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MoD > L17 - Abnormalities of growth, differentiation and morphogenesis > Flashcards

L17 - Abnormalities of growth, differentiation and morphogenesis Flashcards

1
Q

What is a cellular adaptation?

A

Reversible changes in cells due to environment or demand

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2
Q

During cellular adaptation, the cell may make changes in what?

A
  • size
  • number
  • phenotype
  • metabolic activity
  • function
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3
Q

How is cellular adaptation different to cell injury and neoplasia?

A

Cell injury and neoplasia are irreversible whereas cellular adaptation is most often reversible

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4
Q

Why do cells adapt?

A
  • acquire new, steady state of metabolism and structure

- better equips cell to survive in new environment

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5
Q

What may failure of adaptation lead to?

A

Sub-lethal or lethal cell injury

  • marked susceptibility to injury
  • stimulus is too severe
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6
Q

Tissues differ in their susceptibility to stress.

How do cerebral neurones compare to fibroblasts?

A

Cerebral neurones = very sensitive to hypoxia (stress), rapidly die when subject to hypoxic stress

Fibroblasts = very resistant to damage (especially oxygen), can survive for long periods in challenging environments

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7
Q

Give an example of a tissue type that does not need to adapt

A

Fibroblasts

Survive severe metabolic stress without harm eg. absence of O2

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8
Q

Give an example of a tissue type that can adapt easily

A

Epithelial cells

Labile cell population, active stem cell population, highly adaptive in number and function

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9
Q

Give an example of a tissue type that cannot adapt

A

Cerebral neurons

Terminally differentiated, permanent cell population, highly specialised function, easily damaged by environmental change

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10
Q

What is PHYSIOLOGICAL cellular adaptation?

A

Responding to normal changes in physiology or demand

e.g muscles grow during work outs

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11
Q

What is PATHOLOGICAL cellular adaptation?

A

Responding to disease related changes

e.g Broken arm and immobility causing muscles to die off

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12
Q

What are 3 types of adaptive responses?

A
  • increased cellular activity
  • decreased cellular activity
  • changes in cell function and/or morphology
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13
Q

In what ways can a cell adapt to increase cellular activity?

A

Increase size and/or number of cells

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14
Q

In what ways can a cell adapt to decrease cellular activity?

A

Decreased size and/or number of cells

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15
Q

What is hypertrophy?

A

increase in size of cells

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16
Q

what is hyperplasia?

A

increase in number of cells → increased cell mass

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17
Q

Hypertrophy and hyperplasia may co-exist. What do they both lead to?

A

Hypertrophy/hyperplasia = increased cell mass = increased capacity

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18
Q

What 2 things does hypertrophy lead to?

A
  • increased synthesis of structural components

- increased metabolism

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19
Q

In which tissues is hypertrophy particularly seen in?

A

Permanent cell populations, especially cardiac and skeletal muscle

NB: they tend to get bigger in terms of size rather than number

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20
Q

Under what circumstances might a uterus be pathologically hypertrophied?

A

post-partum haemorrhage

Causes uterus to be significantly larger after delivery

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21
Q

Permanent cell populations can only respond to increased demand by doing what?

A

Increasing cell size

hypertrophy

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22
Q

What causes left ventricular hypertrophy?

A
  • atheroma plaque

- calcification of valve cusps leading to inflexibility and narrowing of orifice (hard to push blood through)

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23
Q

How might you diagnose left ventricular hypertrophy?

A
  • clinical examination
  • ECG
  • imaging
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24
Q

Which valve abnormality would lead to left ventricular hypertrophy (LVH)?

A

Aortic stenosis

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25
Q

What can LVH predispose to?

A
  • sudden degeneration of rhythm
  • ventricular tachycardia
  • ventricular fibrillation and sudden cardiac death
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26
Q

What is subcellular hypertrophy and hyperplasia?

A

Increase in size and number of subcellular organelles (demand for more metabolism)

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27
Q

Smooth endoplasmic reticulum hypertrophy ultimately leads to what?

A

Increased metabolism of drugs

due to increase in P450 mixed function oxidases

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28
Q

Smooth endoplasmic reticulum hypertrophy is caused by which drug?

A

Barbiturates

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29
Q

What is hyperplasia?

A

Increase in number of cells caused by cell division

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30
Q

Which cell population types is hyperplasia possible in?

A

Labile and stable cell populations

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31
Q

Give 2 types of physiological hyperplasia

A
  • hormonal

- compensatory

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32
Q

Give 2 types of pathological hyperplasia

A
  • excess hormones

- growth factors

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33
Q

What is gynaecomastia?

A

Enlargement of the male breast due to hyperplasia of the glandular and stromal tissue in the breast

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34
Q

What may gynaecomastia be caused by?

A
  • physioloigcal at puberty
  • drugs (anabolic steroids, excess oestrogen)
  • pathology eg. cirrhosis of liver
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35
Q

Why might you get hyperplasia of one kidney?

A

Due to hypoplasia of the other

36
Q

What are the characteristic eye signs called in Grave’s disease and what is this caused by?

A

Exophthalmos

Caused by abnormal deposition of ground substance in orbital tissues

37
Q

What feature do you get in adenomyomatous hyperplasia of the prostate?

A

Hyperplastic nodules

normal age-related change

38
Q

The abnormal healing process in a cirrhotic liver leads to the formation of what?

A

Hyperplastic nodules of hepatocytes

39
Q

What is atrophy?

A

Reduction in size of organ or tissue by decrease in cell size and number

40
Q

Give 2 examples of physiological atrophy?

A
  • embryogenesis

- uterus after pregnancy or menopause

41
Q

Pathological atrophy can be classified into which 2 categories?

A
  • localised

- generalised

42
Q

Which factors cause pathological atrophy?

A
  • decreased workload
  • loss of innervation
  • diminished blood supply
  • inadequate nutrition
  • loss of endocrine stimulation
  • pressure
43
Q

What is disuse atrophy?

A

atrophy caused by decreased workload

44
Q

What is denervation atrophy?

A

atrophy caused by loss of innervation

45
Q

Give an example of atrophy caused by inadequate nutrition

A

Cachexia

46
Q

Give an example of a situation which may cause disuse atrophy

A

Leg in cast/broken limb

47
Q

Give an example of an organ which may atrophy due to loss of endocrine stimulation

A

Uterus

48
Q

Ageing and cerebrovascular disease has what effect on the brain?

A

Global atrophy

49
Q

Give 2 examples of how atrophy of the kidneys may be caused

A
  • renal artery stenosis (decreased blood supply)

- hydronephrosis (back pressure, from ureteric obstruction)

50
Q

What is hydronephrosis?

A

A condition where the kidney becomes stretched or swollen as a result of a build up of urine inside them (eg. due to ureteric obstruction)

51
Q

Which organ atrophies with age and is barely recognisable microscopically in the adult?

A

Thymus

physiological atrophy

52
Q

What can pathologically cause atrophy of the adrenal cortex?

A

Steroid therapy - reduce the ACTH drive causing decrease in hormonal stimulation

53
Q

What may patients be at risk of if long term steroids are stopped suddenly?

A

Addisonian crisis due to hypoadrenalism

Addisionian crisis = extremely low levels of cortisol (cortisol = important hormone produced by adrenal glands)

54
Q

What are 2 mechanisms of atrophy?

A
  • reduction in volume of individual cells

- death of individual cells (apoptosis)

55
Q

What is involution?

A

Physiological atrophy caused by apoptosis

56
Q

Reduction in volume of individual cells leads to formation of residual bodies. What can accumulation of residual bodies in cells be seen as?

A

Lipofuscin pigment

57
Q

What does reduction in volume of individual cells lead to the formation of?

A

Residual bodies

58
Q

Not all reduced cell mass is due to atrophy. What else can it be related to?

A

Developmental abnormalities

59
Q

Give some conditions in the steps of development from embryonic cell mass to normal organ, which may cause reduced cell mass

A
  • agenesis
  • aplasia
  • dysgenesis
  • hypoplasia
60
Q

What is metaplasia?

A

Transformation of one differentiated cell type into another

better adaption to new environment

61
Q

Which tissues can metaplasia affect?

A

Epithelium and mesenchymal tissues

62
Q

What pathological metaplasia does cigarette smoke cause?

A

Pseudostratified ciliated bronchial epithelium CHANGES TO squamous epithelium

63
Q

What pathological metaplasia does bladder calculus/schistomosiasis/longstanding catheter cause?

A

Transitional epithelium of bladder CHANGES TO squamous epithelium

64
Q

What pathological metaplasia does chronic trauma cause?

A

Fibrocollagenous tissue CHANGES TO bone

65
Q

What pathological metaplasia does acid reflux cause?

A

Oesophageal squamous epithelium CHANGES TO columnar (glandular) epithelium

66
Q

Why does smoking cause squamous metaplasia?

A

Squamous epithelium is better able to cope with noxious environment - squamous cell carcinomas

67
Q

How are all these different types of adaptations linked to neoplasia?

A

Metaplasia/hyperplasia etc may form the basis on which neoplasia develops

68
Q

Squamous metaplasia in cervix may lead to which neoplasia?

A

CIN and squamous cell carcinoma

69
Q

Endometrial hyperplasia due to increased oestrogen may lead to which neoplasia?

A

Adenocarcinoma

70
Q

Parathyroid hyperplasia due to chronic renal failure may lead to which neoplasia?

A

Adenoma

71
Q

Squamous metaplasia in bronchus may lead to which neoplasia?

A

Dysplasia and squamous cell carcinoma

72
Q

Squamous metaplasia in bladder may lead to which neoplasia?

A

Squamous cell carcinoma

73
Q

Glandular metaplasia in oesophagus may lead to which neoplasia?

A

Adenocarcinoma

74
Q

Which is dysplasia?

A

Earliest morphological manifestation of multistage process of neoplasia (hence irreversible)

75
Q

Is dysplasia reversible or irreversible?

A

Irreversible

76
Q

Dysplasia in an in-situ disease. What does this mean?

A

It is non-invasive. The abnormal cells have not yet acquired the capacity for invasion so they cannot spread

77
Q

Carcinoma in-situ is another term for what?

A

Severe dysplasia

78
Q

Dysplasia shows no invasion but does show what?

A

Cytological features of malignancy

79
Q

The prostate enlarges with age with what process?

A

Adenomyomatous hyperplasia

80
Q

how can enlargement of the prostate lead to the bladder having a trabeculated appearance?

A
  • a degree of bladder outlet obstruction

- detrusor muscle of bladder has to work harder = hyperplasia = trabeculated appearance.

81
Q

What might be the adverse consequences of having a bladder diverticulum?

A
  • urinary tract infections
  • bladder stones
  • urine flowing backwards - into the kidneys (“reflux”)
  • bladder tumors
  • trouble urinating (the bladder doesn’t contract or empty well)
82
Q

what are the 2 mechanisms of atrophy?

A
  • reduction in volume of individual cells

- death of individual cells

83
Q

what is aplasia?

A

failure of differentiation to organ-specific tissues

84
Q

what is dysgenesis?

A

failure of structural organization of tissues into organ

85
Q

what is hypoplasia?

A

failure of growth of organ to full size

MoD (19 decks)

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