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FDN2 by Minnie > FDN2_WK3_CellAdaptationAndDeath > Flashcards

FDN2_WK3_CellAdaptationAndDeath Flashcards

1
Q

What is hypertrophy?

A

Increase in cell size and metabolic activity

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2
Q

What is atropy?

A

Decrease in cell size, metabolic activity, and number

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3
Q

What is the term for “increase in cell size and metabolic activity”

A

Hypertrophy

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4
Q

What is the term for “decrease in cell size, metabolic activity, and number”

A

Atrophy

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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

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6
Q

What is the term for “increase in normal cell number”

A

Hyperplasia

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7
Q

What is metaplasia?

A

The transformation of one differentiated cell type into another

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8
Q

What is the term for “transformation of one differentiated cell type into another”

A

Metaplasia

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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

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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

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11
Q

Give examples of physiologic causes of hypertrophy

A

Increased load in skeletal muscle cells -> larger cells

Uterus in pregnancy -> larger cells

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12
Q

Give an example of a pathologic cause of hypertrophy

A

Cardiac muscle due to hemodynamic overload -> Enlarged heart

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13
Q

Give an example of a physiologic cause of atrophy

A

Embryonic structures in development

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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)

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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

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16
Q

Give some examples of pathologic hyperplasia

A

There are none!

Hyperplasia refers to the normal proliferation of cells due to physiologic signals

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17
Q

What is the name for pre-malignant cell growth?

A

Dysplasia

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18
Q

What is dysplasia?

A

Disordered growth

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19
Q

What are some characteristics of dysplasia?

A

Pleomorphism (loss of uniformity)

Accumulation of mutations

Dysregulated proliferation

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20
Q

What might cause a dysplastic growth to become a malignant neoplasm?

A

Accumulation of more mutations

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21
Q

Give some examples of physiologic causes of dysplasia

A

There are none! Dysplasia is always pathologic

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22
Q

What is neoplasia?

A

Unchecked growth; the unregulated, clonal differentiation of abnormal cells

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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

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24
Q

Supposed there is a tissue experiencing metaplasia.

How would loss of regulation affect this tissue?

A

The tissue may become dysplastic

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25
Q

What characteristic would lead a dysplasia to be classified as “malignant”?

A

Invasion of the basement membrane

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26
Q

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?

A

Hypertrophy

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27
Q

Give some examples of physiologic causes of metaplasia

A

Menarche

Glandular, columnar epithelium in the cervix transforms into squamous epithelium in the “transformation zone”

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28
Q

What are some pathologic causes of metaplasia?

A

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

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29
Q

In which tissues is metaplasia most common?

A

Epithelial

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30
Q

Under a microscope you see a high density of uniform cells with very little cytoplasm.

Should you be worried? Why or why not?

A

No worries! This sounds like hyperplasia

The cell uniformity indicates that the cells are clonal, and do not have new (and potentially dangerous) mutations

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31
Q

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?

A

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

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32
Q

In the name of a neoplasm, what does the prefix indicate?

A

The type of tissue that has the neoplasm

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33
Q

In the name of a neoplasm, what does the suffix indicate?

A

Whether the neoplasm is benign or malignant

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34
Q

The prefix ________ indicates a glandular neoplasm

A

Adeno

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35
Q

The prefix ________ indicates a smooth muscle neoplasm

A

Leiomyo

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36
Q

The prefix ________ indicates a skeletal muscle neoplasm

A

Rhabdo

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37
Q

The prefix ________ indicates a neoplasm in adipose tissue

A

Lipo

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38
Q

The prefix ________ indicates a neoplasm in the bone

A

Osteo

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39
Q

The prefix ________ indicates a cartilage neoplasm

A

Chondro

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40
Q

The prefix ________ indicates a squamous neoplasm

A

Squamous (yay!)

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41
Q

The prefix adeno indicates a neoplasm in ___________

A

Some type of gland

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42
Q

The prefix eiomyo indicates a neoplasm in ___________

A

Smooth muscle

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43
Q

The prefix rhabdo indicates a neoplasm in ___________

A

Skeletal muscle

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44
Q

The prefix lipo indicates a neoplasm in ___________

A

Adipose tissue

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45
Q

The prefix osteo indicates a neoplasm in ___________

A

Bone

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46
Q

The prefix chondro indicates a neoplasm in ___________

47
Q

The prefix squamous indicates a neoplasm in ___________

A

Squamous epithelium

48
Q

The suffix -oma indicates what type of neoplasm?

A

Benign

Except if it is an adenoma of the GI tract

49
Q

The suffix -sarcoma indicates what type of neoplasm?

A

malignant mesenchymal neoplasm in connective tissue or muscle

50
Q

The suffix -carcinoma indicates what type of neoplasm?

A

Malignant epithelial neoplasm

51
Q

What is a lymphoma?

A

A malignant lymphoid tumor

52
Q

What is a melanoma?

A

A malignant melanocytic tumor

53
Q

What are the 4 most common types of malignant neoplasms?

A

Carcinoma, sarcoma, lymphoma, melanoma

54
Q

You’re reading the results of your patient’s colonoscopy and you see “Adenoma”

What are the appropriate next steps?

A

Adenomas of the GI tract are not benign

They must be removed before they can evolve into carcinomas

55
Q

What is the only adenoma that is concerning for malignancy?

A

An adenoma in the GI tract

56
Q

What is the suffix that indicates a benign neoplasm?

A

-oma

(except if in the GI tract)

57
Q

What is the suffix that indicates a malignant mesenchymal neoplasm?

58
Q

What is the suffix that indicates a malignant epithelial neoplasm?

A

-carcinoma

59
Q

What is the word that indicates a malignant lymphoid neoplasm?

60
Q

What is the suffix that indicates a malignant melanocytic neoplasm?

61
Q

What change does female breast tissue undergo in pregnancy?

A

Lobular hyperplasia

62
Q

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?

A

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
Q

What are two pre-neoplastic changes a tissue can undergo?

A

Metaplasia and dysplasia

64
Q

What is the difference between a lipoma and a liposarcoma?

A

A lipoma is a benign neoplasm

A liposarcoma is a malignant neoplasm

65
Q

What is the difference between grading and staging of a tumor?

A

Grading is histologic: How closely does a tumor reflect benign counterparts?

Staging is clinical: How far has the tumor spread?

66
Q

What is TNM classification?

A

T = Tumor (T1-T4)

N = lymph Node (N0-N3)

M = Metastasis (M0-M1)

67
Q

What are 6 cellular responses to injury?

A
  1. Decreased ATP production
  2. Mitochondrial damage
  3. Calcium influx
  4. Accumulation of ROS
  5. Increased membrane permeability
  6. DNA damage
68
Q

What is the key factor in the downstream effects of hypoxia on tissues?

A

Decreased ATP production

69
Q

What triggers formation of the mitochondrial transition pore

A

Damage to the mitochondria

70
Q

What are the possible consequences after formation of the mitochondrial transition pore?

A

Reversal

Necrosis due to decreased ATP production and increased ROS

Apoptosis due to leakage of apoptotic proteins

71
Q

What is the first consequence of hypoxia?

A

Decreased ATP synthesis

72
Q

What are 4 reversible cell injuries?

A
  1. ATP depletion
  2. Inhibition of protein synthesis
  3. Loss of glycogen
  4. Cell swelling (due to subtle failure of membrane function)
73
Q

What are 4 irreversible cell injuries?

A
  1. Mitochondrial swelling
  2. Accumulation of electron-dense inclusions in mitochondria
  3. Nuclear changes
  4. Rupture of membranes (lysosomal, plasma, other organelle)
74
Q

What are some light microscopic signs of irreversible injury?

A

Nuclear shrinkage

Breakdown of membranes

Increased staining (darker pink)

75
Q

What are some (5) electron microscope signs of irreversible cell damage?

A

Swollen mitochondria

Electron-dense deposits in mitochondria

Disrupted plasma membrane

Abnormal deposits of lipids, proteins, glycogen, pigment, calcium

Accumulation of indigestable material

76
Q

Describe the time course of events that happen in resposne to hypoxia

A
  • 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
Q

Does the following scenario apply to Necrosis or Apoptosis?

Always occurs in groups of cells

78
Q

Does the following scenario apply to Necrosis or Apoptosis?

Always pathogenic

79
Q

Does the following scenario apply to Necrosis or Apoptosis?

Can result from physiologic processes

80
Q

Does the following scenario apply to Necrosis or Apoptosis?

DNA is cleaved into nucleosomal subunits

81
Q

Does the following scenario apply to Necrosis or Apoptosis?

Can occur in a single cell

82
Q

Does the following scenario apply to Necrosis or Apoptosis?

Results in inflammation

83
Q

Does the following scenario apply to Necrosis or Apoptosis?

Energy dependent

84
Q

Does the following scenario apply to Necrosis or Apoptosis?

Organelles are fragmented

85
Q

Does the following scenario apply to Necrosis or Apoptosis?

Blebbing in the plasma membrane

86
Q

Does the following scenario apply to Necrosis or Apoptosis?

Can result from stress response

87
Q

Does the following scenario apply to Necrosis or Apoptosis?

Programmed/planned

88
Q
  1. Where does coagulative necrosis occur?
  2. What causes it?
A
  1. Anywhere except the brain
  2. Ishemia or toxicity due to myocardial infarction
89
Q
  1. Where does liquifactive necrosis occur?
  2. What causes it?
A
  1. The brain
  2. Ichemia, infection, injury
90
Q
  1. Where does caseous necrosis occur?
  2. What causes it?
A
  1. Any tissues
  2. Tuberculosis
91
Q
  1. Where does fat necrosis occur?
  2. What causes it?
A
  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
Q
  1. Where does fibrinoid necrosis occur?
  2. What causes it?
A
  1. Blood vessles
  2. Immune reaction/vasculitis
93
Q
  1. Where does gangrenous necrosis occur?
  2. What causes it?
A
  1. Soft tissue and lower limbs
  2. Ischemia and hypoxia

Note: “gangrene” is a clinical, rather than histologic, diagnosis

94
Q

Which type of necrosis is associated with myocardial infarction?

A

Coagulative necrosis

95
Q

Which type of necrosis is associated with brain injury?

A

Liquifactive necrosis

96
Q

Which type of necrosis is associated with tuberculosis infection?

A

Caseous necrosis

97
Q

Which type of necrosis is associated with alcoholism?

A

Fat necrosis

98
Q

Which type of necrosis is associated with injury to pancreatic acinar cells?

A

Fat necrosis

99
Q

Which type of necrosis is associated with an immune reaction in the blood vessels?

A

Fibrinoid necrosis

100
Q

What are some characteristics of coagulative necrosis?

A
  • Absent nuclei (ghosts)
  • Cell outlines remain (enzymes can’t break down dead cells)
101
Q

“absent nuclei with visible cell outlines”
is characteristic of ________ necrosis

A

Coagulative

102
Q

“No visible cell borders, looks like a solid sheet”

​is characteristic of ________ necrosis

A

Liquifactive

(This is a type of coagulative necrosis that only occurs in the brain; caused by cells lysing when they die)

103
Q

“Forms granulomas”

​is characteristic of ________ necrosis

104
Q

“Leakage of lipase, hydrolytic enzymes, saponification that forms chalk consistency (after 2 weeks)”

​is characteristic of ________ necrosis

105
Q

“Bright pinnk, amorphous vessel. Thick bands visible”

​is characteristic of ________ necrosis

106
Q

What are some characteristics of liquifactive necrosis?

A

Occurs in the brain

Liquid

No cell borders visible

Looks like a solid sheet

107
Q

What are some characteristics of caseous necrosis?

A

Forms granulomas (hallmark)

Inflammatory cells are surrounding a central area of necrosis

Resembles dry cheese

May have some coagulative and some liquifactive characteristics

108
Q

What are some characteristics of fat necrosis?

A

Leakage of lipase and hydrolytic enzymes

Injured acinar cells of the pancreas

Saponification w/chalk consistency after 1-2 weeks

109
Q

What are some characterisitcs of fibrinoid necrosis?

A

Bright pink, amorphous blood vessel

Thick bands visible

110
Q

What is karyorrhexis?

A

Fragmentation of the nucleus.

Seen in necrosis

111
Q

What is reperfusion injury?

A

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
Q

What is karyolysis?

A

Dissolution of the nuclus (preceeded by swelling)

Seen in necrosis

113
Q

What is pyknosis?

A

Shrinkage of the nucleus due to chromatin condensation

Preceeded by swelling in necrosis

The DNA is broken apart in an orderly fashion in apoptosis

FDN2 by Minnie (14 decks)

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