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Goljan High Yield Cell Injury EC Flashcards

1
Q

PO2

A

driving force for diffusion of O2 into tissue

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2
Q

SaO2

A

percent heme groups occupied by O2

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3
Q

Cyanosis

A

decreased O2 saturation (SaO2)

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4
Q

O2 content

A

1.34HbSaO2 + PaO2

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5
Q

Oxygen

A

electron acceptor in oxidative pathway

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6
Q

Hypoxia

A

inadequate O2 leads to ATP depletion

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7
Q

Ischemia

A

Decreased blood flow

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8
Q

Respiratory acidosis

A

retention of CO2 always decreases PaO2

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9
Q

Ventilation defect

A

impaired delivery of O2 to alveoli

Intrapulmonary shunting of blood (ie RDS)

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10
Q

Perfusion defect

A

absent blood flow to alveoli

Increased alveolar dead space (ie PE)

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11
Q

Methemoglobin

A

Decreased SaO2
Heme Fe +3
Oxidizing agents (sulfur/nitro drugs) cause
Treat with IV methylene blue

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12
Q

Clinical methemoglobinemia

A

Cyanosis not corrected by O2

Chocolate colored blood

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13
Q

Carbon monoxide

A

Decreased SaO2
Left-Shifted OBC
inhibits cytochrome oxidase

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14
Q

Causes carbon monoxide poisoning

A

Car exhaust
Space heaters
Smoke inhalation

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15
Q

S/S carbon monoxide poisoning

A

Headache (#1 sign)

Cherry red color of skin (masks cyanosis)

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16
Q

Cyanide

A

inhibits cytochrome oxidase

Systemic asphyxiant

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17
Q

Carbon monoxide + cyanide poisoning

A

House fire

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18
Q

Left shifted O2 curve

A

decreased 23-BPG, CO, alkalosis, HbF, methemoglobinemia, hypothermia

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19
Q

Right shifted O2 curve

A

increased 23-BPG, high altitude, acidosis, fever

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20
Q

High altitude

A

respiratory alkalosis enhances glycolysis

Increased synthesis of 23-BPG

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21
Q

Mitochondrial poisons

A

damages membrane and drains off protons

Alcohol and salicylates

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22
Q

Uncoupling agents in mitochondria

A

drain off protons

Dinitrophenol, thermogenin (brown fat)

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23
Q

Complication of mitochondrial poisons/uncoupling agents

A

Hyperthermia

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24
Q

Decreased ATP

A

Impaired Na/K ATPase pump (cellular swelling)

Reversible

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25
Anaerobic glycolysis
ATP synthesis in hypoxia Lactate decreases intracellular pH Denatures proteins
26
Irreversible injury hypoxia
membrane/mitochondrial damage
27
Mitochondrial damage
release cytochrome c which activates apoptosis
28
Irreversible injury hypoxia
Increased cytosolic Ca activates phospholipase, proteases, endonuclease
29
Free radicals MOA
Unpaired electron in outer orbit | Damage cell membranes and DNA
30
What are some some free radicals
Superoxide Hydroxyl Peroxide Acetaminophen
31
Superoxide dismutase
Neutralizes superoxide
32
Glutathione
Neutralizes peroxide and drug free radicals
33
Catalase
Neutralizes peroxide
34
Lipofuscin
Indigestible lipid of lipid peroxidation | Brown pigment increased in atrophy and FR damage
35
Reperfusion injury in heart
Superoxide FRs+Ca
36
Mitochondrial injury
cytochrome C in cytosol initiates apoptosis
37
SER hyperplasia
alcohol barbiturates phenytoin
38
Complications of SER hyperplasia
increased drug metabolism (ie oral contraceptives) | Decreased vit. D
39
Chediak-Higashi
AR Giant lysosomes Membrane protein defect in transferring lysosomal enzymes to phagocytic vacuoles
40
I-cell disease
``` Absent enzyme marker in Golgi apparatus (mannose-6-phosphate) Empty lysosomes (enzymes spilled into blood) ```
41
Rigor mortis
stiff muscles after death due to ATP depletion
42
Fatty change in liver
MCC alcohol (increase in NADH) DHAP-->G3P-->TG Increased VLDL pushes nucleus to side
43
Causes fatty change
Increased synthesis of TG/FAs | Decreased beta-oxidation of FAs/synthesis of apoproteins/release of VLDL
44
Fatty change in kwashiorkor
Decreased synthesis of apoproteins
45
Ferratin
Primary Fe storage protein Soluble in blood Serum level reflects marrow storage of Fe
46
Hemosiderin
Insoluble ferritin degradation product visible with Prussian blue stain
47
Atrophy
Reduction in cell/tissue mass by either loss or cell shrinkage
48
Brain atrophy
Ischemia | Alzheimer's
49
Exocrine gland atrophy in CF
Pancreatic duct obstruction by thick secretions
50
Labile cells
Stem cells (skin, marrow, GI)
51
Stabile cells
in G0 phase (SM, hepatocytes) | Can enter cell cycle (growth factors, hormones stimulate)
52
Permanent cells
Cannot replicate Cardiac/striated muscle Neurons
53
Hypertrophy
Increase in cell size (structural components, DNA)
54
LVH
``` Increased preload (valve regurg) Increased afterload (hypertension, aortic stenosis) ```
55
RVH
Pulmonary hypertension
56
Bladder smooth muscle hypertrophy
Prostate hyperplasia constricts urethra
57
Removal of kidey
Hypertrophy of remaining kidney
58
Hyperplasia
Increase in number of cells
59
Endometrial hyperplasia
Unopposed estrogen (obesity, taking estrogens)
60
RBC hyperplasia
Increased EPO (blood loss, ectopic secretion, high altitude)
61
Prostate hyperplasia
Increased DHT
62
Gynecomastia
Hyperplasia in male breast tissue | Normal in newborn, adolescent, elderly
63
Squamous metaplasia in broncus
smoking
64
Intestinal metaplasia in stomach
Paneth cells, goblet cells | H. pylori chronic atrophic gastritis
65
Squamous metaplasia of the bladder
Schistosoma haematobium infection
66
Barrett's esophagus
glandular metaplasia of distal esophagus due to GERD
67
Dysplasia
Atypical hyperplasia or metaplasia are precursors for cancer
68
Squamous dysplasia in cervix
HPV
69
Squamous dysplasia in broncus
Smoking
70
Necrosis
Death of groups of cells
71
Coagulation necrosis
Preservation of structural outlines (due to increased lactic acid)
72
Infarction
Pale (heart, kidney) Hemorrhagic (lung, small bowel) Dry gangrene
73
Liquefactive necrosis
Brain infarct Bacterial infections Wet gangrene
74
Caseous necrosis
Variant of coagulation necrosis | Granulomas due to TB/systemic fungi
75
Granulomas
``` Activated macrophages (epithelioid cells) join to form multinucleated giant cells Th1 CD4 cells ```
76
Epithelioid cells
Gamma interferon released by CD4 T cells activates macrophages to become
77
Multinucleated giant cells
fusion of epithelioid cells
78
Granulomas
Type IV hypersensitivity
79
Enzymatic fat necrosis
``` Associated with pancreatitis Soap formation (Ca+FAs) aka saponification ```
80
Fibrinoid necrosis
Necrosis of immune reactions (immune vasculitis/endocarditis)
81
Postmortem necrosis
autolysis | no inflammatory reaction
82
Dystrophic calcification
calcification of damaged tissue | Normal serum calcium
83
Metastatic calcification
Calcification of normal tissue | Increased serum calcium or phosphorus
84
Nephrocalcinosis
Metastatic calcification of collecting tubule basement membranes
85
S/S nephrocalcinosis
Polyuria due to nephrogenic diabetes insipidus | Renal failure
86
Apoptosis
gene regulated individual cell death (little to no inflammation)
87
Signals activating apoptosis
Mullerian inhibitory factor Tumor necrosis factor Hormone withdrawal
88
Signal modulators of apoptosis
p53 suppressor gene | BCL-2
89
BCL-2 genes
Anti-apoptosis gene | Prevents cytochrome c from leaving mitochondria
90
Caspases
responsible for enzymatic cell death in apoptosis | Proteases and endonucleases
91
Markers of apoptosis
Eosinophilic cytoplasm | Pyknotic (ink dot) nucleus
92
Apoptosis examples
Loss of Mullerian epithelium in male fetus Thymus involution Killing cancer cells

ZGoljan Pathology (9 decks)

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