Lecture 1- Cell injury, cell death, cell adaptations 8/23

Question 1

The…. is the origin of the disease, including underlying causes and modifiers. WHY a disease occurs

Answer 1

etiology

Question 2

The… is the development of disease, from molecular/cellular changes to functional and structural abnormalities. HOW a disease occurs

Answer 2

pathogenesis

Question 3

cell injury may be…, may result in … or lead to ….

Answer 3

reversible
cell adaptation
cell death

Question 4

If cell injury is irreversible then it will lead to one of 2 kinds of cell death:

Answer 4

necrosis

apoptosis

Question 5

7 causes of cell injury (patients view)

Answer 5

hypoxia
chemicals/drugs
physical injury
immune response
nutritional imbalance
genetic abnormalities
infectious agents

Question 6

3 examples of hypoxic inury

Answer 6

cerebral infarction
myocardial infarction
renal atrophy

Question 7

4 examples of infectious diseases

Answer 7

tuberculosis
actinomycosis
candidiasis
primary herpes

Question 8

2 examples of physical injury

Answer 8

thermal burn

traumatic ulcer

Question 9

2 examples of chemical/drug reactions

Answer 9

gingival hyperplasia

aspirin burn

Question 10

2 examples of immunologic responses

Answer 10

hemodent rxn (cotton rolls)
cinnamon rxn (gum)

Question 11

3 examples of genetic abnormalities

Answer 11

downs syndrome
cancer
Ehlers-danlos (collagen defect)

Question 12

2 examples of nutritional imbalance

Answer 12

scurvy (vit C deficiency)

diabetes

Question 13

4 cellular targets

Answer 13

DNA
cell membranes
mitochondria
cell proteins

Question 14

clinical signs and symptoms are usually …. from the molecular or biochemical changes following injury

Answer 14

several steps removed

Question 15

cell injury results from a disruption of 1 or more cellular components that maintain…

Answer 15

cell viability

Question 16

Injury at 1 point induces a …. of …

Answer 16

cascade

effects

Question 17

… is common to all forms of pathology

Answer 17

cell inury

Question 18

6 cell injury mechanisms

Answer 18

ATP depletion
altered membrane permab.
DNA/protein damage
generation of ROS
loss of Ca2+ homeostasis
mitochondrial damage

Question 19

In the hypoxic-ischemia model, impaired functionn of the plasma membrane ATP dependent Na+ pump leads to an increase in…. influx, an increase in …. influx and an increase in … efflux.

This leads to an increase in … influx which ultimately leads to…. swelling, … swelling, membrane… and loss of ….

Answer 19

Na+
Ca2+
K+

H2O
cellular
ER
blebs
microvilli

Question 20

In the hypoxia-ischemia model, detachment of ribosomes leads to a decrease in…. which then leads to … deposition

Answer 20

protein synthesis

lipid

Question 21

In the hypoxia-ischemia model, an increase in glycolysis leads to a decrease in… which leads to … clumping.
There is also a decrease in … stores

Answer 21

pH

chromatin

Question 22

Generation of ROS is associated with ? (5)

Answer 22

Oxygen toxicity
Inflammation
Chemical/drugs- metabolism
Radiation (UV, xray)
Aging

Question 23

3 types of ROS

Answer 23

superoxide
hydrogen peroxide
hydroxyl radicals

Question 24

ROS damage cells in 3 different ways:

Answer 24

1. lipid peroxidation
2. protein cross-linking (fragmentation)
3. react w/ thymidine&guanine to induce single strand DNA breaks

Question 25

ROSS cause ... breaks

Answer 25

single stranded

Question 26

ROS cause more than.... different base modifications in both purines and pyrimidines-- ... and... being major sites

Answer 26

30 thymidine guanine

Question 27

ROS are controlled by enzymes such as ..., ... and ... and antioxidants such as vitamins ..., ..., and ... and .... and ... and serum proteins that reduce/bind iron such as ... and ...

Answer 27

SOD catalase glutathione peroxidase ``` A C E glutathione cysteine ``` transferrrin, ferritin copper (ceruloplasmin)

Question 28

In calcium induced cell injury, there is an increase in cytoplasmic calcium which leads to an increase in these 4 enzymes: ... which causes?

Answer 28

ATPases Endonucleases Proteases Phospholipases decrease ATP, decrease phospholipids, protein damage, DNA damage

Question 29

5 causes of cell membrane injury

Answer 29

1. complement- C5-C9 MAC 2. Cytotoxic T and NK cells- perforin 3. Virus 4. Bacterial endotoxins and exotoxins 5. drugs

Question 30

The degree of cell injury is determined by: (4)

Answer 30

1. physiologic state of cell 2. intensity of insult 3. duration of insult 4. # of exposures to insult

Question 31

4 common etiologies of reversible cell injury

Answer 31

hypoxia infectious agents toxins thermal injury

Question 32

is there a single biochemical event that equates death?

Answer 32

no

Question 33

2 morphologic forms of cell death are

Answer 33

necrosis | apoptosis

Question 34

cell death leads to release of cellular constituents into the ...

Answer 34

extracellular environment | example MI

Question 35

5 cell proteins released hours after an acute MI

Answer 35

``` cTNT cTNI CK/CK-MB LD/LD1 Myoglobin ```

Question 36

4 morphologic types of necrosis

Answer 36

coagulative liquefactive caseous enzymatic

Question 37

... necrosis is the most common form, the histologic signs are that the ... is retained, there is a ... cytoplasm and they are ... cells

Answer 37

Coagulative cell outline pink anucleated

Question 38

... necrosis is associated with pus and bacterial or fungal infections

Answer 38

liquefactive

Question 39

... necrosis is associated with a tuberculosis infection, the tissue has a white and cheesy appearance on gross examination

Answer 39

Caseous

Question 40

... necrosis is common in trauma to the breast or in cases of pancreatitis. Adipose tissue has a chalky white-yellow gross appearance and the dead adipocytes give a "soap bubble" histologic appearance

Answer 40

Enzymatic (fat)