LC Cellular Responses to Stress Flashcards
A woman presents with an enlarged thyroid gland that is negatively affecting her swallowing ability. She subsequently underwent a thyroidectomy. The first picture represents normal thyroid tissue. The one below is a representative section of her thyroid. Based on histology, what is the mostly likely mechanism of the morphological changes in her thyroid?
An increase in the size of the cells
A transformation of cell type
An increase in the cellular proteins
An increase in the number of the cells
A decrease in the size of the cells
A decrease in the number of the cells
An increase in the number of the cells
This is a case of thyroid nodular hyperplasia. Hyperplasia is defined as an increase in the number of cells in an organ or tissue in response to a stimulus. In the thyroid, the stimulus is often a sustained elevation of TSH (thyroid stimulating hormone) that drives the increase in the number of cells.
It tends to be bluer. An increased number of cells means an increased number of nuclei.
A two-week old baby is brought in by her concerned parents because he has been experiencing severe projectile vomiting. On physical exam, palpation of the abdomen reveals a mass in the epigastrium. This mass feels like an ‘olive’. The definitive treatment was surgical resection. The first picture is an example of normal muscularis propria. The picture below is from this baby. Based on histology, what is the most likely mechanism of the morphological changes seen here?
An increase in the cellular proteins
An increase in the number of the cells
A decrease in the number of the cells
A decrease in the size of the cells
A transformation of cell type
An increase in the cellular proteins
Hypertrophy is the result of increased production of cellular proteins and increase in the size of the cells, not the number of cells.
(side note this is classic presentation of pyloric stanosis)
It is more pink. Pink is protein in the cytoplasm. This means that there are more proteins and thus there is hypertrophy.
An 86 year-old woman presents with hematuria (blood in the urine). A bladder biopsy was performed to evaluate for abnormal tissues. The first picture is of a normal bladder transitional (urothelium) epithelium. The picture below is from the biopsy. Based on histology, what is the most likely mechanism of the morphological changes seen here?
An increase in the cellular proteins
An increase in the size of the cells
A decrease in the size of the cells
A decrease in the number of the cells
An increase in proliferative capacity of the cells
An increase in proliferative capacity of the cells
Hyperplasia is defined as an increase in the number of cells in an organ or tissue in response to a stimulus.
A 44 year-old quadraplugic man had a biopsy of his muscle. The first picture is of normal muscle tissue. The picture below is from this patient. Based on histology, what is the most likely mechanism of the morphological changes seen here?
An increase in the size of the cells
A decrease in cell size and number
An increase in the cellular proteins
An increase in the number of the cells
A decrease in cell size and number
Atrophy is defined as a reduction in the size of an organ or tissue due to a decrease in cell size and number. Atrophy can be physiologic or pathologic. Here, it is pathologic.
The first picture is a section of the wall of the uterus during pregnancy. The second picture is a section of the wall of the uterus postpartum. Based on histology, what is the most likely mechanism of the morphological changes seen from pregancy to post-partum?
An increase in the size of the cells
A transformation of cell type
An increase in the cellular proteins
An increase in the number of the cells
A decrease in the size of the cells
A decrease in the size of the cells
Atrophy is defined as a reduction in the size of an organ or tissue due to a decrease in cell size and number. Atrophy can be physiologic or pathologic. In this case, it physiologic.
During pregnancy you usually get hypertrophy and hyperplasia. After pregnancy you would get atrophy.
A 76 year-old man underwent resection of his prostate because of urinary obstruction. The first picture is from a normal prostate. The second picture represents this patient’s prostate. The morphological changes seen here are possible because prostate tissue contains …
Terminally differentiated cells
Cells capable of dividing
Non-dividing cells
Cells susceptible to apoptosis
Cells capable of dividing
Hyperplasia is defined as an increase in the number of cells in an organ or tissue in response to a stimulus. Hyperplasia can only take place if the tissue contains cells capable of dividing; thus increasing the number of cells.
A 44 year-old woman with a longstanding history of gastroesophageal reflux presented to a gastroenterologist for an endoscopy. A velvet red mucosa was identified in the distal portion of the esophagus. Biopsy was taken and is seen below. Based on histology, what is the most likely mechanism of the morphological changes seen here?
An increase in the size of the cells
A transformation of cell type
An increase in the cellular proteins
An increase in the number of the cells
A decrease in the size of the cells
A decrease in the number of the cells
A transformation of cell type
Metaplasia is a reversible change in which one differentiated cell type (epithelial or mesenchymal) is replaced by another cell type.
A long-time smoker presents with a chronic coughing. There was a concern for a malignant process. A biopsy was performed to rule out neoplasm. The first picture is from a normal bronchus mucosa. The second picture is from the patient. Which of the following statements is true?
This a reversible physiologic repsonse to adverse environment
The squamous epithelium is irreversibly damaged from the adverse envirnoment
This is a reversible adaptive response to adverse environment
A deficiency to vitamin C can lead to similar change in cell type
This is a reversible adaptive response to adverse environment
In the habitual cigarette smoker, the normal ciliated columnar epithelial cells of the trachea and bronchi are often replaced by stratified squamous epithelial cells. This is a reversible adaptive process.
Select the two cellular adaptations that are more frequently seen together in the same tissue secondary to stress!
Hyperplasia
Hypertrophy
Metaplasia
Atrophy
Hyperplasia
Hypertrophy
Although hyperplasia and hypertrophy are distinct processes, they frequently occur together, and may be triggered by the same external stimulus.
An 86 year-old woman with cervical prolapase underwent a complete hysterectomy. The first picture represents her endocervical canal. The second picture is also from her distal endocervical canal. The finding in the second picture is the result of …
Change in the phenotype of already differentiated cell type
Reprogramming of stem cells from normal tissues
Reprogramming of differentiated cells from normal tissues
Increase in the number of differentiated cells from normal tissues
Reprogramming of stem cells from normal tissues
Metaplasia does not result from a change in the phenotype of an already differentiated cell type; instead it is the result of a reprogramming of stem cells that are known to exist in normal tissues, or of undifferentiated mesenchymal cells present in connective tissue. In a metaplastic change, these precursor cells differentiate along a new pathway. The differentiation of stem cells to a particular lineage is brought about by signals generated by cytokines, growth factors, and extracellular matrix components in the cells’ environment. These external stimuli promote the expression of genes that drive cells toward a specific differentiation pathway.
A 33 year-old man was admitted to the hospital after he presented with fever, weight loss. A 5 cm lung mass was identified by imaging. The first picture below represents normal lung. In the second picture, identify the injured tissue!
No viable tissue is present. No cell nuclei are identified. In the periphery, there are hsitiocytes.
The mass from the patient described from the previous question was associated with tuberculosis. Classify the type of necrosis!
Caseous necrosis
Liquefactive necrosis
Gangrenous necrosis
Fat necrosis
Coagulative necrosis
Fibrinoid necrosis
Caseous necrosis
Caseous necrosis is encountered most often in foci of tuberculous infection. The term “caseous” (cheeselike) is derived from the friable white appearance of the area of necrosis. On microscopic examination, the necrotic area appears as a structureless collection of fragmented or lysed cells and amorphous granular debris enclosed within a distinctive inflammatory border; this appearance is characteristic of a focus of inflammation known as a granuloma.
A 66 year-old man with history of chronic alcohol abuse and chronic pancreatitis was urgently admitted to the ICU because of acute abdominal pain. He was subsequently diagnosed with acute pancreatitis. A pseudocyst was also found in his pancreas. Segment of his pancreas was resected and is seen below. What type of injury is seen below?
Caseous necrosis
Liquefactive necrosis
Gangrenous necrosis
Fat necrosis
Coagulative necrosis
Fibrinoid necrosis
Fat necrosis
Fat necrosis refers to focal areas of fat destruction, typically resulting from release of activated pancreatic lipases into the substance of the pancreas and the peritoneal cavity. This occurs in the calamitous abdominal emergency known as acute pancreatitis.
51 year-old woman with uncontrolled diabetes underwent limb amputation. The hstology slide is from the blackened heel. What type of necrosis is seen here?
Caseous necrosis
Liquefactive necrosis
Gangrenous necrosis
Fat necrosis
Coagulative necrosis
Fibrinoid necrosis
Gangrenous necrosis and Coagulative necrosis
Gangrenous necrosis is not a specific pattern of cell death, but the term is commonly used in clinical practice. It is usually applied to a limb, generally the lower leg, that has lost its blood supply and has undergone necrosis (typically coagulative necrosis) involving multiple tissue planes.
This picture is from a nephrectomy specimen. Identify the injured tissue!
Coagulative necrosis is a form of necrosis in which the architecture of dead tissues is preserved for a span of at least some days. The affected tissues exhibit a firm texture. Presumably, the injury denatures not only structural proteins but also enzymes and so blocks the proteolysis of the dead cells; as a result, eosinophilic, anucleate cells may persist for days or weeks. Ultimately the necrotic cells are removed by phagocytosis of the cellular debris by infiltrating leukocytes and by digestion of the dead cells by the action of lysosomal enzymes of the leukocytes. Ischemia caused by obstruction in a vessel may lead to coagulative necrosis of the supplied tissue in all organs except the brain. A localized area of coagulative necrosis is called an infarct.
This tissue is from an hypoxic tissue from the central nervous system. Which of the followings is true regarding this pattern of necrosis?
The necrotic material is frequently clear and watery
It is more often seen in the limb following ischemia
Characterized by digestion of the dead cells
Leukocytes are rarely associated with this injury
Characterized by digestion of the dead cells
Liquefactive necrosis, in contrast to coagulative necrosis, is characterized by digestion of the dead cells, resulting in transformation of the tissue into a liquid viscous mass. It is seen in focal bacterial or, occasionally, fungal infections, because microbes stimulate the accumulation of leukocytes and the liberation of enzymes from these cells. The necrotic material is frequently creamy yellow because of the presence of dead leukocytes and is called pus. For unknown reasons, hypoxic death of cells within the central nervous system often manifests as liquefactive necrosis.
The cellular components that are most frequently damaged by injurious stimuli include … (choose best answer)
Mitochondria, cell membranes, the machinery of protein synthesis and packaging, and DNA
Mitochondria, nuclear membranes, the machinery of protein synthesis and packaging, and DNA
Mitochondria, cell membranes, the machinery of protein synthesis and packaging, and endoplastic reticulum
Mitochondria, nuclear membranes, the machinery of protein synthesis and packaging, and endoplasmic reticulum
Mitochondria, cell membranes, the machinery of transport and packaging, and DNA
Mitochondria, cell membranes, the machinery of protein synthesis and packaging, and DNA
Which of the following statements best describe the role of calcium in cell injury?
The accumulation of Ca2+ in mitochondria results in decreasing of the mitochondrial permeability transition pore
Increased cytosolic Ca2+ activates a number of enzymes with potentially deleterious effects on cells.
Decreased intracellular Ca2+ levels also result in the induction of apoptosis, by deactivation of caspases and by increasing mitochondrial permeability.
Increased intracellular Ca2+ levels also result in the induction of apoptosis, by deactivation of caspases and by increasing mitochondrial permeability.
Increased cytosolic Ca2+ activates a number of enzymes with potentially deleterious effects on cells.
Early loss of selective membrane permeability, leading ultimately to overt membrane damage, is a consistent feature of most forms of cell injury, except
Apoptosis
Necrosis
Autophagy
Apoptosis
Which of the following processes is not considering a physiologic cell death?
The destruction of cells during embryogenesis
Involution of hormone-dependent tissues upon withdrawal of hormone
Cell loss in proliferating population of immature lymphocytes
Atrophy in parenchymal organs after duct obstruction
Atrophy in parenchymal organs after duct obstruction
Which of the followings represents a morphologic change seen in apoptosis?
Cell swelling with dense cytoplasm
Nuclear and cytoplasmic enlargement
Abundant background leukocytes
Cell shrinkage with dense cytoplasm
Nuclear shrinkage with abundant cytoplasm
Cell shrinkage with dense cytoplasm
Which of the followings best describes the process of autophagy?
Delivery of cytoplasmic materials to the lysosome for degradation
Phagocytosis of injured cells by phagocytes and other inflammatory cells
Reversible process upon removal of insult and introduction of internal stimuli
Delivery of cytoplasmic materials to the lysosome for degradation
