
67
What are 6 cellular responses to injury?
1. Decreased ATP production
2. Mitochondrial damage
3. Calcium influx
4. Accumulation of ROS
5. Increased membrane permeability
6. DNA damage
68
What is the key factor in the downstream effects of hypoxia on tissues?
Decreased ATP production
69
What triggers formation of the mitochondrial transition pore
Damage to the mitochondria
70
What are the possible consequences after formation of the mitochondrial transition pore?
Reversal
Necrosis due to decreased ATP production and increased ROS
Apoptosis due to leakage of apoptotic proteins
71
What is the first consequence of hypoxia?
Decreased ATP synthesis
72
What are 4 reversible cell injuries?
1. ATP depletion
2. Inhibition of protein synthesis
3. Loss of glycogen
4. Cell swelling (due to subtle failure of membrane function)
73
What are 4 irreversible cell injuries?
1. Mitochondrial swelling
2. Accumulation of electron-dense inclusions in mitochondria
3. Nuclear changes
4. Rupture of membranes (lysosomal, plasma, other organelle)
74
What are some light microscopic signs of irreversible injury?
Nuclear shrinkage
Breakdown of membranes
Increased staining (darker pink)
75
What are some (5) electron microscope signs of irreversible cell damage?
Swollen mitochondria
Electron-dense deposits in mitochondria
Disrupted plasma membrane
Abnormal deposits of lipids, proteins, glycogen, pigment, calcium
Accumulation of indigestable material
76
Describe the time course of events that happen in resposne to hypoxia
* ATP synthesis stops
* Na/K ATPase stops
* Cell swelling (more salt = more water in)
* Increased anerobic glycolysis
* Decreased pH (due to lactic acid buildup)
* Loss of glycogen
77
Does the following scenario apply to Necrosis or Apoptosis?
## Footnote
**Always occurs in groups of cells**
Necrosis
78
Does the following scenario apply to Necrosis or Apoptosis?
## Footnote
**Always pathogenic**
Necrosis
79
Does the following scenario apply to Necrosis or Apoptosis?
## Footnote
**Can result from physiologic processes**
Apoptosis
80
Does the following scenario apply to Necrosis or Apoptosis?
## Footnote
**DNA is cleaved into nucleosomal subunits**
Apoptosis
81
Does the following scenario apply to Necrosis or Apoptosis?
## Footnote
**Can occur in a single cell**
Apoptosis
82
Does the following scenario apply to Necrosis or Apoptosis?
**Results in inflammation**
Necrosis
83
Does the following scenario apply to Necrosis or Apoptosis?
**Energy dependent**
Apoptosis
84
Does the following scenario apply to Necrosis or Apoptosis?
## Footnote
**Organelles are fragmented**
Necrosis
85
Does the following scenario apply to Necrosis or Apoptosis?
**Blebbing in the plasma membrane**
Both!
86
Does the following scenario apply to Necrosis or Apoptosis?
## Footnote
**Can result from stress response**
Both!
87
Does the following scenario apply to Necrosis or Apoptosis?
Programmed/planned
Apoptosis
88
1. Where does coagulative necrosis occur?
2. What causes it?
1. Anywhere except the brain
2. Ishemia or toxicity due to myocardial infarction
89
1. Where does liquifactive necrosis occur?
2. What causes it?
1. The brain
2. Ichemia, infection, injury
90
1. Where does caseous necrosis occur?
2. What causes it?
1. Any tissues
2. Tuberculosis
91
1. Where does fat necrosis occur?
2. What causes it?
1. Adipose tissue adjacent to the pancreas
2. Alcohol or galstones (injury to acinar cells of the pancreas). Increased enzyme activity -\> more lipases -\> more free fatty acids -\> saponification
92
1. Where does fibrinoid necrosis occur?
2. What causes it?
1. Blood vessles
2. Immune reaction/vasculitis
93
1. Where does gangrenous necrosis occur?
2. What causes it?
1. Soft tissue and lower limbs
2. Ischemia and hypoxia
Note: "gangrene" is a clinical, rather than histologic, diagnosis
94
Which type of necrosis is associated with myocardial infarction?
Coagulative necrosis
95
Which type of necrosis is associated with brain injury?
Liquifactive necrosis
96
Which type of necrosis is associated with tuberculosis infection?
Caseous necrosis
97
Which type of necrosis is associated with alcoholism?
Fat necrosis
98
Which type of necrosis is associated with injury to pancreatic acinar cells?
Fat necrosis
99
Which type of necrosis is associated with an immune reaction in the blood vessels?
Fibrinoid necrosis
100
What are some characteristics of coagulative necrosis?
- Absent nuclei (ghosts)
- Cell outlines remain (enzymes can't break down dead cells)
101
"absent nuclei with visible cell outlines"
is characteristic of ________ necrosis
Coagulative
102
"No visible cell borders, looks like a solid sheet"
is characteristic of ________ necrosis
Liquifactive
(This is a type of coagulative necrosis that only occurs in the brain; caused by cells lysing when they die)
103
"Forms granulomas"
is characteristic of ________ necrosis
Caseous
104
"Leakage of lipase, hydrolytic enzymes, saponification that forms chalk consistency (after 2 weeks)"
is characteristic of ________ necrosis
Fat
105
"Bright pinnk, amorphous vessel. Thick bands visible"
is characteristic of ________ necrosis
Fibrinoid
106
What are some characteristics of liquifactive necrosis?
Occurs in the brain
Liquid
No cell borders visible
Looks like a solid sheet
107
What are some characteristics of caseous necrosis?
Forms granulomas (hallmark)
Inflammatory cells are surrounding a central area of necrosis
Resembles dry cheese
May have some coagulative and some liquifactive characteristics
108
What are some characteristics of fat necrosis?
Leakage of lipase and hydrolytic enzymes
Injured acinar cells of the pancreas
Saponification w/chalk consistency after 1-2 weeks
109
What are some characterisitcs of fibrinoid necrosis?
Bright pink, amorphous blood vessel
Thick bands visible
110
What is karyorrhexis?
Fragmentation of the nucleus.
Seen in necrosis
111
What is reperfusion injury?
After perfusion has been re-established, sudden increase in oxygen leads to an increase in reactive oxygen species that overwhelms the antioxidant system
This can lead to death
112
What is karyolysis?
Dissolution of the nuclus (preceeded by swelling)
Seen in necrosis
113
What is pyknosis?
**Shrinkage of the nucleus due to chromatin condensation**
Preceeded by swelling in necrosis
The DNA is broken apart in an orderly fashion in apoptosis
