Lecture 2 Study Guide- Cell injury and Adaptation Flashcards by Abagayle Moody

Q

An increase in the size of an organ without an increase in cell number:

A

hypertrophy

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Q

Enlargement of major salivary glands (due to alcoholism, bulimia, diabetes, pregnancy, anorexia, malnutrition, hypothyroidism, acromegaly):

A

sialodenitis

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Q

Sialodenitis is an example of:

A

hypertrophy

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Q

An increase in size of organ due to an increased number of cells:

A

hyperplasia

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Q

A reduction in the size of cells, tissues, or organs:

A

atrophy

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Q

The death of most or all cells in a tissue or organ due to disease, injury, or failure of blood supply:

A

necrosis

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Q

The replacement of one mature cell type by a “tougher” cell type:

A

metaplasia

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Q

Hypertrophy, hyperplasia, atrophy, and metaplasia are all:

A

adaptive cell responses to non-lethal injury

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Q

The complete absence of an organ:

A

agenesis/aplasia

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Q

Hypodontia & oligodontia are clinical ways to describe:

A

agenesis/aplaisa

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Q

The incomplete development of an organ; never reaches normal size:

A

hypoplasia

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Q

Abnormal formation of an organ (often describes a pre-cancerous condition)

A

dysplasia

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Q

Pure hypertrophy usually occurs only in:

A

skeletal & cardiac muscle

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Q

Two examples of pure hypertrophy include:

A

cardiac muscle due to HTN
masseter muscle due to jaw clenching

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Q

In cells other than the cells of cardiac muscle and skeletal muscle, you are more likely to get a combination of:

A

hypertrophy & hyperplasia

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Q

The following is an example of what type of hyperplasia?

erythroid bone marrow at high altitudes

A

physiologic hyperplasia

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Q

The following is an example of what type of hyperplasia?

cyclic enlargement of endometrium and breast during menstrual cycle

A

physiologic hyperplasia

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Q

The following is an example of what type of hyperplasia?

Regrowth of liver parenchyma after surgical excision

A

physiologic hyperplasia

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Q

The following is an example of what type of hyperplasia?

Epithelial hyperplasia caused by human papilloma virus

A

pathologic hyperplasia

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Q

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

A

physiologic hyperplasia combined with hypertrophy

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Q

The following is an example of what type of hyperplasia?

prostatic glands and smooth muscle in benign prostatic enlargement

A

pathologic hyperplasia combined with hypertrophy

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Q

Enlargement of male breast due to hormonal imbalance or leydig tumor:

A

gynecomastia- (we think pathologic hyperplasia)

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Q

A papilloma is an example of:

A

epithelial hyperplasia

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Q

A pyogenic granuloma is an example of:

A

endothelial hyperplasia

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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?

1. poor oral hygiene 2. diabetes 3. 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)

1. inflammatory hyperplasia 2. drug-induced enlargment 3. leukemic infiltrates 4. amyloid infiltration 5. klippel-trenaunay-weber syndrome 6. juvenile hyaline fibrzomatosis 7. cowden syndrome 8. 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)

1. atrophy of uterus after pregnancy 2. involution of thymus in early adult life

Give an example of pathologic atrophy: (3)

1. atrophy of skeletal muscle following denervation 2. atrophy of brain due to ischemia 3. loss of alveolar bone in edentulous patients

pathologic atrophy may result from: (6)

1. disuse 2. denervation 3. lack of trophic hormones 4. ischemia 5. malnutrition 6. 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:

1. Squamous Metaplasia in smokers 2. Barrett Esophagus 3. 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)

1. treacher-collins syndrome 2. pierre-robin syndrome

Give examples of hypoplasia: (4)

1. treacher-collins syndrome 2. pierre-robin syndrome 3. hypo plastic roots (due to radiation) 4. 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)

1. epithelial dysplasia 2. ectodermal dysplasia 3. fibro-osseous dysplasia 4. fibrous dysplasia 5. regional odontodysplasia 6. 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?

1. Necrosis 2. 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)

1. pyknosis 2. karyoorrhexis 3. 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:

1. coagulation necrosis 2. liquefaction necrosis 3. caseous necrosis 4. 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:

1. physiologic 2. 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

1. programmed destruction of cells during embryogenesis 2. hormone-dependent involution of tissues in adults 3. deletion of potentially harmful self-reactive lymphocytes 4. cell death induced by cytotoxic t-cells (virally-infected or neoplastic) These are all examples of:

physiologic apoptosis

1. If DNA repair mechanisms can't cope with damage, the cell kills itself 2. Cell death in certain viral infections (hepatitis) 3. Pathologic atrophy in organs after obstruction 4. Cell death in tumors These are all examples of:

pathologic apoptosis

Exogenous picotements include:

1. carbon 2. tattooing

Endogenous pigments include:

1. lipofuscin 2. melanin 3. hemosiderin 4. 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