Pathophysiology 3 - Cell Injury And Patterns Of Injury

Front 1

Cell injury can result in (3):

Back 1

1. Reversible Injury

2. Irreversible Injury

3. Cell death

Front 2

What are the principal pathways of pathological cell death?

Back 2

Necrosis and apoptosis

Front 3

Loss of plasma membrane barrier function in necrotic cells leads to passage of ____ and ____ into the cell, and ____ and ____ out of the cell

Back 3

Ca++ and Na+ into the cell, K+ and Enzymes out of the cell

Front 4

What enzymes (2) can be tested for to diagnose hepato-biliary disease and osteoblast hyperactivity? Where are the enzymes located? Which enzyme is more specific?

Back 4

Alkaline phosphatase (ALP) and Alanine aminotransferase (AST - more specific) In cell membranes

Front 5

What enzyme can be tested for to diagnose diffuse cell necrosis (hepatitis), and alcohol-induced liver disease? Where is the enzyme located?

Back 5

Aspartate aminotransferase (AST). In the mitochondria.

Front 6

Which enzymes are increased in the blood in acute myocardial infarction?

Back 6

Creatinine kinase-MB, Troponin

Front 7

What enzymes are increased in the blood during acute pancreatits?

Back 7

Amylase and Lipase

Front 8

Which tissues are especially susceptible to hypoxia?

Back 8

The brain, the heart, and the kidneys

Front 9

What are some of the important changes involving the mitochondria that result due to hypoxia?

Back 9

Mitochondrial accumulation of calcium, ATP synthesis decreases, leading to Na+/K+ pump function loss, and anaerobic glycolysis

Front 10

What is the most common cause of hypoxia?

Back 10

Ischemia

Front 11

Cell swelling and continued hypoxia causes accumulation of Ca++, and activation of (4):

Back 11

Protein kinases, phospholipases, proteases, endonucleases

Front 12

What kind of damage does the activation of protein kinases (1), Phospholipases (2), Proteases (3) and Endonucleases (4) cause? (1 answer for each)

Back 12

1. chromatin damage and phosphorylation
2. membrane damage
3. cytoskeletal damage

4. nucleus damage

Front 13

Hypoxia causes a decrease in ATP production, which in turn leads to (1) Efflux of K+ and Influx of Ca2+, H2O and Na+, a (2) decreased pH, and (3) decreased protein synthesis. What is the end result of each of these 3 cellular changes?

Back 13

1. ER swelling, cellular swelling, loss of microvilli and Blebs

2. Clumping of nuclear chromatin

3. Lipid deposition

Front 14

What is the typical cellular response to metabolic alterations (genetic or acquired), or chronic injury?

Back 14

Intracellular accumulations; calcification

Front 15

What is the typical cellular response to cumulative sub-lethal injury over long life span?

Back 15

Cellular aging

Front 16

How can genetic derangements cause cell injury (2)?

Back 16

Deficiency of functional proteins, or accumulation of damaged DNA or misfolded proteins (will eventually trigger cell death when beyond repair)

Front 17

With re-oxygenation of a hypoxic tissue, cell injury may occur. What is this type of injury called, and what causes it?

Back 17

It is called reperfusion injury, and is caused by ROS.

Front 18

What are 4 important ROS found in human tissues?

Back 18

Nitric Oxide, Hydrogen Peroxide, Superoxide anion radical and hydroxyl radical

Front 19

What enzymes are responsible for removal of harmful ROS in humans, and where is each one found? (3)

Back 19

Superoxide dismutase (mitochondria)
Glutathione peroxidase (mitochondria)
Catalase (peroxisomes)

Front 20

The accumulation of radicals either due to inadequate removal or excess production results in _______.

Back 20

Oxidative stress

Front 21

ROS can cause 3 main types of damage if they aren't properly removed or produced in excess. What are they?

Back 21

Protein damage, lipid damage, and DNA damage

Front 22

What 2 vitamins are important antioxidants?

Back 22

Vitamin C and Vitamin E

Front 23

Which 2 eye disorders are ROS linked to?

Back 23

Cataracts and macular degeneration

Front 24

What is the most common cause of acute optic neuropathy in older age groups? What is the end result?

Back 24

AION (anterior ischemic optic neuropathy), ischemia is the end result

Front 25

What is the sequence of events following cell injury? After what stage is the cell injury non-reversible?

Back 25

1. Cells become non-functional

2. Biochemical changes can be detected

3. Ultrastructural changes

4. Light microscopic changes

5. Gross morphologic changes

Injury is non-reversible after cells become full non-functional and biochemical changes are detected.

Front 26

The consequences of an inurious stimulus depend on: (4)

Back 26

the cell type, the cell status (nutritional or hormonal), the adaptability, and the genetic makeup of the cell

Front 27

Give an example of variations in response to injury between striated skeletal muscle in the leg and cardiac muscle.

Back 27

Leg muscle can accommodate complete ischemia for 2-3 hours, cardiac only for 20-30 minutes

Front 28

Give an example of a beneficial nutritional status for cell response to injury (think liver)

Back 28

A glycogen filled hepatocyte can tolerate better ischemia

Front 29

Reversible cell injury is characterized by:

Back 29

General swelling of cell and organelles, blebbing, blunting and loss of microvilli, detachment of ribosomes from ER, clumping of nuclear chromatin

Front 30

What are the two recognizable features of reversible cell injury under a light microscope?

Back 30

Cellular swelling and Fatty change

Front 31

What are two other name for cellular swelling?

Back 31

Hydropic swelling or vacuolar degeneration

Front 32

__________ is a type of intracellular accumulation of triglycerides in the cytoplasm (especially the ______)

Back 32

Fatty change; VLDL

Front 33

Describe the mechanism of fatty change

Back 33

Increased production of NADH (ie: from alcohol metabolism) causes increased conversion of DHAP to G3-P. Addition of 3 FAs to G3-P produces Triglycerides. Triglycerides -> lipoproteins -> lipid accumulation

Front 34

In what condition are lipids often located in the outer layers of the retina, and seen as hard exudates?

Back 34

Diabetes