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Cell Injury and Cell Death
Pathology exam 1
25
Other
Professional
08/17/2007

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Term
If a patient presents with a + AST & CK in thier bloodstream, what most likely has occurred and how long ago did it happen?
Definition
Myocardial cell death (necrosis)...shows up within 2 hours on cell death
Term
Give me at least 2 reasons necrosis would have occurred & what would it look like on a histological level?
Definition
Due to some type of cellular injury, (1) hypoxic (2) free radical, to the point that it is irreversible. Histologically (showing up within 12 hours of injury) there is cell swelling, cell acidosis, organelle disruption, loss of membrane integrity, coagulation or liquefaction of cell protein
Term
What would cause hypoxic cell injury?
Definition
Local hypoxia or anoxia due to: Ischemia, anemia, CO poisoning, decreased perfusion of blood, decreased oxygenation of blood
Term
What does hypoxic cell injury result in?
Definition
(1) Mito affected: failed Na+ pump, cell swelling, vacuolization of cytoplasm (2) Increased anaerobic glycolysis: decreased glycogen, increased lactic acid, decreased pH, Ribosome broken, chromatin clumping (3) Myelin figures, blebs (4) cell death
Term
If a patient shows up with gangrene, what has most likely occurred and why?
Definition
Liquefactive necrosis...protein denaturation predominates....usually due to CNS hypoxic necrosis or infective cell death
Term
In dissection of a lung you notice a "cheesy" appearance. What has most likely happened and why?
Definition
Casseous necrosis usually due to TB
Term
A patient presents with characteristics of an MI. What happened and why?
Definition
Coagulative necrosis from hypoxic death...enzymatic digestion predominates, basic outline of cell could be preserved for days due to the fact that acidosis may block enzymatic digestion
Term
Besides hpoxic cell injury, what else can occur to cause cell death, and how does it occur?
Definition
Free radical injury which can be normal due to ETC reduction of oxygen or could be due to oxygen toxicity, ionizing radiation, UV radiation, drugs & chemicals, reperfusion after ischemic injury
Term
What are the free radicals that cause cell injury and what are their target systems?
Definition
unstable configurations that want to become stable so the ROS target: Lipid peroxidation, ECM destruction, S-S bonds, SH group crosslinking, DNA strands, and induction of apoptotic cascade
Term
How does the body get rid of free radicals?
Definition
(1) intracellular enzymes: glutathione peroxidase, catalase & superoxide dismutase (2) Antioxidants: vit A,C,E, glutathione, selenium, transferrin (3) spontaneous decay
Term
Match the following: 1. Hypertrophy 2.Hyperplasia 3. Hypoplasia 4.Aplasia 5.Atrophy 6.Metaplasia A. Decrease in cell production B.Increase in # of cells C.Replacement of tissue D.No cell production E.Increase in cell size F.Decrease in mass of pre-existin
Definition
1.E 2.B 3.A 4.D 5.F 6.C
Term
Why do adaptations occur in a cell and what happens if it can not adapt?
Definition
Occurs due to environmental stress such as: hypoxia, chemicals, infectious agents, immunological rxns, genetic defects, nutritional deficiencies, physical agents, aging....if can not adapt then cell injury occurs
Term
If a patient presents with localized erythematous candidiasis what has happened to the papillae?
Definition
Atrophy of the papillae
Term
If a patient notices a kidney missing, when getting an abdominal radiograph, for the 1st time, what is most likely the cause?
Definition
Aplasia during embryogenesis which would lead to agenesis of an organ
Term
If you notice hematopoiesis in the spleen or squamous cells in a cervix or larynx (histologically), what has occured?
Definition
Metaplasia....myleois and squamous
Term
If you notice gingival overgrowth in a patient taking seizure medication, what would be the most likely diagnosis?
Definition
Periodontal hyperplasia
Term
If you notice some sort of hypoxic injury in a patient & they told you they had been going to the tanning bed for 20 years, how do you explain to them what they have done to their cells?
Definition
They have caused environmental stress to cells which impairs ATP generation, oxidant regulation, calcium homeostasis, cell membrane integrity, protein synthesis & DNA structures
Term
What are the 2 most important cellular systems that environmental stress has affected?
Definition
ATP generation and calcium homeostasis
Term
How is ATP depleted from environmental stress?
Definition
Stresses induce high-conductance channels in mito...these destroy proton gradients which are needed for ATP generation
Term
How is calcium homeostasis lost from environmental stress?
Definition
Cytoplasmic Ca++ is normally lower than extracellular and when there is extracellualar influx or intracellular exflux multiple enzymes are activated...phospholipase, protease, ATPase, endonuclease
Term
Cell death occurs after severe or prolonges injury...what indicates a point of no return?
Definition
Marked irreversible damage to cell membranes, massive calcium influx, extensive mito damage. (the time for irreversible hypoxic injury to cells varies on cell type from minutes (neurons) to hours (skeletal)
Term
What are the 2 processes used to get rid of necrotic bodies?
Definition
extracellular enzymatic digestion of cell remnants and phagocytosis by leaukocytes
Term
What are the 4 events that make up apoptosis?
Definition
Signaling, control & integration, execution, removal of dead cells
Term
What is the purpose of adaptor proteins with respect to apoptosis?
Definition
bridge the initial signals with the execution machinery
Term
What is the purpose of regulator proteins with respect to apoptosis?
Definition
block or promote execution machinery
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