Lecture 2 Study Guide- Cell injury and Adaptation Flashcards
An increase in the size of an organ without an increase in cell number:
hypertrophy
Enlargement of major salivary glands (due to alcoholism, bulimia, diabetes, pregnancy, anorexia, malnutrition, hypothyroidism, acromegaly):
sialodenitis
Sialodenitis is an example of:
hypertrophy
An increase in size of organ due to an increased number of cells:
hyperplasia
A reduction in the size of cells, tissues, or organs:
atrophy
The death of most or all cells in a tissue or organ due to disease, injury, or failure of blood supply:
necrosis
The replacement of one mature cell type by a “tougher” cell type:
metaplasia
Hypertrophy, hyperplasia, atrophy, and metaplasia are all:
adaptive cell responses to non-lethal injury
The complete absence of an organ:
agenesis/aplasia
Hypodontia & oligodontia are clinical ways to describe:
agenesis/aplaisa
The incomplete development of an organ; never reaches normal size:
hypoplasia
Abnormal formation of an organ (often describes a pre-cancerous condition)
dysplasia
Pure hypertrophy usually occurs only in:
skeletal & cardiac muscle
Two examples of pure hypertrophy include:
- cardiac muscle due to HTN
- masseter muscle due to jaw clenching
In cells other than the cells of cardiac muscle and skeletal muscle, you are more likely to get a combination of:
hypertrophy & hyperplasia
The following is an example of what type of hyperplasia?
- erythroid bone marrow at high altitudes
physiologic hyperplasia
The following is an example of what type of hyperplasia?
- cyclic enlargement of endometrium and breast during menstrual cycle
physiologic hyperplasia
The following is an example of what type of hyperplasia?
- Regrowth of liver parenchyma after surgical excision
physiologic hyperplasia
The following is an example of what type of hyperplasia?
- Epithelial hyperplasia caused by human papilloma virus
pathologic hyperplasia
The following is an example of what type of hyperplasia?
- Myometrial smooth muscle cells are increased in number and also size in an enlarged uterus of pregnancy
physiologic hyperplasia combined with hypertrophy
The following is an example of what type of hyperplasia?
- prostatic glands and smooth muscle in benign prostatic enlargement
pathologic hyperplasia combined with hypertrophy
Enlargement of male breast due to hormonal imbalance or leydig tumor:
gynecomastia- (we think pathologic hyperplasia)
A papilloma is an example of:
epithelial hyperplasia
A pyogenic granuloma is an example of:
endothelial hyperplasia
Hyperplasia of vascular processes commonly in gums:
pyogenic granuloma
A fibroma is an example of:
fibrous hyperplasia
mucosal-colored sessile area on tongue; may be caused by repeatedly biting:
fibroma
Ill-fitting dentures irritating the alveolar mucosa:
epulis fissuratum
Epulis Fissuratum is an example of:
fibrous hyperplasia
Ill-fitting dentures irritating the palate can cause:
inflammatory papillary hyperplasia
Inflammatory papillary hyperplasia is an example of:
epithelial & fibrous hyperplasia
Hyperplasia of hard tissue; causes bony protrusions of maxillary alveolar ridge:
exostoses
Reactive condition; hyperplastic bone growth under pontic of bridge:
sub-pontic osseous hyperplasia
Sub-pontic osseous hyperplasia and exostoses are both examples of:
Osseous hyperplasia
Hyperplasia often due to poor oral hygiene and diabetes:
gingival hyperplasia
What is associated with gingival hyperplasia?
- poor oral hygiene
- diabetes
- gingival enlargement (may be drug-induced)
Procardia, Cyclcosporin, Dilantin & calcium channel blockers
What do these drugs have in common?
All may cause gingival enlargement/gingival hyperplasia
List all possible causes of gingival enlargement (hyperplasia) (8)
- inflammatory hyperplasia
- drug-induced enlargment
- leukemic infiltrates
- amyloid infiltration
- klippel-trenaunay-weber syndrome
- juvenile hyaline fibrzomatosis
- cowden syndrome
- wegener granulomatosis
Also known as “strawberry gingivitis”
wegener granulomatosis
Idiopathic unilateral growth of the mandibular condyle:
condylar hyperplasia
With condylar hyperplasia, we often see _____ in which the chin deviates toward the affected side (cross-bite/open-bite)
facial asymmetry
Enlargement of dental follicle:
hyperplastic dental follicle
In the case of a hyperplastic dental follicle, it is recommended:
that tissue be removed
Gynecomastia=
hyperplasia of the male breast
The reduction in the size of cells, tissues, or organs:
atrophy
Atrophy can be classified as either:
physiologic or pathologic
Give an example of physiologic atrophy: (2)
- atrophy of uterus after pregnancy
- involution of thymus in early adult life
Give an example of pathologic atrophy: (3)
- atrophy of skeletal muscle following denervation
- atrophy of brain due to ischemia
- loss of alveolar bone in edentulous patients
pathologic atrophy may result from: (6)
- disuse
- denervation
- lack of trophic hormones
- ischemia
- malnutrition
- idiopathic
Give an example of idiopathic atrophy:
Parry-Romberg Syndrome
Parry-Romberg syndrome is an idiopathic atrophy causing:
progressive hemifacial atrophy
Metaplasia occurs to allow the cells to:
withstand a tougher environment
The replacement of one mature cell type by another one
metaplasia
metaplasia generally represents a change to a ____ type of cell
tougher
Is metaplasia reversible or irreversible?
generally reversible (tissue reverts to its normal state after irritant is removed)
What happens to metaplasia if irritant persists?
Metaplasia may progress to dysplasia and then to frank neoplasia
Give some examples of metaplasia:
- Squamous Metaplasia in smokers
- Barrett Esophagus
- Necrotizing Sialometaplasia
Discuss how metaplasia may occur in smokers and what this may progress to:
replacement of bronchial stratified columnar epithelium (with cilia) by squamous epithelium
squamous metaplasia may progress to squamous carcinoma if irritant is not removed
Discuss Barrett’s Esophagus and what this is caused by and potential progression:
Intestinal metaplasia of the esophagus in which there is replacement of the esophageal squamous tissue by columnar tissue (that is more gastric like); mucosa above the z-line is now the same as below the z-line (Z-line is the separation of esophageal to stomach tissue)
Caused by chronic irritation by gastric juices in acid reflux; adenocarcinoma
Discuss necrotizing sialometaplasia:
Squamous metaplasia of glandular tissue; replacement of the glandular cuboid tissue by squamous tissue
Exclusively in the oral cavity on the palate (quick onset, piece of the palate “falls off”
Describe the specific cell changes that occur in squamous metaplasia of smokers:
bronchial stratified columnar epithelium (with cilia) –> squamous epithelium
Describe the specific cell changes that occur in Barrett’s esophagus:
esophageal squamous tissue —> columnar tissue (gastric-like)
Describe the specific cells changes that occur in necrotizing sialometaplasia:
Glandular cuboidal tissue —> squamous tissue
Hypoplasia of the mandible (retrognathic) is characteristic of what syndromes? (2)
- treacher-collins syndrome
- pierre-robin syndrome
Give examples of hypoplasia: (4)
- treacher-collins syndrome
- pierre-robin syndrome
- hypo plastic roots (due to radiation)
- regional odontodysplasia (hypo plastic teeth)
Condition characterized by hypo plastic teeth:
regional odontodysplasia
The incomplete development of an organ:
hypoplasia
abnormal formation:
dysplasia
Hypoplasia may also be considered:
aplasia
List examples of diseases involving dysplasia: (6)
- epithelial dysplasia
- ectodermal dysplasia
- fibro-osseous dysplasia
- fibrous dysplasia
- regional odontodysplasia
- dentin dysplasia (type 1)
What condition involving dysplasia is being described?
- A pre-malignant condition
- looks like speckled leukoplakia
epithelial dysplasia
What condition involving dysplasia is being described?
- abnormal formation of ectodermally derived structures (i.e., teeth, sweat glands, hair)
- pointy teeth
- NOT pre-cancerous
ectodermal dysplasia
What condition involving dysplasia is being described?
- NOT pre-cancerous
- benign lesion that expands unilaterally
- affecting upper or lower jaw
fibrous dysplasia
What condition involving dysplasia is being described?
- NOT pre-cancerous
- common among black females age 30
fibre-osseous dysplasia
What condition involving dysplasia is being described?
- altered formation of the tissue
- causes hypoplastic teeth
regional odontodysplasia
Give an example of a condition characterized by a reversible change:
fatty change- liver
What are the two types of irreversible changes that cells/tissue may undergo?
- Necrosis
- Apoptosis
What irreversible change can be described as a “messy response”?
Necrosis
What irreversible change can be described as a “clean response”?
Apoptosis
An irreversible change characterized by lysosomes disrupting cells, causing leakage of cellular contents:
Necrosis
Necrosis ultimately involves an:
inflammatory response
Cell response to irreversible damage.. what happens after irreversible damage; end result:
necrosis
An irreversible change characterized by one, individual cell being targeted, attacked, and phagocytized by macrophages:
Apoptosis
Nuclear changes that signal cell death are involved in:
necrosis
What are the nuclear changes that signal cell death in necrosis? (3)
- pyknosis
- karyoorrhexis
- karyolysis
Nuclear change signaling cell death in necrosis characterized by a small, dark and shrunken nucleus:
pyknosis
Nuclear change signaling cell death in necrosis characterized by nuclear fragmentation:
karyorrhexis
Nuclear change signaling cell death in necrosis characterized by dissolution of the nucleus (no fragments):
karyolysis
List the 4 tissue patterns of necrosis:
- coagulation necrosis
- liquefaction necrosis
- caseous necrosis
- fat necrosis
Pattern of necrosis seen in hypoxic injury such as heart attack:
coagulation necrosis
Pattern of necrosis seen in patients with bacterial infections or stroke (cerebral infarction):
liquefaction necrosis
Pattern of necrosis seen in patient seen with tuberculosis (necrotic tissue is converted into a cheesy mass):
caseous necrosis
Describe caseous necrosis:
necrotic tissue is converted into a cheesy mass
Pattern of necrosis seen in acute pancreatitis:
fat necrosis
_____ tells you IF a cell has died; ____ tells you HOW a cell has died
Nuclei; cytoplasm
Programmed cell death occurring through the activation of an internal suicide program:
apoptosis
Enzymes responsible for apoptosis:
caspases
Apoptosis ____ eliminates unwanted cells with:
selective; minimal disturbance to surrounding cells
Discuss the plasma membrane in the event of apoptosis:
plasma membrane remains intact, but structure is altered so that it becomes a target for phagocytosis
What happens to the dead celling the event of apoptosis:
The dead cell is rapidly cleared before its contents have leaked out and therefor does NOT elect an inflammatory response
What irreversible change do cells/tissues undergo that does NOT elicit an inflammatory response?
Apoptosis
What irreversible change do cells/tissues undergo that DOES elicit an inflammatory response?
Necrosis
Apoptosis can be either:
- physiologic
- pathologic
Is an example of physiologic or pathologic apoptosis?
Programmed destruction of cells during embryogenesis
Physiologic
Is an example of physiologic or pathologic apoptosis?
Hormone-dependent involution of tissues in adults (example thymus)
physiologic
Is an example of physiologic or pathologic apoptosis?
If DNA repair mechanisms can’t cope with damage and the cell kills itself:
Pathologic
Is an example of physiologic or pathologic apoptosis?
Deletion of potentially harmful self-reactive lymphocytes
Physiologic
Is an example of physiologic or pathologic apoptosis?
Cell death in certain viral infections (hepatitis)
Pathologic
Is an example of physiologic or pathologic apoptosis?
Pathologic atrophy in organs after obstruction:
pathologic
Is an example of physiologic or pathologic apoptosis?
Cell death in tumors
pathologic
Is an example of physiologic or pathologic apoptosis?
Cell death induced by cytotoxic T-cells (virally-infected or neoplastic)
physiologic
- programmed destruction of cells during embryogenesis
- hormone-dependent involution of tissues in adults
- deletion of potentially harmful self-reactive lymphocytes
- cell death induced by cytotoxic t-cells (virally-infected or neoplastic)
These are all examples of:
physiologic apoptosis
- If DNA repair mechanisms can’t cope with damage, the cell kills itself
- Cell death in certain viral infections (hepatitis)
- Pathologic atrophy in organs after obstruction
- Cell death in tumors
These are all examples of:
pathologic apoptosis
Exogenous picotements include:
- carbon
- tattooing
Endogenous pigments include:
- lipofuscin
- melanin
- hemosiderin
- bilirubin
A result of smoking- respiratory tissues become black in color:
Exogenous pigment- carbon- anthracosis
Intentional on the skin and unintentional on mucosal surfaces due to amalgam:
Exogenous pigment- tattooing
Endogenous pigment considered an aging pigment:
lipfuscin
Endogenous pigment formed by melanocytes:
melanin
Endogenous pigment that is hemoglobin derived (in tissues, not blood)
hemosiderin
Endogenous pigment that is a byproduct of RBC degradation:
bilirubin
Bilirubin is a biproduct of:
RBC degredation
Hemosiderin is derived from:
hemoglobin
The abnormal deposition of calcium salts in tissue:
pathologic calcification
Occurs in nonviable or dying tissues in presence of normal serum calcium levels:
dystrophic calcification
Dystrophic calcification occurs in _____ in the presence of ____ levels
nonviable or dying tissues; normal serum calcium levels
Occurs in viable tissues and is associated with high serum calcium levels (hypercalcemia)
Metastatic calcification
Metastatic calcification occurs in ____ and is associated with ____ levels
viable tissues; high serum calcium