Baker - Basis Of Pathology Cell Response To Stress

Question 1

What should we think about with diseases?

Answer 1

Cause/etiology

Pathogenesis
-Causal sequence of molecular events

Morphologic changes
-Structural consequences (diagnostic)

Clinical changes and prognosis

Question 2

What are 7 causes of cell injury and death?

Answer 2

Physical

Ischemia and hypoxia

Toxins and drugs

Infection

Inflammation

Genetic diseases

Nutritional problems

Question 3

What is hypertrophy?

Answer 3

Increase in cell size

Question 4

What is atrophy?

Answer 4

Degeneration of cells

Reduced size of an organ or tissue from a decrease in cell size and number

Question 5

What is hyperplasia?

Answer 5

Increase in number of cells

Question 6

What is metaplasia?

Answer 6

Cells change to another type

THIS IS REVERSIBLE

Question 7

What is dysplasia?

Answer 7

Pre-cancerous

More serious than metaplasia

Cells change to a more irreversible state

Question 8

What is fatty atrophy/cachexia?

Answer 8

Wasting syndrome

Loss of weight
Muscle atrophy
Fatigue
Weakness
Loss of appetite

Common in:
Cancer
AIDS
COPD
RA
TB
Crohn’s

Question 9

Cachexia is fatal at ___% of normal body weight.

Answer 9

~68%

Question 10

What is an example of metaplasia?

Answer 10

Smoker’s airways that reverse after smoking subsides

Question 11

Which highly metabolic cells are most prone to injury?

Answer 11

Cardiac myocytes

Renal tubular cells

Hepatocytes

Question 12

Which rapidly proliferating cells are most prone to injury?

Answer 12

Testicular germ cells

Intestinal epithelium

Hematopoietic cells

Question 13

When is cell injury reversible?

Answer 13

Damage not enough to kill cell

Question 14

What is cell injury irreversible?

Answer 14

Holes in membrane, long Ca2+ influx, Mito loss

*Apoptosis, necrosis

Question 15

What are reversible injuries?

Answer 15

Hypoxia

Anaerobic glycolysis

Cell swelling

Question 16

What is apoptosis?

Answer 16

Energy-req programmed death

No inflammation, usually one cell at a time

Happens in:

Embryology

Cell turnover

Viral infection

Cell damage

Question 17

What are the 2 apoptotic pathways?

Answer 17

Extrinsic pathway
-Cells in surroundings kill the cell
—Caspase 8 activation

Intrinsic pathway
-Cell kills itself
—Caspase 9 activation

*Both caspases lead to caspase 3 cleavage

Question 18

Tell me the extrinsic pathway.

Answer 18

TNF or Fas can stim the cell membrane

• TNF binds the TNF receptor
• Fas binds the Fas ligand

This leads to caspase 8 activation, influence by P53

That leads to caspase 3 cleavage

Leads to caspase cascade

Leads to apoptosis

Question 19

What is necrosis?

Answer 19

Uncoordinated cell death

ACUTE INFLAMMATION

Death in clusters, instead of cell by cell (like apoptosis)

Question 20

Nuclear pyknosis has what characteristics?

Answer 20

Shriveled, dark

Question 21

Karyolysis has what characteristics?

Answer 21

Digested, pale nucleus

Question 22

Karyorrhexis has what characteristics?

Answer 22

Nuclear fragmentation

Question 23

What is coagulation necrosis?

Answer 23

Accidental cell death typically caused by ischemia or infarct

*Heart infarct

Question 24

What is liquefactive necrosis?

Answer 24

Loss of substance

• Coagulative - cell outline is preserved*
• Liquefactive - cell outline NOT preserved*

Question 25

What is fat necrosis?

Answer 25

Lipase releases FAs from triglycerides Then complex with Ca2+ to form soaps -White, chalky deposits

Question 26

T/F - Gangrenous necrosis is a type of necrosis where blood supply is not present.

Answer 26

TRUE

Question 27

T/F - Organelles can have hypertrophy or atrophy.

Answer 27

TRUE

Question 28

**Tell me about necrosis**

Answer 28

Swelling of ER and mitochondria Membrane blebs Inflammation Breakdown of membrane

Question 29

**Tell me about apoptosis**

Answer 29

Condensation of chromatin Membrane blebs Cellular fragmentation Phagocytosis of apoptotic cells and fragments by MACROPHAGES

Question 30

What happens in cholesterolosis of gall bladder?

Answer 30

Lipid filled macrophages (Foam cells) seen in gallbladder lumen. No muscular mucosa is present

Question 31

What are the 3 brown storage products?

Answer 31

Lipofuscin -Degraded lipid in lysosomes Bilirubin - Hb breakdown product - Present in bile - Too much causes jaundice Hemosiderin - Iron containing pigment - Excessive iron absorption, bleeding into tissues

Question 32

What is melanin?

Answer 32

Produce by tyrosine oxidation, followed by polymerization

Question 33

What are the 2 types of protein storage?

Answer 33

``` Intracellular -Russell bodies in plasma cells -Alpha-1-antitrypsin deficiency Extracellular -Amyloid -Fibrosis (Scar) ```

Question 34

What is anthracosis?

Answer 34

Carbon pigment Harmless, around lungs

Question 35

What is calcification?

Answer 35

Calcification in wrong places

Question 36

Frostbite is an example of what type of necrosis?

Answer 36

Gangrenous necrosis

Question 37

Muscles in a body builder = what? Brain in dementia pt = ? Prostatic enlargement = ? Uterine cervical premalignant change = ?

Answer 37

Hypertrophy Atrophy Hyperplasia Dysplasia

Question 38

Tell me the 3 abnormal storage products.

Answer 38

Fatty change of liver -Common and nonspecific Glycogen accumulation - In liver in diabetes - Glycogen storage disease - Certain tumors Lipid storage -In vessels in atherosclerosis

Question 39

What is coagulative necrosis?

Answer 39

With ischemia = infarct Proteins denature and aggregate Cell outline preserved

Question 40

What is liquefactive necrosis?

Answer 40

Loss of substance (Brain or lung abscess) Cell outline NOT preserved

Question 41

What is fat necrosis?

Answer 41

Necrosis in fat

Question 42

What is caseous necrosis?

Answer 42

Necrotizing granulomas Combo of liquefactive and ocagulative Fungal or TB

Question 43

What is gangrenous necrosis?

Answer 43

Necrosis of whole anatomic area

Question 44

What is fibrinoid necrosis?

Answer 44

Ag/Ab complex form in arteries and vessels

Question 45

Tell me about the intrinsic pathway.

Answer 45

Bcl-2 (stabilizes mitochondria) Bax (destabilizes mitochondria) This leads to cytochrome C leaks from mitochondria That leads to caspase 9 activation influenced by P53 That leads to caspase 3 cleavage That leads to caspase cascade That leads to apoptosis

Question 46

P53 influences caspases. Name them.

Answer 46

Caspase 8 activation (Extrinsic pathway) Caspase 3 cleavage Caspase 9 activation (Intrinsic)