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cell injury 1 Flashcards

Cell injury (reversible vs. irreversible) Cell death (Necrosis vs. apoptosis) Causes of cell injury Necrosis and its morphological pattern (86 cards)

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1
Q

give examples on anatomical pathology

A

Surgical pathology
Cytopathology
Forensic pathology

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2
Q

give examples on clinical pathology

A

Hematology
Biochemistry
Serology & hormones
Microbiology
Body fluids
Molecular pathology

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3
Q

general pathology include?

A

Cell injury, death and adaptations
Inflammation and repair
Hemodynamic disorders
Diseases of immune system
Neoplasia
Genetic & pediatric diseases
Environmental and nutritional diseases

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4
Q

what is Homeostasis?

A

the capacity of the human body to maintain a stable constant state

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4
Q

give examples on adaptation?

A

hypertrophy-hyperplasia-atrophy-metaplasia

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5
Q

when the irreversible injury happens?

A

if the stress is severe, persistent, or rapid in onset, it results in irreversible injury and death of the affected cells

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6
Q

what is ischemia?

A

lack of blood flow

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6
Q

what is hypoxia?

A

lack of o2 in the cells

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7
Q

what are the types of the cell death?

A

apoptosis-necrosis

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8
Q

what is the most common cause of hypoxia?

A

ischemia

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9
Q

what more dangerous?ischemia or hypoxia

A

ischemia

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10
Q

other causes of hypoxia?

A

inadequate oxygenation of the blood (lung disease)
reduction in the oxygen-carrying capacity of the blood (anemia, CO poisoning)

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11
Q

what is reversible injury?

A

stage of cell injury at which the deranged function and morphology of the injured cells can return to normal if the damaging stimulus is removed

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12
Q

what are the most common causes of cell injuries?

A

Hypoxia
Ischemia

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13
Q

why cell become swollen in reversible injury?

A

-they take in water
as a result of the failure of
energy-dependent ion pumps in the plasma membrane
leading to an inability to maintain ionic and fluid homeostasis

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14
Q

what is main morphologic correlates of reversible cell injury?

A

Cellular swelling
Fatty change

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15
Q

what happens in hydropic degeneration?

A

first hypoxia then
ATP production decrease and activity of Na/k pump decrease
then na in the cell increase
and water in the cell increase by osmosis which cause cellular swelling
cisternae of ER distend and rupture and form vacuoles (extensive vacuoltion)

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16
Q

cellular swelling macroscopically or cellular swelling morphologically causes what?

A

Pallor(as result of compression of capillaries)
increased turgor, and an increase in organ weight

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16
Q

microscopic examination of cellular swelling shows ?

A

Microscopic examination may show
small, clear vacuoles within the cytoplasm; these represent distended and pinched-off segments of the endoplasmic reticulum (ER).
Hydropic change or vacuolar degeneration

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17
Q

Causes of cell injury can be?

A

Hypoxia, ischemia
Infectious agent
Toxins
Immunological reactions
Genetic abnormalities
Nutritional imbalances
Physical agents
Aging

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17
Q

Cell injury happen after?

A

1injurious stimuli
2 adaptive responses exceeded or significant damaging insults

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18
Q

What happen to ER in cell cell injury?

A

Swell/dilation
With detachment of ribosomes and dissociation of polysomes

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19
Q

What’s get in the cell in cell injury?

A

Sodium and water and potassium out

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20
Q

why cellular swelling happen?

A

Increased permeability of the plasma membrane

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21
What the colour of injured cytoplasm might be?
Redder(eosinophilic)
22
What is the hydropic change or vacuolar degeneration?
Include macroscopic and microscopic view
23
What is fatty change in cell injury?
the appearance of triglyceride containing lipid vacuoles in the cytoplasm
24
What happen to mitochondria in cell injury?
changes such as swelling and the appearance of phospholipid-rich amorphous densities;
25
What happen to plasma memin cell injury?
alterations such as blebbing, blunting, or distortion of microvilli, and loosening of intercellular attachments;
26
What nuclear alternations might happen in cell injury?
Clmping of chromatin
27
Cell size in necrosis and apoptosis
Necrosis= enlarged/swell due to permeability Apoptosis= shrink due to the cell feed on it self
28
Explain myelin figure that happen in cell injury
which are collections or membranous whorls or lamellated aggregates of phospholipids resembling myelin sheaths that are derived from damaged membranes of mitochondria or ER or cell membrane
29
In which death the cell skrink?
Apoptosis
30
Nucleus in necrosis and apoptosis
Necrosis=pyknosis,karyorrhexis,karyolysis Apoptosis=fragmentation into nucleosome-size fragments
31
Plasma membrane in apoptosis and necrosis
Necrosis= distrupted_loss plama membrane integrety Apoptosis=intact -plasma membrane blebbing
32
Cellular conent in necrosis and apoptosis
Necrosis= enzymatic digestion ,may leak out of the cell Apoptosis= intaxt =may release in apoptotic bodies
33
What is called accidental cell death?
Necrosis
34
Is necrosis regulated or programmed
inevitable end result of severe damage that is beyond salvage and is not thought to be regulated by specific signals or biochemical mechanisms.
35
What is the programmed cell death
When the injury is less severe, or cells need to be eliminated during normal processes, they activate a precise set of molecular pathways that culminate in death.
36
Clean form of cell suicide is?
Apoptosis
37
When apoptosis happen in pathological situations?
when a cell’s DNA or proteins are damaged beyond repair or the cell is deprived of necessary survival signals.
38
Which death type is always an indication of pathological process?
Necrosis
39
Does cellular function loss happen after cell death?
be lost long before cell death occurs, and that the morphologic changes of cell injury (or death) lag far behind loss of function and viability
40
What is necrosis?
Necrosis is a form of cell death in which cellular membranes fall apart, and cellular enzymes leak out and ultimately digest the cell. * Necrosis elicits inflammation, induced by substances released from dead cells and which serves to eliminate the debris and start the subsequent repair process
41
From where the enzymes responsible for the digestion of the cell come from?
Derived from lysosomes and may come from the dying cells themselves or from leukocytes recruited as part of the inflammatory reaction
42
Explain the biochemical mechanisms of necrosis
1_ Failure of energy generation in the form of ATP because of reduced oxygen supply or mitochondrial damage; 2. damage to cellular membranes, including the plasma membrane and lysosomal membranes, which results in leakage of cellular contents including enzymes; 3. irreversible damage to cellular lipids, proteins, and nucleic acids, which may be caused by reactive oxygen species (ROS); and others.
43
What are the morphological changes in necrotic cell?
1_increased eosinophilia 2_glassy, homogeneous appearance (loss of lighter staining glycogen particles) 3_When enzymes have digested cytoplasmic organelles, the cytoplasm becomes vacuolated and appears “moth-eaten.
44
Describe how the necrotic cell look under electron microscope?
1_discontinuities in plasma and organelle membranes 2_marked dilation of mitochondria associated with the appearance of large amorphous intramitrochondrial densities 3_ disruption of lysosomes 4_ intracytoplasmic myelin figures
45
Explain the nucleur changes in necrotic cell
1_Pyknosis: The nucleus shrinks and becomes dense due to chromatin condensation. 2_Karyorrhexis: The nucleus fragments into smaller pieces. 3_Karyolysis: The nuclear fragments dissolve/fade leading to complete loss of the nucleus due to action of DNAases and RNAases And in 1_2 days the nucleus may disappear completely
46
What is the fate of dead cells?
Dead cells may be replaced by myelin figures, which are either phagocytosed by other cells or further degraded into fatty acids. * These fatty acids bind calcium salts, which may result in the dead cells ultimately becoming calcified.
47
Explain necrosis in 6 steps
1_ always pathogenic 2_cell enlarged 3_loss of membrane integrity 4_leakage of content 5_inflammation 6_nuclear degeneration
48
Explain apoptosis in 5 steps
1_programmed cell death(unwanted cells) 2_cell shrink 3_nuclear fragmentation 4_apoptotic bodies 5_phagocytosis of apoptotic bodies(no inflammation)
49
List the morphological patterns of tissue necrosis
1_coagulative necrosis 2_liquefactive necrosis 3_gangrenous neceosis 4_caseous necrosis 5_fat necrosis 6_fibrinoid necrosis
50
Where we find coagulative necrosis?
characteristic of infarcts (areas of necrosis caused by ischemia) in all solid organs except the brain.
51
Coagulative necrosis is characterized by?
1_The underlying tissue architecture is preserved for at least several days after death of cells in the tissue. 2_ firm texture 3_ the injury denatures not only structural proteins but also enzymes 4_eosinophilic, anucleate cells 5_ Leukocytes are recruited to the site of necrosis, and the dead cells are ultimately digested by the action of lysosomal enzymes of the leukocytes. 6_The cellular debris is then removed by phagocytosis mediated primarily by infiltrating neutrophils and macrophages
52
Why in coagulative necrosis the proteolysis of dead cells is blocked?
Because the injury denatures not only structural protiens but also enzymes
53
Talk about liquefactive necrosis
1_ In Focal bacterial and, occasionally, fungal infections, because microbes stimulate rapid accumulation of inflammatory cells 2_ and the enzymes of leukocytes digest (“liquefy”) the tissue 3_ For obscure reasons, hypoxic death of cells within the central nervous system often evokes liquefactive necrosis.
54
Which necrosis evoked by hypoxic death in cns?
Liquefactive necrosis
55
When liquefactive necrosis happen?
In Focal bacterial and, occasionally, fungal infections, because microbes stimulate rapid accumulation of inflammatory cells
56
What happen to dead cells in liquefactive necrosis?
are completely digested, transforming the tissue into a viscous liquid that is eventually removed by phagocytes.
57
PUS , when it happen in liquefactive necrosis?
If the process is initiated by acute inflammation, as in a bacterial infection, the material is frequently creamy yellow and is called pus.
58
Explain gangrenous necrosis
is not a distinctive pattern of cell death, but the term is still commonly used in clinical practice. * It usually refers to the condition of a limb (generally the lower leg) that has lost its blood supply and has undergone coagulative necrosis involving multiple tissue layers. When bacterial infection is superimposed, the morphologic appearance changes to liquefactive necrosis because of the destructive contents of the bacteria and the attracted leukocytes (resulting in so-called “wet gangrene”).
59
What is wet gangrene?
bacterial infection is superimposed, the morphologic appearance changes to liquefactive necrosis because of the destructive contents of the bacteria and the attracted leukocytes (resulting in socalled “wet gangrene”)
60
multiple Coagulative necrosis in leg is called?
Dry gangrene
61
Liquefactive necrosis in gangrentic tissue is called?
Wet gangrene
62
Cheeselike necrosis is ?
Caseous necrosis
63
Caseous necrosis is caused by ?
Granuloma (nodular inflammatory lesion)
64
what cause coagulative necrosis?
ischemia(sudden cessation or decrease in blood flow)
65
what necrosis is seen in the brain mostly?
liquifactive necrosis
66
the cell in coaqulative necrosis is characterized by ?
eosinophilic, anucleate cells
67
why in coagulative necrosis The underlying tissue architecture is preserved for at least several days after death of cells in the tissue??
Because the injury denatures not only structural protiens but also lysis enzymes which delay the breakdown process of dead cells for several days
68
if cougulative necrosis denatures enzymes of the cell . then how dead cell is removed ?
Leukocytes are recruited to the site of necrosis, and the dead cells are ultimately digested by the action of lysosomal enzymes of the leukocytes. The cellular debris is then removed by phagocytosis mediated primarily by infiltrating neutrophils and macrophages.
69
wet gangrenous is caused by ?
bacterial infection
70
dry gangrenous is caused by ?
loss of blood supply
71
what is the microscopic characteristics of the Caseous necrosis?
the necrotic focus appears as a collection of fragmented or lysed cells with an amorphous granular pink appearance
72
Tuberculous infection can cause?
Caseous necrosis
73
what is granuloma?
Caseous necrosis is often surrounded by a collection of macrophages and other inflammatory cells; this appearance is characteristic of a nodular inflammatory lesion called a granuloma.
74
75
the cuase of fat necrosis?
resulting from the release of activated pancreatic lipases into the substance of the pancreas and the peritoneal cavity
76
example on fat necrosis
Acute pancreatitis
77
histological features of fat necrosis
On histologic examination, the foci of necrosis contain shadowy outlines of necrotic fat cells surrounded by basophilic calcium deposits and an inflammatory reaction.
78
how fat saponification happen?
The released fatty acids combine with calcium to produce grossly visible chalky white areas
79
how fibrinoid necrosis happen?
Immune reactions in which complexes of antigens and antibodies are deposited in the walls of blood vessels Deposited immune complexes and plasma proteins that leak into the wall of damaged vessels produce a bright pink, amorphous appearance on H&E preparations called fibrinoid (fibrinlike) by pathologists
80
how to detect tissue-specific necrosis ?
by using blood or serum samples bcz Leakage of intracellular proteins through the damaged cell membrane and ultimately into the circulation provides
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pathology (5 decks)

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