Pathology: Cell Injury, Inflammation & Recovery

Question 1

What does the development and progression of a disease depend on?

Answer 1

• Cause, duration and severity
• Cell type, stage of cell cycle, and cell adaptability
• Complex and critical biochemical and molecular changes

Question 2

Hypertrophy

Answer 2

Exercise - enlargement of the muscle

Question 3

Atrophy

Answer 3

Disuse - shrinking of the muscle

Question 4

Hyperplasia

Answer 4

Increased cell numbers

Question 5

Are hypertrophy, atrophy and hyperplasia reversible?

Answer 5

YES

Question 6

How are cells injured?

Answer 6

• Lack of oxygen
• Lack of blood flow (very common)
• Toxic chemicals/drugs
• Heat/cold; immune reaction; trauma
• Depletion of energy (ATP)
• Mitochondrial damage
• Free radical formation
• Build-up of intracellular Ca2+
• Cell signalling pathways

Question 7

Cell death pathways

Answer 7

Necrosis

Apoptosis

Question 8

Necrosis

Answer 8

Associated with acute inflammation

Question 9

Apoptosis

Answer 9

Has LITTLE associated acute inflammation

Question 10

Major issues to patients from cell and tissue injury

Answer 10

Pain 
Nausea 
Fatigue 
Weakness
Lack of mobility 
Lack of confidence 
Muscle wasting 
Cachexia (complete lack of energy - cancer patients)

Question 11

Inflammation

Answer 11

Can be acute or chronic

Aim: to wall off, remover, dilute and start the process of healing

Question 12

Acute inflammation example

Answer 12

Apendicitis

Question 13

Chronic inflammation example

Answer 13

Arthritis

Question 14

General signs of acute inflammation

Answer 14

Heat - local reaction
Redness - blood slows because vessels dilate
Swelling - fluid leak from vessels to dilute the damage
Pain and loss of function - this allows time to heal

Question 15

Systemic signs of acute inflammation

Answer 15

Fever
Increase in Leukocytosis
Acute phase proteins
Acute phase reactions such as sleepiness and hypertension

Question 16

Resolution

Answer 16

Tissue goes back to normal

Question 17

Nature of acute inflammation

Answer 17

Stereotyped, predictable

1. Changes in blood vessels
2. Increased fluid from vessels
3. Increased leucocytes

Question 18

Meningitis

Answer 18

Viral/bacterial infection of the meninges, inflammatory response, oedema. Oedema causes increased pressure. This causes a headache, etc. Inflamed (dilated) meningeal blood vessels become occluded. Hemorrhagic infarction of associated brain occurs

Question 19

Laryngitis

Answer 19

Viral/bacterial infection, inflammatory response, oedema, airway obstruction

Question 20

Factors that influence healing

Answer 20

Nutrition, age, adequate blood supply, disease, hormones

Question 21

Wound healing

Answer 21

• Induction of acute inflammatory response
• Migration and proliferation of normal tissue cells
• Building wound strength

Question 22

Difference between resolution and organisation

Answer 22

R = no scar
O = scarring

Question 23

Granulation tissue consists of:

Answer 23

proliferation of activated macrophages, activated fibroblasts and vessels, collagen and other ECM proteins in area of damage

Question 24

Growth factors involved in granulation tissue

Answer 24

Epidermal growth factor, platelet derived growth factor, fibroblast growth factor

Question 25

Healing by 1st intention

Answer 25

Clean cut

Question 26

Healing by 2nd intention

Answer 26

Large area of destruction

Distortion of scar

Question 27

Fractures and wound healing

Answer 27

• Involves cell death
• Acute and chronic inflammation
• Rebuilding/regeneration/remodelling of bone