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87 Cards in this Set

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What characteristics accompany Apoptosis?
Cell Shrinkage, Specific DNA Fragmentation, NO INFLAMATION
What characteristics accompany Necrosis?
Cell Swelling, Random nuclear fragmentation and inflammation.
Cell Shrinkage, Specific DNA Fragmentation, NO INFLAMATION are associated with?
Cell Swelling, Random nuclear fragmentation and inflammation are associated with?
Describe Apoptosis
A form of cell suicide that is orchestrated by genes. It affects single cells and does not induce an inflammatory response.
What enzymes are responsible for protein cleavage during Apoptosis?
Caspases - digest nuclear and cytoplasmic proteins and activate endonucleases
What activates endonucleases during Apoptosis?
Which gene induces Apoptosis?
Which gene inhibits Apoptosis?
Which protein activates Caspases during Apoptosis?
What is the final phase of Apoptosis?
Removal of dead cell fragments by phagocytosis (no inflammatory response)
List 5 morphological changes associated with Apoptosis.
cell shrinkage, chromatin condensation with peripheral clumping, surface blebs, fragmentation into apoptotic bodies and ingestion by macrophages
List 4 examples of Apoptosis.
implantation, hepatic cell death in viral infection, lining of uterus during menstruation and deletion of auto-reactive t-cells in the thymus
What causes Coagulative necrosis?
denaturation of cellular proteins
What tissues are affected by Coagulative necrosis?
solid organs (ex: heart, intestines, kidney and liver)
Name an event that can cause Coagulative necrosis.
Myocardial Infarction (associated with ischemia)
Name an event that can cause liquifactive necrosis.
tissue digestion by phagocytes (hydrolytic enzymes)
Infarction causes what type of necrosis in the CNS?
liquifactive necrosis - leaves watery cavities in the brain
What type of necrosis is Dry Gangrene?
Coagulative necrosis occurring over a large area
What type of Gangrene involves bacteria?
wet gangrene
What type of necrosis is Wet Gangrene?
liquifactive necrosis
What can lead to Dry Gangrene?
loss of blood supply to a limb
What combination of necrosis causes Caseous Necrosis?
Coagulative and liquifactive
What commonly causes Caseous Necrosis?
Tuberculosis and fungal infections
What color are Caseous nodules?
What does the tissue look like in Caseous Necrosis?
completely destroyed and structureless
What can cause Fat Necrosis?
the release of pancreatic lipase
How can Fat Necrosis cause fat saponification?
fatty acids combine with calcium
What mineral do fatty acids combine with to cause saponification?
Where does Fibrinoid Necrosis occur?
blood vessels
What type of injury is Fibrinoid Necrosis associated with?
What happens to the Fibrin during Fibrinoid Necrosis?
Fibrin in the plasma leaks out of the blood vessels
What are the most common organs affected by atrophy?
skeletal muscles, heart, secondary sex organs and the brain
Inadequate supplies of what molecule results in ischemia consistent with atrophy?
Interruption of what type of signal can cause atrophy?
tropic (hormonal)
What is an example of persistent cell injury that can lead to atrophy?
chronic gastritis
Define Hypertrophy.
An increase in the size of the cells and consequently in the size of the affected organ.
What organ is Hypertrophy common in?
Heart (due to hypertension)
What can lead to Hypertrophy?
an increase in the amount of intracellular proteins
What is Hyperplasia?
an increase in the number of cells due to increased cellular division (can lead to increased organ size)
Can hyperplasia and hypertrophy occur together?
Yes, they are not mutually exclusive
What type of cells cannot exhibit hyperplasia?
Nerve, cardiac and skeletal muscle
What mediates hyperplasia?
growth factors, increased DNA synthesis and cellular division
What are two hormones that cause hyperplasia?
endogenous estrogen and EPO
What are two factors that can increase functional demand and lead to hyperplasia?
Increased bone marrow in high altitude and antigenic stimulation in lymphatic
Define Metaplasia.
reversible replacement of one mature cell by another that is better suited to tolerate the stress
What happens in bronchial metaplasia?
in smokers, columnar epithelium becomes squamous epithelium
What occurs in acid reflux metaplasia?
in the lower esophagus normal squamous epithelia become columnar epithelia
Define dysplasia.
Not a true adaptive change. It is an abnormal proliferation characterizied by changes in the size, shape and organization of mature cells
Is dysplasia cancer?
No, but it can lead to it.
Is dysplasia a true adaptive change?
List the 11 causes of cell injury
.Ischemia/hypoxia (most common type) , physical agents, burns/trauma, chemical agents, drugs poisons, nutritional, inadequate calorie, protein or excess vatamin deficiency, infectious diseases, viruses bacteria parasites, immunological mechanisms, hypersensitivity immunodeficiency or autoimmunity.
List two cellular and subcellular changes in reversible injury
cellular swelling and vacuole formation (decreased function of NaK ATPase), fatty change
What changes due to reversible injury will show under electron microscope
blebbing of the plasma membrane, swelling of mitochondria and clumping of chromatin, dilation of ER and dispersion of ribosomes
When can irreversible injury occur
mitochondrial damage (cell unable to make ATP), membrane is severely damaged, influx of calcium, nuclear changes, rupture of lysosomes
What occurs during disruption of the plasma membrane
massive influx of calcium
What nuclear changes accompany irreversible injury
pyknosis, karyorrhexis, and karyolysis
define pyknosis
the irreversible condensation of chromatin in the nucleus of a cell undergoing necrosis or apoptosis.
define karyorrhexis
destructive fragmentation of the nucleus of a dying cell whereby its chromatin is distributed irregularly throughout the cytoplasm
define karyolysis
the complete dissolution of the chromatin matter of a dying cell due to the activity of DNase
What are the three mechanisms by which cells undero injury and death
ATP depletion due to a loss of oxidative phosphorylation in the mitochondria, Loss of calcium homeostasis, reactive oxygen species
What 5 steps occur during ATP depletion due to loss of oxidative phosphorylation in the mitochondria
NaK pump fails and Na accumulates intracellularly, K diffuses out of the cell, Na Ca pump fails and Ca moves intracellularly, H2O and ions diffuse into the cell, Cell swells
What occurs during a loss of calcium homeostasis
Ca2+ influx due to energy failure of the ATP dependant calcium transporter will activate calcium dependant degradative enzymes
Name the three ROS's
hydrogen peroxide, superoxide anion, hydroxyl radicals
What are three protective factors against free radicals
Superoxide dismutase SOD, glutathione peroxidase GPx, Catalase
What are the intracellular adaptations
Fatty change, lipofuscin, hemosiderosis, cholesterol, calcification, hyaline changes
Describe fatty change
in alcoholic liver injury- reduced lipid export from liver cells and can no longer synthesize apoproteins
describe lipofuscin
wear and tear pigment, insoluble lipoprotein. Byproduct of lipid peroxidation and is nontoxic. Resists digestion and persists as membrane bound residual bodies
describe hemosiderosis
partially denatured form of ferritin- 25% of iron is stored in the form of ferritin and hemosiderin. Found in areas of hemorrhage and bruises. Normall in spleen , bone marrow and liver. When deposited systemically- hemosiderosis. In hemosiderosis as in frequent blood transfusion, iron present in organs where it is normally found and throughout the body, skin, pancreas, heart and kidney.
Describe cholesterol
muscle layer of heart blood vessel is filled with foam cells with lipid vacuoles
What are the two types of calcification
dystrophic and metastatic
Where does Dystrophic calcification occur
dead or injured cells
what happens to blood calcium levels during Dystrophic calcification
nothing, they remain normal
what does Dystrophic calcification lead to
crystal formation
what is the microscopic appearance of Dystrophic calcification
deep purple deposits in necrotic tissue
where does Dystrophic calcification commonly develop
aging or damaged heart valves
do small deposits of calcium in necrotic tissue have clinical consequences
Where does metatstatic calcificaiton occur
living cells or tissue
what kind of calcium conditions occur during metatstatic calcificaiton
hypercalcemic states
what happens to serum calcium concentrations during metatstatic calcificaiton
they increase
What can cause metatstatic calcificaiton
Vitamin D intox, multiple myeloma, parathyroid hormone, hyperparathyroidism, pagets disease
Describe hyaline changes
nonspecific term used to describe any intracellular or extracellular alteration that has pink homogenous appearance on an H and E stain
what are some examples of hyaline changes
alcoholic hyaline (intracellular), amyolid (extracellular), mallory bodies
what are mallory bodies
they are a type of intermediate filament between the size of actin and myosin
What happens to cells during necrosis vs apoptosis
necrosis- cell swelling apoptosis- cell shrinkage
what happens to the nucleus or DNA during necrosis vs. apoptosis
necrosis-- random nuclear fragmentation, apoptosis- specific DNA fragmentation
does inflammation occur during necrosis vs. apoptosis
necrosis- inflammation apoptosis- no inflammation