Pathology Exam 1 (finished)

_____________ is the death of single cells within clusters of other cells or programmed cell death controlled by genes

apoptosis

during apoptosis, increased ___________ in the cell activates endonucleus enzymes which disrupts DNA so the cell dies

calcium

what are the features of apoptosis?

cell shrinkage, nucleus, formation of apoptotic bodies

during apoptosis, the chromatin aggregates into irregular masses on the ____________ membrane

nuclear

during apoptosis, the nucleus breaks into ______ or more fragments

2

during the formation of apoptotic bodies, extensive _______ _________ separate into numerous apoptotic bodies

surface blebs

phagocytosis of apoptotic bodies by adjacent cells leads to degraded ____________ enzymes (NO inflammation)

lysosomal

what are the 2 types of causes for apoptosis?

pathological and physiological

what are examples of physiological causes of apoptosis?

development of lumina in hollow organs during embryogenesis, involution of thymus in adults, deletion of self-reactive lymphocytes in thymus

what are examples of pathological causes of apoptosis?

cell injury in viral hepatitis, elimination of mutant cells before turn into cancer

during cell injury in viral hepatitis, apoptotic bodies are taken by liver cells aka ______________ ______________

councilman bodies

pigments in the body can be ____________ or ___________

endogenous or exogenous

what are examples of exogenous pigments?

anthracosis and tattoos

what are examples of endogenous pigments ?

lipofuscin, melanin, hemosiderin, bilirubin

_____________ is the accumulation of carbon particles or coal dust- picked up by macrophages in the alveoli and transported by lymphatic system to regional lymph nodes

anthracosis

what are the effects of anthracosis?

blackening of tissue (lung and lymph nodes), chronic irritation and fibrosis (coal miners pneumoconiosis, black lung disease)

a tattoo is injected pigment picked up by dermal macrophages and remains in the skin for life without ______________

inflammation

Lipofuscin is composed of degraded membranes of cytoplasmic organelles due to the __________ of polyunsaturated fatty acids

peroxidation

lipofuscin is commonly seen in.....

the elderly, severe malnutrition, chronic diseases, and progressive ischemia

The three organs where lipofuscin is most commonly found are the __________, __________, and __________

liver, heart, and brain

lipofuscin is the lipochrome, _________ and _________ pigment

wear and tear

melanin is a brown-black pigment produced by melanocytes that is present in the ___________

epidermis

melanin is formed in __________________ (tyrosinase enzyme converts tyrosine into 3,4 dihydroxyphenylalanine)

melanocytes

melanin is the pigment that protects the skin from....

UV rays

an accumulation of melanin is malignant ____________

melanoma

hemosiderin is _________ stored as golden brown hemosiderin granules

iron

Excess iron causes accumulation of hemosiderin (hemosiderosis), this can either be ____________ or ______________

local or systemic

example of local hemosiderosis:

skin bruise/contusion, hemolysis of TBC's

example of systemic hemosiderosis:

hemosiderin deposits in many tissues

bilirubin is derived from ______________ (non-iron part)

hemosiderin

bilirubin ____________ serum levels which leads to deposition of bilirubin in connective tissue of skin, sclera, and internal organs leading to yellow/green discoloration aka __________

increases, jaundice

__________ is the death of a group of cells within a living body caused by injurious agent

necrosis

T/F: necrosis and apoptosis are NOT the same

true

what are the 6 different types of necrosis?

coagulative, liquefactive, caseous, enzymatic fat, fibrinoid, gangrenous

what type of necrosis is the most common in all tissue except the brain?

coagulative

what is the cause of coagulative necrosis?

ischemia

the mechanism of _____________ necrosis is: cell injury -> intracellular acidosis (via lactate) -> denaturation of cytoplasmic protein and enzyme protein (inactivation of lysosomal enzymes) -> necrotic cells retain their outline and tissue architecture preserved for days

coagulative

what is the gross appearance of coagulative necrosis?

area appears pale, firm, and swollen

what is the micro appearance of coagulative necrosis?

cells devoid of nuclei appear as mass of pink homogenous cytoplasm, keep outline for several days till removed by phagocytosis

what does coagulative necrosis heal with?

fibrosis

the mechanism of ____________ necrosis: cell lysis prevails over protein denaturation; necrotic tissue is soft, liquid like (calcium soaps)

liquefactive

what are the causes of liquefactive necrosis?

necrotic lesions of the brain and suppurative inflammation (potent proteolytic enzymes of neutrophils)

liquefactive necrosis primarily occurs in the __________

brain

Liquefactive necrosis occurs in the brain because:

It is rich in hydrolytic enzymes and lipids

___________ in the brain leads to cyst cavity formation with liquefactive necrosis

gliosis

____________ necrosis is a combination of coagulative and liquefactive necrosis

caseous

what is the gross appearance of caseous necrosis?

white and cheesy

what is the cause of caseous necrosis?

tuberculosis

the mechanism of ___________ necrosis: coagulative necrosis with partial liquefaction (coagulative then digestive but NOT complete), necrotic cells neither retain their outline nor disappear by lysis, appear as amorphous debris of fragmented coagulated cells (no shape)

caseous

____________ necrosis also has a cyst formation

caseous

what is the cause of enzymatic fat necrosis?

Release of pancreatic enzymes into surrounding tissue (ex: traumatic injury, acute pancreatitis)

the mechanism of ______________ necrosis: phospholipases and proteases attack plasma membrane of fat cells and lipases split triglycerides into fatty acids and glycerol. fatty acids combine with calcium forming calcium soaps (hard chalky white patches - fat saponification - formed of necrotic fat cells)

enzymatic fat

enzymatic fat necrosis is seen with.....

acute pancreatitis

__________ necrosis is the loss of normal structure, its replaced by eosinophilic material that resembles fibrin

fibrinoid

what is the cause of fibrinoid necrosis?

autoimmune diseases involving the blood vessels when antigen-antibody reaction is deposited in the walls... this leads to necrosis of the media, leakage of plasma protein and deposition of fibrin in the wall of the artery

fibrinoid necrosis can be seen with....

malignant hypertension (affects the arterioles)

__________ is massive necrosis of tissue due to vascular occlusion followed by putrefaction

gangrenous

gangrenous necrosis commonly occurs in....

the toes and feet due to a loss of blood supply; ischemia, coagulative necrosis

superimposed bacterial infection of coagulated tissue leads to _______________ and secondary liquefaction by the bacteria and the attracted white blood cells (wet gangrene)

inflammation

H2S + iron --> iron sulfide, which results in what gross appearance of the gangrene?

black color in dry gangrene when necrotic tissue dries out

fatty change is also known as ____________

steatosis

fatty change/steatosis is the accumulation of fat within _________________ cells

parenchymal

fatty change/steatosis is commonly seen in the ____________, _____________, and _____________

liver, heart, and kidneys

steatosis is most commonly seen in the liver since it is involved with......

fatty metabolism

what are the causes/etiology of fatty change in the liver?

obesity, diabetes mellitus, hypoxia, hepatotoxic drugs, protein malnutrition, alcohol abuse

what is the most common cause of steatosis/fatty change in adults?

alcohol abuse

Fatty change in the liver involves increased synthesis of __________ secondary to an increase in fatty acids

triglycerides

Excess __________, as seen in diabetes, alcohol use, or corticosteroid use, can lead to fatty liver changes

lipolysis

One cause of increased fatty acids is increased fat intake, commonly seen in __________

obesity

Decreased __________ of fatty acids can occur due to alcohol, hypoxia, or hepatotoxins

oxidation

Alcohol metabolism can increase the synthesis of __________ __________

fatty acids

Decreased mobilization of triglycerides from the liver can occur due to decreased __________

apoprotein

A clinical cause of decreased apoprotein production is __________

malnutrition

what is the gross appearance of a liver with steatosis/fatty change?

enlarged, soft, greasy, tender on palpation

what is the micro appearance of a liver with steatosis/fatty change?

small clear fat vacuoles or large single one displacing the nucleus, rupture of contagious cells --> fat vacuoles coalesce into fatty cyst

what is the etiology of steatosis in the heart?

prolonged hypoxia or toxic myocarditis

what is the gross appearance of a heart with steatosis?

soft, flabby, dilated, yellow alternating with normal red-brown uninvolved bands (tabby cat)

what is the micro appearance of a heart with steatosis?

fine fat vacuoles in rows within muscle fibers

what is the gross appearance of kidneys with steatosis?

enlarged, pale, soft

what is the micro appearance of kidneys with steatosis?

fat vacuoles inside cells of convoluted tubules, in severe cases, all structures involved

fatty change can appear as ____________

vacuoles

fatty change/steatosis can either be ____________ or _____________

microvesicular or macrovesicular

microvesicular:

small clear fat vacuoles

macrovesicular:

large single fat vacuole

fatty change is ________________, but severe form may cause cell death

reversible

macrovesicular steatosis is most commonly seen in.....

chronic alcoholics

microvesicular steatosis is most commonly seen in...

children with reye syndrome, acute fatty change of pregnancy

cells can accumulate fat with _________ ____________

cellular injury

irreversible injury: The most crucial step leading to cell death in irreversible injury is an increase of __________ in the cell

calcium

irreversible injury: Damage to the __________ __________ causes loss of proteins, essential enzymes, co-enzymes, and RNA

plasma membrane

irreversible injury: Irreversible cell injury involves vacuolization of the __________

mitochondria

irreversible injury: Release of __________ enzymes leads to digestion of the cytoplasm

lysosomal

irreversible injury: Damage to the __________ includes breakdown of DNA

nucleus

irreversible injury: __________ is the term for a small, dense, dark-staining nucleus due to chromatin condensation

Pyknosis

irreversible injury: __________ refers to fragmentation of the nucleus, also described as nuclear swelling

Karyorrhexis

irreversible injury: __________ is the dissolution of chromatin, also known as nuclear rupture

Karyolysis

irreversible injury: The type of cell death associated with irreversible injury is called __________

necrosis

Acute inflammation is a __________ process that begins within minutes of injury and lasts for a short time

transient

Acute inflammation is typically caused by an intense __________ acting for a short time.

irritant

__________, viruses, parasites, and protozoa are all infectious agents that can trigger acute inflammation

Bacteria