Ch. 1 - Cell Growth, Injury, and Death Flashcards Preview

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Flashcards in Ch. 1 - Cell Growth, Injury, and Death Deck (92):
1

differentiate hypertrophy from hyperplasia

hypertrophy: inc in size
hyperplasia: inc in number of cells

2

(hypertrophy/hyperplasia) involves gene activation, protein synth, and production of organelles

hypertrophy

3

t/f: hypertrophy and hyperplasia tend to happen together

true

4

What are the permanent tissues that cannot undergo hyperplasia and can only hypertrophy?

cardiac muscle
skeletal muscle
nerve

5

pathologic hyperplasia leads to...

dysplasia and cancer

6

atrophy is the opposite of...

BOTH hyperplasia and hypertrophy

7

dec in cell number in atrophy occurs as a result of increased....

apoptosis

8

dec in cell size occurs via (blank) mediated proteosome degradation of the cytoskeleton and autophagy of cellular components

ubiquitin

9

what part of the cytoskeleton is tagged with ubiquitin?

intermediate filaments

10

autophagic vacuoles fuse with what other organelle to break down cellular stuff?

lysosomes

11

what is the most common type of metaplasia?

change in one type of surface epi to another (eg squamous to columnar)

12

t/f: metaplastic cells are better able to handle the stress that creates them

true

13

t/f; metaplasia is reversible

true

14

what vitamin deficiency can lead directly to metaplasia?

vitamin A

15

with a vit. A def, goblet and columnar cells of the conjunctiva metplast into what cell type?

keratinizing squamous epi

16

t/f: connective tissue can undergo metaplasia

true

17

dysplasia results from....

long standing pathologic hyperplasia

18

t/f: dysplasia is reversible

true

19

neurons are particularly susceptible to what type of injury?

ischemia

20

slowly developing ischemia results in (blank), whereas acute ischemia results in (blank)

chronic ischemia: atrophy
acute ischemia: injury

21

How does hypoxia lead to cell injury?

lack of ATP production

22

What are the three general causes of decreased flow through an organ?

1. dec arterial perfusion
2. dec venous drainage
3. shock state

23

What are the measured cutoffs for ischemia?

PaO2 <90%

24

High altitude lowers what O2 sat?

PAO2

25

Hypoventilations lowers which O2 sat?

inc. PACO2 leads to dec PAO2

26

A diffusion defect has a normal PAO2 but results in hypoxemia because...

the PAO2 is not able to push as much O2 into the blood due to a thicker diffusion barrier

27

Describe how a V/Q mismatch leads to hypoxemia

blood bypasses oxygenated lung (shunting) or oxygenated air cannot reach the blood (atelectasis)

28

t/f: in anemia, both the PaO2 and SaO2 are normal

true

29

Which O2 sat decreases in CO exposure?

SaO2

30

what is the classic finding in CO poisoning?

cherry red skin

31

Methemoglobinemia, in which Fe is oxidized to Fe3+, is commonly seen after what?

oxidant stresses like sulfa and nitrate drugs OR in newborns

32

what is the treatment for methemoglobinemia?

methylene blue

33

what is the weird ass classic presentation of methemglobinemia?

cyanosis with chocolate colored blood!

34

As a result of decreased ATP from hypoxia, what are the three major processes that are impaired?

1. water buildup from impaired Na/K ATPase
2. Ca buildup in the cytosol
3. Lactic acid buildup and pH lowering from anerobic glycolysis b/c no more aerobic glycolysis

35

What is the histological hallmark of reversible cellular injury?

cellular swelling

36

Cytosol swelling results in the loss of (blank) and membrane (blanking)

loss of microvilli
membrane blebbing

37

Swelling of the rER leads to dissociation of the ribosomes and what result?

dec protein synth

38

What is the histological hallmark of irreversible cell injury?

membrane damage

39

Plasma membrane damage leads to what two things?

1. cytosol enzymes leaking into the serum
2. buildup of Ca in the cell

40

Mitochondrial membrane damage leads to what two things?

1. loss of electron transport if the inner membrane is damaged
2. Apoptotic activation via cytochrome C leaking into the cytosol

41

Lysosome membrane damage releases lysozymes into the cytosol which are activated by....

the already elevated intracell Ca

42

what is the histologic hallmark of cell death?

loss of the nucleus

43

What are:
pyknosis
karyorrhexis
karyolysis

nuclear condensation
fragmentation
dissolution

44

t/f: the tissue remains firm in coagulative necrosis

true

45

t/f: cell shape and organ structure are preserved in coagulative necrosis

true

46

coagulative necrosis is indicative of an ischemic infarction in any organ except the...

brain

47

in coag. necrosis, the infarct is (blank) shaped and pale

wedge

48

When do you get a red coag. infarction?

when blood reenters a loosely organized tissue (lung or testicle)

49

Liquefactive necrosis is seen primarily in which three processes?

brain infarction
abscess
Pancreatitis

50

Gangrenous necrosis resembles mummified tissue and is a subtype of what type of necrosis?

coagulative

51

If gangrenous necrosis of dead tissue occurs, then liquefactive necrosis takes over and this is known as...

wet grangrene

52

Caseous necrosis is the combo of which two types of necrosis?

coagulative and liquefactive

53

Caseous necrosis is characteristic of what type of infection?

Tb or fungal

54

what does fat necrosis look like?

chalky white due to Ca deposition

55

Fat necrosis happens after what?

trauma to fat or pancreatic mediated

56

What is dystrophic calcification?

Necrotic tissue acts as a nidus for calcification in NORMAL serum Ca

57

What is metastatic calcification?

HIGH serum Ca or PO4 leads to calcium deposition in normal tissues

58

what is fibrinoid necrosis?

necrosis of a Blood vessel

59

How does a BV look that has fibrinoid necrosis?

bright pink wall

60

fibrinoid necrosis is characterstic of what dzs?

malignant HTN
vasculitis

61

Describe the histologic changes of the cell that is undergoing apoptosis (3)

1. Cell shrinks; cytoplasm more eosinophilic
2. Nucleus condenses and fragments
3. Apoptotic bodies form

62

What are the the things that activate the intrinsic mitochondrial pathway of apoptosis?

1. cell injury
2. DNA damage
3. dec. hormonal stim which leads to inactivation of Bcl2

63

Lack of Bcl2 lets (blank) leak out of the IMM into the cytosol to activate caspases

ctyochrome C

64

Which ligand pair activates the extrinsic apoptotic pathway?

1. FAS ligand binds the death receptor CD95 on the target cell
2. TNf binds the TNF receptor on the cell

65

Explain how CTLs kill virally infected cells

1. perforins make holes in the membrane
2. granzymes get into the cell and activate caspase

66

what are the causes of pathological generation of free radicals?

1. ionizing radiation - Water hydrolyzed to free radical OH
2. inflammation - NADPH oxidase makes superoxide ion
3. copper and Iron - Fe2+ via Fenton rxn
4. Drugs and chemicals- P450 system during detox

67

how doe free radicals cause cellular injury?

peroxidation of lipids
oxidation of DNA and proteins

68

what are the four common intracellular antioxidants? (hint: three are vitamins!)

1. glutathione
2. Vit. A
3. Vit. C
4. Vit. E

69

What are the three antioxidant enzymes and where are they found in the cell?

1. Superoxide dismutase: mito
2. Glutathione peroxidase: mito
3. Catalase: peroxisomes

70

What are the two metal carrier proteins that prevents iron oxidation in our blood?

transferrin
ceruloplasmin

71

Describe the free radical damage caused by CCl4 in dry cleaning?

converted to CCl3 by P450
cell injury; swelling of rER
Dec apolipoproteins leads to fatty liver changes

72

Describe the free radical injury in reperfusion injury

return of blood to ischemic tissue produces O2 free radicals

73

Where does amyloid deposit wrt the cell?

in the extracellular space

74

What are the shared features of deposisted amyloid proteins?

b-sheet config
CONGO RED STAINING WITH APPLE GREEN BIREFRINGENCE

75

From what protein is the AL amyloid derived from in primary amyloidosis?

immunoglobulin light chain

76

What dz is primary amyloidosis associated with?

plasma cell dyscrasias d/t multiple myeloma

77

From what protein is the AA amyloid derived from in secondary amyloidosis?

serum amyloid associated protein

78

SAA is a (blank) type protein

acute phase reactant

79

SAA is elevated in chronic inflammatory states, malignancy, and in Familial (blank)

familial Mediterranean fever

80

How does FMF present?

episodes of acute fever and acute serosal inflamm that can mimmic appendicits, arthritis, or MI

81

High levels of SAA in FMF attacks leads to..

deposition of AA amyloid in normal tissue

82

What are the three classic findings in systemic amyloidosis?

Nephrotic syndrome: KIDNEY IS MOST COMMONLY INVOLVED
Restrictive cardiomyopathy/arrhythmia
Tongue enlargement, malabsorption and HSM

83

What test must be done to Dx systemic amyloidosis?

biopsy of abd fat pad or rectum

84

t/f: amyloid cannot be removed

true; damaged organs must be transplanted

85

In senile cardiac amyloidosis, what protein deposits in the heart? what familial disorder is this associated with?

non-mutated serum transthyretin; assc'd with familial amyloid cardiomyopathy

86

deposition of mutated serum transerythrin in the heart leads to....

restrictive cardiomyopathy

87

5% of what particular minority carries the gene for familial amyloid cardiomyopathy

blacks

88

What type of amyloid deposits in the pancreas in type II DM

amylin

89

Which amyloid deposits in the brain in Alzheimer's?

amylin in the islets of the pancreas

90

the Gene for b-APP in alzheimers is present on which chromosome?

21

91

In dialysis-associated amyloidosis, which protein deposits in the joints?

b2-microglobulin

92

"tumor cells in an amyloid background" are characteristic of calcitonin deposits in what type of tumor?

Medullary carcinoma of the thyroid