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Altered Cellular and Tissue Biology
Understanding Pathophysiology : Chapter 3 & 8
71
Pathology
Undergraduate 2
01/13/2014

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Cards

Term
What is homeostasis?
Definition
The maintenance of a relatively constant range environment within the body
Term
What happens to physiologic values if homeostatic mechanisms cannot cope with a particular stress?
Definition
The drift outside the normal range
Term
What is the difference between EUSTRESS and DISTRESS?
Definition

Eustress: Positive events that stimulate growth

Distress: Harmful or unpleasant stress

Term
What role does a stressor play with stress?
Definition
Stressor is the agent responsible for producing stress
Term

T or F:

Stress is a non-specific response of the body to any demand placed on it?

Definition
TRUE
Term

Stress comes in a variety of doses

(ranging from small to large)

What are some ways the body reacts to stressors?

Definition
1. Homestatic adjustments
2. General Adaptation Syndrome (Hans seyle)
I) Alarm phase
II) Resistance phase
III) Exhaustion phase (recovery)
Term

ALARM PHASE

Which system (symp or parasymp) provides an immediate response?

Definition

Sympathetic Nervous System:

Blood supply increases

Eyes dilate

Digestion decreases 

Term

ALARM PHASE

During this phase the "fight or flight" response is triggered;

What is the dominant hormone involved?

Supporting hormones?

Definition

Dominant:

Epinephrine: adrenaline

Supporting:

Renin: overall retains Na+ and increases bp

ADH: retains H2O, reabsorption & bp increase

Glucocorticoids: increase blood sugar

Term

RESISTANCE PHASE

When does this phase occur? 

Definition
When stress lasts longer than a few hours
Term

RESISTANCE PHASE

What is the dominant hormone involved?

Supporting hormones?

Definition

DOMINANT

Glucocorticoids 

 

Supporting:

Epinephrine, GH, thyroid

Term

RESISTANCE PHASE

 What role do hormones play in this phase?

Definition

Mobilize lipid and protein reserves to conserve glucose for neural tissues

 

NOTE:

Insulin decreases blood sugar

Glucagon increases blood sugar

Term

RESISTANCE PHASE

T or F:

Goals of this phase include-

1. Mobilize lipid and protein reserves

2. Conserce glucose for neural tissues

3. Elevate blood glucose concentrations

4. Conservation of salt and water

Definition
TRUE
Term

RESISTANCE PHASE

What are the individual causes for these problems?

1. Anti-inflammatory suppresses healing & immune system

2. High bp leads to stress for L ventricle

3. Structural proteins are tore down

Definition

1. Glucocoticoids

2. Conservation of fluid

3. Depletion of lipid reserves

Term

EXHAUSTION PHASE

What is the main result of this phase?

Definition

Collapse of vital systems;

If no corrective actions are taken immediately, one or more system failures can prove fatal

Term

EXHAUSTION PHASE:

T or F

Possible causes of this phase include:

1. Lipid reserve exhaustion

2. Inability to produce glucocorticoids 

3. Failure of electrolyte balance

4. Structural or functional damage to vital organs

Definition
TRUE
Term
What are possible stress related disorders?
Definition
Hypertension, ulcers, asthma, skin disorders, GI disorders, anxiety, drug abuse etc..
Term

Match the words to definitions:

1. Disease 2. Etiology

3. Pathogenesis 4. Pathophysiology

 

a. Cause of disease

b. Sequence of events in the development of disease

c. Failure to maintain homeostatic conditions

d. Study of functional & structural changes caused by disease

Definition

1. C

2. A

3. B

4. D

Term

MATCH

1. Inherited 2. Congenital 3. Acquired 4. Multifactorial

5. Idiopathic 6. Iatrogenic

 

a) Present at birth 

b) Developed during lifetime

c) Due to a genetic defect

d) More than one factor

e) Treatment induced

f) No understood cause

Definition

1. C

2. A

3. B

4. D

5. F

6. E

Term

Intrinsic etiologies (from within the body) include:

MATCH

1. Degenerative 2. Immunologic 3. Metabolic

4. Nutritional 5. Psychogenic

 

a) Abnormal body chemistry

b) Abnormal immune response

c) Progressive loss of normal structure & function

d) Related to psychological state

e) Abnormal dietary intake or nutrient use

Definition

1. C

2. B

3. A

4. E

5. D

 

Term

T or F:

Extrinsic etiologies are produced from the environment?

Definition
TRUE
Term

Which does not cause extrinsic etiologies?

a) Trauma

b) Chemicals, drugs, toxins

c) Infectious

d) Psychogenic

e) Hypoxia

f) Environmental agents

 

Definition
d) Psychogenic
Term

How are adapted cells classified?

a) Abnormal

b) Normal

c) Stressed

Definition
c) Stressed
Term

T or F

Cellular injury can be reversible or irreversible?

Definition
TRUE
Term

T or F:

Programmed cell death is necrosis, while cell death is apoptosis?

Definition

FALSE

Apoptosis: programmed cell death

Necrosis: cell death

Term

Atrophy is the shrinkage in cell size by loss of cell substance (also diminished function). 

What are some causes of this?

Definition
Decreased workload, loss of innervation, decrease in blood supply, inadequate nutrition, loss of endocrine stimulation, aging
Term

T or F:

Hypertrophy is the decrease in size of individual cells?

Definition

FALSE!

It's the increase of size of individual cells

Term

During hypertrophy, no new cells are formed. The cells aren't swollen by fluid either.

(Swell by an increase of structural protein and organelle processes)

What are some examples of hypertrophy?

Definition

Skeletal muscles

Cardiac muscles

Kidneys

Term

T or F:

Hyperplasia is a decrease in the number of individual cells in an organ or tissue

Definition

FALSE:

It's an increase in # of individual cells, not decrease

Term
Which three types of cells cannot undergo hyperplasia?
Definition

Skeletal cells

Cardiac cells

Nerve cells

Term

MATCH types of hyperplasia

1. Compensatory 2. Hormonal 3. Pathologic

 

a) Estrogen dependent

b) Excess hormones or growth factors

c) Enables organs to regenerate

Definition

1. C

2. A

3. B

Term

T or F:

Metaplasia is the reversible replacement of one cell type by another in response to a particular stress or stimuli

Definition
TRUE
Term

In metaplasia, a (disorderly/orderly) arrangement of the new cell type is found.

 

T or F:

An example of metaplasia can be found in cigarette smokers?

Definition

Orderly

 

TRUE

Term
Is dysplasia a true cellular adaptation?
Definition
No, the cells are abnormal
Term
Dysplasia is a (normal/abnormal) change in the size, shape and arrangement of matrue cells in response to a stimulus.
Definition
Abnormal
Term

T or F:

Dysplasia may be reversible and is often called atypical hyperplasia?

Definition
TRUE
Term

T or F:

If a stimulus persists during dysplasia, it may progress to neoplasia?

 

Some examples of dysplasia can occur in the cervix and breast?

Definition

TRUE 

 

&

 

TRUE

Term

When a cell is injured, it (can/cannot) maintain homeostasis.

Definition
Cannot
Term

With cell injury it is (easy/difficult) to distinguish between primary target of injury from any secondary or ripple effect.

 

 

Definition
Difficult
Term
T or F:
The precise cut-off point between reversible and irreversible cell injury is easy to determine.
Definition

FALSE:

It's difficult to determine

Term
Is there a common pathway for cell death?
Definition
NO
Term

Which three things influence cellular response to cell injury?

1. Depth of injury

2. Type of injury

3. Severity of injury

4. Duration of injury

Definition
2, 3, & 4
Term

Which three factors do consequences of cell injury depend on?

1. Type of cell injured

2. Size of cell injured

3. Cell's current health status

4. Cell's adaptability

 

Definition
1, 3 & 4
Term

Diseases can be described by the degree, onset and distribution. 

(i.e.)

 

1. mild -> moderate -> severe

2. acute -> subacute -> chronic

3. focal/localized -> multifocal -> systemic/generalized

Definition
Term
What is the single most common cause of cellular injury?
Definition
Hypoxic injury
Term
What are some general mechanisms of cellular injury?
Definition

1. Hypoxic injury

2. Free radicals & reactive oxygen species

3. Chemical injury

4. Tissue trauma

5. Infections

6. Immunologic

7. Inflammatory

8. Genetic

Term
What are free radicals and where do they come from?
Definition

Unstable, unpaired electrons 

 

Come from:

UV lights, xrays, oxidative rxns, normal metabolism

Term

MATCH:

In what way do free radicals cause injury?

1. Lipid peroxidation

2. Fragmentation of polypeptide chains

3. Alteration of DNA 

 

a) W/ proteins

b) Destroy unsaturated fats

c) Breakage leads to decrease of protein synthesis

Definition

1. b

2. a

3. c

Term

T or F:

Damage from free radicals can be decreased with antioxidants?

(i.e. superoxide, vit C & E, beta carotene)

Definition
TRUE
Term

MATCH:

Chemical injury can be caused by the following..

1. Carbon tetrachloride

2. Carbon Monoxide

3. Alcohol

and the results of such..

a) Special affinity for hemoglobin & decrease ability to carry O2

b) Metabolized by liver enzyme, toxic free radicals

c) liver disease, nutritional disorder, CNS impairment

Definition

1. b

2. a

3. c

Term

Match the traumatic tissue injury with it's example

1. Blunt force 2. Contusion 3. Abrasion 4. Stab wound

5. Incision 6. Avulsion 7. Gunshot wound 8. Asphyxiation

 

a) Bruise b) Accident c) Scrape d) Longer e) Deeper

f) Speed = (1/2)mv^2 g) Skin tearing away h) Drowning

Definition

1. b

2. a

3. c

4. e

5. d

6. g

7. f

8. h

Term

MATCH

Three types of hypoxic injury include:

1. Anoxia 2. Hypoxia 3. Ischemia

 

a) Lack of sufficient oxygen supply to tissues

b) Inadequate blood flow in tissues

c) Complete lack of oxygen

Definition

1. c

2. a

3. b

Term
What can hypoxia result from?
Definition

1. Decreased oxygen levels in air

2. Respiratory or cardiovascular diseases

3. Lack of RBC's/anemia

4. Inadequate/dysfunctional hemoglobin (CO)

Term
What does ATP depletion lead to?
Definition

1. Anaerobic glycolysis: lactic acid produced,

decrease pH, less efficient (36 v. 2 ATP), glycogen depleated

2. Failure of Na/K pump: Na+ accumulates in cell,

K+ diffuses out of cell, net gain of Na+ results in 

osmotic gain of H2O in cell

3. Acute cellular swelling results (NOT hypertrophy)

Term

T or F:

Cellular swelling causes dilation of the endoplasmic reticulum.

 

T or F:

Lysosomal swelling leads to leakage of lysosomal enzymes autolysis.

Definition

TRUE 

 

&

 

TRUE

Term

Which of the following aren't present during reversible cellular injury?

1. ATP production restored

2. Cell recovery due to pumping out water

3. Cell returns to homeostasis from acute cellular swelling

4. Injury is prolonged and severe

Definition

4. Injury is prolonged and severe;

 

At this point, the injury is no longer reversible

Term
At what point is cell injury irreversible?
Definition

Extent cell membrane damage:

1. increased permeability of membrane

2. Loss of volume regulation

3. Massive calcium influx

4. Loss/leakage of proteins, essential coenzymes and ribonucleic acids

 

Term

Match types of cell death:

1. Necrosis

2. Apoptosis

3. Autolysis

 

a) Programmed cell death that occurs normally in developing and adult tissues

b) Changes that follow cell death in living tissue

c) Postmortem dissolution and disintegration of cells or tissues by the enzymes present in those tissues

Definition

1. b

2. a

3. c

 

Term

What do coagulative liquefactive necrosis have in common? 

 

Definition
Both are often due to hypoxia
Term

What happens in coagulative necrosis and where does it affect?

 

Definition

1. Protein denaturation

2. Kidneys, heart

Term
What happens in liquefactive necrosis and where does it affect?
Definition

1. Solid tissue is dissolved into fluid by hydrolases

2. Affects brain - neural & glial cells

Term
What combination of 2 necrosis' form caseous necrosis?
Definition
Coagulative & Liquefactive
Term
What takes place during caseous necrosis?
Definition

Dead cells disintegrate, debris is not entirely digested

 

EX: tuberculosis

Term

T or F:

During fat necrosis, lipases degrade triglycerides & free fatty acids combine with calcium ions to form soaps

Definition

TRUE

 

EX: located in pancreas, breast

Term
What two things does gangrene consist of?
Definition
Necrosis + bacterial infection = gangrene
Term

MATCH:

1. Wet gangrene

2. Dry gangrene

3. Gas gangrene

 

a) Area of coagulative necrosis becomes dried out, wrinkled & dark black

b) Infection of necrotic tissue by Clostridium species

c) Neutraphils invade necrotic site causing secondary infection

Definition

1. c

2. a

3. b

Term

MATCH:

Where can you find examples of each gangrene?

1. Gas gangrene

2. Wet gangrene

3. Dry gangrene

 

a) Distal extremities

b) Moist areas of body

c) GI tract

Definition

1. c

2. b

3. a

Term

T or F:

Dystrophic calcification is deposition of calcium in dead or dying tissues.

Definition
TRUE
Term

Dystrophic calcification is advanced in arteriosclerosis and acts as evidence of previous cell injury. It is often a cause of organ dysfunction.

 

What is an example?

Definition
i.e. Damaged heart valves
Term
When does metastatic calcification occur?
Definition
In normal tissues whenever there is hypercalcemia
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