Gen. Path Palmer Quiz 1

What is the study of disease?

pathology

What are examples of pathology?

conditions, sickness, illness, disorders, syndromes

What is the origin of disease, "why"?

etiology

What are 3 examples of etiology?

1. genetics

2. environmental exposures

3. risk factors

What are steps in development, "how"?

pathogenesis

What are the 4 main adaptations to cellular stress?

1. hypertrophy

2. metaplasia

3. hyperplasia

4. atrophy

What does irreversible injury result in?

death through necrosis or apoptosis

What is known as an increase in size of cells and incapable of division?

hypertrophy

What occurs during rhinophyma?

sebaceous gland hypertrophy

What is Rhinophyma?

form of roasacea and is idiopathic

What is the tendency toward a relatively stable equilibrium between interdependent elements?

homeostasis

What is a structural or functional change in the body that is harmful to the organism; a deviation from optimal homeostasis?

disease

What is an objective and observable indication that a disease is present?

sign

What is an example of a sign?

fever

What is subjective evidence of disease or physical disturbance?

symptom

What is an example of a symptom?

pain

What is the term used in pathology to represent additional stressors that are placed on a cell?

stress

What are 2 examples of cellular stress?

1. high blood pressure places stress on the heart muscles, requiring myocytes to contract harder

2. vitamin C deficiency resulting in scurvy

What are the 2 factors that influence a cell's ability to adapt?

1. cell type

2. nature of the cellular stress

What will occur if a cell is no longer able to adapt to a cellular stressor?

cellular injury

What specific disease has a larger genetic role?

Huntington disease

What specific disease has a larger environmental role?

Mesothelioma

What term is often used to label a causative agent that plays an etiological role in the development of a disease?

risk factor

What is a neurodegenerative disease that causes severe dementia during middle adulthood?

Huntington disease

What is a cancer of the pulmonary pleura that is strongly associated with a history of exposure to asbestos?

Mesothelioma

What are physiological adaptations?

responses that would occur with normal physiological changes

What are 2 examples of physiological adaptations?

1. enlargement of uterus and breasts during pregnancy

2. skeletal muscle tissue hypertrophy following weight training

What are responses to excessive cellular stress and indicate a loss of optimal structure and function?

pathologic adaptations

What do pathologic adaptations allow?

cells to avoid or delay injury

What are 2 examples of pathologic adaptations?

1. cardiac ventricular hypertrophy

2. heavy alcohol consumption serves as a source of stress for hepatocytes and may lead to hepatitis and cirrhosis.

What are reversible changes in cell populations?

cellular adaptations

How is hypertrophy achieved?

due to an increase in the synthesis of intracellular proteins and organelles

What is an example of pathologic hypertrophy?

ventricular hypertrophy in patients with heart failure

What is an example of hypertrophy being commonly associated with processes that also cause cellular proliferation via hyperplasia?

estrogen acts as a growth factor on the pregnant uterus

What is an increased number of cells, due to cellular division?

hyperplasia

What is an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease?

biopsy

What is an example of tissue hyperplasia?

patients with the pathology known as benign prostatic hyperplasia (BPH)

What does Benign prostatic hyperplasia (BPH) result in?

frequent urination since it is more difficult to empty the bladder

What is an example of how hyperplasia may be stimulated by certain viral infections?

human papillomavirus (HPV) infects cells, introduces growth, promoting genes, and stimulates cellular hyperplasia

What does the resulting site of HPV hyperplasia take on?

an irregular surface known as a wart

What is the shrinkage of cell size, due to a loss of the cell's structural proteins?

atrophy

What 2 things are involved with atrophy?

1. reduced protein synthesis

2. increased rate of protein breakdown (catabolism)

What process is atrophy commonly associated with?

autophagy

True or False: An atrophic cell remains viable and is not dead?

True

What are the 6 causes of atrophy?

1. immobilization

2. denervation

3. ischemia

4. malnutrition

5. endocrine disruption

6. aging

What is a form of cellular adaptation where one cell type is replaced by another cell type?

metaplasia

True or false: Metaplasia is known to be an irreversible cellular adaptation?

False: removal of a cellular stressor may result in reversal of cellular metaplasia

What are 2 examples of metaplasia?

1. cells lining the upper respiratory tract of chronic smokers

2. lower esophagus of patients with GERD

In a patient with GERD, what cells are replaced and by what?

normal esophageal cells (stratified epithelia) are replaced by columnar cells

What does regular upper respiratory tract irritation cause?

chronic bronchitis

What do metaplastic changes predispose the involved cells to?

malignant transformation (cancer)

What is an insufficient blood supply to a tissue?

ischemia

What are the 4 pathologies that characteristically develop following insufficient arterial blood supply?

1. myocardial infarction (heart attack)

2. cerebral infarction (stroke)

3. ischemia bowel disease

4. gangrene

What do reductions in blood supply most commonly develop from?

atherosclerotic plaque formation, blood clots, reduced cardiac output (heart failure), or compression of major arteries

What are times when hypoxia may develop in the absence of ischemia?

pneumonia, carbon monoxide poisoning, or a disease that inhibits the movement of the thorax

What are examples of a pathology that inhibit the activity of the diaphragm?

botulism, Gullain-Barre syndrome (GBS), or anything that injures the phrenic nerve

What is a bluish discoloration of the skin?

cyanosis

What is a substance that may kill, injure, or impair a living organism?

poison

What are 3 examples in which innocuous substances may have a harmful effect?

1. excessive glucose in individuals with diabetes

2. excessive water consumption

3. premature infants receiving pure oxygen may have injury to retinas

What is an over-activation of the normal immune mechanisms may injure cells via autoimmunity or allergies?

immunological reaction

What are immunological reactions commonly called?

hypersensitivity reactions

What 4 things cause cell and tissue injury?

1. mechanical trauma

2. thermal trauma

3. electrical injury

4. injury from high-energy radiation

What is the reduced capacity for cells to react to stress and maintain homeostasis known as?

cellular senescence

What 2 things do reversibly injured cells commonly demonstrate?

1. swelling

2. accumulation of fat

Why does cellular swelling develop?

because injured cells may not have enough ATP to power ATP dependent pumps

What does reduced pump activity result in?

an accumulation of ions within the cell, which produces a loss of fluid homeostasis and an accumulation of water within the cell

What is the primary organ that manifests with fatty change following injury?

liver

What are the 3 features of cellular death?

1. significant mitochondrial damage or dysfunction

2. a damaged or dysfunctional plasma membrane

3. genetic or nuclear damage

What does the pathway a dead cell takes depend on?

nature of the injury as well as the specific type of cell that was injured

What is the form of cellular death involving destruction of cellular membranes which serve to initiate a prominent inflammatory reaction?

necrosis

What does the inflammatory reaction of necrosis bring?

phagocytes to eliminate dead cellular debris and initiate the healing process

Necrosis is the primary pathway for cellular death following?

severe ischemia, trauma, infections, toxic exposure, or other causes of severe tissue injury

True or False: Necrosis is both a pathological and physiological process?

False: always an unregulated pathological process

What is a form of regulated cell death that allows for controlled cellular breakdown?

apoptosis

What form of cell death is involved with physiologic and pathologic processes?

apoptosis

Apoptosis maintains what?

the integrity of the outer plasma membrane by forming apoptotic bodies

Apoptosis serves to eliminate unwanted cells during what 4 things?

1. severe DNA damage

2. severe protein damage

3. a loss of cellular survival signals

4. cells that have been infected by viruses

What are observed when a cell undergoes necrosis?

morphologic features

Why do destructive changes originate with necrosis?

leakage of cellular enzymes of the white blood cells that are attracted to the site of necrosis

What cytoplasmic change is necrotic cells manifest with an increased pink or red appearance?

eosinophilia

What do myelin figures resemble?

myelin sheath surrounding nerves

What nuclear change is the nuclear shrinkage and increased basophilia, due to nuclear DNA condensing?

pyknosis

What nuclear change is fragment or fall apart?

karyorrhexis

What nuclear change is the nucleus continues to degrade and the basophilia fades?

karyolysis

During karyolysis, after 1 or 2 days, what completely disappears?

the nucleus

Sites of coagulative necrosis maintain a ____ ______ for several days after the tissue dies?

firm texture

What are examples of tissues that manifest with coagulative necrosis?

sites of a myocardial infarction, ischemia to a kidney, adrenal glands

What type of necrosis will manifest with CNS ischemia (stroke)?

liquefactive necrosis

What is it called when extremities experience coagulative necrosis?

gangrenous necrosis

What are examples of conditions that produce gangrene?

peripheral vascular disease, frostbite, major trauma that obstructs blood supply

What is uncomplicated gangrene called?

dry gangrene

What is infected gangrenous tissue that has liquified?

wet gangrene

What gangrene occurs when bacteria, such as clostridium perfringens, infects gangrenous tissue?

gas gangrene

What is liquefactive necrosis associated with?

bacterial infections, but deep fungal infections may also produce this pattern of tissue death

What is the process of liquefactive necrosis?

-WBC's release enzymes that quickly breakdown necrotic tissue into isolated liquid/viscous mass

-mass will eventually be completely digested, assuming patient survives to allow time for this process to occur

What is a cheese-like pattern of necrosis known as?

caseous necrosis

What is a common way of describing caseous necrosis microscopically?

caseous granuloma

What are a pattern of chronic inflammation that consist of collections of macrophages?

granulomas

What are areas of fat destruction that result in saponification known as?

fat necrosis

What are the 4 things that cause fat necrosis?

1. ruptured pancreas where the pancreatic enzymes cause tissue necrosis

2. acute pancreatitis from chronic alcoholism

3. direct trauma to the upper abdominal cavity

4. trauma to breast tissue