Pathology Exam 1

Intro to Pathology, Biochemical Mechanisms Associated with Injury, Acute and Chronic Inflammation

Understanding of the ____ and ____ function and structure of cells, tissues, organs, and organ systems will aid in the determination of a diagnosis and also guide to the appropriate treatment

normal; abnormal

What are the two divisions of Pathology?

General Pathology & Systemic Pathology

______ ______ refers to the general and fundamental changes that occur at the molecular, cellular and tissue levels due to disease processes

General Pathology

______ ______ refers to the responses that specialized organs within organ systems will have to disease

Systemic Pathology

Cells tend to maintain a _____ internal enviornment

constant

What are the two fates of a cell that encounters physiological stress?

1) Adaptation

2) Injury to possibly the point of death

What are 8 causes of cell injury?

Infectious Agents

Genetic Defects

Oxygen Deprivation

Exogenous and Endogenous Chemical Agent exposure

Physical Agents

Nutritional Imbalances

Immunological Reactions

Aging

What are 4 forms of adaptation?

Atrophy

Hypertrophy

Hyperplasia

Metaplasia

_____ is shrinkage in the size of the cell by the loss of cell substances

Atrophy

Are cells that go through Atrophy still alive?

yes - but they have diminished function

If many cells go through atrophy, the entire tissue or organ will ____ ___ ____

decrease in size

The regulation of _____ _____ plays an important role in atrophy

protein degradation

Two components in the regulation of protein degradation are:

Lysosomes

Ubiquitin-proteasome Pathway

Digestion of subcellular components in atrophy occurs via ______

lysosomes

_____-_____ ____ is the process where cytosolic and nuclear proteins are degraded and molecular components are reused, excreted, or metabolized

Ubiquitin-proteasome Pathway

In the Ubiquitin-proteasome Pathway, ____ and ____ -___ are degraded and ____ ____ are reused, excreted or metabolized

cytosolic and nuclear proteins = degraded

molecular components = reused, excreted, or metabolized

What are 6 causes of atrophy?

A reduction in blood supply

A loss of nerve innervation

A decrease in workload

Reduction in nutrition

Reduction in endocrine stimulation

Aging

______ is an increase in SIZE of the cells

Hypertrophy

Hypertrophy results in a(n) ____ __ ____ of the tissue or organ

increase in size

In hypertrophy, cell number (decreases/ increases/ remains constant)

remains constant

Hypertrophy often occurs with _____

hyperplasia

Hypertrophy can be (physiological/ pathological/ either)

either physiological or pathological

Hypertrophy is caused by _____ __ ____ ___ or ____ ____

increase in functional demand

hormonal stimulation

Skeletal muscle cell enlargement as a result of increase in functional demand (ie working out) is an example of _______ _______

physiological hypertrophy

Uterine enlargement during pregnancy due to estrogen stimulation is an example of _____ _____ and is also associated with ____ of ____ ___ _____

physiological hypertrophy; associated with hyperplasia of smooth muscle cells

Pathological Hypertrophy is often caused by _____ ____ or is secondary _____ _____ _____

genetic defects; abnormal hormonal stimulation

Two examples of genetic induced pathological hypertrophy are:

Hypertrophic Cardiomyopathy

Congenital Hypertrophy of the RPE

Cushing’s Disease secondary to overproduction of ACTH is an example of ____ ____ ____ ______

hormonal induced pathological hypertrophy

_______ is an increase in the cell number of an organ or tissue

Hyperplasia

Hyperplasia is often associated with ______

hypertrophy

Hyperplasia can be (physiological/ pathological/ either)

either physiological or pathological

Physiological Hyperplasia is divided into _____ and _______

hormonal and compensatory

_____ _____ ____ is when cell count increases with hormone stimulation

hormonal physiological hyperplasia

Hormonal Physiological Hyperplasia occurs in _____ tissue and ____ ___ muscle & ______

Mammary Tissue

Uterine Smooth Muscle and Endometrium

______ ______ _______ is when new cells are replacing lost cells

Compensatory Physiological Hyperplasia

Compensatory Physiological Hyperplasia occurs with ____ of the ____

Hepatocytes of the Liver

_____ ______ is usually caused by excess hormonal or growth factor stimulation

Pathological Hyperplasia

Papillomavirus causing tropic stimulation of skin cells is an example of _____ _____

Pathological Hyperplasia

Metaplasia is a (reversible/ irreversible) change

reversible

_______ is a reversible change in which one adult cell type is replaced by another adult cell type

Metaplasia

Metaplasia is more likely to occur in _____ or ______ cells (_____tissue)

epithelial or mesenchymal cells (connective tissue)

_____ is a form of adaptation to make tissue more able to withstand stresses

Metaplasia

Pseudostratified Ciliated Columnar Epithelium changing to Stratified Squamous Epithelium in the respiratory tract is an example of ______

Metaplasia

Stratified Squamous Epithelium changing to Columnar Epithelium in the esophagus is an example of _____

Metaplasia

Metaplasia is protective, however it can result in ___ __ ____

loss of function

Metaplasia is thought to occur as a result of ______ ______

“genetic reprogramming”

continued induction of metaplasia can induce _____ ______ in epithelium or mesenchymal cells

neoplastic transformation

Transforming non-bone connective tissue into bone is an example of _______

metaplasia

_____ _____ occurs when the adaptive capability of the cell is exceeded

Cell Injury

Two types of cell injury are ____ and _____

reversible and irreversible

______ cell injury is non-lethal, and after injury cells can return to normal function

Reversible

______ cell injury is lethal, the cell dies

Irreversible

Two types of Irreversible cell injury are:

Necrosis

Apoptosis

______ is a irreversible cell injury that occurs most often after loss of blood supply to a tissue and may cause severe tissue dysfunction

Necrosis

_____ is a irreversible cell injury that is death of cells due to a programmed death process

Apoptosis

Apoptosis is (physiological/ pathological)

physiological

Does Apoptosis cause tissue dysfunction?

No, apoptosis causes none to minimal tissue dysfunction

What are 8 causes of cell injury?

Hypoxia

Infectious Disease

Chemical Agents

Genetic Defects

Immunological Reactions

Physical Agents

Nutritional Imbalance

Aging

____ is lower than normal oxygen and _____ is no oxygen supply

Hypoxia = low

Anoxia = no

The cause of Hypoxia is _____ _____

Inadequate Oxygenation

What are 3 respiratory system causes of hypoxic induced cell injury:

inadequate ventilation

reductions in functional respiratory surface (ie: Pneumonia)

higher elevation

What are 3 blood and vascular related causes of a hypoxic induced cell injury:

drop in hemoglobin levels (reduction of oxygen carrying capacity of blood)

CO binding to hemoglobin (poisoning)

A reduction in blood supply to tissue (ischemia)

_____ is a reduction in blood supply to tissue

Ischemia

The most common form of hypoxic induced cell injury is ________

ischemia

Toxins are _____ agents and Microbes & Parasites are ____ agents

toxins = chemical agents

microbes & parasites = infectious agents

7 examples of infectious agents are:

Viruses

Prions

Bacteria

Fungal

Protozoan

Helminths

Higher Animal Forms

4 examples of Chemical Agents are:

Pollution

Insecticides

Normally innocuous agents in high enough concentration (ie oxygen, glucose, salts)

Drugs (prescription or OTC)

What are the 4 types of reactions/ effects associated with chemical agents?

Physical Effects

Chemical Effects

Formation of Free Radicals

Teratogenic Effects

Physical Effects associated with chemical agents have _____ influence and can cause _____ __ ___ ____ ____ (especially if lipid is soluble)

osmotic influence

disruption of the plasma membrane

Two examples of Chemical Effects associated with chemical agents are:

Carbon Monoxide

Cyanide Toxicity

(Chemical Effects associated with chemical agents) Carbon monoxide binds to _____ in ____ to form _____. An (inc/ dec) in affinity of oxygen to iron is what restricts oxygen from being released at the tissue level.

Carbon monoxide binds to iron in hemoglobin to form methemoglobin

Increase in affinity to oxygen

(Chemical Effects associated with chemical agents) Cyanide toxicity occurs (slowly/ rapidly) and almost irreversibly binds to ____ and inactivates _____ _____ in cellular mitochondria

rapidly; irreversibly binds to heme; inactivates cytochrome oxidase

Cyanide toxicity causes a stop in ____ dependent activities

ATP

______ _____ are toxic molecules that bind to and damage intracellular substance

Free Radicals

_______ ______ cause damage to the developing embryo

Teratogenic effects

_____ ______ are congenital malformations or teratogenic effects that cause minor to major cellular and tissue injury. Can cause neoplasia.

Genetic Defects

_____ ______ are a system designed to protect the body.

Immunological Reactions

Over reaction or abnormal immunological action can result in ___ and ______ _____

cell and tissue injury

Two examples of cellular injury caused by immunological reactions are ______/_____ and ________ ______

hypersensitivity/ anaphylaxis

autoimmune disease

______ ______ are forms of cellular injury caused by forms of energy

Physical Agents

5 examples of physical agents that cause cell injury are:

**** Dr Scott said he “won’t ask questions on these”

mechanical

radiation

electrical shock

temperature extremes

changes in pressure

______/ ______ are blunt force cell injuries associated with the crushing, tearing, and shearing of tissues

Mechanical/ Trauma

5 examples of mechanical/ trauma cell injury are:

contusions

avulsions

fractures

lacerations

abrasions

______/ _______ _______ are cellular injuries associated with cutting and piercing of tissues

Sharp/ Force Injuries

5 examples of sharp/ force cellular injuries are:

incised wounds

stab wounds

puncture wounds

chopping wounds

gunshot wounds

_____ wounds are longer that it is deep

incised wounds

_____ wounds are deeper than it is long

stab wounds

_____ wounds are made by objects with sharp points but not edges

Puncture wounds

____ wounds are caused by heavy, edged instruments that produce wounds with a combination of sharp and blunt force characteristics usually associated with crushing of the wound edges and underlying tissue.

Chopping wounds

Two examples for causes of cellular injury by radiation are:

electromagnetic radiation

ionizing radiation

Two examples for causes of cellular injury by extremes in temperature are:

Thermal Burns

Frostbite

Two examples for cellular injury caused by changes in atmospheric pressure are:

heights

depths

What are the 2 types of nutritional imbalances that might cause cellular injury:

Deficiencies

Excesses

3 examples of deficiencies that might cause cellular injury due to nutritional imbalance:

protein (caloric)

vitamins

minerals

4 examples of excesses that might cause cellular injury due to nutritional imbalance:

vitamins

iron

calcium

fat (caloric)

_____ is a cause for cellular injury that is characterized by a reduction in a cells ability to replicate & repair and can present as intrinsic cellular deterioration

aging

cell injury from aging likely results from the progressive accumulation of alterations in _____ and ______ associated with repeated activities leading to a (increased/reduced) capacity to respond to injury

alterations in structure and function associated with repeated activities leading to a reduced capacity to respond to injury

____ is the energy currency of the cell

Adenosine Tri-phosphate (ATP)

ATP is necessary for ______ processes

anabolic

4 anabolic processes ATP is necessary for:

Protein and nucleic acid synthesis

Membrane transport mechanism

Maintenance of cellular osmolarity

Intracellular homeostatic mechanism