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93 Cards in this Set

  • Front
  • Back
Etiology
cause
pathogenesis
mechanism
What are labile cells? Give 2 examples:
Ones that continuously divide
1. Bone marrow cells
2. Epithelial cells
What are Stable cells? Give 3 examples:
Cells that have the ability to replicate but don't normally.
1. Hepatocytes
2. Fibroblasts
3. Endothelium
What are permanent cells? Give 2 examples:
Cells that cannot divide and regenerate.
1. Neurons
2. Muscle (cardiac/skeletal)
What are the 4 stages in a cellular response to stress?
1. Normal stress
2. Adaptation
3. Cell injury
4. Cell death
What are the 2 patterns of cell death?
-Necrosis
-Apoptosis
Which type of cell death is always pathologic?
necrosis
What type of adaptation do we usually see happen in the pregnant uterus?
-Hyperplasia
-Hypertrophy
What type of adaptation do we usually see happen in the heart?
Hypertrophy only
What type of adaptation do we usually see happen in the pubertal breast?
Hyperplasia only
What type of adaptation do we usually see happen in the renal tubules?
Both hyperplasia and hypertrophy
What type of adaptation do we usually see happen in the prostate?
Hyperplasia only
What type of adaptation do we usually see happen in response to a partial hepatectomy?
Hyperplasia only
What is hyperplasia?
An increase in cell number
What cells are capable of hyperplasia?
Labile and Stable only
What are 3 common causes of hyperplasia?
1. Hormone stimulation
2. Loss of tissue / resection
3. Wound healing
What makes hyperplasia distinct from cancer?
The cells respond to normal regulatory growth control mechanisms.
What are 4 mechanisms of hyperplasia?
1. Increased growth factors
2. Incr. growth fx receptors
3. Activation of intracell signaling pathways
4. Turning on of certain genes
What are 2 types of physiologic hyperplasia?
1. Hormonal as in pregnancy and puberty
2. Compensatory as in damage or resection
What is an example of pathologic hyperplasia?
Cancer
What is hypertrophy?
An increase in cell size due to synthesis of structural components (not swelling).
What cells are capable of hypertrophy?
Any - labile, stable, or permanent.
What are 2 common causes of hypertrophy?
1. Increased functional demand
2. Hormonal stimulation
What are examples of physiologic hypertrophy?
Uterine - as in pregnancy
Heart - as in athletes
What is an example of pathologic hypertrophy?
Cardiac - as in hypertension
What is atrophy?
A decrease in cell size
What is metaplasia?
The replacing of one mature cell type with another.
What causes/triggers metaplasia?
Chronic irritation necessitating adaptation.
Is metaplasia permanent?
No it's reversible
What are 4 variations of Epithelial metaplasia?
1. Squamous metaplasia
2. Barrett metaplasia
3. Intestinal metaplasia
4. Cystitis glandularis
What is the most common type of epithelial metaplasia?
Squamous
What happens in squamous metaplasia?
Columnar cells transform into stratified squamous cells.
In what 3 tissues is squamous metaplasia observed?
-Endocervix
-Bronchi
-Bladder
What is Barret metaplasia?
A transformation from squamous to columnar in the esophagus
What are 2 types of mesenchymal metaplasia?
-Myositis ossificans
-Osseous metaplasia
Why is metaplasia not necessarily desirable?
Because it is associated with the risk of malignant transformation.
What malignancy is associated with Barrett's esophagus?
adenocarcinoma of the esophagus
What malignancy is associated with Squamous metaplasia of respiratory epithelium? Cystitis glandularis?
Squamous carcinoma of the lung
Adenocarcinoma of the bladder
What are 7 causes of cell injury?
Chemicals
O2 deprivation
Physical agents
Infections
Immune agents
Nutritional imbalances
Genetics
COPIING
What are 2 types of oxygen deprivation?
-Hypoxia
-Ischemia
What is hypoxia? what are 3 examples?
Lack of oxygen
-Cardiorespiratory failure
-Anemia
-CO poisoning
What is ischemia?
Loss of blood supply resulting in o2 deprivation PLUS lack of nutrients like glucose
What causes more rapid and severe damage to cells; hypoxia or ischemia?
Ischemia
What is ischemia often followed by?
Reperfusion injury
What are 3 causes of reperfusion injury?
-Generation of ROS
-Complement activation
-inflammatory reaction
What are the 5 targets of cell injury?
CAPCG
-Cell membranes
-Aerobic respiration and mitochondrial production of ATP
-Protein synthesis
-Cytoskeleton
-Genetic apparatus
What are the 5 mechanisms of cell injury?
DMIAD
-Depletion of ATP
-Mitochondrial damage
-Influx of calcium
-Accumulation of ROS
-Defects in membrane permeability
What are 2 major causes of decreased oxidative phosphorylation by mitochondria?
-Ischemia
-Toxins
What happens when mitochondria can't do oxidative phosphorylation?
ATP is depleted
What are the 2 major effects of no ATP?
-Inhibition of the Na/K pump which results in cellular swelling
-Increased anaerobic glycolysis
What are 2 effects of increased anaerobic glycolysis?
-Depleted glycogen stores
-Decreased pH in the cell which causes nuclear chromatin clumping
What happens to protein synthesis after ATP depletion?
It is decreased due to ribosomal detachment from the ER
What does direct damage to mitochondrial membranes do?
Leads to leakage of cytochrome c which can cause apoptosis
What does increased intracellular calcium lead to?
Activation of enzymes that cause cell damage
What is a free radical?
A byproduct of mitochondrial respiration that has a single unpaired electron in its outer orbital.
What do ROS cause damage to?
-Lipids
-Proteins
-Nucleic acids
What are 4 ways of getting rid of ROS?
-natural decay
-antioxidants (vit e/a)
-bind iron/copper to proteins
-enzymes
3 enzymes that get rid of ROS:
-catalase
-superoxide dismutase
-glutathione peroxidase
What is responsible for defects in membrane permeability?
Increased cytosolic calcium which activates phospholipases and proteases
What is the result of irreversible cell injury?
Cell death by necrosis
What is necrosis characterized by?
Massive leak of stuff out of the cell
Influx of calcium
What leaks out when heart cells necrose?
-CK
-troponin
What leaks out when biliary tract epithelium undergoes necrosis?
Alk phosphatase
What leaks out when hepatocytes undergo necrosis?
Transaminases
When injury is still reversible, what morphologic changes can be seen in the
-cytoplasm?
-nucleus?
Cytoplasmic: swelling, fatty changes
Nuclear: clumping of chromatin
When injury is irreversible, what morphologic changes can be seen in the
-cytoplasm?
-nucleus?
Cytolasmic: Increased eosinophilia, vacuolization, calcification
Nuclear: karyolysis, pyknosis, and karyorrhexis
What is pyknosis?
Nuclear shrinking with increased basophilia due to DNA condensing
What is karyorrhexis?
Fragmentation of the nucleus - it wrecks it rhexis
What is karyolysis?
fragmentation of the nucleus
What are the 5 morphologic types of necrosis?
1. Coagulative
2. Liquifactive
3. Caseous
4. Fat
5. Gangrenous
What causes coagulative necrosis?
Cell death due to hypoxic death in all tissues except in the CNS.
What is coagulative necrosis characterized by?
Preservation of the basic cell architecture
What are 2 examples of coagulative necrosis?
-Myocardial infarct
-Renal infarct
What makes Liquifactive necrosis different from coagulative?
There is complete digestion of dead cells - no preservation of structure.
What are 3 common causes of liquifactive necrosis?
-Bacterial infection
-Fungal infection
-Hypoxia of the CNS
What are 2 examples of Liquifactive necrosis?
-Abscesses
-Brain infarct
What is caseous necrosis? What is it characterized by?
-A form of Coagulative necrosis
-Id'd by CHEESY WHITE MATERIAL
What is the CLASSIC example of caseous necrosis?
TB - yes, that's tuberculosis, my dear.
What is the morphologic characteristic of fat necrosis? What is it caused by?
Morphology: enzymatic fat destruction (ewwww)
Caused by: acute pancreatitis
What pathologicaly causes apoptosis?
Irreversible injury
What is fat necrosis?
Destruction of fat
What causes fat necrosis?
Trauma or release of activated pancreatic lipases
What is the characteristic feature of Fat necrosis?
Chalky white areas
What is the classic example of fat necrosis?
Acute pancreatitis
What does apoptosis mean?
Falling off
What is the acronym for features of apoptosis?
PREAN
What is PREAN?
-Plasma membrane intact
-Rapid phagocytosis
-Enzymes degrade nuclear/cytoplasmic proteins
-Activation of intracel -program
No inflammatory response
What is Gangrenous necrosis?
Ischemic injury to tissue with an overlying bacterial infection.
What are the 3 causes of Reperfusion injury?
1. Increased oxygen free radicals
2. Increased inflammation
3. Activation of complement
What are 2 ways by which Chemicals can cause cell injury?
1. Direct combination with some critical element of cell function
2. Conversion to toxic metabolites
What system is responsible for converting toxic metabolites?
P450 in the liver
What is formed by the P450 system?
Reactive free radicals