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Hpct > LEC2 - CELL INJURY AND CELL DEATH > Flashcards

LEC2 - CELL INJURY AND CELL DEATH Flashcards

1
Q

___ is one of the most crucial events in the
evolution of disease in any tissue or organ

A

Cell death

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2
Q

STRESSORS of normal cell

A

physiologic adaptation
pathologic adaptation

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3
Q

2 reason or causes of cell injury

A

inability to adapt and injurious stimuli

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4
Q

2 types of cell injury

A

mild and transient (reversible)
severe progression (irreversible) causing death

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5
Q

2 types of cell death

A

necrosis or apoptosis

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6
Q

refers to the steady state of the body processses

A

homeostasis

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7
Q

reversible functional and structural
responses to changes in physiologic states (e.g.,
pregnancy) and some pathologic stimuli, during
which new but altered steady states are achieved,
allowing the cell to survive and continue to function

A

Adaptations

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8
Q

f the limits of adaptive responses are exceeded or
if cells are exposed to injurious agents or stress, deprived of essentials nutrients, or become compromised by mutations that affect essential cellular constituents, a sequence of events follows
that is termed

A

cell injury

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9
Q

Cell injury is reversible up to a certain point, but if the stimulus persists or is severe enough from the beginning, the cell suffers irreversible injury and ultimately undergoes ___.

A

cell death

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10
Q

the end result of progressive cell
injury

A

cell death

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11
Q

, is one of the most crucial events in the
evolution of disease in any tissue or organ

A

cell death

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12
Q

cellular response to the altered physiologic stimuli, some non lethal injurious stimuli

A

cellular adaptations

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13
Q

cellular response to increased demand, increased stimulation

A

hyperplasia or hypertrophy

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14
Q

cellular response to decreased nutrients, and decreased stimulation

A

atrophy

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15
Q

cellular response to chronic irritation (physical or chemical)

A

metaplasia

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16
Q

cellular response to reduced oxygen supply, chemical injury, microbial infection

A

cell injury

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17
Q

cellular response to acute and transient

A

acute reversible injury, cellular swelling fatty change

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18
Q

cellular response to progressive ad severe including dna damage

A

irreversible damage leading to death
necrosis or apoptosis

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19
Q

cellular response to metabolic alterations, genetic, or acquired chronic injury

A

intracellular accumulations; calcification

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20
Q

cellular response to cumulative sublethal injury over long life span

A

cellular aging

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21
Q

Interferes with aerobic oxidative respiration

A

Hypoxia or oxygen deficiency

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22
Q

Common cause of cell injury and death

A

Hypoxia or oxygen deficiency

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23
Q

A loss of blood supply in a tissue due to
impeded arterial flow or reduced venous
drainage (infarction or occlusion

A

Hypoxia or oxygen deficiency

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24
Q

Most common cause of hypoxia

A

Ischemia

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25
Q

pathological causes of ischemia

A

Pneumonia, Anemia, carbon monoxide (CO)
poisoning

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26
Q

Agents commonly known as poisons (arsenic,
cyanide, or mercuric salts)

A

Chemical/toxic agents

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27
Q

how chemical or toxic agents cause cellular injury

A

Cause severe damage at the cellular level by
altering membrane permeability

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28
Q

example of Chemical/toxic agents

A

(arsenic, cyanide, or mercuric salts)

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29
Q

Toxic agents encountered in our environment

A

o Air pollutants
o Insecticides
o CO
o Asbestos
o Ethanol (social “stimuli”) – recreational
drug
o Therapeutic drugs

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30
Q

a toxic chemical that is known as the recreational drug

A

o Ethanol (social “stimuli”)

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31
Q

Infectious agents

A
  • Viruses
  • Parasite
  • Bacteria
  • Fungi
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32
Q

Immune reaction can also result in cell and tissue injury

true or false

A

true

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33
Q

Immunologic reaction examples

A

autoimmune
allergic reactions
immunocompromised

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34
Q

Genetic defects example

A

Congenital malformations
Sickle cell anemia
Genetic defects/deficiency of functional proteins

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35
Q

as cause of cell injury - Nutritional imbalances

give the etiology

A

o Protein-calorie insufficiency
o Vitamin deficiencies
o Nutrition causes of morbidity and mortality

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36
Q

Physical agents that causes cell injury

A
  • Trauma
  • Extremes of temperatures (burns and deep cold)
  • Radiation, electric shock
  • Sudden changes in atmospheric pressure
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37
Q

a non modifiable cause of cell injury wherein there’s a degenerative changes

A

aging

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38
Q

it Leads to alteration in replicative and repair abilities of individual cells and tissue

A

aging

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39
Q

a non modifiable factor that Diminished ability to respond to damage and eventually the death of cells and the organism

A

aging

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40
Q

It is useful to describe the structural alterations that occur in damaged cells

A

MORPHOLOGY OF CELL AND TISSUE INJURY

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41
Q

2 morphology that correlates with reversible cell injury

A

CELLULAR SWELLING
FATTY CHANGE

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42
Q

a morphology that correlates with reversible cell injury

is the result of failure of energy-dependent ion pumps in the plasma membrane

A

cellular swelling

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43
Q

morphology that correlates with reversible cell injury

inability to maintain ionic fluid homestasis

A

cellular swelling

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44
Q

morphology that correlates with reversible cell injury

in microscopic examination, it will appear and reveal ___

A

small, clear vacuoles within the cytoplasm

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45
Q

morphology that correlates with reversible cell injury

in cellular swelling, also known as

A

hydropic change or vacuolar degeneration

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46
Q

morphology that correlates with reversible cell injury

imbalance of the retention of fluid

A

cellular swelling

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47
Q

morphology that correlates with reversible cell injury

occurs in hypoxic injury and in various forms of toxic excesses such as chole, salt, sugar or metabolic injury

A

fatty change

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48
Q

morphology that correlates with reversible cell injury

microscopically, fatty change will appear and reveal ___

A

small or large lipid vacuoles in the cytoplasm

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49
Q

morphology that correlates with reversible cell injury

It is principally encountered in cells
participating in fat metabolism
(hepatocytes, myocardial cells)

A

FATTY CHANGE

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50
Q

intracellular changes associated with reversible injury particularly the plasma membrane

A

producing blebs, blunting, distortions of microvilli, and loosening, or intercellular attachments

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51
Q

intracellular changes associated with reversible injury particularly the mitochondrial changes

A

swelling and the appearance of phospholipid-rich amorphous densities

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52
Q

intracellular changes associated with reversible injury particularly the ribosomes

A

dilation of the endoplasmic reticulum detachment of ribosomes and dissociation of polysomes

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53
Q

intracellular changes associated with reversible injury particularly the nuclear

A

with clumping of chromatin (pyknosis)

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54
Q

intracellular changes associated with reversible injury particularly the myelin figure

A

phospholipid masses (cytoplasm)
derived from damaged cellular membranes

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55
Q

factors to consider on how cell respond to injurious stimuli

A

type of injury,
its duration,
and its severity (chronic or acute)

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56
Q

the consequences of injurious stimulus is based on

A

type of cells
status of cell
adaptability of cell
genetic makeup of the injured cell

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57
Q

Cell injury results from ___ and ___

A

functional and biochemical abnormalities

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58
Q

are the free radicals found in the environment which the body can metabolize in low numbers and lower than ATP

A

reactive oxygen species

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59
Q

what will happen if the mitochondria is damaged

A

damaged mitochondria –> less production of ATP –> ROS increase –> cell injury

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60
Q

Disturbance in calcium homeostasis

Associated with __

A

plasma membrane

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61
Q

Damaged plasma membrane will result in ___

A

inability to manage homeostasis due to influx of fluid (ion, sodium, calcium, potassium) leading to alteration of cells

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62
Q

Damaged lysosomal membrane will result in ___

A

leakage of cellular components and cause damage to the tissue/ cell → cell death (necrotic)

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63
Q

Damage to DNA and misfolding of proteins
(degraded lysosome) will result to

A
  • Apoptosis
  • Increased ROS
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64
Q

what are the principal targets and biochemical mechanisms of cell injury

A

mitochondria
calcium homeostasis
damage to cellular plasma and lysosomal membrane
damage to dna and misfolding of proteins

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65
Q

The major causes of ATP depletion are

A

reduced supply of oxygen and nutrients, mitochondrial damage,
and the actions of some toxins

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66
Q

Increased cytosolic Ca2+ activates a number of
enzymes, what are they

A

phospholipases
proteases
endonucleases
adenosine triphosphates (ATPaseS)

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67
Q

an enzyme that can cause membrane damage

A

Phospholipases

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68
Q

an enzyme that Break down both membrane and cytoskeletal proteins

A

Proteases

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69
Q

an enzyme that is Responsible for DNA and chromatin
fragmentation

A

Endonucleases

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70
Q

an enzyme that is very necrotic

A

Endonucleases

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71
Q

the enzyme that Hastening ATP depletion

A

Adenosine triphosphates (ATPaseS)

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72
Q

Increased intracellular Ca2+ levels may also
induce apoptosis, by ___ and by ___

A

direct activation of caspases
and by increasing mitochondrial permeability

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73
Q

describe the cell size if it’s necrosis

A

enlarged (swelling )

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74
Q

describe the cell size if it’s apoptosis

A

reduce /shrinkage

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75
Q

describe the nucleus if it’s necrosis

A

pyknosis–> karyorrhexis–>karyolysis

75
Q

describe the nucleus if it’s apoptosis

A

fragmentation into nucleosome-size fragments

76
Q

describe the plasma membrane if it’s necrosis

A

disrupted

76
Q

describe the plasma membrane if it’s apoptosis

A

intact; altered structure; especially orientation of lipids

77
Q

describe the cellular contents if it’s necrosis

A

enzymatic digestion, may leak out of cell

78
Q

describe the cellular contents if it’s apoptosis

A

intact; may be released in apoptotic bodies

79
Q

describe the adhacent inflamation if it;s necrosis

A

frequent

80
Q

describe the adjacent inflammation if it’s apoptosis

A

no adjacent inflammation

81
Q

describe the pathologic or physiologic role if it’s necrois

A

invariably pathologic (culmination of irreversible cell injury )

82
Q

describe the physiologic or pathologic role

A

often physiologic, means of eliminating unwanted cells; may be pathologic after some forms of cell injury, especially dna damage

83
Q

___is the type of cell death that is associated
with loss of membrane integrity and leakage of cellular content

A

Necrosis

84
Q

Necrosis is associated to which causes

A

loss of membrane integrity
leakage of cellular contents

85
Q

2 morphology of necrosis

A

CYTOPLASMIC CHANGES
nuclear changes

86
Q

morphology of necrosis that is associated with increased eosinophilia

A

cytoplasmic changes

87
Q

morphology of necrosis that is associated with homogenous appearance

A

cytoplasmic changes

88
Q

morphology of necrosis that is associated with myelin figures are more prominent

A

cytoplasmic changes

89
Q

morphology of necrosis that is associated with cytoplasm becomes vacuolated and appears “moth eaten”

A

cytoplasmic changes

90
Q

nuclear changes is presented with 3 nuclear parts

A

karyolysis
pyknosis
karyorrhexis

91
Q

nuclear change wherein The basophilia of the
chromatin may fade secondary
to deoxyribonuclease
(DNAse) activity

A

Karyolysis

92
Q

nuclear change wherein it’s Characterized
by nuclear shrinkage and increased basophilia;
the DNA condenses into a solid shrunken mass

A

Pyknosis

93
Q

Pyknotic nucleus undergoes
fragmentation. In 1 to
2 days, the nucleus
in a dead cell may
completely
disappear

A

Karyorrhexis

94
Q

Fates of Necrotic Cells

A

May be digested by enzymes and disappear
Dead cells may be replaced by myelin figures

95
Q

the dead cell will not disappear and digested by enzymes

if will become __, it’s the remnant that will eventually cause fibrosis and decalcify

A

myelin figures

96
Q

Dead cells may be replaced by myelin figures,
which are either phagocytosed by other cells or further degraded into fatty acids. These fatty acids bind calcium salts, which may result in the dead cells ultimately becoming ___

A

calcified

97
Q

Coagulative Necrosis is closely related to what organ

A

heart and kidney

98
Q

a necrosis wherein the affected tissues exhibit a firm texture

A

Coagulative Necrosis

99
Q

localized area of coagulative necrosis

A

Infarct

100
Q

Nuclear changes in coagulative necrosis

A

Pyknosis
Karyorrhexis
Karyolysis

101
Q

Contrast to coagulative necrosis

A

Liquefactive Necrosis

102
Q

Characterized by digestion of dead cells, resulting
in transformation of the tissue (liquid viscous
mass)

A

Liquefactive Necrosis

103
Q

It shows softening and liquefaction of tissu

A

Liquefactive Necrosis

104
Q

It characteristically results from ischemic injury to the CNS

A

Liquefactive Necrosis

105
Q

Liquefactive Necrosis is closely related to what organ

A

brain

106
Q

characteristic of liquefactive necrosis

A

suppurative infections characterized by formation of pus (creamy yellow) common in ischemic infection in CNS - liquefaction of tissue

107
Q

Seen in focal bacterial, or occasionally, fungal
infections
because microbe stimulate the
accumulation of leukocytes and liberation of
enzymes from these cells

A

Liquefactive Necrosis

108
Q

Hypoxic death of cells within the CNS often
manifests as

A

liquefactive necrosis

109
Q

Refers to focal areas of fat destruction, typically resulting from release of activated PANCREATIC LIPASES into the substance of the pancreas and
peritoneal cavity

A

Fat Necrosis

110
Q

Caused by trauma to tissue with high fat content

A

Fat Necrosis

111
Q

The fatty acids released from the digestion from calcium salts will result to

A

Soap formation (saponification) or dystrophic
calcification

Chalky-white area

112
Q

Caseous Necrosis is closely related to what organ

A

lungs

113
Q

Cheese-like (caseous, white) appearance to the
naked eye

A

Caseous Necrosis

114
Q

caseous necrosis will Appears as an ____ material
on microscopic examination

A

amorphous eosinophilic

115
Q

Structureless collection of fragmented or lysed
cells (granuloma)

A

Caseous Necrosis

116
Q

Caseous necrosis is typical in what condition

A

tuberculosis

117
Q

Gangrenous Necrosis is due to

A

vascular occlusion

118
Q

Gangrenous Necrosis

complicated by bacterial
infection which leads to superimposed
liquefactive necrosis

A

Wet gangrene

119
Q

Gangrenous Necrosis

there is only coagulative
necrosis without liquefactive necrosis

A

dry gangrene

120
Q

Special form of necrosis, visible by light
microscopy

A

Fibrinoid

121
Q

Usually in immune reactions in which
complexes of antigens and antibodies are
deposited in the walls of arteries

A

Fibrinoid

122
Q

The deposited immune complexes, together with
fibrin that has leaked out of vessels

A

Fibrinoid

123
Q

Produce a bright pink and amorphous
appearance on H&E preparations called
fibrinoid (fibrin-like) by pathologists

A

Fibrinoid

124
Q

___is a pathway of cell death in which cells
activate enzymes that degrade the cells’ own
nuclear DNA and nuclear and cytoplasmic
proteins

A

Apoptosis

125
Q

Apoptotic cells break up into fragments, called
___, which contain portions of the cytoplasm and nucleus

A

apoptotic bodies

126
Q

APOPTOSIS

The process was recognized in what year

A

1972

127
Q

Sometimes referred to as “programmed cell
death

A

APOPTOSIS

128
Q

Apoptosis in Physiologic Situations

A

To eliminate cells that are no longer needed
The programmed destruction of cells during
embryogenesis
Elimination of cells that have served their
useful purpose
Elimination of potentially harmful self-reactive
lymphocytes
Cell death induced by cytotoxic T lymphocytes

129
Q

Apoptosis in Pathologic Conditions

A
  • Apoptosis eliminates cells that are genetically
    altered or injured beyond repair
  • DNA damage
  • Accumulation of misfolded proteins
  • Cell injury in certain infections
  • Pathologic atrophy in parenchymal organs
    after duct obstruction
130
Q

2 Mechanism of Apoptosis

A

MITOCHONDRIAL (INTRINSIC) PATHWAY
DEATH RECEPTOR (EXTRINSIC) PATHWAY

131
Q

pathway of apoptosis which is responsible for apoptosis in most physiologic and pathologic situation

A

MITOCHONDRIAL (INTRINSIC) PATHWAY

132
Q

pathway or mechanism of apoptosis wherein it’s responsible for elimination of self-reactive lymphocytes and damage by cytotoxic T lymphocytes (more toxic)

A

DEATH RECEPTOR (EXTRINSIC) PATHWAY

133
Q

An external and internal examination of the body after death

A

AUTOPSY

134
Q

main purpose of AUTOPSY

A

To ascertain the cause of death
which can be natural, homicide, suicide or
accident

135
Q

Clinically what’s the purpose of autopsy

A

→ To confirm diagnosis
→ Discover
→ Academic interest
→ Teaching purpose
→ Research purpose

136
Q

“medico-legal” what’s the purpose of autopsy

A

→ Identify the body
→ Ascertain cause of death
→ Discover COD
→ Determine nature and number of
injuries
→ Determine presence of poisons
→ Expectation of life for insurance purposes
→ Presence of natural disease and its
contribution to death
→ Interpretation of injuries, either criminal, suicidal or accidental

137
Q

Most common manner of
death; body function failure as
a result of age, illness, or
disease

A

NATURAL

138
Q

Unintentional manner of death

A

ACCIDENT

139
Q

Victim intentionally takes his
or her own life; the cause of
death is usually a gunshot,
hanging, or poisoning

A

SUICIDE

140
Q

One individual takes the life of
another intentionally or
through a negligent or
reckless act; up to the court to
determine whether the death
is a murder; in certain
circumstances, a person is
justified in killing someone
else in self-defense

A

HOMICIDE

141
Q

The pathologist is not able to determine the manner of death, even after all internal and external examinations are completed and
toxicological tests are evaluated

A

UNDETERMINED

142
Q

Autopsy Techniques

A

Virchow
Letulle
Gohn
Rokitansky

143
Q

Organ remove one by one from cranial cavity
down to the abdominal organs

A

Virchow

144
Q

For high-risk autopsies or where permission is
limited to one organ

A

Virchow

145
Q

Good for demonstrating physical change in an
individual organ but the relationship between
various organs may be hard to interpret

A

Virchow

146
Q

Best technique for preserving the vascular supply and relationships between organs, and for routine inspection because it is fast and the body can be made available to the undertaker

A

Letulle

147
Q

En masse (organ) removal then subsequently dissected into organ blocks

A

Letulle

148
Q

BY SYSTEM, Thoracic and cervical organs, abdominal organs and the urogenital system are removed in
functionally related blocks preserving anatomical
relationship

A

Gohn

149
Q

techniques usually used in academe

A

Gohn and Letulle

150
Q

In situ dissection combined with en bloc removal

A

Rokitansky

151
Q

Estimation of Time of Death

A

algor - cool
rigor - hard
livor -

152
Q

—postmortem cooling of the body

A

Algor Mortis

153
Q

Temperature generally falls ___ every hour until the body reaches ambient temperature

A

1.5°F

154
Q

Determine body temperature
→ At the crime scene – ____
→ At the crime lab – ___

A

→ At the crime scene – rectally
→ At the crime lab – in the liver

155
Q

In Rigor Mortis

Normal stiffening occurs in ____ hours after death

A

2-3

156
Q

In rigor mortis,

muscle stiffening Complete in ___ hours

A

6-8 hrs

157
Q

rigor mortis

muscle stiffening Persist in ___ hours

A

12-36

158
Q

Rigor Mortis

Begins with what muscle

A

small muscle group (head and neck)

159
Q

rigor mortis or the stiffening of the muscle are Delayed in __, ____, and ____

A

cold, emaciation, extreme obesity

160
Q

Post mortem staining, subcutaneous hypostasis,
cadaveric lividity

A

Livor Mortis

161
Q

Livor Mortis

  • Fixed in ___ hours
  • Completed in ___ hours
A

6-8;

8-12

162
Q

Determines whether body position was change

A

Livor Mortis

163
Q

Putrefaction are hastened in

A

warm environment
air than water
water than buried

164
Q

factors affecting Putrefaction

A

bacteria, moisture, temperature of
environment, medium where body lies

165
Q

The type of biopsy to be performed depends on the _____, ___, ___ of the lesion

A

location, size and clinical impression

166
Q

An ___ biopsy takes out even more
surrounding tissue

A

Incision Biopsy

167
Q

it takes out some of the abnormality, but not all

A

Incision Biopsy

168
Q

The doctor will slice into the lesion and remove
only a portion of it

A

Incision Biopsy

169
Q

If the lesion is found to be cancerous, further
___ may be needed to remove or excise the entire lesion

A

surgery

170
Q

An ____biopsy generally removes the entire area in question

A

excisional

171
Q

Is the simplest, least invasive test and uses the
smallest needle to simply remove cells from the area of abnormality

A

Fine Needle Aspiration

172
Q

fine needle aspiration

This is not always adequate to obtain a diagnosis,
depending on the area to be biopsied

true or false

A

true

173
Q

Considered the primary technique for obtaining
diagnostic full-thickness skin specimens

A

punch biopsy

174
Q

The technique involves the use of a circular blade that is rotated down through the epidermis and dermis, and into the subcutaneous fat, yielding a
3-to-4 mm cylindrical core of tissue sample

A

Punch Biopsy

175
Q

Removes not only cells, but also a small amount of the surrounding tissue

A

Core Needle Biopsy

176
Q

This provides additional information to assist in the examination of the lesion

A

core needle biopsy

177
Q

____ and ____ yields pleural fluid

A

Thoracentesis and Chest Tube Thoracostomy

178
Q

___directly aspirates pleural fluid from
lungs

A

Thoracentesis

179
Q

aspirates pleural fluid through suction bottles

A

CTT / Chest Tube Thoracostomy

180
Q

o A needle is inserted onto the patient’s chest
piercing the lungs
o These needle with tubes is inserted onto the
patient for several hours or days depending on the fluid content of the lungs

A

Chest Tube Thoracostomy

181
Q

The patient is prep for bone marrow procedure
similar to CSF collection

A

Bone Marrow Biopsy

182
Q

Bone Marrow Biopsy

Samples acquired through this procedure is either
received by ____ section or ____ section

A

hematology section of histopathology section

183
Q

Bone Marrow Biopsy

___ are the usual end product of this
procedure

A

Prepared slides

184
Q

Demonstrates the topographic distribution of cell types which can be obtained by ___

A

bone marrow
aspiration

Hpct (18 decks)

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