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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
Q

What is hypertrophy?

A

Increase in cell size

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26
Q

What is atrophy?

A

Decrease in cell size

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27
Q

What is metaplasia?

A

Where cells are replaced by cells of a different type

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28
Q

Are the vast majority of cellular adaptations, reversible or irreversible?

A

Reversible

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29
Q

Hyperplasia can occur in which sorts of tissues?

A

Labile

Stable

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30
Q

What causes hyperplasia in tissues? (2)

A

Increased functional demand

Hormonal stimulation

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31
Q

Hyperplasia remains under _______________ control

…and is reversible/irreversible?

A

Physiological

Reversible

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32
Q

Repeated cell divisions seen in hyperplasia exposes the cell to increased risk of…

A

Mutations/Neoplasia

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33
Q

In what type of tissues is hypertrophy seen?

A

Labile
Stable
Permanent (especially)

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34
Q

What can cause hypertrophy of cells? (2)

A

Increased functional demand

Hormonal stimulation

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35
Q

Hypertrophied cells contain more…

A

Structural components

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36
Q

In labile and stable tissue, hypertrophy usually occurs along with…

A

Hyperplasia

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37
Q

Give an example of physiological hypertrophy and pathological hypertrophy

A

Phys - pregnant uterus

Path - RV hypertrophy

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38
Q

Do athletes get cardiac muscle hypertrophy? How does this compare to someone with hypertension?

A

Yes, to some extent

Not as much, in hypertension the heart doesn’t get a chance to rest

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39
Q

What is compensatory hypertrophy? In what organ is it commonly seen?

A

Increase in size of an organ/tissue when called on to do additional work of a destroyed/impaired organ

Kidneys

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40
Q

What is atrophy?

A

Decrease in number/size of cells resulting in a decreased tissue size

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41
Q

In atrophied cells there is a reduction in…

A

Cell components

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42
Q

Give an example of physiological atrophy

A

Ovarian atrophy in post menopausal women

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43
Q

What causes atrophy of disuse?

A

Reduced functional demand/workload

44
Q

What causes denervation atrophy? What can this result in?

A

Loss of innervation

Wasting of muscles

45
Q

Which disease is a prime example of atrophy of extracellular matrix?

A

Osteoporosis

46
Q

What is metaplasia? What causes it?

A

Reversible change of one differentiated cell type to another

Altered stem cell differentiation

47
Q

When can metaplasia take place?

A

When cells that are sensitive to stress are substituted by cells better able to withstand the stress

48
Q

Metaplasia can be a prelude to…

A

Dysplasia and cancer

49
Q

Where does no metaplasia take place?

A

Across germ layers

50
Q

In which sorts of cell types can metaplasia take place?

A

Labile

Stable

51
Q

Describe an example of metaplasia and its cause

A

Bronchial pseudostratified ciliated epithelium —> stratified squamous epithelium

Cigarette smoke

52
Q

Describe the metaplasia that can take place in the bronchi/bronchioles due to cigarette smoke

A

Pseudostratified ciliated epithelium —-> stratified squamous epithelium

53
Q

What is aplasia? What type of disorder is this?

A

Complete failure of a specific organ or tissue to develop

Embryonic disorder

54
Q

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

A

Have ceased to proliferate

E.g. Bone marrow in aplastic anaemia

55
Q

What is hypoplasia?

A

Underdevelopment or incomplete development of a tissue/organ at embryonic stage

56
Q

What is involution? Give an example.

A

Normal programmed shrinkage of an organ

Uterus after childbirth

57
Q

What is reconstitution? It is very rare in humans, give an example.

A

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
Q

What is atresia? Give an example of where this can take place

A

Congenital imperforation (closing) of an opening

Anus, vagina and small bowel

59
Q

What is dysplasia? It is often…

A

Abnormal maturation of cells within a tissue

Pre-cancerous

60
Q

What is the difference between dysplasia and neoplasia?

A

Dysplasia - abnormal maturation of cells in a tissue
Neoplasia - abnormal growth of a tissue

Dysplasia - potentially reversible
Neoplasia - irreversible

61
Q

Give 4 general effects of trauma

A

Bleeding
Infection (possible sepsis)
Specific organ/system effects
Multi-organ failure/dysfunction

62
Q

Name 4 types of intercranial haemorrhage

A

Extradural
Subdural
Sub-arachnoid
Intracerebral

63
Q

Give two examples of closed brain injuries

A

Contusions

Diffuse axonal injury

64
Q

Name 4 potential consequenes of head injury

A 
Raised intracranial pressure 
Reduced Glasgow (consciousness) score
Specific neurological defects
Infection
65
Q

How are rib fractures most commonly treated?

A

With analgesia

66
Q

Rib fractures can result in… (3)

A

Pulmonary contusions
Pneumothorax
Haemothorax

67
Q

What is a contusion?

A

An area of injured tissue where blood capillaries have leaked into - BRUISE

68
Q

What is a pneumothorax?

What is a haemothorax?

A

Air in the pleural cavity

Blood in the pleural cavity

69
Q

What is the most fatal type of aortic injury?

A

Aortic transection

70
Q

Name 4 types of abdominal injury

A

Liver laceration
Spleen laceration
Intestinal perforation
Pancreatic injury

71
Q

Fractures of the spine can potentially lead to ______________ problems

A

Neurological

72
Q

What type of force is required for a pelvic fracture to occur? What is special about this break? What can it lead to?

A

Lots of force

Breaks in two places

Heavy bleeding

73
Q

Name 4 potential causes of vascular injury due to trauma

A

Stab wounds
Gun shot wounds
Impalement
Plate glass accidents

74
Q

State 6 systemic effects of burns

A 
Release of cytokines/inflammatory mediators 
Cardiovascular changes 
Myocardial contractility decreased 
Respiratory changes
Metabolic changes
Immunological changes
75
Q

Describe the cardiovascular changes seen in burns

A

Increased vascular permeability —> loss of fluid/protein

76
Q

What effect can decreased myocardial contractility as a result of burns have?

A

Can cause hypotension/hypoperfusion and ischaemia

77
Q

Describe the respiratory changes seen in burns (2)

A

Direct inhalation of toxic fumes

Adult respiratory distress syndrome

78
Q

Describe the metabolic changes seen in burns

A

Increased metabolic rate - aggressive enteral feeding required to decrease catabolism

79
Q

Describe the immunological changes seen in burns

A

Down regulation of the immune response

80
Q

Haemorrhage can result in _______________ shock

A

Hypovolaemic

81
Q

When can haemorrhage (blood loss) become life-threatening?

A

When blood loss is over 20%

82
Q

How does haemorrhage affect…

I) cardiac output
II) perfusion of organs

A

Impaired (reduced)

Reduced

83
Q

What does SIRS stand for? What is SIRS?

A

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
Q

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
A

> 38.5, <36

> 90 bpm

> 20 breaths/min

<32 mmHg (low)

> 12000, <4000

85
Q

Sepsis = SIRS +

A

Suspected/Confirmed Infection

86
Q

Severe sepsis = sepsis + at least one sign of…

A

Organ dysfunction

87
Q

Sever sepsis can lead to…

A

Septic shock

88
Q

What can the mottled skin seen in sepsis be attributed to?

A

Poor perfusion to the skin

89
Q

Sepsis can result in inappropriate activation of the coagulation system and which condition…

A

Disseminated Intravascular Coagulopathy

90
Q

Describe the typical capillary refill time in sepsis. Is this higher or lower than normal?

A

> 3 seconds

Higher

91
Q

How can sepsis affect the kidneys? Why?

A

Can cause acute kidney injury

Reduced perfusion to the kidneys

92
Q

In sepsis you may see acidosis, lactate levels above…

A

2 mmol/L

93
Q

In sepsis what sort of platelet count will you see?

A

Low platelets - < 100

94
Q

Septic shock = sever sepsis + one of the following conditions…

I) mABP
II) Lactate

A

< 60 mmHg after adequate fluid resuscitation

High lactate - > 4 mmol/L

95
Q

What drugs are required to maintain blood pressure in septic shock?

A

Inotropes - e.g. Noradrenaline

96
Q

What does MODS stand for? What is MODS/multi-organ failure usually caused by?

A

Multi-organ dysfunction syndrome

Hypometabolism
Immunosuppression

97
Q

Name some consequences/presentation of multi-organ failure/MODS

A 
Acute kidney injury 
ARDS
Cardiac dysfunction 
Encephalopathy 
GI disturbance 
Liver dysfunction 
Coagulopathy 
Bone marrow suppression
98
Q

State two consequences of acute kidney injury due to MODS/failure

A

Acidosis

Uraemia

99
Q

What does ARDS stand for? What does it result in?

A

Acute respiratory distress syndrome

Impaired gaseous exchange

100
Q

Cardiac dysfunction due to MODS/failure can result in… (2)

A

Reduced cardiac output

Hypotension

101
Q

What does encephalopathy due to MODS/failure result in?

A

Reduced conscious level

102
Q

Describe the GI disturbances that may occur in MODS/failure

A

Ischaemia
Perforation
Ileus
Pancreatitis

103
Q

What happens in ileus due to MODS/failure?

A

Bowel stops working and fills with fluid

104
Q

What can result from liver dysfunction due to MODS/failure?

A

Jaundice

Low albumin

105
Q

Give an example of a condition related to coagulation that can result from MODS/failure

A

DIC - disseminated intravascular coagulopathy

106
Q

Bone marrow suppression as a result of MODS/failure can result in… (2)

A

Anaemia

Neutropenia

107
Q

Is recovery from MODS/Multi-organ failure possible?

A

Possible with intensive organ support and treatment of any underlying cause - contributes to many deaths

Pathological Processes (10 decks)

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