PATH:Reversible Cell Injury and Cellular Adaptation Flashcards

1
Q

What is the difference between ischemia and hypoxia? What is an example of a case when hypoxia can exist without ischemia?

A

Ischemia refers to a lack of blood flow, while hypoxia refers to a lack of oxygen; CO poisoning would induce hypoxia but not ischemia

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2
Q

How can a lack of oxygen lead to ATP depletion?

A

The majority of ATP in a cell is made through oxidative phosphorylation- without oxygen, this process cannot occur. Though ATP can still be generated through the glycolytic pathway, it is not enough

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3
Q

How do reactive oxygen species cause cellular damage?

A

By causing damage to proteins, lipids, DNA

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4
Q

How do defects in membrane integrity cause cell injury?

A

Decreased membranal integrity leads to increased permeability and a decreased ability of the cell to maintain ion concentrations and homeostasis

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5
Q

How does increased intracellular [Ca++] cause cellular damage?

A

Activation of cellular enzymes including lipases that can break down cellular constituents and organelles, resulting in membranous damage, nuclear damage and ATP depletion

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6
Q

What two organelles serve as major calcium stores?

A

Mitochondria and sER

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7
Q

What is the Mitochondrial Permeability Transition Pore?

A

Pores that are generated on the internal mitochondrial membrane in response to damage, which interrupts oxidative phosphorylation

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8
Q

What component of the inner mitochondrial membrane, if released into the cytoplasm, is a potent pro-apoptotic stimulus?

A

Cytochrome c

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9
Q

How can mitochondrial damage lead to either apoptosis or necrosis?

A

Cytochrome c and other pro-apoptotic proteins released from the mitochondria can initiate the apoptotic pathway; severe ATP depletion can cause necrosis

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10
Q

Is ischemia/hypoxia a source of reversible or irreversible cell damage?

A

It is reversible if reversed in time, however, prolonged ischemic/hypoxic injury will lead to irreversible damage

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11
Q

What are the reversible changes that are induced by acute ischemia/hypoxia?

A

Decreased membrane transporter activity secondary to decreased ATP, which results in influx of Na+ and H2O and cellular swelling; Decreased oxidative phosphorylation stimulates an increase in glycolytic pathway activity, lactic acid accumulation, and decreased pH which can alter enzymatic activity, protein structure, chromatin clumping; Decreased protein synthetic function (detachment of ribosomes from rER); Altered cytoskeletal elements (loss of micovilli, blebbing); Functional aspects of differentiated cells may cease

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12
Q

What is hyperplasia?

A

An increase in number of cells in an organ

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13
Q

What is hypertrophy?

A

An increase in the size of a cell

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14
Q

What are three examples of physiologic hyperplasia?

A

1) Hormonal (estrogen) stimulation of endometrium during menses 2) Increased size and # of glands and smooth muscle cells of pregnancy-associated organs 3) Removal of 1/2 of the liver–> rapid cell division and differentiation

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15
Q

What are two examples of physiologic hypertrophy?

A

1) exercise results in increased size of skeletal muscle cells 2) remove a kidney and the contralateral kidney shows increased size of glomeruli and tubules (compensatory hypertrophy)

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16
Q

What pathologic cellular adaptation occurs in the heart in response to extra demand, usually due to hypertension or valvular heart disease?

A

Pathologic hypertrophy

17
Q

What are 2 examples of pathologic hyperplasia?

A

Endometrial hyperplasia, chronic renal failure–> parathyroid hyperplasia

18
Q

What are the major mechanisms of hyperplasia and hypertrophy?

A

Hormone or growth factor over-stimulation, and increased functional demand

19
Q

What is atrophy?

A

Decrease in cell size and volume; decrease in cell number; decreased size/weight of an organ

20
Q

What is physiologic atrophy

A

A decrease in size of embryologically formed structures primarily through apoptosis

21
Q

What are three types of pathologic atrophy?

A

Disuse atrophy- secondary to decrease in workload; Denervation atrophy- cutting nerves to skeletal muscles ; Ischemic atrophy- gradual reduction in blood supply over time

22
Q

What are the mechanisms that result in atrophy?

A

Down-regulation of protein synthesis, increased proteolysis via proteasome, and autophagy

23
Q

What is metaplasia?

A

A change in differentiation of cells forming tissue not normally present in that anatomic site

24
Q

What is squamous metaplasia and what is a common example of this?

A

Transformation of different epithelium into “tough” stratified squamous epithelium; Barret’s esophagus or cigarette smoke irritation

25
Q

What is the mechanism of metaplasia?

A

Reprogramming of stem cells brought about by growth factors or cytokines