If the adaptive capability is exceeded or if the external stress is inherently harmful or excessive
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if the stress is severe, persistent, or rapid in onset, it results in ___________ ____ ________ and necrosis or apoptosis of cells
irreversible injury
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physiologic vs pathologic adaptation
responses of cells to normal stimulation vs to stress
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Labile tissue - made by + ex
cells which retained the ability to proliferate in post-natal life and have a high rate of turnover, hematopoietic cells
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Stable tissues + ex
good regenerative ability but low rate of turnover, bone
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Permanent/differentiated tissues - made by + ex
cells which have lost the ability to proliferate being divided only during fetal life, muscle + neurons
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Hyperplasia
enlargement of an organ or tissue due to the increase of cells
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During hyperplasia in ________ tissues, the structure of the tissue is not affected
labile
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Two types of hyperplasia
compensatory and hormonal
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mechanical factors, chronic hypoxia, hormones overproduction, chronic inflammations, tissue repair, genetic factors are all causes of ___________
hyperplasia
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Consequences of hyperplasia
malignant transformation (reversible)
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Hypertrophy
increase in the size and weight of an organ or tissue due to increase of cells in volume, without division
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Hypertrophy is caused either by
increased functional demand or by growth factor or hormonal stimulation
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2 types of pathologic hypertrophy
adaptive (after workout) and compensatory
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The mechanisms driving cardiac hypertrophy involve at least two types of signals:
mechanical triggers and soluble mediators (for cell growth)
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Consequences of hypertrophy
metabolic disorders, sclerosis
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Atrophy
decreasing of tissue or organ size by the loss of cell substance
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Cellular atrophy results from a combination of decreased _________ _________ and increased __________ ___________
protein synthesis, protein degeneration
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Generalized atrophy is associated with
cachexia, malnutrition, senile atrophy
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Local atrophy is associated with
decreasing in size, vessels with winding direction
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mechanical factors, loss of innervation, malnutrition, hormonal insufficiency, aging are causes of ____--
atrophy
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What organs undergo involution/physiological atrophy
thymus + genital organs
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Hypoplasia
failure of organ or whole body development, of morphogenesis, decreasing in size
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Aplasia
lack of development/morphogenesis of an organ
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Agenesis
lack of an organ and its primitive embryological structures
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Metaplasia
transformation of a mature tissue into another mature tissue
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In which type of cell adaptation does a cell type sensitive to a particular stress is replaced by another cell type better able to withstand the adverse environment?
metaplasia
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The influences that induce metaplastic change in an epithelium, if persistent, may predispose to
malignant transformation
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Types of metaplasia
squamous (smokers) + columnar (intestinal)
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dystrophy
Metabolic disorders with morphological changes
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Which disorders are reversible? Dysmetabolism, dystrophy, necrosis
dysmetabolism and partially dystrophy
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Hypoxia, physical, infectious + chemical agents, immunological rxns, cell aging, metabolism errors and nutritional imbalances are causes of what?
cell injury
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Reversible cell lesions
- Cellular swelling - Na + /K+ pump - Steatosis (Fatty change) - Disorders of ER
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Irreversible lesions - apoptosis and necrosis - what happens?
Thickening of stratum corneum without retained nuclei (hyperkeratosis w/o parakeratosis)
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Hyperkeratosis
thickening of the stratum corneum
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causes of hyperkeratosis
congenital + mech factors, sun, viruses
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Parakeratosis
increased epidermal turnover lack of stratum granulosum and lucidum + retention of small nuclei in the stratum corneum pinkish red plaques with fine, silver scales
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Dyskeratosis
abnormal keratinization occurring prematurely in the inferior epidermal layers
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leukoplasia
mucosal keratinisation, abnormal location of keratinization process
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cholesteatoma
abnormal location of keratinization process in tympanic cavity
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__________ is a T cell-mediated inflammatory disease
psoriasis
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Verrucae are proliferative lesions of _______________ that are caused by ________
yellow-orange coloration of the skin and whites of the eyes caused by high levels of bilirubin in the blood (hyperbilirubinemia)
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Mechanic (obstructive or post-hepatic) jaundice - cause
obstruction of the bile ducts
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Mechanic (obstructive or post-hepatic) jaundice - consequences
conjugated Bi billiary acids (cholemia) pale faeces (acholia) steatorrhea (fat in stools) lack of Ubg in urine cholangitis billiary hepatitis/cirrhosis
high levels of alcalin phosphatase + cholesterol decolored faeces (hypocholia) Bi- and Ubg-uria in urine
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Hemolytic (pre-hepatic) jaundice - cause
increased hemolysis
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Hemolytic (pre-hepatic) jaundice - consequences
hypercolored faeces (hypercholia) in urine: Bi- and Ubg-uria
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Morphology of severe jaundice
icterus viridis (green) icterus melas (black)
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morpho of jaundice in liver
plugs of Bi in hepatocytes bilirubin cylinders (bile ducts)
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morpho of jaundice in kidney
biliary infarction
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morpho of jaundice in brain
nuclear jaundice (only in newborns)
80
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Gilbert-Meulengracht syndrome
Congenital disorders of Bilirubin metabolism, reduction of glucuronil-transferase activity fluctuating jaundice, tiredness
81
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Crigler-Najjar syndrome
Congenital disorders of Bilirubin metabolism, lack of glucuronil-transferase, death within first year of life
82
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Dubin-Johnson syndrome
Congenital disorders of Bilirubin metabolism, decreasing excretion of bilirubin, fluctuating jaundice, Bi and pigments within hepatocytes, conjugated Bi, hepatomegaly
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Rotor syndrome
Congenital disorder of Bilirubin metabolism, fluctuating jaundice, benign outcome
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lipofuscin
- yellow-brown insoluble pigment in lysosomes, 'aging' pigment
nevi, benign and malignant lentigo, malignant melanoma
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Silicosis
disease due to silica or glass dust in the lungs; occurs in mining occupations
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Asbestosis
Mg silicate, causes fibrosis and risk for mesothelioma
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Congenital metabolic diseases are due to
protein synthesis with defective function
93
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Phenylketonuria (PKU)
Inherited defect of enzymes in the phenylalanine/tyrosine pathway, hyperphenylalaninemia-with impaired brain development (benign is asymptomatic)
94
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Alpha-1-antitrypsin
plasma glycoprotein synthesized by hepatocytes which has an important role in inhibition of proteases, elastase, cathepsin G and proteinase 3 (neutrophils @ inflammation)
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lack of alpha-1-antitrypsin - consequences
pulmonary emphysema - loss of alveolar wall elasticity, cause cholestasis - liver cirrhosis
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cystic fibrosis - cause
- dysfunction of chloride ion channels in cell membranes - mutations in the gene CF - abnormal water and electrolyte transport across cell membranes
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cystic fibrosis - symptoms
mucus with abnormally high viscosity in glands lumen, cystic dilatation of glands
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cystic fibrosis - localization
pancreas, bronchia, gut, testis
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Gierke disease
Glycogen storage disease, in liver + kidney
100
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Pompe's disease
Glycogen storage disease, in heart, liver and muscles