L1 Cell Injury Flashcards

1
Q

What is disease?

A

The reaction of a cell or group of cells to an injury

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2
Q

What 2 broad effects can an injury have on a cell?

A
  1. Disrupt biochemical processes of the cell (function)

2. Damage components of the cell directly (structure)

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3
Q

What is the etiology of a disease?

A

The cause of the disease

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4
Q

What is the pathogenesis of the disease?

A

The mechanisms of disease

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5
Q

What are the 8 general etiologies of injury?

A
  1. Hypoxia (oxygen deprivation)
  2. Chemical
  3. Physical
  4. Infectious
  5. Immunologic
  6. Genetic
  7. Nutritional
  8. Degenerative (aging)
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6
Q

What are the three ways cells change in the adaptation process?

A
  1. Size
  2. Number
  3. Appearance
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7
Q

What are the 4 types of cell adaptation?

A
  1. Hyperplasia
  2. Hypertrophy
  3. Atrophy
  4. Metaplasia
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8
Q

What is hyperplasia?

A

Increase in the number of cells

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9
Q

What is hypertrophy?

A

Increase in the size of a cell because of increased cellular substance

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10
Q

What is atrophy?

A

Decrease in the size of a cell because of loss of cellular substance

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11
Q

What is metaplasia?

A

Substitution of one type of an adult cell for another type of adult cell

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12
Q

A normal cell reacts to stress by ___. When this cannot occur, or when injurious stimuli occur, ___ results. What are the two outcomes of this?

A

Adapting; cell injury; reversible injury, irreversible injury

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13
Q

True or false - as cell function decreases, changes are readily apparent.

A

False - cell function decreases before we can see changes

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14
Q

What are the two features of irreversible cell injury?

A
  1. Non-repairable mitochondrial dysfunction
  2. Profound membrane dysfunction
    (membrane & mito)
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15
Q

What are the 5 major mechanisms of cell injury?

A
  1. Hypoxia and ischemia (decreased ATP)
  2. Multiple injurious stimuli (increased ROS)
  3. Mutations, cell stress, infections (accumulation of misfolded proteins)
  4. Radiation, other insults (DNA damage)
  5. Infections, immunologic disorders (inflammation)
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16
Q

Describe the hypoxic injury model.

A

Ischemia, hypoxemia, or decreased oxygen carrying capacity –> decreased oxidative phosphorylation in the mitochondria –> decreased ATP –> 3 things:

  1. Decreased sodium pump –> increased influx of calcium, water, sodium, efflux of potassium –> ER/cellular swelling, loss of microvilli, blebs
  2. Increased anaerobic glycolysis –> decreased glycogen, increased lactic acid, decreased pH
  3. Detachment of ribosomes –> decreased protein synthesis
17
Q

What can be measured clinically to check for altered membrane permeability?

A

Levels of intracellular enzymes in vasculature

Examples: elevated CK or troponin in myocardial cells (acute MI), elevated AST/ALT in hepatocytes (hepatitis)

18
Q

What is reperfusion injury?

A

Further injury to cells when blood/oxygen returns to ischemic tissue; caused by free radicals (from leukocytes)

19
Q

What are the 5 components of the morphology of reversible cell injury?

A
  1. Cellular swelling
  2. Steatosis (fatty change)
  3. Myelin figures (collections of phospholipids)
  4. ER swelling
  5. Membrane blebs
20
Q

What is necrosis?

A

The sum total of morphologic changes which occur in tissue following cell death

21
Q

The presence of ___ is characteristic of necrosis.

A

Leukocytes (especially neutrophils) infiltrating dead tissue.

22
Q

What are the 5 morphologic patterns of necrosis?

A
  1. Coagulative
  2. Liquefactive
  3. Caseous
  4. Enzymatic fat
  5. Gangrene
23
Q

What type of necrosis is associated with severe ischemia in solid organs?

A

Coagulative necrosis

24
Q

Describe the histology of coagulative necrosis.

A

Ghost-like remnants of intact cells which lack nuclei; cell outline preserved; eosinophilia (cytoplasm stains pink)

25
Q

What type of necrosis is associated with bacterial infections?

A

Liquefactive

26
Q

Liquefactive necrosis is often seen in ___.

A

Brain hypoxia/infarct

27
Q

Describe the histology of liquefactive necrosis.

A

Necrotic amorphous tissue surrounded by a rim of neutrophils

28
Q

What type of necrosis is associated with a granuloma?

A

Caseous

29
Q

Describe the histology of caseous necrosis.

A

Amorphous debris in the center of a granulomatous cell reaction (lymphocytes, macrophages, giant cells)

30
Q

What type of necrosis describes cell death in the pancreas and adjacent fat?

A

Enzymatic fat necrosis

31
Q

What is gangrene?

A

Ischemic necrosis of an extremity, bowel, or gallbladder

32
Q

What is a regulated pattern of cell death characterized by nuclear condensation and fragmentation coupled with fragmentation of cytoplasm into acidophilic bodies, followed by phagocytosis?

A

Apoptosis

33
Q

True or false - apoptosis is not associated with an inflammatory reaction.

A

True

34
Q

Where is apoptosis seen normally?

A
  1. Normal embryogenesis
  2. Hormone dependent physiologic involution (menstrual cycle)
  3. Proliferating cell populations (intestinal crypts)
35
Q

Where is apoptosis seen abnormally?

A
  1. DNA damage
  2. Infections
  3. Accumulation of misfolded proteins