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EMS > Theme 2 - Genetic and environmental cause of disease: Part 3 > Flashcards

Theme 2 - Genetic and environmental cause of disease: Part 3 Flashcards

1
Q

What is a myocyte?

A

muscle cell of heart

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2
Q

If there are pale areas on the heart, what does this mean?

A

pale areas are where there is irreversible cell injury and cell death

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3
Q

What are 5 cellular adaptions to cell injury?

A
  • hypertrophy- getting larger
  • atrophy - shrinking
  • necrosis - severe cell swelling and rupture
  • apoptosis - internally controlled cell death
  • oncosis - pre lethal changes preceding cell death
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4
Q

What are the causes of cell injury?

A 
hypoxia
temperature, trauma, radiation
chemical agents e.g drugs
immunologic reactions
infectious agents
genetic derangements
nutritional imbalances
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5
Q

What are the 3 types of cell injury?

A
  1. reversible cell injury
  2. irreversible cell injury
  3. ischaemic / reperfusion injury
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6
Q

What is reversible cell injury?

A
  • decrease generation of ATP
  • loss of cell membrane integrity
  • defects in protein synthesis, and DNA damage
  • increased water in cell –> swelling
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7
Q

What is irreversible cell injury?

A
  • severe mitochondrial changes
  • extensive damage to plasma membranes
  • swelling of lysosomes
  • triggers apoptosis and enzymatic degradation of cell
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8
Q

What is ischaemic / reperfusion injury?

A

new damage on reperfusion mediated by oxygen free radicals

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9
Q

what are the differences between apoptosis and necrosis?

A

Apoptosis:

  • programmed cell suicide
  • cellular shrinking
  • individual cell deletion
  • no inflammatory response
  • membrane integrity maintained

Necrosis:

  • uncontrolled cell death
  • cellular swelling
  • many cells affected
  • significant inflammation
  • loss of membrane integrity
  • cell lysis occurs
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10
Q

What is autolysis?

A

spontaneous lysis of cells and tissues by the release of lysosomal enzymes

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11
Q

What is autophagy?

A

body’s way of cleaning out damaged cells to regenerate newer, healthier cells

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12
Q

What are the 6 types of necrosis?

A
  1. coagulative
  2. liquefactive
  3. gangrenous
  4. caseous
  5. fat
  6. fibrinoid
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13
Q

What is coagulative necrosis?

A
  • commonest form (occurs mostly in myocardium)
  • caused by ischaemia or infarction e.g MI
  • cell architecture preserved
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14
Q

What is liquefactive necrosis?

A
  • seen in brain
  • can be caused by bacterial/ fungal infection or CNS hypoxia
  • due to lack of supporting stroma, neural tissue may totally liquify
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15
Q

What is gangrenous necrosis?

A
  • putrefaction (decay/rotting) of the tissue
  • cause is mostly infectious
  • appears black
  • 3 types: wet gangrene, dry gangrene, gas gangrene
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16
Q

What is caseous necrosis?

A
  • caused by tuberculosis

- tissue has cheese-like appearance

17
Q

What is fat necrosis?

A

-causes: enzymes or trauma

18
Q

When is fibrinoid necrosis seen?

A

in malignant hypertension and autoimmune disease

19
Q

What are the 3 types of cells involved in cell cycle of replication?

A
  • labile cells: excellent regenerative capacity e.g epithelia
  • stable cells: good regenerative capacity if needed e.g hepatocytes
  • permanent cells: no regenerative capacity e.g neurones
20
Q

When does liver cirrhosis occur?

A
  • when there is an imbalance in the hepatocyte regeneration and failure to reconstruct the liver architecture
  • as the liver is damaged, the connective tissue framework of the liver collapses so regenerated liver cells cannot populate
21
Q

What is contact inhibition?

A

cells at edge of defect multiply to cover defect. once these cells cover defect, proliferation stops

22
Q

What is healing by regeneration?

A
  • tissue returns to normal

- restitution of specialised function

23
Q

What is healing by repair?

A
  • fibrosis and scarring
  • loss of specialised function
  • normal structure cannot be replaced
24
Q

What is organisation?

A
  • the repair of specialised tissue by formation of a fibrous scar
  • production of granulation tissue and removal of dead tissue by phagocytosis
  • granulation tissue contracts and accumulates collagen, forming a scar
25
Q

What happens when granulation tissue matures?

A
  • becomes less cellular and less vascular

- has more collagen and ECM is layer down so the wound becomes stronger

26
Q

What is healing by first intention?

A
  • clean, uninfected surgical would
  • fibrin joins sides of wound together
  • edges of incision are replaced by collagen
  • coagulated blood forms scar
  • would closed with sutures
  • epidermis grows over defect
  • end result is neat scar
27
Q

What is healing by second intention?

A
  • wound edges not apposed
  • Extensive loss of tissue, infection, haematoma
  • tissue defect becomes replaced by granulation tissue which eventually contracts, leaving a scar
28
Q

What condition results in issues with wound healing ?- it is slower and can cause inflammation

A

diabetes

29
Q

which local factors inhibit healing?

A
  • infection
  • haematoma
  • blood supply
  • foreign bodies
  • mechanical stress e.g broken bone
30
Q

Which systemic factors inhibit healing?

A
  • age - children heal better than adults
  • drugs
  • anaemia
  • diabetes
  • malnutrition
  • vitamin C deficiency
31
Q

What is a keloid scar?

A
  • caused by dermal injury followed by excessive fibroblast proliferation and collagen production
  • normally a result of secondary intention
32
Q

How do fractures heal?

A
  • haemorrhage around bone forms haematoma
  • necrotic fragments removed
  • osteoblasts lay down
  • replacement by more organised lamellar bone
33
Q

If the brain tissue is injured, why can’t neurones be replaced?

A

Neurones are terminally differentiated

34
Q

What is gliosis?

A

non specific reactive change of glial cells in response to damage to the CNS
occurs after brain damage instead of scarring

35
Q

Which other type of tissue, except brain cells, cannot fully regenerate?

A

heart muscle

-damaged heart muscle cannot regenerate, so the heart heals by fibrosis

EMS (16 decks)

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