Introduction to Pathology and Cell Injury

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Questions and Answers

What is the primary difference between reversible and irreversible cellular injury?

Irreversible injury occurs only with genetic mutations.

Reversible injury is always associated with necrosis.

Irreversible injury is characterized by membrane blebs.

Reversible injury allows for recovery if the stressor is removed. (correct)

Which of the following accurately describes pathogenesis?

It looks at the clinical symptoms after disease onset.

It evaluates the genetic predispositions to diseases.

It focuses on how underlying causes disrupt normal cellular function. (correct)

It identifies the specific infectious agents causing disease.

What initiates a cascade of damaging events at the cellular level?

Nutritional imbalances affecting metabolic pathways.

Genetic mutations causing cellular adaptations.

Physical trauma leading to immediate necrosis.

Infections from bacterial or viral agents. (correct)

Which change is NOT typically associated with reversible cellular injury?

Complete breakdown of the plasma membrane. Signup and view all the answers

Which of the following best describes the outcome of persistent or intensified cellular injury?

The cell eventually undergoes apoptosis or necrosis. Signup and view all the answers

What is the primary consequence of anaerobic glycolysis when oxidative phosphorylation is compromised?

Lactic acid accumulation leading to pH drop Signup and view all the answers

Which of the following is a direct effect of mitochondrial damage?

Cell necrosis and inflammation Signup and view all the answers

What is the role of DAMPs in cellular injury?

Trigger inflammation and activate the immune system Signup and view all the answers

Which of the following cells can survive the longest without a blood supply?

Hepatocytes Signup and view all the answers

What occurs as a result of ATP depletion in cells?

Detachment of ribosomes from the rough endoplasmic reticulum Signup and view all the answers

Which molecules are released during cellular damage that signal to the immune system?

Uric acid and uridine triphosphate Signup and view all the answers

What cellular abnormality is associated with necrosis?

Chromatin clumping in the nucleus Signup and view all the answers

Which condition primarily leads to fat necrosis due to the digestion of fat tissue?

Stress on pancreatic acinar cells Signup and view all the answers

What role do lipases play in the process of fat necrosis?

They split triglycerides into fatty acids Signup and view all the answers

In pancreatitis, ischemia results from which of the following?

Compression of blood vessels Signup and view all the answers

What is formed during the process of saponification in fat necrosis?

Chalky white deposits Signup and view all the answers

Which of the following is a secondary reaction that highlights the involvement of calcium in fat necrosis?

Saponification Signup and view all the answers

What triggers the premature release of digestive enzymes in acinar cell injury?

Injury to the acinar cells Signup and view all the answers

Duct obstruction can lead to fat necrosis primarily due to which underlying mechanism?

Activation of digestive enzymes Signup and view all the answers

What pathological change drives inflammation in the context of fat necrosis?

Autodigestion of pancreatic proteins Signup and view all the answers

What effect does chronic alcoholism have on pancreatic acinar cells?

Promotes enzyme activation Signup and view all the answers

What is primarily responsible for the chalky white deposits seen in fat necrosis?

Calcium and fatty acid interaction Signup and view all the answers

What characteristic appearance is associated with caseous necrosis?

Cheese-like consistency Signup and view all the answers

What types of cells typically surround the necrotic core in caseous necrosis?

Macrophages and lymphocytes Signup and view all the answers

Which statement is true regarding fibrinoid necrosis?

It shows bright pink, amorphous material in vessel walls. Signup and view all the answers

What is a common mechanism that triggers fibrinoid necrosis?

Immune complex deposition Signup and view all the answers

Which type of necrosis is primarily associated with Mycobacterium tuberculosis?

Caseous necrosis Signup and view all the answers

In which disease is fibrinoid necrosis prominently observed?

Systemic lupus erythematosus (SLE) Signup and view all the answers

What does the pink staining in caseous necrosis represent?

Protein-rich debris from dying cells Signup and view all the answers

Which of the following is NOT a common cause of fibrinoid necrosis?

Viral infections Signup and view all the answers

What histological feature distinguishes caseous necrosis from coagulative necrosis?

Absence of recognizable tissue architecture Signup and view all the answers

Which type of necrosis primarily results from immune-mediated vascular damage?

Fibrinoid necrosis Signup and view all the answers

What is the primary characteristic of a white kidney infarct?

Sharp demarcation line between healthy and infarcted tissue Signup and view all the answers

Which process mainly results in the formation of a depressed scar on the renal surface following an infarct?

Fibrosis Signup and view all the answers

What indicates the absence of cell viability in an acute kidney infarct?

Absence of cellular nuclei Signup and view all the answers

What triggers the inflammatory response after a kidney infarct?

Neutrophil infiltration Signup and view all the answers

What condition is predominantly associated with the occurrence of kidney infarcts?

End-artery occlusion Signup and view all the answers

Which histological feature is indicative of a white infarct?

Increased eosin binding due to necrosis Signup and view all the answers

What is the mechanism by which coagulative necrosis occurs following ischemia?

Decreased oxidative phosphorylation and increased lactic acid Signup and view all the answers

How does a red infarct differ from a white infarct?

Red infarcts have reduced structural integrity Signup and view all the answers

Which factor contributes to the histological absence of neutrophils in early stages of kidney infarction?

Delayed immune response Signup and view all the answers

Study Notes

I. Introduction to Pathology and Cell Injury

Pathology is the study of structural, biochemical, and functional changes in cells, tissues, and organs.
General pathology focuses on common reactions of cells and tissues to injuries.
Systemic pathology focuses on specific organ systems.

II. Cellular Responses to Stress and Noxious Stimuli

Homeostasis in cells maintains a steady state, adapting to physiological changes.
Adaptations include hypertrophy (increased cell size), hyperplasia (increased cell number), atrophy (decreased cell size and metabolic activity), and metaplasia (change in cell type).
Beyond a threshold, stress can lead to reversible or irreversible injury.

III. Cellular Adaptations

Hypertrophy – increase in cell size due to increased workload or growth factors.
Hyperplasia – increase in cell number due to hormonal or compensatory stimuli.
Atrophy – decrease in cell size and metabolic activity due to reduced use.
Metaplasia – a change from one adult cell type to another, typically for better resistance to conditions.

IV. Mechanisms of Cell Injury and Death

Reversible cell injury involves changes that are correctable if the stimulus is removed (cellular swelling and organelle changes).
Irreversible cell injury leads to cell death, either through necrosis (uncontrolled, inflammatory death) or apoptosis (programmed, non-inflammatory cell death).

V. Intracellular and Extracellular Accumulations

Intracellular accumulations involve the buildup of substances inside cells, caused by metabolic disorders, or by genetic problems.
Pathological calcification is the deposition of calcium in normally not calcium-rich areas of the body, and it is most likely caused by tissue damage.
Dystrophic calcification develops in necrotic or degenerating tissue.
Metastatic calcification develops in healthy tissues due to increased blood calcium levels.

II. Necrosis

Necrosis is tissue death accompanied by inflammation, occurring as a result of severe or prolonged injury.
Types of necrosis include coagulative (e.g., in myocardial infarction/kidney injury), liquefactive (e.g., brain and abscesses), caseous (e.g., tuberculous lesions), fat (e.g., pancreatitis), and fibrinoid (e.g., vasculitis).

III. Apoptosis – programmed cell death

Apoptosis is a regulated, orderly process of programmed cell death that helps maintain homeostasis.
This process involves specific steps and is characterized by chromatin condensation, membrane blebbing, and fragmentation into apoptotic bodies.
Two major pathways regulate apoptosis: intrinsic and extrinsic.

IV. Comparative Summary of Necrosis Types

Provides a table summarizing different necrosis types, their appearance, and the factors associated with them.

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Description

This quiz explores the fundamentals of pathology and the cellular responses to stress and injury. It covers key concepts such as homeostasis, adaptations, and the types of cellular injuries that can occur. Test your understanding of how cells respond to various stimuli.