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Pathological Processes > Session 7 > Flashcards

Session 7 Flashcards

1
Q

The size of a cell population depends on the rate of… (3)

A

Cell proliferation
Cell differentiation
Cell death by apoptosis

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2
Q

______________ genes regulate normal cell proliferation

A

Proto-oncogenes

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3
Q

Cell proliferation is controlled by…

A

Chemical signals which either stimulate or inhibit cell proliferation

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4
Q

Chemical signals which stimulate/inhibit cell proliferation bind to a receptor resulting in…

A

Modulation of gene expression

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5
Q

Decide 4 different possible outcomes for cells as a result of chemical signals

A

Survive - resist apoptosis
Divide - enter cell cycle
Differentiate - take on specialised form/function
Die - undergo apoptosis

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6
Q

With regards to the cell cycle, state two things that can result in increased growth

A

Shortening of the cell cycle

Conversion of quiescent cells to proliferating cells (entering them into cell cycle)

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7
Q

Name three checkpoints of the cell cycle

A 
G1 checkpoint
G2 checkpoint
R point (Restriction point)
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8
Q

What does the G1 checkpoint of the cell cycle check?

A

Is cell big enough?
Is environment favourable?
Is DNA damaged?

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9
Q

What does the G2 checkpoint of the cell cycle check?

A

Is cell big enough?

Is all DNA replicated?

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10
Q

In the normal state what happens to cells with damaged DNA that try to replicate?

A

Cannot replicate - attempts to repair damage or cell pushed towards apoptosis

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11
Q

What is the most critical checkpoint of the cell cycle?

A

R point (Restriction point)

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12
Q

What happens as a result of activation of the R point?

A

Delay of the cell cycle and triggering of DNA repair mechanisms/apoptosis via p53

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13
Q

The majority of cells that pass the R point of the cell cycle will…

A

Complete the cell cycle

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14
Q

What is the most commonly altered cell cycle checkpoint in cancer cells?

A

Restriction (R) point

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15
Q

In which phase of the cell cycle is the R point found?

A

Towards the end of G1

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16
Q

Which proteins and enzymes control the cell cycle?

A

Cyclins

Cyclin dependent kinases

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17
Q

How do cyclic dependent kinases (CDKs become active)?

A

Binding with cyclins

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18
Q

How does the activation of CDKs affect the cell cycle?

A

The activated CDKs phosphorylate other molecules allowing the cell cycle to progress. Different cyclins produced at different parts of the cell cycle.

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19
Q

Different cyclins are produced at different parts of the…

A

Cell cycle

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20
Q

Do cells have a limit to how much they can divide?

A

Cells that do not contain telomerase have a limit to how much they can divide

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21
Q

Which cells contain telomerase to maintain telomere length and increase the number of divisions they can undergo?

A

Stem cells

Cancer cells

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22
Q

What is meant by the Hayflick number?

A

The number of times a cell without telomerase can typically divide

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23
Q

What is the average Hayflick number in humans?

A

61.3

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24
Q

What is hyperplasia?

A

Increase in number of cells

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25
What is hypertrophy?
Increase in cell size
26
What is atrophy?
Decrease in cell size
27
What is metaplasia?
Where cells are replaced by cells of a different type
28
Are the vast majority of cellular adaptations, reversible or irreversible?
Reversible
29
Hyperplasia can occur in which sorts of tissues?
Labile | Stable
30
What causes hyperplasia in tissues? (2)
Increased functional demand | Hormonal stimulation
31
Hyperplasia remains under _______________ control ...and is reversible/irreversible?
Physiological Reversible
32
Repeated cell divisions seen in hyperplasia exposes the cell to increased risk of...
Mutations/Neoplasia
33
In what type of tissues is hypertrophy seen?
Labile Stable Permanent (especially)
34
What can cause hypertrophy of cells? (2)
Increased functional demand | Hormonal stimulation
35
Hypertrophied cells contain more...
Structural components
36
In labile and stable tissue, hypertrophy usually occurs along with...
Hyperplasia
37
Give an example of physiological hypertrophy and pathological hypertrophy
Phys - pregnant uterus Path - RV hypertrophy
38
Do athletes get cardiac muscle hypertrophy? How does this compare to someone with hypertension?
Yes, to some extent Not as much, in hypertension the heart doesn't get a chance to rest
39
What is compensatory hypertrophy? In what organ is it commonly seen?
Increase in size of an organ/tissue when called on to do additional work of a destroyed/impaired organ Kidneys
40
What is atrophy?
Decrease in number/size of cells resulting in a decreased tissue size
41
In atrophied cells there is a reduction in...
Cell components
42
Give an example of physiological atrophy
Ovarian atrophy in post menopausal women
43
What causes atrophy of disuse?
Reduced functional demand/workload
44
What causes denervation atrophy? What can this result in?
Loss of innervation Wasting of muscles
45
Which disease is a prime example of atrophy of extracellular matrix?
Osteoporosis
46
What is metaplasia? What causes it?
Reversible change of one differentiated cell type to another Altered stem cell differentiation
47
When can metaplasia take place?
When cells that are sensitive to stress are substituted by cells better able to withstand the stress
48
Metaplasia can be a prelude to...
Dysplasia and cancer
49
Where does no metaplasia take place?
Across germ layers
50
In which sorts of cell types can metaplasia take place?
Labile | Stable
51
Describe an example of metaplasia and its cause
Bronchial pseudostratified ciliated epithelium ---> stratified squamous epithelium Cigarette smoke
52
Describe the metaplasia that can take place in the bronchi/bronchioles due to cigarette smoke
Pseudostratified ciliated epithelium ----> stratified squamous epithelium
53
What is aplasia? What type of disorder is this?
Complete failure of a specific organ or tissue to develop Embryonic disorder
54
As wells as describing the complete failure of an organ/tissue to develop, aplasia can be used to describe an organ whose cells... Give an example
Have ceased to proliferate E.g. Bone marrow in aplastic anaemia
55
What is hypoplasia?
Underdevelopment or incomplete development of a tissue/organ at embryonic stage
56
What is involution? Give an example.
Normal programmed shrinkage of an organ Uterus after childbirth
57
What is reconstitution? It is very rare in humans, give an example.
Replacement of a lost part of the body If a small child (under 4) cleanly cuts the tip off their finger off it may grow back
58
What is atresia? Give an example of where this can take place
Congenital imperforation (closing) of an opening Anus, vagina and small bowel
59
What is dysplasia? It is often...
Abnormal maturation of cells within a tissue Pre-cancerous
60
What is the difference between dysplasia and neoplasia?
Dysplasia - abnormal maturation of cells in a tissue Neoplasia - abnormal growth of a tissue Dysplasia - potentially reversible Neoplasia - irreversible
61
Give 4 general effects of trauma
Bleeding Infection (possible sepsis) Specific organ/system effects Multi-organ failure/dysfunction
62
Name 4 types of intercranial haemorrhage
Extradural Subdural Sub-arachnoid Intracerebral
63
Give two examples of closed brain injuries
Contusions | Diffuse axonal injury
64
Name 4 potential consequenes of head injury
``` Raised intracranial pressure Reduced Glasgow (consciousness) score Specific neurological defects Infection ```
65
How are rib fractures most commonly treated?
With analgesia
66
Rib fractures can result in... (3)
Pulmonary contusions Pneumothorax Haemothorax
67
What is a contusion?
An area of injured tissue where blood capillaries have leaked into - BRUISE
68
What is a pneumothorax? | What is a haemothorax?
Air in the pleural cavity Blood in the pleural cavity
69
What is the most fatal type of aortic injury?
Aortic transection
70
Name 4 types of abdominal injury
Liver laceration Spleen laceration Intestinal perforation Pancreatic injury
71
Fractures of the spine can potentially lead to ______________ problems
Neurological
72
What type of force is required for a pelvic fracture to occur? What is special about this break? What can it lead to?
Lots of force Breaks in two places Heavy bleeding
73
Name 4 potential causes of vascular injury due to trauma
Stab wounds Gun shot wounds Impalement Plate glass accidents
74
State 6 systemic effects of burns
``` Release of cytokines/inflammatory mediators Cardiovascular changes Myocardial contractility decreased Respiratory changes Metabolic changes Immunological changes ```
75
Describe the cardiovascular changes seen in burns
Increased vascular permeability ---> loss of fluid/protein
76
What effect can decreased myocardial contractility as a result of burns have?
Can cause hypotension/hypoperfusion and ischaemia
77
Describe the respiratory changes seen in burns (2)
Direct inhalation of toxic fumes | Adult respiratory distress syndrome
78
Describe the metabolic changes seen in burns
Increased metabolic rate - aggressive enteral feeding required to decrease catabolism
79
Describe the immunological changes seen in burns
Down regulation of the immune response
80
Haemorrhage can result in _______________ shock
Hypovolaemic
81
When can haemorrhage (blood loss) become life-threatening?
When blood loss is over 20%
82
How does haemorrhage affect... I) cardiac output II) perfusion of organs
Impaired (reduced) Reduced
83
What does SIRS stand for? What is SIRS?
Systemic Inflammatory Response Syndrome Where there is a systemic inflammatory response to inflammatory mediators but no specific site of infection to account for it
84
For someone to have SIRS (or sepsis) they must have at least 2 of the following criteria... ``` I) temperature II) heart rate III) respiratory rate IV) pCO2 V)WBCs ```
>38.5, <36 >90 bpm > 20 breaths/min <32 mmHg (low) >12000, <4000
85
Sepsis = SIRS +
Suspected/Confirmed Infection
86
Severe sepsis = sepsis + at least one sign of...
Organ dysfunction
87
Sever sepsis can lead to...
Septic shock
88
What can the mottled skin seen in sepsis be attributed to?
Poor perfusion to the skin
89
Sepsis can result in inappropriate activation of the coagulation system and which condition...
Disseminated Intravascular Coagulopathy
90
Describe the typical capillary refill time in sepsis. Is this higher or lower than normal?
> 3 seconds Higher
91
How can sepsis affect the kidneys? Why?
Can cause acute kidney injury Reduced perfusion to the kidneys
92
In sepsis you may see acidosis, lactate levels above...
2 mmol/L
93
In sepsis what sort of platelet count will you see?
Low platelets - < 100
94
Septic shock = sever sepsis + one of the following conditions... I) mABP II) Lactate
< 60 mmHg after adequate fluid resuscitation High lactate - > 4 mmol/L
95
What drugs are required to maintain blood pressure in septic shock?
Inotropes - e.g. Noradrenaline
96
What does MODS stand for? What is MODS/multi-organ failure usually caused by?
Multi-organ dysfunction syndrome Hypometabolism Immunosuppression
97
Name some consequences/presentation of multi-organ failure/MODS
``` Acute kidney injury ARDS Cardiac dysfunction Encephalopathy GI disturbance Liver dysfunction Coagulopathy Bone marrow suppression ```
98
State two consequences of acute kidney injury due to MODS/failure
Acidosis | Uraemia
99
What does ARDS stand for? What does it result in?
Acute respiratory distress syndrome Impaired gaseous exchange
100
Cardiac dysfunction due to MODS/failure can result in... (2)
Reduced cardiac output | Hypotension
101
What does encephalopathy due to MODS/failure result in?
Reduced conscious level
102
Describe the GI disturbances that may occur in MODS/failure
Ischaemia Perforation Ileus Pancreatitis
103
What happens in ileus due to MODS/failure?
Bowel stops working and fills with fluid
104
What can result from liver dysfunction due to MODS/failure?
Jaundice | Low albumin
105
Give an example of a condition related to coagulation that can result from MODS/failure
DIC - disseminated intravascular coagulopathy
106
Bone marrow suppression as a result of MODS/failure can result in... (2)
Anaemia | Neutropenia
107
Is recovery from MODS/Multi-organ failure possible?
Possible with intensive organ support and treatment of any underlying cause - contributes to many deaths

Pathological Processes (10 decks)

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