Pathophysiology Chapter 2 Study Guide

Front 1

Cells may adapt to the environment by undergoing changes in ___, ____, and ____.

Back 1

Cells may adapt to the environment by undergoing changes in size, number, and type.

Front 2

Atrophy is seen as a decrease in cell ____.

Back 2

Atrophy is seen as a decrease in cell size.

Front 3

Denervation will result in cellular ____.

Back 3

Denervation will result in cellular atrophy.

Front 4

Hypertrophy is an ____ in cell size.

Back 4

Hypertrophy is an increase in cell size.

Front 5

An increase in muscle mass associated with exercise is an example of ____.

Back 5

An increase in muscle mass associated with exercise is an example of physiologic hypertrophy.

Front 6

An increase in the number of cells in an organ or tissue is known as cellular _____.

Back 6

An increase in the number of cells in an organ or tissue is known as cellular hyperplasia.

Front 7

Liver regrowth is an example of ____ hyperplasia.

Back 7

Liver regrowth is an example of compensatory hyperplasia.

Front 8

____ or ____ hyperplasia is due to excessive hormonal stimulation or excessive growth factors.

Back 8

Pathologic or nonphysiologic hyperplasia is due to excessive hormonal stimulation or excessive growth factors.

Front 9

___ represents a reversible change in which one adult cell type is replaced by another adult cell type.

Back 9

Metaplasia represents a reversible change in which one adult cell type is replaced by another adult cell type.

Front 10

Metaplasia usually occurs in response to chronic ____ and ____ and allows for substitution of cells that are better able to survive stressful or harmful conditions.

Back 10

Metaplasia usually occurs in response to chronic irritation and inflammation and allows for substitution of cells that are better able to survive stressful or harmful conditions.

Front 11

Deranged cell growth of a specific tissue that results in cells that vary in size, shape, and organization is known as ____.

Back 11

Deranged cell growth of a specific tissue that results in cells that vary in size, shape, and organization is known as dysplasia.

Front 12

Dysplasia is strongly implicated as a precursor of ____.

Back 12

Dysplasia is strong implicated a s a precursor of cancer.

Front 13

Intracellular ___ represent the buildup of substances that cells cannot immediately use or eliminate.

Back 13

Intracellular accumulations represent the buildup of substances that cells cannot immediately use or eliminate.

Front 14

____ radicals are highly reactive chemical species having an unpaired electron in the outer valence shell of the molecule.

Back 14

Free radicals are highly reactive chemical species having an unpaired electron in the outer valence shell of the molecule.

Front 15

___ deprives the cell of oxygen and interrupts oxidative metabolism and the generation of adenosine triphosphate (ATP).

Back 15

Hypoxia deprives the cell of oxygen and interrupts oxidative metabolism and the generation of adenosine triphosphate (ATP).

Front 16

Reversible cellular injury is seen as either cellular ____ or ____ accumulation.

Back 16

Reversible cellular injury is seen as either cellular swelling or fatty accumulation.

Front 17

___ differs from apoptosis in that it involves unregulated enzymatic digestion of cell components, loss of cell membrane integrity with uncontrolled release of the product of cell death into the intracellular space, and initiation of the inflammatory response.

Back 17

Necrosis differs from apoptosis in that it involves unregulated enzymatic digestion of cell components, loss of cell membrane integrity with uncontrolled release of the product of cell death into the intracellular space, and initiation of the inflammatory response.

Front 18

The increased ___ levels may inappropriately activate a number of enzymes with potentially damaging effects.

Back 18

The increased calcium levels may inappropriately activate a number of enzymes with potentially damaging effects.

Front 19

Metastatic calcification

Back 19

occurs in normal tissues as the result of increased serum calcium levels.

Front 20

Apoptosis

Back 20

programmed cell death

Front 21

Dystrophic calcification

Back 21

Macroscopic deposition of calcium salts in injured tissue

Front 22

Ischemia

Back 22

impaired oxygen delivery

Front 23

Caseous necrosis

Back 23

dead cells persist indefinitely as soft cheeselike debris

Front 24

Gangrene

Back 24

term applied when a considerable mass of tissue undergoes necrosis

Front 25

Why does chronically damaged tissue result in calcification?

Back 25

The pathogenesis of dystrophic calcification involves the intracellular and/or extracellular formation of crystalline calcium phosphate. The components of the calcium deposits are derived from the bodies of dead or dying cells as well as the circulation and interstitial fluid. As tissues die, the calcium crystallizes and deposits form.

Front 26

List the five categories of cellular injury.

Back 26

1. Injury from physical agents.
2. Radiation injury
3. Chemical injury
4 Injury from biologic agents
5. Injury from nutritional imbalances.

Front 27

List and describe the three major mechanisms of cellular injury.

Back 27

The three major mechanisms of cellular damage are free radical formation, hypoxia, and ATP depletion, and disruption of intracellular calcium homeostasis. Multiple pathologies, be it mechanical, chemical, biological, or blunt force, will result in a combination of these mechanisms being activated.

Front 28

Explain why one of the complications of hypoxia is the development of acidosis and how the acidosis will damage the tissue.

Back 28

As oxygen concentrations fall, oxidative metabolism slows down. To make ATP, the cell reverts to anaerobic metabolism. With a decrease in ATP, the ion distribution is altered and cells will swell. The product of anaerobic metabolism is lactic acid, and as lactic acid accumulates ,the pH falls. Low pH will change protein conformation, resulting in total loss of enzyme function.

Front 29

Apoptosis takes place under normal stimulation or as the results of cellular injury. There are two pathways for apoptosis to occur. What are they and what major protein is involved?

Back 29

Two basic pathways for apoptosis are the extrinsic pathway, which is death receptor - dependent and is under cellular control, and the intrinsic pathway, which is death receptor - independent and results from injury. The execution phase of both pathways is initiated by proteolytic enzymes called caspases.

Front 30

Many molecular mechanisms mediate cellular adaptation. Some are factors produced by other cells and some by the cells themselves. These mechanisms depend largely on signals transmitted by chemical messengers that exert their effects by altering the function of a gene. Many adaptive cellular responses after the expression of "differentiation" genes. What can cells do because of this?

Back 30

A cell is able to change size or form without compromising its normal function.

Hint 30

There are numerous molecular mechanisms mediating cellular adaptation, including factors produced by other cells or by the cells themselves. These mechanisms depend largely on signals transmitted by chemical messengers that exert their effects by altering gene function. In general, the genes expressed in all cells fall into two categories: "housekeeping" genes that are necessary for normal function of a cell, and genes that determine the differentiating characteristics of a particular cell type. In many adaptive cellular responses, the expression of the differentiation genes is altered, whereas that of the housekeeping genes remains unaffected. Thus, a cell is able to change size or form without compromising its normal function. Once the stimulus for adaptation is removed, the effect on expression of the differentiating genes is removed and the cell resumes its previous state of specialized function.

Front 31

Hypertrophy may occur as the result of normal physiologic or abnormal pathologic conditions. The increase in muscle mass associated with exercise is an example of physiologic hypertrophy. Pathologic hypertrophy occurs as the result of disease conditions and may be adaptive hypertrophy are the thickening of the urinary bladder from long-continued obstruction of urinary outflow and the myocardial hypertrophy that results from valvular heart disease or hypertension. What is a compensatory hypertrophy?

Back 31

When one kidney is removed, the remaining kidney enlarges to to compensate for the loss.

Hint 31

Compensatory hypertrophy is the enlargement of a remaining organ or tissue after a portion has been surgically removed or rendered inactive. The body does not enlarge its major organs during times of malnutrition. Gene expression, not actin expression, stimulates the body to increase the muscle mass of the heart. Hypertrophy is not a progressive disease in the size of anything.

Front 32

Mercury is a toxic substance, and the hazards of mercury-associated occupational and accidental exposures are well known. What is the primary concern for the general public in regard to mercury poisoning today?

Back 32

Fish such as tuna and swordfish.

Hint 32

The main source of methyl mercury exposure is from consumption of long-lived fish, such as tuna and swordfish. Although there is mercury in amaglam fillings, the amount of mercury vapor given off by the fillings is very small. Most thermometers today are made without mercury. The same holds true for most blood pressure machines. Lead in paint is a concern, not mercury.

Front 33

When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower and more efficient level of functioning that is compatible with survival. This decrease in cell size is called ______.

Back 33

atrophy

Hint 33

When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower and more efficient level of functioning that is compatible with survival. This decrease in cell size is called atrophy.

Front 34

Chemical Agent

Back 34

Free radicals

Hint 34

Chemical agents can cause cell injury through several mechanisms: they can block enzymatic pathways, cause coagulation of tissues, or disrupt the osmotic or ionic balance of the cell.

Front 35

You are a nurse preparing an educational event for a group of single parents. You are going to talk about drugs and the damage they cause to the body. You would known to include what? Name 3.

Back 35

acetaminophen and aspirin, immunosuppressant drugs, alcohol and cigarettes, vitamin supplements and antineoplastic drugs

Hint 35

Many drugs - alcohol, prescription, drugs, over-the-counter drugs, and street drugs - are capable of directly or indirectly damaging tissues. Ethyl alcohol can harm the gastric mucosa, liver, developing fetus, and other organs. Antineoplastic (anticancer) and immunosuppressant drugs can directly injury cells. Other drugs produce metabolic end products that are toxic to cells. Acetaminophen, a commonly used over-the-counter analgesic drug, is detoxified in the liver, where small amounts of the drug are converted to a highly toxic metabolite.