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MTC 3- Immunology > 10.13 Injury/ Inflammation/ Healing / Cancer > Flashcards

10.13 Injury/ Inflammation/ Healing / Cancer Flashcards

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1
Q

_ is an increased size of cells

A

Hypertrophy is an increased size of cells
* Ex: weight lifting

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2
Q

_ is a non-neoplastic increase in the number of cells in an organ/tissue

A

Hyperplasia is a non-neoplastic increase in the number of cells in an organ/tissue
* Physiologic not pathologic
* Ex: mammary tissue increasing during pregnancy

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3
Q

_ is a reduced size of cells or organs

A

Atrophy is a reduced size of cells or organs
* Ex: old people don’t use muscles so they lose them

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4
Q

_ is a conversion of one differentiated cell type to another

A

Metaplasia is a conversion of one differentiated cell type to another

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5
Q

Once changes occur to the _ of the cell, the damage is irreversible and cell death will proceed via _ or _

A

Once changes occur to the nucleus of the cell, the damage is irreversible and cell death will proceed via necrosis or apoptosis

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6
Q

A normal nucleus will appear round with chromatin still _ and nuclear membrane _

A

A normal nucleus will appear round with chromatin still dispersed and nuclear membrane still intact

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7
Q

_ is when the nucleus shrinks into a blue-black dot due to the chromatin clumping

A

Pyknosis is when the nucleus shrinks into a blue-black dot due to the chromatin clumping

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8
Q

_ is the fading or disappearance of the nucleus (less blue and distinct)

A

Karyolysis is the fading or disappearance of the nucleus (less blue and distinct)

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9
Q

_ is the fragmentation of the nucleus

A

Karyorrhexis is the fragmentation of the nucleus

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10
Q

One big difference between necrosis and apoptosis is that _ is always pathologic

A

One big difference between necrosis and apoptosis is that necrosis is always pathologic

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11
Q

(Necrosis/ apoptosis) usually involves mutliple cells within the tissue

A

Necrosis usually involves mutliple cells within the tissue

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12
Q

Another difference in necrosis and apoptosis is that _ can be initiated intrinsically

A

Another difference in necrosis and apoptosis is that apoptosis can be initiated intrinsically
* Apoptosis- intrinsic or extrinsic signal
* Necrosis- extrinsic signal (burn, hypoxia, toxin)

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13
Q

A series of steps involved in apoptosis ultimately release _ from the mitochondria which causes a _ cascade and disrupts the cytoskeleton

A

A series of steps involved in apoptosis ultimately release cytochrome c from the mitochondria which causes a caspase cascade and disrupts the cytoskeleton

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14
Q

The intrinsic apoptotic pathway begins with DNA damage activating _ and increasing _

A

The intrinsic apoptotic pathway begins with DNA damage activating P53 and increasing BAX/BAK
* Leads to cyt c release –> caspase cascade –> cytoskeleton disruption

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15
Q

Alternatively, apoptosis can be triggered extrinsically by _ ligand or by _ adaptive immune cells

A

Alternatively, apoptosis can be triggered extrinsically by Fas Ligand or by CD8+ adaptive immune cells

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16
Q

_ necrosis is the most common type of necrosis and is caused by loss of blood flow (ischemia)

A

Coagulative necrosis is the most common type of necrosis and is caused by loss of blood flow (ischemia)

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17
Q

_ necrosis is a type of necrosis associated with abscess formation with intense infiltration of neutrophils (pus-forming)

A

Liquifactive necrosis is a type of necrosis associated with abscess formation with intense infiltration of neutrophils (pus-forming); it is caused by enzymatic lysis of cells
* Ex: lung abscess with liquifactive necrosis and cavitation
* Neural tissue liquefaction

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18
Q

How would necrotic myocytes look different from normal?

A

Necrotic myocytes (following MI) are hyper-eosinophilic (pink) and have ghost cells (lack nuclei)

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19
Q

_ necrosis occurs when granuloma formation leads to the death of surrounding tissue

A

Caseous necrosis occurs when granuloma formation leads to the death of surrounding tissue

Cheese appearance
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20
Q

What are the common causes of caseous necrosis?

A

TB infection, histoplasmosis
* These are granuloma-forming

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21
Q

_ necrosis occurs from a breakdown of triglycerides and resulting fat saponification (due to pancreatitis)

A

Fat necrosis occurs from a breakdown of triglycerides and resulting fat saponification (due to pancreatitis)

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22
Q

_ necrosis is the deposition of fibrin and immune complexes in blood vessel walls

A

Fibrinoid necrosis is the deposition of fibrin and immune complexes in blood vessel walls
* Associated with vasculitis, autoimmune disease, hypertensive emergencies

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23
Q

4 cardinal signs of acute inflammation:

A
  1. Swelling (tumor)
  2. Redness (rubor)
  3. Heat (calor)
  4. Pain (dolor)
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24
Q

What is the goal of acute inflammation?

A
  • We want to deliver effective molecules to the site of injury/inflammation –> vasodilation
  • We want to cause blood clotting at the site –> clotting
  • We want to promote repair of the tissue –> recruit inflammatory cells
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25
How do we recruit and activate inflammatory cells to come to the site of infection?
**Increase expression of leukocyte adhesion molecules** on endothelial cells
26
During acute inflammation, the first innate immune cells to arrive are _
During acute inflammation, the first innate immune cells to arrive are **neutrophils** * They will kill microorganisms via phagocytosis
27
Neutrophil response will peak about _ hours after injury/infection
Neutrophil response will peak after **24 hours** after injury/infection
28
_ are the predominant cell type 48-72 hours after injury/infection
**Macrophages** are the predominant cell type 48-72 hours after injury/infection
29
What are the steps of neutrophil migration?
1. **Margination**: increased vascular permeability leads to increased hemoconcentration which increases the probability of neutrophils contacting the endothelium; "marginate" meaning they move toward the periphery of blood flow 2. **Rolling**: slows the neutrophil down; Sialyl-lewis glycoproteins interact with the "selectin speed bumps" 3. **Binding**: tight adhesion with ICAM-1 on the endothelium stops the neutrophil in place 4. **Diapedesis**: neutrophil crawls between endothelial cells (PECAM-1) 5. **Chemotaxis**: IL-8
30
Neutrophil rolling involves _ glycoproteins on the neutrophil interacting with _ on the endothelium
Neutrophil rolling involves **sialyl-lewis** glycoproteins on the neutrophil interacting with **E-selectin, P-selectin** on the endothelium; *selectin speed bumps slow down neutrophil*
31
Neutrophil binding involves an integrin on the neutrophil interacting with _ on the endothelium
Neutrophil binding involves an integrin on the neutrophil interacting with **ICAM-1** on the endothelium
32
Diapedesis/ migration of neutrophils through the endothelium involves _
Diapedesis/ migration of neutrophils through the endothelium involves **PECAM-1**
33
Chronic inflammation can onset _ hours after injury/infection and can last weeks, months, years
Chronic inflammation can onset **48 hours** after injury/infection and can last weeks, months, years
34
_ inflammation is exudative _ inflammation is proliferative
**acute** inflammation is exudative **chronic** inflammation is proliferative
35
_ are the main cells of acute inflammation _ are the main cells of chronic
**Neutrophils** are the main cells of acute inflammation **Macrophages, lymphocytes, plasma cells** are the main cells of chronic inflammation
36
What are the manifestations/ results of acute inflammation?
Vascular changes, edema, pus, abscess
37
What are the manifestations/ results of chronic inflammation?
Tissue destruction, angiogenesis, fibrosis, granulomas
38
Define these consequences of chronic inflammation: **Fibrosis:** **Angiogenesis:** **Tissue remodeling:**
Define these consequences of chronic inflammation: **Fibrosis:** scar formation **Angiogenesis:** new vessel formation **Tissue remodeling:** alter structure to suit new environment
39
coagulative necrosis
40
Liquifactive necrosis
41
Caseous necrosis
42
fat necrosis
43
Fibrinoid necrosis
44
Caseous necrosis (infectious granuloma)
45
Non-infectious/ non-caseating granuloma (ex: sarcoidosis)
46
Fat necrosis in the pancreas
47
Liquifactive necrosis
48
Coagulative necrosis (myocyte)
49
_ is chronic inflammation of arteries
**Atherosclerosis** is chronic inflammation of arteries
50
_ is cirrhosis or scarring of the liver parenchyma
**Hepatic fibrosis** is cirrhosis or scarring of the liver parenchyma
51
_ are tracts that form between hollow organs
**Fistulas** are tracts that form between hollow organs
52
_ are tumor-like nodules formed by activated macrophages which can fuse into giant cells and be surrounded by T lymphocytes
**Granulomas** are tumor-like nodules formed by activated *macrophages* which can fuse into giant cells and be surrounded by *T lymphocytes* * Infectious: **TB** * Autoimmune: **Sarcoidosis**
53
Tissue repair following MI: 1. Acute inflammation and _ necrosis
Tissue repair following MI: 1. **Acute inflammation** and **coagulative** necrosis
54
Tissue repair following MI: 1. Acute inflammation and coagulative necrosis 2. Proliferation of fibroblasts and vasculature in attempt to repair --> _ tissue
Tissue repair following MI: 1. Acute inflammation and coagulative necrosis 2. Proliferation of fibroblasts and vasculature in attempt to repair --> **granulation tissue**
55
Tissue repair following MI: 1. Acute inflammation and coagulative necrosis 2. Proliferation of fibroblasts and vasculature in attempt to repair --> granulation tissue 3. Heart cannot repair itself; we have collagen maturation and _ tissue formation
Tissue repair following MI: 1. Acute inflammation and coagulative necrosis 2. Proliferation of fibroblasts and vasculature in attempt to repair --> granulation tissue 3. Heart cannot repair itself; we have **collagen maturation** and **fibrous (scar) tissue** formation
56
Whether a tissue is able to regenerate or will instead be replaced by fibrosis (scar) is determined by two factors _ and _
Whether a tissue is able to regenerate or will instead be replaced by fibrosis (scar) is determined by two factors **tissue type** and **extent of damage to the ECM**
57
Neurons, cardiac muscle, and skeletal muscle are examples of _ tissue which undergo fibrosis
Neurons, cardiac muscle, and skeletal muscle are examples of **non-dividing tissues** which undergo fibrosis
58
Labile tissues (are/ are not) able to regenerate
Labile tissues **can regenerate** --> these are continuously dividng tissues like the skin
59
_ is a new or abnormal growth of tissue in the body
**Neoplasma** is a new or abnormal growth of tissue in the body * Unregulated, irreversible, monoclonal
60
_ is the feature of a neoplasm (tumor) that classifies it as malignant
**Metastasis** is the feature of a neoplasm (tumor) that classifies it as malignant
61
_ is a term that describes the degree to which neoplastic cells resemble the tissue of origin
**Differentiation** is a term that describes the degree to which neoplastic cells resemble the tissue of origin * *Well differentiated* means that the neoplastic cells still look similar to the original tissue
62
_ describes a neoplasm that does not resemble the tissue of origin at all (high grade)
**Anaplastic** describes a neoplasm that does not resemble the tissue of origin at all (high grade)
63
(Stage/ Grade) is the histologic features of the neoplasm (degrees of differentiation)
**Grade** is the histologic features of the neoplasm (degrees of differentiation) * better predictor of prognosis
64
What does cancer *stage* refer to?
**Stage**: tumor size and the extent of the spread
65
Barret's esophagus is a condition where the esophagus is chronically exposed to HCl from the gut, which triggers the replacement of _ cells with _ cells; this is an example of _
**Barret's esophagus** is a condition where the esophagus is chronically exposed to HCl from the gut, which triggers the replacement of **stratified squamous** cells with **columnar** cells; this is an example of **metaplasia**
66
Tobacco smoke causes another type of metaplasia where _ cells are replaced with _ in the bronchi
Tobacco smoke causes another type of metaplasia where **columnar** cells are replaced with **squamous epithelium** in the bronchi
67
What is dysplasia?
**Dysplasia** is disordered growth/formation; involves various shapes, sizes, staining of cells * These cells are rapidly dividing * There is an increase in ratio of nucleus: cytoplasm
68
Cancers that end in -oma are normally (benign/ malignant)
Cancers that end in **-oma** are normally **benign**
69
Cancers that end in _ or _ are normally malignant
Cancers that end in **-carcinoma** or **-sarcoma** are normally malignant
70
What are some **neoplastic cancers** that are the exception to the naming rules?
Neoplastic cancers: * Lymphoma (Lymphocytes) * Leukemia (WBCs) * Mesothelioma * Melanoma * Seminoma (male germ cells)
71
_ is disorganized tissue indigenous to the site
**Hamartoma** is disorganized tissue indigenous to the site (harmless)
72
_ are microscopically normal cells in an abnormal location
**Choristomas** are microscopically normal cells in an abnormal location (benign)
73
4 steps of metastasis
1. **Invasion** decrease cell adhesions (disrupt cadherins and catenins) 2. **Intravasation**: entry into bloodstream/ lymphatics 3. **Extravasation**: exit the bloodstream and into the tissue 4. **Growth at secondary site**: need favorable growing conditions
74
3 routes of metastasis
1. **Hematogenous**: blood 2. **Lymphatic**: lymphatic system 3. **Seeding**: spreading through body cavities
75
What are paraneoplastic syndromes?
**Paraneoplastic syndromes**: groups of signs and sx that occur in cancer patients but aren't directly related to the tumor growth itself * Ex: **squamous cell carcinomas** can cause **hypercalcemia**
76
(True/ False) stress on skeletal muscle can cause hyperplasia
False; skeletal muscle is a permanent tissue --> permanent tissues cannot make new cells --> undergo *hypertrophy only*
77
Metaplasia is technically reversible if stress conditions are removed; however, if not, it can progress to _
Metaplasia is technically reversible if stress conditions are removed; however, if not, it can progress to **dysplasia**
78
_ necrosis is a coagulative necrosis that resembles mummified tissue; it is characterized by ischemia of the lower limb or GI tract
**Gangrenous necrosis** is a coagulative necrosis that resembles mummified tissue; it is characterized by ischemia of the lower limb or GI tract * If superimposed infection of dead tissue happens --> liquifactive necrosis --> *wet gangrene*
79
Noncaseating granulomas are different from caseating granulomomas because they lack _
Noncaseating granulomas are different from caseating granulomomas because they lack **central necrosis**
80
The most common cancers by incidence are: 1. 2. 3
Incidence: 1. Breat, prostate 2. Lung 3. Colorectal
81
The most common cancers by mortality are: 1. 2. 3
Mortality: 1. Lung 2. Breat/prostate 3. Colorectal

MTC 3- Immunology (8 decks)

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