Term
| Increased intracellular calcium and ROS cause.......... |
|
Definition
| Protein breakdown and DNA damage. |
|
|
Term
| Loss of ATP eventually causes...... |
|
Definition
| Hydropic swelling due to osmotic imbalance. |
|
|
Term
| ROS scavenging systems are: |
|
Definition
1) antioxidants (Vitamin E)
2) glutathione peroxidase
3) superoxide dismutase
4) catalase |
|
|
Term
| Enzymes activated by intracellular calcium include: |
|
Definition
1) phospholipases
2) proteases
3) ATPases
4) endonucleases |
|
|
Term
| Irreversible mitochondrial damage is marked by...... |
|
Definition
| Formation of a high-conductance channel in the inner mitochondrial membrane (disrupts oxidative phosphorylation). |
|
|
Term
| The main feature of reversible cell injury is _____________. |
|
Definition
| Hydropic swelling; fluid seems to accumulate in the cisternae of the ER; mitochonria may also swell, and ribosomes may become detached from them; blebs may form too. |
|
|
Term
| In order to control cell size, sodium must be regulated by: |
|
Definition
1) semi-permeable nature of the plasma membrane
2) plasma membrane sodium pump
3) supply of ATP |
|
|
Term
| Anaerobic glycolysis can be stimulated by increased _____________. |
|
Definition
|
|
Term
| Fatty change normally occurs in what cell types? |
|
Definition
| Hepatocytes and myocardial cells |
|
|
Term
| In coagulative necrosis, ___________ is the primary pattern. |
|
Definition
| Protein denaturation; no heterolysis, and compelte autolysis is blocked by lack of lysosomes; in the brain, hypoxia results in liquefactive necrosis! |
|
|
Term
|
Definition
| Chromatin clumping as the nucleus shrinks. |
|
|
Term
|
Definition
| Fragments of the nucleus are scattered throughout the cytoplasm. |
|
|
Term
|
Definition
| No nucleus or loss of chromatin staining. |
|
|
Term
| Liquefactive necrosis is characteristic of ___________ infections. |
|
Definition
| Focal bacterial..... occasionally fungal. |
|
|
Term
| Caseous necrosis is characteristic of ____________. |
|
Definition
| Foci of tuberculous infection; like coagulative necrosis but NO ORIGINAL ARCHITECTURE CAN BE SEEN. |
|
|
Term
| Gangrenous necrosis is............ |
|
Definition
| Ischemic coagulative necrosis with a superimposed liquefactive componenet (commonly from anaerobic saprophytes). |
|
|
Term
|
Definition
| Alterations of injured blood vessels in which accumulations of plasma proteins cause the wall to stain intensely. |
|
|
Term
| Apoptosis is characterized by _____________ and _____________. |
|
Definition
| Chromatin condensation and DNA fragmentation. |
|
|
Term
| Bcl-2 proteins(+) and Bad/Bax(-) |
|
Definition
| One of the regulators of apoptosis in the control stage. |
|
|
Term
| The execution stage of apoptosis involves activation of ___________. |
|
Definition
| Cysteine-specific proteases (caspases). |
|
|
Term
| Mitochondria during apoptosis............ |
|
Definition
| Develop permeability pores and release cytochrome C into the cytoplasm. |
|
|
Term
| Fatty change occurs most often in the _________ and can be caused by............ |
|
Definition
| Liver (parenchymal cells); caused by toxins, protein malnutrition, diabetes mellitus, obesity, anoxia, and hepatotoxins. |
|
|
Term
| Excess proteins within cells usually appear as.......... |
|
Definition
| Rounded, eosinophilic droplets, vacuoles, or aggregates in the cytoplasm. |
|
|
Term
| In diabetics, epithelial cells of the renal proximal tubules are enlarged by ____________. |
|
Definition
| Excess glycogen (from hyperglycemia). |
|
|
Term
| Incomplete digestion of cerebrosides, gangliosides, and the products of the breakdown of mucopolysaccharides are known as what, respectively? |
|
Definition
| Gaucher disease, Tay-Sachs disease, and Hunter syndrome. |
|
|
Term
|
Definition
| An iron storage protein (along with ferritin) that is hemoglobin derived and stains golden yellow to brown; excessive iron in the body results in hemosiderosis. |
|
|
Term
|
Definition
| Golden-brown granules that is formed by the turnover of membrane constituents of a cell (lipid peroxidation); only seen in terminally differentiated cells or cells that cycle infrequently (liver). |
|
|
Term
|
Definition
| Brown-black pigment formed when the enzyme tyrosinase catalyzes the oxidation of tyrosine to dihydroxyphenylalanine in melanocytes. |
|
|
Term
| The most common exogenous pigment is ___________. |
|
Definition
|
|
Term
|
Definition
| A heat-shock protein that facilitates degradation of proteins that are denatured beyond repair; chaperones are intimately involved in protein folding; heat-shock proteins help to limit tissue necrosis. |
|
|
Term
| Hepatocytes respond to barbiturates by.......... |
|
Definition
| Hypertrophy of the smooth ER (leads to increased volume of the ER). |
|
|
Term
| Megomitochondria have been seen in ____________ and increased number of mitochondria have been seen in ___________. |
|
Definition
| Liver of alcoholics..........inherited metabolic diseases. |
|
|
Term
| Cytchalasin B and toxins affect ___________ by preventing polymerization. |
|
Definition
| Thin filaments (composed of actin and myosin) in the cytoskeleton; cytoskeletal abnormalities may be marked by intracellular accumulations of fibrillar material. |
|
|
Term
|
Definition
| Accumulations of keratin filaments and neurofilaments that are associated with cell injury in the liver of alcoholics; intermediate filaments provide a flexible intracellular scaffold. |
|
|
Term
|
Definition
| Occurs locally in non-viable or dying tissues (necrosis); calcium salts have a basophilic, amorphous granular and sometimes clumped appearance; involves the formation of an apatite crystal with both an initiation and propogation phase. |
|
|
Term
|
Definition
| Occurs in normal tissues whenever there is hypercalcemia (as in hyperparathyroidism). |
|
|
Term
|
Definition
| A state that all non-tumor cells eventually reach; it is a non-dividing state. |
|
|
Term
| The most common and most important cause of inflammation is ___________. |
|
Definition
|
|
Term
| AIDS patients can have a fatal infection from _______________. |
|
Definition
|
|
Term
|
Definition
| More blood is brought to an affected area under increased pressure (causes hotness of the area). |
|
|
Term
| Two reasons why edema forms during inflammation: |
|
Definition
2) loss of barrier function of capillaries and venules
3) increased hydrostatic pressure from arterioles |
|
|
Term
| The most common mechanism for increased vascular permeability during inflammation is __________. |
|
Definition
| Formation of gaps/pores in venules and capillaries (fast and short-lived.....unlike junctional retraction); caused by histamine, leukotrienes, etc.; also, there is increased activity of the vesicular transport system across the endothelium. |
|
|
Term
| What are the 3 inflammatory mediators that are preformed in granules? |
|
Definition
| Histamine, serotonin (from platelets), and lysosomal enzymes. |
|
|
Term
| Proteolytic enzymes from from neutrophils do what? |
|
Definition
| Digest vascular basement membranes and activate kinin, complement, and plasmin systems; elastase is an example. |
|
|
Term
| Neutrophils (and to a lesser degree macrophages) release oxygen radicals which then do what? |
|
Definition
| Injure endothelial cells, attack the basement membrane of small vessels, and depolymerize proteoglycans. |
|
|
Term
| Arachidonic acid is formed when............. |
|
Definition
| Membrane phospholipids are hydrolyzed by phospholipase A2 or phospholipase C (abundant in neutrophils, macrophages, and PLATELETS); corticosteroids inhibit phospholipases. |
|
|
Term
|
Definition
| Cysteinyl leukotrienes that are produced by mast cells and cause vasoconstriction, bronchospasm, and increased vascular permeability. |
|
|
Term
|
Definition
| Produced by mast cells and macrophages during ENDOTHELIAL ACTIVATION; cause junctional retraction and upregulation of cell surface adhesion molecules on endothelial cells. |
|
|
Term
|
Definition
| A molecular complex involved in the activation of inflammatory caspases which causes the maturation of immature IL-1. |
|
|
Term
| Necrotic cells induce inflammation and vascular permeability partly via hypoxia-induced production of ______. |
|
Definition
|
|
Term
| The complement system is activated by _____. |
|
Definition
| Ag/Ab, LPS; the plasmin system also activates the complement system; both the kinin and plasmin systems are activated by Factor XII. |
|
|
Term
| Immediate transient responses occur after mild injury and are mediated by ________, _________, and __________. |
|
Definition
| Histamine, bradykinin, and leukotrienes. |
|
|
Term
| Immediate prolonged responses are biphasic and are mediated by ___________, ____________, ___________, and later ____________. |
|
Definition
| Bradykinin, complement products, ROS, and later IL-1/TNF. |
|
|
Term
| An example of fibrinous exudate is....... |
|
Definition
| Pericarditis wherein the fibrin exudate becomes organized and causes scarring instead of resolution via macrophages. |
|
|
Term
| Hemorrhagic exudate is associated with more severe injury and hemorrhagic pericarditis is most likely to occur with _________ or __________. |
|
Definition
|
|
Term
|
Definition
| Caused by endotoxin-producing gram(-) bacilli; endotoxins are bacterial wall lipopolysaccharides consisting of a toxic fatty acid (lipid A) core and a complex polysaccharide coat (including O antigen). |
|
|
Term
| TLR4 recognizes ________, TLR5 recognizes _________, and TLR9 recognizes ___________. |
|
Definition
| LPS, a protein in flagella, and unmethylated C- and G-rich DNA sequences. |
|
|
Term
| Macrophages can secrete ______ and ________ to inhibit inflammation from apoptotic cells. |
|
Definition
| IL-10 and Transforming Growth Factor-beta. |
|
|
Term
| High mobility group box 1 protein (HMGB1) |
|
Definition
| A nuclear protein present in all cells that is thought to be proinflammatory along with DNA-chromatin complexes, heat shock proteins, and monosodium urate microcrystals. |
|
|
Term
| What two cells are associated with allergic reactions? |
|
Definition
| Mast cells and basophils; eosinophils are linked to hypersensitivity reactions (asthma). |
|
|
Term
|
Definition
| The presence of numerous dilated small blood vessels packed with RBCs and slow-flowing blood. |
|
|
Term
|
Definition
| Are ligands on endothelial cells for integrins located on the lymphocytes. |
|
|
Term
| Selectins bind to sialylated forms of oligosaccharides, which themselves are covalently bound to _________________. |
|
Definition
| various Mucin-like glycoproteins. |
|
|
Term
|
Definition
| LFA-1 and Mac-1 bind to ICAM-1 |
|
|
Term
|
Definition
|
|
Term
| P-selectin is normally stored in _______________. |
|
Definition
|
|
Term
| Chemokines that also activate integrins on the leukocytes bind to _______________ on endothelial cells. |
|
Definition
| Heparin sulfate glycosaminoglycans |
|
|
Term
|
Definition
| Transmigration of the leukocyte via the homophilic adhesion molecule PECAM-1. |
|
|
Term
| Which LAD accounts for delayed cord separation? |
|
Definition
| LAD-I; mutation in the gene coding for beta-2 integrin subunit (CD18). |
|
|
Term
|
Definition
| Neutrophils are completely deficient in sialyl-Lewis(x) which causes there to be no reaction with E and P selectins; periodontitis is the major persistent manifestation. |
|
|
Term
|
Definition
| Integrins are expressed normally, but there is a genetic loss in the activation of beta-2 integrin by chemokines; marked by bleeding tendency and leukocytosis. |
|
|
Term
| _____________ is an exogenous source that can cause chemotaxis. |
|
Definition
| N-formyl-methionine terminal amino acid in bacteria. |
|
|
Term
| Endogenous sources that stimulate chemotaxis....... |
|
Definition
| C3a/C5a, Leukotriene B4 (LTB4), and cytokines (particularly those of the chemokine family. |
|
|
Term
| At which stage can the developing neutrophil no longer proliferate? |
|
Definition
|
|
Term
| What types of cells release granulocyte-colony stimulating factor? |
|
Definition
| Fibroblasts, endothelial cells, and lymphocytes. |
|
|
Term
|
Definition
| <1500 neutrophils per mL (normal is 6000); Benign Ethnic Neutropenia is 1200/mL; severe gingivitis or periodontitis are the most common clinical signs of infection in these cases! |
|
|
Term
|
Definition
| Less than 200 neutrophils/mL for 3-6 days every three weeks; treated with G-CSF to get cells past the myelocyte stage. |
|
|
Term
|
Definition
| The first 4 hours after infection for neutrophils to get in and stop it! The status of the local blood supply is a critical factor (i.e. shock is bad). |
|
|
Term
| Receptors on leukocytes for chemotaxis, activation, etc. include...... |
|
Definition
| Seven transmembrane domain G-protein coupled receptors for lipids, formyl-methionyl peptides, and chemokines. |
|
|
Term
| Two opsonins are ______ and _______. |
|
Definition
| IgG and C3b; compromised in patients with hypogammaglobulinemia. |
|
|
Term
| Dead microorganisms are degraded by _____________ and __________. |
|
Definition
| Lysosomal acid hydrolases and elastase; myeloperoxidase (MPO) from granules reacts with hydrogen peroxide to form perchlorate. |
|
|
Term
| Lactic acid in phagolysosomes is actually what kills this bacterium...... |
|
Definition
|
|
Term
|
Definition
| Defect in phagolysosome formation; characterized by photophobia, gingivitis, and periodontitis. |
|
|
Term
| Protain A in Staph aureus has this mechanism of avoiding neutrophils....... |
|
Definition
| Binds to fixed-chain region of IgG. |
|
|
Term
| Resolution of inflammation is accredited to...... |
|
Definition
| Lipoxins (derived from the neutrophils LXA4 and LXB4); they inhibit chemotaxis and superoxide generation and promote neutrophil apoptosis and monocyte chemotaxis (no cytokine production though). |
|
|
Term
|
Definition
| Occurs in neutrophils; hydrogen peroxide is converted to a radical alcohol which oxidizes fatty acids, proteins, and DNA. |
|
|
Term
| Examples of labile cells include......... |
|
Definition
| Skin, mucous membrane of mouth, GI, urinary, and respiratory tracts; more than 1.5% of these cells are undergoing mitosis. |
|
|
Term
| Examples of stable cells include......... |
|
Definition
| Parenchymal cells of the liver, pancreas, thyroid, salivary glands, adrenal cortex, renal tubular epithelium, and connective tissue cells (osteoblasts, fibroblasts, endothelial cells). |
|
|
Term
| Scarring will occur in the absence of necrosis if the exudate becomes organized as in the case of....... |
|
Definition
| Fibrinopurulent pericarditis or peritonitis. |
|
|
Term
| After a cut, hemostasis is initiated by ___________, ___________, and ___________. |
|
Definition
| Serotonin, thromboxane A2, and fibrin clot. |
|
|
Term
| Macrophages secrete __________ and __________ along with ___________. |
|
Definition
| Collagenase and elastase along with cytokines that stimulate fibroblast chemotaxis. |
|
|
Term
| During angiogenesis, endothelial cells secrete __________. |
|
Definition
| Collagenases to degrade the basement membrane surrounding the capillary; capillary and lymphatic channels do not anastamose with each other. |
|
|
Term
| Myofibroblasts have a ___________ nucleus. |
|
Definition
| Folded, accordion-like nucleus; myofibroblasts are normally seen at the periphery of granulation tissue. |
|
|
Term
| Mast cells in the late stage of wound healing: |
|
Definition
| Secrete cytokines for the formation of basement membranes; low-dose histamine may stimulate fibroblasts to make collagen; mast cells are the second most abundant cell in connective tissue behind fibroblasts. |
|
|
Term
| Gaping wounds are made smaller by two mechanisms: |
|
Definition
1) Contraction of the scab (within the first few days)
2) Contraction of myofibroblasts (more significant) |
|
|
Term
| Regenerated epithelium is _______ than the normal epidermis, but without _________. |
|
Definition
| Thicker.......rete ridges; less firmly attached to dermis too. |
|
|
Term
| Which two cytokines have systemic effects? |
|
Definition
|
|
Term
|
Definition
| Chemoattractant for neutrophils, monocytes, and fibroblasts; stimulates proliferation of endothelial cells and macrophages; Regranex is used to treat diabetic ulcers. |
|
|
Term
| EGF (Epidermal Growth Factor) |
|
Definition
| Stimulates proliferation and migration of keratinocytes, proliferation of fibroblasts, and granulation tissue formation; also secreted by salivary glands. |
|
|
Term
|
Definition
| Produced by platelets, macrophages, and endothelial cells in response to PDGF, TGF-beta, and HYPOXIA; in the saliva, it provides oral homeostasis? |
|
|
Term
|
Definition
| Promotes collagen/ECM synthesis and inhibits collagen degradation; also induces TIMPs (tissue inhibitor of metalloproteinases); unfortunately, TGF-beta is involved in fibrosis in lung, liver, and kidneys after chronic inflammation. |
|
|
Term
| Irradiated skin is dry because...... |
|
Definition
| Sebaceous glands and sweat glands are damaged; radiation also causes increased fibrosis and thinning of epidermis due to cytotoxic effects on fibroblasts and keratinocytes. |
|
|
Term
| Vitamin C is needed for........ |
|
Definition
| The hydroxylation of proline and lysine (Scurvy). |
|
|
Term
| Vitamin A is needed for........ |
|
Definition
| Normal epithelialization and proteoglycan synthesis. |
|
|
Term
|
Definition
| Granulation tissue formation; it is a cofactor of numerous enzymes including DNA and RNA polymerase. |
|
|
Term
| Steroids lead to poor wound healing due to............. |
|
Definition
| Diminished fibrosis (good for an eye infection though). |
|
|
Term
| During cancer, three systemic factors include: |
|
Definition
1) Increased glucose turnover
2) Accelerated protein catabolism
3) Uptake of Vitamin C by tumors |
|
|
Term
| Proud flesh may need to be cauterized with ____________. |
|
Definition
|
|
Term
| Keloids may be triggered by...... |
|
Definition
| Implantation of foreign materials or complications from burns and scalds (recurrence is high in keloids). |
|
|
Term
|
Definition
| Contracture (excessive wound contraction); seen in liver cirrhosis and burns of the skin. |
|
|
Term
|
Definition
| Not a neoplasm; reactive proliferation of neuronal tissue after damage; tumor-like mass develops; common site is mental foramen, tongue, and lower lip. |
|
|
Term
| The only part of the kidney that can regenerate is the.......... |
|
Definition
|
|
Term
| In the nervous system the _____ can repair and the _______ can regenerate. |
|
Definition
|
|
Term
| Chronic inflammation results in _______ and _________ hypertension. |
|
Definition
|
|
Term
| Macrophages are unable to degrade bacteria for certain strains of __________. |
|
Definition
|
|
Term
| Most chronic inflammatory lesions are.......... |
|
Definition
| Quiescent with outbursts (as in periodontitis). |
|
|
Term
| Specefic (primary) chronic inflammation can be caused by these three things. |
|
Definition
1) Virus
2) Tumors
3) Transplant rejection
Primary chronic inflammation does not see much acute inflammation! |
|
|
Term
| Infective endocarditis, bronchiectasis, and periodontitis are examples of........ |
|
Definition
| Non-specific chronic inflammation; in these diseases, the primary causative agent may have disappeared a while ago. |
|
|
Term
|
Definition
| A collection of pus usually from S. aureus; acute abscesses can enlarge while a chronic abscess is encapsulated by granulation tissue. |
|
|
Term
| During periodontitis, the sulcular epithelium........ |
|
Definition
| Becomes hyperplastic and migrates apically. |
|
|
Term
| Definition of a granuloma |
|
Definition
| A tissue aggregate of epithelioid macrophages as a part of a cell-mediated immune response. |
|
|
Term
| Characterisitcs of epithelioid cells |
|
Definition
| Lots of pink cytoplasm (like a squamous epithelial cell), but nuclei are long and stringy. |
|
|
Term
| Schaumann bodies ("conchoid bodies") |
|
Definition
| Laminated calcified nuggets in the cytoplasm of giant cells; common in foreign bodies, TB, and rheumatic fever. |
|
|
Term
| Beside TB, what other infections cause caseating necrosis? |
|
Definition
| Dimorphic fungi such as Histoplasmosis capsulatum or Cryptococcus neoformans; also starch as a foreign body. |
|
|
Term
| What are two endogenous sources from which foreign body granulomas can occur? |
|
Definition
| Keratin or bony sequestra |
|
|
Term
|
Definition
| A granulomatous disease of unknown etiology; lung is involved 90% of the time, but it is a mutli-system disorder with cutaneous manifestations 25% of the time (LUPUS PERIO); oral manifestations are uncommon; lung present asteroid bodies and Schaumann bodies with no caseous necrosis! |
|
|
Term
|
Definition
| Bilateral hilar lymphadenopathy or pulmonary fibrosis; positive KVEIM test; ACE levels rise and fall with the disease's activity. |
|
|
Term
|
Definition
| Granulomas are looser than TB or sarcoidosis; Glossitis may appear secondary to the iron, folate, or Vitamin B12 deficiency that develops. |
|
|
Term
| Melkersson-Rosenthal Syndrome |
|
Definition
| An orofacial granulomatous disease with unilateral facial paralysis, facial swelling, and a fissured tongue; when only the lips swell together, it's called Cheilitis granulomatosa. |
|
|
Term
| What is the one granulomatous disease that involves the salivary glands? |
|
Definition
|
|
Term
|
Definition
| Slightly larger than petechiae; caused by thrombocytopenia, mononucleosis, etc. |
|
|
Term
| Differential diagnosis pecking order for non-healing ulcers...... |
|
Definition
| Trauma --> malignancy --> infection |
|
|
Term
|
Definition
| An eosinophilic ulcer in infants due to early eruption of teeth |
|
|
Term
| Epulis fissuratum is more common in males/females. |
|
Definition
|
|
Term
| 3 Ps for the differential diagnosis of an epulis. |
|
Definition
1) Pyogenic granuloma
2) Peripheral ossifying fibroma- occurs ONLY in the gingiva
3) Peripheral giant cell granuloma- ONLY on gingiva as well
Both of the latter two are determined histologically by the presence of multi-nucleated giant cells, extravasated hemorrhage, and hemosiderin. |
|
|
