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HHAD: Human Disease > PATHOLOGY - Response to Injury I: Cellular and tissue responses > Flashcards

PATHOLOGY - Response to Injury I: Cellular and tissue responses Flashcards

1
Q

Outline a brief overview of cell response

A

Noxious agent > mechanism of action >Cell response > Adaptation or cell death

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2
Q

What 3 factors of a stimulus may affect how a cell responds?

A
  1. type
  2. duration
  3. severity
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3
Q

What type of cells can be described as ‘stable’?

A

Hepatocytes

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4
Q

What type of cells can be described as ‘labile’?

A

Skin cells - epidermis

Or oral mucosa

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5
Q

What cells can be described as permanent cells?

A

CNS - axons

Or cardiac myocytes (once lost, cannot be replaced)

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6
Q

Following injury - describe the steps that then occurs in a cell (4)

A
  1. Molecular and genetic changes
  2. Functional change
  3. Structural change
  4. Signs and symptoms
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7
Q

Adaptive responses can be a result of which 2 types of stimulus?

A

Physiological

Pathological

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8
Q

Give an example of a hyperplastic condition that affects the oral cavity

A

Chronic hyperplastic candidosis

Gingival hyperplasia

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9
Q

What is hypertrophy of cells?

A

it is the increase in SIZE of cells without increase in NUMBER of cells

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10
Q

Why is it difficult to differentiate between hyperplasia and hypertrophy in a clinical setting?

A

Hyperplasia and hypertrophy usually occur side by side in response to the same stimulus

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11
Q

What is atrophy?

A

Decrease in size

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12
Q

Which oral condition could be described as causing pathological atrophy? Where would you see this?

A

Lichen planus

Buccal mucosa epithelium

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13
Q

What is metaplasia?

A

It is when one cell type differentiates into another

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14
Q

Outline the 5 ways cells may change in response to injury

A
  1. hyperplasia
  2. hypertrophy
  3. atrophy
  4. metaplasia
  5. dysplasia
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15
Q

What is dysplasia?

A

Abnormal cells - disordered stratification or maturation

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16
Q

Which cellular responses are considered reversible?

A

Hyperplasia
Hypertrophy
Metaplasia

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17
Q

Outline causative agents (5)

A
  1. Physical: trauma, thermal, radiation
  2. Chemical: CO, cigarette smoke, ethanol
  3. Infectious: toxins, metabolic products, lysis, DNA damage
  4. Oxygen deprivation: hypoxia, ischaemia
  5. Immunologic: complement activation, cell mediated cytotoxicity, autoimmune
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18
Q

How may metabolism be disrupted within a cell following injury?

A
  1. ATP depletion > frequently arises from hypoxia
  2. Mitochondria is a very sensitive organelle > prone to damage following injury, can arise from calcium influx or degeneration of reactive oxygen species. and susceptible to damage during hypoxic states
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19
Q

What may cause nutrient/growth factor deprivation occur in response to injury?

A

Ischemia, hypoxia

Lack of endocrine, exocrine or autocrine factor

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20
Q

what is a free radical species?

A

It is a chemical species that has a single, unpaired electron in its outer orbit

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21
Q

What does a free radical species do to a cell?

A

The unpaired electron can cause damage to adjacent molecules - including proteins, carbohydrates and amino acids (e.g. DNA)

22
Q

What is ROS?

A

Reactive oxygen species

It is a type of free radical - product of normal cellular metabolism.
These may accumulate in the cell under certain conditions, and this is damaging to the cell.

23
Q

What may cause excess free radicals?

A

Ionising radiation
Inflammation
Certain drugs
Certain metals

24
Q

What are the main downstream targets of free radicals/ROS? (2)

A

DNA - potent trigger for cell death (e.g. apoptosis)

Membrane - plasma, mitochondrial or lysosomal membranes. Important in cell homeostasis. Can also be disrupted by increased levels of intracellular calcium.

25
Q

Although poorly defined, at which point is it thought that a cell is set on a path of death?

A

Membrane damage no longer reparable

26
Q

What morphological observation characterises necrosis?

A

Swelling mainly

Cells can look pinkier under microscope

27
Q

What is thought to proceed karyolysis?

A

Pyknosis > karyorrhexis > Karyolysis

28
Q

What is pyknosis?

A

It is where the nucleus (chromatin) is condensed - this is irreversible.
Can be seen in necrosis and apoptosis

29
Q

What is karyorrhexis?

A

Destructive fragmentation of nucleus of cell whereby its chromatin is distributed irregularly throughout the cytoplasm

30
Q

What is karyolysis?

A

Dissolution and disintegration of cell nucleus

31
Q

What is the most common type of necrosis?

A

Coagulative necrosis

32
Q

Name 2 common causes of coagulative necrosis

A

Ischemia and infarction

33
Q

What type of necrosis results in a collection of liquid, viscous material?

A

Liquefactive necrosis

No cell outlines discernible
Common in CNS tissue e.g. Brain or bacterial of fungal infection with formation of pus

34
Q

Why is caseous necrosis called caseous necrosis?

A

Because it resembles soft cheese macroscopically

35
Q

Where is caseous necrosis most common?

A

TB infections

granulomatous

36
Q

What is apoptosis? (4)

A

Regulated
Targeted
Programmed cell death
Energy-dependent

37
Q

Outline the death receptor-mediated extrinsic pathway for apoptosis (4)

A
  1. Death ligand binds to death receptor
  2. Activates caspase 8
  3. …this downstream activates caspase 3 (executioner caspase)
  4. causes execution of apoptosis through dismantling of DNA and cytoskeletal proteins
38
Q

Outline the mitochondrial-dependent intrinsic pathway for apoptosis (5).

When does this occur?

A

Brought about in circumstances of DNA damage.

  1. DNA is damaged
  2. Cytochrome C is released in response
  3. This downstream activates caspase 9
  4. This activates caspase 3 (executioner caspase)
  5. causes execution of apoptosis through dismantling of DNA and cytoskeletal proteins
39
Q

What is an early morphological sign of apoptosis?

A

Shrinkage of the nucleus and cytoplasm

40
Q

What stain can be used to show activated caspase 3?

A

Immunohistochemistry - shows as a brown colour

41
Q

Is necrosis pathological or physiological?

A

Pathological

42
Q

Is apoptosis pathological or physiological?

A

Can be either

43
Q

Does necrosis involve groups of cells or individual cells?

A

Groups

44
Q

Does apoptosis involve groups of cells or individual cells?

A

Individual

45
Q

Which morphological feature is characteristic of necrosis?

A

Cell swelling

46
Q

Which morphological feature is characteristic of apoptosis?

A

Cell shrinkage

47
Q

Which is energy dependent - necrosis or apoptosis?

A

Apoptosis

48
Q

Which elicits an inflammatory response - necrosis or apoptosis?

A

Necrosis

although apoptosis may be a RESULT of inflammation, it does not elicit this itself

49
Q

What is autophagy?

A

Consumption of body’s own tissue as a metabolic process occurring in starvation/nutrient deprivation and certain diseases.

Recycle its own contents - highly regulated

50
Q

Outline the steps involved in autophagy (3)

A
  1. isolation membrane develops and elongates around the subcellular organelles - forms autophagosome
  2. autophagosome binds with lysosome
  3. lysosomal contents begins to degrade and deconstruct the organelles into components ready for recycling

HHAD: Human Disease (20 decks)

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