Cell Adaptation/Necrosis

Question 1

Prolonged exposure of cells to adverse/exaggerated normal stimuli –> evokes various changes of individual cells/tissues/whole organs. When cause removed, adapted cells revert to normal and some do not (detrimental results)

Answer 1

Cell adaptation

Question 2

**6 ways cell adapt to change**

Answer 2

• Atrophy
• Hypertrophy
• Hyperplasia
• Metaplasia
• Dysplasia
• Anaplasia

Question 3

Decrease in size of tissue, organ, or entire body

Answer 3

atrophy

Question 4

2 types of atrophy

Answer 4

• physiologic
• pathologic

Question 5

3 examples of physiologic atrophy

Answer 5

• Involution of thymus
• Menopause (ovaries/uterus/breasts)
• Osteoporosis (bones and muscles in elderly thin/prone to fx)

Question 6

3 examples of pathologic atrophy

Answer 6

• kidneys shrinking due to atherosclerosis
• testicular atrophy
• Alzheimer Dementia

Question 7

Ischemic organs are typically small or large? What is this an example of?

Answer 7

Small, due to atherosclerosis (hardening of arteries decreases blood supply). An example of pathologic atrophy.

Question 8

Widening of sulci, narrowing of girations, spares occiput

Answer 8

Pathologic atrophy from Alzheimer’s Disease

Question 9

**Best example of pathologic atrophy?**

Answer 9

Alzheimer’s Disease

Question 10

Increase in size of tissues/organs due to enlargement of individual cells

Answer 10

Hypertrophy

Question 11

Example of physiologic hypertrophy

Answer 11

Enlargement of skeletal muscles in body builders due to weights

Question 12

Example of pathologic hypertrophy

Answer 12

Enlargement of heart which occurs as adaptation to increased workload (HTN)

Question 13

What is the best example of pathologic hypertrophy?

Answer 13

Typically seen w/ HTN (enlarged heart)

• Concentric pathologic hypertrophy of left ventricular muscle, an adaptive response to left ventricular pressure overload

Question 14

Adaptive increase in number of cells, causes enlargement of tissues/organs

Answer 14

Hyperplasia

Question 15

Example of hyperplastic hyperplasia

Answer 15

Hyperplastic polyps of color or stomach (benign)

Question 16

Example of hyperplasia in women?

Answer 16

Edometrial hyperplasia due to estrogens (benign, causes vaginal bleeding)

Question 17

Can hyperplasia and hypertrophy be seen together?

Answer 17

Yes

Question 18

Example where hyperplasia is seen along w/ hypertrophy in women?

Answer 18

-Physiologic hypertrophy of uterine smooth muscle cells w/ pregnancy is accompanied by hyperplasia

Question 19

Example where hyperplasia is seen along w/ hypertrophy in men?

Answer 19

-Hyperplastic prostate (BPH- benign prostatic hyperplasia) results in both size AND number of glands and stroma

Question 20

Adaptive change of one cell type for another cell type to suit the environment

Answer 20

Metaplasia

Question 21

2 examples of metaplasia

Answer 21

• bronchial epithelium changes w/ smoking cigarettes
• gastric or glandular metaplasia of GE junction in Barrett Esophagus

Question 22

Is metaplasia reversible? Why?

Answer 22

Yes, it is always pathologic, never physiologic

Question 23

Normal epithelium in non-smoker changes to which epithelium in smoker?

Answer 23

mucus-secreting ciliated pseudostratified columnar epithelium replaced by stratified squamous epithelium

Question 24

The #1 type of squamous metaplasia of bronchial epithelium

Answer 24

Squamous Cell Carcinoma

Question 25

Disordered growth of tissues from chronic irritation or infection

Answer 25

Dysplasia

Question 26

Pre-cancerous condition

Answer 26

Dysplasia

Question 27

Best example of dysplastic changes as it relates to disease

Answer 27

Cervical dysplasia (CIN: cervical intraepithelial neoplasia) \*\* association of dysplasias/cervical cancers w/ HPV

Question 28

HPV loves which type of epithelium?

Answer 28

Stratified squamous epithelium

Question 29

Type of mild dysplasia

Answer 29

CIN 1 (cervical intraepithelial neoplasia)

Question 30

Undifferentiated and uncontrolled growth of cells

Answer 30

Anaplasia (the hallmark of malignant transformation) = cancer

Question 31

4 names of anaplasia

Answer 31

* Cancer * Neoplasm * Carcinoma * Malignancy

Question 32

4 examples of anaplasia

Answer 32

* Squamous cell carcinoma of cervix * Lung cancer * Malignant Melanoma * Renal Cell Carcinoma (RCC)

Question 33

5 microscopic hallmarks of anaplasia

Answer 33

1. Cell and Nuclei w/ pleomorphism (varied size/shape) 2. Nuclei are irregular and hyperchromatic (purple) 3. Super high nuclear/cytoplasmic ratio (N/C ratio is 1:1 and normally is 1:6) 4. Large nucleoli within nucleus 5. Large numbers of abnormal mitotic figures

Question 34

Death of cells or groups of cells (tissues) within a LIVING organism

Answer 34

Necrosis

Question 35

Necrosis in tissues after death of an organism

Answer 35

Autolysis

Question 36

\*\*4 types of necrosis\*\*

Answer 36

* Coagulative * Liquefactive * Caseous * Fat

Question 37

Most common form of necrosis

Answer 37

Coagulative necrosis

Question 38

Type of necrosis when cell proteins are altered/denatured (cooking eggs). Histologically, cell outlines are preserved and cytoplasm is finely granular

Answer 38

Coagulative necrosis

Question 39

Type of necrosis which occurs in solid internal organs (heart, kidney, spleen, liver) and is caused by Anoxia (lack of O2 in blood supply) Best example?

Answer 39

Coagulative necrosis -Heart tissue w/ MI

Question 40

Type of necrosis where dead cells liquify due to certain cell enzymes. Tissues become soft/gel like

Answer 40

Liquefactive necrosis

Question 41

Where does liquefactive necrosis occur most often?

Answer 41

Brain, cells lose contours and liquefy (typical of brain infarct). Soft and transformed into fluid filled cavity

Question 42

Another example of liquefactive necrosis other than brain?

Answer 42

Bacterial infections in which cavity may develop (abscesses in lungs)

Question 43

A form of coagulative necrosis where thick, yellowish, cheesy substance forms

Answer 43

Caseous necrosis

Question 44

2 examples of caseous necrosis

Answer 44

-TB -Fungal infections such as Histoplasmosis

Question 45

Ghon Complex (development of lung granulomas). Usually heals containing infection.

Answer 45

Caseous necrosis found in TB

Question 46

Specialized form of liquefacation necrosis caused by action of lipolytic enzymes

Answer 46

Fat necrosis

Question 47

Example of fat necrosis

Answer 47

-After rupture of pancreas due to trauma or acute pancreatitis, enzymes are released into adjacent fat tissue causing degradation of fat into glycerol and FFA

Question 48

With pancreatic trauma, once the fat is degraded to form glycerol and free fatty acids (FFA), what do the FFA bind with and form?

Answer 48

Bind with Ca and form soaps causing white calcified specks (a sign of fat necrosis)

Question 49

Bacterial infection of coagulated tissue leading to inflammation and secondary liquefaction

Answer 49

Wet gangrene

Question 50

Provides a good medium for infection by bacteria

Answer 50

Necrotic tissues

Question 51

Wet Gangrene is also called what?

Answer 51

Advanced decubitus ulcers

Question 52

Necrotic tissue becomes black and mummified

Answer 52

Dry gangrene (necrotic tissue dries out)

Question 53

What 2 underlying conditions contribute to gangrene?

Answer 53

* Infarction of intestines - * Infarction in a limb (usually caused by atherosclerosis or diabetes)

Question 54

Necrotic tissue attracts calcium salts and frequently undergoes calcification (macroscopic deposition of Ca in injured/dead tissues)

Answer 54

Dystrophic Calcifications

Question 55

* Visible to naked eye * Range from gritty/sand like grains to firm/rock hard material

Answer 55

Dystrophic Calcifications

Question 56

4 examples of dystrophic calcifications

Answer 56

Calcifications of: 1. Atherosclerotic coronary arteries (narrowing of vessels) 2. Mitral/Aortic valves (impeding blood flow = stenosis) 3. Breast cancers (seen on mammography) 4. Infant periventricular calcifications (congenital toxoplasmosis) - pregnancy and litter boxes

Question 57

* Deranged calcium metabolism (NOT cell injury). * Associated w/ increased serum Ca levels, leads to deposition of Ca in other locations

Answer 57

Metastatic Calcifications

Question 58

Metastatic calcifications are seen in what 3 disorders?

Answer 58

* Hyperparathyroidism * Vit D toxicity * Chronic Renal Failure

Question 59

* Metastatic calcifications forms Ca stones in which 3 organs? * Due to what?

Answer 59

* Gallbladder * Kidneys * Bladder * (due to precipitation of salts from solution into tissues)