Tissue and Cell Injury Flashcards

1
Q

What is homeostasis? How does it work?

A

Maintenance of a steady internal environment

Environmental changed must result in changed at organ and cellular level

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2
Q

How can homeostasis result in some sort of pathology?

A

If alterations made in response to changing environment are abnormal. Cell will not be able to cope and die

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3
Q

What are the types of adaptation that can occur?

A

Increased demand - hyperplasia, hypertrophy

Decreased demand - atrophy

Altered stimulus - metaplasia

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4
Q

What is hyperplasia? How does it occur?

A

Increase in cell number in response to an external stimulus (regresses on stimulus withdrawal) - excessive growth factor, hormonal stimulation of growth

Can be physiological or pathological

Results in increased organ volume

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5
Q

What are physiological examples of hyperplasia?

A

Growth of breast tissue

Pregnancy - hyperplasia of endometrial lining of uterus

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6
Q

When does compensatory hyperplasia occur and where?

A

Occurs after loss of tissue (not common)

Occurs in liver (regeneration via hyperplasia) after e.g: paracetamol induced injury

Also, in bone marrow (e.g: response to rbc decrease)

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7
Q

Mechanism of hyperplasia?

A

Production of increased growth factors - locally or from distant site (hormone may be a growth factor itself)

Increased growth factor receptors

Switch on genes encoding growth factors and cell cycle regulators to promote new cell growth (force cell to undergo multiple cell cycles)

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8
Q

How does pathological hyperplasia occur and give examples?

A

Hormonally induced:
Excess oestrogen leads to endometrial hyperplasia (abnormal menstrual bleeding - often post menopausal)

Androgens cause prostatic hyperplasia

Due to infection:
Areas in lymph nodes undergo hyperplasia

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9
Q

How is pathological hyperplasia reversed?

A

Will regress via withdrawal of stimulus

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10
Q

Describe prostatic hyperplasia

A

Enlargement of prostate (usually walnuts-sized)

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11
Q

Dangers of hyperplastic tissue? Give an example

A

Risk site for development of cancer; cancer grows in absence of stimulus

Endometrial (lining of womb) cancer - more common in obese individuals (background of hyperplasia) or in those with prolonged oestrogen exposure

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12
Q

What is hypertrophy?

A

Increase in cell SIZE (NOT cell number)

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13
Q

When does hypertrophy occur?

A

Often occurs in conjunction with hyperplasia
Often in isolation in non-dividing cells (cardiac myocytes, skeletal muscle)
Often in response to mechanical stress

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14
Q

When does sypertrophy become pathological in the heart? What does this result in?

A

Heart can no longer function and requires more blood than it is supplied with.
Muscle becomes less functional
May cause heart failure (inability of heart to pump normally)

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15
Q

What is atrophy?

A

A physiological or pathological reduction in cell SIZE

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16
Q

Example of physiological atrophy

A

Every month, breast and endometrial lining of uterus undergo proliferation followed by cell death and atrophy

17
Q

Examples of pathological atrophy

A

Denervation of muscle or immobility results in disuse atrophy

Blocked blood supply (associated with atherosclerosis) is thought to account for decreased brain size with AGEING

Inadequate nutrition

Loss of hormonal stimulation (post menopausal uterus)

Due to excessive pressure (e.g: from tumour adjacent to normal tissue)

18
Q

When does atrophy occur and how?

A

Blood flow is reduced
Nerve supply interrupted
Changes in hormone concentrations
Tissue experiences disuse or excessive pressure

19
Q

Mechanism of atrophy?

A

Reduced cellular components
Protein degradation
“digested” in lysosomes and degraded

20
Q

Importance of hormones associated with atrophy?

A

Glucocorticoids and thyroid hormone - promote degradation and atrophy

Insulin - opposes atrophy and promotes growth

This balance of growth and atrophy maintains homeostasis

21
Q

What is metaplasia?

A

Reversible change from one mature cell type to another and is an adaptive response

22
Q

Why does metaplasia occur?

A

Represents a change in signals delivered to stem cells - as a result, differentiate another way

23
Q

What stimulates metaplasia?

A

Maybe a response to cytokines (affect activity of cells, e.g: due to local injury), growth factors and other chemicals

Commonly occurs as response to noxious stimulus

24
Q

Give an examples of where metaplasia can occur

A

Squamous epithelium (cover skin) and are resistant to a range of noxious stimuli

Squamous metaplasia commonly found in response to injury - e.g: in lungs and salivary sucts

25
Q

Metaplastic tissue danger? Giv examples

A

Risk site for cancer development

Although no squamous epithelia in lung, squamous cell carcinoma can occur (smoking results in columnar cell becoming squamous cells)

Adenocarcinoma (gland-forming tumour) can occur in oesophagus despite no glandular epithelium being present