Growth Adaptations and Atrophy
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Questions and Answers

What is the primary difference between hypertrophy and hyperplasia?

  • Hypertrophy results in an increase in the number of cells, while hyperplasia results in an increase in cell size.
  • Hypertrophy occurs in permanent tissues, while hyperplasia does not. (correct)
  • Hypertrophy involves new cell production, while hyperplasia involves cell size increase.
  • Hypertrophy is a response to increased stress, while hyperplasia occurs only in response to decreased stress.
  • Which process leads to a decrease in organ size due to reduced hormonal stimulation?

  • Hypertrophy
  • Hyperplasia
  • Metaplasia
  • Atrophy (correct)
  • What mechanism is primarily involved in the decrease of cell number during atrophy?

  • Metaplasia
  • Cell division
  • Proteolysis
  • Apoptosis (correct)
  • What is a characteristic of pathological hyperplasia?

    <p>Can develop into cancer. (A)</p> Signup and view all the answers

    What is an example of a tissue that undergoes hypertrophy but not hyperplasia?

    <p>Cardiac muscle in response to hypertension (B)</p> Signup and view all the answers

    What type of cellular change does metaplasia typically involve?

    <p>Change from one type of epithelial cell to another (D)</p> Signup and view all the answers

    What happens to cells in the process of ubiquitin-proteasome degradation during atrophy?

    <p>Intermediate filaments are tagged with ubiquitin. (B)</p> Signup and view all the answers

    Which condition is an example of metaplasia?

    <p>Barrett esophagus from chronic acid exposure (B)</p> Signup and view all the answers

    What is the primary morphological hallmark of cell death?

    <p>Loss of the nucleus (C)</p> Signup and view all the answers

    Which mechanism is never physiologic and associated with inflammation?

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

    What type of necrosis is characterized by necrotic tissue that remains firm and the cell structures being preserved?

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

    Which of the following is a characteristic of liquefactive necrosis?

    <p>Formation of abscesses (C)</p> Signup and view all the answers

    What occurs during nuclear condensation in cell death?

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

    In what context does red infarction typically arise?

    <p>When blood re-enters loosely organized tissue (B)</p> Signup and view all the answers

    Which of the following best describes coagulative necrosis?

    <p>Occurs in ischemic infarction except in the brain (A)</p> Signup and view all the answers

    Which cells are primarily responsible for the enzyme activity leading to liquefactive necrosis in the brain?

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

    What is the primary cause of systemic amyloidosis?

    <p>Deposits of serum amyloid-associated protein (D)</p> Signup and view all the answers

    Which clinical finding is most commonly associated with systemic amyloidosis?

    <p>Nephrotic syndrome (B)</p> Signup and view all the answers

    Familial Mediterranean fever is characterized by dysfunction of which type of cells?

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

    In which population is Familial Mediterranean fever most commonly found?

    <p>Mediterranean origin individuals (D)</p> Signup and view all the answers

    Which biopsy site is often used for diagnosing systemic amyloidosis?

    <p>Abdominal fat pad (D)</p> Signup and view all the answers

    What is the primary form of amyloidosis found in the elderly population?

    <p>Senile cardiac amyloidosis (A)</p> Signup and view all the answers

    What happens to amyloid deposits in damaged organs?

    <p>They require transplantation of the affected organs (A)</p> Signup and view all the answers

    What is a common complication of familial amyloid cardiomyopathy?

    <p>Restrictive cardiomyopathy (B)</p> Signup and view all the answers

    What is the primary goal of cancer screening?

    <p>To detect precancerous changes before they become malignant. (C)</p> Signup and view all the answers

    Which method is commonly used to detect cervical dysplasia?

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

    What role do proto-oncogenes play in cellular growth?

    <p>They induce and regulate normal cell growth and differentiation. (B)</p> Signup and view all the answers

    What type of cancer is detected using the hemoccult test?

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

    Which of the following is a characteristic of oncogenes?

    <p>They promote unregulated cellular growth. (A)</p> Signup and view all the answers

    How do carcinogens affect DNA?

    <p>They damage DNA and disrupt critical cellular processes. (D)</p> Signup and view all the answers

    Which of the following best describes a common characteristic of signaling transducers?

    <p>They relay receptor activation to the nucleus. (B)</p> Signup and view all the answers

    What happens when key regulatory systems in DNA are disrupted?

    <p>Tumor promotion and progression can occur. (D)</p> Signup and view all the answers

    Which characteristic is typical of malignant tumors?

    <p>Disorganized growth with loss of polarity (D)</p> Signup and view all the answers

    What type of cancer is known for lematogenous spread?

    <p>Renal cell carcinoma (A)</p> Signup and view all the answers

    Which of the following is a characteristic feature of benign tumors?

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

    How is a tumor classified with certainty?

    <p>Through biopsy or excision (A)</p> Signup and view all the answers

    Which type of carcinoma is particularly associated with omental caking?

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

    Which histologic feature suggests malignancy?

    <p>High mitotic activity with atypical mitosis (A)</p> Signup and view all the answers

    What histologic characteristic is NOT typical of benign tumors?

    <p>High nuclear to cytoplasmic ratio (A)</p> Signup and view all the answers

    What is a common feature of poorly differentiated tumors?

    <p>Invasive growth into local tissue (C)</p> Signup and view all the answers

    What is primarily affected due to the developmental failure of the third and fourth pharyngeal pouches?

    <p>Thymus and parathyroid development (D)</p> Signup and view all the answers

    What characterizes Severe Combined Immunodeficiency (SCID)?

    <p>Defective T-cell activation and maturation (A)</p> Signup and view all the answers

    What is a common infection risk associated with Common Variable Immunodeficiency (CVID)?

    <p>Bacterial and protozoal infections (D)</p> Signup and view all the answers

    Which condition results from a mutation in Bruton tyrosine kinase?

    <p>X-linked Agammaglobulinemia (C)</p> Signup and view all the answers

    Which treatment is commonly used for Severe Combined Immunodeficiency (SCID)?

    <p>Sterile isolation and stem cell transplantation (C)</p> Signup and view all the answers

    What complicates the clinical presentation of X-linked Agammaglobulinemia?

    <p>Maternal antibodies protection during early months (C)</p> Signup and view all the answers

    Which deficiency is characterized by a low level of immunoglobulins and is due to B-cell or T-cell defects?

    <p>Common Variable Immunodeficiency (CVID) (C)</p> Signup and view all the answers

    What is a consequence of adenosine deaminase (ADA) deficiency?

    <p>Toxic buildup of adenosine and deoxyadenosine (A)</p> Signup and view all the answers

    Flashcards

    Organ Homeostasis

    An organ maintains a stable internal environment in response to stress.

    Growth Adaptations

    Changes in organ size or structure due to changes in stress levels.

    Hyperplasia

    Increased number of cells in an organ due to stress.

    Hypertrophy

    Increased size of cells in an organ due to stress.

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    Atrophy

    Decreased size of an organ due to reduced stress or stimuli.

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    Apoptosis

    Programmed cell death, a way to lose cells in atrophy.

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    Metaplasia

    Change in cell type in an organ in reaction to stress.

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    Pathologic Hyperplasia

    Abnormal cell growth that can lead to cancer.

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    Cell Death Mechanisms

    Necrosis and apoptosis are the two main mechanisms of cell death.

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    Necrosis

    The death of large groups of cells, followed by inflammation; pathologic, not physiological.

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    Coagulative Necrosis

    Necrotic tissue remains firm; proteins coagulate, preserving cell shape; nucleus disappears. Characteristic of ischemic infarcts (except brain).

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    Liquefactive Necrosis

    Necrotic tissue becomes liquefied because of enzymatic protein breakdown.

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    Brain Infarction

    A type of Liquefactive Necrosis where proteolytic enzymes from microglial cells break down brain tissue.

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    Abscess

    A type of Liquefactive Necrosis where proteolytic enzymes from neutrophils break down tissue

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    Ischemic Infarction

    Loss of blood supply to a tissue leading to cell death.

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    Red Infarction

    Infarct that re-fills with blood; seen in tissues with loose organization (e.g., lungs, testes).

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    Secondary amyloidosis

    Systemic deposition of AA amyloid, derived from serum amyloid-associated protein (SAA), in response to chronic inflammatory states.

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    SAA (serum amyloid-associated protein)

    An acute-phase reactant that increases in chronic inflammation, malignancy, or Familial Mediterranean fever (FMF).

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    Familial Mediterranean fever (FMF)

    A genetic disorder (autosomal recessive) of neutrophil function, causing recurrent episodes of fever and serosal inflammation.

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    Amyloid deposition

    Abnormal protein deposits in tissues, often causing organ damage.

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    Systemic amyloidosis

    Amyloid deposits throughout the body, affecting multiple organs.

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    Nephrotic syndrome

    Kidney dysfunction characterized by protein loss in the urine.

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    Restrictive cardiomyopathy

    Heart muscle stiffening due to amyloid deposits, disrupting heart function.

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    Diagnosis of amyloidosis

    Requires tissue biopsy of affected organs, like abdominal fat pad or rectum.

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    DiGeorge Syndrome

    A developmental disorder caused by a deletion on chromosome 22, leading to the absence of the thymus and parathyroids resulting in T-cell deficiency and hypocalcemia.

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    Severe Combined Immunodeficiency (SCID)

    A group of disorders characterized by severe defects in both cell-mediated and humoral immunity, making individuals extremely vulnerable to infections.

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    SCID: Cytokine Receptor Defects

    A type of SCID where the body's cells cannot properly respond to cytokines, essential for the development and function of immune cells.

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    SCID: Adenosine Deaminase (ADA) Deficiency

    A type of SCID where a buildup of toxic byproducts causes damage to lymphocytes, leading to severe immune deficiency.

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    SCID: MHC Class II Deficiency

    A type of SCID where the body lacks the MHC Class II protein, necessary for T helper cell activation, leading to impaired immune responses.

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    X-Linked Agammaglobulinemia

    A genetic disorder where mature B cells are absent due to a mutation in the Bruton tyrosine kinase gene, leading to severe antibody deficiencies.

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    Common Variable Immunodeficiency (CVID)

    An immune disorder with low immunoglobulin levels caused by defects in B-cell or helper T-cell function, leading to increased infection risk.

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    IgA Deficiency

    A condition where the body lacks sufficient IgA antibodies, increasing risk of infections, particularly in the mucosal areas.

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    What is lematogenous spread?

    A type of cancer spread where cancer cells travel through the blood stream to distant sites.

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    Which cancers are known for lematogenous spread?

    Renal cell carcinoma, Hepatocellular carcinoma, Follicular carcinoma of the thyroid, Choriocarcinoma

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    What is seeding of body cavities?

    Cancer cells spread directly within a body cavity, typically through peritoneal fluid.

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    Which cancer often spreads via seeding?

    Ovarian carcinoma

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    What are the clinical features of benign tumors?

    Slow growing, well-defined, distinct, and mobile.

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    What are the clinical features of malignant tumors?

    Fast growing, poorly defined, infiltrative, and fixed to surrounding tissue.

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    What are some histologic features of benign tumors?

    Well-differentiated, organized growth, uniform nuclei, low nuclear to cytoplasmic ratio, minimal mitotic activity, no invasion, no metastatic potential.

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    What are some histologic features of malignant tumors?

    Poorly differentiated (anaplastic), disorganized growth, nuclear pleomorphism, high nuclear to cytoplasmic ratio, high mitotic activity, invasion, metastatic potential.

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    Cancer Screening

    Regular tests to detect cancer early, aiming to catch precancerous changes (dysplasia) or cancer before symptoms appear.

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    Pap Smear

    A test to screen for cervical dysplasia (precancerous changes) before it develops into cervical cancer.

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    Mammography

    An X-ray of the breast used to detect breast cancer early, even before it can be physically felt.

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    Prostate Specific Antigen (PSA)

    A blood test used to help detect prostate cancer, along with a digital rectal exam.

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    Hemoccult Test

    A stool test to check for hidden (occult) blood, often used to screen for colon cancer.

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    Carcinogen

    An agent that can cause damage to DNA, increasing the risk of developing cancer.

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    Proto-oncogene

    A normal gene that helps regulate cell growth and differentiation; mutations can turn it into an oncogene, leading to uncontrolled growth.

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    Oncogene

    A mutated form of a proto-oncogene that promotes uncontrolled cell growth, contributing to cancer development.

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    Study Notes

    Growth Adaptations

    • Organs maintain homeostasis under physiologic stress
    • Increased, decreased, or altered stress can lead to growth adaptations
    • Hypertrophy and hyperplasia increase organ size
      • Hypertrophy: increase in cell size through gene activation, protein synthesis, and organelle production
      • Hyperplasia: increase in cell number from stem cells
      • Often occur together; e.g., during pregnancy
      • Permanent tissues (e.g., cardiac muscle) undergo hypertrophy, not hyperplasia, in response to stress
      • Pathologic hyperplasia can lead to dysplasia and cancer (except benign prostatic hyperplasia)

    Atrophy

    • Decreased stress (e.g., hormonal changes, disuse, low nutrients) leads to organ shrinkage (atrophy)
    • Reduced cell number via apoptosis
    • Reduced cell size via ubiquitin-proteasome degradation of the cytoskeleton, and autophagy of cellular components
      • Ubiquitin-proteasome degradation tags intermediate filaments for destruction
      • Autophagy forms vacuoles, which fuse with lysosomes for cellular component breakdown

    Metaplasia

    • Altered stress leads to a change in cell type (metaplasia)
    • Primarily involves epithelial cell type changes (squamous, columnar, urothelial)
    • Metaplastic cells better handle the new stress
    • Barrett's esophagus is a classic example

    Cell Death

    • Cell death markers include nuclear condensation (pyknosis), fragmentation (karyorrhexis), and dissolution (karyolysis)
    • Necrosis and apoptosis are the two mechanisms of cell death
      • Necrosis: death of large cell groups, followed by inflammation; pathologic, not physiologic
      • Apoptosis: programmed cell death
        • Types include coagulative (preserved structure; characteristic of ischemic infarction), liquefactive (enzymatic tissue breakdown; characteristic of brain infarction, abscesses, and pancreatitis) and others

    Amyloidosis

    • Amyloidosis involves abnormal protein deposits
      • Systemic amyloidosis: widespread deposits, leading to organ damage (kidneys, heart); often associated with inflammation
      • Localized amyloidosis: deposits confined to a single organ
        • Senile cardiac amyloidosis: transthyretin deposits in heart, often asymptomatic
        • Familial amyloid cardiomyopathy: mutated transthyretin deposits, leading to restrictive cardiomyopathy (more common in African Americans)
    • Other causes of amyloid deposit (non-systemic)
      • Type II diabetes: deposits of amylin in the pancreas
      • Developmental failure of third and fourth pharyngeal pouches: 22q11 microdeletion, leading to T-cell deficiency, hypocalcemia, and facial and associated abnormalities

    Immunodeficiencies

    • Severe combined immunodeficiency (SCID): defective cell-mediated and humoral immunity, leading to high susceptibility to infections
      • Causes: cytokine receptor defects, adenosine deaminase deficiency, MHC class II deficiency
    • X-linked agammaglobulinemia: complete lack of immunoglobulins due to impaired B-cell maturation, resulting in increased susceptibility to bacteria and enteroviruses
    • Common variable immunodeficiency (CVID): low immunoglobulin levels due to defects in B-cells or helper T-cells, with elevated risk of infections and autoimmune diseases
    • IgA deficiency: reduced IgA levels, leading to increased risk of bacterial infections

    Cancer

    • Cancer (neoplasia) formation: DNA damage in stem cells leading to disrupted regulatory systems
    • Oncogenes: mutations in proto-oncogenes lead to uncontrolled growth
      • Oncogenes include growth factors, receptors, signal transducers, nuclear regulators, and cell cycle regulators.
    • Different cancers have different growth patterns and spread mechanism (e.g., hematogenous versus seeding)
    • Benign tumors: slow-growing, well-encapsulated, distinct, and mobile
    • Malignant tumors: rapid-growing, poorly defined, infiltrative, fixed, and metastatic.
    • Tumor classification: requires biopsy for definite determination

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    Description

    Explore the concepts of growth adaptations and atrophy in relation to organ size and function. This quiz covers hypertrophy, hyperplasia, and the processes that lead to decreased organ size due to stress reduction. Understand how these processes impact homeostasis and cellular structure.

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