Cell Injury and Adaptation

Question 1

• Hypertrophy –

Answer 1

increase in the size of an
organ without an increase in cell number
(hyperplasia)

Question 2

Pure hypertrophy usually occurs only in

2

Answer 2

skeletal and cardiac muscle

Question 3

Hyperplasia is the

Answer 3

increase in size of a tissue or organ due to an increased number of cells

Question 4

Some hyperplasias are physiologic

3

Answer 4

– Erythroid bone marrow hyperplasia at high altitude
– Cyclic enlargement of the endometrium and breast during the menstrual cycle
– Regrowth of liver parenchyma after surgical excision is compensatory

Question 5

Some hyperplasias are pathologic - (1)

Answer 5

epithelial hyperplasia caused by the human papilloma virus

HPV

Question 6

Hyperplasia may be combined with hypertrophy

2

Answer 6

– In an enlarged uterus of pregnancy, myometrial smooth muscle cells are increased not only in number
(hyperplasia) but also in size (hypertrophy)
– In benign prostatic enlargement, there is both hyperplasia and hypertrophy of prostatic glands and smooth
muscle

Question 7

EPITHELIAL HYPERPLASIA: ex

Answer 7

Papilloma

Question 8

ENDOTHELIAL HYPERPLASIA:

ex

Answer 8

Pyogenic Granuloma

Question 9

FIBROUS HYPERPLASIA:

ex (2)

Answer 9

Fibroma

Epulis Fissuratum

Question 10

EPITHELIAL & FIBROUS HYPERPLASIA:

ex

Answer 10

INFLAMMATORY PAPILLARY HYPERPLASIA

Question 11

OSSEOUS HYPERPLASIA:

ex (2)

Answer 11

SUB-PONTIC OSSEOUS HYPERPLASIA

Exostoses

Question 12

GINGIVAL ENLARGEMENT (HYPERPLASIA)
due to (2)

Answer 12

POOR ORAL HYGIENE AND DIABETES

Question 13

DRUG-INDUCED GINGIVAL
ENLARGEMENT-
ex (3)

Answer 13

Procardia
Cyclosporin
Dilantin

Question 14

GINGIVAL ENLARGEMENT (HYPERPLASIA)
(8)

Answer 14

• Inflammatory hyperplasia
• Drug-induced enlargement –Calcium channel blockers, cyclosporine, dilantin
• Leukemic infiltrates
• Amyloid infiltration
• Klippel-Trenaunay-Weber syndrome
• Juvenile hyaline fibromatosis
• Cowden syndrome
• Wegener granulomatosis

Question 15

CONDYLAR HYPERPLASIA

Answer 15

Idiopathic unilateral growth of the mandibular condyle

Question 16

GYNECOMASTIA

Answer 16

HYPERPLASIA OF MALE BREAST

Question 17

Atrophy is the

Answer 17

reduction in size of cells, tissues or organs

Question 18

PATHOLOGIC ATROPHY

2

Answer 18

• Atrophy of skeletal muscle following denervation

* Atrophy of the brain due to ischemia

Question 19

PHYSIOLOGIC ATROPHY

2

Answer 19

• Atrophy of the uterus after
pregnancy
• Involution of the thymus in early
adult life

Question 20

PATHOLOGIC ATROPHY MAY

RESULT FROM: (6)

Answer 20

• Disuse
• Denervation
• Lack of trophic hormones
• Ischemia - reduction in blood supply
• Malnutrition
• Idiopathic –Parry-Romberg syndrome

Question 21

Metaplasia is the

Answer 21

replacement of one mature cell type by another one.

Question 22

METAPLASIA

It generally represents a change to a “—” cell type

Answer 22

tougher

Question 23

Replacement of bronchial stratified columnar epithelium by squamous epithelium is an example of

Answer 23

squamous metaplasia that occurs in smokers

Question 24

Intestinal metaplasia of the esophagus, called Barrett esophagus is caused by

Answer 24

chronic irritation by gastric juices in gastroesophageal reflux

Question 25

Metaplasia is generally

Answer 25

reversible and the tissue reverts to its normal state after the irritant is removed

Question 26

If the irritant persists, metaplasia may progress to

Answer 26

dysplasia and then to frank neoplasia

Question 27

ADAPTIVE (4)

Answer 27

``` Hyperplasia is an increase in cell numbers • Hypertrophy is an increase in cell size • Atrophy is the reduction in cell size • Metaplasia is a change to a “tougher” cell type ```

Question 28

NON-ADAPTIVE (3)

Answer 28

* Agenesis * Aplasia * Hypoplasia

Question 29

• Hypoplasia

Answer 29

is the incomplete development of an organ • The organ never reached its normal size

Question 30

Dysplasia literally means

Answer 30

abnormal formation | • The term is used in many contexts

Question 31

REVERSIBLE CHANGES

Answer 31

• Fatty Change - Liver

Question 32

IRREVERSIBLE CHANGES | 2

Answer 32

* Necrosis | * Apoptosis

Question 33

NUCLEAR CHANGES THAT SIGNAL | CELL DEATH IN NECROSIS (3)

Answer 33

pyknosis karyohexis karyolysis

Question 34

Pyknosis –

Answer 34

a small, dark | and shrunken nucleus

Question 35

Karyorrhexis –

Answer 35

nuclear | fragmentation

Question 36

Karyolysis –

Answer 36

dissolution | of the nucleus

Question 37

THE CYTOPLASM TELLS YOU HOW CELLS HAVE DIED (2)

Answer 37

* Coagulation Necrosis | * Liquefaction Necrosis

Question 38

• Coagulative necrosis –

Answer 38

typically seen in hypoxic injury (myocardial infarct)

Question 39

• Liquefactive necrosis –

Answer 39

typically seen in bacterial infections and cerebral infarct

Question 40

• Caseous necrosis –

Answer 40

necrotic tissue is converted into a cheesy mass (tuberculosis)

Question 41

• Fat necrosis –

Answer 41

characteristically seen in acute pancreatitis

Question 42

Coagulative necrosis – | typically seen in

Answer 42

hypoxic injury | myocardial infarct

Question 43

Liquefactive necrosis – | typically seen in

Answer 43

bacterial infections and | cerebral infarct

Question 44

Caseous necrosis – necrotic tissue is converted into

Answer 44

a cheesy | mass (tuberculosis)

Question 45

Fat necrosis – characteristically seen in

Answer 45

acute pancreatitis

Question 46

APOPTOSIS

Answer 46

• Programmed cell death occurs through activation of an internal suicide program

Question 47

APOPTOSIS occurs with

Answer 47

CASPASES

Question 48

APOPTOSIS | Selectively eliminates

Answer 48

unwanted cells with minimal disturbance to the surrounding cells

Question 49

APOPTOSIS | The plasma membrane remains intact, but its structure is altered so that

Answer 49

it becomes a target for phagocytosis

Question 50

APOPTOSIS | The dead cell is rapidly cleared before its contents have leaked out and therefore does not

Answer 50

elicit an inflammatory reaction

Question 51

APOPTOSIS Physiologic (4)

Answer 51

``` • Programmed destruction of cells during embryogenesis • Hormone-dependent involution of tissues in the adult • Deletion of potentially harmful self-reactive lymphocytes • Cell death induced by cytotoxic T-cells (virally-infected or neoplastic cells) ```

Question 52

APOPTOSIS Pathologic (4)

Answer 52

``` • If DNA repair mechanisms can’t cope with damage, the cells kills itself by apoptosis • Cell death in certain viral infections (hepatitis) • Pathologic atrophy in organs after obstruction • Cell death in tumors ```

Question 53

Exogenous pigments | 2

Answer 53

– Carbon - anthracosis | – Tattooing –skin and mucosal tattoos

Question 54

``` Endogenous pigments (4) ```

Answer 54

– Lipofuscin – Melanin –formed in melanocytes – Hemosiderin –hemoglobin-derived – Bilirubin

Question 55

Pathologic calcification is the

Answer 55

abnormal deposition of calcium salts in tissue

Question 56

Dystrophic calcification occurs in

Answer 56

nonviable or dying tissues in the presence of normal serum calcium levels

Question 57

Metastatic calcification occurs in

Answer 57

viable tissues and is associated with hypercalcemia