Robbins Ch 2 - Cellular Response to Stress and Toxic Insults Flashcards
Define adaptation
reversible changes in size, number, phenotype, metabolic activity, or functions of cells in response to charges in their environment
_ are defined as structural alterations in cells or tissues that are either characteristic of a disease or diagnostic of an etiologic process
morphologic changes
Hypertrophy is a result of _.
Increased in cells due to synthesis and assembly of additional intracellular structural components.
Some cells are able to undergo both hypertrophy and hyperplasia simultaneously, while some can only undergo one or the other. Give an example of types of cell for each.
Cells capable of division may respond to stress by undergoing both hyperplasia and hypertrophy, whereas nondividing cells can only increase tissue mass via hypertrophy like cardiomyocytes.
What are some causes of physiological hypertrophy?
increased functional demand or stimulation by hormones and growth factors. Increased workload.
Give an example of workload induce hypertrophy and a hormone induced hypertrophy.
Workload induced hypertrophy: cardiomyocytes
Hormone induced hypertrophy: uterus during pregnancy
Explain the molecular pathogenesis of cardiac hypertrophy
- integrated actions of mechanical sensors, growth factors (TGF-beta IGF1, FGF), vasoactive agents (a-adrenergic agonists, endothelin-1, angiotensin II). These signals originating in cell membrane activate a complex web is signal transduction pathways (PI3K/AKT pathway) and signaing downstream of G-protein. These signaling pathways activate a set of TF such as GATA4, NFAT, MEF2. these TF work coordinately to increase the synthesis of muscle proteins that are responsible for hypertrophy.
cardiac hypertrophy is associated with switching of it’s contractile proteins to what kind of contractile proteins?
From adult to fetal or neonatal forms. this is cuz the beta isoform of myosin in neonates is more energetically economical.
To prevent the continued hypertrophy of the cardiac myocytes, which of the following can be blocked pharmacologically? A. NFAT B. GATA4 C. MEF2 D. All of the above
D. all of the above.
The hormonally induced changes as seen in the glandular epithelium of the female breast at puberty and during pregnancy results in what adaptive change?
Hyperplasia
The glandular epithelial cells of the breasts and uterus are an example of what kind of adaptation?
hypertrophy
After partial hepatectomy, the liver undergoes what kind of adaptation?
Hyperplasia.
What is the most common causes of pathologic hyperplasia?
1 excessive or inappropriate actions of hormones or growth factors acting on target cells.
The prostate is a common structure that undergoes pathologic _ in responses to hormonal stimulation by androgens.
Hyperplasia
Papillomaviruses have known to cause _ as a characterisitic response to it’s infection.
hyperplasia
Give an example of atrophy of disuse.
when a fractured bone is immobilized in a plaster cast or if a patient is restricted to complete bed rest.
What are some causes of pathologic atrophy?
- Decreased workload
- Loss of innervation
- Diminished blood supply due to atherosclerosis or other other factors
- Inadequate nutrition.
- Loss of endocrine stimulation
- Pressure
Explain how inadequate nutrition can cause pathologic atrophy.
Profound protein-calorie malnutrition (marasmus) is associated with utilization of skeletal muscle proteins as a source of energy after other reserves have been depleted. this results in muscle wasting (cachexia, which is also seen in patients with CI and cancer)
Explain the mechanism of atrophy.
Atrophy results from decreased protein synthesis (due to decreased metabolic activity) and increased protein degradation in cells.
The degradation of cellular proteins as seen in atrophy is mainly by _ pathway.
ubiquitin-proeosome pathway.
Marked increase of autophagic vacuole in a tissue is characteristic of a tissue that is undergoing: A. hypertorphy B. Hyperplasia C. Metaplasia D. Atrophy
D. atrophy
Presence of lipofuscin granules in membrane-bound residual bodies in a tissue is indicative of a tissue that is undergoing: A. hypertrophy B. Hyperplasia C. metaplasia D. Atrophy
D. Atrophy
Explain the metaplasia that is seen in a smoker’s respiratory tract.
Normal ciliated colunar epithelial cells are replaced by stratified squamous epithelial cells.
Explain the metaplasia seen in a patient with chronic GERD
Stratified squamous to simple columnar.
A deficiency of vitamin A can cause what kind of adaptation in the respiraotry tract lining?
Metaplasia. Normal respiratory epithelium is changed to stratified squamous
What kind of metaplasia is seen in myositis ossificans?
Connective tissue metaplasia where the normal tissue is changed to cartilage or bone.
what is the mechanism of metaplasia?
Reprogramming of stem cells that are known to exist in normal tissues, or of undifferentiated mesenchymal cells present in connective tissue.
Explain the hallmark signs of reversible cell injury.
reduced oxidative phosphorylation with resultant depletion of energy stores in the form of ATP, and cellular swelling and caused by changes in ion concentration and water influx.
How does oxygen deprivation cause cell injury?
Hypoxia causes cell injury by reducing aerobic oxidative respiration.
pyknosis leading to karyorrhexis leading to karyolysis is seen in what kind of cell death?
Necrosis
What are characteristics of reversible injury?
- generalized swelling of cell and its organelles
- blebbing of plasma membrane
- detached ribosomes from ER
- clumping of nuclear chromatin
Under the microscope what two characteristics of reversible cell injury are noticeable?
- cellular swelling
2. Fatty acid changes
What is the cause of cellular swelling as seen in reversible cell injury?
cells incapable of maintaining ionic and fluid homeostasis and is the result of failure of energy-dependent ion pumps in the plasma membrane.
In reversible injury, fatty changes with appearance of lipid vacuoles are most prominent in what cell type?
cells that are involved in fat metabolism like hepatocytes and myocardial cells.
Hydropic changes or vacuolar degeneration is characteristic of what kind of cell damage?
nonlethal injury associated with reversible cell injury.
The appearance of increased eosinophilia as seen in necrotic cells is likely due to _.
loss of cytoplasmaic RNA (which binds the blue dye, hematoxylin) and in part denatured cytoplasmic proteins (which bind red dye siosin.
what are myelin figures and where are they commonly found?
In necrotic cells, dead cells may be replaced by large, whorled phospholipid masses referred to as myelin figures that are derived from damaged cell membranes.. they can further degrade into fatty acids; calcification of such fatty acid residues results in calcium soup generation.
Discontinuities in plasma organelle membranes, marked dilation of mitochondria with appearance of large amorphous densities, intracytoplasmic myelin figures, amorphous debris, and aggregates of fluffy material are seen in what kind of tissue damage?
Necrotic cells.
What are some general patterns of tissue necrosis?
- Coagulative necrosis
- Liquefactive necrosis
- Gangrenous necrosis
- Caseous necrosis
- Fat necrosis
- Fibrinoid necrosis
Explain some characteristics of coagulative necrosis and what kind of scenarios you’d most likely see this type of necrosis.
- architecture of dead tissues is preserved for a span of time.
- exhibits firm texture which can be cuz the injury denatured the enzymes needed to proteolysis
- eosinophilic, anucleate cells may persist for days or weeks
- ultimately necrotic cells are removed phagocytes and shows filtration of leukocytes.
Can be seen in localized tissue damaged due to infarct!
Explain characteristics of liquefactive necrosis and where it’s commonly seen.
Characterized by digestion of dead cells, resulting in transformation of the tissue into a liquid viscous masses.
- seen in focal bacterial or fungal infections cuz dmicrobes stimulate accumulation of leukocytes and liberation of enzymes.
- usually creamy yellow cuz of pus
- Usually seen in necrosis of CNS
Explain characteristics of gangrenous necrosis and where its commonly seen
usually applied to limb, generally the lower leg that has lost is blood supply and has undergone necrosis (typically coagulative necrosis) and superimposed by bacterial infection to more liquefactive necrosis. together gives the appearance of wet gangrene.
What are some characteristics of Caseous necrosis and where is it commonly seen?
- often in foci of tuberculous infection
- cheese like
- appears structureless collection of fragmented or lysed cells and amorphous granular debris enclosed within a distinctive inflammatory border;
- focus of inflammation known as granuloma
What are some characteristics of fat necrosis and where is it commonly seen?
- focal areas of fat destruction, typically resulting from activated pancreatic lipases into substance of pancreas and the peritoneal cavity.
- seen as a result of acute pancreatitis where enzymes leak out and liquefy the membranes of fat cells int he peritoneum
- chalky-white areas (fat aponification) is due to split of triglyceride which combine with calcium
What are some characteristics of fibrinoid necrosis and where is it commonly seen?
- usually seen in immune reactions involving blood vessels
- occurs with complexes of Ag-Ab deposits on walls of arteries
- Ab-Ag comlexes along with fibrin that leaked out of vessels results in bright pink and amorphous apperance - fibrinoid
Explain what can happen if necrotic cells are not removed by enzymatic digestion and phagocytosis.
It provide a nidus for deposition of calcium salts and other minerals and thus tend to become calcified. this is known as dystrophic calcification
What are some major causes of ATP depletion?
- reduced supply of oxygen and nutrients,
- mt damage
- action of some toxins (cyanide)
What are some general mechanisms of cell injury?
- Depletion of ATP
- Mitochondrial damage
- Influx of Calcium and loss of calcium hemeostasis
- Accumulation of oxygen-derived free radicals (Oxidative stress)
- Defects in membrane permeability
- Damage to DNA and proteins