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