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Goljan High Yield > Cell injury > Flashcards

Cell injury Flashcards

(61 cards)

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0
Q

SaO2

A

Percent heme groups occupied by O2

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1
Q

PO2

A

Driving force for diffusion of O2 into tissue

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2
Q

Cyanosis

A

Decr O2 saturation (SaO2)

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3
Q

Oxygen

A

Electron acceptor in oxidative pathway

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4
Q

Hypoxia

A

Inadequate O2 leads to ATP depletion

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5
Q

Ischaemia

A

Decreased arterial (or venous) blood flow

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6
Q

Respiratory acidosis

A

Retention of CO2 always decreases PaO2

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7
Q

Ventilation defect

A

Impaired delivery of O2 to alveoli; intrapulmonary shunting of blood (e.g. RDS)

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8
Q

Perfusion defect

A

Absent blood flow to alveoli; incr alveolar dead space (e.g. PE)

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9
Q

Diffusion defect

A

O2 canot cross alveolar-capillary interface; interstitial lung disease (e.g. sarcoidosis)

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10
Q

Methemoglobin

A

decr SaO2; heme iron +3; oxidising agents (sulfur/nitro drugs)

Rx with IV methylene blue

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11
Q

Clinical findings of methemoglobinaemia

A

Cyanosis not corrected by O2, chocolate coloured blood

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12
Q

Carbon monoxide

A

Decr SaO2, left shift O2 binding curve

inhibits cytochrome oxidase

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13
Q

Causes of carbon monoxide poisoning

A

Car exhaust, space heaters, smoke inhalation

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14
Q

Signs + symptoms of CO poisoning

A

Headache, cherry red skin colour

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15
Q

Cyanide action

A

Inhibits cytochrome oxidase, systemic asphyxiant

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16
Q

CO + cyanide poisoning occurs in:

A

house fires

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17
Q

Left shifted O2 dissociation curve causes

A 
Decr 2,3 BPG
CO
Alkalosis
HbF
Methemoglobin
Hypothermia
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18
Q

Right shift O2 dissociation curve

A

Incr 2,3 BPG
high altitude
acidosis
fever

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19
Q

Mitochondrial poisons

A

Damages membrane and drains off protons

alcohol, salicylates

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20
Q

Uncoupling agents in mitochondria

A

Drain off protons
Dinitrophenol
Thermogenin (brown fat)

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21
Q

Decreased ATP

A

Impaired Na+/K+ ATPase pump (cellular swelling); reversible

SIDE note: Digitalis acts on this pump to INCR activity for incr INOTROPY

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22
Q

Anaerobic glycolysis

A

ATP synthesis in hypoxia
lactate decr intracellular pH
Denatures proteins and enzymes

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23
Q

Irreversible injury hypoxia

  • what structures are damaged?
  • How?
A

Membrane or mitochondrial damage

Incr cytosolic Ca2+ activates phospholipase, proteases, endonuclease

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24
Free radicals - what are they and what do they do? | Name 3x examples + antidotes
Unpaired electron in outer orbit Damages cell membranes and DNA - examples: superoxide --> superoxide dismutase hydroxyl + drug FR --> neutrolised by glutathione (Paracetamol/acetominophen toxicity) peroxide --> neutrolised by catalase
25
Lipofuscin
Indigestible lipid of lipid peroxidation | Brown pigment increased in atrophy and FR damage
26
Mitochonidrial injury
Cytochrome C in cytosol initiates apoptosis
27
Smooth endoplasmic reticulum hyperplasia causes: | And complications
alcohol, barbiturates, phenytoin | Incr drug metabolism (e.g. oral contraceptives); decr vit D
28
Chediak-Higashi syndrome
Membrane protein defect in transfering lysosomal enzymes to phagocytic vacuoles AR; giant lysosomes
29
I cell disease
absent enzyme marker in Golgi apparatus (Mannose-6-phosphate) empty lysosomes
30
Rigor Mortis
stiff muscles after death D/t ATP depletion
31
Fatty change in liver
``` MCC alcohol (incr NADH) DHAP --> G3P --> TG ``` Incr VLDL pushes nucleus to side Causes: Incr synthesis of TG/FAs, Decr Beta-oxidation of FA Decr synthesis of apoproteins Decr release of VLDLs
32
Fatty change in Kwashiorkor
Decr synthesis of apoproteins
33
Ferritin (Fx + significance)
Primary iron storage protein; serum level reflects marrow storage of iron
34
Hemosiderin
Insoluble ferritin degradation product visible with Prussian blue stain
35
Atrophy
Reduction in cell/tissue mass by either loss or cell shrinkage
36
Brain atrophy
Ischaemia; alzheimers
37
Exocrine gland atrophy in CF
duct obstruction by thick secretions
38
Labile cells: Stable cells: Permanent cells:
Labile - stem cells (skin, marrow, GIT) Stable: in G0 phase (smooth muscle, hepatocytes) --> can enter cell cycle with influence of growth factors or hormones Permanent cells: cannot replicate; cardiac, striated muscle; neurons
39
Hypertrophy
Incr in cell size (structural components, DNA)
40
LVH and RVH
LVH - incr preload (valve regurgitation), increased afterload (HTN, aortic stenosis) RVH - pulmonary HTN
41
Bladder smooth muscle hypertrophy As/w
prostate hyperplasia constricting urethra
42
Removal of kidney causes:
hypertrophy of remaining kidney
43
Hyperplasia
Increase in number of cells
44
Hyperplasia in tissues: | Endometrial; RBC; prostate; gynecomastier
Endometrial - dt unopposed oestrogen (obesity, taking oestrogen) RBC - d.t increased EPO (blood loss, ectopic secretion, high altitude) Prostate - increased dihydrotestosterone Gynecomastia - hyperplasia in male breast tissue. Normal in newborn, adolescent, elderly
45
Metaplasia
one adult cell type replaces another cell type
46
``` Examples of metaplasia: Squamous metaplasia in bronchus Intestinal metaplasia in stomach Squamous metaplasia in bladder Barret's oesophagus ```
- smoking - paneth cells, goblet cells; H.pylori chronic atrophic gastritis - schistosoma hematobium infection - glandular metaplasia of distal oesophagus due to GORD
47
Dysplasia + examples Squamous dysplasia in cervix Squamous dysplasia in bronchus
Atypical hyperplasia or metaplasia are precursors for cancer - HPV - smoking
48
``` Necrosis defn Types of necrosis: - Coagulation - Liquefactive - Caseous ```
Death of groups of cells - Coagulation - preservation of structural outline (due to incr lactic acid). Can be pale of haemorrhagic - Liq - brain infarct, bacterial infections, wet gangrene - Caseous - variant coagulation; granulomas due to TB or systemic fungi
49
Granuloma
``` Activated macrophages (epithelioid cells); multinucleated giant cells CD4T cells ``` - Type 4 hypersensitivity
50
Granuloma associated cells: - Epithelioid cells - Multinucleated giant cells
- epithelioid - Gamma-IFN released by CD4Tcells activates macrophages - MNGC - fusion of epithelioid cells together
51
Enzymatic fat necrosis
As/w pancreatitis, soap formation soponification Ca++ with fatty acids
52
Fibrinoid necrosis
Necrosis of immune reactions (immune vasculitis, endocarditis)
53
Post mortem necrosis
Autolysis - no inflammatory reaction
54
Dystrophic calcification
Calcification of damaged tissue; normal serum calcium | pancreatitis or atherosclerotic plaque
55
metastatic calcification
Calcification of normal tissue Increased serum calcium or phosphorus
56
Nephrocalcinosis - Definition + S/S
Metastatic calcification of collecting tubule basement membranes Polyuria due to nephrogenic diabetes insipidus; renal failure
57
Apoptosis + signals for apoptosis
Gene regulated individual cell death Signals: Mullarian inhibitory factor, tumor necrosis factor, hormone withdrawal Signal modulators: TP53 suppresor gene, Bcl-2 genes
58
Bcl-2 genes
Anti-apoptosis gene - prevents cytochrome C from leaving mitochondria
59
Caspases
Responsible for enzymatic cell death in apoptosis | proteases and endonucleases
60
Markers of apoptosis
Eosinophilic cytoplasm, pyknotic (ink dot) nucleus.

Goljan High Yield (3 decks)

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