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56 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Cells may adapt to the environment by undergoing changes in ___, ____, and ____.
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Cells may adapt to the environment by undergoing changes in size, number, and type.
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Atrophy is seen as a decrease in cell ____.
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Atrophy is seen as a decrease in cell size.
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Denervation will result in cellular ____.
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Denervation will result in cellular atrophy.
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Hypertrophy is an ____ in cell size.
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Hypertrophy is an increase in cell size.
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An increase in muscle mass associated with exercise is an example of ____.
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An increase in muscle mass associated with exercise is an example of physiologic hypertrophy.
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An increase in the number of cells in an organ or tissue is known as cellular _____.
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An increase in the number of cells in an organ or tissue is known as cellular hyperplasia.
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Liver regrowth is an example of ____ hyperplasia.
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Liver regrowth is an example of compensatory hyperplasia.
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____ or ____ hyperplasia is due to excessive hormonal stimulation or excessive growth factors.
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Pathologic or nonphysiologic hyperplasia is due to excessive hormonal stimulation or excessive growth factors.
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___ represents a reversible change in which one adult cell type is replaced by another adult cell type.
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Metaplasia represents a reversible change in which one adult cell type is replaced by another adult cell type.
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Metaplasia usually occurs in response to chronic ____ and ____ and allows for substitution of cells that are better able to survive stressful or harmful conditions.
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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.
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Deranged cell growth of a specific tissue that results in cells that vary in size, shape, and organization is known as ____.
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Deranged cell growth of a specific tissue that results in cells that vary in size, shape, and organization is known as dysplasia.
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Dysplasia is strongly implicated as a precursor of ____.
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Dysplasia is strong implicated a s a precursor of cancer.
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Intracellular ___ represent the buildup of substances that cells cannot immediately use or eliminate.
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Intracellular accumulations represent the buildup of substances that cells cannot immediately use or eliminate.
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____ radicals are highly reactive chemical species having an unpaired electron in the outer valence shell of the molecule.
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Free radicals are highly reactive chemical species having an unpaired electron in the outer valence shell of the molecule.
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___ deprives the cell of oxygen and interrupts oxidative metabolism and the generation of adenosine triphosphate (ATP).
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Hypoxia deprives the cell of oxygen and interrupts oxidative metabolism and the generation of adenosine triphosphate (ATP).
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Reversible cellular injury is seen as either cellular ____ or ____ accumulation.
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Reversible cellular injury is seen as either cellular swelling or fatty accumulation.
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___ 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.
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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.
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The increased ___ levels may inappropriately activate a number of enzymes with potentially damaging effects.
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The increased calcium levels may inappropriately activate a number of enzymes with potentially damaging effects.
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Acidosis develops and denatures the enzymatic and structural proteins of the cell during ___ necrosis.
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Acidosis develops and denatures the enzymatic and structural proteins of the cell during coagulation necrosis.
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Metastatic calcification
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occurs in normal tissues as the result of increased serum calcium levels.
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Reactive oxygen species (ROS)
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oxygen-containing molecules that are highly reactive.
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Antioxidants
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natural and synthetic molecules that inhibit the reactions of ROS with biological structures
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Apoptosis
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programmed cell death
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Dystrophic calcification
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Macroscopic deposition of calcium salts in injured tissue
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Temperature-induced injury
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ice crystal formation in cytosol
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Ischemia
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impaired oxygen delivery
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Caseous necrosis
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dead cells persist indefinitely as soft cheeselike debris
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Ionizing radiation
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causes injury by changes in electron stability
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Gangrene
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term applied when a considerable mass of tissue undergoes necrosis
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Why does chronically damaged tissue result in calcification?
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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.
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List the five categories of cellular injury.
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1. Injury from physical agents.
2. Radiation injury 3. Chemical injury 4 Injury from biologic agents 5. Injury from nutritional imbalances. |
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Lead has been found in pain used to give children's toys their brilliant colors. Why is this a concern?
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The toxicity of lead is related to its multiple biochemical effects. It has the ability to inactivate enzymes, compete with calcium for incorporation into bone, and interfere with nerve transmission and brain development. Lead exposure in children has been demonstrated to result in neurobehavioral and cognitive deficits.
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List and describe the three major mechanisms of cellular injury.
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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.
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Oxidative stress has been implicated as the causative agent in numerous diseases states as well as the cause of physiological aging. Explain how oxidative stress can cause damage and why it is a concern.
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Oxidative stress leads to the oxidation of cell components, activation of signal transduction pathways, and changes in gene and protein expression. DNA modification and damage can occur because of oxidative stress. In addition, mitochondrial DNA as a target of oxidation and subsequent cause of mitochondrial dysfunction may be the cause of diseases.
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Explain why one of the complications of hypoxia is the development of acidosis and how the acidosis will damage the tissue.
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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.
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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?
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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.
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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?
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A cell is able to change size or form without compromising its normal function.
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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.
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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?
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When one kidney is removed, the remaining kidney enlarges to to compensate for the loss.
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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.
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Metastatic calcification takes place in normal tissues as the result of increased serum calcium levels (hypercalcemia). Anything that increases the serum calcium level can lead to calcification in inappropriate places such as the lung, renal tubules, and blood vessels. What are the major causes of hypercalcemia?
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Hyperparathyroidism and immobilization.
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Metastatic calcification occurs in normal tissues as the result of increased serum calcium levels (hypercalcemia). Almost any condition that increases the serum calcium level can lead to calcification in inappropriate sites such as the lung, renal tubules, and blood vessels. The major causes of hypercalcemia are: hyperparathyroidism, either primary or secondary to phosphate retention in renal failure; increased mobilization of calcium from bone as in Paget disease, cancer with metastatic bone lesions, or immbolization; and vitamin D intoxication. Diabetes mellitus and hypoparathyroidism do not cause hypercalcemia; therefore, they cannot be a cause of metastatic calcification.
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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?
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Fish such as tuna and swordfish.
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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.
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Small amounts of lead accumulate to reach toxic levels in the human body. Lead is found in many places in the environment and is still a major concern in the pediatric population. What would you teach the parents of a child who is being tested for lead poisoning?
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Keep your child away from peeling paint.
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Children are exposed to lead through ingestion of peeling lead paint, by breathing dust from lead paint (e.g. during remodeling), or from playing in contaminated soil. The lead danger to potters is from the ceramic glaze before it is fired. You do not have to keep children away from everything ceramic. Newsprint contains lead, but you are not exposed to a significant amount of lead when you read the newspaper. You have to work directly with ore to be exposed to toxic levels of lead. Walking through part of a mine on a field trip is not a contributing factor to lead poisoning.
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In a genetic disorder called xeroderma pigmentosum, an enzyme needed to repair sunlight-induced DNA damage is lacking. This autosomal recessive disorder is characterized by what?
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Extreme photosensitivity and a greatly increased risk of skin cancer in skin that has been exposed to the sun.
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In a genetic disorder called xeroderma pigmentosium, an enzyme needed to repair sunlight, induced DNA damage is lacking. This autosomal recessive disorder is characterized by extreme photosensitivity and a 2000-fold increased risk of skin cancer in sun-exposed skin. Exposure to sun causes the skin to toughen and become leathery feeling, but not in patches of pink pigmented skin. Vitiligo is a benign acquired skin disease of unknown cause, consisting of irregular patches of various sizes totally lacking in pigment and often having hyperpigmented borders. It can appear in the skin of any race and is not scaly. Photosensitivity is a sign of xeroderma pigmentosum, but this disease increases, not decreases, the person's risk of skin cancer.
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While presenting a talk to the parents of preschoolers at a local day care center, the nurse is asked about electrical injury to the body. She would know to include what in her response?
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The most severe damage is caused by lightning and high-voltage wires.
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Lightning and high-voltage wires that carry several thousand volts produce the most severe damage. In electrical injuries, the body acts as a conductor of the electrical current.
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A man presents to the emergency department after being out in below zero weather all night. He asks the nurse why the health care team is concerned about his toes and feet. How would the nurse respond?
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Your toes and feet are frozen and there is a concern about the formation of blood clots as we warm them again.
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Injury from freezing probably results from a combination of ice crystal formation and vasocontriction. The decreased blood flow leads to capillary stasis and arteriolar and capillary thrombosis. Edema results from increased capillary permeability. Exposure to low-intensity heat (43 C - 46 C), such as occurs with partial-thickness burns and severe heat stroke, causes cell injury by inducing vascular injury. The process of warming tissues that has been frozen or partially frozen causes pain. I the pain is bad enough, then medication to control the pain is given. Health team members are always concerned about giving pain medication to someone who might be an addict. Asking if this is the first time this person has had an injury induced by the cold is appropriate when taking a health history. However, pointing out that "it is obvious you are a homeless person" is not an appropriate remark for the nurse to make. Also not appropriate is wondering when it will happen again.
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Clinical manifestations of radiation injury result from acute cell injury, dose-dependent changes in the blood vessels that supply the irradiated tissues, and fibrotic tissue replacement. What are these clinical manifestations?
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Radiation cystitis, dermatitis, and diarrhea from enteritis.
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Destructive changes occur in small blood vessels such as the capillaries and venules. Acute reversible necrosis is represented by such disorders as radiation cystitis, dermatitis, and diarrhea from enteritis. More persistent damage can be attributed to acute necrosis of tissue cells that are not capable of regeneration and chronic ischemia. Hunger is not a sign of radiation injury, nor are muscle spasms.
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Biologic agents differ from other injurous agents in that they are able to replicate and can continue to produce their injurous effects. How do Gram-negative bacteria cause harm to the cell?
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Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability.
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Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability. Certain bacteria excrete elaborate exotoxins that interfere with cellular production of ATP. Gram-negative bacilli do not disrupt a cell's ability to replicate. Many gram-negative bacilli cause harm to cells.
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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 ______.
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atrophy
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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.
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What does Icterus cause in the body?
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a yellow discoloration of tissue
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Pigments are colored substances that accumulate in cells. They can be endogeneous (i.e. arising from within the body) or exogenous (arising from outside the body) Icterus, also, called jaundice, is characterized by a yellow discoloration of tissue due to the retention of bilirubin, an endogenous bile pigment. This condition may result from increased bilirubin production from red blood cell destuction, obstruction of bile passage into the intestine, or toxic diseases that affect the liver's ability to remove bilirubin from the blood.
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What is Lipofuscin?
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a yellow-brown pigment that accumulates in neurons
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Lipofuscin is a yellow-brown pigment that results from the accumulation of the indigestible residues produced during normal turnover of cell structures. The accumulation of lipofuscin increases with age and is sometimes referred to as the wear-and-tear pigment. It is more common in heart, nerve, and liver cells than other tissues and is seen more often in conditions associated with atrophy of an organ.
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What does an excess of carbon cause in the body?
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a blue lead line along the margins of the gum
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One of the most common exogenous pigments is carbon in the form of coal dust. In coal miners or persons exposed to heavily polluted environments, the accumulation of carbon dust blackens the lung tissue and may cause serious lung disease. The formation of a blue lead line along the margins of the gum is one of the diagnostic features of lead poisoning.
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What is melanin
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a brown or dark-brown pigment that is found in the skin and hair
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Melanin is a black or dark brown pigment that occurs naturally in the hair, skin, and iris and choroid of the eye.
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Physical Agent
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Mechanical forces that produce tissue trauma
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Cell injury can be caused by a number of agents, including physical agents, chemicals, biologic agents, and nutritional factors. Among the physical agents that generate cell injury are mechanical forces that produce tissue trauma, extremes of temperature, electricity, radiation, and nutritional disorders.
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Chemical Agent
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Free radicals
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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.
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Biologic Agent
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submicroscopic viruses
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Biologic agents differ from other injurious agents in that they are able to replicate and continue to produce injury.
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Nutritional Factors
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vitamin B deficiency
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Among the nutritional factors that contribute to cell injury in excesses and deficiencies of nutrients, vitamins, and minerals.
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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.
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acetaminophen and aspirin, immunosuppressant drugs, alcohol and cigarettes, vitamin supplements and antineoplastic drugs
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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.
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