GPHT LEC - Cell Adaptation Flashcards
Normally confined to a fairly narrow range of function and structure by
CELL ADAPTATION
Normally confined to a fairly narrow range of function and structure by:
(3)
Genetic programs of metabolism Differentiation
Specialization
TYPES OF CELLULAR ADAPTATION
5
Atrophy Hypertrophy Hyperplasia Metaplasia Dysplasia
Shrinkage in the size of the cell by loss of cell substance May ultimately lead to cell death
ATROPHY
Atrophy classified as _ due to decreased work load (e.g., decreased size of uterus following child birth, or disease)
physiologic
Atrophy classified as _ primarily due to denervation of muscle, diminished blood supply, nutritional deficiency
pathologic
Cause by increased functional demand or specific hormonal stimulation
hypertrophy
Increase in the size of cells which results in an increase in the size of the organs
hypertrophy
mostly seen in cells that cannot divide, such as skeletal muscle, and cardiac muscle
HYPERTROPHY
Increase in the number of cells in an organ or tissue, leading to increased organ or tissue size
Occurs if the cellular population is capable of synthesizing DNA, permitting mitotic division
hyperplasia
hyperplasia can be classified as __ if Increased local production of growth factor receptors on the responding cells activating transcription factors and leading to cell proliferation
physiologic
hyperplasia can be classified as __ Stimulation of growth factors
Excessive hormonal stimulation
Viral infection (papilloma viruses) May give rise to neoplasms
pathologic
Autoimmune disorder characterized by diffuse goiter, hyperthyroidism, and exophthalmos.
HYPERTHYROIDISM (GRAVES DISEASE)
Immune mechanism: IgG antibodies vs. TSH receptor (agonists), increasing thyroid hormone secretion.
HYPERTHYROIDISM (GRAVES DISEASE)
pathology of HYPERTHYROIDISM (GRAVES DISEASE)
dark red, meaty; tall columnar epithelium with intraluminal papillae.
Proliferation of prostatic glands and stroma resulting in enlargement of the gland with obstruction of urine flow through the bladder outlet.
NODULAR HYPERPLASIA, PROSTATE GLAND
pathogenesis of NODULAR HYPERPLASIA, PROSTATE GLAND
Pathogenesis: unknown; altered normal ratio of testosterone to estrogen that develops in the elderly.
gross manifestation of NODULAR HYPERPLASIA, PROSTATE GLAND
Gross: nodular, enlarged, rubbery
micro manifestation of NODULAR HYPERPLASIA, PROSTATE GLAND
Micro: fibromuscular & glandular hyperplasia
Usually secondary to chronic stimulation by corticotropin
ADRENAL CORTICAL HYPERPLASIA
chronic stimulation by corticotropin due to
2
Primary hypersecretion of corticotropin by pituitary
(Cushing disease)
Ectopic corticotropin production by nonpituitary
tumor
Bilateral diffuse or nodular hyperplasia of
adrenal glands
ADRENAL CORTICAL HYPERPLASIA
clinical manifestations (2) of ADRENAL CORTICAL HYPERPLASIA
Cushing syndrome (obesity, moon facies, osteoporosis, HPN, amenorrhea, virilization) Primary aldosteronism (Conn syndrome)
Primary aldosteronism
conn syndrome
(obesity, moon facies, osteoporosis, HPN, amenorrhea, virilization)
Cushing syndrome
what syndrome: hypersecretion of corticotropin
Cushing syndrome
roliferative lesions of the endometrium usually resulting from hyperestrinism
endometrial hyperplasia
Transformation or replacement of one adult cell type to another adult cell type
Reversible
METAPLASIA
Thought to arise from reprogramming of stem or
undifferentiated cells that are present in adult tissue.
METAPLASIA
most common metaplasia
columnar to squamous
also occurs in mesenchymal tissue (e.g., formation of bone in skeletal muscle).
METAPLASIA
abnormalgrowthanddifferentiation
variations in size and shape of cells
enlargement, irregularity, and hyperchromasia of nuclei
disorderly arrangement of cells within the epithelium
DYSPLASIA
apreneoplasticlesion(astageinthecellular evolution to cancer)
DYSPLASIA
type of cellular adaptation
minor degrees are associated with chronic irritation or inflammation.
DYSPLASIA
most frequently encountered in metaplastic squamous epithelium of the respiratory tract and uterine cervix.
DYSPLASIA
strongly implicated as a precursor of cancer.
DYSPLASIA
Term used when the limits of adaptive response are exceeded, or when the cell is exposed to an injurious agent or stress
The affected cells may recover from the injury (reversible) or may die (irreversible).
CELL INJURY
screening test for cervical cancer
Pap smear
CIN meaning
cervical intraepithelial neoplasia
CIN lower 1/3
CIN 1
CIN lower 2/3
CIN 2
CIN full thickness
CIN 3
ETHANOL in pap smear is for
preserving/preservative
features of reversible cell injury [2]
Cellular swelling and vacuoles formation (Hydropic changes)
Fatty changes
Ultratructural changes of reversible cell injury
blebbing of the plasma membrane, swelling of mitochondria and dilatation of ER
The changes are produced by enzymatic digestion of dead cellular elements, denaturation of proteins and autolysis (by lysosomal enzymes)
what type of cell injury
irreversible/necrosis
cytoplasm of necrotic cell
increased eosinophilia
3 things that happen to the nucleus of a necrotic cell
pyknosis
karyolysis
karyorrhexis
also known as shrinkage (nucleus)
pyknosis
also known as fading(nucleus)
karyolysis
also known as fragmentation (nucleus)
karyorrhexis
intracellular inclusions found in a chronic cell injury (3)
Mallory body
Lewy body
Neurofibrillary tangles
type of cell injury (?)
Non-lethal injury may cause subcellular changes some of which are characteristically seen in certain pathologic conditions.
chronic cell injury
changes that occur in chronic cell injury (2)
- Changes in mitochondria
2. Cytoskeletal changes
Death of cells occurs in two ways:
necrosis
apoptosis
changes produced by enzymatic digestion of dead cellular
elements
what type of cell death
necrosis
what type of cell death
vital process that helps eliminate unwanted cells
an internally programmed series of events effected by
dedicated gene products
apoptosis
Patterns of Necrosis In Tissues or Organs
the outline of the dead cells are maintained and the tissue is
somewhat firm.
- Coagulative necrosis
Patterns of Necrosis In Tissues or Organs
E.g. myocardial infarction
- Coagulative necrosis
Patterns of Necrosis In Tissues or Organs
the dead cells undergo disintegration and affected tissue is
liquified.
E.g. cerebral infarction.
- Liquefactive necrosis
a form of coagulative necrosis (cheese-like).
E.g. tuberculosis lesions.
Caseous necrosis
enzymatic digestion of fat.
E.g. necrosis of fat by pancreatic enzymes.
- Fat necrosis
necrosis (secondary to ischemia) usually with superimposed infection.
E.g. necrosis of distal limbs, usually foot and toes in diabetes.
- Gangrenous necrosis
molecular events in apoptosis (3)
protein cleavage by a group of enzymes (caspases)
protein cross-linking
DNA breakdown
inhibitory gene which regulate apoptosis
bcl-2
stimulatory gene which regulate apoptosis
bax
The final phase of apoptosis?
the removal of dead cell fragments by phagocytosis without inflammatory reactions.
a manifestation of metabolic derangement
accumulation of substances in various amounts
INTRACELLULAR ACCUMULATIONS
3 categories of
INTRACELLULAR ACCUMULATIONS
1. a normal cellular constituent (water, lipids, proteins, carbohydrates) 2. an abnormal substance (mineral, products of infectious agents, products of abnormal synthesis or metabolism) 3. Pigment
pathways of intracellular accumulations
- Production of a normal endogenous substance at a
normal or increased rate, but inadequate rate of
metabolism to remove it. - Genetic or acquired defects in metabolism, packaging,
transport or secretion of a normal or abnormal
endogenous substance. - Lack of enzyme to degrade the substance or inability of transport the substance to other sites.
abnormal accumulations of triglycerides within parenchymal cells
involves the liver, heart, muscles, kidneys
Steatosis (Fatty Change)
causes of steatosis
toxins, protein malnutrition, diabetes mellitus, obesity, anoxia, alcohol abuse
accumulation of cholesterol or cholesterol esters
atherosclerosis
lipid vacuoles fills up the smooth muscle cells and
macrophages of the intimal layer of the aorta and large
arteries giving a foamy appearance (foam cells)
atherosclerosis
accumulation of cholesterol within macrophages
Xanthomas
clusters of foamy cells are deposited in the subepithelial CT
of the skin and tendons, manifested as tumorous masses
Xanthomas
what intracellular accumulation
appear as rounded, eosinophilic droplets, vacuoles or aggregates seen in the cytoplasm
Proteins
causes of protein accumulation (3)
Renal disease (reabsorption droplets in the proximal tubules) Plasma cells actively secreting immunoglobulins (Russel
bodies)
Defects in protein folding
what intracellular accumulation
seen in patients with derangement in glucose or glycogen metabolism
appears as clear vacuoles within the cytoplasm
Glycogen
diseases associated with glycogen accumulation
Diabetes mellitus, glycogen storage diseases
colored substances; may be exogenous or endogenous
what type of intracellular accumulation
pigments
exogenous pigments (4)
carbon, coal dust, tattoo
type of pigment
does not evoke an inflammatory reaction
exogenous
endogenous pigments (3)
lipofuscin
hemosiderin
melanin
Brown, wear and tear, aging pigment
lipofuscin
Golden yellow to brown, Iron excess
hemosiderin
Brown-black
Alkaptonuria, Onchronosis
Melanin
abnormal tissue deposition of calcium salts, iron, magnesium, and other mineral salts
PATHOLOGIC CALCIFICATION
type of pathologic calcification
occurs locally in dying tissues
normal serum calcium level
no abnormality in calcium metabolism
Dystrophic calcification
type of pathologic calcification
deposition of calcium salts in normal tissues
hypercalcemia is present
causes: increased PTH secretion, destruction of bone tissue, vit D-related disorders, renal failure, aluminum intoxication, milk-alkali syndrome, chronic renal dialysis

Metastatic calcification
type of virus that can cause hyperplasia
papilloma virus
classification of physiologic hyperplasia
hormonal
compensatory
endometrial hyperplasia results from
hyperestrinism
causes of endometrial hyperplasia
polycystic ovarian syndrome
estrogen-producing syndrome
obesity
anovulatory cycles
carcinoma constitutes of morphologic and biologic continuum
endometrial hyperplasia
Barrett esophagitis type of cell adaptation
metaplasia
respiratory tract of smokers type of cell adaptation
metaplasia
chronic infection of endocervix type of cell adaptation
metaplasia
Type of cell adaptation
most frequently encountered in metaplastic squamous epithelium of respiratory tract and uterine cervix
dysplasia
hydropic changes in reversible cellular injury
cellular swelling
vacuole formation
Biochemical events seen in the process of cell necrosis (6)
ATP depletion Loss of calcium homeostasis and free cytosolic calcium Free radicals Defective Membrane permeability Mitochondrial damage Cytoskeletal damage
free radicals involved in necrosis
Superoxide anion
Hydroxyl radicals
hydrogen peroxide
necrosis pattern secondary to ischemia
gangrenous necrosis
morphologic changes in apoptosis
shrinkage of cells
condensation of chromatin
formation of apoptotic bodies
phagocytosis of apoptotic bodies by adjacent healthy cells or phagocytes
examples of apoptosis
separation of webbed fingers and toes
development of neural connections
removal of cells from intestinal villa and removal of senescent blood cells
this allows escape of cytochrome-c into the cytosol
abnormal mitochondrial membrane permeability
escape of cytochrom-c causes
caspases activation
what intracellular accumulation
rounded eosinophilic droplets
proteins
what intracellular accumulation
clear vacuoles w/in cytoplasm
glycogen
which intracellular accumulations look similar under the microscope
lipid and glycogen deposits
blackening of the tissues in the lungs
anthracosis
anthracosis is due to what pigment
coal
major storage forms of iron what pigment
hemosiderin
causes of metastatic calcification (major) [4]
increased PTH secretion
renal failure bone resorption
vit-D related disorders
lesser causes of metastatic calcification [3]
aluminum intoxication
milk-alkali syndrome
chronic renal dialysis