Histopathoogy

Hypertrophy

Increase in size

Hypertrophy

Involves gene activation, protein sythesis, and the production of organelles

Hyperplasia

Increase in cell no. of cells

Hyperplasia

Involves the production of new cells from stem cells.

Hypoplasia

Decrease no. of cells

Hypoplasia

Decrease no. in cell production during embryogenesis, resulting in relatively small organ.

Permanent

___________tissue cannot make new cells and undergo hypertrophy only.

Endometrial hyperplasia

Example of pathologic hyperplasia

Benign prostatic hyperplasia

A notable exception of pathologic hyperplasia which does not increase the risk for prostate cancer.

Atrophy

Decrease in organ size and no. of cells

Atrophy

A decrease in stress leads to a decrease in organ size

Apoptosis

Decrease in cell number occurs via _________.

Ubiquitin-proteosome degradation

Decrease in cell size occurs via _______________of the skeleton and __________of cells

Ubiquitin-proteosome degradation

Intermediate filaments of the cytoskeleton are "tagged" with ubiquitin and destroyed by proteosomes.

Autophagy of cellular components

Involves the generation of autophagic vacuoles.

Metaplasia

A change in stress on an organ leads to a change in cell type

Metaplastic cells

___________ are better able to handle the new stress in changing cell types.

Barrett esophagus

A classic example of metaplasia

Acid reflux

Causes metaplasia to non-ciliated, mucin-producing columnar cells

Acid reflux

Is an indication that there's something wrong with the muscle responsible to prevent the acid going to eophagus.

Acid

An exaggerated stress to esophagus

Reprogramming of stem cells

Metaplasia occurs via ______________which then produce new cell type

Gastroesophageal reflux

Treatment of _______________may reverse Barrett esophagus.

Apocrine

A notable exemption of metaplasia is ________metaplasia of the breast which carries no risk for cancer.

Vitamin A

Is necessary for differentiation of specialized epithelial surfaces such as conjunctiva of the eye.

Keratomalacia

In Vitamin A deficiency, the thin squamous lining of the conjunctiva undergoes metaplasia into stratified keratinizing squamous epithelium. This change is called _____________.

Myositis ossificans

Connective tissue within muscle changes to bone during healing after trauma.

Dysplasia

Most often refers to proliferation of precancerous cells

cervical intraepithelial neoplasia

represents dysplasia and is a precursor to cervical cancer.

carcinoma

If stress persists, dysplasia progresses to_____________

Aplasia

It is the failure of cell production during embryogenesis

Hypoxia

Low oxygen delivery to tissue

Oxygen

It is the final electron acceptor in the electron transport chain of oxidative phosphorylation.

oxidative phosphorylation

Decreased oxygen impairs __________________, resulting in decreased ATP production.

Ischemia

decreased blood flow through an organ

Shock

Generalized hypotension resulting in poor tissue perfusion

Hypoxemia

is a low partial pressure of oxygen in the blood

High altitude

Decreased barometric pressure results in decreased PAo2

Hypoventilation

Increased PAco2 results in decreased PAo2.

Diffusion defect

PAo2 not able to push as much O2 into the blood due to a thicker diffusion barrier (e.g., interstitial pulmonary fibrosis)

Decreased O2-carrying capacity

Arises with hemoglobin (Hb) loss or dysfunction.

cherry-red

Appearance of skin in CO monoxide poisoning

Methemoglobinemia

Iron in heme is oxidized to Fe3+, which cannot bind oxygen-Pao2 normal; Sao2 decreased

cyanosis, chocolate-colored

Classic finding with methemoglobinemia is _________ with ____________________ blood.

intravenous methylene blue

Treatment of methemoglobinemia is_______________ intravenous methylene blue, which helps reduce Fe2+ back to Fe2+state.

pH

Lactic acid builds up results in low _____, which denatures proteins and precipitates DNA.

reversible

The initial phase of injury is _______________

cellular swelling

The hallmark of reversible injury is __________________

Cytosol swelling

results in loss of microvilli and membrane blebbing

Rough ER

 Swelling of the__________________results in dissociation of ribosomes and decreased protein synthesis.

membrane damage

The hallmark of irreversible injury is _____________________

cell death

The end result of irreversible injury is _____________________

Necrosis

Death of large groups of cells followed by acute inflammation.

Coagulative necrosis

Necrotic tissue that remains firm ; cell shape and organ structure are preserved by coagulation of proteins, but the nucleus disappears

Coagulative necrosis

Characteristic of ischemic infarction of any organ except the brain.

wedge-shaped

Area of infarcted tissue in coagulative necrosis is often ____________(pointing to focus of vascular occlusion) and pale.

Red infarction

______________ arises if blood re-enters a loosely organized tissue

Liquefactive necrosis

Necrotic tissue that becomes liquefied; enzymatic lysis of cells and protein results in liquefaction.

Brain infarction

Proteolytic enzymes from microglial cells liquefy the brain.

Abscess

Proteolytic enzymes from neutrophils liquefy tissue.

Pancreatitis

Proteolytic enzymes from pancreas liquefy parenchyma.

Gangrenous necrosis

Coagulative necrosis that resembles mummified tissue

Gangrenous necrosis

Usually occurs within diabetic patients. Blood cannot fully come back to the upper extremities because of viscosity of the blood

Gangrene

Usually a characteristic of ischemia, uriline, and geltract

Caseous necrosis

Soft and friable necrotic tissue with "cottage cheese-like" appearance.

Caseous necrosis

Combination of coagulative and liquefactive necrosis.

Caseous necrosis

Characteristic of granulomatous inflammation due to tuberculous or fungal infection.

Fat necrosis

Necrotic adipose tissue with “chalky-white” appearance due to deposition of calcium

saponification

Fatty acids released by trauma or lipase join with calcium via a process called _________________

dystrophic calcification

calcium deposits on dead tissues.

Metastatic calcification

occurs when high serum calcium or phosphate levels lead to calcium deposition in normal tissues

Fibrinoid necrosis

Necrotic damage to blood vessel wall

Fibrinoid necrosis

Characteristic of malignant hypertension and vasculitis

Apoptosis

Energy (ATP)-dependent, genetically programmed cell death involving single cells or small groups of cells.

Apoptosis

There is a continuous shedding that is genetically imprinted to the body. The remnants of the shedding are extruded through urine.

F

T or F: apoptosis is followed by inflammation

caspases

Apoptosis is mediated by ____________that activate proteases and endonucleases.

Proteases

________________break down the cytoskeleton.

Endonucleases

________________break down DNA.

Intrinsic mitochondrial pathway

Pathway: Involves cellular injury, DNA damage, or decreased hormonal stimulation leads to inactivation of Bcl2.

Bcl2

Lack of_________ allows cytochrome c to leak from the inner mitochondrial matrix into the cytoplasm and activate caspases.

Extrinsic receptor-ligand pathway

Pathway: Involves FAS ligand binds FAS death receptor (CD95) on the target cell, activating caspases (e.g., negative selection of thymocytes in thymus

Cytotoxic CD8+ T cell-mediated pathway

Perforins secreted by CD8+ T cell create pores in membrane of target cell.

Granzyme

_____________from CD8+ T cell enters pores and activates caspases.

free radicals

The body produces oxygen derivative called ____________which are toxins that can cause injury to the cells.

Systemic Amyloidosis

Amyloid deposition in multiple organs

Primary amyloidosis

Systemic deposition of AL amyloid, which is derived from immunoglobulin light chain

Secondary amyloidosis

Systemic deposition of AA amyloid, which is derived from serum amyloid-associated protein (SAA).

Serum amyloid-associated protein

is an acute phase reactant that is increased in chronic inflammatory states, malignancy, and Familial Mediterranean fever (FMF).

FMF

is due to a dysfunction of neutrophils (autosomal recessive) and occurs in persons of Mediterranean origin.

Localized amyloidosis

Amyloid deposition usually localized to a single organ.

Familial amyloid cardiomyopathy

Mutated serum transthyretin deposits in the heart leading to restrictive cardiomyopathy.

Non-insulin-dependent diabetes mellitus

Amylin (derived from insulin) deposits in the islets of the pancreas.

Alzheimer disease

A β amyloid (derived from β-amyloid precursor protein) deposits in the brain forming amyloid plaques

Dialysis-associated amyloidosis

β2-microglobulin deposits in joints.

Diseases

Abnormal variation in structure or function of any part of the body.

Pathology

gives explanations of a disease by studying the following four aspects of the disease.

Etiology

It means the cause of the disease

Primary etiology

The cause of a disease is known.