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Questions and Answers

What is hypertrophy primarily characterized by?

  • The formation of new cells
  • An increase in the number of cells
  • Reduction in overall organ mass
  • An increase in cell size (correct)

Which of the following best describes hyperplasia?

  • The death of cells in a tissue
  • An increase in the number of cells typically due to hormonal influence (correct)
  • A decrease in metabolic activity of cells
  • An increase in cell size without a change in numbers

Which type of hypertrophy is triggered by exercise such as weight-lifting?

  • Compensatory hypertrophy
  • Physiological hypertrophy (correct)
  • Stress-induced hypertrophy
  • Pathological hypertrophy

Which condition is an example of pathological hypertrophy?

<p>Cardiac hypertrophy due to hypertension (C)</p> Signup and view all the answers

What primarily triggers hyperplasia in tissues?

<p>Hormones and growth factors (D)</p> Signup and view all the answers

What percentage reduction in ATP levels is considered critical for cellular damage?

<p>5% - 10% (A)</p> Signup and view all the answers

Which of the following processes is NOT directly dependent on ATP?

<p>Lactic acid fermentation (D)</p> Signup and view all the answers

What can lead to impaired ATP production?

<p>Hypoxia (D)</p> Signup and view all the answers

Which ion's gradient fails due to ATP depletion affecting ATPase pumps?

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

What is a consequence of mitochondrial damage during sustained injury?

<p>Inhibition of protein synthesis (A)</p> Signup and view all the answers

Which is NOT considered an injurious agent that can damage mitochondria?

<p>Increased ATP levels (C)</p> Signup and view all the answers

What is the outcome of a membrane permeability transition in mitochondria?

<p>Impaired oxidative phosphorylation (B)</p> Signup and view all the answers

What is a result of ATP depletion affecting cellular functions?

<p>Diminished ionic gradients (C)</p> Signup and view all the answers

What are the three broad cellular responses to cellular stress?

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

Which of the following is a general category of injurious agents that can cause cell injury?

<p>Toxic substances (B)</p> Signup and view all the answers

What is the key difference between apoptosis and necrosis?

<p>Apoptosis is a controlled process, while necrosis is uncontrolled cell death. (C)</p> Signup and view all the answers

Which morphological feature is associated with reversible cell injury?

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

How can necrosis be clinically exploited for diagnosis?

<p>By identifying specific necrotic tissue patterns in biopsies (A)</p> Signup and view all the answers

In what physiological circumstance does apoptosis typically occur?

<p>In response to hormonal changes (C)</p> Signup and view all the answers

What are common cellular adaptations to cellular stress?

<p>Atrophy, hyperplasia, and hypertrophy (C)</p> Signup and view all the answers

What is an example of irreversible cell injury?

<p>Cell death due to cardiac arrest (A)</p> Signup and view all the answers

What is primarily indicated by atrophy in tissues or organs?

<p>Reduced size due to decreased cell size and number (A)</p> Signup and view all the answers

Which of the following conditions is NOT associated with pathological atrophy?

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

What change does metaplasia involve at the cellular level?

<p>Replacement of one differentiated cell type by another (C)</p> Signup and view all the answers

In which scenario does Barrett's esophagus occur?

<p>Because of acid reflux leading to cell type change (C)</p> Signup and view all the answers

Which of the following is a morphological pattern of necrosis?

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

What is NOT a broad category of injurious agents causing cell injury?

<p>Enhanced cellular regeneration (A)</p> Signup and view all the answers

Which of the following represents a clinical example of reversible cell injury?

<p>Swelling of the liver due to excessive alcohol intake (D)</p> Signup and view all the answers

What is a direct consequence of oxygen deprivation in cells?

<p>Damage from bacterial/viral infection (B)</p> Signup and view all the answers

Which mechanism is NOT involved in indirect damage resulting from cell injury?

<p>Increased mitochondrial metabolism (B)</p> Signup and view all the answers

What leads to intracellular release of digestive enzymes during lysosomal membrane damage?

<p>Auto-digestion (D)</p> Signup and view all the answers

Which of the following best describes reversible cell injury?

<p>Structural alterations that reverse upon removing the damaging stimulus (C)</p> Signup and view all the answers

Which of the following factors can lead to DNA damage and protein mis-folding?

<p>Oxidative stress (B)</p> Signup and view all the answers

What characterizes the interrelationship of mechanisms involved in cell injury?

<p>They are generally inter-related and complex (B)</p> Signup and view all the answers

In what scenario can the mechanisms of cell injury be offset?

<p>When the insult is mild and transient (C)</p> Signup and view all the answers

Which of the following is an example of the morphological features observed in reversible cell injury?

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

Which of the following is a characteristic of necrosis?

<p>Leakage of cell contents (C)</p> Signup and view all the answers

What is the primary feature distinguishing apoptosis from necrosis?

<p>Programmed cell death (C)</p> Signup and view all the answers

In which type of necrosis is tissue structure preserved?

<p>Coagulative necrosis (B)</p> Signup and view all the answers

Which cellular change is associated with fatty change?

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

What happens to the cell size during necrosis?

<p>It increases (B)</p> Signup and view all the answers

Which of the following is NOT a feature of apoptosis?

<p>Release of cell contents (B)</p> Signup and view all the answers

How does necrosis commonly affect nearby tissues?

<p>Causes inflammation (B)</p> Signup and view all the answers

What is a characteristic of coagulative necrosis?

<p>Preservation of tissue morphology (D)</p> Signup and view all the answers

Which morphological feature is indicative of irreversible cell injury?

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

What distinguishes gangrenous necrosis from other forms of necrosis?

<p>Presence of necrotic tissues in infection (A)</p> Signup and view all the answers

Flashcards

Homeostasis

The ability of cells to maintain a stable internal environment despite external changes.

Reversible cell injury

A state of cellular stress where the cell can still recover and return to normal function.

Irreversible cell injury/death

A permanent state of cellular damage leading to cell death.

Adaptation

A process where cells adapt to persistent stress by altering their structure or function.

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Cell Injury

A process where cells respond to stress by undergoing changes that eventually lead to cell death.

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Apoptosis

A type of cell death characterized by programmed, orderly destruction of the cell.

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Necrosis

A type of cell death characterized by uncontrolled, disruptive breakdown of the cell.

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Pathology

The study of the causes, mechanisms, and consequences of disease.

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Oxygen Deprivation (Hypoxia)

A process where cells are damaged by a lack of oxygen, leading to various downstream effects.

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Direct Cell Damage

Direct damage caused by bacteria, viruses, or immune system proteins that directly attack cells.

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Indirect Cell Damage

Indirect damage caused by changes in calcium levels, ATP depletion, and reactive oxygen species, ultimately harming the cell.

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Lysosomal Membrane Damage

The breakdown of the cell membrane, leading to the release of destructive enzymes from lysosomes.

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Morphological Features of Reversible Cell Injury

Changes in cell function and structure during early or mild injury that can be reversed if the damaging stimulus is removed.

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Mechanisms of Cell Injury

The six main mechanisms leading to cell injury.

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Interrelationship of Cell Injury Mechanisms

These mechanisms are often interconnected and complex, making it difficult to identify a single dominant cause of injury.

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What is ATP?

Adenosine triphosphate (ATP) is the primary energy currency of cells. It fuels essential cell functions, including membrane transport, maintenance of ion gradients, and protein, DNA, and RNA synthesis.

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Why is oxygen crucial for ATP production?

Efficient ATP production requires oxygen. When oxygen is limited, cells switch to less efficient anaerobic respiration, which produces lactic acid.

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What causes ATP depletion?

ATP depletion occurs when the production of ATP cannot keep up with the demand. This happens in situations like hypoxia (low oxygen) or exposure to toxins, such as cyanide.

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What are the consequences of ATP depletion?

Even a small reduction in ATP levels (around 5-10%) can cause significant damage to cells. This disruption disrupts critical processes like ion gradients and enzyme function.

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How are mitochondria related to ATP production?

Mitochondria are the powerhouses of the cell, responsible for producing ATP. Damage to mitochondria can directly impact energy production, leading to ATP depletion.

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What can damage mitochondria?

Mitochondrial damage can be caused by various factors, including hypoxia, toxins, radiation, and increased calcium levels. Early damage is often reversible, but sustained damage can lead to irreversible consequences.

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What is the MPTP?

The membrane permeability transition pore (MPTP) is a channel that forms in the mitochondrial membrane during sustained damage. This pore disrupts oxidative phosphorylation, leading to further ATP depletion.

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What happens when mitochondrial damage becomes irreversible?

Sustained mitochondrial damage can lead to the release of proteins into the cytoplasm, triggering a process called apoptosis, or programmed cell death.

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Hypertrophy

An increase in the size of cells within an organ, resulting in an overall increase in that organ's size. No new cells are created, but existing cells become larger.

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Hyperplasia

An increase in the number of cells within an organ, which often results in increased organ size. This usually happens in response to hormones or growth factors in tissues that contain dividing cells.

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Cellular Adaptation

A type of cell adaptation where cells change their structure or function in response to prolonged stress. This is a way for cells to maintain homeostasis.

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Cardiac Hypertrophy

An example of pathological hypertrophy. This is an increase in the size of heart muscle cells caused by increased workload on the heart. It often happens due to factors like high blood pressure or heart valve problems.

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GVHD (Graft-versus-host disease)

A condition where the immune system attacks the body's own tissues. A common complication of organ transplant where the donor's immune system attacks the recipient's tissue.

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Cellular Swelling

A type of reversible cell injury characterized by an increase in cell volume due to water accumulation.

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Fatty Change

A type of reversible cell injury where fat accumulates within the cell, often seen in the liver.

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Plasma Membrane Blebbing

A microscopic feature of cell injury characterized by the bulging or outward projections of the cell membrane.

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Mitochondrial Swelling

A microscopic indication of cell damage where the mitochondria become swollen and lose their normal shape.

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ER Dilation

A microscopic feature of cell injury where the endoplasmic reticulum (ER) expands and distends.

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Chromatin Clumping

A microscopic feature of cell injury where the chromatin, the genetic material within the nucleus, clump together in a dense mass.

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What are the key features of Apoptosis?

The process of cell death characterized by cell shrinkage, condensation of the nucleus, and maintenance of plasma membrane integrity.

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What are the key features of Necrosis?

The process of cell death characterized by cell swelling, membrane disruption, and leakage of cell contents.

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Atrophy

A decrease in the size of an organ or tissue due to a decrease in the size and number of cells.

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Metaplasia

A change in which one mature cell type is replaced by another mature cell type.

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Benign Prostatic Hyperplasia (BPH)

A condition where the prostate gland becomes enlarged, but it is not cancerous.

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Endometrial Hyperplasia

A condition where the lining of the uterus becomes abnormally thick. It can be precancerous, but it is not cancer.

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Study Notes

Cell Injury and Cell Death

  • Three broad cellular responses can occur as a result of cellular stress.
  • Categories of injurious agents causing cell injury include oxygen deprivation, physical/environmental factors, chemical agents/toxins/drugs, infectious agents, immunologic reactions, genetic derangements, nutritional imbalances, and aging.
  • Cellular response to injury depends on the severity, duration and type of insult. Consequences depend on the type, state and adaptability of the cell.
  • Injurious agents trigger multiple interconnected mechanisms. Cell injury can result if any of the following cellular processes are disrupted: ATP production, mitochondrial integrity, plasma membrane integrity, protein synthesis, and genetic (DNA) integrity.
  • There are six broad mechanisms responsible for cell injury: ATP depletion, mitochondrial damage, increased intracellular calcium, free radical damage, membrane damage, and DNA damage/protein misfolding. All mechanisms are highly complex and are typically inter-related.
  • Cell injury can result in reversible or irreversible injury.
  • Reversible cell injury can be reversed if the initial insult is mild or temporary.

Reversible Cell Injury

  • Features include morphological changes that are reversible if the damaging stimulus is removed.
  • Microscopic features include cellular swelling and fatty change.
  • Ultrastructure features include plasma membrane blebbing, mitochondrial swelling, endoplasmic reticulum (ER) dilation, and chromatin clumping.
  • Early examples include acute kidney injury (AKI) and hepatic steatosis.

Irreversible Cell Injury/Cell Death

  • Cell death is characterized by two major forms: apoptosis and necrosis.

  • Apoptosis is tightly regulated programmed cell death. Cellular contents are contained, and there is no release of contents/surrounding inflammation.

  • Necrosis involves membrane breakdown, leakage of cell contents into tissues, and inflammation.

  • Morphological patterns of necrosis include coagulative, liquefactive, caseous, gangrene, fat, and fibrinoid necrosis.

Apoptosis

  • Apoptosis is a tightly regulated, programmed cellular suicide.
  • Physiological examples include embryogenesis, hormone-dependent tissue involution, control of cell turnover, elimination of self-reactive lymphocytes, and death of host cells after an immune response.
  • Pathological examples include DNA damage, accumulation of misfolded proteins, infections, and pathological atrophy.
  • Two main pathways for apoptosis include the mitochondrial pathway and the death receptor pathway.
  • Caspase activation is common to both pathways.
  • Apoptosis is characterized by cell shrinkage, chromatin condensation, cytoplasmic blebs, apoptotic bodies, and a lack of surrounding damage.

Necrosis vs Apoptosis

  • Necrosis involves increased cell size, a disrupted nucleus (pyknosis, karyolysis, karyorrhexis), a disrupted plasma membrane, and nearly always triggers nearby inflammation. It is always a pathological process.
  • Apoptosis involves reduced cell size, fragmentation or condensation of the nucleus, an intact plasma membrane, and does not invariably trigger nearby inflammation. It can be physiological or pathological.

Cellular Adaptation, Hypertrophy, Hyperplasia, Atrophy

  • Cellular adaptations are reversible adjustments in cell size, number, phenotype, and metabolic activity to the changes in their environment.
  • Hypertrophy is an increase in the size of cells (and thus organs), usually from increased workload(e.g. body-building). Cardiomyocyte hypertrophy is a common pathological adaptation to circulatory stress.
  • Hyperplasia is an increase in the number of cells in an organ or tissue resulting usually from growth factors or hormones (e.g. breast tissue in pregnancy).
  • Atrophy is a decrease in the size of an organ or tissue, that occurs from decreased workload, denervation, decreased blood supply, or inadequate nutrition.

Metaplasia

  • A switch from one differentiated cell type to another, and is often an adaptive response to adverse environmental factors like inflammation.
  • Examples include the conversion of squamous cells in the esophagus to gastric-like columnar epithelium in response to acid reflux.

Cell Death and Clinical Diagnosis

  • Myocardial infarction, pancreatitis, and apoptosis are all examples of instances where the necrotic release of certain enzymes into the bloodstream allows for clinical diagnosis. Myocardial infarction is often characterized by a release of cardiac enzymes like troponin into the bloodstream. Pancreatitis leads to elevated amylase and lipase levels in blood. Apoptosis, while not involving release into blood, can be diagnosed microscopically, which is important in disease like liver disease and GVHD(graft versus host disease, particularly in transplantation).

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