Cell Injury and Apoptosis
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Questions and Answers

What is the main difference between ischemia and hypoxia?

  • Ischemia generates more ATP than hypoxia
  • Ischemia is a type of hypoxia
  • Ischemia interferes with the delivery of substrates for glycolysis (correct)
  • Hypoxia is a type of ischemia

What is the primary effect of anaerobic glycolysis in hypoxic cells?

  • Increased protein synthesis
  • Increased ATP production
  • Depletion of glycogen stores (correct)
  • Reduced lactic acid accumulation

What is the result of paralysis of ion pumps in hypoxic cells?

  • Exit of Na+ and influx of K+
  • Reduced protein synthesis
  • Increased ATP production
  • Influx of Na+ and exit of K+ (correct)

What is the consequence of reduced protein synthesis in hypoxic cells?

<p>Altered metabolism leading to abnormal accumulations (C)</p> Signup and view all the answers

What type of insult can result from extreme heat or cold?

<p>Physical insult (A)</p> Signup and view all the answers

What is a common target of cell damage?

<p>Cell membranes (C)</p> Signup and view all the answers

What is the result of ischemic injury in tissues?

<p>Anaerobic energy generation stops (A)</p> Signup and view all the answers

What is a type of cell injury that can result from dietary insufficiency?

<p>Nutritional injury (B)</p> Signup and view all the answers

What happens when the limits of adaptive capability are exceeded?

<p>Cell injury occurs (C)</p> Signup and view all the answers

What is reversible cell injury characterized by?

<p>Functional and morphologic changes that are reversible (D)</p> Signup and view all the answers

What type of injurious agent can cause cell injury?

<p>Chemical agents (B)</p> Signup and view all the answers

What factor influences the severity of cell injury?

<p>Type of affected cells (C)</p> Signup and view all the answers

Which cell type is highly susceptible to ischemic damage?

<p>Neurons (C)</p> Signup and view all the answers

What is ischemia?

<p>Local or systemic inadequate oxygenation of tissues (A)</p> Signup and view all the answers

What can interfere with oxidative phosphorylation?

<p>Poisonous substances (C)</p> Signup and view all the answers

What happens with continuing damage?

<p>The injury becomes irreversible (D)</p> Signup and view all the answers

What is the primary cause of cellular swelling in hypoxic injury?

<p>Accumulation of water in the cytoplasm (A)</p> Signup and view all the answers

What is the hallmark of hepatic fatty change?

<p>Lipid accumulation in the hepatocytes as vacuoles (C)</p> Signup and view all the answers

What is the fate of the cell if oxygen is restored after a period of hypoxia?

<p>All disturbances are reversible (D)</p> Signup and view all the answers

What is the primary mechanism of cell death in ischemic injury?

<p>Necrosis (A)</p> Signup and view all the answers

What is the significance of measuring serum levels of creatine kinase and troponin?

<p>To detect tissue-specific necrosis in the heart (B)</p> Signup and view all the answers

What is the consequence of massive influx of calcium into the cell?

<p>Activation of degradative enzymes (A)</p> Signup and view all the answers

What is the common feature of free radicals?

<p>They are highly reactive and unstable (B)</p> Signup and view all the answers

What is the consequence of reduced ATP synthesis and mitochondrial damage?

<p>Irreversible injury and cell death (B)</p> Signup and view all the answers

Study Notes

Cellular Injury

  • Cellular injury occurs when the limits of adaptive capability are exceeded and no adaptive response is possible.

Types of Cell Injury

  • Cell injury can be divided into reversible and irreversible (cell death) types.

Reversible Cell Injury

  • Occurs when the injurious agent is mild or short-lived, and functional and morphologic changes are reversible.
  • Cell injury becomes irreversible with continuing damage, leading to cell death.

Types of Injurious Agents (Causes of Cell Injury)

  • Hypoxia
  • Physical agents (trauma, burns, irradiation)
  • Chemical agents (poisons, drugs, alcohol)
  • Infectious agents
  • Immunological reactions
  • Genetic derangement
  • Nutritional imbalances
  • Aging

Factors Influencing Severity of Injury

  • Type and severity of injurious agent
  • Duration of exposure
  • Type of affected cells (e.g., neurons, myocardial cells, skeletal muscles)

Types of Insult

Hypoxia

  • Reduced oxygen
  • Ischaemia (local or systemic)
  • Hypoxaemia (inspired oxygen too low, diffusion barrier abnormal, or insufficient carrying capacity in blood)
  • Interference with oxidative phosphorylation (e.g., cyanide poisoning)

Chemical Insults

  • Drugs (e.g., paracetamol overdose)
  • Other chemicals (e.g., alcohol, cigarette smoke)

Infections

  • Eukaryotes (Fungi, Protozoa)
  • Prokaryotes (Bacteria, Rickettsiae, Chlamydiae)
  • Viruses (DNA, RNA)

Physical Insults

  • Direct physical effects (extreme heat or cold, sudden changes in pressure, electrical currents)

Immune Insults

  • Humoral
  • Cell-mediated

Nutritional Insults

  • Dietary insufficiency
  • Dietary excess

Principle Structural Targets for Cell Damage

  • Cell membranes (plasma membrane, organellar membranes)
  • DNA
  • Proteins (structural, enzymes)
  • Mitochondria (oxidative phosphorylation)

Examples of Cell Injury and Necrosis

Ischemic and Hypoxic Injury

  • Ischemia is the most common cause of cell injury in clinical medicine.
  • Ischemia injures tissues faster than hypoxia due to lack of substrate delivery for glycolysis.

Hypoxia and Ischemia

  • Loss of ATP generation leads to failure of many energy-dependent systems.
  • Anerobic glycolysis leads to lactic acid accumulation and cell swelling.
  • Reduction in protein synthesis and altered metabolism occur.

Pathogenesis of Cell Injury - Hypoxia

Reversible

  • Loss of ATP
  • Failure of Na/K pump leading to cell swelling
  • Anaerobic metabolism and increased lactic acid
  • Reduced protein synthesis and altered metabolism

Irreversible

  • Massive intra-cytoplasmic calcium accumulation
  • Activation of multiple degradative enzymes
  • Lethal cell damage

Pathogenesis of Cell Injury - Non-Ischaemic

  • Reduced ATP synthesis/mitochondrial damage
  • Loss of calcium homeostasis
  • Disrupted membrane permeability
  • Free radicals

Free Radicals

  • Highly reactive, unstable chemicals associated with cell injury in many settings.
  • Free radical generation occurs through various mechanisms.

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Description

This quiz covers the key features, causes, and morphological changes of cell injury and apoptosis. It outlines the differences between reversible and irreversible cell death.

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