Pathology - Exam 1 Study Guide, Part 1

Are signs objective or subjective?

objective

Are symptoms objective or subjective?

subjective

Etiology is the _______

Pathogenesis is the ______

why

how

Hypertrophy is an ________ in the _______ of cells

increase, size

T/F? Hypertrophy is more likely to occur in cells that are incapable of division

True - hyperplasia in cells that CAN divide

Which of the following is NOT one of the 4 cellular changes/adaptations to cellular stress?

A) metaplasia

B) atrophy

C) hyperplasia

D) necrosis

D) necrosis

What is an example of normal hypertrophy?

Pathological?

weight lifting or pregnant uterus

ventricular hypertrophy

Hyperplasia is an ______ in the ______ of cells

increase, number

What is an example of normal hyperplasia?

Pathological?

liver donation or breasts/uterus

HPV wart

Atrophy is a ______ in the ______ of cells

decrease, size

What happens to protein synthesis and breakdown during atrophy?

decreased protein synthesis, increased protein breakdown

What are 5 causes associated with atrophy?

disuse

denervation

ischemia

endocrine disruption

aging

What is another term to describe atrophy with aging?

senile atrophy

Atherosclerosis, malnutrtion, Alzhemier's, and Huntington are all examples of what kind of atrophy?

They have an increased risk for what?

cerebral atrophy

intracranial hemorrhage

A wart is an example of which cellular adaptation?

hyperplasia

Which cellular adaptation is most likely to represent a precancerous change?

metaplasia

Metaplasia is the ___________

change of one mature cell type to another

What are 2 prolonged stressors associated with metaplasia?

smoking and GERD

What are 2 consequences of metaplasia?

decreased function and malignant transformation

Why does carpal tunnel syndrome cause thenar atrophy?

denervation (atrophy) the signal doesn't make it to the muscle

What is one major stressor that causes cellular injury and death?

ischemia - lack of blood supply to the tissue

What is the difference between hypoxia and ischemia?

hypoxia = lack of oxygen to tissues

ischemia = lack of blood

What are some examples of things that can cause hypoxia and NOT ischemia?

sickle cell and

carbon monoxide poisoning

What are the 2 objective signs that a cell is injured?

cellular swelling and fatty accumulation (steatosis)

Which of the following is a morphological feature of a reversibly injured cell?

A) Pyknosis

B) Autophagy

C) Fatty change

D) Ruptured membranes

C) fatty change

What is the major difference between reversible and irreversible cell injury?

reversible = membrane in tact

irreversible = membranes damaged and nucleus breakdown, contents leak which triggers inflammation

What are the 2 types of irreversible cellular injury (cell death)?

apoptosis

necrosis

T/F? Necrosis is non-inflammatory

False! inflammatory

apoptosis is non-inflammatory

Pyknosis nuclear change means...

solid, shrunken mass

Karyorrhexis nuclear change means...

fragmentation

Karyolysis nuclear change means...

fading, dissolution

Myelin figures are associated with what aspect of cellular injury?

necrosis - indicates damaged cellular membrane

Is apoptosis "bad" cell death?

Not always - cleans up the cell by eliminating damaged DNA, etc

What pattern of necrosis is associated with severe ischemia?

coagulative necrosis

What is the default pathway of necrosis?

coagulative (ischemic)

Coagulative (ischemic) necrosis is the death of what kind of tissue?

solid organ tissue

What is a synonym for coagulative necrosis, usually to indicate the extremities?

gangrenous

What is the difference between infarction and infarct?

infarction = process of cells dying due to ischemia

infarct = area that is dead

Dry gangrene becomes wet gangrene when what occurs?

bacterial infection (liquefies)

How does diabetes cause gangrene or coagulative necrosis?

damages blood vessels, poor circulation and poor wound healing

What type of necrosis presents when dead cells are completely digested?

liquefactive

Neurons of the CNS dying due to ischemia/hypoxia is an indication of what type of necrosis?

liquefactive

Which pattern of necrosis occurs following a cerebral infarction?

liquefactive (damage to CNS neurons)

Wet gangrene (bacterial or fungal infectons) is classified as what type of necrosis?

liquefactive

Tuberculosis is most likely to produce which pattern of necrosis in the apex of the lungs?

caseous

What is "caseous granuloma"?

immune system forms a wall around inflammation when bacteria resists phagocytosis

Which type of necrosis is associated with fat destruction and "saponification"?

fat (enzymatic) necrosis

Pancreatitis (and trauma to pancreas/breasts) is most likely to be associated with what kind of necrosis?

fat (enzymatic) necrosis

Which type of necrosis is associated with autoimmune reactions?

fibrinoid

Which type of necrosis is associated with cell death in walls of blood vessels?

fibrinoid

Which of the following does NOT involve tissue death?

A. apoptosis

B. liquefactive necrosis

C. gangrenous necrosis

D. atrophy

D. atrophy

An HPV infection is most likely to cause _______ in the area of an epithelial infection?

hyperplasia

Inflammation is most likely to be associated with which form of irreversible cellular injury?

necrosis

A cardiac myocyte that is exposed to prolonged hypertension is most likely to adapt via ____________

hypertrophy

T/F? Autophagy AND apoptosis are both associated with cell death

False

Embryogenesis

Endometrium

Breasts

Old WBCs

Autoreactive cells

Are all examples of physiologic or pathologic apoptosis?

physiologic

What are some examples of pathologic apoptosis?

mutated cells (ie: cancer) and viral infections (HIV, T-cells)

Which apoptosis pathway takes place inside of cells? Which caspase does it activate?

mitochondrial (intrinsic) pathway

caspase-9

Which apoptosis pathway takes place outside of cells? Which caspase does it activate?

death receptor (extrinsic) pathway

caspase-8

Which apoptosis pathway is associated when eliminating self-reactive lymphocytes or virally infected cells?

death receptor (extrinsic)

Which apoptosis pathway is activated when eliminating damaged DNA or misfolded proteins?

mitochondrial (intrinsic)

Lysosomal digestion of a cell's insides is called _________

autophagy

Prolonged autophagy can lead to what?

apoptosis (cell death)

Survival during "lean times" and getting rid of misfolded proteins is associated with what?

autophagy

Cellular injury frequently begins with reduced what?

ATP

(ions accumulate so cells swell and may rupture and leak)

What are the 3 vulnerable cellular structures for cellular injury?

mitochondria

membranes

DNA

In ischemia-reperfusion injury, what happens when blood flow is restored? Why?

additional damage

increased ROS and inflammatory cells

Mitochondrial damage will cause ATP to go ______ and ROS to go _____

down, up

What happens during direct cellular injury?

toxins bin to cells and inhibits ATP or damages membranes

What happens during latent (indirect) cellular injury?

conversion to reactive toxic products

What was an example from class of a medication that could provide latent cellular injury if abused?

acetaminophen

Which intracellular accumulation mechanism is associated with fatty liver disease?

abnormal metabolism

Which intracellular accumulation mechanism is associated with genetic mutations?

defective protein folding/transport

Which intracellular accumulation mechanism is associated with tuberculosis?

ingestion of indigestible materials

Which intracellular accumulation mechanism is associated with Tay-Sachs or Gaucher disease?

defective/absent enzymes

We see steatosis (excessive lipid accumulation) where primarily?

liver

What are the 2 types of liver disease?

alcoholic liver disease

nonalcoholic fatty liver disease

Type 2 diabetes and metabolic syndrome can be classified as what type of disease?

nonalcoholic fatty liver disease

What happens to NADH, lipid synthesis and lipoproteins in alcohol metabolism?

increased NADH and lipid synthesis

decreased lipoprotein transport

Metabolic syndrome does what to insulin?

increased insulin resistance (liver takes up FA)

Is steatosis:

A) reversible?

B) symptomatic?

C) what % of heavy drinkers

A) reversible

B) asymptomatic

C) 90-100%

Is hepatitis:

A) reversible?

B) symptomatic?

C) what % of heavy drinkers

A) reversible

B) symptomatic

C) 10-35%

Is cirrhosis:

A) reversible?

B) symptomatic?

C) what % of heavy drinkers

A) irreversible

B) symptomatic

C) 8-20%

What % of individuals with cirrhosis will develop hepatocellular carcinoma?

10-20%

T/F? Most heavy drinkers will develop hepatitis

False ~25% will

What is the name for a clinical sign of alcoholic liver disease that presents as edema of the peritoneal cavity?

Ascites

Mallory bodies are a clinical indicator of what disease?

alcoholic liver disease

What is the name for a clinical sign of alcoholic liver disease that presents as engorged veins with blood/no venous return back past liver?

Caput Medusae

T/F? If cancer spreads to the liver, it is liver cancer

False - it is metastatic cancer that has spread to the liver

HBV, HCV, and Alflatoxin (mold) is assoicated with a risk for what?

hepatocellular carcinoma (liver cancer)

T/F? Males are more likely to develop hepatocellular carcinoma than females

True

Hepatocellular Carcinoma is a cancer of what type of cells?

epithelial cells

Which type of intracellular pigment indicates wear and tear to cell and free radical damage to cell membranes?

Lipofuscin

Which type of intracellular pigment indicates bleeding, RBC lysis, or high iron?

Hemosiderin

Dystrophic calcification is associated with what kind of tissues?

Is calcium metabolism normal or abnormal?

damaged tissue

norrmal calcium metabolism

Metastatic calcification is associated with what kind of tissues?

Is calcium metabolism normal or abnormal?

normal tissues

abnormal (hypercalcemia)

Injury, aging, and necrosis are all associated with what type of calcification?

Dystrophic - Type I

What is the name of dysfunctional soft tissue repair involving an autosomal dominant mutation?

fibrodysplasia ossificans progressiva

In metastatic calcification, are blood calcium levels high or low?

high (hypercalcemia)

What are Progeroid Syndromes?

advanced cellular aging, inability to correct DNA damage