Mechanisms of Disease Flashcards

(45 cards)

1
Q

Name 8 causes of cell injury.

A
Hypoxia
Toxins
Heat
Cold
Trauma
Radiation
Microorganisms
Immune mechanisms
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2
Q

What is hypoxia and what is a common cause?

A

Reduced O2 often caused by ischaemia

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3
Q

What are the reversible changes in hypoxia?

A

Decreased oxidative phosphorylation and ATP production
Increased anaerobic glycolysis
Decreased pH
Accumulation of Na+
Cell swelling via osmosis
Detachment of ribosomes leads to decreased protein synthesis

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4
Q

What are the irreversible changes in hypoxia?

A

Massive accumulation of intracellular Ca2+ resulting in mass enzyme activation

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5
Q

What are the reversible structural changes in cell injury?

A
Swelling
Chromatin clumping
Autophagy - cell self destruction
Ribosome dispersal
Blebbing
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6
Q

What are the irreversible structural changes in cell injury?

A

Nuclear changes - eg. pyknosis, karyorrhexis, and karyolysis
Lysosome rupture
Membrane defects
ER lysis

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7
Q

Define necrosis and apoptosis.

A

Necrosis - changes that occur after cell death in living tissue
Apoptosis - programmed cell death

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8
Q

Name 4 types of necrosis.

A

Coagulative
Liquefactive
Caseous
Fat

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9
Q

Explain coagulative necrosis.

A

More protein denaturation than enzyme release
Cellular architecture preserved creating ghost outline of cells - only lasts a few days before phagocytosis
Often caused by infarct in solid organs - eg. liver

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10
Q

Explain liquefactive necrosis.

A

More enzyme release than protein denaturation
Tissue is lysed and disappears
Often caused by infection
Occurs more commonly in loose tissue - eg. lungs

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11
Q

Explain caseous necrosis.

A

Tissue appears amorphous
Halfway between coagulative and liquefactive
If in the lung, likely to be TB

NEVER MENTION CASEOUS NECROSIS UNLESS TB

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12
Q

Explain fat necrosis.

A

Cell death in adipose tissue

Dead fat can break off in blood and cause embolism

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13
Q

What is gangrene? Explain the difference between wet and dry gangrene.

A

Clinical term for grossly visible necrosis.
Dry = coagulative
Wet = liquefactive

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14
Q

What is infarct and how can it be classified?

A

Necrosis due to ischaemia.

Can be white or red depending on amount of haemorrhage.

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15
Q

Explain the differences between white and red infarct.

A

White infarct - occlusion of an end artery, leaving the area completely devoid of blood, much like Voldemort’s soul.
Red infarct - there some collateral supply, which leads to congestion of blood in the damaged tissue.

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16
Q

Describe what you would see in apoptosis.

A

Cells appear shrunken and very eosinophilic (pink)

Chromatin condensation, pyknosis, nuclear fragmentation

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17
Q

Name the three stages of apoptosis.

A

Initiation
Execution
Degradation/phagocytosis

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18
Q

Describe the intrinsic and extrinsic pathways in apoptosis.

A

Intrinsic - all apoptotic machinery within cell. Caused by DNA damage, lack of growth factors/hormones etc.

Extrinsic - TRAIL and Fas bind to death receptors

Both lead to capsase activations (proteases which mediate apoptosis)

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19
Q

What can you see during degradation in apoptosis?

A

Cell breaks into membrane bound fragments called apoptotic bodies. These are phagocytosed.

20
Q

Name 7 important mediators of apoptosis and their general function.

A
p53 - Guardian of the Genome - acts in response to DNA damage
TRAIL - death ligand
TRAIL-R - death receptor
BcI-2 - inhibits cytochrome c release
Caspase - effector molecule of apoptosis

Cytochrome C (from mitochondria), APAF 1 and caspase 9 form the apoptosome (protein which causes apoptosis)

21
Q

Name and describe two reactions which produce free radicals.

A

Fenton rection - Fe2+ + H2O2 -> Fe3+ + OH- + *OH

Haber-Weiss reaction - O2- + H+ + H2O2 -> O2 + H2O + *OH

22
Q

Name 5 causes of acute inflammation. Bitch.

A
Microbial infections
Hypersensitivity reactions
Physical agents
Chemicals
Tissue necrosis
23
Q

List the cardinal signs of acute inflammation.

A

Calor - heat
Rubor - redness
Tumor - swelling
Dolor - pain

Also loss of function.

24
Q

Outline the steps causing acute inflammation.

A
  1. Vasodilation
  2. Gaps form in endothelium
  3. Exudation
  4. Margination and emigration of neutrophils
  5. Migration and emigration of macrophages and lymphocytes
25
What are the chemical mediators of vasodilation in acute inflammation?
Histamine Prostaglandins C3a, C5a
26
What are the chemical mediators of increased vascular permeability in acute inflammation?
Histamine Prostaglandins Kinins
27
What are the chemical mediators of emigration of leukocytes in acute inflammation?
Leukotrines IL-8 C5a
28
Describe the action of neutrophils in acute inflammation.
Phagocytosis of microorganisms | Release toxic enzymes and metabolites causing damage to host tissue - eg. ROS
29
Name some chemical mediators for chemotaxis of neutrophils.
C5a Cytokines Bacterial peptides and LTB4 too
30
What are the symptoms of the acute phase response?
Decreased apetite Raised HR Altered sleep patterns Changes in plasma conc. of acute phase proteins - eg. CRP, fibrinogen, α1-antitrypsin
31
What are the causes of fever in acute inflammation?
Endogenous pyrogens - IL-1, TNF-α, prostoglandins
32
What are the causes of leukocytosis in acute inflammation?
IL-1 and TNF-α produce accelerated release from marrow. | Macrophages and T lymphocytes produce colony stimulating factors (causes proliferation and differentiation)
33
What are the possible outcomes of acute inflammation?
1. Complete resolution 2. Continued acute inflammation with chronic inflammation 3. Chronic inflammation and fibrous repair, with probable tissue damage 4. Death
34
What factors help stop acute inflammation?
Mediators have short half-lifes and may be inactivated by degradation, dilution in exudate or inhibition.
35
Describe the changes that occur during resolution in acute inflammation.
``` Vascular changes stop Neutrophils no longer marginate Vessel permeability and calibre return to normal Exudate drains via lymphatic system Fibrin is lysed by plasmin Neutrophils die ```
36
When is resolution during acute inflammation possible?
If tissue architecture is intact, regeneration is possible.
37
What are some possible complications of acute inflammation?
``` Swelling - can block tubes/compress vital structures Shock (loss of fluid) Pain and loss of function Chronic inflammation Tissue damage ```
38
Describe what happens in blistering.
Caused by heat, sunlight, chemicals, etc. Symptoms are pain and profuse exudate. Collection of fluid strips off overlying epithelium. Clear exudate (few cells). Normally leads to resolution/scarring.
39
Describe what happens in an abscess.
Happens in solid tissue where inflammatory exudate forces tissue apart. Liquefactive necrosis in center Can cause high pressure, pain, and tissue damage.
40
Describe what happens in pericarditis.
Inflammation of the serous cavity of the pericardium Increased pressure on heart Can lead to cardiac tamponade.
41
Describe hereditary angio-oedema.
Deficiency of C1 inhibitor which inhibits bradykinin Uninhibited bradykinin caused increased vascular permeability leading to oedema Treat with C1 inhibitor
42
Describe α1-antitrypsin deficiency.
α1-antitrypsin inhibits elastase Uninhibited elastase breaks down elastic tissue in lungs and liver Causes emphysema and liver sclerosis
43
Describe chronic granulomatous disease.
Recessive sex linked Immune phagocytes unable to form ROS, so some bacteria can't be killed Leads to excessive granuloma formation.
44
What is the difference between exudate and transudate?
Exudate - fluid loss in inflammation - high protein Transudate - fluid loss due to hydrostatic pressure
45
Explain the action of some drugs used to treat acute inflammation.
NSAIDs (eg. aspirin and ibuprofen) - inhibit prostaglandin formation Corticosteroids - immunosupressants decrease inflammation