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Cell Injury & Death

Lecture 1

You have a patient with an ischemic limb due to a clot and you restore blood flow. What happens to those ischemic cells now? Reperfusion Injury. Blood to flow into the area brings with it O2 (free radical formation) Ca++ (Phospholipase A2 activation) and Leukocytes (inflammation)
Name some antioxidants Vit E, Glutathione, Transferrin, Ascorbic Acid, ceruloplasmin (Ascorbc Acid is commonly given on the wards to help with wound healing)
what are two enzymes that help inactivate ROS Superoxide dismutase and catalase
what are some metals that result in direct chemical cell injury mercury, lead, and Iron
Redundancy? maintenance and repair mechanism of vital structures resulting in increased reliability
Progeria? You may have seen these guys on the Maury show. Premature accelerated aging. Google image this one and you won't forget it!
Werner's Defect on Chromosome 8 that results in rapid aging
Is acute cell injury always permanent NO! there is both reversible and irreversible forms of cell injury
Pyknosis condensation of nuclear chromatin and reduction in nuclear size (Pyk the Pit out of the olive with is what the nuclear content looks like with pyknosis)
Karyolysis dissolution of the nucleus (looks like a speckled ball)
Karyorrhexis Fragmentation of the nucleus (Fragments are larger than specks and you will see clumps)
Necrosis a PASSIVE unregulated injurious process
Heterolysis when enzymes released from inflammatory cells assist in the digeston of necrotic cells
Autolysis begins after cell death and is secondary to release of proteolytic hydrolytic enzymes from lysozymes WITHIN the dead cell
Examples of Coagulation Necrosis are seen in? INFARCT of heart or lung (lots of blood in both of these organs to coagulate)
Examples of liquefaction necrosis are seen in? BRAIN infarcts and Abscesses (Liquid Brain)
Caseous Necrosis combo of liquefactive an coagulative necrosis with a yummy "Cottage Cheese" appearance
When do you see caseous necrosis in real life tuberculosis
You have a brain infarct what type of necrosis do you expect? liquefaction
You have a heart attack. What type of necrosis do you expect? coagulation
You have a lung infarct. What type of necrosis do you expect? coagulation
Where might you find fat necrosis? in the peripancreatic and mesenteric fat
Saponification is part of what type of necrosis? Fat necrosis (soap is just broken down fat)
Gangrene is another word for? Necrosis
Dry Gangrene is what type of necrosis? coagulative necrosis
Wet Gangrene is what type of necrosis? Liquifaction
Apoptosis A HIGHLY regulated energy dependent coordinated process leading to cell death (ACTIVE Programmed death)
Is apoptosis always a bad thing? NO! We would all have webbed hands if it weren't for apoptosis removing cells to separate our fingers.
What happens when apoptosis fails? CANCER and other developmental abnormalities
Place the following aspects of apoptosis in order...1) apoptotic bodies 2) blebs 3) crescents blebs, crescents, bodies
If there is acute inflammation present with the death of a cell what do you have apoptosis or necrosis? Necrosis, apoptosis does not have any acute inflammation
Fas..Inducer or Suppressor of Apoptosis? inducer
TNF ...Inducer or Suppressor of Apoptosis? Inducer (it stands for Tumor Necrosis Factor)
CSF...Inducer or Suppressor of Apoptosis? Suppressor - so if you stimulate colonies of cells to form you should suppress apoptosis
Nerve Growth Factor (NGF) ...Inducer or Suppressor of Apoptosis? Suppressor - growth and apoptosis are opposite so it suppresses apoptosis
Caspases... Inducer or Suppressor of Apoptosis? Inducer
p53 ...Inducer or Suppressor of Apoptosis? Inducer
bax...Inducer or Suppressor of Apoptosis? Inducer
EBV...Inducer or Suppressor of Apoptosis? Suppressor (ebstein barr virus)
viral hepatiis...Inducer or Suppressor of Apoptosis? Inducer
bcl-2...Inducer or Suppressor of Apoptosis? suppressor
TGF-b ...Inducer or Suppressor of Apoptosis? Inducer
Ca ions....Inducer or Suppressor of Apoptosis? Inducer
Major common pathway of apoptosis? Cysteine proteolytic caspases
Does EndoG need the caspases for activation? no it can function on its own
bax and bcl-2 have opposite effects which does which? bcl-2 suppresses appoptoss and bax induces they "fight" each other
What does ubiquitin do? marks substrates for destruction by apoptosis
Comparison of loss of cell adhesion between necrosis and apoptosis Necrosis has late loss of cell adhesion and apoptois has early loss
Are organelles damaged early or late in the process of apoptosis late (necrosis is early)
Karyohexis is associated with necrosis or apoptosis Apoptosis
Karyolysis is associated with necrosis or apoptosis Necrosis
Necrosis is damage at what cellular level Tissues (apoptosis is at the level of single cells)
Do you get scar formation with necrosis or apoptosis necrosis (apoptosis has complete absorption)
Atrophy Decrease in cell size and function
You have a patient in bed for a long period of time with a peripheral nerve injury in a leg that they aren't really using anymore who is eating poorly and not leaving their O2 mask on.... what type of cellular reaction will they have atrophy (note oxygenation is more of a peripheral blood flow thing but it helps to have a picture in your head)
Main difference between hypertrophy and hyperplasia hypetrophy-increase in cell size hyperplasia-increase in the number of cells
When you have a continuous cell injury do you get hypertrophy or hyperplasia hyperplasia (think of it like increasing the padding)
Metaplasia REVERSIBLE conversion of one differentiated cel type to another from chronic irritation or inflammation
You have a nasty habit of smoking three packs of cigarettes a day so your columnar epithelium decides to become squamous epithelium to protect itself. This is an example of? metaplasia due to chronic irritaiton and inflammation
when water accumulates in the cells you get what effect on the tissue Edema
Xanthoma is a result of what accumulated substance cholesterol (Cholesterol is yellow and xantho is greek for yellow)
Hemosiderosis is the result of what accumulated substance Iron (this can be bad news for someone's liver. It can be treated by donating blood so give to your red cross just in case)
Wilsons is the result of accumulation of this substance Copper (it can cause psychosis and will leave little rusty brown rings around the corneas "Keyser Fleischer rings")
Black lung is accumulation of what substance Anthracosis
Jaundice is the accumulation of what substance Bilirubin (this is a yellow pigment normally cleared by the liver but in people who have cirrhosis like alcoholics it is not cleared leaving a yellow hue to the person's skin and eyes)
Gout is the accumulation of what substance Urate (small crystal accumulate leaving joints so painful that even a bed sheet on a big toe is excruciating)