Cellular Adaptations in Pathology

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Questions and Answers

Which cellular adaptation involves the accumulation of triglycerides within parenchymal cells?

  • Hemosiderosis
  • Melanosis
  • Anthracosis
  • Fatty change (correct)

What is the primary mechanism by which alcohol consumption leads to fatty liver?

  • Decreased uptake of triglycerides into parenchymal cells
  • Decreased use of fat by cells (correct)
  • Increased secretion of fat from cells
  • Overproduction of fat in cells

Which of the following is an endogenous pigment that accumulates within lysosomes?

  • Lipofuscin (correct)
  • Bilirubin
  • Tattoo pigments
  • Carbon

What causes jaundice due to the excess accumulation of bilirubin in the body?

<p>Degradation of hemoglobin (B)</p> Signup and view all the answers

What is the primary mechanism behind cellular hypertrophy?

<p>Increased protein synthesis and organelle size and number. (C)</p> Signup and view all the answers

In what specific cell type does hemosiderin normally exist in small amounts as physiological iron stores?

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

Which process involves the swelling and rupture of a cell membrane due to excess fluid intake?

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

A patient with a long history of smoking develops a change in the lining of their bronchi. Which cellular adaptation is most likely responsible for the change?

<p>Squamous metaplasia of the bronchial epithelium. (A)</p> Signup and view all the answers

What key difference distinguishes necrosis in a living organism from the processes occurring in a dead organism?

<p>Intracellular degradative reactions happen only in living organisms as part of necrosis (B)</p> Signup and view all the answers

Which of the following is a physiological example of hyperplasia?

<p>Enlargement of the breast during pregnancy. (A)</p> Signup and view all the answers

What cellular process is most closely associated with the presence of autophagic vacuoles?

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

Which of the following is NOT a primary mechanism contributing to cell necrosis?

<p>Increased cellular division (D)</p> Signup and view all the answers

Which condition is characterized by a reduced production of melanin, leading to decreased pigmentation of the skin?

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

Which of the following is NOT a typical cause of cellular atrophy?

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

In response to a persistent injury, a cell has two main pathways it might take, what are they?

<p>Reversible injury or irreversible injury leading to cell death. (A)</p> Signup and view all the answers

What is anthracosis characterized by?

<p>Accumulation of coal dust in the lungs and lymphatic nodes (B)</p> Signup and view all the answers

If a connective tissue is replaced by bone at the site of an injury, which of the following cellular adaptations occurred?

<p>Osseous metaplasia. (A)</p> Signup and view all the answers

The enlargement of the left ventricle in hypertensive heart disease is an example of which cellular adaptation?

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

Which of the following BEST describes the process of metaplasia?

<p>Replacement of one differentiated tissue with another. (C)</p> Signup and view all the answers

Which cellular adaptation is MOST likely to be observed in skeletal muscle during intense physical training?

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

Which nuclear change is characterized by the clumping and shrinking of chromatin with increased basophilia?

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

Which type of necrosis is most likely to occur following a cerebral infarction?

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

A patient presents with tissue damage in the breast due to trauma. Which type of necrosis is most likely to be observed?

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

In which condition is caseous necrosis most typically observed?

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

What distinguishes wet gangrene from dry gangrene?

<p>Wet gangrene involves bacterial infection leading to superimposed liquefactive necrosis. (D)</p> Signup and view all the answers

Which of the following best describes the mechanism of tissue damage in coagulative necrosis?

<p>Protein coagulation that delays tissue breakdown (C)</p> Signup and view all the answers

Which of the following is a feature of liquefactive necrosis?

<p>Tissue turns into liquid and contains pus (B)</p> Signup and view all the answers

In contrast to apoptosis, which of the following best describes necrosis?

<p>Unregulated cell death involving multiple cells. (B)</p> Signup and view all the answers

Which of these processes is most likely to follow necrosis?

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

After an episode of acute hemorrhagic pancreatitis, what type of necrosis is predominantly expected in the affected pancreatic tissue?

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

Flashcards

Fatty change

The accumulation of triglycerides inside cells, often seen in the liver, heart, or kidneys. Causes include alcohol, diabetes, malnutrition, obesity, and poisonings.

Melanin

A pigment found in the skin produced by melanocytes. Increased melanin causes tanning and some diseases, while decreased melanin leads to albinism or vitiligo.

Bilirubin

A yellowish pigment produced during hemoglobin degradation. Excess bilirubin causes jaundice, a yellowish discoloration of the eyes, mucous membranes, and internal organs.

Hemosiderin

An iron-containing pigment derived from ferritin, normally found in macrophages of the bone marrow, liver, and spleen. Excess hemosiderin accumulates in tissues due to certain diseases.

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Necrosis

A form of cell death where excess fluid enters the cell, causing swelling and rupture of the cell membrane.

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Autolysis

A process in dead organisms where cells are broken down by their own enzymes.

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Heterolysis

A process in dead organisms where cells are broken down by enzymes from external sources.

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Hypoxia

Lack of oxygen to cells, which can lead to cell damage and death.

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Free radicals

Harmful molecules that can damage cell membranes and other cellular components.

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Cell membrane damage

Damage to the cell membrane, which can lead to leakage of cell contents and death.

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Cellular adaptation

The ability of cells to adjust their structure and function in response to changes in their environment or stressors.

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Hypertrophy

An increase in the size of cells due to increased workload, leading to increased protein synthesis and larger organelles.

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Hyperplasia

An increase in the number of cells, often caused by hormonal stimulation, leading to an increase in organ size.

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Atrophy

A decrease in the size of a cell, often caused by disuse, malnutrition, or decreased endocrine stimulation.

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Metaplasia

The replacement of one differentiated tissue by another differentiated tissue. It can be normal or occur in response to chronic irritation.

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Squamous Metaplasia

A type of metaplasia where columnar epithelium is replaced by squamous epithelium, often seen in smokers.

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Osseous Metaplasia

A type of metaplasia where connective tissue is replaced by bone, often occurring at injury sites.

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Apoptosis

A programmed cell death that is a normal part of development and tissue turnover. It's characterized by cell shrinkage, DNA fragmentation, and formation of apoptotic bodies.

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Reversible Cell Injury

The process of cell injury that can be reversed if the stressor is removed. It involves changes like cellular swelling and fatty change.

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What is necrosis?

Necrosis is a form of cell death that occurs when cells are injured beyond repair and undergo a series of biochemical changes that lead to their breakdown and death.

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What is Coagulative Necrosis?

Coagulative necrosis is a type of necrosis that involves the preservation of the general tissue architecture, characterized by the coagulation of proteins. It commonly occurs due to ischemia (lack of blood supply) to an organ.

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What is Liquefactive Necrosis?

Liquefactive necrosis is a type of necrosis characterized by the digestion of tissue, leading to the formation of a soft, liquid mass. It often occurs in the brain and in areas of bacterial infection.

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What is Fat Necrosis?

Fat necrosis is a type of necrosis that specifically affects fat tissue. It occurs when enzymes, often from pancreatitis, break down fat cells, resulting in a chalky, white appearance.

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What is Caseous Necrosis?

Caseous necrosis is a type of necrosis characterized by a cheese-like (caseous) appearance. It is commonly associated with tuberculosis infections.

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What is Gangrenous Necrosis?

Gangrenous necrosis is a type of necrosis that occurs in tissues with limited blood supply, often affecting the extremities and bowel. It can be classified as wet or dry depending on the presence of bacterial infection.

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What is Pyknosis?

Pyknosis is a nuclear change that happens during necrosis, where the chromatin in the nucleus condenses and shrinks, appearing more dense and darker under a microscope.

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What is Karyorrhexis?

Karyorrhexis is a nuclear change characterized by the fragmentation of the chromatin material within the nucleus, leading to a scattered appearance under a microscope.

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What is Karyolysis?

Karyolysis is a nuclear change characterized by the complete dissolution of the chromatin material within the nucleus, leaving behind a pale and indistinct appearance.

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What is Apoptosis?

Apoptosis is a programmed cell death that is tightly regulated and plays a vital role in normal development, tissue turnover, and removing damaged or unwanted cells. It is a more controlled and organized process compared to necrosis.

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Study Notes

Cellular Reactions to Injury

  • Cell injury underlies all diseases. Understanding diseases begins with understanding cell injury.
  • When a cell is exposed to an injurious agent, possible outcomes include:
    • The cell may recover.
    • The cell may experience reversible injury.
    • The cell may experience irreversible injury and die.
    • Cell death can occur via necrosis or apoptosis.
  • The outcome of injury depends on the type, severity, and duration of injury, and the type of cell.

Cellular Adaptation

  • Cellular adaptation is the ability of cells to adjust their structure and function in response to environmental changes or stressors.
  • These adjustments aim to maintain cell homeostasis.

Types of Cellular Adaptation

  • Hypertrophy: Increased cell size due to increased protein synthesis and organelle number. An example is an enlarged left ventricle in hypertensive heart disease.
  • Hyperplasia: Increased number of cells, often causing an enlarged organ. This can be physiological (e.g., breast enlargement during pregnancy) or pathological (e.g., benign prostatic hyperplasia).
  • Atrophy: Decreased cell size and organ size. Caused by disuse, malnutrition, decreased endocrine stimulation, or denervation. Shown by autophagic vacuoles.
  • Metaplasia: Replacement of one differentiated cell type by another.
    • Squamous metaplasia: The replacement of columnar epithelium (e.g., in the bronchi) by squamous epithelium (e.g., in smokers).
    • Osseous metaplasia: Replacement of connective tissue by bone, often at sites of injury.

Reversible Cellular Changes and Accumulations

  • Fatty change: Accumulation of triglycerides in parenchymal cells (hepatocytes, alveolar cells, renal tubular cells, and cardiomyocytes). Often occurs in the liver, heart, or kidneys. Causes can include alcohol, diabetes mellitus, malnutrition, obesity, and poisonings. Fatty change mechanisms include increased triglyceride uptake, reduced fat utilization, increased fat production, or reduced fat secretion.
  • Pigment accumulation: Can be exogenous (from outside the body, e.g., carbon/coal dusts, tattoo pigments) or endogenous (from within the body, e.g., melanin, bilirubin, hemosiderin, lipofuscin). These pigments may accumulate in various tissues and cells.

Cell Death

  • Necrosis:
    • A process of cell death characterized by cell swelling, membrane rupture, and enzymatic digestion of the cell's contents.
    • Occurs in living organisms, and is not controlled by the cell.
    • Types of necrosis include:
      • Coagulative necrosis: Characterized by the preservation of tissue structure for a time after cell death (e.g. in infarcted heart tissue). Marked by nuclear changes including pyknosis (chromatin clumping and shrinking), karyorrhexis (fragmentation of chromatin), and karyolysis (nuclear dissolution).
      • Liquefactive necrosis: Characterized by the digestion of tissue, leading to liquefaction and pus formation (e.g., in brain abscesses or CNS ischemic injury).
      • Fat necrosis: Death of adipose tissue, often due to trauma or pancreatitis.
      • Caseous necrosis: A specific form of necrosis, characterized by a cheese-like appearance (e.g. in tuberculosis).
      • Gangrenous necrosis: Death of a significant mass of tissue, often due to vascular occlusion.
  • Apoptosis:
    • A "programmed" cell death that occurs in a controlled manner, typically involving the shrinkage and fragmentation of the cell, producing apoptotic bodies.
    • Important for normal development and homeostasis.

Pathologic Calcification

  • Metastatic calcification: Abnormal calcium deposition in normal tissues due to excessive serum calcium levels (e.g. hyperparathyroidism).
  • Dystrophic calcification: Abnormal calcium deposition in previously damaged tissues, not related to serum calcium levels (e.g. in atherosclerotic plaques or areas of trauma).

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