Chapter 2 (Sections 1 and 2) - Cell Responses

Question 1

4 things in a cascade that are the disease process overview

Answer 1

1. Etiology - cause of disease
2. Pathogenesis - sequence of cellular events
3. Morphologic Changes - structural alterations in cells
4. Clinical Manifestations - signs and symptoms of disease

Question 2

2 broad classes of causes of disease

Answer 2

1. Genetic

2. Environmental

Question 3

Any deviation from normal structure or function and is manifested by characteristic symptoms

Answer 3

Disease

Question 4

A derangement or abnormality of function

Answer 4

Disorder

Question 5

Any new or abnormal growth

Answer 5

Neoplasm

Question 6

A set of symptoms that occur together

Answer 6

Syndrome

Question 7

Adaptation of a cell

Answer 7

Reversible functional and structural responses to changes that allow the cell to achieve a new steady state to survive and continue functioning

Question 8

If a cell is unable to adapt, what will occur?

Answer 8

Cell injury

Question 9

Is a cell injury reversible?

Answer 9

Yes, up to a certain point and then it becomes an irreversible injury

Question 10

What changes are seen in a cell with a reversible injury?

Answer 10

Swelling and fatty changes

Question 11

If a cell suffers irreversible injury, what will occur?

Answer 11

Cell death

Question 12

List some causes of cell injury

Answer 12

Oxygen Deprivation
Physical agents (stress)
Chemical agents - ex. drugs
Infectious agents - ex. parasite
Genetic mutations
Nutritional imbalances - ex. protein-calorie deficiency
Immunologic reactions - ex. autoimmune rxns

Question 13

Is there a time lag between the stress applied to the cell and the morphologic changes of the cell injury?

Answer 13

Yes

Question 14

With a cell that is undergoing necrosis, the morphologic changes may not be seen for several hours after injury. However, what can be measured much sooner and why?

Answer 14

Specific enzymes and biomarkers released from the cell due to loss of plasma membrane integrity during necrosis!!

Question 15

What 2 phenomena characterize the point of no return for irreversible cell injury?

Answer 15

1. Mitochondrial damage with ATP DEPLETION

2. Lysosomal and plasma membrane rupture

Question 16

For cell death, what are the options?

Answer 16

Necrosis

Apoptosis

Question 17

Necrosis and Apoptosis - Cell size

Answer 17

Necrosis = Enlarged and swollen
Apoptosis = Shrinkage and chromatin condensation

Question 18

Necrosis and Apoptosis - Plasma membrane

Answer 18

Necrosis = DISRUPTED plasma membrane
Apoptosis = INTACT plasma membrane with blebbing

Question 19

Necrosis and Apoptosis - Cell content release

Answer 19

Necrosis = Digested enzymes and contents leak out disrupted plasma membrane
Apoptosis = Cellular contents can be released in apoptotic bodies

Question 20

Necrosis and Apoptosis - Adjacent inflammation

Answer 20

Necrosis = YES
Apoptosis = NO

Question 21

Why is there no adjacent inflammation with apoptosis?

Answer 21

The cell is devoured by macrophages before the contents can leak out and cause an immune response

Question 22

List 3 nucleus changes seen with Necrosis

Answer 22

• Karyolysis
• Pyknosis
• Karyorrhexis

Question 23

Karyolysis

Answer 23

Nuclear fading

- seen with necrosis

Question 24

Pyknosis

Answer 24

Nuclear shrinking

- seen with necrosis

Question 25

Karyorrhexis

Answer 25

Nuclear fragmentation | - seen with necrosis

Question 26

How do necrotic cells appear on a stain?

Answer 26

Increased cytoplasmic Eosinophilia (pink)

Question 27

Necrosis and Apoptosis - Pathologic or Physiologic?

Answer 27

``` Necrosis = Pathologic Apoptosis = Physiologic or Pathologic ```

Question 28

Common things that leak out of necrotic cells?

Answer 28

ATP and Uric Acid

Question 29

Coagulative Necrosis

Answer 29

Dead tissue is preserved for a few days due to proteolysis of dead cells being blocked - Ischemia of a vessel can cause this

Question 30

Liquefactive Necrosis

Answer 30

Digestion of dead cells creates a viscous liquid (pus) | - Focal bacteria in the BRAIN may lead to this

Question 31

Gangrenous Necrosis

Answer 31

Loss of blood supply to a limb; seen in diabetes

Question 32

Caseous Necrosis

Answer 32

Yellow-white "cheesy" appearance to necrotic area | - Tuberculosis infection of the lungs can cause this

Question 33

Fat Necrosis

Answer 33

Fat destruction due to pancreatic lipases; | White chalky deposits are seen

Question 34

Fibrinoid Necrosis

Answer 34

Antigen-Antibody complexes deposited in blood vessel walls that appear more pink (eosinophilic) - Vascular damage during immune reactions cause this

Question 35

Tightly regulated cell death; cell activates its own enzymes to degrade itself and its contents

Answer 35

Apoptosis

Question 36

Physiologic causes of Apoptosis

Answer 36

Eliminating cells no longer needed | - ex. Development, menstrual cycle

Question 37

Elimination of self reactive Lymphocytes uses what mechanism?

Answer 37

Apoptosis -- Extrinsic pathway

Question 38

Pathologic causes of Apoptosis

Answer 38

Eliminating cells that are injured beyond repair | - ex. DNA damage, misfolded proteins, viral infection

Question 39

What enzymes become activated with Apoptosis?

Answer 39

Caspases

Question 40

2 pathways for Apoptosis?

Answer 40

1. Mitochondrial pathway (intrinsic) - Most common! | 2. Extrinsic pathway (Death receptor initiated)

Question 41

Job and example of Anti-Apoptotic molecules?

Answer 41

Keep the outer mitochondrial membrane IMPERMEABLE | - ex. BCL-2

Question 42

Job and examples of Pro-Apoptotic molecules?

Answer 42

Increase permeability of the outer mitochondrial membrane | - ex. Bak and Bax

Question 43

With Apoptosis, once the Pro-Apoptotic molecules increase the permeability of the outer mitochondrial membrane, what is released from there into the cytosol?

Answer 43

Cytochrome C

Question 44

For the Mitochondrial pathway of Apoptosis, what activates Caspase 9 in the cytosol?

Answer 44

Cytochrome C

Question 45

Apoptosome

Answer 45

Cytochrome C + APAF-1 in the cytosol | = Activates Caspase 9!

Question 46

For the Extrinsic pathway of Apoptosis, what receptors are activated?

Answer 46

FAS | TNF

Question 47

Once FAS and TNF receptors are activated with the Extrinsic pathway of Apoptosis, what happens next?

Answer 47

- Activates Caspase 8 which activates Caspase 9

Question 48

What can inhibit the Extrinsic pathway of Apoptosis?

Answer 48

FLIP - binds the Pro-Caspase 8 so it cannot be cleaved and activated

Question 49

Autophagy

Answer 49

Cell eats its own contents

Question 50

When is Autophagy usually present?

Answer 50

Nutrient Deprivation

Question 51

Describe the order of events with Autophagy

Answer 51

- Sequestration of organelles - Creation of an Autophagosome - Autophagosome fuses with lysosomes - Lysosomes degrade Autophagosome contents = Contents are recycled!

Question 52

What is an example of a disease state that dysregulation of autophagy might occur?

Answer 52

Inflammatory bowel disease, Cancer

Question 53

Pyroptosis occurs in cells that are infected with?

Answer 53

Microbes

Question 54

Pyroptosis

Answer 54

Programmed cell death; Caspase 1 activated | Caspase 1 causes IL-1 release and Fever

Question 55

Necroptosis

Answer 55

Programmed Necrosis; NO CASPASES | - Release of cellular contents and evokes inflammation

Question 56

What triggers Necroptosis by ligations?

Answer 56

TNFR1

Question 57

What form holes in the plasma membrane with Necroptosis?

Answer 57

RIPK and MLKL